NLP and the Modern History of Bilateral Therapies

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Excerpt from Chapter 4...

I told Ralph that the way this technique worked, the therapist would first ask the client where they held the picture of their trauma. Ralph said that his was right in front of him, about two feet away, in a square area that roughly encompassed his chest, and he started to tremble and tears came to his eyes as he pointed at it. I told him and the group that it had been my experience that most people with PTSD held their traumatic memories in roughly the same place, and when memories were elsewhere they were usually not the source of true PTSD symptoms. I then told Ralph that to do Eye Motion Therapy a therapist would not have the client look in the direction of the traumatic picture, but would instead direct his eyes everywhere else. As he looked away from that spot, he regained his composure.

Ralph sat opposite me, facing me directly, our knees about six inches from each other. I held up a felt marker pen just above his eye level and told him that with EMT the therapist would ask the client to hold his head steady and just follow the tip of the pen with his eyes. I suggested that he consider the intensity of the emotion he was experiencing right now as 100 on a scale of 0 to 100, and we’d check it again as we went along. Then I began moving the pen around in regular, rhythmic patterns, from side to side, going just to the edge of his field of vision across the top of his field of vision, sort of like I was wiping a blackboard at that height. I continued this for about two minutes, then stopped.

“What’s the intensity of the emotion now?” I asked.

Ralph glanced down and said, “Around 80 percent.”

“Fine,” I said, and repeated the process, this time moving through the center of his visual field as well as above it, but always being careful not to move the pen into the area where he said the painful picture was located. After another two or three minutes of having his eyes follow the pen from side to side again, I stopped and asked how he was doing.

“It’s down around 60 percent,” he said.

We repeated the process again, and this time he said it went to about 40 percent.

One of the keys to doing EMT and avoiding abreactions is to not enter the picture until the intensity is below 50 percent, so when he reported it was at 40 percent, I again moved the pen from side to side but this time did it across his entire visual field, from top to bottom to top, as if I were thoroughly washing a blackboard. Whenever I noticed his eyes tic--seize up for a moment and interrupt the smooth flow of motion following the pen--I’d revisit that area a few times until his eye motions were smooth there. After about two minutes of this, he took a deep breath as his eyes were following the pen, let it out, and began to grin broadly, then chuckled under his breath.

I stopped the pen and said, “What’s up?”

He looked at me with an expression of mixed amusement and astonishment. “I can’t believe what a dummy I’ve been all these years,” he said.

“What do you mean?”

“I should have just let that go and gotten on with my life. Instead, I’ve wasted more than thirty years.”

“Are we talking about the event that was bringing you to tears fifteen minutes ago?” I said.

“We sure are,” he said. “I was with a medivac unit in Vietnam, and after a really nasty firefight I called in two choppers to carry out the wounded. I was pretty sure all the enemy were dead, so after the choppers were loaded, I signaled them to take off. They got about two hundred feet up into the air and two rockets came out of the jungle and exploded them both, raining down helicopter parts and bodies on those of us on the ground.” He shook his head with an expression of regret, although his tone was matter-of-fact. “I blamed myself for their deaths, and every day since that day in 1970 I’ve seen those choppers explode and heard those men screaming as they fell out of the sky.”

“And now?”

He lifted his shoulders and dropped them. “I still remember it. But while you were doing that last pass there with the pen, suddenly it seemed like the pictures flattened out and took on the quality of an old newsreel. And I heard my own voice in my head say to me, ‘You did what you thought was right at the time. It was a mistake, but you did it with good intentions. You wanted to get those men to medical care, and you saved a lot of other lives while you were in that war. And now it’s over and done with, there’s nothing you can do about it, and it’s time to forgive yourself and get on with your life. If nothing else, that’s what the guys who died would want you to do, because it’s what you would have wanted them to do if the situation had been reversed.’”

“And what’s the intensity of the emotion right now?” I said.

He shrugged again. “Close to zero. I mean, damn, it’s been thirty years. It’s over and done with.”

It’s been several years since Ralph participated in that teaching demonstration, and Stephen tells me that he’s doing well in his life, has a job, and is no longer tortured by his past. He’s cured of his PTSD.

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SueN
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Comments

Wouldn't it be nice if there really were such an easily performed, nearly magical solution to all our woes?

Sadly, 30 years of practice and research have failed to find evidence that NLP does much.

List of Studies on Neuro-linguistic Programming.

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reed9
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Apr. 8, 2010 11:26 am

In that list there are considerably more "Generally supportive" studies than not, and there were quite a few negative comments about the metastudies on the "against" side.


It seems to me that like much of psychology, it is a subject that it is difficult to come up with scientific conclusions about, particularly since practitioners vary so much. Word of mouth, while not scientific, may be a better guide than studies.

And the only cost to trying the suggestions in Thom's book is the purchase price - unless you get it from the library, in which case there is no cost at all.

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SueN
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Quote SueN:

And the only cost to trying the suggestions in Thom's book is the purchase price - unless you get it from the library, in which case there is no cost at all.

I believe that you mean well, but that borders on selling snake oil.

Put it another way, "I have this bottle of Reed's All Purpose Health Tonic! Sure, the evidence is ambiguous at best,but hey, only $20 to find out if it works!"

Yes, some studies have shown some promise, but 30 years and untold dollars to get a few studies to say somewhat supportive is hardly a ringing endorsement. Overall, the evidence is negative.

Beyond that, it is wholly unethical to advocate an unproven treatment to people in need.

Word of mouth, otherwise known as anecdotal evidence, is not a better guide. History is replete with "miracle" cures from bloodletting to leeches to lobotomies whose main support was anecdote and word of mouth. Or more recently anything from Airborne to Oscillococcinum. This is people's health and lives we're talking about. It's not right to give false hope and placebos and pretend it's real.

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reed9
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Apr. 8, 2010 11:26 am

One of the catches with these kinds of therapies is that they require a beleif that there will be a positive outcome. in other words if a study is done and the therapist does not project enough personal convidtion or enthusiasm then he will not convince the patient.

Expectation is critical here, as is the patient's willingness to put himself in the practitiner's hands.

Some might call that placebo effect- but most of our effectiveness is acheived through placebo effect. ( It could also be called the doctor patient relationship). As a medical practitioner with 25 years of post graduation experience under my belt I have noted many times that the current "scientific medicine " idealogues actually seem intent on doing everything in their power to obliterate any placebo effect we might have.

Suspend your disbeleif for a little and assume that this is a functional therapy. Devise a trial for yourself- and see what happens. Do not assume that it will enable you to perform miracles- as you will almost certainly fail at that. Go for acheivable goals.

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Barliman
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Perhaps the placebo effect is also in decline because so many doctors have not learned the skills to induce it. The days when doctors were considered omnipotent are now long gone, particularly in this litigous society, so they need to work to instill faith.

Whatever the reason, many have lost faith, yet look for it in alternative medicine.

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SueN
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Quote SueN:

Perhaps the placebo effect is also in decline because so many doctors have not learned the skills to induce it. The days when doctors were considered omnipotent are now long gone, particularly in this litigous society, so they need to work to instill faith.

Whatever the reason, many have lost faith, yet look for it in alternative medicine.

Let me ask an ethics question then. If it's fine to sell placebo as a "working" treatment, is it ok for me to package some sugar pills, slap on a fancy looking label with some weasel words (to stay within the letter of the law on false advertising) strongly implying effectiveness and sell them at $20 a bottle?

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reed9
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It depends, though I would much rather you used something known to do good. And it would vary from case to case, for example, sugar pills might be harmful to diabetics But if you did no harm to each individual, or less harm than the doctors did using modern medicine, then that would be OK. But that would mean you had to be medically trained and spend time with each patient. Not just any old quack. And you shouldn't charge outrageously unless the patient believes that the more expensive something is, the better it will work.

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SueN
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Quote SueN:

It depends, though I would much rather you used something known to do good. And it would vary from case to case, for example, sugar pills might be harmful to diabetics But if you did no harm to each individual, or less harm than the doctors did using modern medicine, then that would be OK. But that would mean you had to be medically trained and spend time with each patient. Not just any old quack. And you shouldn't charge outrageously unless the patient believes that the more expensive something is, the better it will work.

And how would something be known to do good? Doesn't that mean it performs better than placebo? Double blind randomized trials compare the efficacy of treatment against a placebo, right? Oftentimes sugar pills when it comes to pharmaceuticals.

Why do I need medical training to apply a fake treatment designed to make someone feel better? The evidence is that acupuncture with toothpicks stuck any old place performs as well as traditional acupuncture. Since traditional acupuncture actually breaks the skin, it carries some risk of infection or disease transmission, the least harmful method to achieve the same results is to use the toothpicks, right? Why spend all the money on training that doesn't perform any better?

Anyway, what differentiates between "any old quack" and a "legitimate" health care provider? Just the training? What makes a legitimate training program? If a treatment can't perform better than placebo, how do you know it works? How do you differentiate between one treatment and another? Is there evidence that would convince you a treatment didn't work? Is there evidence that would change the way a treatment modality is practiced?

There is evidence that expensive pain killers are perceived to work better. Presumably, I should then charge as much as I can get away with for my sugar pills, or flavored water for those diabetics out there. So long as I'm not doing direct harm, right? It's fine to lie to the patients?

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reed9
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Western medicine is not the only training. Other traditions have been handed down from generation to generation for hundreds of years. We have the benefit of their trial and error, and pity the poor souls who suffered the errors.

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SueN
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Quote SueN:

Western medicine is not the only training. Other traditions have been handed down from generation to generation for hundreds of years. We have the benefit of their trial and error, and pity the poor souls who suffered the errors.

I don't think bacteria and broken bones care about cultural origins. Nor does the placebo phenomenon respect national boundaries. We're still left with the conundrum, how do we know it works? Appealing to the longevity of the practice doesn't really cut it. There's many examples of things that were practiced for centuries which we gave up - bloodletting and leeches for one, the idea of humours, for another. I mean, what was the average lifespan in ancient China? Not to mention things like homeopathy and chiropractic are modern and western, "invented" in only the last couple of centuries. (Thankfully some chiropractors are finally admitting that the foundation for their discipline, the elusive subluxation, doesn't exist.)

I'm still trying to understand how we differentiate between treatments if, as you previously indicated, performing as well as placebo is adequate criteria to say something works.

What about other concerns? It's well known that Traditional Chinese Medicine is a significant market for the sale of endangered species. Do we sacrifice tigers because generations of Chinese lore has handed down the "knowledge" that tiger penis cures impotency? (Another example of how centuries of tradition is no indication of efficacy.) Was it the myopic reductionism of western medicine that prevented it from catching on that heart shaped plant and animal parts "help" with heart problems?

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reed9
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How old is the scientific method? Modern science is very young, for all the amazing strides it has made. There has not been enough study of traditional methods yet, perhaps because there is little money to be made from them. The modern medicine we have is as much a product of our economic system as of science.

Perhaps some remedies worked for the tribes that developed them, but not for people of other races, or who lived in areas which led to different diets. There is so much more to be learned about the effect of diets (including drugs) as a whole, rather than trying to tease out one component, patent it, and sell it to people who follow a different diet or have a different racial makeup. You just have to look at how alcohol affects people differently.

Saving an endangered species was not an issue in the past, we were not aware of which species were endangered. I think it is great that some of us are at last beginning to consider our environment, whether altruistically or out of our own self interest. I believe it is an improvement over our past arrogant lording it over nature. Of course, there have been civilizations in the past which proved themselves to be sustainable, at least until a major shift in climate happened. Nowadays we have a better idea of what the climate has in store, and in theory can prepare for it. Whether we will remains to be seen. Thereare far more of us now, which makes it tougher.

If I had gone into medicine I think I would have gone into epidemiology or similar, trying to tease out the causes of disease from observation of large numbers of people. And then trying to work out as a result, why treatments work for some and not for others.

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Quote SueN:There has not been enough study of traditional methods yet, perhaps because there is little money to be made from them. The modern medicine we have is as much a product of our economic system as of science.

Perhaps. But now we're back to my first question on ethics. For the sake of argument, assuming I grant that there has not been enough study, is it ethical to promote an unproven treatment? Is it ok to claim it does something without evidence and market it as medicine?

Though, for many alternative modalities, there has been a good deal of research. How much is enough? At what point do we stop pouring money into research that time and again doesn't pan out?

I don't disagree that money can and does corrupt the practice of medicine. It's obscene that companies market prescription drugs to people. It's obscene that evidence against some medications has been suppressed to sell a pill. I'm not advocating for separate standards, but universal standards. There should be no "alternative" medicine. If it works, it's medicine, if not, it's discarded. The issue is, again, does it work and how do we know?

That said, why would you think alternative medicine is not just as much corrupted by money as standard medicine? (I would actually argue that alt. med. is more corrupted by money than regular medicine, because it does not have the same government regulation and oversight.) We spend somewhere in the neighborhood of 34 billion a year on alt. med. Maybe not up to the level of major pharmaceuticals, but no drop in the bucket. This isn't a story of the little guy fighting back against Big Pharma anymore, if it ever was. Maybe some alt. medicine works, there are many varieties out there. But an uncritical acceptance of alt. med. because it seems more "natural" or because we're frustrated with the faults of standard medicine opens the door for all manner of potentially dangerous, fraudulent claims.

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reed9
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Apr. 8, 2010 11:26 am

Everything gets corrupted, it seems. People make all sorts of claims just for the money, not out of any belief. People will seek to influence studies to fit in with their own interest or beliefs.

Maybe we need to devise huge studies that can be carried out over the internet, the way that some large computing problems have been carried out using distributed over the internet. The problem would be that not everyone is trianed in the scientific method, and the group would be self-selecting and biased towards people who use the internet. But maybe something useful could be learned.

Government regulation and oversight differs from country to country, and that can be corrupted too.

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Jul. 31, 2007 4:01 pm

I read Thoms Book Walking Your Blues Away. I suffer PTSD and have for decades..... the medications left me like a zombee and unable to be human. without medication I could not function for a whole day and found myself often suicidal. Meditation has helped as have being in exersize clases. I dont care if it is a plecobo effect or something with the neurochemicals in my brain... I just know walking has started to work for ME. I look at all the PTSD the nation will have to deal with as our vetrens come home and need to integrate into society..... if this helps do it!!! It does not hurt and the time to know is short enough so you can try something diff if it does not help.

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