Dr Richard Bolstad is Transformations Principal Trainer

Re-Minding The Body Of Its Own Abilities

Dr Richard Bolstad

NLP and Orthodox Health Care

As an NLP Master Practitioner and a Registered Nurse (RCpN), one of my main interests in applying NLP has been to use NLP-based techniques to assist promotion of health, healing from major illness and reduction of pain.

It has been my experience that clients’ main challenge, as they go to use NLP in this way, is to step out of the mindset which my other professional background had taught me. As a health professional, I am perhaps more aware than other NLP Practitioners of the “hegemony” of the orthodox health-care worldview. I believe that NLP offers health professionals an approach which accords with some important scientific research which has not usually been acknowledged. In this article, I will comment briefly on the change in model of the world which NLP offers us, and then use three examples of places where NLP interventions can make a difference due to this new model. The three areas are healing from surgery, healing from cancer and pain relief.

The Key Factor In Health Is Not External Agents But Internal Homeostasis

Orthodox western health care continues to be based on the model of the disease; the idea that discontinuities in personal health can be explained by the action of a harmful agent from outside. Consider the common cold, still our most common health challenge. As early as 1968, Dr Rene Dubos described research in which sprays of “cold causing” viruses are squirted up the noses of volunteers. About 80% of the volunteers do indeed get colds. But the rest don’t even though given huge amounts of the virus. (It also makes no difference, much to my mother’s horror, if they wear wet socks and stand in a drafty room). The most consistent difference between those who catch the cold and those who don’t, Dubos reports, is their level of psychological stress (Dubos, 1968).

Summarising the growing evidence for this effect of the psycho-social system on health, Robert Ornstein and David Sobel ask “Why do widowers die at a rate three times greater than other men of comparable age? Why do people who lose their jobs have increased rates of heart disease and lung disorders, no matter what their occupation? Changes in the social world. Changes in emotional and mental states. At first glance, it may seem that these changes have little to do with disease. But ‘real’ organic diseases are linked to changed beliefs about oneself, to the nature of one’s relationship to others, and one’s position in the social world.” (Ornstein and Sobel, 1988)

Actually, we only need to look round the world a little to realise that the one-external-physical-cause theory of disease doesn’t fit the facts. Dr Henry Peguignot, professor of medicine at Paris’ Hospital Chochin points out “In France, we would call vague digestive troubles a liver crisis. In the United States you would call it a food allergy. You prescribe anything at all, because it’s not a scientific diagnosis, but rather a different use of placebos.” Lynn Payer, in her book “Medicine and Culture” documents hundreds of similar oddities, shattering the illusion that most illness has been scientifically explained. In fact, people’s beliefs decide what diseases are diagnosed more than some “objective truth” (Payer, 1988).

The Great Medical Leap Forward Never Happened

But all this has been restated so often that it seems clich(?)d. Somehow, we doubt it because we “know” that medicine has made a great leap forward in the last century, and as a result we are all living twice as long. When we have an infection, we can take antibiotics; when we have heart problems, we can have heart surgery; when we have cancer we can have chemotherapy; and if we freak out about it all, we can take Xanax. The reality of our lives seems to affirm the power of western medical models.

The reality is less simple. Even in the case of bacterial infection, it was not the medical wonder drugs that saved us. Tuberculosis, for example, had a death rate of 700 per 10,000 in New York in 1812. In 1882, the germ which “caused” it was discovered, but deaths had already dropped to 370 per 10,000. By the time antibiotics were available to treat it, seventy years later, the rate was down to 48 per 10,000. Did antibiotics save us from tuberculosis? No, they merely completed the success resulting from a combination of non-medical changes which had made people more resilient in general, and more resistant to tuberculosis in particular. The same is true for all the other devastating illnesses of nineteenth century Europe and America (this and many more examples are documented by Illich, 1978).

Even more alarming for us as NLP Practitioners is the real story of the psychiatric miracle of the last half century. In Psychiatry, “miracle drugs” abound. One of the most recent was the anti-depressant Prozac, released in 1988 after only 6 weeks of testing and described as the wonder pill almost without side effects. In fact by 1991 its manufacturer, Eli Lilly and Co faced numerous lawsuits as a result of its tendency to cause compulsive violent behaviour (murder and suicide occurring without the person understanding why). Meanwhile the 1989 Comprehensive Textbook of Psychiatry described it as only as effective as other older anti-depressants. How effective is that? The majority of studies (62%) show that anti-depressants perform only as well as placebos – if you give people sugar pills they’ll improve just as much. On the other hand, 43% of Prozac users will get two or more severe side effects (headaches and nausea being most common). The most popular anti-anxiety drug in the United States today is Xanax, which has overtaken Valium. In the initial research by its maker Upjohn, Xanax performed better than placebos for four weeks. But in the following 4 weeks, unpublished by Upjohn, its effectiveness dropped to placebo level. And once the drug was stopped, those taking it had a 350% increase in their panic attacks (Breggin, 1992).

Dr Keer White, deputy director for Health Services in the Rockefeller foundation stated in 1988, at the peak of medical pride (Payer, 1988) “Although things are much better than they were a generation ago, it is still the case that only about 15% of all contemporary clinical interventions are supported by objective scientific evidence that they do more good than harm. On the other hand, between 40 and 60 percent of all therapeutic benefits can be attributed to a combination of the placebo and Hawthorne effects, two code words for caring and concern, or what most people call “love”.”

Surgery Is Always “Psychic” Surgery

In 1958, a study was done to evaluate the effectiveness of a new surgical treatment for heart disease (Cobb et alia, 1959; Diamond et alia, 1958; also reported in McDermott and O’Connor, 1996, p 75-76). The surgery has since been shown to be completely useless, but the effect for the patients in the study was wonderful. The patients were all told that their surgery would probably help, and indeed ten of the seventeen patients in the study reported great improvement. Their use of heart medication dropped to 1/3 over the next weeks. What is most interesting is that only eight of these patients had actually been given the surgery. Nine of them simply had a skin incision made and sutured up again. Of those nine, five reported they felt much better, and reduced their medication to 1/3. When doctors expressed disbelief, another surgery team replicated the study, with even better results.

In 1972, Dr E. Spangfort reviewed 2504 surgical treatments for lumbar spine problems. In a large percentage of cases no surgically treatable disorder was found, so that, as with the surgery for heart disease, the person was simply opened up and sewn together again, without any actual treatment. As a result of this non-treatment, 37% reported complete relief of sciatic nerve pain, and 43% reported complete relief of back pain. In cases where some abnormality was actually treated, the overall success rate was 64%. That is to say, placebo treatments were 2/3 as successful as real surgery.

Heart failure and lower back pain are not peripheral problems. They are amongst the most common and challenging medical problems we face. These are extraordinary studies, indicating clearly that much of the success of modern medicine is being achieved by the same methods that shamans and witchdoctors across the world have always used. All surgery is, to a large extent, “psychic surgery”: it creates powerful expectations of healing, which are the real source of most of the positive results.

The Results Of Surgery Can Be Altered Once We Understand This

But the healing effect of surgery is dependent on how it is presented by the surgeon and other health practitioners. Psychologist Henry Bennett has collected several hundred studies showing that preparing patients psychologically before surgery will markedly alter the surgical and post-surgical results. Simple changes in what the doctor says will reduce need for pain medication, reduce blood loss, and result in fewer medical complications.

At the Department of Anesthesiology at the University of California, Bennett himself conducted a study on patients admitted for spinal surgery (Bennett, Bensen and Kuiken, 1986). Each patient received a 15 minute preoperative talk with a health practitioner from the centre. There were three subgroups. Group A received basic information about the procedure they were to go through. Group B received a brief training in how to relax their muscles before and after surgery. Group C were given an NLP style intervention. The health professional pointed out that everyone has experienced blushing as a result of a few words said by someone else, so we know that the mind can cause blood to shift around in the body. They then explained that it would help if the person’s blood moved away from the spine during surgery (to prevent blood loss), and then moved back afterwards (to promote healing). They then slowed down their voice and said, “Therefore, the blood will move away from the spinal cord during the operation. Then, after the operation, it will return to that area to bring nutrients to heal your body quickly and completely.”

The result of this simple conversation was dramatic. Patients in Group A and Group B lost, on average 900 cc’s of blood, which is the normal level of blood loss over the course of this operation. Patients in Group C lost an average of 500 cc’s of blood during the operation –only half as much.

In 1993, Bennett conducted another study on patients undergoing gastrointestinal surgery. The main complication in such surgery is due to slow recovery of movement in the digestive system after the operation. Patients were divided into two groups. In Group B the patients were told “Your stomach will churn and growl, your intestines will pump and gurgle, and you will be hungry soon after your surgery.” This group regained gastrointestinal movement in an average of 2.6 days instead of the usual 4.1 days, resulting in them being discharged from hospital two days earlier (at a saving in medical costs of US$1200 per person).

Research on pain relief as a result of preoperative suggestion is abundant. In fact, here the pioneer study was done way back in 1964 by anaesthesiologist Larry Egbert in Massachusetts (Egbert et alia, 1964). After being given presurgical instruction on how to prevent pain by relaxing muscles, patients required less pain medication and returned home sooner.

Bennett also discusses the effects of surgeons talking during surgery itself (Bennett and Disbrow, 1993). In a famous 1960 study by Wolfe and Millet, 50% of surgical patients followed suggestions during surgery to such an extent that they required no medication for pain relief at all afterwards. Bennett demonstrated that such response does not require conscious memory of the surgery (Bennett et alia, 1984, 1985). In a three minute message played during surgery, he instructed patients that they were to touch their ear during their post-operative interview (which was to happen a week later). The interviewers a week later did not know which patients had been told to touch their ears. 82% of those told to did touch their ears, and the average time spent “ear-touching” was 15 times as long in this group as in the control group. These patients did not “remember” the instruction to touch their ears. But they did follow it. In the same way, Bennett cautions, patients do not remember their surgeons negative suggestions during surgery, but they do follow them.

Healing From Cancer Is Done By The Immune System

The same incredible ability of the mind to run the body is demonstrated in its response to tumours. Anecdotal accounts of “spontaneous remission” of cancer have been known for thousands of years. Dr Brendan O’Regan is a neurochemist who has collected a database of 3,500 medically documented cases of spontaneous remission of cancer. Dr Charles Weinstock leads the New York Psychosomatic Study group, and has commented on these cases that “Within a short period before the remission, ranging from days to a few months, there was an important change, such as a marriage, an ordination, the birth of a grandchild, or removal of a relationship that was unwanted. There was a psychosocial rehabilitation of one sort or another, and then the cancer was healed.” (Weinstock, 1997).

The first western research demonstrating that this type of remission could be “reliably” induced was published by Dr Carl and Stephanie Simonton from Dallas Texas, in their book Getting Well Again (1978). Working with 159 people considered to have medically incurable cancer (average life expectancy 12 months) the Simontons reported two years later that 14 clients had no evidence of cancer at all, 29 had tumours which were stable or regressing, and almost all had lived well beyond the 12 month “limit” (p 11-12). Essentially, 10% were cured and 20% were curing themselves. The Simontons used a combination of biofeedback, visualisation, exercise, goalsetting, resolving internal conflicts, letting go of resentment, and engaging family support.

The publication of Beliefs (1990) by Robert Dilts, Tim Hallbom and Suzi Smith first offered an NLP frame for understanding similar processes. This book begins with Dilts’ breathtaking account of his mother healing from cancer after 4 days of NLP to change limiting beliefs and resolve internal conflicts. Talk to most oncologists (cancer specialists) and they will tell you that such results are impossible. It can help for you as an NLP Practitioner to know a little of the research explaining that, not only are such results possible, but at least one mechanism by which they are achieved is already well studied.

One of the simplest ways that such methods work is by mobilising the body’s own natural cancer killing cells (a type of white blood cells or “lymphocytes” called T cells). Increased number of T cells and increased level of their activity is strongly associated in research with cancer being contained in one place, rather than spreading, and with cancer ceasing to reoccur after treatment (Mandeville et alia, 1982; Burford-Mason et alia, 1989). Research shows that bereavement and experimentally induced negative mood states both inhibit the body’s lymphocyte production (Bartrop et alia 1977, Schleifer et alia 1983, Futterman et alia, 1994). Sustained grief and depression, then, are states which increase the risk of cancer. On the other hand, a proactive style of coping with stress is associated with enhanced T cell activity (Goodkin et alia, 1992). That is to say, when someone is in a state where they feel in charge of their life, and as if they are making choices about their future, a check of their T cells will show that these cells are more actively eliminating cancer cells. Research also shows that lymphocyte activity can be anchored using NLP anchoring (classical conditioning) techniques (Buske-Kirschbaum, 1992).

Short term educational psychotherapy can also increase both the percentage of T cells and their activity, by teaching the person how to respond resourcefully (Fawzy et alia, 1990, and 1993). These improvements in T cell activity, due to short term therapy, continue to intensify up to 6 months after the psychotherapy! People with cancer who are taught relaxation and guided imagery (imagining their lymphocytes getting rid of the cancer cells) show significantly higher T cell activity than controls (Walker, 1997). Nicholas Hall, at the University of South Florida, describes a study in which he found that lymphocytes from women with breast cancer who did guided imagery, were both more effectively duplicating themselves and more effectively dissolving and engulfing cancer cells (Batt, 1994, p151). The effect of visualisation is so precise that when students are taught to imagine their lymphocytes doing one specific activity (in the research, they imagined the lymphocytes adhering to other cells better) then that specific activity will be enhanced and not others! (Hall et alia, 1992). How do scientists get these research results, which have been replicated with a number of different types of cancer? They actually take lymphocytes out of the person's body and place them in a test tube next to cancer cells from that same person. What is perhaps most amazing is to realise that once the cells have been “given their instructions” by visualisation, they continue to follow them even when removed from the body, or even after several months in the body.

Creating Comfort

NLP’s origins lie partially in the hypnotherapeutic work of Milton H. Erickson, whose ability to alleviate pain was studied by Richard Bandler and John Grinder in one of NLP’s first books (1975, p 26-50). As early as 1850, the English surgeon James Esdaile (1957) demonstrated that hypnosis could remove the acute pain of major surgery, reliably delivering an effectiveness comparable to chemical anesthesia. There have been plenty of experimental studies showing how and to what degree artificially induced pain can be relieved by hypnosis, but it is now well established that the clinical results of the method far exceed the experimental ones (Hilgard and Hilgard, 1994). Put simply, it’s a lot easier to stop the pain of a person about to be cut up in real-life surgery, than it is to stop the pain you have experimentally induced by asking a volunteer to plunge their hand into ice-water for a few minutes.

This fact alone tells us something extremely important about pain relief by “hypnosis”. It works best when the person really needs it to work. The technique of hypnosis is not a drug which will work regardless of the person’s attitude. It is a technique for utilizing the person’s attitude. In fact, pain, as research shows, is heavily determined by a person’s attitude. Pain which persists or recurs for over six months is called chronic pain. Chronic pain seems to alter the processing in the brain, so that there is abnormal activity in the nociceptors (pain receptors) in the somatosensory cortex (the area of the brain that finally registers what kinesthetic sensations you believe occurred in what part of the body). When the brain is scanned using PET (positron emission tomography) this abnormality is clear. Studies by Pierre Rainville, Catherine Bushnell and Gary Duncan (2001) show that hypnotic suggestions can increase or decrease this abnormal activity in chronic pain, and hence alter the pain experience.

Other more recent studies, using fMRI scans (functional magnetic resonance imaging) show that the mere expectation of pain produces 40% of the response produced by “real” pain in the pain receptors in the cortex of the brain (Porro et alia 2002). Researchers Dennis Turk and Akiko Okifuji explain results of several studies showing that “In chronic pain, pain-related anxiety and fear may actually accentuate the pain experience…. When people with pain symptoms are exposed to a feared situation (eg walking up a flight of stairs), some experience a cascade of avoidance responses…. Fearful patients appear to attend more to signals of threat and to be less able to ignore pain-related information.” (Turk and Okifuji, 2002, p 679-680).

Applying The Research A) Pain Relief

In the last few years, I have collected anecdotal stories where NLP sessions have led to dramatic results in recovery from surgery, cancer treatment, pain relief and achieving many other health outcomes. Here are three simple examples, in which New Zealand Master Practitioners report their work. Libuska Prochazka is an NLP Master Practitioner and Physiotherapist. She says:

Carmen came to see me for physiotherapy to deal with pain in both lower legs. Her right ankle had been surgically reconstructed three years previously after a severe sprain of the ligament. She had suffered pain in both legs for the last year or so. While playing netball and softball, she taped her legs, but suffered severe pain after each game. Both legs ached throughout the day, and the pain kept her awake at night. She had previously tried physiotherapy, specific home exercises prescribed by a physiotherapist, and wearing orthotic shoe inserts and taping her legs. All these interventions had very limited success.

Carmen is very kinesthetic. She very rarely looked directly into my eyes as we spoke but gesticulated a lot and was very 'in touch' with the feelings in her body. She very quickly revealed a fear that had been with her for many years and was able to access the feelings that went with that very easily. This fear, or phobia, was of climbing anything that looked even remotely flimsy. Stairs were the worst as she imagined herself falling through them because she was too heavy. The thought of stairs, ladders, fences, even standing on table tops would all bring her out in a sweat (I was a witness to this as she spoke of it), increase her heart rate and make her legs feel like jelly. I explained to her that there was a possibility that her leg pain was present as a result of her unconscious mind protecting her from this constant fear which was with her every day and limiting many daily activities. With Carmen's permission I decided to use the NLP 'Phobia Cure' .

Five days later, I did a follow-up session with Carmen. From the moment she left the clinic after the Phobia Cure, she had felt no pain at all in her legs. In fact, they felt so good that the next day she played netball (with no tape) and explained how other members of team commented on her enthusiasm in the game. They told her she was playing just like 'her old self’, confident and much more competitive. She experienced absolutely no pain either during or after the game and felt so confident that she played softball the next day. Again, she played better than ever, even sliding into a base as she ran to it and again, feeling no pain.

Carmen almost bounced into the room and as well as hearing from her that she felt 'totally different', she also appeared much more confident. I checked her legs for tenderness and apart from very mild tenderness on palpation of her left Achilles’ tendon, there was no other marked tenderness. She discussed her old fear and said that it was no longer a problem. In fact she was looking forward to climbing up onto the roof (safely she added) to look at the stars with her daughter. This is apparently an activity that her daughter does frequently and has wanted her mother to do with her for a' long time. Her words: "My life has totally changed, this is just magic!"

Applying The Research B) Cancer Remission

Here, NLP Master Practitioner Damian Peters describes his work with a patient with bone cancer.

John was a Samoan chap who was in a wheelchair when I first went to visit him. He was in his home, he was living on his own, and I went to visit him as a volunteer from a hospice, which I had been working with for a while. I asked him “Tell me about your history, basically give me a little bit about your background.” And it was interesting, because one of the first things that he said, was “When I was at school I had to come home and do my homework and dad would always stand behind me and he would have big hands, and he was a big man, and every time I made a mistake he would just hit me over the head, and say ‘No you have done it wrong, do it again.’ The message that I got, was: if you don’t finish your education, you will never survive out there. If you don’t finish your education, you will never get a job; if you don’t finish your education…” and he started going on, and I said, “Stop, stop, stop. That very first one; what was that one you said?” He said, “If I don’t finish my education I won’t survive out there.” and then he stopped, and he looked at me, and suddenly clicked as to what he had said, and I said, “When did you get cancer?” He said, “When I was sixteen.” and I said, “Did you finish your education?” He said, “No, I had an argument with dad, I left home, left school, went flatting with some friends, and within three months I started getting dizzy spells, and blackouts and started going to the doctor, and he sent me into the hospital when they diagnosed me with bone cancer (osteosarcoma).”

So he was 26 when I went to see him, and I met him for the first time, so this was ten years down the track. He had had cancer on and off, had gone into remission and it had come back again. This time it had come back with a vengeance and he was just riddled with it, and he was basically just on morphine and had booked into the hospice programme and was waiting to die. Waiting to die! So I spent three sessions with him, and each session was just reversing that message from his dad, that you don’t need to have an education to survive or to be successful or to do anything in life. I started quoting to him all the various people that I could think of who had become very successful in their business, and had long lives and had never had an education. I used hypnotherapy, I used parts integration and I used Time Line Therapy.. I took him back to the time that he first heard that message from his dad that you needed to have an education to survive and we took away that whole message completely.

The parts integration involved the part of him that believed that you needed to have an education to survive and a part that didn’t believe that you need to have an education to survive. Hypnotherapy was going in and showing the unconscious mind that you don’t need education to live to survive; also to help to get rid of the pain, and using hypnotherapy to reverse the process of the cancer that was happening, so that it was going into remission and that the immune cells would actually start coming back with a vengeance and attacking the cancer cells. So that was really the main thrust of the hypnotherapy. And he had been given between six and twelve months to live. Within three months he was back on his feet, he was out of the wheelchair and he is now playing senior rugby league.

I think attitude is the basis of everything that I am doing at the moment: intent. If you are not coming with the right intention, then I don’t believe that the techniques themselves will work. I am not sure if this is going to sound right in an article, but for me it comes from just the big meaning of the word “love”. If I have a love for myself and that soul, that spirit, that life force inside of me, then I can feel the connection with everybody else that I come into contact with, particularly my clients, and it is just like I feel the energy between us, and I become part of their energy, and impress a whole lot of positive intents towards them, no matter what technique I am doing, even if I am just talking to them.

Applying the Research C) Recovery From Surgery

A good choice for me to complete this article with is my own work with my partner Margot Hamblett, who died of metastatic breast cancer in 2001. It’s a good choice because it reminds us that NLP is not magic, merely the study of how magic happens.

In July 2000, Margot decided to have major breast surgery (mastectomy and reconstruction). Before her operation, NLP Trainer Lynn Timpany and I took her through an Ericksonian trance induction suggesting that she would recover from the surgery quickly and feel comfort easily. While she was in a deeply relaxed and meditative state at times over the days before surgery, she played a track of relaxing music which she had never heard before this time. During the surgery, her anesthetist played the same music through headphones. Our thought was that the relaxed meditative state would be useful during surgery, and then could be used as an anchor after surgery. After surgery, she was given an intravenous morphine drip, and shown how to use it as needed for comfort. However, Margot never used the drip after the time where she was shown how to use it. She found that as soon as she played the music, her body felt completely comfortable, and this was far more pleasant and effective than intravenous morphine. Nursing staff worried that she was using zero pain relief – they explained repeatedly that she would have trouble breathing if she didn’t use the morphine for pain relief. However, there simply was no pain. None at all. Margot left hospital almost two days before her surgeon’s original expectation, largely due to the increased ability to exercise that her own natural comfort strategies produced.

The sequel to this story, however, is also worth telling. Over the next four months, a collection of swollen lymph nodes emerged on Margot’s neck and upper chest (indications of cancer recurrence). These had reached walnut size and were associated with considerable pain by the time (September 17th, 2000) she decided to begin doing six hours of traditional Chinese Chi Kung exercises a day. Doing this was quite tiring because Margot had been losing weight since the surgery, and was taking large doses of opiate pain killers for back and chest pain. But amazingly, by September 18th, one day after starting her new regimen, all Margot’s pain had gone and she stopped taking the pain killers. After another 4 days, Margot wrote in her diary “I feel great; happy, optimistic and energetic.” Two days later, the lumps in her neck and chest had shrunk. She had trouble finding them anymore, as they were the size of apple pips. She began to put on weight. In one week she had produced a dramatic turnaround in her cancer.

Sadly, a reverse turning point seemed to occur later, when Margot began to get new chest pain, and decided to reduce the intensity of the Chi Kung she was doing. Margot’s condition deteriorated, and she died in 2001. There are so many factors involved in such a condition that there is no simple answer to the question “Why?” But there are answers to another question: “What worked?” This is a fundamental NLP question and I want to conclude by sharing Margot’s answer with you. In her diary, on September 26th 2000, Margot wrote “Yesterday afternoon I felt waves of love and happiness…. At times I feel so loved and loving; that love is so abundant.” Written at a time of sudden, dramatic remission, this is a clue to the source of all such healing. My hope is that you will use it, not just to heal others, but to heal yourself.

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Dr Richard Bolstad is an NLP Trainer and Registered Nurse. His book RESOLVE: A New Model of Therapy describes the use of NLP in therapy, and Pro-fusion: NLP and Energy Work is an introduction to the use of NLP in health. He can be reached at richard@transformations.net.nz. or New Zealand +64 9 478 4895. This is one of a series of articles published in Trancescript Number 38, June 2006 Special Edition on Health (Available from Transformations for NZ$10 and most suitable for those with a background in NLP)

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