Dr Richard Bolstad is Transformations Principal Trainer

The NLP Trauma Recovery Process for Canterbury, 2011

NZ Trauma Recovery Team www.traumarecoveryteam.org.nz

Creating A World Worth Living In

CONTENTS

Purpose Of This Kit. Getting Practical Help First
New Zealand Trauma Recovery Team
Resourceful State Management For The Practitioner
Preparing For the Trauma Process
A Sample Script For The Trauma Cure Process
Factors That make The Process Work
An Introduction to the Trauma Cure
Roadblocks in First Response Comments
Reflective Listening
Using Positive Language
Sleight of Mouth Reframes
Research Process and Intake Form
Ministry of Social Development Fact Sheet
Comments On The First Week in Christchurch Richard Bolstad
After the earth moves. Thoughts from the chaos zone for NLP practitioners by Lynn Timpany

Notes and content courtesy of Richard Bolstad, Transformations, for the NZ Trauma Recovery Team, with suggestions from Barbara Belger, Patricia Greenhough, Adrian Metcalf, Charlotte Hinksman and others, and Fact Sheet from New Zealand Ministry of Social Development

Purpose Of This Kit. Getting Practical Help First

This is information for people with expertise in NLP and is not intended for public use. These notes are designed to support certified NLP Master Practitioners with supervision and indemnity insurance arrangements through NZANLP (http://www.nzanlp.org.nz/ ) especially in their NZ Government Ministry of Social Development approved work with survivors of major traumatic events such as the 2011 Christchurch earthquake.

If you need help with Free Fast treatment for Earthquake Psychological Trauma in Christchurch, New Zealand, please call 0800 NLP Recovery, 0800-657-732 and they will take your details and get someone to contact you, or to book a free session email : info@nlprecovery.co.nz.

An excellent manual on preparing for and handling earthquakes is put out in downloadable form by the Los Angeles Fire Department at this address.

In an event such as an earthquake, the first priority is to save lives and very basic NLP pacing and reframing is useful in the moments of disaster events happening. At this time, what is useful to say includes encouraging people by telling them that they are doing well, that now that the event has happened the worst is over and they can continue to work out what to do. However, physical actions to provide safety, water, food, community support and eventually electricity and sewage become priorities rather than NLP sessions in the immediate aftermath of disaster. In an earthquake, aftershocks continue to happen for some weeks and alertness about danger is a realistic response. Lynn Timpany's notes at the end of this section give some ideas about how to help people manage in these times.

Once people feel safer physically, most people will be remarkably resilient and even helpful to others around them, and their idiosyncratic way of being resilient (which may seem obsessional, selfish, overly resuing of others etc) does not need an NLP "fix". After some months, 5-10% of people, depending on the cultural milieu, will continue to be sleepless, panicing etc and will benefit from the NLP trauma process described in detail below. Some people who have traumatic responses to older events will have them restimulated by the current crisis and may benefit from this process earlier, mostly in relation to the earlier events.

New Zealand Trauma Recovery Team

Welcome from the New Zealand Trauma Recovery Team: helping individuals overcome trauma and rebuild their lives. The Trauma Recovery Team is a group of nationally and internationally certified NLP Master Practitioners and Trainers working with victims of trauma. Using ground-breaking techniques that provide profound and lasting relief from trauma and PTSD (post traumatic stress disorder), we are helping people who have suffered from disasters such as the tsunami in Samoa in September 2009. NLP stands for Neuro Linguistic Programming, the study of excellence in a range of areas including therapy, personal change, communication and education. The NLP techniques we employ have been shown to be the most effective solution to treating PTSD in war zones and post 9-11. Trauma Recovery Team has officially become a charitable organisation from November 2010

The Trauma Process (useful AFTER the crisis)

Preparing For The Trauma Process

1. Be in a Resourceful State Yourself, and Establish Rapport

You may be about to hear some disturbing stories that you want to stay dissociated from. You may be about to see people in profound distress. It may be useful to stack a few more resources on to your own resource anchor, and create a 'thought' access for it (not only pressing fingers together or similar) like a 'word' or a colour or phrase, so you can quickly regain resourceful state each time.

Be aware of your response to others: especially if you are working in larger centres where there will be an sense of connectedness. This could mean that emotional events (eg more bad news, somebody turning up with anger...) can shift the whole room full of people (they may have all been in rapport for a few days). Become aware of the 'rapport leader' and get in rapport with them,if ecological and ethical, so you can reframe carefully.

Match the person's breathing, posture and voice, and reflective listen.

2. Check Their Resourcefulness
Is the person able to stay calm enough to talk to you about something pleasant or neutral? If not (i.e. you calibrate the person is distressed or they tell you they are distressed) check with them whether they want to learn how to relax now, so that the experience is easier (this is useful as they may have some misconceptions about an NLP session being the same as a counselling session - i.e. that you need to talk about painful experiences, this would be an opportunity to teach them it will be different to that). If, after helping/teaching them how to relax, this is still difficult you may need to arrange to conduct the session at a later time.

There may be some obvious acute physical responses to anxiety that you need to be prepared for; vomiting, hyperventilation, fainting or screaming. We would suggest you have a "first aid kit" handy for such times, which could include a discretely placed bucket, tissues, and a soft cushion / place to lie down.

Non NLP Treatments. Opinion is divided about how to respond to such physical symptoms of anxiety. You may have other skills from outside of NLP that you usually choose to employ. Please be clear that Ministry of Social Development arrangements with the Trauma Recovery Team do not cover the use of physical treatments such as cranial adjustments. You may choose to enhance relaxation with what many people would consider suggestive placebos or positive suggestions, such as aromatherapy. Researchers at the Medical University of Vienna, Austria did a ten week double-blind, placebo-controlled study of the anti-stress effects of Lavender, on mild-moderate anxiety. Lavender capsules were evaluated against a well-known anti-anxiety drug (lorazepam) and were as effective as the pharmaceutical preparation in every way. Without giving the pills (bordering on illegal prescription) you might, for example, use lavender in the room as an aroma and mention the research. However such responses are not part of our arrangements with the Ministry.

NLP Trauma Process Research: If you have followed a Trauma Process protocol similar to the one described here and your main intervention was the NLP Trauma Process, then your results can contribute to the world-wide research study on the process being done by The NLP Research and Recognition project. The NLP Research and Recognition Project is currently running the first major controlled study on the NLP Trauma Process under a recently submitted $15,000,000 Department of Defense Center for Excellence for PTSD Grant. 3000 veterans will be treated. To use cases in Research you need to get permission from the client at this point, explaining that by agreeing for us to keep track of their change we can get support for more effective care for others in future. To do the research, the client needs to sign the form giving permission (see page 15) and you need to take their contact details.

3. Check What Problems The Person Has Been Experiencing
What symptoms of trauma does the person experience? Briefly ask them to tell you, and reflective listen. Reassure them this can change. From their description you may be able to check off many symptoms from the list on the form (page 15, also listed following). Check about the others in the list if it seems important for safety, taking care not to install new symptoms. Post Traumatic Stress Disorder (DSM-IV 309.81) symptoms include:

Are there any other problems you need to know about (for example, medical problems)?

The scaling question is included in the following Trauma Process script, but could be asked before beginning the script instead. It says: "On a scale of 1 (neutral or calm) to 10 (the worst they can think of) how bad does it feel now?" You can use this same question in follow-up to check the success of the process.

4. Set The Goal
How would the person be acting, thinking and feeling if these problems were solved? If this person's problems were solved, what else would change? Is that okay for them? If not, ask what they need to do to make it okay for them. You are checking for ecology issues eg that the person is afraid that if they don't have their panic, they might not keep themselves/others safe.

5. Give An Overview Of The Process
Eg "This whole process usually takes less than half an hour. The aim is for you to feel relatively comfortable throughout. Most people find that their symptoms disappear immediately. Your brain learns new responses very quickly." You may give The Person An Experience Of How The Way They Imagine Things Causes Their Body To Respond eg Have the person turn around with their arm stretched out pointing. Tell them "Just go round carefully to where your arm feels tight, and see where you're pointing.... Now come back to the front.... Now imagine turning round again, but this time imagine that your body flows easily way round further, perhaps twenty or thirty centimetres further than before. You'd be pointing at a totally different place. What would you be saying to yourself if you went around that far?... and now turn around with that same hand and see how far you go NOW!"

6. Explain Dissociation In NLP Terms
Eg "We are going to teach your brain to react differently to the memories of the event. People can remember events in two different ways. If you think of a simple, enjoyable event you've experienced recently, like eating breakfast today [choose another event if breakfast reminds the person of the trauma], you can remember what you saw through your own eyes [wait for the person to remember] and enjoy all the feelings of eating that breakfast. It may even make your mouth water. That's one way to remember it. Another way to remember it is to imagine seeing yourself sitting in the room eating. Watch yourself over there eating, as if you were watching from a distance. Even make a still picture of yourself, like a photograph, perhaps a black and white photograph. When you see that picture, it's not so easy to get the feeling of enjoying eating breakfast. You need to step back into your body to taste it again. It's quite okay to remember the feeling in your body eating breakfast. But there are some things it's better to step back from, so you can see what happens, but you feel separate from it. People who are enjoying their life can choose which way to remember each thing. We are going to teach your brain to automatically remember those old unpleasant events in a way that keeps you separate from the feelings you had then. That means the other problems you've had will disappear, and you'll get the enjoyment you want in life. Does that sound useful?"

A Sample Script For The Trauma Process

NLP Trauma Process Research: If you have followed a Trauma Process protocol similar to the one described here and your main intervention was the NLP Trauma Process, then your results can contribute to the world-wide research study on the process being done by The NLP Research and Recognition project. NLP Research and Recognition Project is currently running the first major controlled study on the NLP Trauma Process under a recently submitted $15,000,000 Department of Defense Center for Excellence for PTSD Grant. 3000 veterans will be treated. To use cases in Research you need to get permission from the client at this point, explaining that by agreeing for us to keep track of their change we can get support for more effective care for others in future. To do the research, the client needs to sign the form giving permission (see page 15) and you need to take their contact details, and ask them about their symptoms before beginning (see above section).

1. Establish Rapport, Set Up Resource Anchor

"Before we start, what I'd like you to do is to remember a time when you felt in charge of what you were doing, perhaps when you were doing something you know how to do [like baking a cake, or driving a car], and get back the memory of a specific time, so you can step into your body at that time, and see what you saw, hear the sounds, and fell the feeling of being in charge. Now, as you feel that feeling, I want you to press together the thumb and little finger of your left hand and enjoy the sense of being in charge ... Great; now release the fingers and come back to being in the room here, and stretch."

Repeat for two other positive feelings instead of "being in charge" e.g. "confidence", relaxation", "humour". Your being able to create that positive feeling in yourself as they think of it will also help. If they can't think of a time when they felt positive, have them remember a time when someone they like had that feeling, and feel what that person must have felt like.

2. Test Resource Anchor

"OK, now stretch and have a look out the window. Just see something you didn't notice before ... Good; now press that thumb and little finger together and feel the difference."

Check that the anchor (thumb-finger touch) causes the person to shift their breathing/body position/facial expression back to a positive state similar to the one they used remembering the times. If not, repeat step one, emphasising their re-experiencing each positive state.

3. Pretest

"Right, now before we start, I just want to check this thing that has been a problem. I'd like you to just briefly think about the things that have been upsetting you. What does it feel like to remember that? On a scale of 1 to 10 where 1 is calm and neutral and 10 is the worst imaginable, how does it feel now?"

Check for a clear shift in breathing, body posture and facial expression. If you need to, to draw them back out, have them stand up and press the thumb and little finger together until they are out of the memory.

"OK. Come back to here now. You'll know when that changes now won't you?"

4. Set Up The Movie Theatre

"Now panic attacks [or "flashbacks/nightmares/Post Traumatic Stress/phobias like you've been having"] is just a result of the brain having a scary experience and storing it in a less than useful way. The brain did that the first time you had that experience, and it took it less than 30 seconds to do. So its just that easy to change once we know how the brain did that."

"To change it, what we need to do first is set up a kind of movie theatre here. You've been to a movie sometime, so you know there are seats here [point to movie theatre seat] and a screen up here [point to front -ideally a blank wall]. And sitting in the movie theatre here, I want you to see a picture up on the screen, of yourself, a black and white photo. It could be of the way you look now, or of you doing something you do at home, or just a photo like a recent one you've seen in a photo album ... Have you done that?"

"Good. Now, before you had that experience that was scary, there was a time when it hadn't happened yet, and you were safe. Take all the time you need to remember that time, and make a picture of yourself at that safe time before the event. Put that picture of you looking safe before the event up on the screen now, and turn it to black and white too. Have you done that?"

"Great. And after that experience that was scary, there was a time when it was over, and although you still had memories of the event, you were physically safe. Take time to remember that safe time after it happened, and put a picture of yourself at that time on the screen. Have you done that too?" nb if there has not yet been a time that is physically safe, you may need to create an imaginary time in the future.

"OK. Now I'd like you to stand up out of that chair and come back here. This is a chair in the projection room from where they show the movie [seat the person now in the second chair, behind the movie theatre chair]. There's a glass screen through which you can see the movie theatre and you can see that other you sitting in the movie theatre, watching a black and white photo on the screen. Can you see that person in the theatre seat?"

5. Run The Movie Forward "Dissociated"

"So now, as you stay in the projection room, safe behind the glass, you can run the movies, and watch as that other person in the theatre watches them. And because there are holes on the side of the glass, you can hear the movie, because we're going to show a movie soon. And you'll be safe and comfortable here, maybe with something nice to eat and drink while you watch the person watching the movie."

"What I want you to do is to run a movie of yourself in that time when the unpleasant event happened. The movie will start before the event, at the time when you were safe before, and will run through the time after the event, once you were physically safe again. Like any movie, it will show the important parts of the story, form beginning to end, but this movie will be in black and white, like an old film.

OK? Now, while you run the movie, I'd like you to watch that person the movie theatre. They may have some response to the movie, but you're in the projection room, so just run it through and watch their watching. OK, go ahead, and tell me when you're done."

6. Fast Rewind The Movie "Associated"

"Now, in a moment, I'm going to get you to pretend that you float out of the projection room and into the movie at that safe end scene. It may help you to close your eyes to imagine that. Once you're in the movie, in the body of that earlier you, turn the movie to colour. Then we're going to run the movie backwards, from the end to that safe beginning, but fast, like fast rewind on a video. You've seen a video rewind, but this will go so fast the whole thing will only take a second and a half, so it goes zziiiiiiipp! Got that? Okay, now; float into the movie, at the end, turn it colour and zziiiiipp! ... Once you're done, turn the movie back to black and white, and float back to where you actually are, here in the projection room ... Hi."

7. Repeat until Change Occurs

"OK. Now I want you to be here in the projection booth and watch again as that person in the movie theatre sees the movie through from safe beginning to safe end ... OK? Great; and again, imagine you float into the end and turn the movie to colour, then run it backwards zziiiiipp, and come back to the projection booth once its done ..."

"Great. Have a stretch ... Now try and get back that picture at the start of the movie [If they can't, go to step 8]. Now again, watch from the movie projection booth as that person watches the black and white movie, float into the safe end and run it backwards fast in colour, and come back here. Tell me when you're done...".

"Good. Now I want you to try to do this process, a bit faster, and do it through as many times as it takes till you can't get back the movie, or you realise that the feeling has suddenly gone. Some people say the movie gets blank spots and fades out; some say it's as if the tape snaps. It's probably started already. Just go ahead and try to run the movie each way till you know you can't. Then tell me ...".

8. Verify Change (Post-test)

"Great. ,And notice that the feeling went with the picture. Okay; now stretch and look out the window. Notice something there you haven't seen before ...".

"Okay, now what I want you to do is have a go at remembering that time, and try and get back the feelings you used to have about it." [Smile]. "How's that now? Different!"

Check from the person's body posture, breathing and facial expression that this is a different, more relaxed response than the pretest.

"Now I'm not suggesting you'll enjoy that thing now. Just that the uncomfortable feeling is gone. There's often a little uncertainty, as you try to go to remember, because this was a reliable response you had. You had that problem for a while, and it's strange for it to be different, now. Pretty amazing isn't it?" [Try again until the person realises it's different].

9. Ecology Check and Future Pace

"Now one thing that has happened occasionally, is that when someone had an anxiety, it gave them something to do. So now it's important to find out what you can do instead. I'd like you to think of a future time, the kind of time when, in the past, you would have responded in that old way; and notice what you're doing instead, and how you're feeling. How is that? ...".

"And think of another situation when, in the past, you'd have had that problem. How is it different now? ... Is that okay for all of you?"

"On a scale of 1 (neutral or calm) to 10 (the worst you can think of) how does it feel now?" [Note that this scaling question is important for the research study too.]

"Excellent. Welcome to your new life. That was big change wasn't it!"

Factors That Make The Process Work

1. Rapport

Breathe in time with the person
Sit in a similar position to them
Use similar voice tone, speed and volume
Restate their comments to confirm you've understood

2. Use Language That Creates Positive Internal Representations Of Success

Rather than "This may be scary", say "I'm not saying this will be totally comfortable". Once you've started, refer to "the way you used to feel when you thought of this" and "the problem you had", placing the difficulty in the past.

3. Get A Clear Pretest And A Clear, Convincing Post-Test

Before, at step 3. of the process, ask the person to notice their anxiety just enough so you and they can confirm that it has been a problem, and they would know if it changed.

After, at step 8 of the process, ask the person to try to get back the anxiety and have them confirm that it has changed. If it hasn't, don't try to pretend its working. Actually re-run the process till it works and the person is convinced, or has a plan to test it as soon as possible. Many people do not fully notice the change until you point it out to them. Some people need to try three or even five times to be convinced.

4. Keep The "Roles" Or Perspectives In Each Chair Distinct

Always speak to the person as if they are actually in the theatre when they sit on the theatre seat. Always speak as if they are actually in the projection booth when they sit in the projection booth seat. If, while in the projection booth seat, the person begins to talk about what it was like inside the traumatic experience, have them stand up and move "out of the projection booth". You want both seats safely separated from the memory.

5. Know Your Choices For Times When The Person Isn't Dissociating

a) Have the person stand up and fire their resource anchor.
b) Walk around the room with them.
c) Have the person get out of the projection booth and imagine they are further away from the movie screen.
d) Use the Reframe below

6. Be Clear In Your Mind What A Phobia/Traumatic Response Is In NLP Terms

If it could be caused in 30 seconds it can be cured in 30 seconds. Emotionally healthy individuals recall positive experiences associated and negative experiences dissociated. A phobia or an anxiety disorder caused by trauma is just an accidental mis-storage of a memory.

7. Reframe: For When A Part Of The Person Doesn't Want To Let The Fear Go

"Now I know that there's a part of you that thought it was important for you to hold on to those old feelings. A part of you may have been trying to keep you safe, or to make sure that you really learned the lesson of this event. But holding on to the feeling hasn't actually kept you safe. It has made your life more dangerous by having you live in fear. If that part of you really wants you to have learned from that event, then it will really keep you safe by letting go of the feeling now, and keeping the things you needed to learn."

An Introduction to the Trauma Cure

Dr Richard Bolstad

The Problem: PTSD

"Shell shock" was first defined in 1915 as the most common neurosis resulting from exposure to the war in Europe. Thought initially to be a physical result of concussion from shell explosions, its symptoms included tremors, depression, crying, and manic episodes where the soldier appeared to relive the explosions, calling out as if in the battle (Young, 1995, p 50-51).

The problem was renamed Post Traumatic Stress Disorder in 1980 by the American Psychiatric Association in its Diagnostic and Statistical Manual. The DSM-IV (American Psychiatric Association, 1994A, p 209-211) defines PTSD as resulting from the person's fear, helplessness or horror at being confronted by a situation where someone (themselves or others) were at risk of or experienced serious injury. This event is then persistently re-experienced in dreams, in physiological and psychological reactions to cues reminding the person of the event, or in full flashback experiences. As a result, the person avoids any cues of the event, shutting down their emotions and thoughts if needed to achieve this avoidance. This in turn results in a state of continued over-arousal, possibly expressed in difficulty relaxing or concentrating, or in sudden startle responses and angry outbursts.

Behavioural treatments for PTSD were first developed largely in response to the demand from Vietnam veteran organisations. They tended to provide a combination of two approaches (Keane, 1998, p398-407). Firstly, there were Systematic Exposure therapies, in which the person was exposed in a controlled way to thoughts or actual experiences which had previously evoked intrusive memories and panic. These therapies often involved 3-6 months of treatment, and were shown to be remarkably successful, producing a complete resolution of PTSD in 90% of cases. The spontaneous cure rate over this time period is about 30%, so this is impressive, if rather long winded. The second approach was Anxiety Management Training. Used alone, the effects of anxiety management tended to be less permanent, but relaxation training, breathing training, guided self dialogue and communication skills training have all been shown to be effective modifiers of anxiety. Combinations of the two approaches have been most preferred.

The NLP Trauma Cure

The development of the Visual-Kinesthetic Dissociation technique by Richard Bandler and John Grinder promised an entirely new way of intervening with phobias and PTSD. Research on their earlier version of the technique, as used with phobias, was available from 1975. M.S. Denholtz and E.T. Mann reported enthusiastically on "An automated audiovisual treatment of phobias administered by non-professionals" in the Journal of Behaviour Therapy and Experimental Psychiatry (6, p 111-115) then. The technique was written up by Bandler and Grinder (1979, p 110-125) in a demonstration of its use with a woman with a phobia of driving across bridges. At the end of the process, Bandler asks her to imagine driving across a bridge, and she says, with some puzzlement "I drove across the bridge....But always before when I drove across a bridge, I immediately began to program myself "What am I going to do when the car goes off the side."".

Richard Bandler explains the origin of the NLP treatment for phobias and traumas, in his book Time For A Change. "I went out and found two people who had a phobia and who got over it. Then I found out what they did." (Bandler, 1993, p 7). The solution he found was that people who had phobias remembered the traumatic events (or imagined traumatic event) as if they saw it through their own eyes ("associated" in NLP terms) while the two people who had recovered remembered the events as they would look seen from a distance ("dissociated" in NLP terms).

The NLP trauma cure its present form was first reported on medically in the British Medical Journal. British Doctor David Muss did a pilot study on the method, with 70 members of the British West Midlands Police Force, after the Lockerbie air crash in Scotland. The crash resulted from a terrorist bomb exploding in an airplane over the town of Lockerbie. All participants in Dr Muss' study reported that after an average of three sessions they were completely free of intrusive memories and other Post Traumatic symptoms. For most, one session was enough to solve the problem. Follow-up over 2 years showed that all gains were sustained over that time. Dr Muss (1991) says he was puzzled that, six years after the research proving the greater success of the NLP phobia/trauma cure, "psychologists still continued to believe that it takes months or even years of therapy and drugs to cure people of their phobias... They appear to be possessed of certain inertia and seem suspicious of a method which claims to do in a very short time what they have traditionally taken months or years to accomplish."

My Work In Sarajevo

Between 1992 and 1995, after declaring itself independent of Yugoslavia, Bosnia/Herzegovina experienced horrific civil war between the Moslem majority and the Croatian and Serbian minorities. This war began with Serbian moves to clear Moslems from eastern Bosnia ("ethnic cleansing") and unite these Serb areas with Serbia itself. The capital city of Sarajevo was besieged by Serb militias, and for three years was kept under a reign of terror as building after building was destroyed, and person after person shot by Serb snipers. The story of this siege is told in the Miramax films production "Welcome To Sarajevo" based on reporter Michael Nicholson's book of the same name (1997).

My partner Margot Hamblett (who died in 2001) and I were invited to Sarajevo in 1998 and 1999 to run a two day training course for health professionals coping with PTSD problems. We taught a group of thirty people each time, most of whom were Psychiatrists, some of whom were Nurses and Aid Workers who then went into the Kosovo situation in 1999. The courses were run at the Kosevo Clinic, Sarajevo's central Psychiatric Hospital. Our course materials (following) were translated by a number of people in New Zealand and in Sarajevo, and Dubravko Vanicek, was our interpreter.

We taught a basic NLP model of internal processing, rapport skills, resource anchoring, using positive language and positive presuppositions, and the trauma-phobia cure. We taught this collection of techniques within an integrating structure moving from the initial establishment of rapport and pretesting of the problem, through the setting of an outcome, the preframing of change as possible, the actual trauma cure, and the post-testing and futurepacing of change (see my books Transforming Communication, and RESOLVE: A New Model of Therapy).

The professionals present were quickly able to identify that what we had was a whole new approach. They learned the process and demonstrated its effectiveness during the course. Bosnian psychiatrist Dr Azra Mulaomerovic commented after his training that "After NLP training I feel confident in coping with many situations I previously was not confident with." Dr Mehmedika Suljic Enka agreed "This training gives more practice in dealing with survivors of traumatic experiences or clients with phobias. Used with my own similar problem, it helped to relieve my fear, and I realised how I can help other people. I have improved my knowledge in Psychiatry." The following case examples give a sense of what the effect was like for them.

Examples in Sarajevo

Margot Hamblett explains: "When I demonstrated the trauma process, I worked with a man who was triggered into anger and panic by military uniforms. A few days previously he had been stopped by traffic police, and nearly attacked the person. Understandable in the war, but rather a risky reaction in peacetime (especially when the police are armed). But ten minutes later he was able to recall that incident with a sense of calm."

"Of course, here we were testing using a post-war incident. An even more interesting example came later that day and outside the course when I took a woman through a trauma cure on the entire war experience. She began quite tearful, anouncing in English, "I hate the war; and I hate talking about it!" She said she had had nightmares every night since the war. For her, sounds were powerful anchors, and the sound of explosions produced uncontrollable panic. The previous week someone had organised a fireworks display in Sarajevo. Rationally, she knew she was safe, but her panic put her right back in the war situation. She ran into a nearby house and hid in their basement until the display was over."

"After attempting unsuccessfully to explain the trauma process to her (her knowledge of English was limited), I simply asked her to imagine being in a movie theatre and ran the process. Her movie went from the time before the war to the time after it, a period of over three years. Then I asked her to think of the fireworks and find out how it felt now. She laughed. Next, I asked her to remember some of the worst times from the war, and check how they were. She gazed ahead with a dazed expression. "So how is it?" I checked. "Well, she said, with a smile "I'm seeing the pictures, and its as if they're just over there, and I'm here." The entire process had taken twenty minutes. On my return visit in 1999 this woman reported that she had had no further panic attacks or nightmares, and had actually forgotten how seriously they once disabled her. She was delighted with the change in her life."

Implications For NLP

If there was any doubt, I believe that our work in Sarajevo demonstrated that the core NLP techniques are robust enough to deal with the psychological aftermath of the worst experiences humankind can face. We intend to do followup to support this claim further. For those reading with NLP training, there are some important learnings we would like to share, in terms of what seemed to work:

1) We came in with some knowledge of the background of the war and the cultural situation. It helped to have people in the area who could brief us on codes of conduct (eg taking shoes off when entering a Moslem house, not publicly announcing where the bathrooms/toilets were in a training).
2) We had an excellent interpreter for situations where the client could not speak English. One who could translate into positive language, and adjust his voice tonality to produce embedded suggestions, and relaxation processes.
3) We were clear about which situations the techniques would be useful for (the diagnostic description of PTSD, for example) and which they would not be adequate for (eg Psychosis). We were careful not to make outrageous claims.
4) We taught rapport skills, anchoring and the use of positive language before teaching the actual trauma cure. By positive language we mean language which suggests positive or useful internal representations. We used these three patterns extensively, as we ran the trauma cure. Before running the trauma cure we pretested the problem by having the person briefly think of the trauma, and pointing out the resultant distress. Afterwards we post-tested and pointed out the resultant comfort. We thus used the RESOLVE model for NLP as described in our books Transforming Communicationand RESOLVE: A New Model of Therapy.
5) We found running the trauma cure movie from before the war to after it more powerful than dealing with incidents piecemeal. We also had the person identify a resourceful time before the war and a resourceful time after the war, and used these both as resourceful states to anchor, and as the beginning and end of the movie in the trauma cure. We ran the trauma cure using two chairs (a chair in the movie theatre and a chair in the projection room) as spacial anchors.

Chechnya, Beruit, Australia

The model for the trauma cure presented here has reached many other countries. For two decades now, there has been open war between the breakaway republic of Chechnya and the Russian Federation. In early September, 2004, Chechen terrorists, under attack from Russian special forces, killed 344 civilians, including 186 children in the Beslan Number One School. Partially in response to this, the Psychology degree program at Pyatigorsk Linguistic University, kilometres from Beslan,decided to initiate a ining specifically for working with children and young people in traumatic situations. They invited me to design a paper based on my model "RESOLVE", for working with children and young people.

The course, titled "The Psychological Consultation of Children and Youth Using NLP" is required for all Psychologists training there from 2005. It is run by Psychologist Natalia Doroshenko, the Russian translator of several of my books. I met with Ms Doroshenko and Psychology students in September 2005 to initiate the program of study. The staff of the Psychology Department, headed by the Dean, Ms Irina Byazhitova, also attended this introductory training. Since the 1970s,Beirut and the Lebanon have been caught in the crossfire of the mddle east war. NLP Master Practitioner Damian Peters, a member of the New Zealand Lebanese community, was trained by my organization in 1998. In 1999 he ran a one day training for over 100 health professionals in Beirut, using the same handouts presented here.

The handouts are used in many other places. In Australia, Christine and John Sutherland run a series of Trauma Clincs where they use Gary Craig's EFT (Emotional Freedom Techniques), Dr Larry Nim's BSFF (Behavioural & Emotional Symptom Elimination Training) and the NLP Trauma Cure. In April 2000 they began using the script from our Sarajevo training as the basis of their NLP work in those clinics.

Research is being started in the US following clinical use after 9-11, where NLP protocols relieved PTSD symptoms over 80% of the time in two to four hours. Cognitive-Behaviour Therapy, the best of the researched methods, is effective 32% of the time and takes four to nine months (Frank Bourke, Ph.D. & Richard F. Liotta, Ph.D. http://nlprandr.org/?page_id=508 ).

References:

Dr Richard Bolstad is a member of the New Zealand Association of Psychotherapists, a Doctor of Clinical Hypnotherapy, and a certified NLP Trainer. Professionally he is also a trained Teacher, Nurse and Medical Herbalist, and is a certified instructor for two different schools of traditional Chinese Chi Kung. He teaches in several continents each year, and combines a high valuing of research with an openness to ancient wisdom. His books include RESOLVE: A New Model of Therapy, Transforming Communication and The Structure of Personality (the latter co-written with NLP trainers Margot Hamblett, Dr Michael Hall and Dr Bob Bodenhamer). His work is published in Russian, German, Spanish, Portugese, Hebrew, Italian, Chinese, Japanese and Malaysian. He can be reached through www.transformations.net.nz . Here's what people say about his book RESOLVE, for example:


Roadblocks In First Response Comments

Roadblocks are responses intended to be helpful, but which are high risk responses as a first comment when someone else is upset. They imply that what the person is thinking/feeling/doing is wrong. Reflective listening as a first response creates rapport and is more likely to validate the person's functioning. Once you have their permission to help, some of these responses will of course be very useful.

Solution Giving
Commanding: "Just shut up and calm down will you!"
Warning: "If you carry on interrupting I'm not doing this with you."
Moralising: "You should have more consideration for those who had a worse time."
Lecturing: "Research shows that a state of uncertainty is a valuable learning aid; it helps you pay attention to the next events."
Advising: "Why don't you go out of the room and calm down."

Judgments
Blaming: "There's no-one to blame but you for getting so panicked?"
Name-calling: "We really do get some fragile souls here don't we."
Analysing: "I'm sure you're actually quite safe. Are you looking for a bit of attention?"

Denying
Praising: "I'm sure you'll get over it; you're obviously very functional."
Reassuring: "You poor old thing. Hang in there; it's bound to make sense later."
Distracting: "Maybe we should think of nicer things just now."

Interrogating
Questioning: "Do you always have trouble with anxiety?

Reflective Listening

This skill involves reflecting feelings and information from what you heard the other person saying.
Colleague: "I'm in a real panic right now even. I know I should cope but it just goes on and on."
You: "You're doing your best to cope and the panic has to do with this sense that it has been going on and on?"
Colleague: "Yes, I keep thinking that I'll get on top of it, but every little thing is so difficult. I keep wondering when the next one will hit."
You: "It's not knowing if it will happen again that makes it hard to get on top of it?"

Reflective listening is an extremely useful helping skill, and to use it well, you need to be feeling free enough of your own problems to focus on the other person. You also need to trust the person to find good solutions rather than wanting to convince them of your own. This is not a skill for when you want to influence the person. Reflective listening also requires the person to be willing to talk: you can't force them to open up. Also, of course, when simple information is required, you need to give it, not just listen empathically. And when you have permission, guiding them through a process is a valid directive action.

Reflective listening tells the other that you are interested in their concerns, that you can accept them having problems and trust that they will solve them. It deepens your relationship, as you will really start to hear what clients and colleagues say. That is its risk, and its beauty. As a spin-off benefit, colleagues may benefit from your modelling and start to reflectively listen to your concerns about them.

Reflective listening is even more effective when you match the sensory system (visual, auditory, kinesthetic, unspecified) of the person you are listening to. For example, if the person said "My week has been so gloomy.", you might say "It's hard to see the light at the end of the tunnel." If the person said "My week has been out of tune." you might say "You've had difficulty finding the theme."

Using Positive Language

1. Use Positive Language

The unconscious mind can only understand positives. If I say "Don't think of a blue tree", you have to imagine the blue tree in order to understand what I said. Say things positively so your clients make representations of what you intend them to. eg Instead of saying "Don't Panic." say "Relax more comfortably."

2. Include Useful Presuppositions In Your Sentences

Presuppositions are ideas you assume to be true, in order to understand a sentence. In the sentence "Which things do you find most terrifying?", to understand the sentence your client has to assume that some things are terrifying. In the sentence "Which things do you find less comfortable?", the client has to assume that some things are comfortable. The sentence "Which of these things can you already imagine changing?" presupposes that your client already can imagine changing some things; the only question is which ones?. The sentence "How does it feel different now?" presupposes that the client feels different now. Say sentences with presuppositions you want your clients to make into internal representations (pictures, feelings, sounds, words they say to themselves).

Sleight of Mouth Reframes

The Sleight of Mouth patterns include a number of ways to help people find more useful meanings once you have created rapport by reflective listening. Revise them from your Master Practitioner course notes. For example redefining and simple metaphor are useful.

Example 1: Redefining and Simple Metaphor

Client "I know that I should try and stop panicking, but I'm afraid that if I get too relaxed I won't be able to respond fast enough if another one happens."
Practitioner "You wonder if your anxiety is sort of protecting you by helping you stay alert so you can respond quicker."
Client "Yeah"
Practitioner "Well I think of it as being like electricity power points in the wall. I know they're dangerous and I need to be alert when I'm round them, but being frightened when I am trying to plug in something doesn't make me safe; it would make me more likely to do something unhelpful. Actually it's being able to be calmly aware that helps me to be most safe."

Example 2: Redefining and Simple Metaphor

Client "I can't stop thinking that this could happen again at any time. How can I ever feel safe again?"
Practitioner "I agree with you that one of the things we learn from events like this is that the world is not always safe. But what happens out in the world is not what causes us to feel safe or feel unsafe. There are many people who are completely physically safe and have never experienced a physical injury, but who have terrible panic attacks. There are many people who live calmly even though their job, for example cleaning windows on high buildings, involves placing themselves in real physical danger. Feeling safe is something that we do inside. What happens in the world is not predictable and not always in our control. What happens inside us can be changed once we learn how to take charge of our brain. Once we do that we can change the things in the world that can be changed, live comfortably in the uncertainty about those things that we cannot predict or change, and learn to choose wisely which situations are which."

Research and Intake Form

Unique Number For ID
Name
Date
Address (or former address)
Date of Birth
Phone - Home
Phone - Mobile

I consent to the information gathered on this form being seen by other authorised personnel involved with the NLP First Response team, and the NLP Trauma Recovery Trust. This information will be used for follow-up calls, checking on my progress, and for statistical purposes including research to support future funding).

Signed: (by guardian if under the age of 16 years)

BEFORE PROCESS
Brief Description of symptoms (client's words)
Note in particular: Sleeping difficulties, general anxiety, panic attacks, sudden anger/emotional highs and lows, medication and self-medication.

Which of these symptoms did they have (DSM IV)?

On a scale of 10 to 1 where 10 is as bad as it could be and 1 is comfortable and calm, how does it feel now?

Please return forms (once a week of possible) to: info@traumarecoveryteam.org.nz

Fact Sheet, Ministry of Social Development, 25 Feb, 2011

Where to find help

MANY AGENCIES CAN HELP YOU, YOUR FAMILY AND WHANAU FOLLOWING THE EARTHQUAKE. HERE'S A BRIEF OUTLINE OF THE SERVICES AND SUPPORT AVAILABLE FOR CANTABRIANS.
Emergency Assistance

Call the Canterbury Earthquake Government Helpline on 0800 779 997 for information and emergency financial support. It's open 24 hours a day, 7 days a week.

Or visit a Welfare Centre at these locations:

Alternatively you can visit Work and Income between 9am -- 5pm at these locations:

Other Work and Income Service Centres may open in the coming days. Call the Government Helpline to find out if one is open near you.

Civil Defence Payments
You may also be eligible for Civil Defence payments which are available for a range of circumstances. For example, if you've had to leave your home as a result of the quake then Civil Defence payments can help you with accommodation costs. They can assist with the purchase of essential and emergency items, and are also available for those who have suffered a loss of income.
To find out about payments, call the Government Helpline on 0800 779 997.

Help finding accommodation
If you need assistance finding emergency temporary accommodation call 0800 HELP 00 (0800 435 700). Property owners or households with accommodation to offer can also call this number.
For Housing New Zealand tenants calling about damage to their home, or to alert the Corporation to their whereabouts call the Housing New Zealand Helpline 0800 801 601.

Support and counselling services
If you, your family or someone you know needs someone to talk to, we can put you in touch with a range of support and counselling services for free.
For someone to talk to, call 0800 777 846.

For more information from the Ministry about support of families and individuals in crisis, check these "Emotional Support After The Quake" Factsheets

Comments On the First Week In Christchurch

Richard Bolstad

Here are some thoughts after being in Christchurch for 2 days almost immediately after the earthquake of 22 February 2011, and talking to many people and then moving my mother out of the city. These are reality checking thoughts for those wanting to help using NLP. Please understand that you need to be a) extremely resourceful to go there, and b) extremely careful to come back safe after. Resourceful because 2/3 of the city is just what has been described - an area where an ongoing disaster is happening. I met resilient people who immediately asked how I was and checked what I needed. I saw groups of students shovelling the masses of silt from streets so people can get to their door without wading through mud. I also saw people standing on streets just crying, people just staring blankly and immobile, people stoned or drunk and crying, people fist-fighting over bread in at supermarkets. I heard repeated descriptions of people having seen people with limbs amputated, people dying in front of them etc. If you can’t even read this, don’t try to help them yet.

The city remains very challenging. It took me 2-3 hours to travel in a car across a city that usually takes 20 minutes to cross. Someone who tried to contact my mother before I came down gave up because the traffic was unrealistic. That means in a single day someone could travel to your trauma cure process as their sole event of the day. For some people, the city is much the way it was, and for many, the city is suddenly in a 3rd world state. In much of the city (for example where I stayed) there is no electricity, no running water, no wash-water, no toilets. Think through in detail what it takes just to eat food in that situation and you can see that every movement is a challenge. Many people have no way to heat food, let alone boil water for 5 minutes before drinking. The emergency shelters are being moved out of the city itself due partially to the number of cases of diseases related to poor sanitation. The roads in these areas have holes that have half swallowed cars in a moment, roads that are being pre-repaired to look more like country lanes. The CBD is surrounded by military in tanks blocking its entrances. It is routine when entering houses to see a floor covered in glass shards, food, broken plates etc.

You need resilience and absolute clarity about the techniques you are using. This is not a heroic game. I had the sense that right now the kind of trauma support that people need is often not so much dissociation trauma cures as hugging, listening, more water and other realistic help, reassurance that they have done well. The NLP Trauma Process is designed to help people let go of a traumatic response to an event that is no longer there. Symptoms such as anxiety are realistic and normal inside a crisis situation, and do not necessarily need "treatment". For most people they will pass after the danger and challenge itself has passed, provided that some of the above more basic help is available.

That brings me to the next thing. With quakes at 4.7 magnitude today still, the future of each building and of the city in general is not predictable. It’s nice to believe that the city will recover, and I’m sure that eventually it will more than recover; you need to know that people doing building repairs are telling people that it will be years before most repairs are done and telling them that that is a good thing because we do not know what other such events will happen in the next 4 months. This means that there is no safe housing in sight for many people. People are also trying to go back to work… after days of fear, without a bath or shower or a cooked meal or a night of sleep. Many people have just lost their residence, and many at the same time have just been made redundant. To some extent in the south-east city you need an alertness about where to move in an aftershock, what could fall on you and where you could fall, which buildings might not hold up etc.

I had planned to run an Introduction to NLP free talk on the Tuesday after the quake. I let that idea go because it was clear that having large groups (including many distressed people) gather in the dark (with no street lights) driving across town (over roads already clogged and full of hazards travelling for 2 hours each way) to advertise an NLP training is (to me) not a wise idea. It seems frivolous to me. I also accepted that in a month’s time is not a smart time to run an NLP training and bring others into the city, so we are moving our training to another city. Right now, tens of thousands of people are very wisely leaving Christchurch for recovery somewhere else. If you think you can help those who remain, please be careful of yourself, and think carefully about where you will live and how. I know this sounds like a “negative frame”; it’s just that from outside “Helping people with the trauma cure” may look simpler than it really is.

After the earth moves. Thoughts from the chaos zone for NLP practitioners.

Sunday 6th March 2011
By Lynn Timpany
Richmond, Christchurch

I am awake, 4.23am. I realise that I haven't felt an earthquake all night… that worries me. I wonder if the faultline is building up pressure and there will be a big one. I tell myself this is ridiculous. That it takes a few thousand years not a few hours. I feel better, but remember that I didn't put the radio on to recharge and if there's an earthquake I won't be able to hear the radio, again. So I get up to plug it in, and check that the torch is where I thought it was. Like most the people left in the central city area, I find it tricky to sleep. I wonder how to believe that it won't happen again, possibly even worse. All of this seems perfectly rational not anxious. I wonder if I'm traumatised, I don't think so… but as I'm considering that, I have a flashback to seeing my street, a fast flowing river. It isn't much less scary going backwards at high speed! I think, stuff it, if I'm not sleeping I may as well do something constructive, like sort my brain out and write a small article.

After doing a stack of sessions with people since the recent events the most prevalent word was "uncertainty". We don't know if/when another one will happen. Since the earthquakes started back in September I have done only a few traditional trauma cures. The structure of the problems much more frequently generalised anxiety, and also unpleasant conditioned kinaesthetic responses anchored to kinaesthetic triggers.(like trucks going past on the street.) There will of course be those directly effected by the carnage in the central city, but that will be a tiny percentage of those we are likely to encounter doing our NLP sessions.

Any outcome about feeling safe and secure is likely to be problematic, as there's just too much ecology around the reality of the recent experiences and ongoing aftershocks. For many here in ChCh, right now, the idea of feeling safe and secure seems a bit delusional. In the process of writing this there has been around 10 aftershocks, one bad enough to send me under the table, and to throw some of the things off the shelves, that I only put back yesterday.

So, in sessions it's really important to fully address the ecological concerns around any anxiety, with effective meta-level outcomes.

So, as well as the obvious VK dissociation process, these are the kinds of things I've been doing a lot of with clients effected by the earthquakes:

Bridging outcomes:

Goals about responding to the current situation in a way that is satisfying.
"Ideally, how would you like to be able to respond to this uncertainty?"
"How would you need to respond to feel really pleased about how you had coped with this awful situation?"
In a couple of cases asking the values of the current time bridging outcome.
"Whats important to you about how you deal with this?"

Collapsing Anchors:

Especially any kinaesthetic triggers for anxiety.

Useful core questions:

Most people having problems, and also most people getting prepared, are asking "What if.." questions. Again, deal with the ecology of being prepared, and then teach about core questions and help the client pick a good one, and write it down on a card for them, or tattoo it on them, or something that get's them practising. A "how" or "what" question.

Peripheral vision.

Teach clients how to relax using peripheral vision. Tell them to teach everyone else they know, especially children. This is by far the easiest way to relax without butting up against ecological concerns. It's very fast and very effective.

Strategies for dealing with 'stuff'.

Another common response is overwhelm, or generalised stress. These people need a really good strategy for prioritising and chunking down to a manageable step. The strategy will usually work much better if it also includes a great core question as one of the steps. (It could also include peripheral vision as one of the steps.)

For example:
Trigger - Core question →- Imagine the small step/check that it feels ok - do it!
(Whats the first step of the most important thing now?)

Strategies for dealing with aftershocks.

There's lots of people panicking with aftershocks. Having a strategy for a resourcefull reponse helps. (Even a wee plan really helps. For example count to 3, taking breaths, if it's still moving, duck for cover. )

However you do it, support people to have some kind of plan about how they prefer to respond to the ongoing aftershocks and future pace it. Many people are also worried about 20th March, when there is another full moon perigree which may be a high risk time. Future pacing their preferred responses to these concerns is important. I hope that these thoughts help practitioners to feel confident working with earthquake affected clients, even if it's not a usual 'trauma process' type scenario. As a Christchurch resident, thank you so much for your help.

Study this more

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