ME, NLP and LP by Nancy Blake Feb 2018 PostiveHealthOnline

[Countrygirl]

http://www.positivehealth.com/artic...nd-the-lightning-process-in-the-looking-glass

This is an interesting article by Nancy Blake, psychotherapist, NLP practitioner and ME sufferer that she wrote following the SMILE trial.

ME/CFS, NLP and the Lightning Process™ in the Looking Glass
by Nancy Blake(more info)

listed in cfs me, originally published in issue 244 - February 2018

Introduction


The purpose of this article is to provide an explanation of the theoretical model and practical processes underlying both appropriate and inappropriate use of NLP in the treatment of patients with ME/CFS.

The timing of this article has been influenced by recent publicity about a research paper by Crawley et al[1] which purports to supports the use of the Lightning Process™, in addition to Specialist Medical Care, to treat ME/CFS in children between the ages of 12 and 18. The Lightning Process™ is described by its developer as based on Osteopathy, NLP and Life Coaching.

There has been a recent decision to review the NICE Guidelines for treatment/management of ME/CFS, and it is not unreasonable to speculate that evidence for the effectiveness of this trade-marked treatment might be used to support recommending its use, paid for by the NHS, in a revised Guideline. The use of psychological therapies in ME/CFS, which the recent Report by a Committee of the US IOM[2] describes as a serious, complex multisystem disease, not psychogenic, is naturally a cause for controversy.

ME/CFS is generally recognized as an illness in which exercise “exacerbates symptoms”, and it has always seemed illogical to prescribe exercise as a treatment.[3]

The first and last sentence of this article’s abstract epitomize this paradox::

“Severe exacerbation of symptoms following physical activity is characteristic for chronic-fatigue syndrome (CFS) and fibromyalgia (FM). These exacerbations make it understandable for people with CFS and FM to develop fear of performing body movement or physical activity and consequently avoidance behaviour toward physical activity”.





Quote from The Doctor's Dilemma published by Stonebird

In words of one syllable, people who have ME/CFS avoid physical activity because it is followed by severe exacerbation of their symptoms. Avoiding something that makes you sicker seems sensible, and one might expect a responsible physician to recommend [avoiding] it.

But no.

“Individually tailored cognitive behavioural therapy plus exercise training, depending on the patient's classification as avoiding or persisting, appears to be the most promising strategy for treating fear of movement and avoidance behaviour toward physical activity in patients with CFS and FM.”

We want our patient to overcome his (justified) fear of physical activity, and suggest a therapy aimed at changing his belief (in the fact that physical activity makes him sicker), and add ‘exercise training’. [3]

(Then we can take our diabetics, convince them that they don’t have diabetes, and help them practise eating sugar. Lung cancer patients can be taught to overcome their fear of smoking. Children can be helped to overcome their fear of running out into traffic. Why should these people limit themselves just to ME/CFS when there are so many other possibilities for applying this approach?)

Now that the US IOM have further asserted that the defining feature of this disease is that “exertion, of any kind – physical, cognitive or emotional – may adversely affect many organ systems”, it seems that any management pathway intended to “increase activity levels” must be harmful.[2]

Nevertheless, the UK medical community seems determined to persist in such recommendations. A recent decision not to review the NICE Guidelines was reversed following a patient petition to have the NICE Guidelines reviewed which gained more than 15,000 signatures. However, the experts who will be consulted have not been named, which is unusual. The advocacy community wonders whether this is because the panel will consist, as in the past, mainly of people who support the psychiatric model (including, possibly, Prof. Crawley), rather than other medical researchers in the field.

Ethical or Unethical?

Now suppose you have a broken leg, and I am so good at NLP trance induction that I can stop you feeling the pain.

If I do this, so you start walking on it and don’t bother to get it set and in a cast, you are going to end up with a terribly deformed and constantly painful leg. Ethical?

IF I do this to help you and the doctor have an easier time while he sets it correctly and puts it in plaster that is holding it precisely in the right position, I’ve improved your chances of a full recovery. The same process, used ethically.

If your broken leg has completely healed up, but you are still a bit scared it will hurt to walk on it, it is appropriate for me to offer you reassurance that it won’t hurt, and encourage you to try walking on it. (Rehabilitation after successful treatment.). If it’s not healed, and still hurts and is vulnerable to damage, rehabilitation will be harmful.

There is an NLP process called an ‘ecological check’. This is to make sure that whatever process you are using to help with a particular problem or goal is not going to do harm in some other area of the person’s life. (Don’t cure a snake phobia until you’re sure your client knows what a poisonous snake looks like.) In a medical situation, this means making sure that what you are doing is based on an an accurate understanding of the medical situation. If you use NLP techniques to get rid of a headache that is caused by stress, that will probably be fine. If you use NLP techniques to get rid of a headache that is caused by a brain tumour, your ‘help’ may mean the patient doesn’t bother to get it properly diagnosed, and could cost him his life.

If you have a viral illness, your immune system needs all your energy to fight it. It is appropriate for me to reassure you that it is fine for you to go to bed, you have a good chance of getting better more quickly if you rest. If you feel guilty about it, it is appropriate to help you get rid of that guilt by telling you that it would actually be more harmful to go back to work and risk everyone else catching it than for you to stay home and rest.

It is not appropriate for me to tell you you’ll be fine, just keep on doing your normal stuff, don’t give in to it. This will prolong the illness and risk making it worse.

The judgement about the use of NLP for the treatment of ME/CFS hinges on whether we believe the psychiatric model…that the original viral illness is completely over, and exercise is avoided because of irrational fears…or the medical model which observes the continuing relapses following exertion and concludes that this is evidence of a continuing latent infection.

Caveats about the Lightning Process™

 

[Dolphin]

Now suppose you have a broken leg, and I am so good at NLP trance induction that I can stop you feeling the pain.

If I do this, so you start walking on it and don’t bother to get it set and in a cast, you are going to end up with a terribly deformed and constantly painful leg. Ethical?

If you use NLP techniques to get rid of a headache that is caused by a brain tumour, your ‘help’ may mean the patient doesn’t bother to get it properly diagnosed, and could cost him his life.

I think these are useful distinctions.

The judgement about the use of NLP for the treatment of ME/CFS hinges on whether we believe the psychiatric model…that the original viral illness is completely over, and exercise is avoided because of irrational fears…or the medical model which observes the continuing relapses following exertion and concludes that this is evidence of a continuing latent infection.

 

[Dolphin]

The presuppositions of the Lightning Process™ are the ones which underpin Cognitive Behaviour Therapy and Graded Exercise Therapy: that ME/CFS involves only thoughts and beliefs which, if changed, can result in recovery. The patients’ belief that there is an underlying physical cause, and that exertion can do actual damage is considered to be false. Treatment, therefore, can be successful if (and only if) this belief can be eradicated.

The Lightning Process differs from CBT/GET in that adds the use of NLP techniques to change beliefs and encourage the patient to give up his protective energy-conserving behaviour, his physical aids, and enthusiastically engage in exercise.

This would make it very effective indeed if the patient’s symptoms were caused only by unhelpful thought processes.

It makes it potentially harmful if the patient’s problems are in fact caused by a pathogen which is stimulated by exertion, and which the immune system can only fight effectively if the patient rests so that all his physical energy is available for the immune system.

 

[Dolphin]

In relation to ME/CFS, what are the ‘impossible things’ one must believe (and what must one refuse to believe) in order to maintain the view that ME/CFS is, in Simon Wessely’s words, “nothing more than the belief that one has (ME)”?[4]

[..]

You have to believe that people with no previous history of a mental health problem or of undue complaining about their health, and no preceding traumatic event other than a mild flu can become completely incapacitated within days, and continue to be so, simply because of negative thought patterns about minor symptoms.

You have to believe that intelligent, highly educated, successful professional people, including professional athletes, can suddenly, for no apparent reason, become extreme hypochondriacs, whose reports about their illness are either false or exaggerated.

You have to believe that for such people, the ‘secondary gains’ of assuming the role of invalid are somehow greater than loss of their profession, their income, their home, and often their families.

You have to disbelieve what patients report about their experience, even though patient descriptions of this very complex disease are similar across historical periods and disparate geographical locations. Patient experience, although varied in some ways, consistently reports that exertion brings on worsening symptoms, and that continued exertion brings on more permanent and serious relapse.

You have to believe that encouraging or coercing patients into doing something which is known to make them worse is a ‘safe and effective’ way to cure their illness.

 

[Mithriel]

These basic beliefs are very profound. They are a complete answer to the biopsychosocial people. We are continually drawn into convoluted arguments about mind body dichotomy and every disease having a psychological component. We exhaust ourselves getting tied up in the statements they throw into the discussion (to confound us deliberately I am sure) but we have to keep bringing the argument back to what is important to us and that is what their answer is to this set of assumptions and demand to know why they are valid.