Positive Health Online

The Research Participants

Earlier this year I wrote here of my research using Neuro-Linguistic Programming (NLP) to help the healing of sports injuries. [1] Now I have the results. To briefly summarise the project: I wanted to see if NLP could help in healing traumatic injuries, especially those that occur in sports. I had six participants in the research. One man had fluid on the knee (bursitis) following a fall while he was running.

Think of a pleasant memory, be associated back inside it, seeing through
your own eyes; you will re-experience the pleasant feelings.

One lady had twisted her knee while doing vigorous Shiatsu exercises, another had torn her shoulder while doing arm movements in an aerobics class. The fourth participant was suffering from chronic tennis elbow, the fifth had been punched on her shoulder in an incident of domestic violence, and a sixth had fallen and hurt her back. None of the participants knew each other, what they had in common was that they were in pain, and prepared to engage in the research. This was a self selected group who were positively motivated.

Mind-Body Healing

All research has assumptions: here are mine. Firstly, I assumed that hurt held in the mind is also held in the body. In other words the mind and body form one system and mutually affect each other. So we affect our bodies by what we think, we are not passive receivers of treatment, we create our health from moment to moment by what we do and how we think.

The placebo effect is one example, where a substance has the effect that the patient expects – a sugar pill can have the physiological effect of a powerful drug, if they think it is a powerful drug. Our minds give many treatments their power to help us. Ways of thinking and acting have been shown to affect longevity, and our reactions to stressful events can trigger many physical symptoms.

Psychoneuroimmunology is the rapidly growing branch of medicine that researches this area of mind-body healing. My hypothesis was that changing the way people thought about their injury would change their physical experience of the pain and suffering and perhaps allow the body to heal more quickly.

Secondly, I assumed that healing is natural, that the body knows how to heal and will do so if it possibly can. Pain is a signal to pay attention. Even inflammation is part of the healing process, its function is to lubricate the damaged parts of the body and bring the immune system cells to the injured site. Often the body sends too much fluid and this is what leads to painful swelling.

Lastly, I assumed that it is important to learn from an illness or injury. It has something valuable to tell us. It is not unhealthy to be ill. These three assumptions were behind the approach I used with NLP. I did not assume that the NLP interventions I used would work by themselves: that would be buying into the model of the patient passively reacting to outside treatment and would disempower them.

Healing depends on relationships between people, not a one-way passage of influence from one to the other.

The NLP Therapy

The participants were first seen by an osteopath to evaluate their injury. They also completed an initial questionnaire – to describe their injury, the treatments they had to date, and the evidence that would show them that their injury was healing, or had finally healed. I also asked them what they thought might prevent the injury healing, and an indication of the discomfort and inconvenience in their life at that moment through the injury, on a scale of one to ten. One meant no discomfort and ten meant it was very great. Each participant had no other kind of treatment while the research was being carried out.

I worked with each participant separately for about an hour immediately after their session with the osteopath. First I helped them to change their mental representation of the injury, so it was no longer held in the body in the same way. I described this procedure fully in my last article. Briefly, it involves changing their point of view of the memory from associated to dissociated. An associated memory is when you are back in the incident seeing it again through your own eyes, and feeling what was there at the time. When you remember in this way, the feelings are still in the body. A dissociated memory is when you are seeing yourself in the incident, from an outside point of view. When you remember the incident in this way the feelings are greatly reduced or absent. You can confirm this for yourself now.

Think of a pleasant memory, be associated back inside it, seeing through your own eyes; you will re-experience the pleasant feelings.

Next, go back and remember it in a dissociated state: see yourself back in the memory doing whatever you were doing. The feelings will be gone. Do it now and you will have an experience that far outweighs the written words of explanation.

After I had taken them through the memory in a dissociated state, I then guided them through the memory of the experience backwards while associated. This seems to reverse the memory of the trauma in a significant way; they relived it backwards, ending at the time before they were hurt.

Next I asked them what they learned from the injury. I believe this is really important. Unless we learn from what happens to us, we are likely doomed to make the same mistakes with the same consequences. After they had said what they learnt from the incident, I asked them to imagine what they were trying to achieve at the time.

No-one actually intended to hurt themselves. I asked them to imagine the incident in the way they wanted it to happen – without injury, and successfully achieving what they were trying to do.

I then invited them to think about an incident where they had hurt themselves, but the injury healed quickly and easily; an experience of how their body heals naturally, a counter example to the injury they were working with now. I found out how they thought of that past, healed injury, the qualities of the picture they made, the sounds that were present, and the feelings they had. These are their healing qualities of the mind. I asked them to contrast these with the sort of pictures, sounds and feelings they had of their current injury that was not healing so quickly and easily.

In every case they was a significant difference: each put the pictures in a different place in their imagination. For most participants, the picture of the healed injury was central and the current injury was to one side. In every case the healed picture had a quality of warmth that the picture of the current injury lacked.

I asked them how exactly they would act differently now, bearing in mind what they learned from their injury. All had good suggestions.

Finally I gave them a short audio cassette tape with a healing visualisation and asked them to listen to it at least twice a week.

Results

Four weeks later they were re-evaluated by the same osteopath, and filled in a final questionnaire. I asked them what differences (if any) they had noticed in their experience of the injury, what was the most helpful and the least helpful part of the project, and to give a further indication on a subjective scale of one to ten of the discomfort and inconvenience they now experienced in their life from the injury.

The results were interesting: each told a different story. All the participants felt positive and enjoyed taking part in the project. All indicated some lessening in the pain and discomfort measured in their own terms. I will briefly tell the six stories.

One man said the research had made no difference to his injury (although he also wrote that the discomfort had fallen from 4 to 2 on his scale), and did not feel he learned anything new. I did notice, however, that he had continued doing the same behaviour that we had previously agreed in the session was aggravating his injury and stopping it from healing.

A second participant had a similar experience – no change. The third participant had a chronic tennis elbow, which she believed was aggravated by a cortisone injection given by a general practitioner that went into the nerve by mistake. The pain from this injection was so intense, she was in agony for two days. Finally, when she sought advice from a medical specialist, he told her brusquely in a two-minute shared consultation that her elbow was severely damaged and surgery was the only hope, yet even this had a twenty percent chance of making it worse post-operatively. She had almost given up hope. When I worked with her, I used the time to resolve the trauma of the injection rather then the original injury.

After the project, her experience of the discomfort had dropped slightly on her scale from five to four, and she was very much more positive and encouraged. She had decided to shun surgery and pursue other avenues. She had done her best to relax, find time for herself during her day, although this was very difficult with two young children, and to make matters worse, her husband had subsequently developed back problems.

The fourth participant had twisted her knee in a vigorous shaking exercise during a Shiatsu lesson. She said there was a definite improvement during the four weeks, her measurement of the discomfort dropped from ten to five on the subjective scale. I was encouraged because the injury was three months old, and this was a significant change.

She felt much more positive, understood clearly what had happened and what she could do about it. She felt empowered by what she had learned about herself. Before she did not know what was wrong and was worried that at her age (she was in her early fifties), there was nothing to be done and she would just have to live with it.

The fifth participant had been punched on her shoulder by her ex husband in an argument about dinner one evening. Although this happened eight years ago, it had always been a problem, and recently was aching much more. She gave it nine out of ten in her subjective scale. When we were going through the trauma process in our hour together, she suddenly realised that she had made a decision at the time the violence happened to hold on to the incident, to remember how badly her husband had treated her. This helped her resolve to separate from him and finally go through with a divorce. And she realised that that also meant hanging onto the pain. Once she realised this, she let the decision go, it had served its purpose. In the next few weeks she reported the pain had almost gone and she could work normally. What she learned from the project was in her own words, 'To think differently, and not to predict the future using negative arguments.'

She realised that she had made a decision at the time of the violence to hold
on to the incident, to remember how badly her husband
had treated her. This helped her resolve to separate from him.

The sixth and last participant had torn a tendon in her right shoulder during an aerobics session two months previously. It was healing very slowly and she measured the pain and discomfort at five on her subjective scale. When we worked towards a healing visualisation in the session, she kept seeing her shoulder as a mass of plastic wires, that worked mechanically, but was lifeless. She did not like this and wondered if perhaps she did not deserve to heal quickly and easily.

I spoke to her four weeks later and she had made some major changes. Her arm was healing well, she was very much happier, and she had learned, in her own words, 'that my state of mind affects the process of healing; when I am happy the injury heals quicker, when I am depressed, or sad, the pain comes back and the injury heals slower.' She said self love was the most important thing she had learned. Before, she had not liked herself very much. I do not know what brought about this profound change, but I hope the work we did together played some part. It reminded me of a beautiful quote from Bernie Siegel, 'If I told patients to raise their blood levels of immune globulins, or killer T-cells, no-one would know how. But if I can teach them to love themselves and others fully, the same changes happen automatically. The truth is: love heals.' [2]

What did I learn from this research? Traumatic injuries are not only in the body. The body is hurt, but both body and mind need to take part in the healing process. Also, I learned how important it is to get information and reassurance about an injury. All the participants appreciated the osteopath explaining exactly what had happened in a way that they understood. Without that information, they felt helpless, it was hard to know what to do to help their healing, and they felt dependant on outside medical interventions that they did not fully understand. With the information, they could take an active part in their healing.

Discussion

I was struck by how beautifully all the parts of the body work together, and how injuries do not happen at random, out of the blue. They have a pattern. The injured part is innocent. It is just the weak link that gives way under pressure, it is not isolated from the rest of the body. When we make extra demands on ourselves, it is this part that feels the strain, and the extra demands come from the goals and ambitions we have. Body and mind co-operate in the injury as well as in the healing. For example, the lady who hurt her knee during Shiatsu had a weak vastus medialis (the muscle that is a major support for the knee). Her work involved kneeling for long periods, and she had a weakness in the leg from an ankle injury that happened ten years ago. She shook her leg very vigorously in the Shiatsu class because all the other participants were younger than her, and she did not want to be seen to be less enthusiastic and energetic than them. Also, the class was taken by a very prominent Shiatsu teacher, and she wanted to work hard for him.

I have made this a short report, but I hope I have kept the uniqueness of each story. Research risks losing touch with real people because it focuses on a question to be answered rather than the people who will answer the question. Even in clinical trials with thousands of patients, every one has a unique story to tell.

Originally I wanted to have a control group for this project – a group who had approximately the same sorts of injury, but who received no treatment. It would have given more convincing results to compare this group with the group that I worked with to see what difference NLP made. I did not have the resources to gather a large enough group to provide a control group. The research, then, gives no convincing evidence that this approach with NLP is effective, However, I think the results are suggestive.

From the NLP perspective, it is difficult to conduct research that would be respectable in peer reviewed medical periodicals. A control group could match the injury, but you cannot control for the person, for each person and every injury is unique, a product of circumstances and behaviour. Also NLP interventions are not like drugs that work 'objectively' on every one regardless of who administers them. An NLP intervention demands a great deal on the skill of the practitioner.

It does not work 'objectively' and independently of the practitioner and the patient in the way that a drug is supposed to. It would be impossible to conduct trials where neither the patient nor the practitioner knows who is receiving the treatment. It is possible however, to do a study so that the evaluating medical professional is unaware who received the treatment and who was in the control group. There is a good study showing the ffectiveness of NLP in asthma. [3]

NLP has four main principles or pillars: rapport with the other person, having a fixed goal, the sensory acuity to notice whether you are on track towards your goal, and the flexibility to change the means you use at any point. Rapport is crucial. When a person is hurt or ill, they need to trust the medical professional and they need emotional support. My goal here was to evaluate the effectiveness of the NLP approach I used, so I was flexible within that goal, even though I used the same intervention on every participant.

I hope this and my preceding article has given you a flavour of the possibilities of using NLP with sports injuries. I will be doing more research in this field.

Further Information

The project is written up in more detail on Joseph O'Connor's world wide web site:www.lambent.com

The book NLP and Health (published by Thorsons) by Joseph O'Connor and Ian McDermott gives many applications of NLP to health. If you are interested in this research and would like further details contact Joseph O'Connor, Sports Injury Research, c/o Lambent Training, 4 Coombe Gardens, New Malden, Surrey KT3 4AA.

References

1. Sports Injuries: healing the memories. Positive Health Issue 17, January/February 1997.
2. Siegel B., Love, Medicine and Miracles. Harper and Row, 1986.
3. Lund, J. and H., 'Asthma Management' a qualitative research study presented at the congress of the European Respiratory Society, October 1994.