Healing The War Within: NLP And The Treatment Of “Borderline Personality Disorder”
by Richard Bolstad and Margot Hamblett.
Your Therapy Won’t Work With Me!
When people are depressed or anxious, they often seek therapeutic help. When people are psychotically out of touch with “reality”, others often seek help for them. But when someone is angry or hyper-critical (with themselves and others) they don’t necessarily believe they need help, and others don’t necessarily want to help them. If they do seek help, their therapists frequently wish they hadn’t, because their “critical”, “hostile”, “resistant” approach quickly emerges in response to the therapy itself. Over and over, they communicate to the therapist that “Your therapy is bullshit, and your tricks won’t work with me!”
Early on in our work with NLP, we naively believed that NLP change processes would work with all our clients much as they did with us. The clients would do the process, and then they would change, and then they would thank us and leave. Instead, a small group of people told us that none of the processes worked, that NLP was just a set of tricks, that they felt really angry with us for promising things we didn’t deliver, and that they wanted to come back and do some more. We apologised and tried to do better (which made the problem far worse). Since then we’ve learned to detect such responses earlier and respond in ways that quickly enable these people to turn around 180:.
Searching for a name that isn’t too blatantly insulting, psychiatrists have tended to call such people “personality disordered”. The DSM-IV‒2 (American Psychiatric Association, 1994) defines personality as an enduring pattern of relating to the self and environment, and a personality disorder as any such pattern that results in personal distress or social impairment. It lists nine types of personality disorder, which together apply to around 6% of the population (Crits-Christoph, 1998, p 545). It’s important to understand, firstly, that just because a disorder is listed by the DSM-IV‒2 does not mean it actually “exists”. A map is not the territory, even when that map is made by the American Psychiatric Association. Dr Paula Caplan was a consultant to the Personality Disorders Work Group of the APA. She writes a fascinating story of the on-again-off-again existence of a personality disorder called “Self Defeating Personality Disorder” (describing people who put others needs ahead of their own and then feel aggrieved and unappreciated). Caplan criticised the inclusion of this disorder in the DSM because it had contradictory research behind its inclusion, and because it could be used to dismiss abused women as psychiatrically disordered. Finally, in a compromise, the APA included the “disorder” in a DSM-IV‒2 appendix of disorders “requiring further research”. This means that psychiatrists can use the label, but that there is inadequate evidence for its existence (Caplan,1995, p 205-209).
The focus of this article is on helping persons who would be diagnosed by the DSM-IV‒2 with “Borderline Personality Disorder”, defined by emotional impulsivity, instability, emptiness and anger at both self and others. Much of what we say here will also be useful in work with persons diagnosed with Dependent, Antisocial, Histrionic, Narcissistic or Obsessive-Compulsive personality disorders. The term “Borderline”, by the way, referred to an old, pre DSM belief that someone with this disorder was on the borderline between sanity and insanity.
What’s So Fucking Wrong With Being Borderline?
In NLP terms the core characteristic of the person who gets diagnosed with BPD (“Borderline Personality Disorder”) is a severe sequential incongruity. In external relationships this is expressed in swings from idolising another person and desperately wanting to be with them, to despising them and wanting to escape the relationship. In the person’s relationship with themselves it is expressed in swings from apparent arrogant self promotion to self-hatred and disgust. Cognitively, this means constant polarity responses; the person mismatches their own and others’ experience continuously. Emotionally this creates confusion about who they are and what they want, resulting in feelings of frustration, anxiety, depression, emptiness and hopelessness. The person’s final behaviour may be deliberately self destructive (eg suicide attempts, self mutilation), destructive of others (eg physical fighting, smashing objects, explosive shouting) or dangerously impulsive (eg drug abuse, binge eating, reckless driving). It is as if they are at war with themselves, and with anyone else who gets in the way of this primary target.
People with higher “hostility” scores on the widely used Minnesota Multiphasic Personality Inventory (MMPI) are more likely to smoke, drink alcohol excessively, be obese, have high cholesterol levels, and consume more caffeine (Williams and Williams, 1993, p 80). They are also five times more likely to die before the age of fifty (Williams and Williams, 1993, p 54). This fits with the results we see in persons diagnosed with BPD. 56% have anxiety disorders, 41% have a major depression (Crits-Christoph, 1998, p 545) and 69% have an addictive disorder (Santoro and Cohen, 1997, p 90). These other problems, which may first bring the person to an NLP therapist, are also harder to change using cognitive (NLP style) therapy when the person has a BPD diagnosis (Crits-Christoph, 1998, p 549), because they mismatch the therapy process itself.
Why Does This Shit Always Happen To Me?
Research so far rules out even a genetic component in the development of BPD (Crits-Christoph, 1998, p 546). Neurological studies show that the BPD person has more right brain activity (perhaps more emotional processing than logical processing) and an over-responsive noradrenaline system. But that’s just another way of saying they’re angry! The most significant thing known about the origin of the problem is that 70-79% of these people have suffered severe physical or sexual abuse or endured serious trauma in very early childhood (Crits-Christoph, 1998, p 545; Santoro and Cohen, 1997, p 4). Traditional psychotherapists have proposed (Kernberg, 1986, p 142) that during these traumatic early events, healthy repression (we might say in NLP terms, healthy dissociation) was not possible because the child had not developed the skills to manage it. Instead, the state dependent memory of each traumatic event has been fully split off from the rest of the personality. The result is a vast array of parts conflicts. For once, this psychoanalytic proposal fits an NLP frame exactly!
The problem is what to do about it. Results of treatment with antidepressant, anti-anxiety and anti-psychotic drugs has at best been inconsistent, at worst useless (Woo-Ming and Siever, 1998, p 562-564). Behavioural therapy has been shown to reduce impulsive behaviour but not the emotional instability of people with BPD (Crits-Christoph, 1998, p 547-548). Interestingly, one study revealed that 12 months after a year of psycho-dynamic therapy (based on the “Self Psychology” model) 30% of clients no longer met the BPD criteria (Crits-Christoph, 1998, p 548). This is an impressive result, and emphasises several points that Cognitive Therapists (therapists using techniques similar to NLP) have made about the disorder. They describe it as an Identity level disorder (Layden et alia, 1993, p 7) based on core beliefs about the self, such as “I am unloveable”, and “I am broken”. Because the person believes that “This is who I am”, they resent therapeutic attempts to change less central beliefs such as “I can’t manage this particular task”. They are inclined to say “If you think a person like me can change that, you don’t know how serious this is!” The Self Psychology model (Kohut, 1971) sees problems such as “borderline personality disorder” as resulting from damage in the healthy development of a “love of self”. The model holds that when a 3 year old child says “Look at me! Aren’t I great!”, a functional parent will often respond by mirroring this excitement (eg “Wow; that’s amazing!”). If the mirroring available is seriously inadequate, the child becomes fixated at this “level of development”. By creating an empathic environment, the practitioner of Self Psychology also aims to create a relationship in which the person can explore their swinging between idealisation of others and grandiose, self obsessed rage, and grow beyond their child-like responses.
Cognitive therapists point out that the person with BPD has whole areas of their life where they function in a successful, adult way. On the other hand, the state dependent memories which have been split off (the “parts” generating the BPD symptoms) function with a thinking style similar to that of a pre-school child. Even the sensory system used to store the traumatic responses is determined by the early age of the events which created it (Layden et alia, 1993, p 28-33). Events before age 12 months are usually stored kinesthetically and auditory tonally, and events before age two years are stored kinesthetically, auditory tonally and visually. Only after this time does effective auditory digital information get layered into the memories. Mary Anne Layden and colleagues recommend using kinesthetic experiences (such as relaxation and kinesthetic anchors), guided visual imagery (such as the NLP trauma cure), and techniques based on voice tone (eg trance) to access and heal the earlier memories.
Don’t You Tell Me I Mismatch!
The key metaprogram/strategy variables in a person being diagnosed as Borderline Personality Disordered include:
- Sort by self. The person is convinced that everything happening is happening for them. This leads at times to paranoia (“Why did you say that? What are you trying to tell me.”). At other times it leads to interpersonal conflict (“You knew I didn’t want you to do that. Why did you do it?”). The person is not fully separating out first and second position, to use one NLP description. In communication theory terms (Bolstad and Hamblett, 1998, p 73-77) they have confused problem ownership, and in traditional psychotherapy terms, they have “diffuse boundaries”.
- Mismatching. The person sorts compulsively for what they disagree with, and what doesn’t fit. Generally, this means they are continuously aware of how life doesn’t live up to the ideal. In therapeutic relationships this results in them identifying even very small differences between what a therapist said and did (“You said you’d tell me the truth; how come you never mentioned before that you… Much of the person’s auditory digital processing is taken up with mismatching themselves (telling themselves off). Originally in their early life, mismatching was an important skill that protected them from being totally overwhelmed by powerful others. Now, it has become an uncontrollable reflex response to almost every event. Let’s be clear that sorting for differences (mismatching) by itself is not a problem. On the contrary, it is a useful skill, and the source of creativity. The problem is when any metaprogram becomes compulsive.
- Chunking Across. Part of the process of compulsive mismatching involves what is called in cognitive psychology “transductive reasoning” (Layden et alis, 1993, p 38). As the person leaps from one state to another, and one opinion to another, they fail to chunk up and identify general principles behind these separate events. There is a lack of meta-analysis, and, to use Meta-State terminology, an absence of meta-states such as a strong sense of self (Hall, 1996)
- Either-Or Thinking. Another result of compulsive mismatching and polarity based thinking is to perceive things as either perfect or ruined. (“My haircut was a disaster today. I’m going to kill myself.”). This is connected to chunking across, because the person has no chunked up category to experience the specific event as “a part of”. In the example, the haircut is all there is. There’s no “self” above and beyond the events of the moment, so that the bad haircut is the only evidence of self to measure success by. In the person’s strategies to check “Am I loveable” or “Am I competent”, at the Test phase only the immediate evidence is assessed. The danger in relation to other people is that one “mistake” can provide enough evidence to the person with BPD that their very life is threatened by this other human being.
- Present Temporal Focus. The previous example demonstrates how the person assesses most decisions by reference only to the present moment. (“Do I want to use this heroin? Why not? It’ll stop the pain right now!”). They respond based on the principle “Out of sight; out of mind”. In developmental terms, this is described as “lack of object permanence”. The same process often creates anxiety about relationships, because as soon as the other person in the relationship leaves the room, the person with BPD feels abandoned. It also results in the person having what NLP calls a Consistent Convincer strategy, where they never feel fully convinced by what they have experienced previously. In traditional therapy this would be called a “lack of trust”.
- Away From Motivation. Many decisions, such as decisions to commit suicide or use drugs, are a result of moving away from pain without any evaluation of what the person actually wants instead.
- Sequential Incongruity. The combination of the above metaprograms makes it more difficult for the person to hold in their mind two differing responses (eg being annoyed at what someone did, at the same time as loving them). Such polarities are experienced sequentially, each one mismatching and moving away from the previous response. The person frequently feels split off from (“positive” or “negative”) parts of their own experience.
Help Me Change (But Don’t Make Me Do Anything Different!)
The system described above is a very resilient one! It had to be, to enable the person, with the limited resources of a young child, to survive severe trauma. Furthermore, the person does not identify this personality system as their problem. Their problem is anxiety, frustration, emptiness, depression, or even the endless succession of absolute bastards who seem to intrude on their life. The first step in helping them to get lasting change is for you as an NLP Practitioner to identify their extreme mismatching style. The second step is to set up a consulting relationship in which you have permission to help them identify and change this style, which actually generates the unpleasant states they want to change.
A man we’ll call Bob came to one of our weekend trainings. At all our trainings we have people do a visualisation exercise near the start. They turn around and point behind them with their arm, and then come back to the front. Next they imagine themselves going further, and notice what they would see, feel and say to themselves if their body was more flexible and they could turn around further. Then they turn around again and notice how much further they go (Bolstad and Hamblett, 1998, p 81). Unlike 99% of people who’ve done this with us, Bob wasn’t impressed. Here’s how his conversation with Margot went next:
Bob: Well, I think I went further the first time. It didn’t work for me at all.
Margot: That’s right, it didn’t; because you didn’t do the process the way I described it. I said to imagine what it looked, felt and sounded like to go further, and you talked to yourself inside about how this probably wouldn’t work for you….Right?
Bob: Hmmm. Probably. Yeah, I guess so.
Margot: And that’s probably the way you’ve been doing a lot of other things too. You’re already good at talking skeptically to yourself. If you want to get a different result in your life, then it’s worth using these exercises the way we actually describe them, and only do what we describe. You just did more work than you needed to. Now lets do that one more time, the new way.
What we have done here, with this pointing process, is to provide an opportunity for mismatching, before we get to doing the central change processes. This acts as a “mismatching detector”, and we use the same process regularly with individual clients. We know that, in order to mismatch the instructions given, the person needs to overide the internal visual/auditory/kinesthetic representation suggested. The most likely way to do that is by talking to themselves, which Margot was able to then draw the person’s attention to. Margot’s next comment asks the person to mismatch their mismatching. She says that if they keep mismatching, then they are just doing the same old thing every time. The only way to mismatch is follow our (new) method.
This is actually a very simple application of the technique Milton Erickson identified for use in this situation. He says (Erickson, 1980, p 301): “When sufficient material has been obtained from the aggressive, hostile, antagonistic, defensive, uncooperative patients to appraise their unfortunate behavior and attitudes and to judge their type of personalities, they are interrupted by an introductory paragraph of mixed positive and negative, seemingly appropriate and relevant remarks addressed to them in that form of language they can best understand at that moment. However, concealed and disguised in these remarks are various direct, indirect, and permissive suggestions intended to channel their reactions into receptive and responsive behavior.”
So What’s The Deal?
We tell the person explicitly that they need to change their metaprograms in order to get the results they want. In doing so we are setting up a very specific type of “therapeutic alliance” (to use the traditional term) which we would describe as consulting. We want to be the person’s consultant, not their “counsellor”. In this arrangement, we will make suggestions as to processes which they could use to change. If they follow these processes, they will, we believe, get the results they want. If they want to keep us hired as a consultant, they need to actually follow the recommendations. We emphasise that processes must be followed precisely, to get the desired results. This consulting arrangement needs to be very clearly described before we start “formal” NLP interventions (if we ever do). Consistently, we have found that the person with BPD is able to be more resourceful when helping someone else to change, rather than when trying to change themselves. We teach them to utilise this resourceful helping state by becoming their own therapist. We simply provide supervision of their therapy.
For example, in helping a person learn to sort for what is going well in their life we may ask them as a task to take time each evening and identify 3 things that went well in their day. We usually say that we’ve had people come back and tell us that they tried this task and it just made them feel bad. What we then found out was that they didn’t do the task the way we told them. For example, they thought of the first thing that went well, and then thought about how hard it had been to think of that one thing, and then worried that they might not be able to think of two more, and then wondered what that meant about them as a person. Then, understandably, they felt bad. But they had not done the task we gave them.
In order to be this “confrontational”, we need to do two other things simultaneously. One is to use rapport skills (subtly, because the person is on the alert for “NLP tricks” and will mismatch body posture if they detect attempts to match). The second thing is to genuinely tell the person what behaviours they have done that indicate to us the functional areas of their life. This is different to saying “You’re wonderful”, a claim which would directly contradict the person’s Identity level beliefs (Layden et alia, 1993, p 60). We might say “I was impressed with the time you spent helping other course participants. It made our job easier.” This positive feedback is itself a model of the sorting for positives that we want the person to learn. Even when the person disparages it, it still has usefulness as a genuine feedback, and as an example of how we come to believe that the person can change.
There are limits to our help as a consultant. Often, these limits actually exclude us from taking the person through standard NLP processes, where they would have the opportunity, or even the compulsion, to mismatch us. On occasion we have found it more useful to have the person run their own NLP processes, with one of us as a coach. Instead of saying, “See yourself in a movie theatre, and move back to the projection booth” we say, “Here’s how the NLP Trauma process works. Now, just run that through by yourself until you’ve solved the problem, and come back and check in with us then.” Certainly, we need to set limits on how much time we are willing to spend with this person, who, remember, is capable of demanding and dismissing “endless” convincing and reassurance. Our aim is to model new strategies, such as self-reassurance, and then have the person run these strategies themselves.
The following change processes are only applied within the context of the consulting relationship described here. With them, we have found that many “personality disorders” can be reversed in weeks rather than years. If we do not set up this relationship at the start, however, we have sometimes found that we lost the ability to help effectively, because our presence became a powerful trigger for mismatching.
1. Crisis Intervention
The person may have first contacted you for help in a crisis, where they are experiencing extreme anxiety, depression or frustration. See our previous articles (Bolstad and Hamblett, 1999, A, B and C) for models for dealing with the first two types of response. As we say in previous articles (Bolstad and Hamblett, 1999, B) it’s appropriate for you to check how far along the track of suicidal thinking the person may have gone, and what violence the person has previously been involved in or contemplated.
Assess for yourself whether you feel safe working with this person. Being a consultant is different from being a martyr. You have a right to ask that during the time of your consulting the person commits themselves to staying alive, and to taking time out from being with others if they feel anger escalating dangerously. Making these contracts work requires rehearsing the person (and possibly others who live with them) through the process of getting help in a crisis. We often ask the person, while they are in the session with us, to practice contacting a support person by phone. Ultimately, you as a consultant cannot make a person stay alive, or guarantee that they won’t injure others. However in most countries you are legally responsible for having taken all reasonable steps to keep your client and others safe. If this is unfamiliar territory for you, talk to a counsellor for whom this safety process is familiar.
2. Accessing Resources
A major aim of work with a person diagnosed BPD is to generalise skills from areas of their life that are functional to areas where their unresourceful states are triggered (Layden et alia, 1993, p 38). The challenge is that even to begin talking positively is an art with the person who mismatches. Yvonne Dolan (1985, p 29-43) discusses a number of ways to do this without triggering mismatching behaviour. These include the use of interspersed embedded suggestions and presuppositional language. Perhaps the most famous example is Milton Erickson’s comment to an angry youth diagnosed with personality disorder “How surprised will you be when you find next week that you’ve completely changed?” (to which the young man replied “I’ll be bloody surprised!” thus accepting all the positive presuppositions in Erickson’s comment). Dolan explains her method of using such language within metaphor to enable the person to make internal representations of enjoyable experiences, without feeling that they are “required to” as part of some “technique”. Such enjoyable experiences can be anchored and reaccessed later in the session.
Even direct utilisation of the person’s most obvious resources can make a significant difference. Dolan tells the story of Alice, a 25 year old with a history of violence and suicide attempts (Dolan, 1985, p 146-149). While she refused to discuss “therapeutic” topics with Dolan, Alice eagerly discussed her interest in craft and needlework”. Dolan told her “You can really find a way to use all your abilities in a way that lets you win.” To which Alice’s response was characteristically “You’re nuts!” However, she began to smile and interact socially more frequently after this, and then excitedly came in one day to announce that she had found a job as a bouncer in a rough local bar. Her previous skill at fighting served her well! Within a year she was working in the same bar as a bartender, and had begun a college degree in Psychology.
3. Developing The Ability To Match and Move Towards
Teaching the person to sort for agreement and positive results is an important base from which change processes can actually work, rather than being incorporated into a long line of failures. Dolan explains (1985, p 50-57) how to convert a person’s habitual “No” responses to “Yes” responses by the careful use of restating the client’s disagreement and concluding with a negative tag question. If the person says, for example, “I’d rather just give up on this.”, the NLP Practitioner might reply, “You’d rather NOT be here?” or “There are lots of better places to be, are there NOT?”
However, in our experience, mismatching can be directly confronted and reframed as a choice which, while important in childhood, is now being overused. We set the person the conscious task of deliberately sorting for agreement, by asking “What is going well for me?” and “What do I agree with here?”. We will frequently ask the person to refrain from discussing any negative responses or experiences for certain time periods, making a commitment to discuss only what is going well and what they agree with. Solution focused therapy questions also focus our conversation in this direction. Three types of Solution focused questions can be used to elicit such times (Chevalier, 1995).
1. Ask for a description of the person’s outcome.
“What has to be different as a result of you talking to me?”
“What do you want to achieve?”
“What would need to happen for you to feel that this problem was solved?”
“How will you know that this problem is solved?”
“When this problem is solved, what will you be doing and feeling?”
2. Ask about when the problem doesn’t occur (the exceptions).
“When is a time that you noticed this problem wasn’t quite as bad?”
“What was happening at that time? What were you doing different?”
3. If there are no exceptions, then ask about hypothetical exceptions using the “Miracle” question: “Suppose one night there is a miracle while you are sleeping, and this problem is solved. Since you are sleeping, you don’t know that a miracle has happened or that your problem is solved. What do you suppose you will notice that’s different in the morning, that will let you know the problem is solved?”
After the miracle question, you can ask other follow-up questions such as:
“What would other people around you notice was different about you?”
“What would other people around you do differently then?”
“What would it take to pretend that this miracle had happened?”
Auditory digital mismatching of NLP processes, as they are run, can be interrupted in a number of ways. One is to have the person restate the therapist’s instructions to them in their own internal voice. Another is to overload the internal auditory digital channel by having the person count down from 1000 in steps of seven, while the process is being run. We have found clients extremely excited to find that techniques actually work for them once they employ their auditory digital process in a useful way, rather than in self criticism.
4. Healing Early Trauma
Use the standard NLP techniques for healing trauma, such as the Dissociation Trauma Cure (Bolstad and Hamblett, 1998, p 109-112, 118-120), Time Line Therapy. techniques (James and Woodsmall, 1988) and Reimprinting (Dilts, Hallbom, and Smith, 1990). These techniques address what both cognitive psychology and self psychology agree is the original problem in most cases of borderline personality disorder. However, these techniques will only be successful once the consulting relationship has been established, and mismatching has been effectively dealt with. Visualisation and anchoring meet the requirement of accessing non-verbal methods for change in BPD, as referred to by cognitive psychologists (Layden et alia, 1993, p 86-94). These techniques also give the person temporal flexibility (the ability to look into the past, present and future), which is a key to healing depression and anxiety as well as impulsive behaviour (see Bolstad and Hamblett, 1999, D, p 6).
5. Teaching The Person To Chunk Up And Integrate
The Parts Integration process and the Core Outcome process (Bolstad and Hamblett, 1998, p44-49) are important choices in enabling the person to integrate split off areas of the neurology which have been operating separate from the resources the adult person has access to. They involve asking the person to identify the higher positive intention of any split off part. In order to answer the question “What do you get through that behaviour? What higher intention does it serve?” the person has to chunk up and generalise, rehearsing themselves through an important skill which is often underdeveloped in the person diagnosed with BPD.
Because these split off “parts” have previously expressed themselves sequentially, one challenge in integrating them is to ensure that they are available and accessed ready for integration. The person as an NLP “client” is often so good at accessing their resourceful states in the session that they don’t really have full contact with the “parts” that generate damage in their life. As a guide, it’s useful to check that you have in fact re-accessed fully the part that was separated out (eg by having the person step back into a time when that part “that caused the problems” was running things).
6. Teaching Clear First And Second Position
This will usually come up as a priority in terms of managing the consulting contract between the NLP Practitioner and the person diagnosed with Borderline Personality Disorder. This relationship provides a great opportunity for both people to develop more effective ways of experiencing relationships in general. We teach the person the problem ownership model from our Transforming Communication course for co-operative relationships (Bolstad and Hamblett, 1998, p73-77). This model is most important for the NLP Practitioner to have on board too, as we discuss in the following paragraphs. NLP Practitioners who lose track of problem ownership put themselves at risk of various sorts of destructive relationships with clients (confusing sexual relationships, explosive conflicts and ever-more-frantic attempts to “rescue” the client from their own personality, being examples).
Clients who are upset, worried, resentful, frustrated, angry, fearful, or otherwise unhappy with either the consulting situation or some personal issue are said in these terms to “own a problem”. The appropriate approach for the NLP Practitioner is to shift into second position (thinking from the client’s perspective). This includes using skills which maintain rapport (matching the client’s behaviour, acknowledging their concerns, and listening). It also includes using verbal skills which help the client clarify their outcome and safely create their own solutions. Advice giving, criticism, lecturing, interrogating and other directive skills, which may be quite safe in the no-problem situation, are not appropriate first responses when the client gives signals that they “own a problem”. They will meet resistance. The two most effective verbal skills for the NLP Practitioner in this situation are reflective listening (eg “So the problem you’re experiencing is…”, “You want to…”) and open, solution-focused questions (eg “What would it take for you to have solved this?”, “Can I just check, what needs to be different here?”).
On the other hand, when we as NLP Practitioners are upset, worried, resentful, frustrated, angry, fearful, or otherwise unhappy with either the consulting situation or some personal issue, we could also be said, in these terms, to “own a problem”. This doesn’t mean it’s our “fault” -simply that we are the ones who need to get something changed. When my problem is with some issue unrelated to the consulting situation, I use my own solution generating skills to solve it. But when my problem is related to some behaviour of a client’s, I will of course choose to communicate to them in some way. In this case, I am responding from first position (thinking from my own perspective). Advice giving, blameful criticism, lecturing, interrogating and similar skills are again not very effective. The most useful verbal skill for the situation where I “own a problem” is to describe my problem clearly. In doing this, I will give the client information about the sensory specific behaviour that has generated the problem, rather than my theory about their internal intentions or my judgement of that behaviour. Instead of saying “You were careless about our agreements”, I’d say something more specific such as “You arrived half an hour after the arranged start time for this session.”. I can also tell them about any concrete effects the behaviour has on me, and about the nature of the undesired state I’m in. My communication will thus be an “I” message, using a format such as: “I have a problem I’d like some help with. When… The effect on me is… and I feel…” (For example; “I have a problem I’d like some help with. When you arrive late to the session, I find I need to re-plan what we’re doing. I get quite frustrated.”).
In real life, problem ownership is constantly changing. In the middle of assisting a client to solve her relationship problems, I may discover that she has values and attitudes which I deeply resent. I need to monitor the situation, to identify when it becomes appropriate to shift from reflective listening to I message. Certainly, if I send an I message, my client may well feel uncomfortable about that; they may even feel “angry”, “humiliated” or “insulted”. Therefore, before re-sending or re-explaining my I message, I now need to respond to this new client problem with reflective listening. I do this until the client indicates that they feel understood (usually by nodding). We are then back in rapport enough for me to send a revised I message. The result is a kind of “dance” which we term “the two step”, and which leads towards win-win conflict resolution. This dance moves clearly between second and first positions, in NLP terms. Here is an example:
NLP Practitioner:
“There’s something I wanted to mention before we start. The last two sessions we’ve started half an hour later than arranged and I’ve needed to replan what we’re doing. It’s starting to frustrate me.” [Practitioner describes her problem in an I message, from 1st Position]
Client:
“Shit! So now I have to clock in or get my pay docked? What is this crap!” [Client indicates he now owns a problem, having heard the I message]
NLP Practitioner:
“You think I’m being over the top” [reflective listening, from 2nd position]
Client:
nods [feels understood and so is back in rapport]
NLP Practitioner:
“Well I guess it may seem silly. I want to find a way to get the feeling that we’re achieving what we plan to.” [re-sending a modified I message]
Client:
“Well I just can’t handle this. It’s like school. Sometimes I have a bad day, and I don’t find it easy to get up for these early morning sessions.” [Client indicates he still owns a problem]
NLP Practitioner:
“It’s the morning sessions that make it most difficult?” [reflective listening]
Client:
nods [feels understood and so is back in rapport]
NLP Practitioner:
“Okay; I’d really like to solve this so that it works for both of us. So one way would be to change the time of the sessions. What other solutions would work for you?” [Beginning win-win conflict resolution]
Summary
As this last interchange demonstrates, helping a person diagnosed with borderline personality disorder and other mismatching personality responses is often personally challenging. However, since using the model described here, we have found it far easier to invite these people on board and enable them to benefit from the richness that NLP changework offers. Many of these clients have expressed profound gratitude for the personal transformation they have then initiated. They have shifted from feeling despair about their life to feeling confident that they can have all the benefits they see others around them getting. To summarise, the process involves:
Resourceful State For The Practitioner
- Identify strongly mismatching clients early on using the pointing exercise.
- Be clear about your own problem ownership issues.
- Check your own safety working with this person.
Establish Rapport
- Use rapport skills subtly.
- Use tag questions when restating the person’s concerns.
SPECIFY Outcomes
- Contract as a consultant rather than a “therapist”.
- Set limits on your input.
- Ensure the resolution of any immediate crises.
- Include safety arrangements in your contract.
- Use solution focused questions.
Open Up The Person’s Model Of The World
- Access positive resources indirectly using metaphor, congruent compliments, presuppositional language and embedded suggestions.
- Help the person identify their mismatching strategy.
- Reframe mismatching and other metaprograms as the best choice at earlier traumatic times.
Leading (Change Techniques)
- Heal trauma with the Trauma Cure, Time Line Therapy‒2 and Reimprinting.
- Heal parts conflicts using parts integration and core outcome processes.
- Teach clear second and first position, problem ownership and communication skills, and use these in the consulting relationship.
- Set the person tasks to install more useful metaprograms.
Verify Change
- Have the person verify their own change, as a task, using solution focused questions.
Exit/Futurepace
- Have the person futurepace their own changes as a task.
Richard Bolstad is an NLP Master Practitioner and Trainer who has worked with clients individually and as a trainer of groups since 1990. He can be contacted at PO Box 35111, Browns Bay, Auckland, New Zealand, E-mail: learn@transformations.org.nz
Bibliography:
- American Psychiatric Association Diagnostic Criteria From DSM-IV‒2, American Psychiatric Association, Washington DC, 1994
- Bolstad, R. & Hamblett, M., Transforming Communication, Longman, Auckland, 1998
- Bolstad, R. & Hamblett, M., “NLP And The Rediscovery of Happiness: Part One” in Anchor Point Vol 13: No 4, p 3-9, April 1999 (A)
- Bolstad, R. & Hamblett, M., “NLP And The Rediscovery of Happiness: Part Two” in Anchor Point Vol 13: No 5, p 29-38, May 1999 (B)
- Bolstad, R. & Hamblett, M., “Calming Down: NLP and the Treatment of Anxiety” in Anchor Point Vol 13: No 8, p 3-12, 1999 (C)
- Bolstad, R. & Hamblett, M., “Time Line Therapy‒2 And Identity Change” in The Time Line Therapy‒2 Association Journal, Vol 13, p 5-7, 1999 (D)
- Caplan, P.J., They Say You’re Crazy, Addison-Wesley, Reading, Massachusetts, 1995
- Chevalier, A.J., On The Client’s Path, New Harbinger, Oakland, California, 1995
- Crits-Christoph, P. “Psychosocial Treatments for Personality Disorders” p 544-553, in Nathan, P.E. and Gorman, J.M. A Guide To Treatments That Work, Oxford University Press, New York, 1998
- Dilts, R., Hallbom, T. and Smith, S. Beliefs: Pathways to Health and Well-being Metamorphous, Portland, Oregon, 1990
- Dolan, Y.M. A Path With A Heart, Brunner/Mazel, New York, 1985
- Erickson, M.H. ed by Rossi, E.L. The Collected Papers of Milton H. Erickson on Hypnosis: Volume 1, Irvington, New York, 1980
- Hall, L.M. Dragon Slaying: Dragons Into Princes E.T. Publications, Grand Junction, Colorado, 1996
- James, T. and Woodsmall, W. Time Line Therapy And The Basis Of Personality, Meta Publications, Cupertino, California, 1988
- Kernberg, O. Object Relations Theory and Clinical Psychoanalysis, Jason Aronson Inc, Northvale, New Jersey, 1986
- Kohut, H. The Analysis Of The Self, International Universities Press, Madison, Connecticut, 1971
- Layden, M.A., Newman, C.F., Freeman, A. and Byers Morse, S. Cognitive Therapy of Borderline Personality Disorder, Allyn and Bacon, Boston, 1993
- Santoro, J. and Cohen, R. The Angry Heart: Overcoming Borderline and Addictive Disorders, New Harbinger, Oakland, California, 1997
- Williams, R. and Williams, V. Anger Kills, Harper Collins, New York, 1993
- Woo-Ming, A. and Siever, L.J. “Psychopharmacological Treatment of Personality Disorders” p 554-567 in Nathan, P.E. and Gorman, J.M. A Guide To Treatments That Work, Oxford University Press, New York, 1998