NLP: Beyond The Disease Model To Healing

© Richard Bolstad 1995

The Birth of a Disease:

Doctors describe a disease as “a disordered pattern of bodily structure, function, and mentation” which has occurred in several people, “with such frequency as to suggest a common cause.”⁽¹⁾ As an N.L.P. Practitioner, two presuppositions in this description really interest me. Firstly, disease is disordered. Secondly, the disease has one specific cause (and in medical minds that cause is usually a germ or a gene).

The disease model, although an historic advance, is only one reframe of what happens when someone is unhappy. It is, in fact, very close to the opposite of the model used by the developers of NLP. Over the last two centuries, the disease model has become a dominant way of understanding the human condition. We accept it so totally that we no longer remember that it is only a reframe (the map is not the territory). The disease model developed in its modern form in the eighteenth century based on the philosophy of life epitomised by Frenchman Rene Descartes. Descartes imagined the material universe as a giant clockwork mechanism which the spirit/minds of humanity lived in as “ghosts in a machine”. Illness was a breakdown of the machine. In the nineteenth century, researchers such as Lister, Pasteur and Koch had found the cause of the breakdown – germs. This mechanical explanation of physical illness replaced traditional notions of illness as “divine punishment”.

In the Bible germs and genes were unknown. Their place was filled by the sins of an individual or that person’s ancestors. In John 9.1, the disciples find a man blind from birth and ask Jesus “Rabbi, who sinned, this man or his parents, that he was born blind?” This old reframe led to the cruel persecution of such “sinners” as lepers. Today, fundamentalist Christians eagerly apply it to AIDS sufferers (“God’s punishment on gays”). Mostly, though, as a society we have let go of the “sin” reframe, and adopted “disease”. Today the disciples would ask “Rabbi, was this disease caused by germs or genetic damage?” The reduction of blame is obvious, and welcome.

The Disease Model Colonises Life

In the twentieth century, this disease model colonised, or took over two other areas of life previously governed by the sin model. Firstly, the psychiatric area. In 1937⁽²⁾ Sigmund Freud explained “The moment a man begins to question the meaning and value of life he is sick.” In the last century, psychiatry has worked overtime attempting to apply the disease model to an ever increasing range of types of unhappiness. Dr James Ballenger announces proudly in Clinical Psychiatry News (November 1988), “The next gene to be identified for a psychiatric illness may be for panic disorder.”

The third expansion of the disease model occurred largely based on the work of Dr Robert Smith, co-founder in 1935 of Alcoholics Anonymous, who described alcoholism as “an allergy to alcohol.” By suggesting that alcoholism was a progressive, congenital disease, AA shifted the focus on the campaign against drug-taking. Previously, the Temperance movement had maintained that everyone should abstain from alcohol. In 1933, the Prohibition Law they had enforced was repealed, having completely failed to achieve the social miracles the Temperance movement promised for the United States. AA represented a shift from talk of alcohol as a “demon” (and alcoholics as possessed and sinful). Again, the shift was a progressive one, to a less blaming model.

Initially, AA was also a more targeted approach. However, today, Anne Wilson Schaeff and other addiction counsellors claim that 96% of the population suffers from co-dependence, which she describes as a “very interesting disease in itself.” Today overeating, gambling, repeated short sexual relationships and masturbation are amongst the thousands of behaviours being described as diseases. In short, every activity once described as a sin can now be framed as a disease.

Referring someone to a “Twelve Step” Addiction Recovery group sure beats stoning them to death or burning them as a witch. But it has some alarming “side effects” of its own.

The “One Cause” Myth

One problem is that the evidence of “diseases” caused by a breakdown in the body system is weak to say the least – even in the case of the first type of disease; physical conditions. Consider the common cold. Dr Rene Dubos describes research in which sprays of “cold causing” viruses are squirted up the noses of volunteers. About 80% do indeed get colds. But the rest don’t even though given huge amounts of the virus. (It also makes no difference if they wear wet socks and stand in a drafty room.) It is now common knowledge that physical “illness” is a result of a variety of factors.

Robert Ornstein and David Sobel⁽⁶⁾ ask “Why do widowers die at a rate three times greater than other men of comparable age? Why do people who lose their jobs have increased rates of heart disease and lung disorders, no matter what their occupation? Changes in the social world. Changes in emotional and mental states. At first glance, it may seem that these changes have little to do with disease. But ‘real’ organic diseases are linked to changed beliefs about oneself, to the nature of one’s relationship to others, and one’s position in the social world.”

The same is even more true for the second and third types of “disease” (psychiatric diseases and addictions). In 1987 Janice Egeland and others published an exciting piece of research on an Amish community which had several members diagnosed as manic depressive. They claimed to be close to finding a gene which caused this “disease”. Only 3 months later, in the medical journal Lancet, geneticist Julien Mendlewicz and others showed that this report was groundless, and by 1989 the original researchers admitted they were “back to square one”. A 1990 study in the Archives of General Psychiatry (April) “undermines another whole series of earlier research projects purporting to show a genetic linkage in manic-depression” notes Psychiatrist Peter Breggin.⁽²⁾ In his 1993 book, he shows that there is no evidence for a genetic basis for any psychiatric disease. Fascinatingly, many doctors still accept the discredited Amish study and assure their clients diagnosed “manic depressive” that they have a genetic disease.

Shoddy Science

In the 1970s psychiatrist Donald Goodwin studied male children of alcoholic parents who were adopted out. These children were found to be four times more likely to become alcoholic than normal. Proof that alcoholism is genetic? Hardly! Firstly, only 18% of these male children became alcoholic. (Compared to 5% of other male adoptees.) Secondly, once “problem drinkers” statistics are combined with “alcoholics”, the number is the same for both groups. Thirdly, for the girls in the study, the daughters of alcoholics were less likely to be alcoholic than the girls from non-alcoholic parents! Psychiatrist Robin Murray studied identical twins (with the same genes) and fraternal twins (different genes, same family) and found that having the same genes as an alcoholic makes you no more likely to be alcoholic than anyone else. But the fascination with proving a genetic cause for alcoholism remains. Reviewing the literature, Dr David Lester says that evidence for even a genetic predisposing factor in alcoholism is “weak at best”. He suggests that the “attraction and persistence of such views lies in their conformity with ideological norms.”⁽⁴⁾ That is: AA says it’s a disease, so people keep hoping to find some proof for a genetic basis.

The same shoddy science has been characteristic of studies on schizophrenia and other psychiatric “diseases”. Many “research” stories were told to me as a nursing student about schizophrenia. One was about Dr Peter Witt, who injected spiders with urine from psychiatric patients and found that the spiders spun bizarre webs. When injected with normal urine, they spun normal webs. Proof that there’s a chemical basis for schizophrenia? Well, as a student I believed it. But in fact, urine from psychiatric patients only causes bizarre webs when those patients are taking “anti-psychotic” drugs. Urine from non-drugged patients is as normal as anyone else’s.⁽⁴⁾ The same problem occurs in research on the higher level of the chemical dopamine in the brains of schizophrenics. This is a direct result of the anti-psychotic drugs, as is brain size shrinkage and every other physical “cause” of schizophrenia so far demonstrated.⁽²⁾ So far, the evidence suggests that, like someone who is angry, someone who is “crazy” may have a different chemical balance, but there’s no standard pattern or “disease”.

Pretending There’s Only One Culture

Actually, we only need to look round the world a little to realise that the one-physical-cause theory of disease doesn’t fit the facts. Dr Henry Peguignot, professor of medicine at Paris’ Hospital Chochin points out “In France, we would call vague digestive troubles a liver crisis. In the United States you would call it a food allergy. You prescribe anything at all, because it’s not a scientific diagnosis, but rather a different use of placebos.” Lynn Payer, in her book “Medicine and Culture” documents hundreds of similar oddities, shattering the illusion that most illness has been scientifically explained. In fact, people’s beliefs decide what diseases are diagnosed more than some “objective truth”.⁽⁷⁾

In psychiatry this is even more so. Adolf Meyer, Professor of Psychiatry at John Hopkins University simply says “When the patient and the physician agree on the nature of the problem, the patient gets better.”⁽⁴⁾ Which is why, no doubt, indigenous Maori New Zealand psychiatric patients are much more likely to be re-admitted than non-Maori. Maori rates of diagnosis as schizophrenic are twice the non-Maori rate, and Maori rates of diagnosis as alcoholic are one and a half times the non-Maori rate.⁽⁸⁾ Does this mean more Maori are genetically more prone to these illnesses? That’s a very naive racism. In fact there are social causes for both “Diseases”. Furthermore, many Maori believe their problems are inappropriately diagnosed, and prefer to call them “mate Maori” (Maori Sickness).⁽⁸⁾ Those cultural groups (Jewish and Chinese for example) who have been most reluctant to accept the disease model of alcoholism are those where rates of alcohol abuse are very low. Are Jews genetically less alcoholic? It’s more rational to accept that the whole disease notion is just a metaphor.⁽⁴⁾

The Failure of “Cure”(A)

One advantage often claimed for the disease model is that it gives us a solution – cure! Once something is identified as a disease, you can cure it. Unfortunately, history does not usually bear this out. The presence of “cures” has not been the cause of most “medical” success.

Tuberculosis, for example, had a death rate of 700 per 10,000 in New York in 1812. In 1882, the germ which “caused” it was discovered, but deaths had already dropped to 370 per 10,000. By the time antibiotics were available to treat it, seventy years later, the rate was down to 48 per 10,000. Did drugs save us from tuberculosis? No, they merely completed the success resulting from a combination of non-medical changes which had made people more healthy in general. The same is true for all the other devastating illnesses of nineteenth century Europe and America.⁽⁹⁾

The Failure of “Cure”(B)

In Psychiatry, “miracle drugs” abound. One of the most recent was the anti-depressant Prozac, released in 1988 after only 6 weeks of testing and described as the wonder pill almost without side effects. In fact by 1991 its manufacturer, Eli Lilly and Co faced numerous lawsuits as a result of its tendency to cause compulsive violent behaviour (murder and suicide occurring without the person understanding why). Meanwhile the 1989 Comprehensive Textbook of Psychiatry described it as only as effective as other older anti-depressants. How effective is that? The majority of studies (62%) show that anti-depressants perform only as well as placebos – if you give people sugar pills they’ll improve just as much. On the other hand, 43% of Prozac users will get two or more severe side effects (headaches and nausea being most common).⁽²⁾

The most popular anti-anxiety drug in the United States today is Xanax, which has overtaken Valium. In the initial research by its maker Upjohn, Xanax performed better than placebos for four weeks. But in the following 4 weeks, unpublished by Upjohn, its effectiveness dropped to placebo level. And once the drug was stopped, those taking it had a 350% increase in their panic attacks. They had become Xanax addicts!⁽²⁾ If that’s a cure the disease is safer!

The same is true when we examine traditional psychotherapy. Probably most people know that Sigmund Freud’s star patients, such as “Anna O.”  and “The Wolf Man” continued to suffer the same neurotic symptoms the rest of their lives, despite his initial claims for psychoanalysis⁽¹²⁾.  Less well known is just how archetypical that result is for all long term psychotherapy.

In 1951, E. Powers and H. Witmer published one of the most extensive and well designed studies of the results of therapy, “An Experiment in the Prevention of Delinquency” ⁽¹⁴⁾. In this study 650 high risk boys aged 6-10 were chosen and grouped into pairs based on various demographic variables. One of each pair was then assigned to counselling (either client-centred or psychoanalytic), and linked up to support services such as the YMCA.After an average five years of counselling, the boys were followed up. Counsellors rated 2/3 of the boys in their care as having “benefited substantially” from the counselling, and the boys agreed, saying it gave them more insight and kept them out of trouble. Such is success, isn’t it? Well, except for one detail. The treated boys were more likely to have committed more than one serious crime, had higher rates of alcoholism, mental illness, stress related illness, and lower job satisfaction than those left untreated. This remained true at 30 year followup, and the researchers lamely suggest that there “must be” some positive benefits, but they were unable to find them. (Zilbergeld, p132-134). Just because counsellors believe that counselling “feels good” doesn’t mean it helps. This 1951 study demonstrates the risks of dependency-producing models of treatment in general. The boys and their therapists valued “their relationship”, but it did not empower the boys to change; it disabled them.

Hans Eysenck⁽¹²⁾ has repeatedly reviewed the objective (success compared to controls) research on psychotherapy. He discusses the most widely known book collating research on psychotherapy results, The Benefits of Psychotherapy, by M.L. Smith, G.V. Glass, and T.I. Miller (John Hopkins, Baltimore, 1981). It is here that the oft quoted conclusion is reached that “…differences in how psychotherapy is conducted (whether in groups or individually, by experienced or novice therapists, for long or short periods of time, and the like) make very little difference in how beneficial it is.” If this were true, it would itself be an indictment of long term psychotherapy (isn’t it rather unethical to spend ten times as long to achieve the same result).

Actually, Eysenck points out that the book’s own data tables give the lie to this claim. He says “…they found average effect sizes of 0.28 for undifferentiated counselling, for instance, and of 0.14 for reality therapy, with figures like 1.82 for hypnotherapy and 2.38 for cognitive therapies. This does not suggest equality of outcome! They also fail to note a very important conclusion from the same table -that placaebo treatment [checking the client before and after a specified time] (effect size 0.56) is as effective as Gestalt therapy (0.64), client centered therapy (0.62) or psychodynamic therapy (0.69).” Why are hypnotherapy and cognitive therapy so much more successful? One thing they share is a focus on results instead of on disease. NLP, it could be noted, is essentially a combination and extention of cognitive therapy and hypnotherapy.

The Failure of Cure (C)

In the addictions area, research on the failure of “cure” has been closely guarded. The truth is that most people who recover from addictions do so on their own, according to researcher Stanton Peele, author of “Love and Addiction” and “Diseasing of America”. 95% of the 40 million Americans who have quit smoking did so without medical or AA style help, for example. Several surveys by the institution for Health and Aging (University of California) show that drinking problems up to the level where blackouts occur almost always disappear before middle age, without medical assistance.⁽⁴⁾

Psychiatrist Dr George Vaillant is a firm advocate of both AA and medical treatment for alcoholism. But his own research on his Cambridge Hospital patients over an 8 year period gave, in his words, “compelling evidence that the results of our treatment were no better than the natural history of the disease.” Dr Keith Ditman, head of the Alcoholism research Clinic at the University of California studied 3 groups of alcoholic offenders randomly assigned by a court to AA, to a medical clinic or as controls (no treatment). In the follow-up period 69% of AA clients re-offended and 68% of clinic clients. Only 56% of the controls did. Jeffrey Brandsma in 1980 studied alcoholics randomly assigned to AA, other therapy, or a control group. At three month follow-up binge drinking was far higher for the AA group, but by 12 months, all groups were doing as well as each other.⁽⁴⁾

Finding Sickness

One thing’s for sure, if you look for disease you can find it. The clearest demonstration is still a 1934 experiment where 1,000 New York 11 year olds were checked by medical doctors at a free clinic. 61% were found to have already had their tonsils removed. Of the rest, 45% were found to “need a tonsillectomy”, and 55% didn’t. That 55% of those who didn’t need one were sent to another group of doctors at the free clinic and these doctors found that 64% of these children needed their tonsils out too. The remainder were sent to a third group of doctors who also found that 45% of this remainder needed the operation. At this point (65 children left not recommended for surgery) the free clinic ran out of new doctors to test. But the result was clear. The doctors would find that 45% of children needed  tonsillectomy, whoever was sent in.

In 1973 psychologist D.L. Rosenhan published a study in which his psychology students went to prestigious Psychiatric hospitals in their community and claimed to have one symptom out of the ordinary (e.g. hearing a voice in their head). They were all admitted, and most were diagnosed schizophrenic, although in every way apart from their one symptom they behaved normally. After one week, they reported the symptom gone and asked to be discharged. Their experiment was over. Unfortunately, the hospitals would not release them, until finally Rosenhan rang up and explained the situation. Rosenhan now told the hospitals there were others who had not been named, who were in the experiment. Within a few days the hospitals found and released other patients whom they now realised were sane, although in fact there were no more psychology students.

In addiction groups, it is the clients themselves who are eager to find disease, or to act as the disease model predicts. Psychologists Alan Marlatt gave alcoholics heavily flavoured alcoholic drinks and found that – as long as they believed the drinks were alcohol free – they drank only normal amounts. On the other hand, alcoholics told their drink contained alcohol began to drink compulsively, even though their beverage contained none. According to AA, even a single taste of alcohol sets off uncontrollable binge drinking. The belief is clearly the reason why AA binge drink more than controls (see section “Better Off on Your Own?” above). AA members’ belief in their disease produces its own evidence.

The Risks of Disease Care (A)

As a nurse, I find myself about this time wanting to reassure you. Doctors, nurses and other health professionals, in general, truly mean well. And, frankly, we save peoples lives.

As an NLP Practitioner, I’m well aware of how scathing health professionals can be about “unproven, unscientific, unorthodox,” approaches to health. I think it’s only fair to subject both orthodox and unorthodox health systems to the same challenge.

The Southern Medical Journal in May 1967 published a study on the health hazards of medical care.⁽⁹⁾ They note that U.S. Department of Health statistics show that 7% of all patients suffer compensable injuries while in hospital. One case in thirty leads to death. Half of the cases result from drug treatments. Like anyone, we do make mistakes. It’s lucky there aren’t more mistakes actually. Dr Keer White, deputy director for Health Services in the Rockefeller foundation stated in 1988⁽⁷⁾ “although things are much better than they were a generation ago, it is still the case that only about 15% of all contemporary clinical interventions are supported by objective scientific evidence that they do more good than harm. On the other hand, between 40 and 60 percent of all therapeutic benefits can be attributed to a combination of the placebo and Hawthorne effects, two code words for caring and concern, or what most people call “love”.

The Risks of Disease Care (B)

When we shift to the second wave of the disease model, psychiatry, this is even more true. A review of research in the October 1989 American Journal of Psychiatry showed that Valium (a “minor tranquilliser”), opium (a sedative), placebo (sugar pills) and actual neuroleptics (the drugs designed as anti-psychotic) were all equally effective in controlling acute psychotic episodes in schizophrenics and others. This is astounding, because the drugs most frequently used in actual hospitals (neuroleptics such as Thorazine, Chlorapromazine, Melleril) cause permanent brain damage. The 1986 Manual of Clinical Psychopharmacology says that the brain damage of tardive dyskinesia occurs in 50-60% of chronic users of neuroleptics. The June 1990 Clinical Psychiatry news updates this, saying that exposure for 15 years or more leads to “almost certain” tardive dyskinesia. This incurable brain damage causes the odd rocking motions, tremors, bizarre postures and twisting tongue movements we often imagine as features of long term psychiatric clients. It’s the clinical end result of interfering with the flow of dopamine and other neurochemicals between the lower brain and the frontal lobes of the brain – a process of chemical lobotomy.⁽²⁾

Psychologist Dr Hans Eysenck has warned of the dangers of traditional psychotherapy for some time. He describes⁽¹²⁾ a longitudinal study of 7000 inhabitants of Heidelberg, from 1973 to 1986. This study was designed to discover the health effects of psychotherapy. Clients in psychotherapy were able to be matched by age, sex, type and amount of smoking etc with controls.  This study showed that cancer and heart disease were most prevalent in the group who had had two years or more of “therapy”, less frequent in the group who had one year or more in “therapy”, and least frequent in the group who had no “therapy”. Talking about what’s wrong with life once a week for years is not healthy. This is a persuasive argument for brief therapy!

Symptoms: The Order Behind “Disorder”

Dr Carl Simonton is a medical doctor who doesn’t buy the old disease model. In his first studies of cancer therapy, his clinic took in 159 patients who had been given less than a year to live. A year later, 19% had gotten rid of their cancer completely and 22% had cancers that were disappearing. Of those who eventually died, the average life-span was twice the normal, Simonton says “I believe we develop our diseases for honourable reasons. It’s our body’s way of telling us that our needs – not just our body’s needs but our emotional needs, too – are not being met, and the needs that are being fulfilled through illnesses are important ones.”⁽¹⁰⁾

This model suggests that what we’ve called diseases are actually messages from our inner self, our unconscious mind in NLP terms. They are not states of disorder or the result of attacks from outside, so much as an attempt to re-establish a deeper order than our lives have had. Psychiatrist Peter Breggin says that he believes the same is true for psychiatric “diseases” such as schizophrenia. He says “so called schizophrenics, especially during their initial crisis, almost always are preoccupied with the meaning of life, God, love and their own personal identity, often with cataclysmic implications about the end of the world or the disintegration of their own personalities.” He says that their metaphorical communication and behaviour “can be understood as conflicts or confusion about … identities, values and aspirations rather than as biological aberrations”.

New Zealand author Janet Frame spent a decade at psychiatric hospitals, drugged, given 200 applications of shock treatment and narrowly escaping brain surgery. She explains in her biography that deep down she wanted to be a writer. No one in her family believed this possible. She called her “disease” of schizophrenia “a problem which had such a simple solution. A place to live, and write, with enough money to support myself.” Her “illness” was the sanest part of her, as she now understands it, looking back on a decade of torment.⁽¹¹⁾ This is close to surgeon Dr Bernie Siegel’s regret that in years of surgery, cutting out “diseased” organs, he was cutting out “the vocal cords of the person’s unconscious mind.”

Addiction: Seeking Happiness In All The Wrong Places

Stanton Peeles points out that addictions are understandable in the same way. “When narcotics relieve pain, or when cocaine produces a feeling of exhilaration, or when alcohol or gambling creates a sense of power, or when shopping or eating indicates to people that they are being cared for, it is the feeling to which the person becomes addicted. No other explanation – about supposed chemical bondings or inbred biological deficiencies – is required. And none of these other theories come close to making sense of the most obvious aspects of addiction.”⁽⁴⁾

The clearest example historically of the relationship of addiction to unsatisfied but genuine needs is the Vietnam war. Of U.S. soldiers who used heroin in the war (and most did) 73% became addicted and displayed withdrawal on return. Authorities were terrified, expecting a huge surge in addiction numbers. In fact, most simply stopped once they got back to America. Researchers noted “It is commonly believed that after recovery from addiction, one must avoid any further contact with heroin. It is thought that trying heroin, even once, will rapidly lead to re-addiction … Half the men who have been addicted in Vietnam used heroin on their return, but only one in eight became re-addicted to heroin.” In fact, points out Peele, one eighth still had severe unmet needs on their return. The others simply stopped, because the need had stopped. They were never powerless over the drug, they were overwhelmed by their own inner yearnings; remarkably sane, understandable yearnings I might add. No “disease” is required to explain this process. Peele notes that similarly research shows that workers quit smoking when they achieve job security and less anxiety at work.⁽⁴⁾

Research on 2700 British smokers showed that they give up when they “lose faith in what they used to think smoking did for them” while creating “a powerful new set of beliefs that non-smoking is, of itself, a desirable and rewarding state.” In other words, they simply find better ways to meet their needs than the addiction.

Real Healing: Beyond the Disease Model

People do heal. Carl Simonton proved that with his cancer patients. The smokers who give up smoking and the Vietnam veterans who gave up heroin proved that. The estimated 50% of “schizophrenics” who spontaneously recover (World Health Organisation Studies on Schizophrenia 1993⁽²⁾) prove that.

NLP was developed by modelling such excellence. NLP is an attitude of curiosity and willingness to experiment; not just a set of techniques. When we use NLP techniques within a disease model, the key presuppositions of NLP are violated. All behaviour is the best choice currently available, and people have all inner resources they need to succeed.

That doesn’t mean that, as NLP practitioners, we should never use the word disease. It helps to be able to discuss “diseases” with colleagues in the health services (there are no resistant doctors, only lack of rapport). Also, it’s important to preserve the ecology of a client who has been using the disease model: to “pull it out from under them” could leave them with only the sin model as choice. That’s impoverishment. I believe our best hope is to expand the person’s range of options for understanding their unhappiness. Particularly to recognise in it the message that tells them how to find happiness. That’s what NLP does at its best, and is the subject of my book Pro-fusion⁽¹³⁾ . This article is one side of the story. The other side, “What do we do instead?”, is at least worthy of a book to answer. But the principle is easy to follow. People who believe they have a disease simply don’t heal as well as people who believe they have an inner teacher that loves them and wishes them well.

“And his disciples asked him, “Rabbi, who sinned, this man or his parents, that he was born blind?” Jesus answered, “It was not that this man sinned, or his parents, but that the works of God might be made manifest in him.”

Footnotes

1. De Gowin, E. and De Gowin, R. Bedside Diagnostic Examination, MacMillan, 1981, New York.
2. Breggin, P. Toxic Psychiatry, Fontana, 1992, London.
3. Wilson, Schaef, A. When Society becomes An Addict, Harper and Row, 1987, San Francisco.
4. Peele, S. Diseasing of America, Houghton Mifflin, 1989, Boston.
5. Dubos, R. Man, Medicine and Environment, Penguin, 1968, Harmondsworth.
6. Ornstein, E. and Sobel, D. The Healing Brain, Papermac, 1988, London.
7. Payer, L. Medicine and Culture, Penguin, 1988, Harmondsworth.
8. Pomare, E. and de Boer, G. Hauora: Maori Standards of Health, Department of Health, Wellington
9. Illich, I. Limits to Medicine, Penguin, 1978, Harmondsworth.
10. Siegel, B. Love, Medicine and Miracles, Arrow, 1988, London.
11. Frame, J. An Autobiography, Randon Century, 1989, Auckland.
12. Eysenck, H. “The outcome problem in psychotherapy”, in Dryden, W. and Feltham, C. ed. Psychotherapy and its Discontents, Open University, 1992, Buckingham. p100-123
13. Bolstad, R. with Hamblett, H. and Dyer Huria, K. Pro-fusion: Neuro Linguistic Programming and Energy Work, Transformations, 1996, Christchurch.
14. Zilbergeld, B. The Shrinking of America, Little Brown & Co, 1984, Boston.