Removal of PTSD Symptoms in a Client Using Neuro- Linguistic Programming

Bruce Grimley, Master NLP Trainer, Chartered Psychologist (BPS), Author

This paper is originally published in The Journal of Experiential Psychotherapy, vol. 19, issue 3 (75) September 2016. Re-printed with author’s permission.

Abstract

Introduction: Neuro-Linguistic Programming, (NLP) is an eclectic modality and can be regarded as experiential in many ways. The introduction takes the reader through a very brief understanding of the history, epistemology and methodology of NLP with the aim of providing a framework which can be elaborated in the case history.

Objectives: The objective of this paper is to stimulate thinking around the use of a multi- paradigmatic modality in the context of psychotherapy and to demonstrate how NLP can work in that context. This section provides one example of an 18 session case history, with discussion, of how NLP successfully assisted the resolution of Post-Traumatic Stress Disorder (PTSD) in a case of historical sexual abuse.

Methods: The method used in this paper is that of a single case study. NLP is regarded as the main theoretical orientation throughout the intervention and the methodology arising from such a theoretical orientation is discussed.

Results: The results of the psychotherapy intervention are provided by reference to before and after profiles on the Detailed Assessment of Post-Traumatic Stress, (DAPS, Briere, 2001) and a 15 item feedback form. Results are also provided in the form of statements from the client during and after therapy. Before and after scores from an on-line personality questionnaire are discussed as well.

Conclusions: NLP when used by an experienced therapist can be effective in resolving the symptoms of PTSD.

Keywords: post-traumatic stress, neuro-linguistic programming, NLP treatment

I.  Introduction

The rather scientific name Neuro-Linguistic Programming, (NLP), has many stories surrounding it. One version tells us it was a name made up on the spot when Richard Bandler, one of the Co-Founders, was stopped by a police officer and asked what he did, (Brown, 2007, p. 173). Another story is that NLP was coined by Bandler and Grinder in an intentionally mischievous way, possibly poking fun at its quasi academic status (Tosey & Mathison, 2009, p. 12). Whatever the truth behind the name, what is beyond dispute is NLP, despite predictions by some academics that it would die out within a decade because of its lack of scientific rigour and it’s fad/cult like status, (Elich, Thompson, & Miller, 1985), is still very active and used in many domains,

Heap in 2008 summarises the current and possibly future trajectory of NLP from a psychological perspective when he says:

“I believe that the following impressions are also likely to be reliable.

1. NLP continues to make no impact on mainstream academic psychology

2. NLP has made only limited impact on mainstream psychotherapy and counselling

3. NLP remains influential amongst private psychotherapists, including hypnotherapists, to the extent that they claim to be trained in NLP and ‘use NLP’ in their work.

4. NLP training courses abound and NLP now seems to be most influential in management training, lifestyle coaching, and so on. Particularly with reference to this, the term ‘growth industry’ appears to be apposite.” (Heap, 2008, p. 7)

However from the NLP perspective some practitioners fight against this perceived pejorative forecast and point to such academic volumes as “The Clinical Effectiveness of Neurolinguistic Programming, (Wake, Gray & Bourke., 2013) and papers such as “Effects of Neuro-Linguistic Psychotherapy on psychological difficulties and perceived quality of life” (Stipancic, Renner, Schutz, & Dond., 2010). These academic contributions however seem to be very much the exception which proves the rule and often are to be found in the psychotherapy and counselling sectors.

II. What is NLP?

There are as many definitions of NLP as there are NLP practitioners around the world. Professor Sturt makes the telling point; “the very fact that there is no agreed definition of NLP indicates how little evidence we have of its benefits.” (Sturt, 2012). However key to understanding NLP is an appreciation of the belief that our experience has a stable structure. This appreciation owes much to the syntactically driven paradigm of the day in linguistics, Transformational Grammar, (TG). John Grinder, a Co-Founder of NLP says: “The single most pervasive influence in NLP is the paradigm that was current in linguistics at the time of the creation of NLP” (Bostic St Clair, & Grinder, 2001, p66)

Just as in each alphabet around the world there are a limited number of letters it is also the case that those letters can be arranged to create an almost unlimited set of meanings when they are organised syntactically and interpreted through lexical meaning, semantics and pragmatics. The parallel within NLP is that we also, as experiencing individuals, have a limited sensory scope in our 3 major senses, Visual, Auditory and Kinaesthetic, (VAK) yet through various organising processes we create highly individual mental representations, carving up the external world in an idiosyncratic way resulting in a personal pattern of behaviour and language in various contexts as a result of experiencing the world through these individual patterns. Key to NLP is an appreciation that people act as a result of the relationship with their patterning and not as a result of a relationship with the territory of objective world. It has been argued that TG relies too much on syntax and not enough on the generative meaning making capacity of semantics and phonology, (Jackendoff, 2002), however other aspects of NLP acknowledge and recognise the individuals capacity to generate meaning in non-syntactical ways through other non-verbal patterns which have been modeled from exemplars, one example being that of anchoring, or in psychological terms classical conditioning. Within NLP there are therefore 2 levels of information processing sensory (F¹) and then linguistic (F²) often it is the confusion between these levels which leads to a lack of ecology in a person’s life and the reason they find themselves in therapy.

Continuing to demonstrate the influence of TG on NLP Bostic St Clair and Grinder, (2001), point out that the meaning making characteristics of syntax are implicit. A native speaker of English for instance needs little formal education to know the words “Two houses” is a valid linguistic representation yet “Two mouses” is not, and should be “Two mice”. In many similar ways individuals may intuitively “know” something is not right for them in a particular context, however formally and at the level of language they cannot represent what is “not right” and consequently struggle to move forwards in an intelligent way. Bostic St Clair and Grinder (2001) say:

“These intuitions have a stability and consistency across individuals differing widely in all respects except that they are fluent speakers of the language in question. Such a characteristic makes this set of intuitions ideal as the basis for modeling-for the development of explicit representations” (Bostic St Clair & Grinder 2001, p73).

Even though the stability of the intuitions cited above refers to language, it would be the moot claim of NLP practitioners that just as there is structure to language there is also a structure to non-verbal experience and through the creation of NLP design variables we now have a language to map such implicit experience. The first NLP model, or explicit representation was the “Meta Model” and is formally laid out in book form; The Structure of Magic, (Bandler & Grinder, 1975). This model primarily was the result of Bandler researching video tapes and reading transcripts of the work of Fritz Perls and observing the work of Virginia Satir and then sharing the skill he developed at University.

After asking Associate Professor John Grinder to observe him running his Gestalt workshops at the University of Santa Cruz with Frank Pucelik, Grinder noticed that there already was a formal linguistic representation which the emerging model could map onto and that model was TG.

Along with the Meta Model which is a linguistic model based on TG and the Milton model which is often referred to as the reverse of the Meta Model, being based on the modelling of Milton Erickson, it is also the non-verbal design variables which make up much of the current NLP practitioner curriculum. These design variables offer linguistically a representation of what is implicit structurally within human phenomenology and thus provide individuals with the capacity to make meaningful alterations at an unconscious level which changes their experience. They were arrived at inductively during the modeling process as Bandler and Grinder observed and imitated their subjects. Many of these non-verbal design variables are described in The Structure of Magic ll (Grinder & Bandler 1976) and later NLP volumes. Examples of such design variables are the use of rapport, multiple perceptual positions, anchoring, framing, time orientation and scope / categorisation of sensory representation.

If a client was therefore afraid in a particular context the NLP therapist would be more interested in how the object of fear was mentally represented contrasted with the actual content….say a spider, snake, or angry boss. If the scope of representation was big, in colour, close up and in focus….the NLP therapist might ask; “what would happen to the associated feelings if that same mental representation was made small, in black and white, pushed away and seen through opaque glass?

It is this emphasis on structure and process rather than content which characterises the NLP therapist and was one of the criticisms of Heap who made the point:

“However, it becomes clear when you read the early literature that the claims that Bandler and Grinder make do not simply refer to the particular techniques, ploys and styles of the select number of individuals they studied. They are statements about the way human beings in general behave and think and communicate with one another. In other words, they are the kind of observations and assertions that one would expect to appear in textbooks of human psychology, to be taught on psychology courses at schools and colleges, to be the subject of research in psychological laboratories at our universities, and to inform broader theories of social and cognitive psychology.” (Heap, 2008, p. 1)

The position Heap takes seems very reasonable and it is one of the main drawbacks of the NLP approach that some of the fundamental tenets as well as the derived patterns have not been tested in a rigorous way and findings communicated to the academic world. This is despite early proponents of NLP advocating a more scientific writing up of NLP practice; “Clearly these practitioners would provide a service to the field by presenting their data in the literature so they may be critically evaluated.” (Einspruch & Forman, 1985)

To use a metaphor, so we can see the wood as well as the individual trees, Bostic St Clair and Grinder conveniently tabulate the higher level ordering of every single NLP pattern:

1. “The Meta Model, designed to verbally challenge the mapping between first access to the outside world through our senses (F1), and our linguistically mediated mental maps (F2).

2. Operations defined over representational systems and their sub-modalities, for example the Swish technique.

3. Reframing patterns, where representations are placed in a different cognitive structure.

4. Anchoring, where differentiated ¹groupings of representations are brought together for purposes of integration. (Note ¹ In an email to me, 9^th August 2014 John Grinder suggested this should be “differentiated” rather than in the published version; “undifferentiated”.)

5. The Milton Model, where representations at F1 (first access through our senses to the world) are shifted by using F2 (linguistically mediated maps) patterning without the need to map those representations into the client’s conscious understanding.” (Bostic St Clair & Grinder, 2001, pp. 198–9).

So my hypothetical therapeutic example above of changing the visual characteristics of a mental representation to see if that elicited a different feeling would fall into category 2) above. There is a lot of jargon in NLP as in any modality and a glossary to assist comprehension might be useful and can be found at Grimley, (2013). Given the lack of representation in the academic literature and the critique of academic psychologists it would be a valid question to ask why is NLP still with us, and further how in Austria for instance has NLP therapy been formally recognised by the government as a legitimate modality and in the UK is recognised and accredited indirectly by the government, (Professional Standards Authority, PSA) through inclusion in the voluntary register of the United Kingdom Council for Psychotherapy, (UKCP).

PhD research of the Author discovered, using a grounded theory approach that the success of NLP and NLP therapy is predicted by a synthesis of popular variables fitting into the acronym P.E.A.S. NLP is:

P. “Process oriented, Pragmatic, Positive, Playful, Phenomenological, eliciting Patterns, and Practicing within the Presuppositions of NLP.

E. Eclectic, Experimental, Experiential, with a focus on obtaining Elegance in all practitioners do.

A. Focused on Application rather than theorising, however evidence for the effectiveness of such application is mainly Anecdotal.

S. Systemic in orientation with a strong emphasis on Sales in the market place for ideas and utility.” (Grimley, 2015, p. 250).

To summarise, NLP is the study of the structure of subjective experience. The methodology of NLP is behavioural modeling and the first 3 exemplar models were counsellors/psychotherapists. NLP design variables elicited from these modeling projects are regarded as not only being instrumental in the context of excellent psychotherapy, but also are regarded as providing a framework for the structure of human experience and have thus been used in other contexts such as business, education, negotiation, sports and personal development to name a few.

Case Study. Introduction

Throughout this case study I would like to show the reader what made this intervention uniquely an NLP intervention by reference to the above NLP frame and through reference to other aspects of NLP not mentioned in the above introduction. The intention of using this format is to get to the meat of the paper, rather than distract the reader with too much of an introduction as to what NLP is and how it works without any reference to live content. Hopefully this will contextualise the practice of NLP therapy more usefully. I will make use of the personal pronouns “I” and “my” during this case study rather than the more cumbersome, “the author”. This intervention also was framed as a coaching intervention as well as a psychotherapeutic one as implicit in the latter is often stigma and the sense something needs to be fixed, which is not a judgement an NLP therapist would make.

Initial sessions

In my work I make use of the NLP operating frame of Richard Bolstad, (2002); RESOLVE. This stands for:

• Resourceful state of the practitioner

• Establish rapport

• Specify the outcome

• Open up the client’s model of the world

• Lead the client to their desired state

• Verify the change

• Ecological exit

This was a good time for me to take on a new client. I did not have a high case load and during the free chemistry check which took place at my home from where I practice, my client seemed very keen to work with me. He had been recommended by his Doctor to seek a psychologist from the Directory of Chartered Psychologists and he liked my online profile as well as my telephone manner on initial enquiry. I concluded my own State was very resourceful in the context of this client and invited him to a first session after he said he would like to work with me.

Rapport was established in the opening sessions through observation and listening. A key part of NLP therapy and especially when using the Milton Model, (the third of NLP’s models), is to appreciate your client experiences their world indirectly through their own unique mental representation of the world.

To exert leverage and lead them away from the source of their dissatisfaction, which is that representation, the NLP therapists needs to have a deep appreciation of the structure of that representation which NLP therapists refer to as “map of the world” after Korzybski, (1994). In NLP, rapport is obtained through matching and pacing, so a lot of these early sessions involved me verbally matching my client’s ongoing experience.

One consequence of matching and pacing verbally as well as non-verbally is the therapist himself begins to appreciate intuitively the structure of the clients map of the world and this experience can generate both useful and relevant questions which can open that map of the world up more which can have the effect of providing greater choice for the client. There is a double dynamic at work here. Initially the client has expectations, (a predictor of outcome). The more the NLP therapist accurately matches and paces the clients ongoing experience the greater those expectations, as the client recognises the therapist is truly present and is feeding back accurately their map of the world. This builds trust and as trust builds the client feels more confident in exploring their map of the world without judgement and in total confidence. It is for this reason it is important the NLP therapists checks their own state before taking on a new client. Unless the therapist can be truly present and focused upon their client, rather than any pressing matter of their own, this process cannot unfold.

Seeing the world through your client’s map of the world is known in NLP as adopting the 2^nd perceptual position. As I began to experience the world through David’s map of the world I sensed a sharp divide between his ability to think and his ability to feel. Professionally he was a software developer and presented as exceptionally logical and rational. I sensed he clearly was in touch with his feeling side, which in NLP is represented Kinaesthetically, however this was highly introverted to the extent I felt he was not fully aware and the possibility for me arose, to use psychodynamic language, was David was compartmentalising much of his feeling self in order to retain a keen sense of logic and thus functioning in the world.

To test this intuition and indeed whether David did have PTSD which he had been diagnosed with through his doctor, I resorted to some psychology and asked David to fill out the Detailed Assessment of Post-traumatic Stress (DAPS, Briere, 2001), Alter-Ego, an online personality questionnaire, (Grimley, 2010), and an online stress questionnaire, (Grimley, 2009). Alter-Ego brought in another NLP aspect to this intervention as it is a measure of which Meta-Program the client is currently favouring in the context under consideration. In NLP a Meta-Program is effectively a pattern running at a deeper neuro-logical level and thus a pattern which is responsible for a greater range of experience contrasted with lower level patterns such as a simple anchoring of response in a particular context or a favourite cognitive frame. Meta-Programs in NLPare very similar to Personality in psychology however they are regarded as situational and may vary within person and across context.

The only characteristic which was not fulfilled in order to allow a full diagnosis of PTSD was Psycho- Social Impairment. When discussing the results of this alongside the Alter-Ego Meta-Program profile, David and I co-developed a working hypothesis that he was using his exceptional ability to think (as demonstrated formally by a preference for thinking over feeling) to present himself as socially intact, despite all of the other symptoms of PTSD such as re-experiencing, avoidance, hyper-arousal being present. DAPS also brought to the fore David was abusing substances regularly, a common sequelae to sexual abuse and PTSD which I normalised by sharing a DAPS profile of similar type to David from the technical manual.

During the initial sessions, despite developing an appreciation for David’s map of the world, I became curious as to why his symptoms seemed to be significant at this particular stage of his life. I discovered that he had a child who was autistic and also his wife had significant mental health issues herself and was struggling to effectively manage. This meant David not only had to do a full time job, but also then needed to attend to housework and parenting when he was quite tired. Continual reference to his wife seemed to be significant and I pointed out I could only represent his state of affairs as he presented them to me, agreeing that I too would be exhausted if this were the case. However I had no way of checking the validity of such data without his wife present. After a few sessions, his wife, Alice agreed to become involved in the sessions and provide us both with her map of the world.

The significance of this from an NLP perspective is that what informs many of the NLP Presuppositions, which are the operating assumptions and the closest NLP has to a theory, is a reliance on systems theory to explain our phenomenological representation of the world. Not only is there a systemic inter-relation between unconscious and conscious mind, the quality of which determines the quality of life, but there are also systemic inter- relations between ourselves and others. In order to understand and model out such a system one needs access to all parts. It is for this reason I believed it important to invite Alice to our sessions with the full agreement of David.

Mid-Sessions

Once I had established rapport and trust it was time to address the index event. David said he had been sexually abused and was experiencing flashbacks of the experience. He felt through sharing his experience with Alice, who had also been sexually abused, he strengthened their relationship, however he felt she lacked energy to such an extent he was losing the motivation to support her.

We agreed a guided exploration of how he currently represented his past experiences would be useful and at this stage it was very important to emphasise 2 points. Firstly what was creating David’s symptoms was not the sexual abuse, but rather how he was representing it. This did not exonerate the sexual abuse, however it created a cognitive frame which allowed David the realisation that he could change his experience by changing his representation. In other words it provided him with the opportunity to take control of his experience if he accepted this frame.

The second point was about working together with valid information. Often clients, in my experience, will begin to talk about “red herrings” to avoid facing the patterns of experience which emerged from an index event. This is not useful as the relevant patterning in such cases is left unaltered and the symptoms remain. In the NLP pattern Visual- Kinaesthetic Dissociation, (V/KD), Gray and Liotta, (2012) talk about how important in the context of PTSD, reconsolidation of long term memory is as a mechanism for change compared to that of extinction, which to date is the treatment of choice, yet unreliable and subject to relapse. They say this is because the extinction protocol works through creating new associations, yet leaves the old ones intact as demonstrated by spontaneous recovery of trauma association. Reconsolidation however works by accessing, (emphasis mine), the trauma memory and by doing so making it more labile and during that time of lability re-framing the memory, effectively updating it. Just as extinction has reliable characteristics so does reconsolidation, Gray and Liotta tell us, these are; “complete elimination of the target memory, resistance to spontaneous recovery, lack of net gain in reacquisition learning, and lack of contextual renewal” (Gray & Liotta, p. 8).

I wanted to emphasise these two points to David before we began working on the index event to assist him frame the experience as one he does have control over and one that will result in a complete resolution of symptoms if successful. Also to encourage him to be honest with me and work with the deep patterning, which though painful to re-experience, would by such re-experiencing render such a memory labile and more amenable to change. I believed byframing it this way I would increase the expectancy of a positive outcome and thus increase engagement in therapy and eventually a successful result.

The NLP pattern I chose for this intervention was “change personal history” rather than the V/KD. This pattern is credited to Grinder and Bandler by Dilts and DeLozier, (2000, p. 159). There were many reasons for this, however the key reason was David did not have a clear representation of the abuse happening, his memory of it was very implicit. I needed to remind him he could not use the contents of this therapy session as evidence he had been abused and also the danger of co-constructing false memories. Indeed even though David had been diagnosed as having PTSD by his doctor, a key outcome he wanted from therapy was to actually surface these implicit memories which he “felt” were there and were responsible for his PTSD.

After anchoring David into a resourceful state and agreeing with him he can re-enter this state at any time during the session at will, we made use of the NLP design variable of time and started walking back down the time line through 30’s and 20’s noting any incident of notice and making comments on them. We also lightly anchored the symptoms of PTSD that had been caused by the index event and at each incident of notice I asked David if this was the index event that was primarily responsible for the PTSD symptoms. During this time the NLP variables of perceptual positioning, re-framing, anchoring and others were used, so David could come off the time line and look at himself and other people from what NLP calls the 3^rd perceptual position, seeing the systemic interplay between him and others.

This perspective was useful in that it often generated more productive frames for David to create and then associate into when he stepped back on to the time line to continue his journey into the past. In NLP this is termed 1^st perceptual position when one fully experiences the world through one’s own senses and one’s own map of the world. It transpired that these new frames discovered in this session were very useful when the change personal history pattern was used again during future sessions. This was because the new frames gave David the resources and therefore the confidence to explore deeper than he had ever explored before. For instance in an instance with his mother when he got incredibly angry as a result of some comments she made, he found in the 3^rd perceptual position it was most useful to have a Plexiglass shield which allowed him to respond to the content of his mother’s communication but shielded him from the force of her emotion.

During later sessions David explored at the age of 6 a house and many different rooms which were triggers for specific events and specific types of abuse. Often he would simply represent what was going on somatically with jerks, twitches, catatonia and catalepsy, commenting occasionally as he felt able to and responding to questions. One question he found most useful, given he had been educated in earlier sessions as to the constructivist philosophy of NLP, was “and what would you like to do with these experiences?”

On some occasions he made himself much larger and expressed verbally what he wished to say to the perpetrator. On other occasions he found it useful to re-frame the experience commenting on how as a 6 year old this was not his fault and others were to blame. It was during these times and these sessions the new resources discovered on the time line down to 6, like the Plexiglass shield, were most useful in working with these labile memories to make something else of them.

Closing sessions

As the reader might imagine a lot of content from the 18 sessions has been omitted from this paper to save space. But hopefully to date a slight sense of how an NLP therapist might work experientially with a client has been gleaned.

Towards the closing sessions a sense that the initial therapeutic outcome of understanding more fully the nature of the implicit abuse memories had been forthcoming as well as a diminution of PTSD symptoms and there was a sense we now needed what NLP calls a new “Well-formed Outcome” (WFO). This was felt strongly by both me and David.

I pointed out I was concerned about Alice and in order for her to regain the energy needed to function effectively, and increase David’s motivation to assist her, would need considerable expertise possibly from a team of professionals. A Beck Depression inventory, (Beck, Steer, & Brown, 1996) administration returned a diagnosis of moderate depression (24) and I suspected elements of Bi-Polar as well were present for Alice. Often Alice’s thinking processes appeared so disorganised I suggested symptoms of schizophrenia, however I re-iterated I suspected she would need a referral from her Doctor to a multidiscipline team of possibly Clinical Psychologist/Psychiatrist, Social Worker, and Therapist. David had wanted Alice to continue to see me, however she said she would prefer to see a CBT therapist through the National Health Service, pointing out it was probably not wise of her to have missed 6 sessions of therapy with me to look after their daughter. I believe as David was my client, Alice had never had my full attention as her presence was secondary to the resolution of David’s symptoms. Consequently I believe I did not build and maintain the levels of trust I had with David with Alice and this is something I could have done better I believe, had I been able to re-live the intervention.

III. Results

On our final session David reported being very happy with the outcome. He said the police had been around to talk to his mother about the report he had filed over a year ago, and while understanding that the legal system needed evidence in order to move forward, felt if this was not forthcoming in further enquiries which David now felt comfortable to conduct, then he was happy to draw a line underneath this.

David interpreted this visit by the police as a form of synchronicity, in a positive way. He confirmed that he was no longer getting flashbacks nor intrusive thinking and his bearing during wrap up sessions and ratings on the exit questionnaire suggested that this state of affairs was both valid and continuing. He felt even though he retained a very high Thinking profile on Alter-Ego he now could access his feeling side much more readily and not fear what he might find there. He pointed out he could now use his feeling side to associate into new plans and goals involving music composition and was excited in experiencing and exploring this new process. He said he would keep me on his books, however felt he did not need regular sessions anymore. I said that would be fine.

Even though David continued to take soft drugs to help him relax he said his consumption was much less now and he recognised the need to continue this trend in the future, understanding that with the appropriate mental representations he could naturally produce all the feelings that were necessary for his personal development and contentment.

David’s satisfaction is represented in his exit questionnaire, (see figure 1). The before and after profiles on DAPS also support his verbal account of cessation of the main PTSD symptoms, (see figure 2).

Figure 1. Exit form measuring satisfaction with service

IV. Conclusions

As can be seen from figure 2 below David was symptom free after therapy. What was most gratifying was the belief that this state of affairs was sustainable even in the challenging context of supporting both his wife and autistic child whilst needing to excel in a demanding full time job. This is supported by his response to item 15 on the exit questionnaire, (figure 1). As an NLP therapist I was most pleased that the items around utility on the exit form seemed to be the ones which attracted the marks of 10. Not only was the outcome sustainable but it was also relevant to his needs, (item 6) and the outcome was fully achieved, (item 9).

One interesting blip was a rise in the PDST score. This scale measures Peritraumatic distress, which is the amount of distress experienced at the time of the index event. This is relevant because high measures on this scale are related to a greater severity of PTSD symptoms. Discussing this paradoxical blip David recognised that now he had understood more fully what he had gone through, indeed he could see it as horrible, however dwelling on this and representing the sensory scope in an enlarged way was probably not useful. We did some work which in NLP is called sub- modality work to make the abuse images, the sounds and associated feelings smaller and weaker and began to work more on another Meta-Program dimension surfaced by Alter Ego, (see figure 3). This was David’s lack of towards orientation. As we began to work on what was exciting about composing and producing music and performing we were able to co-create a compelling future which David was motivated to move towards. The questionnaires were administered as appropriate, and with the therapy sessions lasting between 8^th April 2016 and 30^th September 2016 there was plenty of time in the finishing sessions to learn from the psychometrics and adjust therapy accordingly.

What is also interesting to note is that throughout this therapy when one looks at the shape of the Alter Ego profile, apart from the slight move to a “Towards” orientation and a “Feeling” orientation David’s profile is  remarkably similar. Having experienced such a change vis a vis PTSD, such similarity of Meta Program profile over time indicates a stability and it may be a useful research project to explore further the claims that these Meta Programs are as changeable as NLP practitioners think they are.

Figure 2. Before and after intervention DAPS profile.

8^th April 2016 and 9^th July 2016

The intention of presenting this case study is to stimulate thinking around the use of NLP in the context of psychotherapy and through creating such visibility in an open and transparent way hopefully generate further narratives in the academic world concerning the utility of NLP as a modality and ultimately generate some good quality empirical research to test some of the claims of NLP therapists and the patterning they make use of in their professional work.

Figure 3. Before and after intervention ALTER EGO profile

13^th March 2016 and 21^st July 2016

References

Bandler, R. & Grinder, J. (1975). The structure of magic. A book about language and therapy. Palo Alto, CA: Science and Behaviour Books.

Beck, A,T., Steer, R,A., Brown, G.K. (1996). BDI-ll Manual. London, New York: The Psychological Corporation. Harcourt Brace & Co.

Bolstad, R. (2002). Resolve. A new model of therapy. Carmarthen: Crown House.

Bostic, St. Clair, C. & Grinder, J. (2001). Whispering in the wind. Scotts Valley, CA: J & C  Enterprises. 

Briere, J. (2001). Detailed assessment of posttraumatic stress. Florida, US: Psychological Assessment Resources. 

Brown, D. (2007). Tricks of the mind (2nd edn). London: Channel 4 Books. 

Dilts, R. & DeLozier, J. (2000). Encyclopedia of systemic neuro- linguistic programming and NLP new coding. Scotts Valley, CA: NLP University Press.

Einspruch, E.L. & Forman, B.D. (1985). Observations Concerning Research Literature on Neuro-Linguistic  Programming. Journal of Counseling Psychology, 32(4), 589–696.

Elich, M., Thompson, R.W., & Miller, L. (1985). Mental Images as Revealed by Eye Movements and Spoken Predicates: A Test of Neuro-Linguistic Programming. Journal of Counseling Psychology, 12, 622-625.

Grimley, B. (2009). On line Stress Questionnaire. Retrieved on 10^th October 2016 from: http://www.achieving- lives.co.uk/questionnaires/stress-test/7.

Grimley, B. (2010) Achieving-Lives Team Effort Role. Enhancing Generative Outcomes (ALTER EGO). Retrieved on 10^th October   2016    from:   http://www.achieving- lives.co.uk/alter-ego-free-personality-profile- questionnaire.

Grimley, B. (2013). Theory and Practice of NLP Coaching. A psychological approach. London: Sage. Glossaryretrieved      on        12^th      October           2016    from: https://uk.sagepub.com/sites/default/files/upm- binaries/52143_Glossary.pdf. 

Grimley, B. (2015). What is Neuro-Linguistic Programing, (NLP)? The development of a grounded theory of NLP within an Action Research Journey. Nicaragua: University of Central Nicaragua (UCN). Retrieved on 8^th October 2016 from: ow.ly/XQqcA. 

Grinder, J. & Bandler, R. (1976). The structure of magic 2. A book about communication and change. Palo Alto, CA: Science and Behaviour Books.

Heap, M. (2008). The Validity of Some Early Claims of Neuro- Linguistic Programming. Skeptical Intelligencer, 11, 6-13. 

Jackendoff, R. (2002) Foundations of language: brain, meaning, grammar, evolution. Oxford: Oxford University Press. 

Korzybski, A. (1994) Science and sanity: an introduction to non- Aristotelian systems and general semantics (5th ed). New York: Institute of General Semantics.

Stipancic, M., Renner, W., Schutz, P., Dond, R. (2010). Effects of Neuro-Linguistic Psychotherapy on psychological difficulties and perceived quality of life. Counselling and psychotherapy research, 10(1), 39-49.

Sturt, J. (2012b). Little evidence for NLP in Healthcare, Para 3. Retrieved on 6th October 2013 from http://www.kcl.ac.uk/nursing/newsevents/news/2012/Littl e-evidence-for-NLP-in-Healthcare.aspx 

Tosey, P. & Mathison, J. (2009). Neuro-linguistic programming: a critical appreciation for managers and developers. Basingstoke: Palgrave Macmillan. 

Wake, L., Gray, R.M., Bourke, F.S. (2013). The clinical effectiveness of neurolinguistic programming. A critical appraisal. London: Routledge.