Tuesday, 11 April 2017

Just a small prick

One residential care environment that I worked in specialised in a particular method of annoying the insane.  It used the "are you sure?" method.  For those unfamiliar with this method it goes something like this.

Staff:  "Hi John, how are you feeling today?  Have you been feeling anxious?"
Patient: "I'm fine thanks."
Staff:  "Are you sure?" (spoken with a tone that suggests superior knowledge)

I saw the same routine occurring with the daily enquiry of, "any suicidal thoughts today?" The patient would deny suicidal thinking and the staff with the same tonality would ask, "are you sure?"

Here's another example.

Staff:  "Did you have breakfast this morning?"
Patient: "Yes."
Staff: "Are you sure?" (with that same tone as before)

It took me a little while to work out just what going on in that place, because it seemed to me that pretty much all of the staff used the same pattern; it was as if everyone was reading the same script.

I'd have hated to be a patient there, it all seemed so demeaning and really rather unproductive.  But I doubt any of it was intentionally so, because staff tend to adopt each others patterns and this often occurs in close-knit working environments.

In hospitals for example, cliche phrases, mannerisms and expressions emerge amongst groups of staff and these can differ from department to department and hospital to hospital.  For example, anyone that has received an injection in a UK hospital is likely to have heard the nurse say, "Sharp scratch!" as the injection is delivered.  It's what nurses say, it is part of the culture.  Personally I always preferred the, "you will just feel a slight prick" gag, but that is a different story.  Another common expression is the "...for me..." tag when asking patients to do something, as in, "stand up for me," "take a deep breath for me," "squeeze this for me" and so on.  Although this was more common on the elderly care units.

The adoption of these little cliches is in part the adoption of the local culture and this often happens without conscious thought or consideration.  It is almost Pavlovian in nature. For example, non-NLPers should watch out: Never say, "I am sure" to an NLPer.  They will nearly always fire back the Bandlerism of, "Are you sure enough to be unsure?"  NLPers can be strange like that.  I once bet a nursing colleague that she couldn't go through a day without saying, "sharp scratch!"  She took the bet and promptly lost it about 15 minutes later.  As Pavlov found, some conditioned responses can be very hard to extinguish without sufficient counter-stimulus.

People adopt cliches and mannerisms that shape the perceived role in which they operate.  For example, saying, "Sharp scratch" fulfilled the need to say something and was acceptable to the peer group.  It fitted in.  My line about feeling a slight prick, which oddly was always acceptable with doctors but almost never with nurses, simply didn't fit in with the language of the peer group.  I learned early in life that, for so many people, fitting in is more important than anything else.  It is frightening sometimes to not fit in.

Hierarchy emerges within groups and the person who best knows how to use the language peculiar to his group is the person who can garner the most status from the group.

Most institutions possess their own language.  The armed forces each possess their own linguistic pecularities, prisons have their own language and currencies and most major professions and institutions also adopt their own expressions and terminology, not least of all, the medical profession.  In medicine, the language used can sound foreign, or like some kind of weird code.

For example, "upon admission the patient was cyanotic, SOB and with pyrexia of 42 degrees" translates as he was blue, couldn't breathe and was pretty hot.  Every part of the body has a name and that name means something to doctors and related professionals.  The words, "he had a heart attack" doesn't actually mean very much from a medical point of view since there are so many variables of what actually constitutes a "heart attack."

All these variables have a name or a medical description that immediately translates meaningfully to those who understand the language.  Given the complexity of what is involved and the size of the subject, it surprises me not one bit that medical training takes so long and requires so much intense study and experience.

NLP has its own peculiar set of words and phrases.  My favorite and one that I like to never miss an opportunity to use is, "kinesthetic transderivational search."  This isn't a term I hear often from NLPers, but is readily understandable to the initiated and rather bewildering to everyone else.  Much like the medical terminology, many (but not all) of these terms are useful in communicating concepts and ideas, such as "a submodality swish" versus a "content swish" and other referential terms such as, "eye accessing cues", "presuppositions", "double binds", "submodalities" and "pacing and leading" function the same way.

So, we have these two type of linguistic cliches - those that enable us to fit in, and those that enable us to understand.  I've never been too much of a fan of the former but must admit to being a bit of a fan of the latter.  I urge NLPers to watch out for the former, these "fitting in" cliches such as the "are you sure?" and the "are you sure enough to be unsure?" examples. Unfortunately, all too often, excessive demonstrations of "fitting in" tend to negate demonstrations of understanding to those outside of the peer group.

Now, it must be said that I didn't exactly fit in at the mental health unit from which I drew the "are you sure" examples, and an inverse relationship between how much my patients trusted me and how much my colleagues didn't trust me became apparent.  The staff tended to think that I didn't "get it" whilst my patients tended to disagree and suggested that I did "get it"; my employment at that unit was never going to last long, that much was agreed by everyone.

In the handover meetings between shifts, the reason for the "are you sure?" nonsense became clear.

The acting unit manager was an unusual individual in that she radically changed her appearance and identity so that she became sexually androgynous on the day she was "made up" to manager level and she would grill the staff about their handover reports.  It seems a bit bizarre now when writing this, but basically, she'd demand that the staff "check" what they wrote by asking the patients if they were sure.  Pettiness was taken to new extremes as in the following example:

Staff: "...and this morning John had a good breakfast before taking his medications..."
Androgyne: "What do you mean, he had a good breakfast?" (spoken with a slight tone of contempt)
Staff: "Well, he had cereal and toast."
Androgyne: "Which cereal?" (again, spoken with that same contemptuous tone)
Staff: "Ummm...not sure..."
Androgyne: "Well, go and ask him."

Yes dear reader, it really did get that petty.

That member of staff would then have to leave the office and go and ask the patient what cereal he had for breakfast whilst the rest of us waited.  I guess many people have been unlucky enough to meet managers like this, androgynes or not.  They don't actually have to do too much to create significant levels of stress in employees.  They also have the following effect.

Those that understand the necessary rituals and ceremonies that keep the manager happy will garner status with her, those that don't end up ostracised by the group.  Over time, the group becomes self-selecting and those who play the game will stay, those that don't will leave, and so a shared and delusional mindset emerges amongst the group.

It can become quite cult-like and it can be really quite unsettling; it is the Emporer's New Clothes all over again, only without the humour and nudity.

I have observed that many NLPers fail to model effectively and simply imitate instead.  I have lost count of how many people I have experienced doing a spontaneous impression of Milton Erickson, not based on their own experience of Erickson (via available audio-visual material) but rather based on a famous trainers' impression of him.  Meanwhile, I have noticed that NLPers no longer imagine things, instead they "hallucinate"; they no longer seem to have opinions, they have "maps"; they don't learn things, they "model" things and "install strategies."  Here are some other examples I experience far too often for comfort:

Me:  "Hi!"
Them:  "Very Hi!"

Me: "How you doing?"
Them: "I'm GREEAT!!  What about you?"
Me:  "Err...fine thanks."
Them: "Just fine?  You should be feeling GREEAT!"

Me: "I don't like that."
Them: "Don't like it how, specifically?"

For too many NLPers, being an NLPer depends upon using all the cliches, mannerisms and attitudes that they observe the rest of the NLP herd using and make attempts at garnering status within the "NLP Community."

Sadly, this can have the effect of distancing them from their own existing community who worry that their loved one has joined some kind of mind control cult.  People that behave in these ways do not always come across as especially functional human beings and I cannot help but wonder if there is a degree of a cargo cult mindset meeting The Field of Dreams - "build it and they will come" - as if the NLPer only need use the right words and parrot what they have heard other NLPers say then life success, happiness, wealth and status is as good as theirs.

Experience goes far deeper than the mere use of the right words.  Remember this before you find yourself abducted and deprogrammed by well-meaning people who "care."

NLP provides a great set of tools for building great states and mindsets, and there are as many states and mindsets as there are people. The emperor wore no clothes, an interesting choice and not one that I would necessarily choose for myself. Be grateful for that. But imagine if the crowd all chose the emulate the emperor, the sight might not be a such a pretty one; depending on where you are stood in the crowd, I guess.

As I see an increased uniformity amongst NLPers striving to reach that elusive but correct NLP mindset this is something that all-too-often tends to get forgotten. 

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