My old Internet friend, the Gentle Giant of NLP, Quentin Grady, died over a year ago, on June 7, 2010, after a long and valiant struggle with cancer.

For you who knew him, there’s nothing I can say that could inspire you to appreciate him more than you already do. You know he was an amazing man.

For those who didn’t know him… I grieve your loss as much as I do my own. You could read over 1200 of Quentin’s Usenet posts from alt.psychology.nlp if you wanted to get a feel for who and what he was.

If this is the first you’ve heard of Quentin’s death, I’m sorry to have waited so long to pass it on.

Visit Quentin’s Memorial Web site and leave a comment.

RIP Quentin Grady originally appeared on NLPhilia Blog on 2011-07-24 (Sunday).

Every article I’ve read there has been awesome in its usefulness. (Cops aren’t big on theory. Theory can get you shot!) What got my attention, though, was his five-part series called “The Poor Man’s Polygraph:”

1. The Well… Technique
2. The Land of Is
3. Forced Response
4. Why Should I Believe You?
5. Parallel Lie

Short, to the point, extremely useful, easy to learn and implement. Go check it out!

The Poor Man’s Polygraph originally appeared on NLPhilia Blog on 2011-01-14 (Friday).

According to the original article, there are three things Bill Clinton does that make people feel as if a “reality distortion field” has wrapped around them:

1. Eye contact;
2. Judicious manipulation of interpersonal space; and
3. Focused attention.

I’m pretty good at the second one, though there are a couple of aspects of it that I could improve. It isn’t so much the actual space, but the way the other person perceives it. There are things one can do to make interpersonal space seem smaller or larger without actually moving toward or away from the other person. I think that’s an interesting idea. I’ll play with that last.

The third one? I’m horrible at it. Nearly 25 years of security and Emergency Medical Services work have required me to habitually cast my attentiveness as wide as I can. It looks like I’m easily distracted, especially in unfamiliar places. I’m really not, but there’s no way someone talking to me can tell that. I’ll play with that next.

What I’m playing with now is eye contact. I’ve always been really bad with it. When I lock eyes with someone, I get the same feeling I get when I look into someone’s living room window. Sure, if the curtains are open, you can’t help but notice it in passing, But to really look? It feels invasive to me. Like I’m violating someone’s privacy.

Irrational, I know. I’m hoping to find someone who can offer me a better way to think about what I’m doing. In the meantime, I’ve been doing it anyway. Looking into people’s eyes and keeping it.

Two things have surprised me.

The way other people respond to it is a surprise. Most of them genuinely don’t mind, and some of the rest really seem to appreciate it. Those who (apparently) feel like I do simply look away quickly, but they don’t seem offended.

Many of the first group suddenly find me a better conversationalist. Not that I say anything. They do a lot more talking to me. I guess if I appear fascinated, they must assume they’re fascinating… which does make sense. A number of people have found it difficult to go on about their business. One deliciously beautiful woman actually accused me of preventing her from leaving.

The other surprise was my own internal responses. Absolutely nothing bad has happened, and sometimes I feel surprised at that. On occasion, when I lock eyes with someone and they look away quickly, I feel a small, but primal, sense of power that I’m not at all happy about in retrospect. With many, I really am a better listener; I want to listen, I actually crave it. And the most unusual response of all: one particularly blue pair of eyes actually fascinated me… and I mean that in the original sense of the word: “to cast a spell which renders one unable to move.” I have studied hypnosis long enough to be able to break that “spell,” but for the few seconds that I was there, I went meta to it and wondered how something like that could happen to a grown man.

I learned, as well, that there are times when I need to not make or hold eye contact.

In a restaurant, for example, no matter which staff member I looked at, they stopped what they were doing and asked what they could do for me. I was actually interrupting them without meaning to. Not polite.

I spoke with the CEO of the hospital for which I work a couple of days ago, and I intentionally did not lock eyes with him. I won’t tell you the circumstances (no, I wasn’t in trouble; far from it) but somehow I felt it wasn’t appropriate at the time. He’s the type of guy that I could connect with that way if the context were different, though.

Tonight, I made eye contact with a co-worker, and I quickly broke it. I believed that if I held it, he’d ask me what the heck I was doing. I didn’t feel like explaining because I was ready to go home. You know how it is.

It’s been interesting and pleasant so far, and I think it’ll continue to be.

If you have a good, strong belief that allows you to make and hold eye contact comfortably, would you mind sharing it with me in the comments? I’d appreciate it.

Locking Eyes originally appeared on NLPhilia Blog on 2010-12-6 (Monday).

Listening to the CDs reminded me that I’d never really spelled out how I think about how I do it, so I resolved to put it here. I’ll start with one particular aspect: how to shift someone from a high-energy unresourceful state, such as anger, to something a little more flexible.

Many years ago, I was an Emergency Medical Technician working for a private ambulance company, and I was stationed at a state psychiatric hospital. I happened to walk in on a training they were having for their nurses and technicians: Bruce Chapman’s Handle With Care Behavior Management System. I was immediately captivated by Master Bruce’s teaching style and his philosophy. I arranged to take the training for myself. What I’m about to share here is roughly based on something I learned in that class and in much subsequent reading of Chinese philosophical work such as the Tao Te Ching by Lao Tzu and The Art of War by Sun Tzu.

Tai Chi Tu (click image for SVG source)

Here we have the Tai Chi Tu, commonly known as the “Yin/Yang symbol”. This is the Taoist in-a-nutshell representation of the way the universe works. You’ve seen it many times, no doubt, but I imagine nobody’s really explained it. I’ll give it a shot.

First, you’ll notice that it’s a circle. No beginning, no end. Now, pick a spot, either at the top or the bottom, where either the black or the white is almost non-existent. Moving clockwise, you’ll see that the color you chose increases while its opposite color decreases… and that as soon as it gets to the point where it can’t hold any more, you’ll see that the opposite color starts to kick in, PLUS, there’s a little “seed” of the opposite color contained in the fullest part of the swell.

Now, I can’t find the citation at the moment, but there’s an old saying that hard winds don’t blow all morning and heavy rains don’t last all day. Physics tells us that energy constantly changes form. Biology tells us that we change or we go extinct. It isn’t just that change always happens; it’s that it must happen. So when I’m in front of an angry person, I know I don’t have to do anything at all to get them to stop being angry. All I have to do is get rapport, pay close attention to when their angry state changes to another state, catch the transition point, and steer it to where I want it to go. The best part is, if I can figure out what the “seed” of the next state is, knowing that it’s already there, I can speak to it… drawing attention, and therefore the other person’s energy, toward it… making sure that it really is what’s next.

Anger, and most other high-energy emotional states, cannot last long. It’s physically impossible to maintain it. It costs too much. Anyone who claims they’ve been angry about something for years and years… they aren’t angry. They may be bitter, but they aren’t angry. Anger is a flash, not a smoulder. (This is one of the ways the psych nurses know when someone is faking a condition, and why we keep people for observation for up to 72 hours.)

Jonathan suggests in the Automatic “Yes” CDs that, to move someone out of a high-energy unresourceful state, we should turn it up rather than try to turn it down. I agree. Several times I’ve been called to the psychiatric unit where I work because a patient is scaring the staff and the other patients despite the fact that he isn’t actually doing anything. He’s got a clenched jaw, closed fists, and knitted brow, and he’s pacing, and he’s been doing it all day. When I respond, all I do is engage the guy in some sort of conversation and then do something that I think will annoy him. Not anger him; just irritate him. It adds energy to his stuck state, and then he has to choose which side of the fence he’s going to crawl off on. Is he going to start throwing things and kicking walls and cursing, or is he going to start talking? As soon as he gets to the decision point, I lead him to the state I want him to have. Usually I just tell him what it is: “It’s gotta be frustrating,” I say, or “I’d be scared too if I were in your place.” Sometimes I offer a path to follow instead: “You just have to wonder what’s going on, but the more questions you ask the more answers you get.”

(Of course, I’m ready if he decides to go the other way, too. It’s never actually happened, but if it does, at least he’ll have resolved his stuck state and can work from there.)

I can take these more energetic states and ride/drive them to something a little more useful for the other person and a lot safer for those around them. Which is, essentially, what state chaining is about.

I strongly recommend Jonathan’s “Automatic ‘Yes’” CD set to you and to anyone else who wants to take their social skills to the next level. And I want to thank him publicly for helping me to think more clearly about one of the things I’ve been doing without realizing it.

The US Federal Trade Commission requires that I add: While Jonathan did ask me for a product review, it should also be noted that I bought my copy of this audio program directly from his Web site, and that my recommendation is not a form of payment for the product.

Changing States originally appeared on NLPhilia Blog on 2009-10-31 (Saturday).

Sometimes, though, I question whether or not we should. I see value in grief, myself, and believe it should be left alone unless it’s crippling. According to my CISM trainer, post-traumatic stress should be left alone too, at least for the first 24 hours, to give the client’s own coping abilities time to work. And as I mentioned in this thread on NLP Connections, I believe altering or eliminating the memory of a painful event could have negative effect in and of itself, by preventing the client from learning from the event.

I actually learned this from a client, a good friend of mine. She had been sexually abused as a child, and had a phobic response whenever someone patted their thigh in a “come sit on my lap” sense. She’d talk about it, and every time I’d offer to help her with it, she’d refuse. She was wise enough to know she wasn’t done with it, and knowing she could have my help with it gave her the strength to face it on her own, as much as she could, drawing knowledge and wisdom from the event. This went on for many months. When she finally gave me permission to help, it took all of fifteen minutes. (I can’t tell you how gratifying it was when, a couple of days later, she came over to me and sat on my lap.)

Anyway, today on the Freakonomics Blog, author Steven Levitt wrote:

My son Andrew died exactly ten years ago today, October 23, 1999, nine days after his first birthday. No one would describe me as emotional. And yet the wound still remains remarkably raw.

I say there’s nothing wrong with that.

Please read the rest of the article: Naming the Child

The title of his article is taken from the book of the same name, which he recommends. It looks quite compelling. (If you choose to buy the book, please go ahead and follow the amazon referral link from his article, rather than the one here.)

All I’m suggesting is that we, perhaps, consider ecology before we do anything like this. We humans evolved with the ability to feel fear, anxiety, sadness, grief, and the like, and there’s an evolutionary advantage to them. Let’s not just toss them away.

Painful memories originally appeared on NLPhilia Blog on 2009-10-24 (Saturday).

In this economy. Think about that. She not only got a new job easily, she created an environment in which they are, relatively speaking, throwing money at her.

As synchronicity would have it, Seth Godin wrote a short article today which explains how she’s doing it:

You will never be out of work if you can demonstrably offer one of the following:

• Sales
• Additive effort
• Initiation

She’s an absolute star at the latter two, and makes up for her current lack of sales skills with wit, charm, and physical attractiveness. Who knows what will happen when she decides to learn to sell.

Anyway, for an explanation of what those three terms mean in real-world terms, go read The three elements of full employment at Seth’s Blog. How you learn to apply them to yourself is up to you.

How to Keep a Job originally appeared on NLPhilia Blog on 2009-10-9 (Friday).

(Tum-tum-te-tum)

Welcome back. How are you feeling?

I thought it was hilarious. Keep in mind that I love cats, especially calicos, and especially kittens. Humor is thought to be a tension release, and that pic really inspires tension in a guy like me. So when I read the caption, I laughed.

Now go back and read the comments. Well over a hundred people who didn’t get it had to announce their didn’t-get-it-ness to the world. The comments on CO almost always suck (though at least it has comments, which most of my articles don’t) but the ones on that page suck differently. Self-righteously. As if their state is the blog’s fault.

Sheesh.

State Elicitation originally appeared on NLPhilia Blog on 2009-09-3 (Thursday).

In it, he points out that NLP was originally a methodology for modeling, and that now… well, it’s hard to tell what it is. Is it a bunch of techniques for self-improvement? Is it a therapeutic modality? Is it still modeling? There are hundreds of “NLP books” available, and they’re all about different stuff!

I think he has a strong point, and at the same time, I’m not worried.

Let me start with what he says he thinks NLP is:

From what I understand, these are all misunderstandings. NLP is about the structure of subjective experience. It’s about learning to recognise and interact with the structure of how people think. It’s a meta-discipline. You can use the “trail of techniques” to do many things, but the techniques don’t define the scope of NLP.

I start there because I agree with him. This is NLP to me, too. A meta-field, an epistemology, a set of tools. By way of analogy: carpentry is a way of building a house, but it is not a house, and calling a house “carpentry” just confuses people.

Then Chris goes on to say:

It’s got more confusing too. Like most groups of young people, the original NLP creators and developers fell in and out of love. Some even got married, and then divorced. 35 years on, most of them don’t speak to each other. And while mummy and daddy both still love their baby very much, they have different hopes and dreams for it, and very different parenting styles.

That’s correct, too, and there’s a little more to the story. In the process of giving birth to, and then raising, NLP, they either refused to or neglected to legally protect the property. Richard later tried to correct that, but it was too late. The label “Neuro-Linguistic Programming” is now a generic term, and people are free to apply it incorrectly if they want to.

Then Chris says this:

NLP has become like a horse with two riders, each going in different directions. In fact, it’s like a horse with hundreds or maybe even thousands of riders, because each of the co-creators and some of the developers have anointed a series of trainers, master trainers and apprentices to spread their word. And, inevitably, after a few months or years, these people discover they have ideas of their own too, and they start adding their own spin on things. Gradually or suddenly, they start spreading their own version of NLP.

He seems to me to be presenting this as a problem and a Bad Thing. This is where I feel compelled to part company with him.

For a few years now, I’ve been interested in the idea of evolution. (Now, evolution is a well-documented phenomenon, and there’s no credible argument against its existence. Whether or not you believe evolution is how we humans got to where we are has nothing to do with whether or not evolution exists, and we aren’t discussing that.) Evolution is how a species of organisms changes over time into other species. It seems to apply to other systems, such as language and economics, as well.

Just to hit the high points, there are four factors at work in genetic evolution:

1. Sexual selection. Based on criteria of their own, one organism chooses to mate with a particular other. The characteristics of those two organisms get passed to the next generation, and the characteristics of organisms not chosen do not.
2. Natural selection. Factors in the environment stress the organism, and those organisms that survive will grow up to pass on the characteristics that helped them to survive while those who die will not.
3. Mutation. Damaged DNA or errors in copying genes cause cells to do things they wouldn’t ordinarily do. If those mutations create characteristics that help the organism survive and reproduce, those mutations are likely to get passed on to the next generation, where they create an advantage in the offspring.
4. Genetic drift. Gene variants (alleles) are combined in reproductive cells at random. That’s why you look similar to, but not identical to, your siblings. Sometimes, these random combinations produce features that create a reproductive or survival advantage.

This is how I see what’s going on with NLP now. It’s the early stages of evolution. We’re in a Paleozoic-era-style experimentation soup, where everyone is trying something different just to find out what will work and what won’t. This unlimited freedom to experiment is the direct result of what Bandler and Grinder did, or, rather, didn’t do:

But how have they been as leaders of their field?
“Follow me, I’m right behind you.”

Again, I don’t see that as a bad thing. Chapter 66 of the Tao Te Ching, an ancient Chinese treatise on How Stuff Works, you read that If you want to govern the people, you must place yourself below them. If you want to lead the people, you must learn how to follow them. Now, I’d never accuse either Bandler or Grinder of abject humility, but teaching your followers to lead themselves is, I think, a mark of real leadership.

Chris asserts that Bandler and Grinder, by allowing almost unlimited freedom to experiment in NLP, are killing their legacy. I don’t know if I agree with that or not. Maybe they are, and if it dies, perhaps it should die. Maybe they aren’t, though; maybe what they’re doing is allowing their legacy to become greater than they themselves could make it.

So my suggestion is twofold:

1. Encourage people to differentiate, as Robin Manuell (in the comments of Chris’ article) pointed out that John Grinder does, among “NLP modelling”, “NLP applications”, and “NLP Training”. It’s high time to permit “speciation” in the field, and drawing people’s attention to the reasonable distinctions that can be made will be good for all three “species” of NLP.
2. You, whoever you are, whatever you do with and within NLP, should get exceptionally good at it and share with with others. The better you are, the more flexible you are, the more likely that what you do will matter, and then it will survive.

A Response to Chris Morris originally appeared on NLPhilia Blog on 2009-07-26 (Sunday).

• Profiles in Manliness: Viktor Frankl is a post at a quite compelling blog called The Art of Manliness. I won’t try to explain it here, but if you’re a guy or are interested in guys, spend some time reading it. The article about Frankl talks about how he is a positive role model for men.
• Priorities in black and white and Priorities in black and white, part 2 are written by Rick Brinkman, one of my favorite CareerTrack presenters, and are focused on his recent relationship with his father, who survived the concentration camps.
• Here’s an amazon.com link to Frankl’s masterpiece, Man’s Search for Meaning.

Updating “I met a survivor” originally appeared on NLPhilia Blog on 2009-04-5 (Sunday).

I had to admit that I took a shortcut and made them from Bisquick. She was a bit annoyed. See, she made them from Bisquick, too, but, she said, hers were always flat and tough and tasteless. Mine were light and fluffy and delicious.

She and I used the same recipe — followed the same prescribed steps in the same order — but my results were good, and hers weren’t. What’s the deal?

It turns out that there are a great many things they don’t write into a recipe. Things that a cookbook author, who is adept at cooking, assumes one knows. So people buy cookbooks, or trade recipes online or with friends, and complain that theirs doesn’t “turn out” and they don’t know why.

I taught myself to cook. I love to eat, and I enjoy good food, and I absolutely enjoy trying new things, so learning to cook was a must. I can read a recipe and hallucinate how it’ll taste, at least most of the time. It took me a long time to get where I am, and if I’d gone to culinary school I’d have cut that time way down. I’d be a lot better at cooking, too. But I’m still pretty good. I can follow a recipe and it’ll “turn out”.

Anyway, here’s what pancake recipes don’t tell you:

• Don’t beat the batter. Stir it. It’s OK if there are some lumps. If the lumps bother you, break them up with a whisk. Just don’t beat the batter. It develops the gluten in the wheat flour, which will make your pancakes flat and tough and bland.
• Let the batter sit for a while. Ten or fifteen minutes at the very least. Overnight in the refrigerator is great. This lets the milk and eggs soak into every bit of the flour, which helps the flavor a lot.
• The griddle or skillet has to be hot. Toss a drop of water on it, and it doesn’t sit there and sizzle; it jumps around and tries to get away. Pancakes cook quickly to trap air bubbles in the batter. Cook them too slowly and the bubbles can all break up and get away, making things flatten out.
• Flip the pancakes once and only once. Flipping is another thing that can develop gluten.
• Most important: use real maple syrup, not that godawful fake maple flavored stuff. It matters. Try it once and you’ll see. Just don’t use too much, because real maple syrup has a rich flavor you won’t find in those chemical compounds that pretend to by syrup.

Enjoy your breakfast.

(Jeez… why is he writing about pancakes on an NLP blog?)

The recipe isn’t what matters originally appeared on NLPhilia Blog on 2009-03-21 (Saturday).

I’d been keeping an eye on him for a little while, off and on, because he was Italian. Some of the staff, for all of their intelligence, don’t know how to handle it when a guy whose parents came over from Italy starts acting normal. “Normal” for an Italian guy is to talk loudly and rapidly, wave his hands about, and get “uncomfortably” close, and on rare occasion I’ll get a call about a guy “getting in my face and yelling and making threatening gestures”. It’s kind of funny, I think.

I had no trouble connecting with him, and he was free with his verbal affection for me. To top it off, he was intoxicated and getting “up there in years”. A little earlier, he’d mentioned that his father died at age 90; not too long after, he mentioned, in a little too offhanded way, that he himself was 89. So I’m thinking that he’s thinking about how he’s probably going to die soon.

Anyway, so he asked me if I knew what they call him, and I said, “No, what do they call you?”

“They call me Wagon Wheel.”

I thought that an odd nickname. “Wagon wheel?”

“Yeah, Wagon Wheel.”

That’s odd,” I said.

“Yeah”, he added. “Wanna know why they call me Wagon Wheel?”

“Sure.”

“It’s cuz I been through a lotta shit!”

How could I not laugh?

I tore myself away and went to take care of other business, but I stopped in and checked on him a couple of times. When it came time to let him go home, he said, “Hey… are you going to remember anything? Have I given you anything?” It really mattered to him.

“Yeah, you bet. I’m gonna remember “Wagon Wheel”.

“You a wagon wheel? You been through a lotta shit?”

“Sure,” I said, “I been through a lotta shit. They could call me Wagon Wheel too.”

“Well, then, remember this,” he said. “There’s four wheels on a wagon. Three other wheels been through the same shit as you.”

If he was worried about leaving a legacy, he can stop after that.

Wagon Wheel originally appeared on NLPhilia Blog on 2009-02-14 (Saturday).

When they finally paid her what they owed her, she paid me back. Instead of blowing that big check, I paid off my massive debt.

It felt so amazingly good to be free of it that I haven’t had any long-term debt since. (Long-term debt is a contract for more than a year. I bought a new vehicle in 2002 and financed it for twelve months.) And I’ve been saving a large portion of my paycheck for years, too.

So the $4-a-gallon gasoline didn’t bother me. The current “credit crunch” can’t really touch me. I didn’t buy a poorly-built, overpriced McMansion with a subprime mortgage, either.

All around me, though, are people who make two to five times my annual salary and who don’t have a pot in which to urinate. And people who are absolutely flat broke who trade their food stamps for snacks and sodas and spend their government stipend on expensive skin care products and cell phone contracts.

The only thing I can think of that separates me from them is that I’ve been where they are, I’ve been where they aren’t, and I know which one works better. They’ve just been where they are.

In times like these, get-rich-quick schemes really do well… for the grifters who purvey them, that is. And I’ve been active in online NLP forums for ages, so I’ve seen hundreds of “How can I use NLP to get rich?” messages. I just recently responded to one about that so-called “Law of Attraction” nonsense, and since I didn’t get a response I’m guessing I wrote something the poster didn’t want to read. I wish they’d include a disclaimer that said “Only reinforce my delusions, please. No reality checks welcome.”

The funny thing is, even if it all worked, even if all this “huge income with little effort” stuff actually paid off, it wouldn’t help. If you make a million dollars a year and you spend a million dollars and fifty cents, you’re still broke. No matter how big your bucket or how cool and sweet the water with which you fill it, if there are big holes in it you’re going to be thirsty all the time.

So for a little while, let’s put aside our money-making strategies and work on some money-keeping strategies.

There’s a blog called No Credit Needed and I encourage you to read it all. The author started from debt-plus-no-savings and worked his way to financial stability, and he chronicled his journey. Excellent stuff. First-class exemplar of the skill. In a post today, he offers up the10 basic steps he followed to escape the paycheck-to-paycheck cycle.

There are good books, too, like The Millionaire Next Door and The Millionaire Mind by Thomas Stanley and The Total Money Makeover by Dave Ramsey. (FYI: those are Amazon.com links.)

Shop around at local or regional banks, too, for your banking services. They’re less likely to have been caught with their scruples down and are doing a bit better right now.

If we’re going to fix this economy, we have to do it the way we do everything else: go first.

Oh, by the way: stay safe at work. Being screwed by Worker’s Comp is no way to live!

Put More Water in the Soup originally appeared on NLPhilia Blog on 2008-12-4 (Thursday).

The economy is stressing lots of people to the point of strain now, and because strain is a leading cause of various illnesses, the opportunity for we people-helpers to help the physically ill with their emotional and mental challenges is likely to present itself more and more often. You never know when you might have a friend, relative, or co-worker who’s suddenly faced with something bigger than they’re equipped to handle alone.

The Psych Central blog has featured several “coping with illness” articles over the past couple of months. I’d like to draw your attention to three of them.

Breast Cancer Coping Styles refers to a Temple University study on responses to a diagnosis of breast cancer.

Ericksen set out to explore how women respond to a diagnosis of breast cancer shortly after receiving her own diagnosis. She discovered there are four types of responders, including the “take charge” type, each valuable for different women.

And, because breasts are one of the most important Western symbols of femininity and breast cancer receives more attention in the media than other forms of cancer, Ericksen also investigated how the cultural messages women receive about breast cancer inform their journeys.

PTSD Among ICU Survivors references an article from HBNS which reports that one in five ICU survivors experiences PTSD Symptoms.

PTSD can occur in people who have experienced or witnessed life-threatening events, such as serious accidents, violent personal assaults or natural disasters. Symptoms — which include nightmares and problems sleeping, flashbacks, irritability, anger and feelings of emotional detachment or numbness — often extend for months or years after the traumatic event, and affect about 6.8 percent of the general U.S. population, according to National Center for PTSD figures.

The trauma of an ICU stay triggers PTSD symptoms in many survivors and negatively can affect a person’s quality of life after leaving the hospital, the authors discovered.

Family Members Experience PTSD highlights a University of Pittsburgh study on how families of ICU survivors also experience PTSD.

Researchers found that symptoms of anxiety and depression in family members of ICU patients diminished over time, but high rates of post-traumatic stress and complicated grief remained.

“Our findings suggest that family members of patients in the intensive care unit are at risk for serious psychological disorders that may require treatment,” said Cindy L. Bryce, Ph.D., associate professor of medicine and health policy and management at the University of Pittsburgh School of Medicine.

One more thing I want to mention is a book which forever changed the way I think about working with people who are facing life-changing events: When Bad Things Happen to Good People, by Harold S. Kushner. If you haven’t read it yet, believe me, it’s worth the time and effort. I keep having to buy new copies because whenever I loan mine, it doesn’t come back.

So keep your eyes, ears, and heart open to those in pain, and remember those close to them as well.

Helping People Coping with Illness originally appeared on NLPhilia Blog on 2008-11-22 (Saturday).

The night I’m thinking of, she was evaluating a big, burly, truck-driver-looking guy because he’d threatened to kill himself. She’d decided he meant it and needed to stay with us for a few days. Under state law, we have to give everybody a chance to sign themselves in, and she was going to do that… and if he refused, she’d have him committed against his will.

(We do it more often than we like. It sounds mean, but, really, it’s not. Most people in that position end up glad we did it.)

She was worried that he’d react violently when she offered him this apparent Hobson’s Choice, so she asked me to be close by. I stood just out of sight and listened. He didn’t react violently, but he did do something interesting.

He repeated, “I’m damned if I do, and I’m damned if I don’t.”

She did her best to assure him that it was his choice, and he’d say, “I’m damned if I do, and I’m damned if I don’t.” Then he’d ask her what she thought he should do, and she’d repeat that she couldn’t choose for him, that it was his choice. And again he’d say, “I’m damned if I do, and I’m damned if I don’t.”

This went on for, I’m guessing, FIVE STRAIGHT MINUTES. He couldn’t choose, she wouldn’t help. (She couldn’t help. I’m not blaming her for this. He was in a bind, he knew it; he wanted out of it, and she had no way of figuring out how to help without appearing to lead or coerce him. So she was in a bind too.)

I decided I’d stood there long enough, feeling sorry for them both. So I walked around the corner and “listened” for a couple of “I’m damned if I do, and I’m damned if I don’t” rounds. Then I said:

“Look, man… you’re damned if you do and you’re damned if you don’t, right?”

“Yeah!” he said. Frustrated. Wanting help.

So I said, “Well, you might as well get it over with.”

He tilted his head, went inside for a second, nodded, grabbed the clipboard, and signed himself in.

The Social Worker was shocked, but didn’t say anything to me.

I’ll only point out to her, if she’s reading this, that I didn’t tell him which choice to make… I only suggested that he make one. Choosing to be committed would have been every bit as valid a response to my statement as signing himself in, and I would have found it every bit as respectable. The truth is, though, signing himself in was in line with his values and being committed was not, so he chose to sign.

Ticking off the pros, the third originally appeared on NLPhilia Blog on 2008-09-24 (Wednesday).

The patient was a rather large and muscular guy who looked as if he’d been in a few fights in his life. I’m not sure what he was doing, but the staff were quite intimidated. When I got there, he was sitting in one of the common areas, slouched in his chair, with a look of exaggerated indifference on his face. Deb was sitting at the opposite end of the table and talking to him with a great sense of reason in her voice. (It’s hard to describe the tone in more detail. Sorry.) I sat down at the table, too, in view of him but not her, and I slouched in my chair and put an exaggerated indifference on my face.

When she said anything I thought he should agree with, I’d shift my expression to “Well, that makes sense”, and then shift it back to mirror his.

(Deb would say something like, “I called him so he could help me, and all he did was sit there!“)

And when I figured he and I were on the same wavelength, I yawned. A little noisily, but not loudly.

(Deb would nearly shout at this point in the story, “And then he started yawning! I’m trying to defuse a dangerous situation and he’s yawning!“)

I sat and listened and paced him for another minute and yawned again. And then he yawned too. I guess he got tired or something. No more fight in him. Shortly, he asked her if he could just go to bed.

As we walked out of the room, she gave me the “WTF did you do?!” look. I just shrugged.

Ticking off the pros, part two originally appeared on NLPhilia Blog on 2008-09-17 (Wednesday).