Anthony Collinge explains neurolinguistic programming, a method of matching the way a patient thinks, to improve communication
Anthony Collinge explains neurolinguistic programming, a method of matching the way a patient thinks, to improve communication
A technique which can help when dealing with patients is that provided by NLP (Neurolinguistic programming). This rather awesome sounding phrase really means matching the way a patient thinks, talks and acts, so that communication between you and them becomes clearer, with less likelihood of confusion.
It is a way of deciding how a person does what they do, how they make decisions and so on, so that you can match the way they do this and become more effective. It was said earlier in this series that 'people like people like themselves' and to a certain extent NLP is about you becoming (temporarily) like the patient.
Gaining rapport
The first way of doing this is by matching the way a patient speaks and their posture. In NLP this is called gaining rapport with someone. If you can more nearly match the pitch of someone's voice, the speed of their speech and, to a lesser extent, its volume, they are far more likely to hear what you are saying. You may have noticed that some people are harder to understand than others.
This is not an intellectual problem, it may be simply that you are not 'tuned in' to their speech patterns. As I explained in an earlier article, if someone tends to speak rapidly, they will find someone with a slower delivery of speech quite frustrating. Similarly, someone who speaks slowly may feel that someone who speaks rapidly tends to gabble.
If you can match a person's rate of speech, they are far more likely to be able to hear what you say and similarly in adopting their rate of speech you are more likely to become attuned to it and hear what they say, and therefore understanding becomes easier.
The way a person speaks is to some extent dictated by the representational system they are using - this is explained later on in this article.
Similarly, if you can manage to adjust the pitch of your voice to that of the person you are talking to, they will feel that you are more like them and therefore more likeable to them. In all this it is essential not to try to mimic them, especially if they have a regional accent.
These techniques are a way of gaining rapport with patients which makes their visit to the practice less stressful and generally more pleasant for all concerned. Some people speak more loudly than others, sometimes because they are hard of hearing, and if you try to match the volume they use, it will help the conversational flow. On the other hand, some people speak softly and you may have to reduce the volume of your voice so as not to appear to be shouting at them.
With all these techniques, it is perhaps best not to try to get too accurate a match of the patient, (although this is what psychotherapists, who of course have a much longer contact time with their patients, will try to do), but rather to modify your natural voice patterns, subtly, to make them nearer to those of the patient. Perhaps if you slow down or speed up a little, raise or lower the pitch of your voice slightly and increase or decrease the volume of your voice to some extent, you will achieve your objective, namely improving the quality of your communication with the patient.
Body language
Another method of helping to build up rapport between you and the patient is to match their body posture. The classic example given of people in rapport is that of two people very much in love enjoying a meal together in a restaurant. If you watch them you will see an almost balletic show with them moving at the same time, reflecting one another's gestures, even picking up their glasses at the same time to take a drink.
They may not be saying anything but their bodies show how deep their rapport is. Conversely, people who may have just had, or be in the middle of, an argument tend to show their lack of rapport by the way that they do the opposite to their partners. They may sit back when their partner sits forward, fold their arms when their partner has theirs open and generally display that the two are not alike.
Deliberately breaking rapport can be a subtle way of ending a conversation. If you and your companion are both sitting, perhaps both lounging, then you can break rapport by changing your body posture to be completely different to theirs, standing up being the most obvious change you can make, but just sitting up straight can signal that it is time to move on.
Some people feel uneasy when copying another person's posture and indeed if not done with a certain amount of discretion the person being copied may be offended by what they perceive as mimicking. To avoid this there is a technique known as cross-matching. This involves making similar movements to them, but in a much less obvious manner. If, for example, a person has their legs crossed at the knee you can cross yours at the ankle. If they are rhythmically swinging their leg you can tap your finger at the same pace.
If they are stroking their chin, you can rub your leg in rhythm. As long as you let their unconscious see that you are the same as them they will be more in rapport with you. If you are sitting at a reception desk, or a dispensing table, if the patient leans forward so should you, if they lean back, so should you. Obviously, don't lean forward so that your noses are touching, but mimic their posture, to a lesser degree.
You may wonder if these strategies are perhaps manipulative and certainly they can be powerful ways of getting people to do what you want them to. Whether or not they are manipulative depends on you. What I am suggesting is that these are techniques which you can use to help you 'get on with people' better, and provided you don't take them to extremes, there is no reason why they should be construed as manipulation.
Have you ever felt that you were talking a different language to someone and wondered why you just weren't on the same wavelength? (Assuming you both speak English of course.) Perhaps in a way you were talking different languages. NLP explains that we all have a preferred way of thinking, some people think in pictures, some in sounds and some in feelings (there are others, but these are the main three).
It is known that we tend to 'filter' our experience of the world to avoid being overwhelmed by all the sensory input with which we are constantly bombarded.
At the moment, in order to take in all that you are reading, it is necessary to filter out the extraneous noises surrounding you (which you may now have become aware of) and of the various smells nearby and you may become aware that you could do with making yourself more comfortable.
All these inputs have been filtered out to allow you to concentrate on the task in hand. When we are carrying out our daily tasks we tend to concentrate mainly on one of our senses, to the exclusion of the others. Some people tend to prefer to concentrate on what they see, some on what they hear and some on how they feel. These are called their preferred 'representational systems'.
What is the relevance of this? People will tend to use the language appropriate to the system they are using. This means that visual people may 'see your point of view', want to 'get things in perspective', or 'take a dim view of things'. (They also tend to talk more rapidly). Similarly, kinaesthetic people (who are using their feelings) may want to 'get a grasp of the situation', perhaps they 'have a feeling about something', or need to 'get a grip' on things. (They also tend to talk more slowly).
Auditory people want to know if they 'like the sound of things', to know if things 'resonate with them' and might ask what you 'have to say' about something. (They tend to have a more rhythmical quality when they speak). The words people use give an indication as to which particular representational system they are using at the time. If you can reply to them using the same type of language then you are far more likely to communicate effectively with them.
It is also useful when helping them to choose their spectacles if you know what their preferred system is. Visual people might like to see several frames and to make sure that they 'look right' on them. Kinaesthetic people may want to make sure that they feel comfortable and that they are robust. Auditory people could wish to know what you have to say about the frame. Taking account of their preferred system will make you more effective here.
There is another clue to which particular system a person is using at any particular time and this is to note which 'eye accessing' clues they demonstrate. Someone who is in 'visual' mode will tend to look upwards, someone in 'auditory' mode will look to the side and someone in 'kinaesthetic' mode will glance down and to the right (if they look down and to the left they are probably talking to themselves) (Figure 2).
At first you may find it difficult to decide exactly where a person is looking and it will take a certain amount of practice to note when this takes place. It must be emphasised that this is only an indication as to which representational system someone is using, it is not a hard and fast rule and it may in fact depend on what sort of question you ask.
If you ask someone what colour their front door is, you may well provoke an upward eye movement as the person scans their visual memory, similarly you may get a sideways movement if you ask someone to remember a certain sound. Having said all this, if you can become proficient at watching eye movements, it certainly helps to optimise your communication skills.
If you want to improve the way that you interact with people, NLP has a technique which helps you to review how a recent conversation with someone has been perceived. This is the technique of using different positions. First position is from your own perspective, second position is from the point of view of the person to whom you were speaking, and third position is what an observer would see.
If you have had a difficult time with a patient and you want to see if you can prevent a similar occurrence, you can review what happened using this technique. When you can reflect on what happened, run through the episode from your point of view. Then run through what happened, imagining yourself as the other person, if possible adopting the way they were standing, their attitude and so on. This will give you an insight as to why things went wrong for the other person.
Then imagine what it would have looked like to an impartial observer; perhaps your posture made you look more aggressive than you realised, perhaps they felt you weren't as helpful as you might have been. Assessing what happened using this technique can help you avoid making the same mistakes if the situation happens again, and adjust your actions appropriately. Using this method is an excellent way of improving your performance as a communicator.
*Anthony Collinge is an independent optometrist working in Cumbria. He writes and gives talks on communication skills
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A technique which can help when dealing with patients is that provided by NLP (Neurolinguistic programming). This rather awesome sounding phrase really means matching the way a patient thinks, talks and acts, so that communication between you and them becomes clearer, with less likelihood of confusion.
It is a way of deciding how a person does what they do, how they make decisions and so on, so that you can match the way they do this and become more effective. It was said earlier in this series that 'people like people like themselves' and to a certain extent NLP is about you becoming (temporarily) like the patient.
Gaining rapport
The first way of doing this is by matching the way a patient speaks and their posture. In NLP this is called gaining rapport with someone. If you can more nearly match the pitch of someone's voice, the speed of their speech and, to a lesser extent, its volume, they are far more likely to hear what you are saying. You may have noticed that some people are harder to understand than others.
This is not an intellectual problem, it may be simply that you are not 'tuned in' to their speech patterns. As I explained in an earlier article, if someone tends to speak rapidly, they will find someone with a slower delivery of speech quite frustrating. Similarly, someone who speaks slowly may feel that someone who speaks rapidly tends to gabble.
If you can match a person's rate of speech, they are far more likely to be able to hear what you say and similarly in adopting their rate of speech you are more likely to become attuned to it and hear what they say, and therefore understanding becomes easier.
The way a person speaks is to some extent dictated by the representational system they are using - this is explained later on in this article.
Similarly, if you can manage to adjust the pitch of your voice to that of the person you are talking to, they will feel that you are more like them and therefore more likeable to them. In all this it is essential not to try to mimic them, especially if they have a regional accent.
These techniques are a way of gaining rapport with patients which makes their visit to the practice less stressful and generally more pleasant for all concerned. Some people speak more loudly than others, sometimes because they are hard of hearing, and if you try to match the volume they use, it will help the conversational flow. On the other hand, some people speak softly and you may have to reduce the volume of your voice so as not to appear to be shouting at them.
With all these techniques, it is perhaps best not to try to get too accurate a match of the patient, (although this is what psychotherapists, who of course have a much longer contact time with their patients, will try to do), but rather to modify your natural voice patterns, subtly, to make them nearer to those of the patient. Perhaps if you slow down or speed up a little, raise or lower the pitch of your voice slightly and increase or decrease the volume of your voice to some extent, you will achieve your objective, namely improving the quality of your communication with the patient.
Body language
Another method of helping to build up rapport between you and the patient is to match their body posture. The classic example given of people in rapport is that of two people very much in love enjoying a meal together in a restaurant. If you watch them you will see an almost balletic show with them moving at the same time, reflecting one another's gestures, even picking up their glasses at the same time to take a drink.
They may not be saying anything but their bodies show how deep their rapport is. Conversely, people who may have just had, or be in the middle of, an argument tend to show their lack of rapport by the way that they do the opposite to their partners. They may sit back when their partner sits forward, fold their arms when their partner has theirs open and generally display that the two are not alike.
Deliberately breaking rapport can be a subtle way of ending a conversation. If you and your companion are both sitting, perhaps both lounging, then you can break rapport by changing your body posture to be completely different to theirs, standing up being the most obvious change you can make, but just sitting up straight can signal that it is time to move on.
Some people feel uneasy when copying another person's posture and indeed if not done with a certain amount of discretion the person being copied may be offended by what they perceive as mimicking. To avoid this there is a technique known as cross-matching. This involves making similar movements to them, but in a much less obvious manner. If, for example, a person has their legs crossed at the knee you can cross yours at the ankle. If they are rhythmically swinging their leg you can tap your finger at the same pace.
If they are stroking their chin, you can rub your leg in rhythm. As long as you let their unconscious see that you are the same as them they will be more in rapport with you. If you are sitting at a reception desk, or a dispensing table, if the patient leans forward so should you, if they lean back, so should you. Obviously, don't lean forward so that your noses are touching, but mimic their posture, to a lesser degree.
You may wonder if these strategies are perhaps manipulative and certainly they can be powerful ways of getting people to do what you want them to. Whether or not they are manipulative depends on you. What I am suggesting is that these are techniques which you can use to help you 'get on with people' better, and provided you don't take them to extremes, there is no reason why they should be construed as manipulation.
Have you ever felt that you were talking a different language to someone and wondered why you just weren't on the same wavelength? (Assuming you both speak English of course.) Perhaps in a way you were talking different languages. NLP explains that we all have a preferred way of thinking, some people think in pictures, some in sounds and some in feelings (there are others, but these are the main three).
It is known that we tend to 'filter' our experience of the world to avoid being overwhelmed by all the sensory input with which we are constantly bombarded.
At the moment, in order to take in all that you are reading, it is necessary to filter out the extraneous noises surrounding you (which you may now have become aware of) and of the various smells nearby and you may become aware that you could do with making yourself more comfortable.
All these inputs have been filtered out to allow you to concentrate on the task in hand. When we are carrying out our daily tasks we tend to concentrate mainly on one of our senses, to the exclusion of the others. Some people tend to prefer to concentrate on what they see, some on what they hear and some on how they feel. These are called their preferred 'representational systems'.
What is the relevance of this? People will tend to use the language appropriate to the system they are using. This means that visual people may 'see your point of view', want to 'get things in perspective', or 'take a dim view of things'. (They also tend to talk more rapidly). Similarly, kinaesthetic people (who are using their feelings) may want to 'get a grasp of the situation', perhaps they 'have a feeling about something', or need to 'get a grip' on things. (They also tend to talk more slowly).
Auditory people want to know if they 'like the sound of things', to know if things 'resonate with them' and might ask what you 'have to say' about something. (They tend to have a more rhythmical quality when they speak). The words people use give an indication as to which particular representational system they are using at the time. If you can reply to them using the same type of language then you are far more likely to communicate effectively with them.
It is also useful when helping them to choose their spectacles if you know what their preferred system is. Visual people might like to see several frames and to make sure that they 'look right' on them. Kinaesthetic people may want to make sure that they feel comfortable and that they are robust. Auditory people could wish to know what you have to say about the frame. Taking account of their preferred system will make you more effective here.
There is another clue to which particular system a person is using at any particular time and this is to note which 'eye accessing' clues they demonstrate. Someone who is in 'visual' mode will tend to look upwards, someone in 'auditory' mode will look to the side and someone in 'kinaesthetic' mode will glance down and to the right (if they look down and to the left they are probably talking to themselves) (Figure 2).
At first you may find it difficult to decide exactly where a person is looking and it will take a certain amount of practice to note when this takes place. It must be emphasised that this is only an indication as to which representational system someone is using, it is not a hard and fast rule and it may in fact depend on what sort of question you ask.
If you ask someone what colour their front door is, you may well provoke an upward eye movement as the person scans their visual memory, similarly you may get a sideways movement if you ask someone to remember a certain sound. Having said all this, if you can become proficient at watching eye movements, it certainly helps to optimise your communication skills.
If you want to improve the way that you interact with people, NLP has a technique which helps you to review how a recent conversation with someone has been perceived. This is the technique of using different positions. First position is from your own perspective, second position is from the point of view of the person to whom you were speaking, and third position is what an observer would see.
If you have had a difficult time with a patient and you want to see if you can prevent a similar occurrence, you can review what happened using this technique. When you can reflect on what happened, run through the episode from your point of view. Then run through what happened, imagining yourself as the other person, if possible adopting the way they were standing, their attitude and so on. This will give you an insight as to why things went wrong for the other person.
Then imagine what it would have looked like to an impartial observer; perhaps your posture made you look more aggressive than you realised, perhaps they felt you weren't as helpful as you might have been. Assessing what happened using this technique can help you avoid making the same mistakes if the situation happens again, and adjust your actions appropriately. Using this method is an excellent way of improving your performance as a communicator.
*Anthony Collinge is an independent optometrist working in Cumbria. He writes and gives talks on communication skills