Table Of ContentPersuasion in Clinical Practice
Persuasion in
Clinical Practice
HELPING PEOPLE MAKE CHANGES
LEWIS WALKER FRCP (GLAS)
General Practitioner, Ardach Health Centre, Buckie
Honorary Senior Clinical Tutor, Aberdeen University
Radcliffe Publishing
Oxford (cid:129) New York
Radcliffe Publishing Ltd
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© 2010 Lewis Walker
Lewis Walker has asserted his right under the Copyright, Designs and Patents Act 1998 to be
identifi ed as the author of this work.
All rights reserved. No part of this publication may be reproduced, stored in a retrieval system
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A catalogue record for this book is available from the British Library.
ISBN-13: 978 184619 383 5
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Contents
About the author vii
Acknowledgments viii
Introduction 1
1 Foundations of Persuasion in Clinical Practice 9
2 Styles of change 22
3 Problems and solutions 31
4 Assessing importance, confi dence and readiness for change 42
5 Present and curious 47
6 Avoiding roadblocks 56
Interlude 1: Kick ‘but’ . . . without ‘try’ing 65
7 Raising awareness 73
Interlude 2: Changing frames 81
8 Resolving ambivalence 89
Interlude 3: Persuasive phrases 101
9 Preparing to make changes 108
Interlude 4: Emotional messages 120
10 Taking action 129
Interlude 5: You, me and them 141
11 Staying on track 148
Appendix: Modal operators 160
Bibliography 162
Index 163
To Pam, for all your continuing, behind-the-scenes support
About the author
Graduating from Aberdeen University in 1981, Lewis Walker spent the next fi ve
years training in hospital general medicine, initially at Glasgow Royal Infi rmary
where he obtained the MRCP (UK) in 1984, then subsequently at Raigmore
Hospital, Inverness. In 1986, he began vocational training for general practice
and in 1989 joined what is now a seven-doctor training practice at Ardach
Health Centre, Buckie, on the Moray Firth Coast. He was elected Fellow of the
Royal College of Physicians of Glasgow in 1998. He is Honorary Senior Clinical
Tutor at Aberdeen University and is involved in the teaching of medical students,
foundation-year doctors and registrars in general practice.
In the early 1990s, fascinated by what made people ‘tick’, he developed a
keen interest in behavioural change mechanisms, which led him to study both
classical and Ericksonian hypnosis, together with neuro-linguistic programming
(NLP). To date he has undertaken certifi ed courses at the levels of Practitioner,
Master Practitioner, Health Practitioner and Trainer of NLP. With numerous
other short courses in addition attesting to his wide experience, he has also
trained with many of the leaders and developers in the NLP fi eld. He has the
Certifi cate of Accreditation of the British Society of Medical and Dental Hypnosis
(Scotland), and is also a Trainer of Hypnosis. He is the author of Consulting with
NLP: neuro-linguistic programming in the medical consultation (2002) and Changing
with NLP: a casebook of neuro-linguistic programming in medical practice (2004),
both published by Radcliffe Publishing.
vii
Acknowledgments
There are three people in particular who have made a signifi cant impact over
the years on my thinking about how change happens and what we can do to
prepare both ourselves and our patients to navigate the process effectively with
successful outcomes.
Ian McDermott, Director of Training for International Teaching Seminars,
was one of my early trainers when I was fi nding my feet in what seemed to be
a directionless, complicated and often contradictory maze of interventions. Ian
brought much clarity to the process, made things simple without being sim-
plistic and modelled an almost effortless low-key style of helping people make
signifi cant change easily.
I have been a long-term fan of John Overdurf’s material. He is at the cutting
edge of investigating the kinds of states that lead to automatically achieving
one’s goals…and beyond. He has a particular mastery of linguistic applications
and I have learned much from listening to and later analysing his specifi c inter-
ventions. One key piece that remains with me is to be always on the lookout
for the next smallest step!
Tony Robbins is one of the global change giants who has impacted millions
of people worldwide. He has a very energetic, proactive style and taught me that
the emotional aspects of change can often be far more important than logical
rationalisations. The ability to elicit very powerful positive emotional states and
aim them in the right direction can overcome much of the inertia that “stuck-
ness” brings and galvanise focused action for results that count.
I have never met William Miller, Stephen Rollnick, James Prochaska, Martin
Seligman, Jim Loehr, Tony Schwartz, Rick Botelho, Barry Duncan, Mark Hubble
nor Scott Miller. What they all have in common, however, has been their ability
to communicate directly with me through the written word. I have pored over
their various outputs, tried it all out fi rst hand, learned from my mistakes and
integrated the best of their change processes into my methodologies. I hope that
Persuasion in Clinical Practice may have exactly the same effect on you.
viii
Introduction
What happens when you imagine getting access to powerful persuasion tools and
being able to use them automatically to help your patients (and others, including
yourself) get what’s really best for their health and future well-being?
This is your opportunity to begin to master infl uential communication skills.
By the end of this book – Persuasion in Clinical Practice – you are going to be part
of an exclusive group. Very few health professionals get consistently good results
across the entire spectrum of presenting problems that are the bread and butter
of everyday practice. The skill-sets you are about to learn will help you become
one of a select few who can, time and time again, help people make changes
in any clinical encounter. I want you to get very good at this – so good that it
becomes second nature in every consultation you have from now on.
Before I give you specifi c details of just what you’ll be learning here, I want
to ask you a few questions to make sure we are both on the same page. These
are powerful questions so I’d like you to stop for a moment and really think about
your answer to each of them . . .
➤ What fi rst sparked your interest in persuasion in practice? With me it was
recognising that too few patients really ‘followed doctor’s orders’. I found
that many medical messages literally fell on deaf ears – they just weren’t
acted on. I began to notice that this was more to do with my failure to
understand the process of how people made changes rather than their
innate ‘resistance’. I wanted to be more effective in my work so I decided
to learn the kinds of communication skills that could help me ethically
infl uence people in a way that got them what they really wanted deep
down – better health. How about you?
➤ What happens when you imagine getting more of the kinds of results you and
your patients want, no matter what the situation? When I fi rst began to
explore this area I was amazed that, even with just a few additional skills,
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