“What do you do when a method doesn’t work?”

When a session is successful, that is a nice confirmation of what I already know. But what do you do when a method doesn’t work? Often I hear therapists say, “I tried X method with a client, but it didn’t work.” Perhaps they made a mistake, or the method was inappropriate, or the client may have found a creative way to alter the process. And then the therapist basically gave up.

It’s a lot more useful to realize that when something doesn’t work, it’s an opportunity to learn. Many years ago, Connirae and I developed the grief process, and taught it successfully for a year or two. Then a workshop demonstration failed utterly, so we had to figure out why. It turned out that the client had a major resentment toward her dead husband, and we had to use the forgiveness process before the grief process would work. Minor resentments don’t interfere with the grief process, but a major one will. So we learned something new and useful.

The simplest answer to, “What do you do when a method doesn’t appear to work?” is that you try to figure out what else is going on, using specific information-gathering questions, trying out something different, and paying close attention to feedback from the client—particularly the nonverbal. However, that answer is so general that it doesn’t help much. I thought it might be useful to offer a couple of specific examples of how to do this.

Claustrophobia

Quite a few years ago I worked with a woman who had a fear of being trapped, with no way out. Everything went very smoothly using the NLP phobia process, and she immediately tested by going into a small closet and closing the door. She was completely calm, but a little doubtful, saying, “But I know I can open the door, so I’m not really trapped.” When I kept the door shut with the weight of my body, holding onto the doorknob so she couldn’t unlatch it, she still felt calm, and she became convinced.

However, when I checked with her about a week later, she said that the change hadn’t stayed with her, so I offered her a follow-up session. After some exploration about what it meant to her to be “trapped,” we discovered that she had two somewhat different meanings for the same word. One was being trapped physically in a small space; the other was feeling trapped emotionally in a relationship. The first session actually had worked; she still had a new and more resourceful response to being physically trapped. But that change hadn’t generalized to relationships, because to her that was a different category of experience. After I used the phobia cure on her most intense memory of feeling trapped in a relationship, she was fine in both physical and emotional contexts.

Airplane Anxiety

Recently a father in northern California asked me to work with both him and his grown daughter, Sara, on their anxiety about flying. They were making a trip to the East Coast soon, and were motivated to find a way to be more comfortable. On separate Skype calls I used the same two wonderful methods that I learned from Nick Kemp; spinning feelings and slowing the tempo of the frantic internal voice that usually triggers the feelings.

After they returned from their trip to the east coast I got an email from the father, “grading” the results. “For me it was an A-, but for Sara it was an F.”

I scheduled a follow-up session with Sara to find out what was going on. She said that during the outgoing flight across the country she was completely fine. However, the trip back was horrible, a “full on panic,” and that was what earned the F grade. When I asked her what was different about the two trips, she said she thought perhaps it was because she had rehearsed the slowed tempo of the anxious internal voice and reversing the spin of her feelings many times before the outgoing trip, but hadn’t rehearsed before the return trip. She also said that when she visualized being on an airplane during our session, it was always on the outgoing flight, not the return flight. This explanation didn’t quite make sense to me, because after that much rehearsal, and a successful trip east, I would expect that her new response would have generalized and become automatic.

When I checked with her about what we had done in the previous session, it was actually intact. She’d had a voice saying, “Here we go!” in a shrill and rapid tone, which had led to feeling anxiety. When I asked her to hear this voice now, it didn’t elicit anxiety, so I concluded that she must have additional ways to scare herself. I asked her, “What can you do to get the anxiety back now?” Initially she said something like, “When the airplane suddenly sinks, I get a ‘butterflies’ feeling in my stomach.” As she said this, she looked down at about a 30-degree angle, With this little bit of information, pause to think about what you might do next if you were working with her. . . .

First I asked her to try looking up about 30 degrees above the horizon as she imagined the plane sinking under her, just to see what would happen. Sara reported that immediately made “a huge difference” in how she felt.

Next I spent some time explaining to Sara that the “butterflies” feeling was a normal physical sensation that everyone feels when they suddenly feel unsupported. It’s the body’s physical response to sudden weightlessness, not an anxiety response. Anxiety is also felt in the body, but in a different area, and it’s a response to imagining what might happen in the future, not to what’s happening in the present. I also pointed out that some people even pay money to go on carnival rides so that they can enjoy the thrill of that sinking feeling.

Then I tested by asking her to imagine being in an airplane again and feel it suddenly sink, and just notice that butterflies feeling. She said she felt fine with that now. She was still looking 30 degrees above the horizon, instead of reverting to the downward look she had before.

Then I asked her to imagine being on a plane again, and find out if there was any other way that she could get the anxiety back. She said that if the plane was headed steeply down she felt anxious. She added, “I wonder if this has to do with a time about 10 years ago when I had a seizure on an airplane, and became unconscious for a while. They speeded up the plane and descended rapidly to a nearby airport to get medical help as fast as possible. I had an oxygen mask on my face, and I was kind of groggy and disoriented, so I didn’t really understand what was going on, but I remember feeling that steep descent.”

Sara said that she’d had two seizures prior to the one on the airplane, which she attributed to being under stress in high school, when she was not sleeping or eating well. She was put on medication, which she took for five years, but then stopped taking it because she hadn’t had any seizures since the one on the airplane, and she hadn’t had any seizures since then.

Sara’s “rapid descent” airplane experience certainly sounded like the kind of memory that could have elicited a phobic response, especially since her groggy state after the seizure would have made her very suggestible. A phobic response of fear can easily be confused with anxiety, and most people who say that they have an “airplane phobia” actually have anxiety. It’s important to differentiate the two, because they have a different underlying structure. Phobias happen by stepping back into a past intense experience, while anxiety is a result of anticipating a future disaster.

I hadn’t thought to ask if she had had a terrifying past experience of being on a plane. Apparently Sara had originally had a phobic response in addition to anxiety. I immediately used the phobia method with this memory, and after that she could imagine a steep descent with comfort and ease.

Again I asked Sara to imagine being on an airplane to find out if there was any other way she could get the anxiety back, even if the plane bounced around or did something else. At this point she could no longer find a way to get the anxiety back. I asked her if she had any questions or concerns about what we had done, or about her upcoming trip over the Christmas holidays. When she smiled and calmly said she didn’t, I ended the session by asking her to send me an email after she landed, to give me a report. When I didn’t receive an email from her before Christmas, I thought maybe there was still more to do. But on January 6, after she had returned, Sara emailed me:

“I’m writing to let you know that my travels back east went very well! I was still a bit nervous on the flight at times, but significantly less anxious and nothing near the level of panic of my previous trip. Thanks so much for your help. I’m really relieved and feel like I’m suddenly free to move/fly about as I’ve always wanted.”

A couple of weeks later I decided it might be interesting to write this article, so I emailed Sara, asking if we could Skype so that she could help me recall the details of what we had done in our second session. In our call she said that she thought that changing the memory of her seizure and swift descent had made the most difference, saying, “That was a big deal; I was unhooked from all of that.”

Then she said something very interesting, “The seizure happened on a westward flight; I wonder if that is why I was OK going east, but panicked going west on the way home? I’m usually very oriented in space.” When I said, “I wonder what it would be like to fly north or south,” she smiled and said, “Even back then I remember joking to a friend that if I thought about a little quick trip down to LA, or up to Seattle or something, it didn’t bother me very much at all.” Notice that she used the words “quick little” to describe these, whereas before she had used the words “huge,” and “big deal,” indicating the importance of size to her. I found this fascinating. Apparently going west—something that most people wouldn’t have noticed—had become one of the triggers that elicited her phobic response.

At the moment when someone has a terrifying experience, whatever they are focused on at the time can become a trigger that elicits the fear later. Often it’s something directly related to the cause of the terror, such as a snarling dog, or being immersed in water, or a steep descent in an airplane. But at other times they may be focused on something that is irrelevant to the cause of the fear, yet becomes associated with it. Several of my favorite examples are a woman who was afraid of stuffed olives, a woman who freaked out if she couldn’t see her feet, and in this case traveling west.

Since these triggers are often random, it can be difficult to determine what they are. However they often emerge if you ask about contrasts. When I initially asked Sara about the difference between her flight out and the return after our first session, she gave me some very important information that only made sense to me later when I asked for more. It became even clearer when I asked if it would be different if she flew north or south, another contrast. Understanding events like this often looks simple and obvious in retrospect, but they can be very puzzling at the time.

For an example of working with a more complicated set of anxieties, you can read a verbatim transcript of me working with a man who couldn’t bring himself to deal with his financial situation. I have included many explanatory comments about what I did, including pointing out a number of mistakes that I made—and corrected in response to client feedback.

Fears and anxieties are usually relatively simple and easy to resolve, using what I like to call “off the shelf software,” standard processes that have been developed and tested over a period of time. There are also processes for a variety of other common problem states, such as shame, guilt, anger, and grief. The basic principle is the same: elicit the underlying unconscious structure that elicits the problem state, and then alter that structure to elicit a more useful state. There are still problems that we don’t yet understand sufficiently well to resolve rapidly, but that is true in any field. Year by year we understand more and more, allowing us to work more and more rapidly and elegantly with a wider and wider range of presenting problems.