Rapport: The First 30 Seconds - by Garner Thomson
In a time-starved working world, you can carve out 30 vital seconds simply by getting up and going to fetch your patient (supposing that he or she is ambulatory, and that you are, too). During the walk back to your office, you can lock in two essential requirements for effective communication: rapport and concordance.
Much is made of 'rapport' in communication courses and NLP texts and trainings, and the usual means of accomplishing it is "mirroring" - reflecting the subject's physical postures and movements. This kind of phase-locked 'dance' can be seen anywhere two people are in close accord. Watch out in restaurants and public places for those couples who unconsciously reflect each other's moves: one picks up a drink, the other follows; one sits forward and folds his or her arms, the other follows.
The following method is easy and almost instantaneous, and has proved successful with hundreds of practitioners incorporating it into the "meet-and-greet" phase of the consultation. Four steps, performed almost simultaneously, are involved.
Achieving Rapid Rapport
1. Smile - a full face, not a "social", smile. Get into the habit of smiling with your eyes as well as your mouth.
2. Look directly into the patient's eyes, mentally noting his colour. In contrast to the quick glance skating across the subject's face, this creates the effect of being full "looked at" and "seen".
3. Silently project a 'message' of goodwill or well-wishing towards the patient. If you are good at mental imagery, you can create an internal representation of the patient looking healthy, happy and satisfied.
4. If culturally and / or physically appropriate, shake hands. Frank Bernieri, chair of the psychology department at Oregon State University and an expert in non-verbal communication, believes a good handshake is "critically important" to first impressions. Strength is unimportant, he says, but "web-to-web" contact and alignment of hands is. Handshakes should be avoided if:
- you know of suspect cultural difference: when in doubt, don't;
- the patient is very frail or in pain; the reason for this are self-evident; or,
- the patient is markedly distressed. The risk of linking a psychophysiological state to a touch (kinesthetic anchoring) is ever-present, and it is sensible to avoid the risk of associating your touch to another's distress, especially as you may have to conduct an examination later.
Other caveats include the following: do not present your hand with the back facing upwards (signalling dominance) or downwards (signalling submission); and, do not touch the patient's forearm, upper arm our shoulder with your free hand while shaking hands. This sometimes interpreted as patronising or manipulative if occurring in the opening stage of a meeting...
Garner Thomson goes on to talk about other aspects of using NLP in the surgery later in this chapter.
Garner Thomson, NLP Master Practitioner and Trainer, and founder and training director of the Society of Medical NLP, is the creator of the Medical NLP programme taught to doctors, psychologists, psychiatrists, nurses, allied health professionals and medical students since 1996. Trained in NLP by Dr Richard Bandler, and with a background in psychology, communications, Ericksonian hypnotherapy and trans-cultural and integrative health-care approaches spanning more than 30 years, he also runs a busy Medical NLP and Hypnotherapy practice in London, mostly by referral from doctors in primary and secondary care. He writes and lectures widely, and appears on radio and television, both as presenter and guest. He is the author of Magic in Practice, Introducing Medical NLP – The Art and Science of Language in Healing and Health (Hammersmith Press 2008), editor of Richard Bandler’s Guide to Trance-formation (HCI and HarperCollins 2009), and co-author with Dr Bandler of the forthcoming book, Living Up – The Technology of Hope, Health and Happiness.
To find out more about building rapport and read a systematic description of how to use NLP in Practice, buy Garner's book Magic In Practice from our bookshop, today.
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