As explained in the body of the book, strategies are chained internal actions (visual, auditory, kinesthetic) that, when run sequentially, result in a specific behavior, feeling, or response. We have internal strategies or ‘schemas’ for all our behaviors, from making scrambled eggs and buying a shirt to feeling depressed or having an hallucination. In order to achieve the same result, the steps of the sequence will always be repeated in exactly the same order.
In order to assist patients struggling with many chronic psychological and/or physical disorders, it is useful to understand the sequence, or strategy, that their processing follows.
Strategies are most easily elicited by first observing the patient’s description of the behavior, noting especially the respective sequences of eye accessing cues and sensory modalities used.
Unpleasant feelings almost inevitably result from an inappropriate coding of a triggering event. Post-Traumatic Stress Disorder results from ‘flashbacks’ usually experienced as if happening in the present tense (associated). The physiological response is to present-tense threat.
Depression frequently involves melancholic or despairing self-talk (Ad–) or gloomy images (Vi–), which trigger negative feelings (Ki–). These, in turn, result in further pessimistic imagery or internal dialog, leaving the sufferer physically and emotionally depleted.
Anxiety is often a pattern-matching process, transferring a past experience into future possibility, thus setting up a ‘meta-state’ (the fear that fear will come).
Annotation
In order to be able to analyze a subject’s internal processes more easily, they may be annotated as follows:
V = Visual
A = Auditory
K = Kinesthetic
The following superscripts are then added:
i = internal
e = external
r = recalled
c = constructed
d = digital (e.g. auditory digital is annotated as Ad)
The signs + and – may also be incorporated to represent subjectively pleasant or unpleasant feelings, and the sign > signifies a progression from one step to another.
Eliciting strategies
The question, ‘How does it happen?’ is useful in eliciting a strategy. The answer might be, ‘Well, I wake up every morning and the first thing I feel is a weight on my chest (Ki–) and it’s like: “I can’t go on this way!” (Ad–), and that’s when the panic comes (Ki–), and I think: “You’re going to have a heart attack!” (Ad–) and the weight just presses down harder and harder, and it just never seems to stop…’
This can be annotated as follows:
It will be clear from the above that this strategy is a self-maintaining ‘two-point loop’ (that is, the subjective experience loops from K to A and then back again, repeating endlessly). The practitioner’s role is to find an entry point in order to break the loop, provide an appropriate ‘exit point’, and leverage change.
The sequence of eye accessing cues that patients use when re-accessing their experiences can give the practitioner further clues to the strategy being employed. The above sequence might be:
Eyes down and to the right > across and down to the left > across and down and to the right, etc.
This repeating Ki > Ad pattern, known as a ‘two-point loop’, is characteristic of people suffering from depressive and anxiety disorders.