Time, place, and space are illusions, having no existence save in the mind of man which must set limits and bounds in order to understand.—Robert E. Howard196
Think about the last meal you had. Did you enjoy it? Did you linger over each mouthful in full appreciation? Or perhaps it was a sandwich, grabbed at your desk?
Now, think of the meal you ate before the last one. And, the one before that…And, here’s the question:
‘How do you tell the difference between your last meal and the ones before?’
Take a minute to think about this. Compare the two memories. Notice the distinctions between the two. Check the sub-modalities, first of one, then of the other—then together. Here’s a guess. The two representations are in different positions in your internal field. One is probably smaller and less distinct than the other. One may even be still, like a slide or photograph, the other moving, like a movie or video.
Now, to challenge yourself, think ahead to your next meal. Decide what you’d like to be eating, where you’ll be, who your dining companions will be. More differences.
And, whatever they are, there are differences. If there were none, you would have no way of making the kinds of distinction that allow you to separate your life into the categories we call past, present, and future. Without those distinctions, your internal and external life would descend into chaos. Quite literally, you would not know whether you were coming or going.
On a day-to-day basis, most of us have a kind of consensual agreement about ‘time’. We agree that everything before today happened in the ‘past’. Where we are now (roughly) is the ‘present’. Later today, tomorrow, and everything after that are in the ‘future’.
We also agree, more or less, when we are ‘on time’, or not. But after that, things start to become somewhat less clear. Some of us have ‘time on our side’; others are always ‘running out of time’. We try to get our kids to calm down during exams, reassuring them that they have ‘plenty of time’ in which to answer the questions. On the other hand, we tell each other how there ‘just don’t seem to be enough hours in the day’, or how that patient who wanted to talk about his family concerns was ‘wasting’ too much of our precious time. And of course, as we get older, time starts to ‘go by’ more quickly each year.
Time seems to be something that ‘happens to’ us—and it happens very differently, according to the situation we are in at the time.
Remember, for example, how slowly time passes when you are standing at a bus stop on a rainy day without an umbrella, or how quickly it whizzes by when you are having fun. Equally important is the distinctive way in which each of us codes time and its passage. This determines not only whether we seem to have enough or too little, but whether the past or the future directs our subjective experience more than the present moment.
Most of us run into trouble over the issue of time because we fail to notice that it is a nominalized word, suggesting a commodity, rather than a process. Time, we are saying, is not a ‘thing’.
We have subjective ways of measuring movement from one place or event to another; we have clocks and watches and an awareness of the cycles of day and night and the seasons. But the ‘passage’ of time—as Albert Einstein upset the scientific world by demonstrating—does not exist in the way we think it does.197
The framework of time
Happily, when things are going smoothly, we can continue along our daily lives without too much concern about the ‘reality’ of time. But when they are not, we can benefit ourselves and our patients by recognizing that, as physicist Sir James Jeans puts it, the ‘framework’ of time in which we place our experience is personal to individuals or small groups.198
The ‘personal framework’ of time, as experienced by the patient, is the focus of this chapter. Should you repeat the experiment at the start of the chapter with a friend or colleague, you will almost certainly find that the way in which he distinguishes between his last meal and the one before that differs in some degree from your own.
Patients experience and respond to their chronic condition in a number of different ways: in terms of the anxiety it produces; the extent of the effect it has on their lives; the meaning attributed to the condition; the implications for the quality of their future existence, etc. And one of the most prevailing influences concerns time—how long the condition has existed, the duration of an ‘attack’, when they can anticipate some respite or, in the case of conditions said to be ‘terminal’, how long they have ‘got’.
In fact, enormous semantic confusion surrounds our sense of time. Einstein and the New Physics showed us that all knowledge about ‘reality’ begins and ends with experience. Experience, in turn, is dependent on our senses. Certainty begins to dissolve before our eyes (and our ears and feelings) when we start to recognize that how, where, and when we apply our attention can affect that quality of our experience. Quite literally, then, we are ‘making time’.
The ‘meaning’ of time
Our attitude to the passage of time is a quality of our relationship with both our internal processes and the world outside. As mentioned above, the experience of waiting for a bus in the rain is likely to be not only ‘dragged out’, but also unpleasant.
‘Type A’ people are characterized by an exaggerated sense of urgency. Both their internal ‘sense’ of the passage of time and their behavior appear restless and ‘driven’.199 Conversely, athletes, artists, musicians, meditators, and martial artists are among a group of people who regularly experience something widely known as ‘flow’—a highly pleasurable, timeless state in which activity seems to happen without effort or intention.200
The subjective experience of time is a black hole in medical science. Aside from the number of days a patient will occupy a hospital bed, or how long the patient himself will have to endure his pain, time simply does not enter the clinical picture. This is a major omission. How we perceive time can kill or cure.
The birth of time as we know it
Not that far back in our collective history, our attitude to time was different. We lived according to natural cycles—the rising and setting of the sun, the changing of the seasons. Fine measurement was a crude affair. We have used dripping water, trickling sand, knots on a string and marks on a burning taper. But these units of measurement were arbitrary. An hour or a minute or a second simply did not exist as such. Most of us got up as soon as the sun rose and went to bed when it set, until two inventions changed all that. And, in changing the way we marked the unfolding of events, we changed the very fabric of our lives.
Dutch scientist Christiaan Huygens’s pendulum clock brought sequential, rather than cyclical, time to our immediate attention.201
This was followed by the invention of the electric light, and, suddenly, we were no longer bound by the rhythms of nature—so work, usually for the poorer classes, could extend deep into the night. And while the material benefits were far-reaching (for those who ‘controlled’ time and the means of buying it from others), for most of us the separation from nature was profound.
Problems with linear time
As a chronocentric (centered on time) society, we have lost our sensitivity to the cycles in nature and to those of our own bodies. We eat, drink, make love, have children, sleep, wake, work, and retire according to the linear measurement of time, instead of when we are hungry, thirsty, horny, paternal, tired, feel rested, or are ready to slow down. Most of us live and die in the thrall of linear time without ever realizing that it does not really exist.
Everything we do (in our Western culture) is based on multiples of something arbitrarily called a ‘second’—in fact, nothing more than 9,192,631,770 cycles of the frequency associated with the shift between two energy levels of the isotope caesium 133.202 This is the nearest we can get to a ‘thing’ called Time.
Here’s a little experiment about how the myth of linear time runs your life:
Using a watch or clock with a second hand, close your eyes as it points to the 12 o’clock mark. Now, mentally review what you have to do today—then open your eyes when you ‘feel’ one minute has past.
Supposing you didn’t cheat by counting off the seconds, how accurate was your estimation? Was your guess less or more than one minute? If it was markedly less than a minute, you are likely to feel tense, ‘rushed’, as if ‘there is never enough time’. If it was markedly more, you are likely to be feeling calm, relaxed, laid back—or bored—with the experiment.
Now…what was your emotional response when you interpreted your particular estimate?
Interestingly, most people are vaguely unsettled by either response: the first because of their underlying sense of hurry, the second because, somehow, they are ‘wasting’ time.
The toxicity of time
So profoundly influential is the experience of linear time on the health and wellbeing of both patient and practitioner that we have felt compelled to create a word—‘chronopathic’—to describe the disorders in which the perception and experience of time play a significant part.
To that, we have added ‘hyperchronic’ (the sense of time passing too quickly) and ‘hypochronic’ (time dragging) to describe the experiences and responses of those suffering from chronopathic disorders. At the top of all the surveys of doctor dissatisfaction we have reviewed from both the United Kingdom and the United States is lack of time. At the top of all the surveys of patient dissatisfaction we have reviewed from both countries is…lack of time.
It is saddening that the very interaction intended as a healing encounter should be marked by one of the disorders it should be seeking to resolve. In earlier chapters, we discussed stress and allostatic load as underlying factors in all chronic conditions. Here, we contend that the subjective perception of time can be one of the most important contributors to allostatic load.
The ‘toxic’ effects of time-perception are not entirely restricted to feeling its lack. The ‘passage’ of time is experienced in different ways, each with its own impact on the individual. But the most prevalent, and arguably the greatest, risk factor is the feeling of having too much to do with too little time in which to do it. Hyperchronicity is virtually unrecognized as pathological in Western medicine, except perhaps as an element in the catch-all diagnosis of ‘stress’.
Medicine’s response to this is limited: take time off and reduce your commitments…or, take the pills.
Time-poor patients, once described as suffering from ‘hurry sickness’, are vulnerable to a wide range of illnesses. These include abnormal heart rate and blood pressure; elevation of blood hormones, including adrenalin, insulin, norepinephrine, and hydrocortisone; increased gastric acid and insulin production; breathing disorders; sweating; and musculoskeletal pain.
Patients suffering from hyperchronicity are particularly susceptible to cardiovascular disease, type II diabetes and metabolic syndrome.
As may be expected, hyperchronicity affects high achievers driven by goals, deadlines and targets—all characteristics of what economists call ‘turbo-capitalism’. A short time ago, this was considered to be essentially a male response, but an increasing number of women are reported to be presenting with similar life and work patterns—and the consequences thereof.
To our knowledge, only one country in the world has officially recognized the consequences of time poverty and turbo-capitalism on the individual. Japanese researchers have made a positive connection between a model known as ‘lean production’, purported to improve economic productivity, and sudden death from cardiovascular and cerebrovascular disease. These types of death, known as karoshi (Figure 15.1), are said to be caused by increased workload, shift work, and abnormal demands on the worker’s time.
Figure 15.1 Karoshi, or death by overwork
But ‘too little time’ is also a health factor for patients lower on the socioeconomic scale, especially unemployed single mothers. Hurry sickness is not simply the price you pay for being rich.
Time and chronic disorders
The patient’s felt sense of time will usually differ from his experience of its duration. The felt sense is often one of constriction. As we have said elsewhere (see pages 175, 243, 265 and 322), feelings of discomfort are usually constricted, localized and intense. Duration—in chronic disorders—is expanded; the problem seems to stretch endlessly across ‘space’.
Time distortion is a characteristic of altered states, and illness is, by definition, a state that differs from the patient’s default ‘normal’ state.
Depending on the condition, the degree of discomfort is related to the degree of attention being paid to both felt sense and duration, and to how and where on the continuum of his personal model of time the patient places the ‘cause’ of the problem.
The former (focusing on the problem) is a well-known amplifier of the experience of pain. Conversely, when our attention is diverted (for example, while playing a sport we enjoy), we may not even notice an injury when it occurs.
The second form of coding—in which the patient places the cause of his problem in his ‘past’ or ‘future’—is always a factor in conditions such as depressive or anxiety disorders. ‘Panic attacks’ recur wherever the patient, consciously or unconsciously, runs an internal representation of an event happening sometime in the future. Reactive depression is always a response to an event (real or imaginary) in the past.
Likewise, post-traumatic stress disorder and phobias are present-time responses to earlier, sensitizing events. However, as Viktor Frankl pointed out, since two people experiencing the same ‘objective’ experience may have entirely different reactions and interpretations, it is evident that it is less what happened in the past that causes present-time problems, but the way in which we are responding to it. The past (or the future) is experienced ‘as if’ it is happening now—and our physiology responds ‘as if’ it is real.
A number of other conditions can affect our experience of the passage of time, including age (a sense of time ranges from undifferentiated at birth, through various phases until around the age of 16, when the ‘existence’ of linear time is established); socioeconomic status (an extended sense of time is more prevalent among middle-class children); and even body temperature. Certain drugs, both prescription and recreational, ranging from thyroxine and caffeine, through cocaine to cannabis and amphetamines, directly affect the experience of time.
Time, healing and health
Paradoxically, the experience of time changes when we learn to pay attention to specific symptoms or sensations ‘as they are’, in the present moment, without judgment or expectation (awareness at Alfred Korzybski’s more fluid, wordless Object level). The ‘felt sense’ of time expands, while duration contracts.
It is our belief that many systems—such as some forms of meditation; yoga; T’ai chi; hypnosis; certain breathing techniques; reorganizing the patient’s model of time (see below) and some of the Medical NLP techniques we will discuss further in later chapters and Appendix A (pages 357 to 360)—affect therapeutic change by reversing the constricted sense of time, and activating the mechanism that counter-balances the fight-or-flight response. This ‘relaxation response’, as it has been named by Herbert Benson, seems to transcend linear time.203
NLP and the time line
One of NLP’s many major contributions to applied psychology is the observation that, just as people have individual sensory preferences, they also have unique ways of coding their experience of time. As the example at the start of the chapter showed, we make and store distinctions between experiences that occurred in the past, are occurring in the present, and may occur in the future.
We also organize these experiences sequentially, characteristic of our culture’s tendency to represent events spatially. That is, when we think of the meal we ate two days ago, it will tend to be placed in our internal landscape ‘as if’ it occupies an actual position different from where we placed the meal we had yesterday. This has become known as a ‘time line’—a personal construct or ‘map’ of experiences in time–space.
Most NLP books and courses have a fairly lengthy method of ‘connecting’ similar experiences in order to reveal each person’s construct.
We consider the following method easier for most people to understand and to use in some of the ways we will discuss later. Here is the kind of suggestion we offer to patients:
‘Imagine your life, from birth until now, represented by a road, a pathway or a stream, with the earliest part—the time of your birth—furthest away, and the most recent part, the present, nearest to you.
‘There’s no right or wrong way to do this, so just point to let me know where in your imagination that road or path or stream appears to begin.’ (The patient points.) ‘Thank you. Now, where is the present?’
(The patient indicates the present.) ‘Thank you. Now…if the future were also a road or path or stream, how would that run?’ (The patient points.) ‘Thank you.’
We consider it important to add the following as part of the set-up for later change work:
‘Of course, this is not a real thing. It’s just the way the brain makes a map of how we use time. But sometimes the brain tends to act as if the map is real. And if it isn’t detailed enough, or in the wrong place, or doesn’t suit our purposes, we might need to change it. Does that make sense?’ (Make sure you have the patient’s understanding and agreement before proceeding.)
Note: Before we proceed, we suggest you elicit your own time line for future use.
Time line variations
Almost as many different permutations of time lines exist as there are people. Some may place the past behind them, others to one side. Yet other people perceive the past in front of them, or encircling them, or as extremely short or even non-existent. Likewise, the future may be curved, sloping, wide, narrow, short, or long. Two points should be borne in mind here:
- The patient’s organization of his time line has subjective relevance (even though it may be outside his conscious awareness).
- Whatever other characteristics might be revealed, he will be either associated into his time line (it seems to pass through his body) or dissociated from it (the time line passes from past to future separated by a distance from his body).
Cultural variations
Some writers suggest that different cultures have distinctive ways of coding time, and experiences show that this may be true—up to a point. Certainly, many people claim to detect (and sometimes suffer at the hands of) cultural time-keeping that differs significantly from their own. But, in practice, our own experience has been that where health problems exist, we can proceed using the same approach with patients from other cultures as we do within our own.
The time line as a diagnostic tool
In Medical NLP, the first application of the time line is as a diagnostic tool. Figure 15.2 shows some observations made by ourselves and other practitioners. The patterns are just some of the many possibilities you may encounter. In using the time-coding diagnostically:
- Accept it as if it were a ‘real thing’, and ask yourself what effect this could have. (For example, if the past—particularly a traumatic past—were running continuously as a kind of internal movie in front of a subject, he would almost certainly be considerably disabled by the subliminal memories, or would ‘keep running into’ the same kind of experience.)
- Always check with the patient. As an example, we suggest asking, ‘Now, if time were really running past without touching you, how much would you feel in control over your life? How would it be to step back into your own life?’
Figure 15.2 will help the practitioner to use time constructs as a diagnostic tool.
Please note: You should still calibrate to the speaker and test whether his subjective experience matches that suggested by the way he arranges his time line. See Glossary: ‘Calibration’.
The language of time
The patient’s linguistic patterns
Pay special attention to the patient’s temporal language. Note phrases such as, ‘I’m always putting things off’ (suggesting that the patient’s goals are not physically positioned on or in his representation of the future); ‘Time is passing me by’ (suggesting dissociation); ‘I can’t see a way forward’ (the future is literally obscured); ‘I can’t stay on track’ (direction needs clarification); ‘I’m always short of time’ (a truncated future); etc.
These will provide you with clues as to how to proceed once the patient’s time line has been reorganized.
The practitioner’s linguistic patterns
Since people process verbs differently from tense to tense (distinctions between different time frames being necessary in order to extract meaning from the communication), the Medical NLP practitioner uses temporal language to support a recoding of the patient’s perception of his problem. A general rule is as follows:
- Draw resources from the future (‘When you have found you are feeling better…’);
- Place the problem in the past (‘…and the problem you’ve been having has been sorted out…’); and
- Anchor the solution-state in the present (‘…what specifically do you find is different and better…now?’).
| Orientation | Effect | |||
| 1. | The time line is markedly separate from the patient’s body | Time is “passing me by”; “things are out of reach”; “no control” over events | ||
| 2. | The past is directly in front of the patient | Extremely common in behavioural patterns that keep repeating; where the patient is adversely affected by, or reminded of, the past (including abuse and other traumatic experiences), or keeps “making the same mistake” | ||
| 3. | The future is behind the patient | Characterized by disorganization; inability to plan; feelings of ‘hopelessness’; literally ‘no future’ or confusion, when asked about anything beyond the present time | ||
| 4. | Extremely short or non-existent future | Often encountered in patients with a diagnosis, or fear, of terminal disease | ||
| 5. | Both the past and the future are in front of the patient | Sometimes associated with confusion between the past and future. | ||
| 6. | The time line runs from left to right in front of the patient | A frequently encountered arrangement (possibly related to hemispheric organisation and reading Western languages from left to right). Good for planning and organisation, but sometimes associated with a sense of detachment | ||
| 7. | The past or future is steeply inclined | The past or future has been or will be a tough climb | ||
| 8. | The time line encircles the patient | Often accompanied by feelings of being ‘trapped’ and ‘running to stay in the same place’ | ||
| 9. | The past is directly behind the patient’s head | Amnesia; inability to ‘look back’ at the past; failure to ‘learn from past mistakes’ | ||
Figure 15.2 Time line observations
Note: Use the past continuous tense (‘the problem you were having’) rather than the past tense (‘the problem you had’) to avoid mis-matching the patient and losing engagement.
Reorganizing the time line
We have two purposes in reorganizing the time line when it seems to be dysfunctionally arranged—to provide a new, subjectively more appropriate, or useful, frame for the patient’s experience, and to access resources and make changes at different perceived times in the patient’s life.
Sometimes a simple reordering is enough to produce generative change—for example, moving the past behind the patient, and opening up the future in front of him. We may speculate that ‘experiencing’ the past as ‘behind’ him changes his processing mode from a ‘present, all-pervasive’ problem to ‘something that happened and is now over’.
A strong element of creativity and experimentation is necessary on the part of the practitioner, especially where complex and unusual configurations are encountered. We recall one patient (a fellow practitioner suffering from ‘burn-out’) who visualized her future time line ‘like a huge funnel, sloping down towards me, with massive amounts of “stuff” pouring down at me like an avalanche’. She described feeling ‘absolutely engulfed by everything’. No surprise there, then.
Rearrangement required several steps—including reversing the flow of tasks yet to be tackled so they moved away from, and not towards, her—and considerable experimentation before she began to regain a sense of control.
Changes are always made with the consent and co-operation of the patient. ‘Let’s try something…’ is a more respectful and productive approach than, ‘Do this!’ Some patients experience a strong kinesthetic when rearranging a time line; if this fails to settle down, rearrange it until it feels comfortable. An individual’s time line should be presented as neither right nor wrong, but simply as useful or not useful.
Among the many possibilities available, we regard the arrangement shown in Figure 15.3 as the most compatible with both remedial and generative change.
Tips for reorganizing the time line
All instructions may be prefaced by suggestions such as, ‘I want you to imagine you can actually take hold of the very start of your time line and begin to swing it around…’, etc. Add the reassurance, ‘All your experiences, learnings and memories will stay in their proper sequence, as we…’ etc.
- Reassociate the time line into the patient (if dissociated), metaphorically placing him back ‘in’ his own life (have him pull the time line towards him until it ‘clicks into place’);
- Have the patient swing the beginning of the past around until it runs diagonally towards either his left or right shoulder. A useful suggestion is, ‘You know how those people who somehow just bounce back from problems always say, “Just put it behind you and move on”? Well, this is your chance to put it behind you—but, if you need to look back at the past, it’s there…’;
- Arrange the future running directly out in front of him, encouraging him to extend it out ‘over the horizon’. This suggests a long life with lots of time still ahead;
- Have the patient widen out the future time line (‘So you have lots of room to put all your options, choices, opportunities’, etc); then,
- Throw the entire future time line into bright sunlight (‘People sometimes talk about having “a bright future”. Make it as bright as that…’).
The final step in this process is to place the internal representation the patient made of his direction, outcome, or goal on the future time line, ‘just a few steps in front of where you are now’. Suggest, ‘This is the direction in which you want to move. Make sure it’s bright and compelling—something that really pulls you into it—and, we’ll come back to it a little later.’
Now, summarize for the patient:
‘So, what you’ve done here is to put everything that’s happened behind you in the past so you can start to let it go. Of course, you can look back at it, if you need to, but it won’t be distracting you’ (‘in your face’; ‘on top of you’; or any other metaphorical description the patient has given about his problem-state) ‘any more. And it’s good to know that whatever has happened has already happened and is over with, and where you are now is in the present, with a very long, wide and bright future pulling you into it…isn’t it?’
Figure 15.3 Time line arrangement (seen from above). The past time line now runs diagonally from behind towards the patient’s head, either from the left or the right (depending on his preference), while the future is directly in front, opening up and extending over his imaginary horizon.
The purpose of eliciting and reorganizing the patient’s time line may be regarded as expanding his internal map of reality. Even if we choose to regard this simply as a metaphor, the presupposition that problem states began—and, can potentially conclude—in the ‘past’, and that a ‘different’ future can be envisaged, is a more hopeful model than the fear-ridden one with which he has been operating: that the problem is present tense, all-pervasive, and likely to extend indefinitely into the future.
EXERCISES
1. Elicit your own time line and re-orientate it as suggested in Figure 15.3 above. Notice how it feels.
2. Create a well-formed outcome and place it on your time line, a little in front of you. Ensure that it is richly detailed in all sensory modalities. The outcome should be a dynamic representation of you functioning in the situation it represents.
3. Explore how your life would be different were you to be strongly drawn into this outcome. Use all your senses to create a full representation.
4. List all the resources you have and all those you would need in order to turn this outcome into your personal reality.
5. Now, see yourself stepping into the future, taking on all its qualities and moving on, watching how your life plays out as you disappear over the distant horizon.
6. See the future you reappearing, floating up above the horizon and back, bringing with you all the experiences you have gained from your time-travel adventure. Have the future you drop down inside you as you are now, allowing all the knowledge, experiences and learnings to integrate with you for your use, starting…now.
Notes
196. Howard RE (2006) Kull: Exile of Atlantis. New York: Del Rey Books.
197. See Clark RW (1984) Einstein: The Life and Times. New York: Avon, for an entertaining and informative account of an extraordinary life.
198. Jeans, Sir James (2009) The New Background of Science. Cambridge, UK: Cambridge University Press.
199. Friedman M, Rosenman R (1974) Type A Behaviour and Your Heart. New York: Alfred A Knopf.
200. Csikszentmihalyi M (1991) Flow: The Psychology of Optimal Experience. Copenhagen: SOS Free Stock.
201. Whitrow G (1972) The Nature of Time. London: Thames & Hudson.
202. Ornstein R (1969) On the Experience of Time. New York: Penguin.
203. Benson H (1990) The Relaxation Response. New York: Avon Books.