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Dr. Maineman - admitting diagnosis, cause of death COFFEE


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#31 maineman

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Posted 17 February 2006 - 02:59 PM

CC, Here's a patient I saw this afternoon. Tell me how you would approach her: "Nancy" is 71 years old. I've known her for 20 years. Her husband died of lung cancer from cigarette smoking 12 years ago. She never smoked but clearly has mild emphysema from his second hand smoke. She has a 12th grade education and worked in the shoe factory. She has hypertension which has been well controlled with a single blood pressure pill. She is 5 foot 4 inches and 192 pounds. She is extremely sweet. She and her sister like to go out every day to lunch. They usually like to go to this god-awful place in town that is very popular which serves fried fish and other local seafood. They used to go out dancing on the weekends but have done that less lately. I've asked her about diet and exercise for years. I've discussed the food groups, calories, etc. I've helped her enroll in exercise programs and she has never gone more than one or two times. Her cholesterol, blood pressure and fasting sugars are ok. How can I help her lose weight? What would you offer to her? Thanks, mm
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#32 calmcookie

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Posted 17 February 2006 - 03:34 PM

I'd buy her a coffin. :lol: :D :lol:

Seriously, MM ... I can't summarize these techniques in a paragraph or two. That's impossible.

I don't know how interested you are. If you have the desire, I'd suggest you get a book that outlines the principles of NLP. Several good ones have been written and are applicable to various fields of behaviour change. For example, there are NLP techniques to help bosses get employees to BEHAVE as the boss wants them to. There are NLP techniques for shaping the behaviour of children.

This whole approach was developed by a mathematician and a linguist who carefully observed a number of successful therapists (Virginia Satir and Erickson were the most influential) and then said "Others can learn to do what these "change masters" have done. Others CAN learn to do it ... if they realize and practice WHAT these people are doing. NLP is a summary of exactly WHAT works to alter behaviour.

Personally, I love the book "The Structure of Magic" by Bandler and Grinder. But, it's not everyones cup of tea. People with no counselling experience usually don't "get it." Do an amazon search for NLP and have a look at reviews. I've also done many courses over the years These have included practical sessions. The approach cannot be learned overnight. And it's not a magic wand ... but, pretty close. :)

Good luck, C.C.

Edited by calmcookie, 17 February 2006 - 03:38 PM.


#33 maineman

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Posted 17 February 2006 - 08:59 PM

"I'd buy her a coffin. :lol: :D :lol: " Nice.... this is a real person I'm talking about and typical of the average patient we see in real life. She is human. She is an average American. She is a nice person. Has great kids and grand kids. She is active, visits family, loves her kids. So is she a "bad person" because she is fat? Is she a bad person because she is clueless about nutrition? She has a pretty good idea of fat versus protein versus carbs, but I doubt she's ever set foot in a health food store. In spite of her ways, she is doing pretty good for her age. I don't think she's ever been hosptialized or suffered from any serious illness. So my question to you stands. As a health care provider/nutrition counselor, how would you approach "Nancy". 1. First, is Nancy healthy or unhealthy? 2. Would you try to teach her new ways of eating? 3. Does she need to change? 4. How would you motivate her? 5. What would you do if she came back in a month and had not lost any weight? 6. How do you propose helping the general population - of which she is truly representative of? All 300 MILLION Nancies here in the USA? I look forward to your views. As for NLP I am VERY familiar with it. We study all of these things, you know. I've even read several NLP for Traders books. SInce its been a tough debate this week I'll keep it at that for now. maineman
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#34 PorkLoin

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Posted 22 February 2006 - 08:00 AM

Maineman: How do you propose helping the general population - of which she is truly representative of? All 300 MILLION Nancies here in the USA?


That's a heck of a good question, Maineman. We're all those individuals but we also have group consciousness at different levels. I certainly don't have the answer to the question, but I figure it lies in the motivation of both the individual and of the group. Not saying we need to brainwash everybody, but I don't think all 300 million can be "reached" on the individual level.

The family often makes a big difference -- if mom and dad lie around all day in front of the TV, shoveling junk food into their mouths, the kids probably are behind the eight ball, on average, more than kids in households where the elders are active, concerned with good nutrition, involve the kids, etc.

There are regional and cultural differences too. I worked in Canada for nine years, all over the counry, and in Quebec the people are thinner on average versus the other Provinces. The culture is different there, more "European," and less like the "meat-and-potatoes" rest of Canada.

I've noticed that in and around Boston one sees a lot of runners, and on average people are not as fat there as in the rest of the US. I know this is anecdotal stuff, and it may be a bunch of gross generalizations, but I feel the observations are valid -- they come from 21 years of working "on the road."

"Helping the general population" -- that is one tall order.

Great thread.


Best,

Doug