A framework for assisting clients

A client-centered approach that combines 1) Attribution theory 2) Transpersonal psychology and 3) Neuro-linguistic programming, can serve as a framework for assisting patients or clients who had a transpersonal experience.

Client-centered approach

For Carl Rogers (1902-1987), a humanistic psychologist, interacting with clients meant letting them be the driving force for discussing their issues. His approach is called client-entered. The approach involves showing positive regard for the individual without judgment. In a client-centered approach the health professional, in an empathetic environment, asks open-ended questions to assist the client in identifying their issues and possible solutions. The approach, unlike the historically authoritative approach used in health care, is nondirective (Rogers, 1951).

This client-centered approach is also consistent with a new trend in providing nursing care. According to Oudshoorn, “Nurses are challenged to develop a new way of seeing empowerment practice, and encouraged to focus on 'being with' clients, rather than 'doing to' them.”  To be less judgmental the term non-adherent be used instead of noncompliant. Non-adherent is seen as allowing more open inquiries with patients as to difficulties staying with recommended medical treatment (Ofri, 2012).

Moody (2001) reports the following conclusions from his interviews with NDErs in the early 70s.

Despite their own certainty of the reality and importance of what has happened to them, they realize that our contemporary society is just not the sort of environment in which reports of this nature would be received with sympathy and understanding. Indeed, many have remarked that they realized from the very beginning that others would think they were mentally unstable if they were to relate their experiences. So, they have resolved to remain silent on the subject or else to reveal their experiences only to some very close relative (p. 78).

A client-centered approach with positive regard enables the individual to freely express their feelings and beliefs about their transpersonal experience.

Attribution theory

In 1958, Heider proposed a theory of attribution, explaining people will attempt to understand behavior by thinking of a reasonable cause or explanation. Others (Harvey & Weary, 1985; Jones, Kannouse, Kelley, Nisbett, Valins, & Weiner, 1972) elaborated on this idea and described a major theory of attribution in social psychology.

According to Forsterling (2001) when we experience an event, we all try to explain it with whatever education or information we have. We not only see or experience an event, we also interpret and try to explain it. That explanation will have a description of an antecedent event, the attribution and then the consequences.

A person may have an experience, say indigestion, remember they ate at a new restaurant, attribute the indigestion to the food there and resolve not to go to that restaurant. If the ‘indigestion’ is severe enough, they may come to the hospital. Tests may show that the patient is having a myocardial infarction and not indigestion. Before someone can convince the patient of the reality of the situation, the healthcare professionals must ask this patient what he believes is happening. Without hearing the patient’s interpretation of the situation, it is difficult to present an alternative explanation that is more accurate.

Neuro-linguistics programming

There are many dimensions of Neuro-linguistic programming (NLP) which studies how the mind creates experiences from sensory stimuli. NLP is based on the theory that all thoughts are experienced as either pictures, sounds, smells, feelings and/or taste (Hoobyar, Dotz & Sanders, 2013). Early descriptions of transpersonal phenomena focused on visual experiences. We now know that experiences can be visual, auditory or kinesthetic. When working with a client who has had a transpersonal experiences it may helpful to know how the client weighs visual, audio or kinesthetic stimuli.

Lawrence (2014) describes the application of NLP in the following manner:

The early researchers on deathbed communication, for example, described these events as deathbed visions. In fact, not only do individuals see apparitions, they also can hear voices or music or feel them and emotionally respond. In working with individuals who have these transpersonal events, it is important to listen to the descriptive words they use, be they visual, auditory or kinesthetic. It is important to not generalize, delete or distort the person’s description or emotional response.

Transpersonal approach

Helpful approaches

Transpersonal experience often alter an individual's understanding of life and world view. These changes can be challenging for family, friends and co-workers. Increased spirituality combined with a less materialistic life view can generate discord particularly with the spouse. When meeting with the individual and/or family members the following approaches have been found to be helpful and consistent with the above framework.

Documentation of the transpersonal experience

Transpersonal experiences can have a significant impact on the client's physical and emotional well-being.  It is important that a thorough description of experience is documented in the patient’s record in order rule out mental or physical disorders.  Here are some recommendations for what should be documented:

Instant feedback

Assisting the patient to identify their health issues and possible solutions by ask open-ended questions in an empathetic environment best describes

A client-centered approach
Attribution therapy
Neurolinguistics programming
All of the above