Dear Garner,

Just a note to say that your book is excellent. I must say that I formed this opinion after something of a shaky start. My initial concerns were that

- My NLP training is from non "licensed" training companies and has been of and excellent standard. I do, however, hold Richard B in very high esteem.

- Early in the book you provide a critique of evidence based medicine that did not fit my model of the world. I subscribe to the view of David Sackett who described EBM as,"the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of the individual patient. It means integrating individual clinical expertise with the best available external clinical evidence from systematic research ”. To paraphrase this- the best evidence applied by the best doctors.

I feel that NLP skills link into the best doctor element and where evidence exists, enable us to implement best practice. I have a suspicion that were strong scientific evidence to emerge to support NLP effectiveness from RCTs we would be enthusiastic about using it. As we move towards functional MRI scanning it may be possible to understand some of the science as well as the art of NLP. Certainly UCL are actively researching hypnotherapy using a range of approaches.

Having said the above I found your book excellent, relevant to clinical work and worthy of the positive comments made about it.

Well done!

Two other aspects worry me.

The first is, despite the lip-service paid to the importance of ‘individual clinical expertise’, in the real world, the opinions and experience of the individual doctor occupy the very lowest rung of acceptable practice. The second is that a lack of evidence (usually RCT-based) is largely regarded as ‘proof’ that a particular procedure is worthless. Absence of evidence is taken as evidence of absence, rather than highlighting the need for more inclusive ways of measuring things. Some procedures simply don’t lend themselves to RCTs.

Equally, the EBM model argues for the responsibility of the individual practitioner to seek out and apply ‘best possible’ treatment – and yet, few doctors have the time to do so, and none has the legal right to do this. Real responsibility for deciding what is best practice is therefore assigned to committees of organisations such as NICE. This is theology, not science, and (as we can all see from the recent fiasco over the SSRIs), may be fraught with risk.

One of the leading intentions of Magic in Practice is to encourage practitioners to develop and trust their own senses and experience and to apply - adjunctively - knowledge gained this way with ‘objective’ evidence, such as that gained by RCTs. Medical NLP was set up as an integrative approach to health-care, not as an ‘alternative’ or ‘complementary system. If we genuinely seek ‘whole-person’ healing, it would be as stupid to ignore useful, verifiably effective, scientific evidence (the perspective of many ‘alternative’ approaches) as it would be to regard the practitioner as nothing more than the neutral deliverer of some objectively ‘true’ intervention (the stance taken up by purely evidence-based science).

Thank you again for your kind and thoughtful reading of the book and your encouragement.

GT