A person can leave a therapeutic encounter looking and behaving very differently from when they arrived. That change matters. It does not tell us, by itself, what produced the difference, whether it lasted or how much of the person’s wider difficulty remains. An honest account of therapeutic work needs to retain those distinctions.
Core Transformation has been an important influence on my thinking about change. One especially difficult encounter also taught me how easily a messy afternoon can become a polished story about a practitioner knowing exactly what to do. The polished version can hide the most useful learning.
From The Rainbow Machine: Tales from a Neurolinguist’s Journal by Andrew T. Austin.
What Core Transformation explores
Core Transformation was developed by Connirae Andreas and presented in the book Core Transformation: Reaching the Wellspring Within, co-authored with Tamara Andreas. The official account of the method’s development provides the appropriate starting point for its history and training.
The process works with an aspect of experience often described as a part: a response, feeling or behaviour with which the person is having difficulty. Rather than immediately trying to eliminate it, the enquiry follows what that part wants and what having that outcome would make possible. In the method’s own terms, this can lead towards a core state of being.
I have understood it in relation to NLP parts work and the six-step reframe, although understanding the structure of a method is different from being able to facilitate it well. Learning a sequence of questions does not guarantee that a practitioner understands the experience being explored or the limits of the setting.
The language of parts is a way of organising an enquiry. It need not be taken as a claim that separate beings inhabit somebody’s mind. Likewise, descriptions of spiritual or expansive states express qualities of experience, rather than providing evidence for a supernatural explanation.
A difficult afternoon
Family members or friends once brought a woman to me who was in severe distress and behaving in an unusual, disorganised way. They were afraid of taking her to psychiatric services in the country where they lived. That fear was part of the circumstances in which we met. It did not give me a clear diagnosis or a ready-made solution.
She made hissing and screeching sounds. Describing her as cat-like can make the situation memorable, but she was not claiming to be a cat. My initial response was to mirror some of what she was doing. This was familiar territory from matching and mirroring, but it was also an improvised response to not knowing what else to do.
The encounter lasted several hours. It involved attempts that did not work, awkward exchanges and periods in which I had little idea where the conversation was going. It was not a short, clean demonstration of a planned intervention. I had time available and wanted experience, and those circumstances helped make a lengthy encounter possible.
Eventually we were able to talk more about her internal experience. Within the parts model I was using at the time, I identified a part with which to work and introduced Core Transformation. By the end of the afternoon, I observed a substantial difference in how she presented and communicated.
What the encounter establishes and what it does not
I had no subsequent contact with her. I therefore do not know whether the changes lasted, how she understood the experience later or what happened in the rest of her life. I can describe the difference I saw that afternoon. I cannot honestly turn it into evidence that a psychiatric disorder had been cured.
There were also several things happening together: sustained attention, a developing relationship, changing circumstances over a number of hours and the eventual use of a particular process. The fact that one technique occurred before improvement does not isolate it as the cause. A memorable clinical story is an account worth considering, not a controlled test.
Severe or newly emerging psychiatric disturbance calls for appropriate assessment. NICE recommends prompt specialist assessment where possible psychosis is accompanied by distress and declining function. The uncertainty in this encounter is a reason to recognise the limits of an anecdote, not an invitation to substitute an improvised NLP session for specialist care.
The relationship before the technique
One useful question is what made communication possible at all. My impression was that not maintaining an immaculate expert persona changed the interaction. When I did not know what to do, I did not consistently pretend otherwise. The encounter became an exchange between two people trying to understand each other, rather than a performance of effortless professional mastery.
That does not make every spontaneous response helpful. Mirroring a distressed person could be experienced as recognition, mockery or threat, depending on the person and the situation. It cannot responsibly be reduced to an instruction to copy unusual behaviour. What matters is the person’s response and whether the exchange creates safety and understanding.
Honesty is equally different from unloading the practitioner’s feelings onto the client. A person seeking help should not have to manage the helper’s insecurity. Useful candour makes limits clear while retaining responsibility for the work.
The power hidden inside a friendly conversation
In an institution, friendliness does not remove the difference in power. A member of staff can write records, report concerns, influence decisions and help determine what happens next. A patient may reasonably wonder which parts of a conversation will be repeated, how they will be interpreted and whether disagreement will have consequences.
That uncertainty can shape what the person says. A reassuring manner may coexist with authority that is not openly acknowledged. Someone can appear cooperative because they feel safe, because they trust the member of staff, or because they are trying to avoid a feared response. Those are different relationships, even if the outward behaviour looks the same.
Simply changing the word patient to resident, client or customer does not settle the issue. Respect requires attention to actual choices, boundaries and consequences. Explain the role, what will be recorded and the limits of confidentiality. Trust becomes easier to assess when the terms of the relationship are visible.
A ward incident and a troubling form of trust
A separate experience in a residential unit brought this into sharp focus. During a sleeping night shift I was woken by an argument between two residents. One was shouting and the other had turned music up loudly. They remained at their respective doorways because entering another person’s room without permission was against the unit’s rules.
After one resident withdrew, the other refused to turn down the music. I entered the room and removed the music equipment. That broke the boundary I was supposed to observe. In the morning, the resident reported what had happened. An argument about conduct and reporting then developed, with each of us exposed to possible consequences.
I experienced a change in our subsequent relationship, partly because my position became more predictable to her. But a relationship shaped by mutual vulnerability to being reported is not an adequate model of clinical trust. Breaking a boundary and relying on silence or collusion cannot be recommended as a therapeutic method. The incident is useful precisely because it reveals how power can enter an apparently personal interaction.
Progress that can be described honestly
A meaningful account of change can be modest and specific. The person was able to communicate something that had previously been inaccessible. Distress seemed lower at the end of the meeting. An exercise became possible after a relationship developed. These observations can guide further work without being enlarged into promises they cannot support.
For practitioners, the practical task is to record what was attempted, what the person actually reported and what remains unknown. Make follow-up part of the work where possible. Ask whether the change survives ordinary life and whether there were unwanted effects. Core Transformation deserves the same honest examination as any other method, including when the experience of using it is encouraging.