Developing Ericksonian Therapy

A State Of The Art

Jeffrey K. Zeig, Stephen R. Lankton

• Publisher: Routledge
• Year: 2013
• ISBN:
  9781134847495
• Edition: 1
• Topic: Psychology
• Subtopic: Psychotherapy
• Index: Psychology

The volume presents the proceedings of the Third International Congress on Ericksonian Approaches to Hypnosis and Psychotherapy held in Phoenix, Arizona, December 3-7, 1986. The third Congress brought many new people to the Erickson movement. Approximately 1, 800 attended, a striking indication of the continuing influence and growth in the therapeutic legacy of Milton H. Erickson.

SECTION ONE: PRINCIPLES

PART I

Position Statements

Chapter 1

What Makes Ericksonian Therapy So Effective?

Sidney Rosen

Sidney Rosen, M.D. (University of Western Ontario), is in private practice in New York City. Rosen is an Assistant Clinical Professor of Psychiatry at New York University Medical Center and University Hospital. He has considerable background in psychoanalysis and is on the faculty of the American Institute for Psychoanalysis (Karen Horney). Founding President of the New York Society for Ericksonian Psychotherapy and Hypnosis, Rosen has been an invited faculty member of three International Congresses on Ericksonian Approaches to Hypnosis and Psychotherapy (1980, 1983 and 1986) and three national Erickson seminars. He has conducted workshops on Ericksonian approaches at various locations in the United States and Europe. Author of numerous professional publications, Rosen is the editor of My Voice Will Go With You: The Teaching Tales of Milton H. Erickson.

Rosen presents fundamental aspects of Erickson’s approach and outlines factors which are effective in all forms of psychotherapy.

On Nov. 16th, 1986, The New York Times (Lindsey, 1986) featured a front-page article about a Mrs. Knight, who maintained that a 35,000-year-old man, Ramtha, “used her body to speak words of wisdom.” This rather ordinary-looking, 40-year-old American woman commands a following of thousands and her long mesmerizing monologues are attended by hundreds of people who pay $400 each. Many of them feel that this is the best money they have ever spent.

After attending one of her seminars, George Hain, a millionaire businessman from Cheyenne, Wyoming, “returned to Cheyenne (the next day), disposed of his five Burger King restaurants and moved to a rural area in northern California, where he is building a house that is shaped like a pyramid, he says, to ‘manifest the energy’ of the universe.” However, one of her more skeptical observers reported, “She’s either psychotic or she’s a good actress. She’s obviously a fake, but she sure is a spellbinder.”

In our terms, she is able to enter into a trance, to do “automatic speaking,” to influence large groups of people, and to voice oracular pronouncements, coupled with prophesies of doom for those who do not follow her advice. Can we, with all our education, training, hard work and sincere caring for our patients, inspire, guide and heal them more successfully than does Mrs. Knight or the hundreds of other gurus or the thousands of other “healers” and “channelers” who are offering their skills today? Mrs. Knight, with good old American entrepreneurial directness, says, “I’m not a guru…. This is a business.” We claim that we are practicing a healing or a teaching profession. As professionals, we are constantly questioning ourselves and undergoing self-examination. We strive to improve our skills and help our patients more effectively.

I am not prepared at this time to discuss the intriguing question of our effectiveness in comparison with guides, healers, and gurus. Just comparing our effectiveness with other psychotherapists is enough of a challenge.

When I talk about “Ericksonian Therapy,” I run into difficulties. I recall the comments that people would make to Erickson about hypnosis: “I know what hypnosis is now—it is suggestion!” “I know what hypnosis is—it is concern with body image.” “I know—it is transference.” “It is relationship.” “It is regression.” “It is dissociation.” “It is focusing of attention.” And Erickson would answer, “Is that a .. a .. a .. all?”

Probably every one of the hundreds of therapists and students who visited Erickson had his or her own idea of what was the central feature, the secret of hypnotherapy. At congresses such as this one, scholarly researchers and clinicians are still trying to pinpoint the true “jewel in the lotus.” And we can imagine Erickson, saying to each one of us who believes that he or she has identified that central feature, “Is that a .. a .. a .. all?”

As I tried to put my finger on factors that make Ericksonian therapy so effective (and I realize that outside of meetings such as this Third International Congress I would not necessarily get universal agreement that it is “so effective”), I found myself coming up with the same kind of unsatisfying partial answers, answers such as these:

Ericksonian therapy is especially effective because it uses trance states which heighten suggestibility, and suggestion is a major element in all psychotherapies. Or, Ericksonian therapy is especially effective because it allows for and encourages experimentation on the part of therapist and patient. Because of the concept of reframing. Because of its emphasis on health and resources rather than pathology. Because of its focus on goals, rather than genesis. Because it applies “systems thinking.” Because … because …

I despaired that, even if we could agree that there is such an entity as “Ericksonian psychotherapy” and that it is so effective, we would be unlikely to be able to pin down one or two elements that lead to its being “so effective.”

In this chapter I will discuss some of the more demonstrable or observable elements in the therapies which each of us devises for himself or herself, based on what we think we have learned directly and indirectly from the writings and teachings of Milton Erickson. And, after finishing this self-indulgence, I expect Milton to have his voice go with me, asking, with a chuckle, “Is that a .. a .. a . . all?”

Still, I will proceed with my observations and theses, which are based on my own experience of almost 40 years of exploring the effects of many different approaches to psychotherapy. I also will take into consideration some of the reported experiences of others. It would be foolish of me to argue that other forms of psychotherapy are not effective. I propose, however, that, when they are effective, it is because of the elements that I will outline in this paper. In other words, I will take on the rather daunting task of outlining the main elements which make any form of psychotherapy effective.

NOVELTY

I create a new theory for each patient. (Erickson, personal communication, 1977)

“Practitioners of various forms of behavior therapy are also taking longer to obtain results” (Klein et al., 1969). “It is hard to believe that the lengthening of treatment reflects changes in the severity of patients’ problems or symptoms. More probably it reflects a decrease in therapists’ zeal with the disappearance of the novelty effect, and reduction of the need to proselytize as therapy gains recognition” (Frank, 1973). Several studies (Frank, 1973, p. 167) have shown that medical students obtain about the same improvement rates in short-term therapy as do psychiatrists. Certainly the zeal that goes with novelty applies here.

Since Ericksonian therapy is now in the forefront of some people’s awareness, it will take us a while to determine whether this situation prevails here. In my own experience, I have found that whenever I have tried a new approach to therapy, I would get good results at first. Curiosity, zeal, enthusiasm, novelty … whatever it is, these are all very important factors which the therapist brings to the therapy and which are conveyed to the patient. Certainly, if, like Erickson, we approach each patient as a new challenge and create a new therapy for him, we will maintain this zeal.

THERAPIST ACTIVITY

If you do not do, I will do. (Erickson, personal communication, 1978)

Frank (1973, p. 186) also quotes Whitehorn and Betz (1954): “More successful therapists offered a therapeutic relationship characterized by active, personal participation rather than passive permissive interpretation and instruction or practical care.” In this regard Erickson’s degree of active involvement in his patients’ lives was rarely seen in the work of other therapists of his day. Even today, especially in psychoanalytic circles, that degree of involvement is frowned upon.

For patients who did not have the initiative or the know-how to seek out community resources, Erickson would make arrangements for them to receive help and advice in all areas, ranging from help in dressing and grooming to advice on buying genuine, high-quality turquoise (“Go to the Heard Museum”). He would accompany patients on dinner dates and arrange for the waitress to treat them in a prescribed manner. He would stage fights in order to help desensitize a patient to anger. He would do whatever was necessary to promote therapeutic or growth experiences.

FLEXIBILITY AND ADAPTABILITY

Therapies may focus predominantly on the past, the present, or the future. Erickson’s approaches—with age-regression, doing and experiencing on the present, and pseudo-orientation in time or age-progression—encompass all of these. Of course, if we simply use the hypnotic state in order to bring back memories from early childhood, as in hypnoanalysis, it might not be considered “Ericksonian,” but on the other hand it is not prohibited within an Ericksonian framework.

Erickson was noted for developing and varying his approaches according to the existing climate and the uniqueness of the patient. In his early years, working with Lawrence Kubie, he used analytic understandings. In his later experimentation, he applied imagery and what could be called cognitive approaches. He constantly developed applications of nonverbal communication. He learned the language of psychotics, of children, of workers, and of mystics, speaking to each in their own language, even while apologizing that, “I know that I can never really understand the language of another person.” He brought to his therapeutic approaches anything of value that he had learned from different areas of human knowledge—history, literature, anthropology, science, and, of course, medicine. In exploring ways of getting people to move or to change, he developed approaches which have been dubbed “strategic.”

When I review the contents of a single issue of any psychotherapy journal, I am struck by many factors that might be considered the essential features which make therapy effective including production of dissociation, transference, corrective emotional experiences, and insight. Perhaps the strength of Erickson was that he did not exclude any of these, but rather included all of them and added his own innovations.

The technique of “reframing” has become identified with Erickson although other therapies also use it. Approaches which I have dubbed “corrective regression” are based on Erickson’s “February Man” and are truly original; they do not seem to be included in any other therapeutic approaches. They involve the actual creation of new memories or, as somebody has put it, they prove that “it is never too late to have a happy childhood.”

Erickson’s own summation of “hypnosis” was that “hypnosis is the evocation and utilization of unconscious learnings” (Rosen, 1982a, p. 28). As he said, in order to do therapy, all you do is: “First you model the patient’s world, and then you role-model the patient’s world” (Rosen, 1982a, p. 35). The approaches mentioned above and dozens of others are applied within this flexible framework.

MULTILEVEL COMMUNICATION

We are all aware that a patient communicates with us on many levels. Erickson has made us more aware of the fact that we also communicate with the patient on many levels. When this communication is done with thought and intent, and when we are aware of the various ways in which we can communicate therapeutically, our results are bound to be better than if we simply rely on our desire to help, trusting that verbal interpretations, clarifications, and suggestions will be sufficient to enable us to help our patients.

A LEARNING APPROACH RATHER THAN A PATHOLOGY-FOCUSED ONE

Therapy is the substitution of a good idea for a bad idea. (Erickson, personal communication, 1978)

Erickson seemed to think of life’s problems, including neuroses and psychoses, as arising from faulty or insufficient learning, or from inability to utilize the learning which we have already acquired. The therapeutic situation gives the opportunity for new learnings and for the utilization of helpful old learnings. The therapist guides the patient, acting as a model, as a teacher, and sometimes as a guru. Learning is generally more easily achieved when the patient is in a trance state. The therapist uses the trance state in himself in order to make the best contact with the patient, and to more completely understand him. And as Minuchin stated in his letter to Erickson (Rosen, 1982a, p. 18), Erickson was able “to look at simple moments and describe their complexity” and had “trust in the capacity of human beings to harness a repertory of experiences they do not know they have.”

If what is learned is a result of therapeutic experiences that help the person to cope better with life, the new patterns and approaches will likely be retained and built upon so that the results will be long-lasting. They will be retained only if they can free the person to continue growing and learning.

MAGIC AND ENTERING A NEW REALITY

Every child likes a surprise. (Erickson, personal communication, 1970)

When a person entered into Erickson’s sphere, he entered into a new reality—a world of magic, of childhood, and of whimsical humor. In this atmosphere we are likely to revert to childlike responses, to childlike openness to learning, and to the malleability of childhood. When a therapist can create a world of wonder, of freshness of view, his patients are likely to respond with the “suggestibility” of children. Therapeutic suggestions and role modelling are bound to be more effective than they would be if presented only to the conscious, logical, “left brain” mind.

Healing has always been associated with magic, as in the healing rituals and practices of so-called “primitive” groups, or the reported practices of the temple priests in biblical times. Hypnosis has also always been associated with magic, despite efforts by Erickson and others “to disassociate the study of hypnosis from mystical and unscientific connotations” (Rosen, 1982a, p. 192). In spite of our disavowals, when we do therapy under the aegis of hypnosis, we tend to arouse, in many patients, particularly the most desperate ones, overt or latent magical beliefs, and this may add power to our interventions, whether or not we ourselves believe in magic. We can benefit from the popular association between hypnosis, magic and mysticism. In scientific circles, it leads to hypnosis being viewed with scorn, but with desperate patients it adds power to our therapy and may, indeed, be one of the more powerful factors in making Ericksonian therapy “so effective.”

ORACULAR PRONOUNCEMENTS, INTERPRETATIONS AND DIRECTIONS

You know much more than you think you know.

Your unconscious mind will protect your conscious mind. And, at an appropriate time, in an appropriate place, your unconscious mind will let your conscious mind know something that you already know, but don’t know that you know. (Erickson, personal communication, 1970)

It appears that people are most helpful to themselves when they come to their own conclusions about the causes of their problems and discover their own solutions. The wheel does seem to have to be invented over and over again. In Ericksonian therapy, this inclination is encouraged by what I call “oracular” comments, predictions and interpretations. These are statements made in ways that access the patient’s inclination to look into himself—to discover his own resources and his own explanations. They can be applied by almost every person to himself or herself: for example, “You have sometimes wished that your parents would die, yet you were terrified that your wish might be fulfilled” or, “you have some deep-seated feelings of inadequacy.”

In dealing with a patient who has premature ejaculations, I might say, “I do not know anything about your background, your childhood, your family, your sexual history. But you know about these things. And you can, in a trance, get in touch with the things you know but don’t know that you know and you can find attitudes and approaches that will enable you to enjoy sex in ways that you desire.” T...

Table of contents

• Cover Page
• Half Title page
• Editorial Review Board
• Title Page
• Copyright Page
• Dedication
• Contents
• Introduction
• The Milton H. Erickson Foundation, Inc.
• Faculty
• Section One: Principles
• Section Two: Practice
• Section Three
• Section Four