Milton H. Erickson: Encyclopedia II - Milton H. Erickson - Ericksonian Therapy

Milton H. Erickson - Ericksonian Therapy

Erickson is most famous as a hypnotherapist, but his extensive research into and experience with hypnosis led him to develop an effective therapeutic technique. Many of these techniques are not explicitly hypnotic, but they are extensions of hypnotic strategies and language patterns. Erickson recgonised that resistance to trance resembles resistance to change, and developed his therapeutic approach with that awareness.

Jay Haley identified several strategies, which appeared repeatedly in Erickson's therapeutic approach.

• Encouraging Resistance - For Erickson, the classic therapeutic request to "tell me everything about..." was both aggressive and disrespectful, instead he would ask the resistant patient to withhold information and only to tell what they were really ready to reveal:

• Providing a Worse Alternative (The 'Double Bind') - Example: "Do you want to go into a trance now, or later?" The 'double bind' is a way of overloading the subject with two options, the acceptance of either of which represents acceptance of a therapeutic suggestion.

• Communicating by Metaphor - This is explored extensively in Sydney Rosen's 'My Voice Will Go With You', but a beautiful example is given in the first chapter of David Gordon's book Phoenix:

• Encouraging a Relapse - To bypass simple short-lived 'obedience' which tends to lead to lapses in the absence of the therapist, Erickson would occasionally arrange for his patients to fail in their attempts to improve, for example by overreaching. Failure is part of life, and in that fragile time where the patient is learning to live, think and behave differently, a random failure can be catastrophic. Deliberately causing a relapse allowed Erickson to control the variables of that failure, and to cast it in a positive therapeutic light for the patient.

• Utilizing Space and Position - Hypnosis and therapy are experienced subjectively by the patient, and any part of their total experience can be used to reinforce an idea. The physical position or even the posture of the patient can be a significant part of the subjective experience. Manipulating these factors can contribute to a therapeutic transformation.

• Emphasizing the Positive - Erickson was dyslexic as a boy, and was both colour blind and tone deaf throughout his life. He claimed that these sensory 'disabilities' helped him to focus on aspects of communication and behavior which most other people overlooked. This is a typical example of emphasizing the positive.
  Erickson would often compliment the patient for a symptom, and would even encourage it, in very specific ways. In one amusing example, a woman whose parents-in-law caused her nauseous feelings in the gut every time they visited unexpectedly was 'taught' to puke spectacularly whenever the visits were especially inconvenient. Naturally the parents-in-law would always sympathetically help her clean up the vomit. Fairly soon, the annoying relatives started calling in advance before turning up, to see if she was 'well enough' to see them.
  The subject of dozens of songs, 'emphasizing the positive' is a well known self-help strategy, and can be compared with 'positive reformulation' in Gestalt Therapy.

• Prescribing the Symptom and Amplifying a Deviation - Very typically, Erickson would instruct his patients to actively and consciously perform the symptom that was bothering them (see the nailbiting example under #Resistance), usually with some minor or trivial deviation from the original symptom. In many cases, the deviation could be amplified and used as a 'wedge' to transform the whole behaviour.

• Seeding Ideas - Hypnosis makes existing learnings more accessible. It's not realistic to suggest to someone that they do something they have never learned. For example, the suggestion "You will be able to carve marble like Michelangelo..." can have only limited impact on someone who has never had a chisel in their hands.
  Certainly new patterns may be synthesised in a hypnotic state from existing (and perhaps forgotten) learnings, - and this is perhaps a good definition of hypnotherapy - but if there is no seed for the suggestions, the subject will not be able to respond effectively. Erickson would often ensure that the patients had been exposed to an idea, often in a metaphorical form (i.e. hidden from the conscious mind) in advance of utilizing it for a therapeutic purpose. He called this 'seeding ideas', and it can be observed to occur at many levels‚ both coarse and fine grained, in many of his case histories. In a simple example, the question "Have you ever been in a trance before?" seeds the idea that a trance is imminent - the presupposition inherent in the word before is "not now, but later".

• Avoiding Self-Exploration - In common with most brief therapy practitioners, Erickson was entirely uninterested in analysing the patient's early psychological development. Occasionally in his case histories, he will briefly discuss the patent's background, but only as much as it pertains to the resources available to the patient in the present.

Adapted from the Wikipedia article "Ericksonian Therapy", under the G.N U Free Docmentation License. Please also see http://en.wikipedia.org/wiki