The Legacy of Dr. Milton H.Erickson

Erickson’s Legacy

1. He reclaimed hypnosis as a reputable form of therapy

2. He pioneered the indirect method of hypnosis: conversational hypnosis

3. Utilization: the cornerstone of his work.

4. Attitude : Creative Curiosity.

5. A unique methodology :

Erickson brought together very effectively some ancient medical traditions

Information communicated indirectly is far more effective than information communicated directly. Heraclitus (535-475 BC)(Indirect method)

The secret of change is to focus all our energy not on the old but on building the new. Socrates (469-399 BC)(Outcome-focus)

It is natural forces within us that are the true healers of disease. Hippocrates (460-370 BC)(Utilisation)Summoning the healer within : the basis of Shamanism.

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Erickson’s Definitions

Trance: a naturalistic state: the absence of a multiplicity of foci of attention, ideal for learning.

Hypnosis: the evocation and utilization of unconscious learnings, thus giving greater freedom and access to innate creativity.

A process of communication of ideas and installation of useful values and beliefs.

What emerges:

Conversational Hypnosis: the subtle and artful use of language for a change

An “Ericksonian” Hypnosis Method

Indirect, permissiveSelf-taughtA conversation with a purposeCreative curiosityTherapeutic relationship

Pre-suppositions

There is such a thing as the unconsciousThere is the possibility of a positive outcomeThe patient has resourcesThere is only nowThere is only neurology to work with

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Factors

Intention purposeful relationship: outcome-focus

State Get yours right first Curiosity, grounding, shieldingMatch, pace, lead (go there first)

Rapport (the individual responding to the individual, both unconscious and conscious) InductionDisease: conscious and unconscious out of rapport (Jung): produces neuro-muscular lock

Deep-trance identification (n.b grounding and shielding)

Communication with the unconscious

Distraction of the conscious mind

Utilisation Using what is there

Role of family

Clinician’s role re-parenting, sponsoring: create environment where the patient’s unconscious comes up with the answers

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Methodology

Ask better questions, then question the answers.The only reason for asking a question is to generate an

unconscious response.

Identify intention

Identify patterns, strategies

Distract the conscious mind: break neuro-muscular lock

Once in, disrupt the old patterning and allow the new, improved and updated version to emerge: sponsorship, reparenting

“I don’t know how you are going to get over this….”

Use archetypal energies: Tenderness, Fierceness, Humour, ….and Musicality

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Clinician’s skills

State modulation Getting your own state right first and adjusting it

Calibration spotting trance: de-hypnotising

Active listening patience, control of process, Patient responsible for the content

Rapport building

Goal setting the ability to make choices, especially about state, is a sign of health

Flexibility Behavioural and Linguistic

Determination and tenacity

Freedom Break prohibitions The emphasis is on impulse and feeling (trust the unconscious: but programme it well first)over intellect and concept

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Techniques

Overload conscious attention

Use of confusion: pattern interrupts ambiguityartful vagueness

Utilisation it is far easier to re-direct a stream than it is to dam it up.

The Ericksonian Mantra

That is interesting. Something is waking up/ seeking healing. I am sure that makes sense. Welcome

Artful use of language sentence constructionCharisma pattern : KAV(Kinaesthetic, auditory, visual)

Stories The Hero’s Journey: Joseph Campbell

Metaphors

Therapeutic tasks

Amnesia eliminate past and change the futurewithout the past the future can be one of positive expectancy

Release of neuromuscular lock

Use whatever you have to:musicality, tenderness, fierceness, humour

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Some notes on Resistance

There is no such thing as a resistant patient. All behaviour is purposeful at some level. Resistance is a response to a post-hypnotic suggestion. De-hypnotiseUtilisation: welcome the dissenting part and involve it in the solution-generating process. (Parts reframing)The therapy takes as long as it takes.Fixing things quickly is not a quick fix.

Some conversational techniques for addressing resistance

Linguistic agility

Inflection

You do not have to go into a trance so you can easily wonder about what you notice no faster than you become ready to become aware that your hand is slowly rising

I understand that you have never been hypnotized…you are now…curious about hypnosis… aren’t you…now…close your eyes…

Chunk down: break into smaller bits

Threshold: Encourage Relapse: sick and tired of being sick and tired

Utilize polarity response: Paradoxical injunction (e.g. weight gain), Ignore silence until patient becomes compelled to speak

Utilise space and position: swap chairs

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Prescribe symptom: with some modification: “I wonder what will happen if…and…” Disrupts pattern

Adler: Therapy is like spiting in someone’s soup. They can still drink it but not enjoy it. If you make the symptom obligatory it loses its appeal

Use of time: seeding ideas

Miracle question. Presupposes resolutionAn idea installed in a metaphor and hence beyond conscious awareness can then be used therapeutically

Shocks and ordeals: symptom prescription: e.g. gorging, weight gain

Reframes content. Context

Epicetus (AD 50-135)It is not the things themselves that trouble me, but the opinions I have about these things.

Virginia Satir (1916-1988)The problem is not the problem. The problem is how people are dealing with the problem.

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Criticisms

Not scientific

Anti-scientism.

If something cannot be measured it does not exist (The McNamara Fallacy)

Anti-labelling.

Labelling is the dead end of modern psychotherapy. Makes a process a thing: neuromuscular lock. Isolated from the creative unconscious. We are all incurable deviants. There is no "normal" in medicine. We all have our Greek mask we present to the world. Behind this is an infinite web of processing and experiencing, most of which we would not wish others to be aware of.

Einstein. A problem cannot be resolved at the level of thinking that created it.

Inappropriate behaviour.

Shock techniques.

Cruel crude jokes against psychiatric patients

Use of restraints for psychiatric patients

Authoritarian

Erickson’s Daily mantra

What am I going to learn today, and how am I going to enjoy doing it.?

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Bringing It All Together

Strategic therapy. Clinician controls process. Patient supplies content. Each patient is unique. Not formulaic.

The problem is not the problem. The problem is how people are dealing with the problem.

Give the patient the space, direction and opportunity to do it and they will come up with the answer.

Utilisation. Easier to redirect a stream than to dam if up

Unconscious is benign, homeostatic. Responds to stories, symbols, imagery. Not full of the dark, forbidden, repressed desires and repression of Freud

The basis of the work is rapport and deep trance identification.

4 Pillars of Hypnosis

Outcome-focus: set congruent goalsRapportCalibration: sensory acuityFlexibility: observe, reflect, adjust, including reframing (content,context), which alters meaningsAs change meanings, relationships, subjective feelings and perceptions change. People change how they feel by changing what they believe is going to happen in the future

The only useful function of the conscious mind is planning the futureStart this process by reflection

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Tips for the Practitioner:

Get your state right first: CuriosityCompassionHumourDeterminationFlexibility

Have a clear idea of the state you want the patient to achieve by the end of the session. Go there yourself first.Agree congruent goals (s) for the session (5 words maximum each) Stated in positive, under patient’s control, sensory-evidence based. Secure the patient’s commitment.Creative curiosity. "I don't know. Let's find out". Places focus in future, on outcome. No paralysis by analysis. The best thing about the past is that it is over.Frame session: how will you know this has been useful?(5 words)

Calibrate patient’s state Match, pace, leadBuild rapportGet them laughing. Behind every smile (limbic resonance) is a solution.Build hopeBuild motivation: shift focus from past to future: get them heading in the right direction and over threshold. Purpose-led life. Sick and tired of being sick and tired.Use patient's creative unconscious (“right brain functions”: primary processes, archaic language (pre-verbal)), emotions, space and form (i.e. images) to generate solutions.Calibrate, monitor, adjust

Asking better questions:

What is the intention?How are they doing it?

Rather than “Why?” use “How?”Rather than “Is it true?” use “Is it useful?” How will you know when you know longer have the problem?

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(Future memory: reticular activating system) Virtual rehearsal in hypnosis. Sets blueprint. Easier to do something a second time. Presuppositions do this.What needs to happen for that to happen?What will you do? What will you do now?What if....?

Conversational hypnosisSentence structure. The devil is in the detail. Mirrors whole process. People remember beginning and end. Put important message at end, after universal destroyer: ‘but.” Pre-suppositions

Mark suggestions: pause, change in tonality (down at end for command), change in body position, use patient's name.

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Structure of a session(Stephen Gilligan)

Perhaps you would like toSettle inSettle downSet intention (5 words)RapportAccess to resources

Close your eyes when you are ready to start to relax

Redirect focus from external awareness into breathingRise of tummy with in-breathRelease stress, adrenaline with each out-breath , and with each out breath allowing the relaxation to spread     

Elegant suggestions appropriate to intention

Future rehearsalPost-hypnotic suggestionsCalibration, reflection and adjustment.Reorientation

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Summoning the Healer Within

"I want you to allow your unconscious to do everything that your unconscious knows it needs to do to enable you to change all you need to change right now."

Your unconscious knows right now, what to do to make all the changes needed to find the outcomes and results, your unconscious now knows what you truly need. So allow your unconscious now to make all the changes today, tomorrow and in the daze ahead, so you can achieve everything your unconscious knows you want to choose to achieve now. (John Grinder)

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The NLP Milton ModelRichard Bandler and John Grinder

Microanalysis

The map is not the territory (General Semantics: Korzybsky)

The Milton Model is aimed at helping the patient make changes at the unconscious level. The patient has to make corrections to their model of the world at the deepest levels of their mind.

Many of the Milton Model categories create confusion and a search for resolution rather than meaning.

Presuppositions

Elicit agreement indirectly. Taken for granted and not explicit. Not noticed by conscious mind. Have to be true for the sentence to make sense.

Temporal presuppositionsBefore, after, as, continue, during, when, since and while.

"You can deepen your understanding as you read this manual"

Ordinal presuppositions: presupposes a sequence:"We will come to the third example in a minute."

Juxtaposition of truism and presuppositionYou are 4 years older now. It will be alright if you take the gold medal.

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Linguistic Ambiguity

Words or statements have more than one meaning and are open to interpretation.Recipient has to attempt to ascribe meaning to the words (transderivational search)Creates confusion. Ambiguity is trance-inducing by its nature. 4 types of linguistic ambiguity:

Phonological ambiguity

Homonyms. Words sound the same but spelled differently.“Right/write/rite/wright” “not/knot” “here/hear” “two/too” “there/their” “your/you’re” Synonyms. Words spelt the same but can mean different things. “Left” “Watch” “Like”

“And what is it thinking, your unconscious mind, right now?”

Syntactic ambiguity

-ing

“The revolting peasants need their hair cutting badly.”“Running shoes”“Hypnotising hypnotists can be tricky”

Scope ambiguity (=semantic ambiguity)

Not clear how much of the sentence is qualified by a particular word or phrase.

“You are aware that you are sitting and starting to relax.”

Punctuation ambiguity

Leaving out punctuation makes sentences ungrammatical. This creates confusion in the conscious mind and the patient has to go into their experience to make sense of what has been said.

“That’s an attractive watch my hand closely.” “ Is there anything you can do something.”

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Embedded commands

Indirect suggestions buried in a sentence.Analogue marking: lower tone of voice and raise volume for the relevant words.Downward inflection to voice at end of sentence makes the content a command.

“I wonder if you can learn about these things easily.”“You can say lots for things to help people feel better.”

Putting a name in after a modal operator (can, may, must) can aim the suggestion more specifically.

“Everyone must, Amanda, listen carefully.”

Embedded commands. Said with emphasis and followed by pause, then post-hypnotic suggestion : be curious about what is going to change

Embedded questions

“Wonder, curious, know, understand” Make question rhetorical and achieves indirect communication of message.

“ I am curious about why you feel that way.”“I am wondering if you can remember a time when you knew you could achieve anything”

Negative commands

Good for mismatchersThe unconscious cannot directly process a negative. It has to create the concept then negate it. “Don’t think about pink elephants”

“Don”t pay close attention to this section.”“Don’t send me that cheque until you are ready.”

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Conversational Postulate

A command posing as a question. Avoids provoking resistance that might meet a direct command.

“Can you close the door?”“Would you like to read the last sentence again?”

Tag Questions

“Adding a question at the end of a statement distracts the conscious mind and so reduces resistance, doesn’t it?”“It is easy to go into trance….isn’t it?”

Simple deletion

"This makes sense.""It is easy."

Comparative deletion

"They want more.""You can feel better."

Lack of referential index

"They all know the answers.""Someone is coming"

Unspecified verb

Experience, feel, understand, sense, learn.

"You can understand how you will feel better.""It is easy to remember the learning from this workshop"

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Cause and effect

People naturally think in causal terms; one thing follows as a consequence of another.If the first statement is verifiable in experience, the unconscious mind will often accept the linkage as true, even if there is no basis in fact.

"It does not have to be true, it just has to be plausible" (Tad James)

“Makes, causes”.

"The sound of my voice will make you feel comfortable""This manual has been carefully structured to make it easy for you to learn."

Complex equivalence

"That means…"

"You are learning hypnosis. That means you are interested in people""You are approaching 50. You are too old to start again."

Conjunction

And, but, for, yet, so."You can notice your breathing and begin to relax""You are smiling so you can be sure of success"

Implied causative

If, then, during, while, soon, as you/so you, the more/ the more

"If you consider these patterns you can learn them easily""While you weigh up these options you will be taking them in unconsciously."

Even more effective if use negative phrasing. Harder for listener to keep track.

" You won't be able to resist getting curious when you hear what is coming next.”Lost Performative

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Presenting a judgement or evaluation as fact, without stating who is making the judgement/evaluation.Good for bypassing resistance."It's"

"It's essential to practice language patterns at every opportunity.""It is useful to understand the way lost performatives work."

Mind-Reading

"I know you are curious about what is going to happen.""There are new things you are learning right now."

Nominalisations

Abstract nouns created from process words."Happiness" from "being happy"."Curiosity" from "being curious""Relationship" from "relating"Very powerful as people attach their own meanings to them.

"You can take satisfaction in your knowledge.""Insights, understandings and discoveries await you."

Universal Quantifiers

All, every, always,everyone, never, no-one, people.

"People always learn more easily when they relax""Nobody wants to resist discovering new things"

Modal Operators

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Necessity: "should/shouldn't", "must/mustn't", have to/don't have to". Limit choice."And you don't even have to try. It can happen all by itself".

Possibility: "can/can't", "will/won't", "able/unable".

"You are able to come up with many creative ideas"

Desire: “like

“You might like to become curious about how many different ways you can learn to go into trance”

Double bind

Presuppositions used to give an illusion of choice. Both options lead to the desired outcome.

"Shall we discuss this here or in your office""Will you tidy your bedroom before or after supper.”

Awareness (factive) predicates

“Know, realize, notice, aware.” Presupposes the truth of what is being said.

“Do you realize that there are many ways of becoming more knowledgeable?”

Adjectives and adverbs

Amplify presuppositions.

“Deeply, surprisingly, happily, luckily, readily, easily”

“You are going deeply into trance.”

Commentary adjective and adverbs

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At the beginning of the sentence reinforces the subsequent presupposition.

“Happily, fortunately, usefully, obviously.”

“Fortunately, this concept is easy to understand. Happily, you have grasped it easily already.”

Quotes

Conceal commands in a “story”.

“The doctor said to me, “You need to make that change now. “It is time to start to take better care of yourself.””

Selectional restriction violation

Attributing feelings to inanimate objects.People make sense of it by assuming it refers to them in some way.

“The chair will be pleased to have someone sit in it.”

Pacing current experience

Effective rapport can be quickly built by making statements which match and pace person’s current experience. This focuses them on what they are seeing, hearting and feeling and encourages them to become self-aware in the present.Incorporate kinaesthetic, auditory and visual truisms (pace) then add the presupposition which leads to the next objective.

“As you become aware of your breathing, hear the sounds in the room around you, and focus on the words on this page, so you can feel comfortable and relaxed.”

TTTP pattern (3 truisms then a presupposition)TTPP also works well.

MetaphorBibliography

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Uncommon TherapyJay Haley 1983

Hypnotherapy: An Exploratory CasebookMilton H Erickson and Ernest L.Rossi 1979

My Voice Will Go With YouSidney Rosen 1982

The Patterns of the Hypnotic Techniques of Milton H. Erickson M.D. (2 Volumes) Bandler and Grinder 1975

Jacqui Lee Schiff. Transactional Analysis: Treatment of Psychosis: reparenting

A teaching seminar with Milton H EricksonJeffrey Zeig

7 Habits of Highly Effective PeopleStephen Covey

Steps to an Ecology of MindGregory Bateson 1972

Therapeutic Trances: The Cooperation Principle in Ericksonian Hypnotherapy.Stephen Gilligan 1987

Innovative Hypnotherapy. The Collected Papers of Milton Erickson on Hypnosis Vol 4. (Ed.Ernest Rossi) 1980

Man’s Search for Meaning Victor FranklRider 2004 ISBN 184413239-0

M.E.W.C 19/2/2017mctraining.org.ukmewchambers@icloud.com08968 046315

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