In common with most hypno-psychotherapists, Erickson was concerned to appease clientsâ critical faculties. As one way of achieving this, he customised his scripts to the individual. As another – in a sense at the opposite extreme – Erickson remained âartfully vagueâ, presenting a general framework for clients to work within. He firmly believed that all the resources for change are already present in the client and an important (though rarely the only) element of therapy is to provide some âskeleton keysâ to unlock and utilise such resources. These skeletal frameworks are termed âprocess instructionsâ, effecting content-free therapy. Thus, the therapist may be able to work without a detailed knowledge of the presenting issue and its ramifications.
A fundamental Ericksonian process instruction may be composed from the access/amplify/apply structure of the mastery model. A script – albeit condensed for illustrative purposes – might proceed along the following lines.
As you reflect upon issues important to you right now, certain abilities, skills and resources may spring to mind for you to use in ways you may not have realised before [pause]. You can allow yourself to select one such capability [pause]. And you may find yourself drifting back to a time when you used that resource in a satisfying way [pause].
Allow yourself to become fully absorbed in that positive experience . . . more and more vividly [pause]. Gather up everything you need. Allow your body to memorise those good feelings for future use [pause].
Now, allow that capability to become firmly fixed in your future, where and when you would like to use it again [pause] . . . rehearsing through those skills and pleasant associated feelings, in ways which meet your needs and goals.
Note the generic nature of such process instructions. This kind of script can be used with a wide range of clients. The two examples below are taken from the videotape, The Artistry of Milton H Erickson, MD, part 2 (Lustig, 1975).
Itâs important for you to realise that your unconscious mind can start a train of thought and develop it without your conscious knowledge, and reach conclusions, and let your conscious mind become aware of those conclusions. And you can enjoy discovering so many things that are possible for you. When I see patients, I really want them to do a great deal of thinking, because I donât know whatâs right for them. They have to reach that through an understanding of what they know, have experienced. And each person can put past experiences and learnings together in a way that is satisfying.
. . . your unconscious is sorting over your memories, your understandings, your hopes, your anticipation, your wishes, and trying to make for a new arrangement of everything that youâve learned – a new arrangement that will be for your betterment and for your satisfaction.
Further examples of process instructions have been proposed by other therapists influenced by Erickson and are outlined as follows.
There are several things you know about problem X [insert presenting issue] which you do not know that you know. One is that you already know very well how to eliminate [or reduce] X. You know this because X has occurred so many times before and yet been discontinued/reduced, sometimes only for a few moments, sometimes for much longer. Your mind and body knows exactly how to create X and how to eliminate/reduce X. Since youâre an expert at eliminating/reducing X, having had so much experience of this, you can use this unconscious knowledge to immediately eliminate/reduce X should it ever start again. And thereâs another thing you know about X which you do not know that you know. You already know the patterns of X. And your unconscious mind can change such patterns in any way that will break you out of the X rut. You have all these abilities and more, but thereâs no way to determine which ones will be the most useful, how quickly you will find relief, or whether the relief will be total or partial [presuppositions].[Adapted from OâHanlon & Weiner-Davis (1989: 141)
Now that you are ready to continue therapy on an even deeper level, you can begin by simply becoming more sensitive to yourself. [Pause]
When a deep part of your inner mind knows it can resolve that problem, you will feel yourself getting more and more comfortable, and your eyes will close. [Pause]
Now your inner mind can continue working all by itself to solve that problem in a manner which fully meets your needs. [Pause]
There are memories, life experiences, and abilities that your inner mind can use in many ways you may not have realised before. [Pause]
When your inner mind knows that it can continue to deal effectively with that problem, you will find yourself wanting to move a bit, and you will open your eyes and come fully alert.[Rossi (1986: 73-4)]
Rossi appears to be one of the few therapists courageous enough to use only process instructions during a session (the above effectively represents an entire therapy session in five sentences). Such a minimalist approach may, however, be contraindicated for some clients, especially those of low verbal intelligence and those who would benefit from a more direct approach.