The Power of Milton H Erickson

The Power of Milton H Erickson

Hypno-Psychotherapy often finds itself having to justify its place as a psychotherapy as there is no single “unified theory” of what hypno-psychotherapy is and what its components are. Looking away from Experimental Hypnosis which conforms to the norms of academic research, Milton Erickson is probably the best known practitioner of the art. There are a plethora of ideas of what makes the “Ericksonian Approach” psychotherapeutic. This presentation will endeavour to show exactly what makes Ericksonian Hypno-Psychotherapy, psychotherapy.

In 1963, the noted family systems therapist Jay Hayley looked at Erickson’s approach to therapy and came to the following conclusions:

“Hayley characterised Erickson’s work as directive: therapists were to get their patients to do something, often by directing them to behave in the symptomatic way with some addition. Therapists used positive redefinition and accepted patients’ behaviour to ensure cooperation and to facilitate therapy. The directives utilised the patients’ assets and personality factors. Implication was often used indirectly to elicit behaviour from patients. The goal of therapy was arranging or changing the environment for symptomatic behaviour”

O’Hanlan in Ericksonian Psychotherapy Vol 1 Ed. Zeig

If one looks at this early description of the work, one can see the almost traditional view of hypnotism. That being that the hypnotist gets the client to do what he/she wants through direct suggestion with perhaps some behavioural modification as well, but nothing that would be considered “psychotherapeutic”.

In 1967, Hayley revisited this and came up with additional elements to the Ericksonian Model. These were identified in Ericksonian Psychotherapy as:

1. The therapeutic posture: here therapists need to incorporate and modify techniques to express their individual personalities (thus making the process unique to the practitioner) as well as modifying the techniques to adapt to the clients’ unique personality and behavioural traits
2. Expectation of change: the therapist accepts that not only will change happen but that it is inevitable
3. Emphasis that positive normal behaviour and growth are processes of living and psychopathology is an interference with those processes. Here the unconscious is viewed as a positive aspect of the self and not a collection of repressed, primal urges and conflicts; we can re-evaluate clients’ deficits as being potential assets.
4. Accepting what the patient has to offer: this includes symptoms, pessimism, resistances, rigid ideas and delusions
5. Emphasis on the range of possibilities: this is a dual process of the therapist approaching the client and for the client behaving and viewing things differently
6. Willingness to take responsibility: therapists must be willing to take responsibility and make decisions for people if it is necessary; each case is handled individually as to how much responsibility the therapist needs to take.
7. Blocking off symptomatic behaviour: therapists are not concerned with the “roots of symptomatic behaviour, symptoms are malfunctions to be corrected. To this end, they might block the symptomatic behaviour by either relabeling the behaviour, by taking it over and changing it under direction, or by providing an ordeal which makes it difficult to continue symptomatic behaviour.
8. Change occurs in relation to therapists: therapists create an intense relationship and then use that relationship to get the client to co-operate or therapeutically rebel to prove the therapist wrong.
9. Use of anecdotes, analogies, and/or stories: these are used to peg ideas or to make previously unacceptable possibility acceptable
10. Willingness to release clients: once the particular symptom is resolved the client is released from the treatment. No attempt is made to resolve all present or future difficulties.
11. Erickson’s approach has 5 premises:
12. The focus is on the present
13. The focus is on interactions
14. Symptoms are communications
15. Awareness/insight is unnecessary for change
16. The cause of change is the rearranging of the patient’s situation