Friday, August 30, 2019

如何將缺陷變成自己的優勢?

看看催眠大師Milton Erickson 如何和缺陷、疾病共存,充分發揮自己擁有的身體功能,在不可能中找到可能性:

埃里克森17歲開始的脊髓灰質炎的故事是一個傳奇。不過,對埃里克森而言,類似這樣的傳奇也未免太多了一些。

他患有色盲、音盲、閱讀障礙……

埃里克森是色盲,他的視覺只能對紫色有感覺。他還是一個罕見的音盲,聽不到音調的變化,沒有辦法欣賞正常人稱之為“音樂”的東西。

他有嚴重的閱讀障礙,到了16歲時才發現,字典是從A排到Z的。小時候同學給他起了綽號“字典”,因他常常數個小時就是在看字典,同學以為他喜歡看字典,卻不知道他不過是在找一個字,因不知道字典的排序,他每次都是從第一頁開始,逐個字逐個字地找。

好像是,相比正常人,他與世界溝通的許多通道都被關閉了。但是,他從未抱怨過命運,並反而因此打開了正常人所沒有的一些通道。

既然只對紫色敏感,那麼他就坦然享受一個“紫色主義者”的生活,穿紫色衣服,用紫色杯子,在紫色的辦公室里工作,在紫色的家中居住……

6歲時,他走過一個教堂,教堂裡很多人在進行合唱練習。因是音盲,他聽不到他們合唱的音樂,他只是納悶,這一群人發出這麼奇怪的聲音,為什麼卻那麼快樂?他看著看著,找到了一個答案,哦,他們在一起呼吸,呼吸的節奏是一致的,所以這麼快樂。

於是,從6歲起,別人給他講話,他就和別人一起呼吸。譬如老師講課,他不去聽老師講什麼,而是跟著老師的節奏呼吸,老師看著他,他就點頭,發出“嘣嘣”的聲音,這聲音是踩著老師呼吸的節奏而發出的。別人都無法理解他到底在做什麼,但有一個人和自己呼吸的節奏一致,會產生一種奇特的和諧。

這種節奏感成了埃里克森催眠的重要基礎。學催眠時,老師教我們去和個案的呼吸保持同節奏的呼吸,我們要花很大努力才能做到這一點,而埃里克森從6歲起就可以很自然地做到這一點了。

甚至閱讀障礙也幫助了埃里克森。 16歲時的那個冬天,一天中午很冷,他待在地下室裡用字典查一個字,突然間,彷彿一道白光照亮了整個地下室,埃里克森剎那間明白,原來字典是按照字母從A到Z排序的。那一刻,他深深地感謝內在的自己,把這個訊息留這麼久才讓他發現,因為這讓他對英文有了更深的理解,他在無數次的逐字查詢的路上,學了更多。

許多正常人所擁有的與世界溝通的渠道,在埃里克森那裡被命運無情地關閉了,但埃里克森反而因此打開了獨特的通道。這些通道,本來正常人也有,只是,因為那些常見的通道太好使了,我們開始依賴它們,於是忽略了那些獨特的通道,也是更為深邃、更富有價值的通道——與潛意識溝通的通道。

相比起埃里克森來,一般人擁有的命運的饋贈要多很多,然而,或許是擁有的東西太多了,我們反而喜歡抱怨,為什麼我擁有的還不夠多呢?為什麼命運對我如此不公呢?
埃里克森恰恰相反,他對他所擁有的一切總是心存感激,他永遠是在享受已擁有的資源,而不是將注意力放在欠缺上。

埃里克森70歲以後,只能坐在輪椅上。有天晚上,吉里根去廚房裡見埃里克森太太,看到埃里克森也在廚房,他穿著紫色的運動裝,在切晚餐用的菜,非常投入,並對吉里根說:“我正在運動。”

脊髓灰質炎的後遺症跟隨了埃里克森一輩子,他有過數次嚴重的複發,因為不斷萎縮的肌肉,他本來可憐的視力和聽力也不斷在減損。儘管他傳奇般地站了起來,但他右半邊身體的肌肉幾乎徹底失去了力量,他只能靠著少許的肋間肌和橫膈膜呼吸。此外,他還患有痛風和輕微的肺氣腫。

當他70多歲時,早晨是身體最疼痛的時候,通常他要花數小時來進行疼痛管理,要做很大的努力才能穿好衣服和刮鬍子,但即便如此,他也保持著坦然的樂觀。 1974年的一天,他對薩德說:“今天凌晨4點,我覺得我可能會死掉,中午的時候,我很高興我還活著,我從中午一直高興到現在。”

埃里克森1980年過世,他的太太總結說:“他活到78歲,比他自己預期的久得多,直到過世前一周,他還是過著積極不懈的生活。”

作者:海明
鏈接:https://www.zhihu.com/question/38310066/answer/75802444
來源:知乎

How to turn disadvantages to advantages

在这本书中:


艾瑞克森指出,「殘障」也許能提供當事人某種利益,令他與別人相較「占盡優勢」。他同時暗示大家,「學習」應是最佳的娛樂方式。當他全身癱瘓時,曾自問:「我能如何娛樂自己」他隨即描寫自己如何藉機發展敏鋭的觀察能力,並且進一步表達在深入學習後的喜悅——獲知原屬於潛意識領域的訊息著實令人快慰無比,但也以行走為例,詳述了儲存於潛意識範圍內的行動步驟。



Dr Milton Erickson 從小體弱多病,有各種缺憾和殘障。但他對他所擁有的一切總是心存感激,他永遠是在享受已擁有的資源,而不是將注意力放在欠缺上。




30 8 2019

Milton Hyland Erickson (5 December 1901 – 25 March 1980) was an American psychiatrist and psychologist specializing in medical hypnosis and family therapy. He was founding president of the American Society for Clinical Hypnosis and a fellow of the American Psychiatric Association, the American Psychological Association, and the American Psychopathological Association. He is noted for his approach to the unconscious mind as creative and solution-generating. He is also noted for influencing brief therapystrategic family therapyfamily systems therapysolution focused brief therapy, and neuro-linguistic programming.[1]

Personal history[edit]

Biographical sketches have been presented in a number of resources, the earliest being by Jay Haley in Advanced Techniques of Hypnosis and Therapy[2] which was written in 1968 collaboration with Erickson himself. Though they never met Erickson, the authors of The Worlds Greatest Hypnotists[3] did a thorough job of researching the details of his biography. The following information about his life is documented in that source. Currently the most comprehensive information is available through The Milton H. Erickson Foundation in Phoenix, Arizona, a non-profit founded the year prior of his death.

Milton Hyland Erickson was the second child of nine of Albert and Clara Erickson. Born in a mining camp in Aurum, Nevada where his father mined silver, the family moved to the farming community of Beaver Dam, Wisconsin when he was quite young. The family settled on a modest farm, and the children all attended the one-room schoolhouse in nearby Lowell. One of only two boys with seven sisters, the family farm was very demanding of physical labor.[4]

Erickson was late in learning to speak and had difficulties in reading which he described as dyslexia. He was also color blind and tone deaf. Later in life as he explained what seemed to be extraordinary abilities, he stated that the "disabilities" (dyslexia, color blindness, being tone-deaf) helped him to focus on aspects of communication and behavior which most people overlooked. This is a typical example of emphasizing the positive, which is characteristic to his overall approaches.[5]

Though the family valued education, books were scarce. His desire to learn led him to read the dictionary front to back, repeatedly, along with the few other texts the family treasured. He overcame his dyslexia and described the pivotal moments in a paper entitled "Auto-hypnotic Experiences of Milton Erickson" which is contained within The Collected Works of Milton H. Erickson, MD. The early moments of creative change, which he described as a "blinding flash of light" was later recognized by him to be an early spontaneous auto-hypnotic experience.[6]

He first became interested in hypnosis at an early age when a traveling entertainer passed through the area. He later described his feelings that hypnosis was too powerful of a tool to be left to entertainers and decided to bring this tool into the realm of scientific evaluation and into the practice of medicine. At the time, Erickson already admired the local community doctor and had committed himself to becoming a physician.[2]

At age 17, he contracted polio which left him with lifelong disabilities. Having long been interested in hypnosis, the year of his recovery gave him the opportunity to explore the potential of hypnosis self-healing. He began to recall "body memories" of the muscular activity of his own body. By concentrating on his memories, he slowly learned to tweak his muscles to regain control of parts of his body to the point where he was eventually able to talk and use his arms. Still unable to walk, he decided to train his body further by embarking – alone – on a thousand-mile canoe trip with only a few dollars. After this grueling trip, he was able to walk with a cane which he used throughout his adult life, becoming confined to a wheelchair only in his last decade of life. While he himself attributes his self-healing with giving him insight into the use of hypnosis, the magnitude of the extent that his own ordeal contributed to the techniques he became known for remain speculative.[2]

After recovering his ability to walk, he attended the University of Wisconsin and achieved graduate degrees in both psychology and medicine. It was there that he began his formal studies of hypnosis and worked in the laboratory of Clark Hull. His ideas were somewhat different from Hull's, and he began to explore his own views of hypnosis, investing himself in rigorous scientific exploration of the nature of hypnosis. Specializing in psychiatry, he took a series of positions at state hospitals that allowed him to continue research in hypnosis while refining his approaches to therapy. He was already a prolific writer focusing primarily on case studies and experimental work relevant to advancing understanding of hypnosis. These earlier writings are now also included in The Collected Works of Milton Erickson, M.D.[2]

During WWII, he conducted physical and mental examinations of the soldiers. He was called upon by the U.S. intelligence services to meet with other experts to help the war effort through a better understanding of the psychological and mental factors involved in communication relevant to combat. Margaret Mead and Gregory Bateson were among those with whom he worked in this capacity and with whom he developed lifelong friendships. Over the subsequent decades, they consulted many times on a series of projects.[7]

In his late 40s, he developed post-polio syndrome which resulted in additional muscle loss and additional pain.[7] At that time, he and his wife Elizabeth and family of five young children departed from Detroit and his position at Eloise State Hospital to relocate in Phoenix, Arizona where it was believed that the weather conditions would support healing. Once in Phoenix, he established himself in private practice, and had a home office for the remainder of his life.[2]

At this stage of his career, he became active in the Society for Clinical and Educational Hypnosis (SCEH) which promoted research and taught physicians how to use clinical hypnosis. Due to personal differences with others in the organization, and strong feelings about the most effective manner in which to bring clinical hypnosis into the hands of practicing physicians and dentists, Erickson ended his affiliation with the SCEH and broke away to form the American Society of Clinical Hypnosis (ASCH) in July 1957. For a decade he was the founding editor of the American Journal of Clinical Hypnosis and had at least one article in every issue. He dedicated the next two decades of his life to professional writing, teaching other professionals, and maintaining a private practice. This was a productive period during which he developed and refined his own unique style of hypnotherapy which caught the attention of other notables.[8]

His ongoing relationship with Gregory Bateson led others to take an interest in Erickson's unique communication skills and therapeutic approaches. In 1973, Jay Haley published Uncommon Therapy, which for the first time brought Erickson and his approaches to the attention of those outside the clinical hypnosis community. Erickson's fame and reputation spread rapidly, and so many people wished to meet him that he began holding teaching seminars, which continued until his death.[9]

Throughout his professional career, he collaborated with a series of serious students, and the colleagues who recognized the uniqueness and effectiveness of Erickson's approaches amassed Erickson's individual publications into volumes. His weekly workshops remained popular until his death. It was during that interval of time that his students began to create frameworks for the work that Erickson did, and describe in their own way the style of his work. Those efforts have influenced a vast number of psychotherapeutic directions, including brief therapy, family systems therapy, strategic therapy, neuro-linguistic programming, and additional directions.[9]

Milton H. Erickson died in March 1980, aged 78, leaving behind his wife Elizabeth, four sons, four daughters, and a lasting legacy to the worlds of psychology, psychiatry, psychotherapy, hypnotherapy, pedagogics and communications.[9]

Hypnosis[edit]

Milton Erickson dedicated his professional career to the advancement of the use of hypnosis in the context of medicine. He was committed to scientific methodology and a staunch advocate of the regulated professional training for practitioners. The investigations of Erickson in the first half of the 20th century were particularly influential on the second half. Erickson's clinical innovations on the practice of hypnosis are credited with inspiring its renaissance and arousing a new generation of practitioners.[10]

Trance and the Unconscious Mind[edit]

Erickson's view of the unconscious mind was distinctly different from that of Freud whose ideas dominated the context of the times. Zeig quotes Erickson as describing "The unconscious mind is made up of all your learnings over a lifetime, many of which you have forgotten, but which serve you in your automatic functioning".[11] Andre Weitzenhoffer points out: "The Ericksonian 'unconscious' lacks in particular the hostile and aggressive aspects so characteristic of Freud's system".[12]

It is clear from Erickson's writing that he relied on a supposition of an active, significant, unconscious.[13] It was Erickson's perspective that hypnosis provided a tool with which to communicate with the unconscious mind and access the reservoir of resources held within. He describes in a 1944 article on unconscious mental activity, "Since hypnosis can be induced by trance and manifests the unwarranted assumption is made that whatever develops from hypnosis must be completely a result of suggestion, and primarily an expression of it". In the same publication Erickson repeatedly comments about the autonomy of the unconscious mind and its capacity to solve problems.[14]

Erickson was an irrepressible practical joker. The essential element of Erickson's jokes was not hostility, but surprise.[15] It was not uncommon for him to slip indirect suggestions into a myriad of situations. He also included humor in his books, papers, lectures and seminars.[16]

The same situation is in evidence in everyday life, however, whenever attention is fixated with a question or an experience of the amazing, the unusual, or anything that holds a person's interest. At such moments people experience the common everyday trance; and get that faraway or blank look. Their eyes may actually close, their bodies tend to become immobile (a form of catalepsy), certain reflexes (e.g., swallowing, respiration, etc.) may be suppressed, and they seem momentarily oblivious to their surroundings until they have completed their inner search on the unconscious level for the new idea, response, or frames of reference that will re-stabilize their general reality orientation. We hypothesize that in everyday life consciousness is in a continual state of flux between the general reality orientation and the momentary micro-dynamics of trance.[17]

Many people are familiar with the idea of a "deep" trance, and early in his career Erickson was a pioneer in researching the unique and remarkable phenomena that are associated with that state, spending many hours at a time with individual subjects, deepening the trance. Erickson's work on depth of trance is detailed in his 1952 paper in which he provides history, justification, and ideas about its use.[18] Trance states for therapeutic reasons can be either light or deep, depending on such factors as the personality of the patient, the nature of the problem and the stage of therapeutic progression.[19]

Where traditional hypnosis is authoritative and direct and often encounters resistance in the subject, Erickson's approach is permissive, accommodating and indirect.[20] For example, where a classical hypnotist might say "You are going into a trance", an Ericksonian hypnotist would be more likely to say "you can comfortably learn how to go into a trance." In this way, he provides an opportunity for the subject to accept the suggestions they are most comfortable with, at their own pace, and with an awareness of the benefits. The subject knows they are not being hustled and takes full ownership of, and participates in, their transformation. Because the induction takes place during the course of a normal conversation, Ericksonian hypnosis is often known as conversational hypnosis. In a 1976 paper, Erickson describes his developments of indirect suggestions.[21]

Techniques[edit]

While Erickson explored a vast arena of induction methodologies and techniques of suggestions, there are certain areas where his name is known as key in the development or popularity of the approaches. He used direct and indirect approaches, though he is most known for his indirect and permissive suggestion techniques.[22]

Indirect Suggestions[edit]

Erickson maintained that it was not consciously possible to instruct the unconscious mind, and that authoritarian suggestions were likely to be met with resistance. The unconscious mind responds to opportunity, metaphors, symbols, and contradictions. Therefore, effective hypnotic suggestion should be "artfully vague," leaving space for the subject to fill in the gaps with their own unconscious understandings – even if they do not consciously grasp what is happening.

Erickson developed both verbal and non-verbal techniques and pioneered the idea that the common experiences of wonderment, engrossment and confusion are, in fact, just kinds of trance. An excellent example of this can be viewed in the documentary film.[23]

Metaphor[edit]

Erickson sometimes instructed people to climb a mountain or visit a botanical garden. His narrative and experiential metaphors are explored extensively in Sydney Rosen's My Voice Will Go With You, but an example is given in the first chapter of David Gordon's book Phoenix. The following quotes Erickson:[24]

I was returning from high school one day and a runaway horse with a bridle on sped past a group of us into a farmer's yard looking for a drink of water. The horse was perspiring heavily. And the farmer didn't recognize it so we cornered it. I hopped on the horse's back. Since it had a bridle on, I took hold of the tick rein and said, "Giddy-up." Headed for the highway, I knew the horse would turn in the right direction. I didn't know what the right direction was. And the horse trotted and galloped along. Now and then he would forget he was on the highway and start into a field. So I would pull on him a bit and call his attention to the fact the highway was where he was supposed to be. And finally, about four miles from where I had boarded him, he turned into a farmyard and the farmer said, "So that's how that critter came back. Where did you find him?" I said, "About four miles from here." "How did you know you should come here?" I said, "I didn't know. The horse knew. All I did was keep his attention on the road."

Interspersal Technique[edit]

Erickson describes hypnotic technique as a means to an end while psychotherapy addresses guidance of the subject's behaviors. As such, the same hypnotic technique can be applied towards diverse patient concerns. In his discussion of the applications of the interspersal technique, Erickson offers two case examples in which a similar application of the technique was made. One patient was suffering from intolerable malignant pain from a terminal condition, while the other subject was an intelligent though illiterate man who sought to relieve a disabling symptom of frequent urination. Erickson provides an interesting case write up for each of the cases chosen to illustrate his use of the interspersal technique. Erickson provides a transcript for the induction in which he interwove personalized therapeutic suggestion, selected specifically for the patient, within the hypnotic induction itself. The transcript offered illustrates how easily hypnotherapeutic suggestions can be included in the trance induction along with trance-maintenance suggestions. In the follow-up case discussions Erickson credits the patients' positive responses to the receptivity of their unconscious minds: they knew why they were seeking therapy, they were desirous of benefiting from suggestions. Erickson goes on to state that one should also give recognition to the readiness with which one's unconscious mind picks up clues and information. Erickson stated that "Respectful awareness of the capacity of the patient's unconscious mind to perceive the meaningfulness of the therapist's own unconscious behavior is a governing principle in psychotherapy. The patient's unconscious mind is listening and understanding much better than is possible for his conscious mind".[25]

Confusion Technique[edit]

"In all my techniques, almost all, there is a confusion". – Milton H. Erickson[26]

Erickson describes the confusion technique of hypnotic induction that he developed as being done either through pantomime or through plays on words. Spoken to attentive listeners with complete earnestness, a burden of constructing a meaning is placed upon the subject, and before they can reject it another statement can be made to hold their attention. One example is offered in which he uses verb tenses to keep the subject "…in a state of constant endeavor to sort out the intended meaning". He offers the following example: One may declare so easily that the present and the past can be so readily summarized by the simple statement "That which is now will soon be yesterday's future even as it will be tomorrow's was. Thus the past, the present, and the future all used in reference to the reality of today". Erickson describes the second element of confusion to be the inclusion of irrelevancies and non-sequiturs. Taken in context these verbal distractions are confusing and lead progressively to the subject's earnest desire for and an actual need to receive some communication they can readily understand. A primary consideration of the confusion technique is the consistent maintenance of a general causal but definitely interested attitude and speaking in a gravely earnest and intent manner expressive of a certain utterly complete expectation of the subject's understanding. Erickson wrote several articles detailing the technique and results that can be achieved. This succinct overview comes from a 1964 article, one of several detailing the technique, the justification and the responses that could be achieved.[27]

Handshake Induction[edit]

Erickson describes the routine as follows:[26]

  • Initiation: When I begin by shaking hands, I do so normally. The "hypnotic touch" then begins when I let loose. The letting loose becomes transformed from a firm grip into a gentle touch by the thumb, a lingering drawing away of the little finger, a faint brushing of the subject's hand with the middle finger – just enough vague sensation to attract the attention. As the subject gives attention to the touch of your thumb, you shift to a touch with your little finger. As your subject's attention follows that, you shift to a touch with your middle finger and then again to the thumb.
  • This arousal of attention is merely an arousal without constituting a stimulus for a response.
  • The subject's withdrawal from the handshake is arrested by this attention arousal, which establishes a waiting set, and expectancy.
  • Then almost, but not quite simultaneously (to ensure separate neural recognition), you touch the under-surface of the hand (wrist) so gently that it barely suggests an upward push. This is followed by a similar utterly slight downward touch, and then I sever contact so gently that the subject does not know exactly when – and the subject's hand is left going neither up nor down, but cataleptic.
  • Termination: If you don't want your subject to know what you are doing, you simply distract their attention, usually by some appropriate remark, and casually terminate. Sometimes they remark, "What did you say? I got absentminded there for a moment and wasn't paying attention to anything." This is slightly distressing to the subjects and indicative of the fact that their attention was so focused and fixated on the peculiar hand stimuli that they were momentarily entranced, so they did not hear what was said
  • Utilization: Any utilization leads to increasing trance depth. All utilization should proceed as a continuation of extension of the initial procedure. Much can be done nonverbally. For example, if any subjects are just looking blankly at me, I may slowly shift my gaze downward, causing them to look at their hand, which I touch and say "Look at this spot." This intensifies the trance state. Then, whether the subjects are looking at you or at their hand, or just staring blankly, you can use your left hand to touch their elevated right hand from above or the side – so long as you merely give the suggestion of downward movement. Occasionally a downward nudge or push is required. If a strong push or nudge is required, check for anesthesia.

Hand Levitation[edit]

Erickson was the first to describe the hand levitation method of induction, described as being broadly applicable. Weitzenhoffer describes the technique as broadly applicable and quotes a colleague as describing Erickson's demonstration as "the best of all induction procedures. It permits the participation in the induction process by the patient and lends itself to non-directive and analytic techniques"[28] It is however, the most difficult of methods and calls for greater endurance on the part of the hypnotist". A transcript of Erickson demonstrating this technique script is included.[29] The nature of the induction is for the hypnotherapist to repeatedly suggest a lightness in the hand, which results in a dissociative response and the hand elevating unconsciously.

Resistance[edit]

In the book Uncommon Therapy, Jay Haley[5] identified several strategies that appeared repeatedly in Erickson's therapeutic approach. 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 ready to reveal:

[Erickson] "I usually say, "There are a number of things that you don't want me to know about, that you don't want to tell me. There are a lot of things about yourself that you don't want to discuss, therefore let's discuss those that you are willing to discuss." She has blanket permission to withhold anything and everything. But she did come to discuss things. And therefore, she starts discussing this, discussing that. And it's always "Well, this is all right to talk about." And before she's finished, she has mentioned everything. And each new item – "Well, this really isn't so important that I have to withhold it. I can use the withholding permission for more important matters." Simply a hypnotic technique. To make them respond to the idea of withholding, and to respond to the idea of communicating."

Some people might react to a direction by thinking "Why should I?" or "You can't make me." This is called a "polarity response" because it motivates the subject to consider the polar opposite of the suggestion. The conscious mind recognizes negation in speech ("Don't do X") but according to Erickson, the unconscious mind pays more attention to the "X" than the injunction "Don't do." Thus, Erickson used this as the basis for suggestions that deliberately played on negation and tonally marked the important wording, to provide that whatever the client did, it would be beneficial: "You don't have to go into a trance, so you can easily wonder about what you notice no faster than you feel ready to become aware that your hand is slowly rising."

Double Bind[edit]

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.

Erickson provides the following examples: "My first well-remembered intentional use of the double bind occurred in early boyhood. One winter day, with the weather below zero, my father led a calf out of the barn to the water trough. After the calf had satisfied its thirst, they turned back to the barn, but at the doorway the calf stubbornly braced its feet, and despite my father's desperate pulling on the halter, he could not budge the animal. I was outside playing in the snow and, observing the impasse, began laughing heartily. My father challenged me to pull the calf into the barn. Recognizing the situation as one of unreasoning stubborn resistance on the part of the calf, I decided to let the calf have full opportunity to resist, since that was what it apparently wished to do. Accordingly, I presented the calf with a double bind by seizing it by the tail and pulling it away from the barn, while my father continued to pull it inward. The calf promptly chose to resist the weaker of the two forces and dragged me into the barn".[17]

Shocks and Ordeals[edit]

Erickson is famous for pioneering indirect techniques, but his shock therapy tends to get less attention. Erickson was prepared to use psychological shocks and ordeals in order to achieve given results: The ordeal process is different from other therapeutic techniques originated by Erickson. Extending the dissociative effects of paradox and non sequitur, wherein confusion is used only as an entry to a trance state, the technique of ordeal superimposes a distressing but achievable challenge over the therapeutic aim such that the achievement of the former implies a positive outcome in the latter. Hence ordeal therapy is not merely an induction technique but a theory of change. The therapist's task is to impose an ordeal, appropriate to the problem the person wishes to change, an ordeal more severe than the problem. The main requirement is that it cause distress equal to or greater than that caused by the symptom. It is also best that the ordeal is good for the person. The ordeal must have another characteristic: it must be something the person can do. It must be of such a nature that the therapist can easily say "This won't violate any of your moral standards and is something you can do". The final characteristic is that it should not harm anyone else. One final aspect of the ordeal is that sometimes the person must go through it repeatedly to recover from the symptom.[30]

Influence on Others[edit]

One of Erickson's first students and developers of his work was Jay Haley. Other important followers who studied directly with Erickson include Ernest Rossi, Stephen Gilligan, Jeffrey Zeig, Bill O'Hanlon, Michele Ritterman, Stephen Lankton, Richard Landis, Jane Parsons-Fein, Herb Lustig, Alex & Annellen Simpkins and Sidney Rosen. The majority of today's Ericksonians consist of individuals who have never known Erickson. Today, and for some time now, much of the teaching of the Ericksonian approach is and has been done by individuals who have acquired their knowledge second and third hand. Some of those who did spend time with Erickson, like Jeffrey Zeig, Ernest Rossi, and William O'Hanlon have tried, to present and preserve as much as they could what they believed and have understood Erickson's thought and methods to be. They have succeeded to do so to a fair degree. Others, like Richard Bandler and John Grinder have on the other hand, offered a much adulterated, and at times fanciful, version of what they perceived Erickson as saying and doing guided by their personal theorizing. Further distortions have resulted outside of the United States due to translation problems as well as for other reasons. More and more the Ericksonians have become a heterogeneous group of practitioners.[31]

Jay Haley told of sending a group of his students to see Erickson. When they returned, one student was particularly touched at Erickson's sensitivity to his own issues. The student then related one of the stories that Erickson and told the group. He says he knew this story was intended specifically for him. Another student corrected him and said that the story was for her, not for him. She pointed out a few of its features that addressed her issues. Haley said he found that very strange. He had heard that same story years earlier and knew that Erickson and created it especially for him![32]

Erickson eschewed rigid approaches to therapy and thus never accepted a binding framework or schematic set of procedures during his lifetime, though a multitude of other approaches grew from his perspective and practice. He had a strong influence on the diverse areas of Strategic therapy, Family Systems, Brief Therapy, Ordeal Therapy, Narrative Therapy, and Neuro-Linguistic Programming.[33]

Ericksonian Approaches[edit]

Following Erickson's death in 1980, The Erickson Foundation lead by Jeffrey Zeig held a conference which at the time was the largest professional hypnosis conference ever held.[9] Afterward, many participants began to teach Erickson's ideas in their own way. It was not until after Erickson's death that the word Ericksonian was used to describe his methodology. Over the decades that followed, there were various attempts to identify the key components that bring together the individual styles of an Ericksonian. In an attempt to identify the key elements of Erickson's work, Stephen Lankton contributed an extensive overview of Erickson's ideas and techniques which he referred to as the "Ericksonian Footprint".[34] More recently, the development of Ericksonian Core Competencies spearheaded by Dan Short and Scott Miller defines Ericksonian approaches in a manner that makes it amenable to evidence-based studies.[35]

Lankton and Matthews state that perhaps Erickson's greatest contribution to psychotherapy was not his innovative techniques, but his ability to de-pathologize people and consider a patient's problematic behavior as indicative of a best choice available to the individual. His approach was to facilitate the patient's access to inner resources to solve the problems.[36]

The concept of utilization in psychotherapy is identified primarily with the work of Milton Erickson. More than any other therapist, he taught us to appreciate everything the client brings and whatever the client brings should be regarded as valuable. Perhaps Erickson's struggles with polio as a teenager impressed on him the value of regarding everything as a potential asset. All weaknesses can become strengths in the same way a negative can become a positive. Many imperfections can be altered slightly so that they become endearing. Some things can be highlighted while others can be de-emphasized. To recognize and use the qualities of the individual and the situation is to affirm something in which they have already invested.[37]

A 1954 article by Erickson describes his technique of utilizing a patient's own personality and ideas, "Doing it His Own Way", in which a patient requested hypnosis for the explicit purpose of ceasing his reckless driving, and the patient did not want psychotherapy for any other purpose. Erickson worked with him and provided a summary of the case, after carefully assessing the patient's potential for safe practices, as well as his motivation for change. The discussion of working with the patient while allowing him to guide his own healing is a clear example of the concept of utilization for which Erickson has become known.[38] Another key principle that is associated with Erickson's techniques is described in his 1964 paper entitled the "Burden of Effective Psychotherapy" whereby he describes the essential nature of the investment of the subject in the experiential process of healing.[39]

An entry in the prestigious American Psychological Association Dictionary of Psychology[40] defines Ericksonian psychotherapy. Based on the work of Milton Erickson, this approach to psychotherapy is described as a "form of psychotherapy in which the therapist works with the client to create, through hypnosis and specifically through indirect suggestion and suggestive metaphors and real life experiences, intended to activate previously dormant intra-psychic resources".

Core Competencies of Ericksonian Approaches[edit]

The Core Competencies Manual was a joint endeavor between the Erickson Institute of Phoenix, and The Milton H. Erickson Foundation to define Ericksonian approaches in a manner that makes it amenable to evidence-based studies. Using the wisdom of individual professionals who studied with Erickson, the organizers developed a matrix of features associated with what they had learned from Erickson about his approaches. The developers then developed a matrix to evaluate clinical approaches used to ascertain whether or not a style of therapy could be considered Ericksonian. The elements involved included four skills: Observation, Validation, Cultivation, and Challenge, combined with six competencies: Tailoring, Utilization, Strategic, Competency, Destabilization, Experiential, Naturalistic. This resource is available for a free download, and its founders are supportive of research-controlled studies to further evaluate the utility of the model.[35]

Controversy[edit]

A colleague, friend and fellow researcher, André Weitzenhoffer, a prolific and well-respected author in the field of hypnosis himself, has criticized some ideas and influence of Erickson in various writings, such as his textbook The Practice of Hypnotism. Weitzenhoffer displays a clear and explicitly stated, opposition to Ericksonian hypnosis in his book, in favor of what he terms the semi-traditional, scientific, approach.[31] For Erickson, the shift from conscious to unconscious functioning is the essence of trance. Nowhere in his writing however, can one find an explicit definition of the term "unconscious" or, for that matter, of "conscious".[12]

This criticism persists among clinicians and researchers of today, not only about Erickson himself, but also about his followers. Nash and Barnier note that some clinicians, especially those working in the tradition of Milton Erickson may discount the importance of hypnotizability.[34]

In a book largely complementary to the works of Erickson,[41] Rosen alludes to the uncertainty that can result from his clinical demonstrations: "This has nevertheless raised the question of whether or not the patient is playing a role by pretending not to feel pain…" In an interview, this sentiment of uncertainty regarding completeness of Erickson's case reports and demonstrations is valid, reports his daughter, Roxanna Erickson-Klein, who is a professional psychotherapist. She added that although he tirelessly advocated scientific investigations of hypnosis, and was a prolific writer on techniques, he often left details out of case reports that could have been meaningful to clinicians of today. More importantly, critics often overlook the context of the times. He was a physician who worked from a framework of a country doctor, and clinicians of today are hasty to judge by today's standards, while not taking into consideration the context of the times.

Self-professed "skeptical hypnotist," Alex Tsander, cited concerns in his 2005 book Beyond Erickson: A Fresh Look at "The Emperor of Hypnosis", the title of which alludes to Charcot's characterization in the previous century as "The Napoleon of the Neuroses." Tsander re-evaluates a swathe of Erickson's accounts of his therapeutic approaches and lecture demonstrations in the context of scientific literature on hypnotism and his own experience in giving live demonstrations of hypnotic technique. Emphasizing social-psychological perspectives, Tsander introduces an "interpretive filter" with which he re-evaluates Erickson's own accounts of his demonstrations and introduces prosaic explanations for occurrences that both Erickson and other authors tend to portray as remarkable.[42]

In an audiotape that is attributed to him, Dharma Teacher Tenshin, Reb Anderson of the Zen tradition, has referred to Erickson as a "Magician/Healer."[43] Zeig concurs that professional skepticism and education is paramount for the advancement of a discipline. He states "Among psychotherapists there are some who worship Erickson with a reverence that borders on idolatry. Every word, sentiment, opinion, or act is presumed to have an inspired meaning. Such deification rooted in expectation of timeless power and omnipotence can ultimately lead to disillusionment. Equally prejudiced are those who regard Erickson as a maverick whose egregious methods are a passing fancy that will eventually be consigned to the dustbin of outmoded schemes. [Both] these attitudes do injustice to a highly creative and imaginative original mind… A poignant criticism of Erickson's strategic therapy is that it is overvalued by those who believe that clever tactics can substitute for disciplined training.[16]

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