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Is there such a thing as Ericksonian Hypnosis? (Part 1)

12 July 2019/ Therapeutic Hypnosis

What's the real difference between “traditional hypnosis” and an “Ericksonian” approach?

Some people have the idea that “Ericksonian hypnotists” are glamour seekers or glamour merchants.  By which I mean, they are calling themselves Ericksonian to hang their shingle on the efforts of an apparently Great Man.  And so the critics say, he was a “Great Man” who was really not that much different from other hypnotists.  So the criticism goes,  with mystery acquired over the passage of time, Milton Erickson is now steeped in an aura (or glamour) of wisdom and perspicacity he only slightly deserves.  And these “Ericksonians,” the new kids on the block wish to have some of that aura (or glamour) as their own.

Perhaps there are some “Ericksonians” or people either practising or training with “Ericksonian methods” who are absolutely using Erickson's aura as a way to get themselves more traction. If so,  perhaps this is not as bad as it sounds. It all depends.  On what? On whether they are actually using his methods or just doing “traditional” clinical hypnosis while calling it “Ericksonian.”

Because they are Different

Because there is indeed a difference. Ericksonian and Traditional hypnosis are really very, very different. But it's not in a way that's very obvious.

For example, Erickson is famous for his arm-levitation inductions.  He used arm levitation as an easy pacing  tool for suggestions.  And  also he used it as a “convincer for the client.  When the hypnosis was done the client would know something happened because one arm or the other could feel it.  And  yet traditional hypnotists have also done arm levitation from time to time since long before Milton Erickson took up psychiatry.

Erickson is also famous for people going to see him and them not remembering that he'd done any hypnosis with them.  His hypnosis didn't always seem like hypnosis.  There wouldn't have been other hypnotists that had that effect, right?

So, looking at these obvious things the criticism seems to have some credence. But this is to forget Erickson's real contribution and the reason he is so lauded.

Why Is He So lauded?

Before we go any further, we should to bear in mind that despite being a psychiatrist with a prescription pad, amongst his goals, Erickson sought to get people off unnecessary medications. That included psycho-pharmaceutical treatment.

His psychiatric patients are famous for getting well and going home.  His test for success with his patients is also famous.  It went something like: they ended up getting a job, getting married, having children and sending him presents. 

This, it should be remembered was at a time when almost all psychiatric treatment just boiled down to administering “maintenance drugs.” That means drugs designed to keep patients docile, but which were really very bad for them.

So this tendency to have his patients get better at a time when this was very rare is part of where his much sought-after aura comes from.

Doing Things Differently

And his success was because he was doing something different from other people.  Actually – he was doing a lot of things, many of them the same things others did but – he was doing almost all of them differently.

Perhaps when you've survived a near fatal polio infection and been partially paralysed you do see things a little differently from other people.  Who can say?

Ericksonian hypnosis is not about a more impressive experience of trance for the client.  As just outlined above, many of his clients never thought they had been hypnotised and yet their lives changed.

So it is more about impressive after-experiences; that is, the client having better, more permanent results. It's about getting more effectiveness from the trance work done across the widest range of clients possible.  I believe this is why many clinicians have embraced his approach, whether they call themselves “Ericksonians” or not. I cannot call myself an Ericksonian, nor would I want to, but I too embrace his approach.

So what is so different about his approach?

To come to grips with how Erickson's understanding  was different we first have to find out the presuppositions and assumptions underlying the therapy of his  day. Those assumptions underlay clinical hypnosis at the time too.  If we see clearly what people previously assumed then we can understand how distinct Erickson's approach was. 

The Well Known Points of Divergence

 

Before we do that, I should acknowledge some things first.  There are a couple of better known points of difference between traditional hypnosis and Erickson's version which don't require more that restatement to be understood.  For example, Erickson took Hull's work on suggestion and pioneered a much more permissive approach than had ever been before.  Previously, hypnosis placed tremendous reliance on the hypnotist's authority. That isn't to say Erickson didn't employ authority, but he was the first person to develop a truly permissive approach.

Another known point of difference was his style of hypnosis.  He developed a tremendous ability to tell endlessly fascinating or boring stories.  All of them were filled with natural metaphors designed to teach the client new learnings.

And he's famous for those things.

But the real difference between his approach and that of traditional hypnosis, is in where the solution to the client's problem was going to come from.

Got All Broken

 

The presupposition of traditional hypnotherapy, and indeed psychotherapy is that the client is somehow broken.  For some knowable, but for now, unknown reason the client got all broken and needs fixing up.  So we the therapists have to fix them, or at least “lead the horse to water, so to speak. One belief that arises here is we know where the water is and our poor broken down horses don't.  And so we show them the water and they won't drink it!  That used to be called “resistance.

Another belief arising from this assumption is that of a causal relationship between past events and present problems. The client was just fine until something happened to make them this way.  This belief leads directly to another belief, this time one completely devoid of solid foundation in evidence.  This belief is that the solution to the client's problem will be in understanding the terrible event(s) of the past and experiencing catharsis.  Sometimes the client would report no terrible events and still have problems, so they must have repressed the memories, obviously.

The assumption of the broken client is not without justification - after all, they have come seeking help.  So it's natural that clinicians might assume it. But the all too easy outcome of this view was decades of iatrogenesis.

In any case, this underlying assumption leads to a variety of solution-models.

The Psychodynamic Models

The first Solutions were the familiar psychoanalytical or psycho-dynamic models. These models make insight king:

“If we can just get them to unlock their psyches and understand themselves, clients will magically get better.

In hypnotherapy, we get to hypno-analysis. Among other things, it uses automatic writing, reliving traumatic events and generation of “cathartic” abreactions.

Maybe this does work. Sometimes.

Alas, all too rarely.

But never mind, because we also have drugs!

The Behaviourist Model

In the fifties and sixties the psychodynamic models began to be replaced by alternatives.  One was the behaviourist model.  Behaviourists deemed Psychoanalysts extremely unscientific and prone to magical thinking.  And to be fair, the Behaviourists had a point.  The whole Psychoanalytical field was characterized by a profound lack of replicability of even phenomenological results.   Measurability of results itself ran counter to the qualitative approach of psychoanalytic therapy which abounded with untestable theories about what produced client suffering.

The trouble for the behaviourists was they didn't have too many therapeutic ideas.   Sure, they knew how to apply rewards and punishments (very scientifically).  They also had quite a bit of data about learning and different capacities for learning.  And they believed they knew all about something they called “muscle-memory.”  Plus, the main thing they had was lots of data about stimulus and response; they spent lots of time ringing bells, inducing addictions, psychoses and neuroses in their experimental subject animals.   It's just that they were somewhat lacking in the human sphere. 

However, we do have to thank them for most of our desensitization therapies and habit changing therapies.  Even the NLP technique of anchoring is derived in part from the behaviourist understandings of stimulus-and-response. 

Their versions of therapy were usually about learning new behaviours and conditioning.  These use both explicit and operant reward-punishment matrices.  And they became quite good at knowing how to obtain a variety of responses by varying stimuli.  Some of the first systematic attempts at non-pharmacological relief from allergies, from nervous ticks and other involuntary behaviours were designed by behavioural therapists. 

The Cognitive Model

About thirty years ago, Behavioural Therapy was largely subsumed by the Cognitive Behaviourist model although versions of a Cognitive model went all the way back to the fifties. This model basically says (although not in so many words):

“People are broken because they perceived things incorrectly at one time and then got stuck in some kind of wrong thinking or  behaviour or learned a wrong way of thinking and that led to bad behaviours or habits which eventually got them the problems they have today.

And since we therapists can see the problem, we can surely fix it.  We can point out the flaws in the client's thinking or perceiving, rationally and calmly.  And then they'll change because human beings are rational and act in their own best interests! 

Don't they?

Yes! All we need do is explain the right way to think and then everything will be just fine. 

Well sort of.  There is still the problem of resistance. For some clearly irrational reason, humans resist doing what we tell them!

Yet this approach is actually quite a bit more effective than the first Models.  I suppose humans do genuinely want to get better and often will in spite of the limitations in the approach.  Its effectiveness is why most psychotherapists today practise (among other things) some version of Cognitive Behavioural Therapy (CBT). But as anyone who's been through CBT will know, it's still a very hard path to “getting fixed,” so it seems to still be missing something to make it truly effective. 

But they do say life wasn't meant to be easy, don't they?

Scientific Traditional Hypnotherapy

But “ah-hah,” say the hypnotherapists “– our time has arrived!”  If we're hypnotherapists we can put suggestions about the right way to think into the client.  So because we can make clients more suggestible, we can easily overcome client resistance and vous voila, client fixed!

And in order to achieve acceptance from the medical/therapeutic community after a hundred years out in wilderness, great pains were gone to to make the hypnotic process “scientific.

Traditional hypnosis is mostly about getting the client “down” into a “really deep” state (which is measurable on a scale, so tick!) Where you as the hypnotist can give them all the right suggestions (for their own good, so tick!) Suggestions that will properly integrate inside them (because now they're highly suggestible, again measurable, tick!) And make them change their direction. So that even after the suggestions wear off (because they do – we hypnotists know our limitations, tick!) the clients are already grooved into the new, healthier direction. In spite of themselves.

This characterization may be a touch exaggerated, but that really is the gist of the traditional approach. And the underlying assumption is still that the client is like a broken down car and we hypnotherapists are the mechanics.

But it does also work reasonably well for certain things.

This is largely because of the quality of trance achieved in traditional hypnosis. Ever since James Braid, hypnosis has been about wrapping the subject inside an extreme kind of focus: with true single-minded intent.  And this makes the hypnotised client very good for following the hypnotist's instructions – at least for a little while.

Next week we'll take a look at the alternative to these kinds of models for therapy and discover what made Milton H. Erickson really different.

Until then!

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