Ericksonian Hypnosis and Therapy Techniques

Ericksonian Therapy Defined:
An experiential, phenomenologically based approach to problem solving that utilizes existing client attributes while evoking natural processes of learning and adaptation.

Ericksonian therapy is a perspective of learning, healing, and growth that fosters flexibility in an ongoing adaptive way. Thus, practitioners are encouraged to exercise great flexibility and creativity as they work collaboratively with the client. The standard by which progress is measured is subjective, and it is established by the client, relative to his or her personal goals (i.e., phenomenological).

Core Competencies

The Core Competencies of Ericksonian Therapy consists of a series of foundational principles for practitioners and institutes seeking mastery in Ericksonian therapy. These principles have been divided into a set of core relational foundations.

Tailoring

A readiness to individualize treatment.

One of the basic tenets of Ericksonian therapy is that every client is a unique individual who requires a tailored therapeutic treatment. Erickson was unimpressed with the results produced by treatment standardization and replication. He viewed the individualization of treatment as a therapeutic imperative and objected to protocols of how therapy should proceed. Erickson emphasized the importance of observation and flexibility as he used immediate knowledge of the client to guide intervention, rather than theoretical knowledge derived from a diagnosis.

Utilization

A readiness to utilize client attributes, interpersonal dynamics, and situational factors.

The concept of utilization is considered by many to be one of Erickson’s greatest contributions to psychotherapy. Simply put, utilization is a psychotherapeutic strategy that engages circumstances, habits, beliefs, perceptions, attitudes, symptoms, or resistances in service of the overarching goals of therapy. Thus, the Ericksonian practitioner learns to become “response ready,” a special state of heightened observation and inclination toward validation that helps the therapist reduce conflict while working toward meaningful outcomes.

Strategic

A readiness to create a self-organized problem solving context.

In addition to emphasizing the importance of accepting the uniqueness of every individual, Ericksonian therapy also recognizes the innate design of human beings as self-organizing creatures or “life builders.” Erickson believed that we are purposeful organisms oriented toward survival and growth with an innate need for mastery of internal and external life experiences. This results in a striving to overcome obstacles and challenges, while drawing from organic knowledge and a lifetime of learning. Therefore, in Ericksonian therapy it is assumed that all individuals have an elemental need to seek out challenges of their choosing, to strive toward personally meaningful goals, to build a adaptive future, and to exercise personal will in regard to one’s identity, relationships, and world view. This is collectively referred to as “self-agency.”

Destabilization

A readiness to disrupt stable psychological patterns to encourage flexibility and learning.

In Ericksonian therapy numerous systems are targeted for change. These include cognitive systems, behavioral systems, social systems, and even biological systems. As stated earlier, people are believed to be self-organizing, if there is sufficient flexibility., which means that growth and adaptation are innate processes. Any system that is too rigid (whether it be cognitive, behavioral, or social) is characterized by patterns that perseverate and repeat over time and are insensitive to shifts in contextual demands, all of which inhibit adaptation. In such instances, Erickson believed that learning new patterns of thought and behavior required a temporary period of destabilization during which conditioned responses are denied full expression.

Experiential

A readiness to prioritize open-ended experiential learning.

Experiential learning is the process of learning through experience. It is specifically defined as learning through reflection on doing. For experiential therapies in general, the therapist is viewed as a facilitator of certain kinds of exploration of experience. The therapist should not be seen as an expert on the content of the client’s experience. Rather, clients are viewed as experts on their own experience and therapy is meant to be a discovery-oriented process.

Naturalistic

A readiness to create the expectation that change will occur naturally and automatically

Erickson taught that each human being is part of nature, and therefore endowed with certain universal powers of nature. For those who view growth, learning, and freedom as inherent in all living things, then it logically follows that during therapy people should be given the freedom to respond in a way that corresponds with natural growth, learning, and healing.

Storytelling

Stories have the ability to engage people emotionally and to move them to change, but telling the right story at the right time to the right person is an art and a skill. Erickson’s use of stories in his conversations gave people of diverse views, using metaphors where they discovered their own ideas. Each anecdote was put in such a way that quite different people thought it was designed precisely for them. One of Erickson’s greatest skills was his ability to influence people indirectly. Erickson would tell the same case example in different ways to different people. While the essentials of the case remained the same, what he emphasized in the complex story would vary with the analogy he was communicating to that particular listener. What Erickson said and did had multiple purposes and he taught in complex analogies.

Metaphors

A metaphor is a figure of speech in which a word or phrase is applied to an object, person, or action that it does not literally denote (e.g., the journey of life) for the purpose of creating a forceful analogy. The use of metaphor is commonly used in Ericksonian therapy, especially in conjunction with anecdotes and storytelling. Metaphors can provide vivid visualizations and help simplify complex concepts.

Interspersal

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.

The Confusion Technique

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.

All Ericksonian Hypnosis and Therapy Techniques

Erickson taught his students to be skeptical of theory and any academic constructs that limit a practitioner’s flexibility or stifle creativity. While the conventional wisdom within the research community is that good practice should be driven by theory, this is not the position taken by most scholars and teachers of ET. Rather, they emphasize the importance of knowledge developed through concrete experience and direct observation. As some have said, “It is the client who informs the therapy, not a textbook.”

Ericksonian therapy is broadly classified as any goal-oriented, problem-solving endeavor grounded in methodology inspired by the teachings and casework of Milton H. Erickson, MD. More specifically, Ericksonian therapy is defined as an experiential, phenomenologically based approach to problem solving that utilizes existing client attributes, while evoking natural processes of learning and adaptation. Meaningful therapeutic change can occur across multiple systems (e.g., cognitive, behavioral, affective, subconscious, autonomic, and social) as symbolic or directly lived experiences are used to destabilize maladaptive patterns and bring forth inherent resources that can be utilized for immediate and future problem solving endeavors. Hypnosis and/or hypnotically derived methods are central. Utilizing inherent resources that may be obscure to the client is essential, while an explicit theory of personality and the interpretation of patterns in one’s history are not.