A discussion on the work of Milton Hyland Erickson

Milton H. Erickson received his MD degree from the University of Wisconsin . He was President (and founder) of the American Society of Clinical Hypnosis and a life fellow of the American Psychiatric Association and the American Psychopathological Association. Dr Erickson was the founder and the editor of the American Journal of Clinical Hypnosis.

More than any other individual therapist, Milton Erickson has been responsible for shaping the modern view of hypnosis. His most notable contribution was his ability to locate an individual's inner resources for coping creatively with the real problems of everyday life, something he had had to do from a very early age.

Milton Hyland Erickson, MD was born on the 5th of December in 1901 at Nevada . He was born colour blind a factor that would influence his work in latter life. He was raised on a farm in Wisconsin and was a very slow learner. At 4 years of age he still could not talk. This was another factor that influenced his later work and also gave the title to Sidney Rosen’s book “My Voice Will Go with You” a collaborative and anecdotal autobiography of Erickson and featuring his work with metaphor. At the age of 17 he was struck down with polio and was not expected to live past the illness. He did in fact here his doctors tell his mother just that fact – “he wont last through the night” and this inspired Erickson to live, he was inspired to see one more sun rise and just never stopped seeing them and he made a spectacular recovery from his illness. The after effect of his polio was that he was crippled and wheelchair bound but not until after he had modeled his recovery on the babies within his family circle and re-taught himself to use his damaged limbs. Cruelly, when in his fifties, he once again was struck by polio, and in fact was even more severely paralysed this second time around. He once again called upon his previous strategy to rescue himself. However post his second recovery, he was required to use a wheelchair constantly plus suffer chronic pain, which he controlled with self-hypnosis:

He is quoted as follows; “It usually takes me an hour after I awaken to get all the pain out. It used to be easier when I was younger. I have more muscle and joint difficulties now... Recently the only way I could get control over the pain was by sitting in bed, pulling a chair close, and pressing my larynx against the back of the chair. That was very uncomfortable: But it was discomfort I was deliberately creating. “

By the time he died on March 25th 1980 the colour blind cripple from Nevada had trail blazed an illustrious career that today has its effect on millions of people around the world and will continue to do so through years to come.

So what of his work, he was regarded for several developments besides the model of his work that helped discover Neuro Linguistic Programming which is probably the single most important thing that will leave his name in the history books of medical achievements forever. One such development was of the unconscious mind as a separate, indeed highly separate force from the conscious mind. He showed that the subconscious mind had its own awareness, its own response platform, interests and learning center. Erickson championed that the unconscious mind was creative, solution seeking and positive in its own right. Gersalt therapy as developed by Perls and Satir also drew on the works of Erickson with their “positive reformulation”.

He had an unsurpassed ability to draw or utilise anything from the client in pursuit of their change. He could draw from their background, culture, personal history, beliefs and favorite words or even personal neurosis’s

He championed the belief that the unconscious mind was always alert and listening to the world whether a trance state or waking state. As such Erickson could make suggestions that would lead to a hypnotic state all so long as the suggestions struck a chord with the client’s subconscious – so any experience in life could influence the hypnotic trance. This meant that he could make any number of indirect suggestions to the client in order to have the unconscious participate in the curative process. Erickson used this knowledge to engage in what seemed to be perfectly normal conversations with clients however these speech communications would induce a trance.

It is said that Erickson was a trickster who enjoyed practical jokes. It was not uncommon for him to slip indirect suggestions into all kinds of situations, including in his own books, papers, lectures and conferences.

Erickson also had the opinion that it was even appropriate for the therapist to go into trance alongside the client and is quoted as saying

“I go into trances so that I will be more sensitive to the intonations and inflections of my patients' speech. And to enable me to hear better, see better”.

Erickson also proffered that a trance state is a normal, everyday occurrence. He quoted the examples of; waiting for buses and trains, train or bus rides, reading or listening, or even being involved in hard physical exercise,” it’s quite normal to become immersed in an activity and go into a trance state, removed from any other irrelevant stimuli. Most people do not even recognise that they have been in a trance state so common are the occurrences of hypnotic phenomena.”

Erickson exploited the fact that he considered and expected that trance states occur quiet naturally and also with great frequency amongst his clients even whilst not with him in a session. His works also lead him to discover many ways to elicit a trance state within others. His discoveries also led him to develop both verbal and maybe more surprisingly non verbal ways to bring on a trance especially in common occurrences and experiences. This being much the same type of trance that spiritual leaders and preachers elicit or even political leaders such as Hitler and Mussolini or any other orator who can hold sway over the masses.

In his career Erickson spent many hours with test subjects researching the way and effects of deepening a trance. He was in fact a pioneer in his research into all aspects of the trance, the type of trance, the effects of trance and all their associated effects and so bringing hypnosis back to the forefront of medical science.

He also crossed the line between light and deep trance states and in so doing removed the previously held belief that a trance was a single dimensional state. He developed the way to have a hypnotised patient to behave as if in a waking state and so narrow the gap between the awakened and the trance state. Erickson was the master of the hypnotic technique in so much as he developed several techniques beyond the then fashionable “direct technique” and discrediting it in the process. Probably the technique for which he is most remembered is the “Indirect technique” however he also discovered and developed the “Confusion technique” and the “Handshake technique” amongst others. Each of these techniques owes much to Erickson’s ability to endlessly look for answers and to delve deep into results rather than accept what had been accepted as the normal solution or expected result. Indirect Techniques is directly opposite to the then popular “Authoritative approach or direct technique”. So at the time the ‘classical’ approach to hypnosis was authoritative and direct, for example "you will go to sleep", however this often encounters resistance or conflict in the subject, as the sub conscious mind rebuffs the order. The Erickson approach is more accommodating and indirect. For example, where a classical hypnotist might say "you are going into a trance", Erickson would be more likely to say "you may now find it is more comfortable to close your eyes and when you are ready it is okay then go into a trance". The difference is less than subtle and in this way, he provided an opportunity for the subject to accept the suggestions they are most comfortable with and at their own pace. In this way the patient takes a full responsibility for their well being and therefore is substantially more likely to own the outcome.

The center piece to Erikson's thinking was that the sub conscious mind was most likely to resist authoritive suggestions whereas the sub conscious mind would respond to suggestions that are vague, contradictions, metaphors or filled with gaps. This way the sub conscious mind could select the outcome best suited to it - to own the outcome. This work was soon to be exploited to the whole world when Grinder and Bandler modeled Erickson by creating the “Milton Model” and so leading to their discovering Neuro Linguistic Programming (NLP) when they placed the Milton Model and their previous work the Meta model alongside each other.

The “Confusion technique”, Erikson said “In all my techniques, almost all, there is a confusion.” Erickson & Rossi - Hypnotic Realities

A confused person has their conscious mind busy and occupied, and is very much inclined to draw upon unconscious learning to make sense of things. A confused person is in a trance of their own making - and therefore goes readily into that trance without resistance. Confusion might be created by ambiguous words, complex or endless sentences, pattern interruption or a myriad other techniques to incite transderivational searches. Transderivational searches were one of Erickson’s greatest tools as any suggestion no matter how indirect would be searched for by the unconscious which would in turn lead to a trance state.

James Braid (1796 – 1860), who coined the term 'hypnosis' claimed that focused attention i.e. "look into my eyes..." was the way for creating hypnotic trances, indeed, his thesis was that hypnosis was in essence a state of extreme focus. However Erickson realised it can be difficult for people wracked by pain, anger or emotional upset to focus on anything. Thus other techniques such as his for eliciting trance become important, or as Erickson explained:

“...long and frequent use of the confusion technique has many times effected exceedingly rapid hypnotic inductions under unfavourable conditions such as acute pain of terminal malignant disease and in persons interested but hostile, aggressive, and resistant...”

Erickson's famous hypnotic handshake is based on the confusion already experienced by the subject. NLP breaks information or behaviour into chunks; some actions are transparently a single "chunk" of behavior: shaking hands and tying shoelaces being two perfect examples. Erickson argued that if a person’s behavior is diverted or frozen midway, the person literally has no mental space for this - they are stopped in the middle of unconsciously executing a behavior that hasn't got a "middle". The mind responds by suspending itself in trance until either something happens to give a new direction, or it "snaps out". In Erickson style a perceptive hypnotist can often use such a momentary confusion and suspension of normal processes to induce trance quickly and easily.

By disturbing the normal or expected pattern of a handshake the hypnotist causes the subject's unconscious mind to wonder what is going on. If the handshake continues to develop in a way which is out-of-keeping with the anticipated, a simple, non-verbal trance is created, which may then be developed upon by the hypnotist. All these responses happen naturally and usually spontaneously without telling the subject to consciously focus on an idea or action.

From the various descriptions of Erickson's hypnotic handshake, including his own very detailed accounts, indicate that a certain amount of improvisation is involved, and that watching and acting upon the subject's responses is key to a successful outcome. The most important thing is that the 'normal' handshake is subverted in such a way to cause puzzlement, which may then be built upon

Here is an extract written by Erickson and his foremost writing partner Rossi.

· 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 undersurface 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 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.

· Utilisation: Any utilisation leads to increasing trance depth. All utilisation 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 anaesthesia.

- Erickson & Rossi - Hypnotic Realities

The observations in this essay owe much to the information gathered from the Erickson-foundation. The Erickson-foundation is now an enormous network of Milton H. Erickson Institutes throughout the world. There are now 73 Institutes located in the and in 20 other countries. Other sources include the Wiki encyclopedia and other Internet web sites. This as a discussion document has barely touched the surface of Erickson’s work which spanned nearly 50 years and always as an ever enquiring mind. The fact that his work was one of the most important points of reference for NLP means his legacy will live on for many years and his sphere of influence will continue to expand with each new pupil studying NLP. Every hypnotherapy course or workshop will deliver Ericksonian tutorials for many years to come such was his enormous impact on his subject and so widely are they accepted, which is an impressive legacy.

- Erickson was a prolific writer, often working in collaboration with others. His chief collaborator was Ernest L. Rossi. His books include:

Hypnotic Realities ISBN 0829001123 (With Ernest L. Rossi) Hypnotherapy - An Exploratory Casebook ISBN 0829002448 (With Ernest L. Rossi) Experiencing Hypnosis ISBN 0829002464 (With Ernest L. Rossi) The Practical Application of Medical and Dental Hypnosis ISBN 0876305702 (with Seymour Hershman and Irving I. Secter) (out of print) Time Distortion in Hypnosis ISBN 1899836950 (With Linn F. Cooper) His clinical papers have been collected into a four volume work:

Collected Papers on Hypnosis: Volume 1 - Nature of Hypnosis and Suggestion ISBN 0829012060 (Ernest L. Rossi, Editor) Collected Papers on Hypnosis: Volume 2 - Sensory, Perceptual and Psychophysiological Processes ISBN 0829012079 (Ernest L. Rossi, Editor) Collected Papers on Hypnosis: Volume 3 - Hypnotic Investigation of Psychodynamic Processes ISBN 0829012087 (Ernest L. Rossi, Editor) Collected Papers on Hypnosis: Volume 4 - Innovative Hypnotherapy ISBN 0829012095 (Ernest L. Rossi, Editor) - note, these four volumes are sometimes made available digitally under the misleading (and erroneous) name 'Complete Works'.

Some books collecting transcriptions of his lectures and seminars:

My Voice Will Go With You - The Teaching Stories of Milton H. Erickson ISBN 0393301354 (Sydney Rosen, Editor) Seminars, Workshops and Lectures of Milton H. Erickson Volume 1 - Healing in Hypnosis ISBN 1853434051 (Margaret O. Ryan & Florence Sharp, Editors) Seminars, Workshops and Lectures of Milton H. Erickson Volume 2 - Life Reframing in Hypnosis ISBN 0829015817 ( Florence Sharp, Editor) Seminars, Workshops and Lectures of Milton H. Erickson Volume 3 - Mind-Body Communication in Hypnosis ISBN 0829018050 (Ernest L. Rossi, Editor) Other Works which collect specific parts of Erickson's output

The Wisdom of Milton H Erickson: The Complete Volume ISBN 1904424171 (Ronald A.Havens, Editor) An Uncommon Casebook: Complete Clinical Work of Milton H.Erickson, M.D. ISBN 0393701018 (William Hudson O'Hanlon & Angela L. Hexum) Many books have been written about Erickson and his techniques, which typically include extended citations from his papers, lectures and workshops, including:

Patterns of the Hypnotic Techniques of Milton H.Erickson: Volume 1 ISBN 1555520529 - John Grinder & Richard Bandler Patterns of the Hypnotic Techniques of Milton H.Erickson: Volume 2 ISBN 1555520537 - John Grinder, Richard Bandler & Judith DeLozier Milton H.Erickson (Key Figures in Counselling & Psychotherapy Series) ISBN 0803975759 (Jeffrey K. Zeig & W. Michael Munion) Uncommon Therapy: Psychiatric Techniques of Milton H.Erickson, M.D. ISBN 0393310310 (Jay Haley) Phoenix : Therapeutic Patterns of Milton H.Erickson ISBN 0916990109 (David Gordon, Maribeth Meyers-Anderson) Taproots: Underlying Principles of Milton Erickson's Therapy and Hypnosis ISBN 0393700313 (William Hudson O'Hanlon)

Book list obtained from Answsers.com

Author Colin Winston Aldridge and coutesy of http://www.hypno-therapist.net