Research Comparisons And Medical Applications Of Ericksonian Techniques

Stephen R. Lankton, Jeffrey K. Zeig, Stephen R. Lankton, Jeffrey K. Zeig

• Publisher: Routledge
• Year: 2013
• Topic: Psychology
• eBook ISBN:
  9781134848058
• Subtopic: Developmental Psychology
• Index: Psychology

This is the fourth volume in the widely hailed series of Ericksonian Monographs sponsored by the Milton H. Erickson Foundation as part of its expanding educational forum for mental health professionals. The Ericksonian Monographs make available original work - theory, clinical technique, case material, and research - on the cutting edge of Ericksonian thought and practice. Ericksonian Monographs No. 4 presents a richly stimulating collection of articles which deal with three extremely important areas of development in Ericksonian work: research, integration within the practice of other therapies and medical applications.

Research

Evocation and Indirect Suggestion in the Communication Patterns of Milton H. Erickson

Jean Godin, M.D., Ph.D.

Jean Godin, M.D., Ph.D., is Director of The Milton H. Erickson Institute of Paris. He is co-author of Milton H. Erickson: De l'Hypnose Clinique à la Therapie Strategique, which is the first book on Erickson originally published in French.

Godin provides an intriguing schema to analyze indirect suggestions. Subsequently he creates a field study and applies his schema to a portion of one of Erickson's induction transcripts. He illustrates the frequency of several elements in indirect suggestion.

Suggestion is an implicit part of all human interaction and cannot be eliminated from hypnosis or psychotherapy. The present investigation considers suggestion, both direct and indirect, as it is used in hypnosis. The concept and technique of indirect suggestion has been allied with the work of Milton H. Erickson as he used it to replace direct suggestion. A classification system is outlined which articulates the structure and components of direct and indirect suggestions. Using this classification system a hypnotic induction by Milton Erickson is analyzed and several intriguing questions are raised regarding the form and use of suggestions.

Direct Suggestion

What is direct suggestion? During Bernheim's career (Bernheim, 1902), hypnosis was equated with suggestion. At that time, suggestion was an affirmation. In the early practice of hypnosis it was thought sufficient to deliver an affirmation with assurance so that the hypnotic subject would go into a trance. As a result, the subject was then considered to be in a state of readiness to receive other affirmations.

While there were failures, many subjects did respond to this approach of induction and suggestion delivery. But this approach was only possible if certain conditions were fulfilled.

Nature and Psychological Impact

The suggestions used in Freud's time were direct suggestions. A series of statements were used which conveyed the information, “That is true because I am telling you so.” In such a situation, what can the relationship be between the subject and the omnipotent hypnotist? A great deal has been written on this topic. The consensus in some circles is that a “massive transference” or “psychological regression” occurs.

The myth about hypnosis shared by therapists and patients concerned the power one person can exert over another. This myth, in itself, created a social atmosphere which magnified the suggestive power of statements made by the therapists. The suggestions made by a traditional hypnotist and by Erickson do not have the same psychological impact on the listener. In the traditional case, a patient might understand that the therapist is the origin of a hand levitation or other phenomenon. That is to say, “I (the therapist) have brought it about because I wish to do so, and you are a subject in my hands.” In Erickson's approach, the subject is informed in various ways that any phenomena that occur are a function or result of what is happening in the subject's own mind; the therapist's role is minimized. Hypnosis is an exercise which explores certain resources. The therapist can have the status of a “teacher,” yet such status should not hinder an egalitarian relationship.

The early writings on the nature of hypnosis, and in particular the writings of Freud, appear to us not to relate to Ericksonian hypnosis. Actually, this relationship imbalance between the hypnotist and subject is nothing but an artifact. It is no more a component of hypnosis than were the hysterical convulsive attacks which were at one time considered an inherent part of the phenomenon.

This chapter provides an analysis of Erickson's suggestion. It reveals that he also used traditional or direct suggestions, but he used them to a much lesser extent.

Indirect Suggestion

Erickson's approach defines hypnosis as a state of heightened inner concentration where attention is concerned with one's memories, values, thoughts, and beliefs about life. We can assume that the hypnotic state is nothing more than entering into one's own “self” so that unconscious phenomena appear in the foreground due to a temporary dissociation from the realities of the surrounding world. We can be thankful to Erickson for demonstrating that there are other means to obtain a hypnotic state beside direct suggestion. One such technique is indirect suggestion.

While Milton Erickson did not invent indirect suggestion, he did emphasize its importance. However, one may still ask, “What is an indirect suggestion?” Milton Erickson had little interest in theorizing; he did not always distinguish between and delineate the characteristics of the suggestions he used. One might expect these characteristics to be uniform, but this does not appear to be the case. The present work analyzes suggestion along five polar parameters. This leads to a classification of suggestions along the following five polarities: 1) evocation versus compliance-based suggestion (referred to as suggestion, for short); 2) visible versus invisible perception of suggestion; 3) authoritarian versus permissive suggestions; 4) obligation versus freedom in response; and 5) conscious versus unconscious mediation. Each of these will be examined briefly before being applied to a transcript that represents a well-known case treated successfully by Erickson.

Classification of Suggestions

Purpose: External Suggestion or Evocation

The primary and perhaps most important differences between traditional and Ericksonian approaches are the concepts of external suggestion versus evocation. For Bernheim, suggestion was imposing an idea upon another person who must submit to the idea. For Erickson, suggestion was a tool for evocation or elicitation of an existing unconscious possibility or potential from the subject. These are radically different purposes.

Whether it is the hypnotic phenomenon, a specific hypnotic phenomenon, or a therapeutic possibility, for Erickson nothing could appear which had not previously existed in the subject. Therefore, the problem for him was not to “suggest” a compliance but to “evoke” a potential.

For Erickson, internal responses represented the indirect aspect of hypnotic communication: “You make a lot of statements to patients that evoke certain natural associative responses within them. It is these responses within them that are the essence of hypnotic suggestion” (Erickson & Rossi, 1981, p. 28). As Rossi notes, hypnosis is the facilitation of a process in which the subjects give suggestions to themselves (Erickson et al., 1976). Thus, suggestion is not blind acceptance or obedience, but a “response.”

There is, at a certain level, a self-dialogue: “Do I want to or not?” This dialogue is not addressed to the superficial level of the conscious mind, it is addressed to the subject's unconscious, which perhaps is not aware of what the subject wants consciously.

This is why trance does not assure acceptance of suggestions. It is a modality in which the mental processes of the subject have an opportunity to interact in a spontaneous and autonomous way with the hypnotist. This new, Ericksonian approach, based on evocation, has nothing in common with traditional and/or classical suggestion and, actually, should be referred to with a different term.

Subject's Perception of the Suggestion

An indirect suggestion can be said to be a suggestion the subject's conscious mind cannot perceive. Many of the statements used by Erickson are, in this sense, invisible. For Erickson, this characteristic is of major importance. In fact, if the subject understands that something is being asked, it is difficult to distinguish what aspect of the subject's response is voluntary and what is not. If the subject is not aware of what has been asked by the suggestion, the subject's associated response will always contain an element of surprise. As mentioned, this creates a true hypnotic response. Suggestions which are intended to result in very obvious responses will be called visible.

Degree of Direction of the Suggestion

Since the suggestions of traditional hypnosis are authoritarian, the hypnotic response is confused with obedience. The authoritarian approach can be exemplified by the use of the linguistic imperative, “Sleep!” or the present indicative, “Your eyes are closing,” or the future tense, “I am going to count to 5.” These subtleties of language have, for ths study, the same value. As mentioned, they imply that the hypnotist has an authoritarian role to which the subject must comply.

Permissiveness is generally a part of Erickson's approach. The linguistic structure might be, “Sooner or later your eyes might close.” In this approach, the social and psychological relationship between the hypnotist and subject is quite different. Such suggestions will be classified as permissive.

Degree of Freedom in Response to the Suggestion

In the case of per...

Table of contents

• Front Cover
• Half Title
• Title Page
• Copyright
• Ericksonian Monographs
• Contents
• Contributors
• Introduction by Stephen R. Lankton
• Research
• Comparisons
• Medical Applications