Ericksonian Approaches to Clinical Hypnosis

Reprinted from ERICKSONIAN APPROACHES TO HYPNOSIS AND PSYCHOTHERAPY, edited by Jeffrey K. Zeig,

Brunner,IMazel, Inc., New York, 1982.

I would like to discuss in this paper what I consider to be some essential aspects of an Ericksonian approach to hypnosis and Hypnotherapy. I want to first contrast briefly the Ericksonian view of the hypnotic relationship to other more traditional views, and then to identify what I consider to be the general principles of communication in the Ericksonian approach and their application to the specific situation of hypnotic inductions. Finally, I want to comment about the need for integrity in applying these principles and techniques. Each of these topics is a major one, and in a short discussion I can convey only a general sense of their significance. Therefore, my remarks will be highly selective and necessarily incomplete. A more comprehensive treatment of these issues will be found in my forthcoming book, Hypnotherapeutic Changes: An Ericksonian Approach.

The Hypnotic Relationship

The first issue is the nature of the hypnotic relationship. Below I list the three main views of the hypnotic relationship: 1) the authoritarian approach; 2) the standardized approach; and 3) the utilization approach. The authoritarian approach emphasizes the power of the hypnotist. This approach, spawned by Mesmer and others, is still explicitly exploited by stage hypnotists and is consequently often the conceptualization held by the uninformed layperson. Even many trained clinicians implicitly adhere to this view, which in its extreme form involves some powerful 2-..d charismatic operator (usually a male) exercising some strange power O"'-e some hapless and weak-willed subject (often a female). In essence,

the􀀭operator gets the subject to do something he or she wouldn't ordinarily do (e.g., bark like a dog or stop smoking). This approach gen­erally assumes that the unconscious is some passive receptacle into which suggestions are "placed" or some fertile ground which the hyp­notist "digs into" so that he can "plant" suggestions. Frankly, I don't think the unconscious should be treated like a piece of dirt. For this and other reasons-such as the fact that direct suggestions generally don't work very well, and people often don't like to be told authoritatively what to do-this approach has rather limited value.

Many people have realized these limitations and subsequently de­veloped what might be called the standardized approach. This concep­tualization, adhered to by many experimentalists, is in part a reaction to the misplaced emphasis of the authoritarian approach on the power of the hypnotist. The standardized approach generally assumes that hypnotic responsiveness is determined by some inherent trait or ability of the subject. The hypnotist really isn't important-the subject is either hypnotizable or he isn't. This view further assumes that you can assess a person's "susceptibility" to trance by presenting 10 or 20 minutes of standardized and repetitive suggestions and then administering some quick behavioral tests such as hand immobility or heaviness. If the sub­ject passes most of these tests, he is considered a good hypnotic subject; otherwise, too bad. I might note that the hypnotist is considered so unimportant in this approach that suggestions are sometimes put on tape. So, if you're a busy person, you can put the tape on, go out and drink coffee for 10 or 20 minutes, and then come back and administer the tests.

There is nothing inherently wrong with this approach, especially in a research setting, where sometimes it is necessary. However, it doesn't work very well for a lot of subjects, especially those in clinical situations. The standardization approach interprets the large percentage of unre­sponsive subjects as evidence that some people are just not susceptible to the phenomenon of trance. I think their unresponsiveness is more a reflection of the limitations of the approach. The standardized inductions are usually poor in quality and essentially tell the subject to relax about 40 or 50 times. The standardized form demands that the subject attempt to fit his experience into some predetermined structure; it cannot handle or utilize any difficulties a subject might be having, such as a nagging internal dialogue.

Another problem in the standardized approach is that trance is defined in terms of the number of behavioral items passed on a test. I think this is like defining love in terms of the number of kisses emitted by a person or saying that I can't dance because I don't know the fox trot. I think this approach misses a major point about trance: It is a subjective internal experience whose behavioral manifestations will vary across individuals.

This point is central to the Ericksonian approach, which I put under the heading of being the utilization approach. In contrast to the authori­tarian and standardized approaches, it stresses the interactional nature of the hypnotic relationship. Neither hypnotist nor subject is of prime importance; what is of major importance is the interaction between the two. The hypnotic endeavor is a cooperative effort in which responsibility is mutually assumed. The hypnotist's task is to guide and supervise the subject; the subject's task is to decide if, how, and when to respond to the hypnotist's communications.

The utilization approach also assumes that each person is unique in terms of the strategies used to create his or her own experience and that, consequently, the hypnotist's effectiveness depends upon how well he is able to adapt his strategies to those of a given subject. Thus, stand­ardized communications are not used. The approach further assumes that unconscious processes can operate in an intelligent, autonomous, and creative fashion and that people have stored in their unconscious all the resources necessary to transform their experience. This is what trance is all about: It is an opportunity for the subject to set aside his identification with any limiting conscious processes and shift into a con­text (i.e., trance) where he/she can access and utilize unconscious re­sources for therapeutic gain.

Principles of Ericksonian Communication

The question thus becomes: How does the hypnotist facilitate hypnotic processes in the subject? Instead of standardized techniques, he has to use general principles to guide his efforts. I consider the most important of these principles to be 1) accept and utilize the client's reality, 2) pace and lead the subject's behavior and 3) interpret "resistance" as lack of pacing.

The first principle-accept and utilize-was stressed again and again by Erickson and is the essential theme of Erickson and Rossi's Hypno­therapy (1979). Briefly stated, accepting means assuming and communi­cating to the subject that "What you're doing at this point in time is exactly what I'd like you to be doing. It's fine; it's perfect." Utilizing means assuming and communicating the attitude that "What you're doing right now is exactly that which will allow you to do X." The ?nx:ess of accepting and utilizing is one of communicating that what 􀁚-ie subject is doing is fine and it will allow him/her to do something else e.g., experience trance).

Bandler and Grinder (1975) discussed these principles in the more process-oriented terms of pacing and leading the subject's behavior. Pacing communications essentia1Iy feed back the subject's experience; they add nothing new. Their major intent is to enhance the rapport between hypnotist and subject. This enables the subject to be more trustful and cooperative and the hypnotist to be more understanding. Once rapport has been developed, the hypnotist can lead by introducing behaviors that are different from, but consistent with, the subject's present state and slightly closer to the desired state (e.g., trance).

According to these principles of Ericksonian communication, the ef­fective hypnotic communicator assumes all experience is valid and uti­lizable and then behaviorally paces and leads toward the desired state. He freely admits that he does not know exactly which path will lead to the desired state and really does not know which techniques will work best. But he does know that he can "get in tune with" the subject, thereby establishing a rhythmic, continuous feedback loop in which one closely observes, accepts, and utilizes the subject's ongoing response. In this sort of interaction, the trek toward the desired state unfolds in a nonlinear, spiral-like fashion.

Within this feedback loop of interaction, the principles of pacing and leading can be applied in many different ways and at many different levels. One of the simplest forms of pacing and leading involves direct verbal description of the subject's ongoing behavior. This is often a good way to start a hypnotic induction. For example, you, as hypnotist, might note to a subject:

 

  1. You're sitting there, (pacing statement)
  2. You're looking at me, (pacing statement)
  3. You're breathing in and out, (pacing statement)
  4. eyes blinking up and then down, (pacing statement)
  5. and as you shift in your chair (pacing statement)
  6.   you can also begin to shift into a state of comfortable relaxation. (leading statement)

The first five clauses are all pacing statements; they simply describe the undeniable reality of the subject's observable behaviors. The final clause, however, uses pacing to introduce a leading statement (develop relaxation).

Of course, just any leading statement will not do. Sometimes you will lead too quickly or inappropriately. But that's fine; you simply observe how the subject responds and pace and utilize that. If he/she follows, fine, that becomes your new state to pace; if not, fine, simply pace what he/she is doing. This whole interaction is one of pacing and leading, pacing and leading, again and again and again and again.

Pacing and leading can be done nonverbally, too. For instance, if you wanted to calm down an excited client, you could begin to mirror or reflect back his nonverbal excitedness by speaking in the same breath­less, high-pitched and frantic way. After a while you could begin to lead by slowing down just a bit and relaxing just a bit more. If you lead too quickly and the subject continues in his frenetic rhythm, that's fine; you can shift back into the quick pace once again, talking about how fast things can really get and then again begin to gradually slow down. You can continue this process until the subject reaches the desired state.

Another way to nonverbally pace and lead is to synchronize one of your behavioral parameters-such as the tonal inflections in your voice-to a different behavioral parameter of the subject-say his breath­ing rate-so that every time he breathes out, your tonal inflection goes down. You might nod your head subtly every time the subject blinks his eyes and then begin to nod occasionally when the subject is not blinking. This leading can be gradually increased to the point that you can elicit eyelid flutters from the subject, a response that can easily be utilized to develop a trance. This technique, which I call cross-behavioml pacing and leading, is usually quite effective. It is indirect and thus by­passes the subject's conscious processes.

Pacing and leading can be more complex and sophisticated. For ex­ample, a co-therapist and I worked with a psychotic who terrorized the psychiatrists on his ward with gross hallucinations of dead babies, hot dogs coming out of his ears, and other bizarre images. When we first interviewed him, he looked wildly about and asked us if we saw the hallucinations. We agreed with him in a matter-of-fact fashion and then looked crazily into space before asking him if he saw our hallucinations. Of course, this was all done quite elaborately and dramatically. He was understandably stunned by our response. He tried to counter with more hallucinations, which we again accepted and then led by introducing more of our own. After a while we disappointedly confessed that we had asked to see him because we were interested in becoming better hallucinators and had been told that he was an expert. However, we pointed out, there had obviously been a mistake; after all, we had 10 good hallucinations, while he only had three mediocre ones. Besides, we continued, the guy on the next ward had half a dozen hallucinations of a much better variety

Needless to say, this produced a state of confusion in the patient, - which we used by offering to teach him to be a better hallucinator. He agreed, so over the next several months we showed him how to generate oth _, hallucinations, how to hallucinate in a relaxed fashion, and how to have comforting hallucinations. We gradually led from scary and uncontrolled hallucinative processes, to more relaxed and valuable sorts of hallucinations, and then to dropping hallucinations altogether.

Another client of mine was a successful corporate president who suf­fered from intense internal conflicts. As part of the therapeutic strategy, I hypnotized him and had him visualize himself at a "board meeting" where all of the different "parts" of himself were present. He was di­rected to use his position as "chairman" to solve the various disagree­ments between the "board members." This was done over several sessions and produced favorable results.

The point to be drawn from these examples is that you take what the person gives you and use it. That becomes your strategy. One of the profound consequences of this way of thinking and acting is that there really is no such thing as "resistance" in a utilization approach. Every­thing the person is doing is exactly what you would like him to be doing. Your task is to generate communications that use ongoing experiences. When you are not fully using them, the subject will tell you, usually indirectly and nonverbally. You will find yourself accusing the person of being "resistant" or branding him/her as "nonsusceptible." You are reacting to communications from the subject that are saying, ''What you're doing is not pacing me at this time. You're not using some behavior or ex­perience of mine." Neither the hypnotist nor the subject is a "bad person" or "wrong" or "sick" or "crazy." "Resistance" is just a message that you need to synchronize yourself with the subject again. I think this is a radical concept that is incredibly useful to the clinician.

The Process of Induction

How do these utilization principles apply to the specific situation of inductions? The main strategies or principles that the Ericksonian hyp­notist uses to induce trance are: 1) Secure and maintain the subject's attentional absorption; 2) access and develop unconscious processes (associational strategies); and 3) pace and distract conscious processes (dissociational strategies).

The first thing you want to do in an induction is to secure the subject's attention and then maintain that absorption. To do this, you use non­verbal processes in certain ways: 1) Stay externally oriented; 2) remain flexible; 3) communicate meaningfully; and 4) be confident.

The first-staying externally oriented-is critical, because your major task as a hypnotist is to use the subject's ongoing processes. It is therefore rather important that you remain aware of what the subject is doing all the time. To best do this, you might develop what Bandier and Grinder call an up-time state, which I call an externally-oriented trance. In

this state the hypnotist breathes comfortably and focuses fully and continually on the subject. He gets intc a rhythmic feedback loop where he feels strong contact with the subject. In this state the hypnotist's behaviour is not mediated by conscious processes; rather, he allows himself to drop into trance and let his unconscious respond. Stated another way, the sole contents of the hypnotist's consciousness are the subject's behavior,

rather than the internal imagery that normally pervades thinking processes. It is as i f the notion of mind extends beyond the normal boundaries of the body to include the subject. This is not a state of total empathy; it is a paradoxical state in which the hypnotist simultaneously experiences complete rapport with the subject and an observational detachment from the interaction. This process enhances both the hypnotist's and subject's feelings of rapport. It also helps both participants to develop focused but effortless styles of processing. Furthermore, it helps the hypnotist to detect subtle aspects of the subject's experience.

Now all of this may sound a bit strange, but I train my students to develop and use this style of processing while operating as hypnotists. Most of them find it easy to develop and almost all of them claim that it markedly enhances their effectiveness as hypnotists. It is a process

not unlike those used by great entertainers and athletes. These master practitioners spend endless hours using conscious, analytical processes to develop and refine their skills, but they "stop thinking" and let their unconscious do it for them when it comes time for the actual performance. An effective Ericksonian hypnotherapist thinks long and hard before and after a clinical session, but while actually interacting with a client, he lets his unconscious use the products of those contemplations. I learned of this process from Erickson, who used it rather often. For example, during the early part of my training with him I watched him do a marvelous piece of work with a patient. Assuming that his sophisticated strategies had to be generated from complex conscious cognitions,

I was determined to identify the exact thought processes he used. After the patient left, I poised pencil on paper and resolutely began to interrogate him.

 

"Milton, do you make a lot of pictures?"

"No," he slowly but firmly stated.

"No pictures," I muttered, crossing that category out on my sheet.

"OK. Do you have a lot of internal dialogue in that situation?"

"No," he again convincingly replied.

"OK. No internal dialogue. Let me write that down here. OK. Well, do you have kinesthetic sensations? You know, feelings in the body, tll.at sort of thing."

“No.”

I was beginning to grow both suspicious and confused. "Let's see. No pictures, no internal dialogue, no kinesthetic sensation. Well, Milton, I don't understand. How do you know what to do?"

"I don't know. I don't know what I'm going to do, I don't know what I'm going to say. All I know is that I trust my unconscious to shelve into my conscious that which is appropriate. And I don't know how they're going to respond. All I know is that they will respond. I don't know why. I don't know when. All I know is that they'll respond in an appropriate fashion, in a way which best suits them as an individual. And so I become intrigued with wondering exactly how their unconscious will choose to respond. And so I comfortably await their response, know­ing that when it occurs, I can accept and utilize it."

He paused, his eyes twinkling. "Now I know that sounds ridiculous. But it works!!"

And after my initial confusion, I checked it out and found that indeed it did work.

The second process involves remaining flexible when you're in this externally-oriented trance state. If a technique doesn't work, fine, use another one. If a communication does not seem appropriate, fine, shift to a different one. There are really no mistakes you can make in well-intentioned hypnotic communication. There are only outcomes, and every outcome is useful. You offer behavioral communications and then observe and use the responses. To do this, you must really stay in tune with the subject, not trying to fit him/her into any rigid, preformed category.

Another interaction I had with Erickson illustrates the importance of this point. It was one of the most important teaming experiences in my life. After years of diligently studying his approach, I felt I had a fairly good grasp of his sophisticated strategies, yet clearly sensed that I was lacking something. My work was not as effective as I knew it could be, but I was unclear about how I was limiting myself. Finally, on the last day of a week-long visit with Erickson, I respectfully requested some guidance in the matter. Instead of launching one of his lengthy and indirect answers, he stated in a simple but intensely meaningful fashion, "You've got a tendency to overcompartmentalize your experience, and it gets in the way of your unconscious." He then immediately ended the session.

As I walked out with a colleague, I confessed my disappointment about not being given any useful feedback, but sympathetically sug­gested that it was because Erickson was getting old, and besides, he never did have a good conscious understanding of what he did. In other words, I "compartmentalized" his response! Several months later, at the end of a similar training session, I again advanced the question, to which he replied a bit more sternly, "You've got a tendency to overcompart­mentalize your experience, and it gets in the way of your unconscious!" My disappointment was even more marked this time, for Erickson was clearly getting a bit senile; he didn't even remember what he had told me before.

Four months later, my despair deepened when a third phrasing of the question was met with the same response. Why was Milton being so uninformative? Why couldn't he remember what he had told me before? Did he give such unhelpful advice on such matters to all his students? If so, what happened to his emphasis on unique solutions for each person? I gave the question one more try several months later, to which he replied: "You've got a tendency to overcompartmentalize your ex­perience, and it gets in the way of your unconscious!" FLASH!! Four times and eight months later, I was startled with the blinding (or rather unblinding) insight: I had a tendency to overcompartmentalize my experience, and did it ever get in the way of my unconscious!! When I finally looked at Erickson, his eyes were twinkling. "That's right," he said softly. My realization really unfolded and developed over the next months. It became all too clear that most of my time as a hypnotist was spent in internal dialogue, trying to classify the subject's behavior and then come up with some sophisticated response. The more I indulged in these conceptual evaluations, the less I attended to what the subject was ac­tually experiencing and doing. In addition, I was forced to "objectify" the subject into this or that class, thereby limiting the degree of possible rapport. As I relinquished the need for such "compartmentalizations," my appreciation of the uniqueness of each individual grew. Most im­portantly, my communications became more fitting and my work more effective.

Of course, I sometimes find myself mired again in this evaluative mode. But when I do, I think back to Erickson's simple but persistent suggestion. It is difficult to resist such a suggestion.

The final two points are that you must communicate in a meaningful and confident fashion to the subject. This process was a major part of what Erickson emphasized in his writings. Your non verbal delivery must unequivocally communicate to the subject that what you're saying is important and that he/she can respond to it. In many respects your nonverbal communication is more important than your verbalizations. If what you're saying seems meaningful and important, the person will feel compelled to respond.

Once the subject is attentive, you use rapport to develop unconscious processes; that is, you want to develop hypnotic experiences in the subject. You can accomplish this in a number of ways. A nice technique to begin an induction is with questions that access trance-relevant ex­periences from the person's memory. For instance, you might ask gen­eral questions:

  • Do you remember what you felt like during your last trance?
  • What did it feel like when you were in the deepest trance you've ever been in?

Or, if the subject has no previous trance experience:

  • Can you imagine and begin to describe to me what it would be like for you to begin to develop a trance?
  • Do you remember a time when you felt very relaxed?

Or, if you wish to develop a particular trance phenomenon, such as age regression, you might ask more specific questions:

  • Did you have a nickname as a child?
  • Did you have a favorite game as a youngster?
  • Did you have an imaginary playmate as a child?

There are countless numbers of these questions, which essentially ask the subject to revivify some naturalistic experience relevant to trance processes. It is important to realize that the subject's response to such inquiries will depend in large part on how they are delivered. Generally speaking, the subject will access and become absorbed in the revivified experiences to the extent that the hypnotist asks the question(s) in a meaningful, compelling, and expectant fashion.

The subject's responses can then be developed, either through further questions or through other, more elaborate techniques. Many of these techniques are well known already, so I will not say much about them except that most traditional techniques are suitable, as long as you adapt them to the particular subject. For example, you might use progressive relaxation techniques with kinesthetically-oriented subjects, or guided imagery methods with visually-oriented persons. With a person whose conscious processes (e.g., internal dialogue) interfere with the devel­opment of trance, you might tell metaphorical stories. Such stories, which were a trademark of Erickson's work, have content that is dis­similar to the subject's experience or problems, but specify processes or themes that are quite similar to those salient in the subject's experience. So you talk about other people going into a trance, or interactions with other clients, or even personal experiences. The subject is consciously distracted because he/she thinks, "Gee, that's not about me," and yet unconsciously identifies with the story and thus gains access to the experiences suggested by it.

This last point leads to the third induction principle, that of pacing and distracting the conscious processes. Distraction or confusion tech­niques are useful because accessing techniques alone will generally be effective only to the extent that the subject allows them to be. That is, the subject not only must be willing to participate, but must also be able to let unconscious experiences develop. Many subjects have difficulty doing this. Specifically, their conscious processes interfere by continually questioning, analyzing, or trying to help with the development of the hypnotic experience. To the extent that such conscious participation occurs, the hypnotist needs to employ techniques and strategies that de-potentiate such interference.

There are many ways in which this can be done. For example, the hypnotist can use techniques that totally occupy the subject's internal processes with tasks irrelevant to the trance development. One such technique involves instructing the subject to count backwards (silently) from a thousand to one by three's. While the subject does this, the hypnotist goes on with his induction patter. If the subject seems to be able to do this without any problem, you can use an overloading tech­nique such as having him verbalize the letters of the alphabet in a for­ward fashion while visualizing them backward. The subject begins by verbalizing an "a" to himself, at the same visualizing the letter "z"; the letter "b" is then verbalized while "y" is visualized; and so on. If you try this yourself, you quickly will realize how overloading and disorient­ing it can be. Meanwhile back at the unconscious, the hypnotist is using accessing techniques for the development of trance.

In addition to distraction techniques, Erickson developed a large body of confusion techniques. Briefly stated, underlying the use of confusion techniques are the following assumptions: 1) There are many automatic and predictable patterns in a person's behavioral processes; 2) the un­expected discontinuation of any of these patterns will create an uncertainty state dominated by undifferentiated arousal (e.g., confusion); 3) the arousal will increase unless the person can cognitively attribute it to something; 4) most people strongly dislike uncertainty states and are motivated to avoid them; 5) consequently, most people will grab onto the first thing that enters their consciousness that reduces the uncer­tainty.

Based on these assumptions, most confusion techniques involve the following five steps.

  1. Identify a dominant pattern in the subject's behavior.
  2. Pace the pattern for awhile.
  3. Interrupt or overload the pattern in a way which confuses the subject.
  4. Amplify the confusion a bit.
  5. Use the confusion by introducing a simple leading statement (e.g., "drop into trance").

These principles can be understood through a few examples. My first experience of involuntarily dropping into trance illustrates how relatively simple interruption techniques are easily effected. I was sitting in Er­ickson's office. As I intently listened to him tell a number of metaphorical stories, I was strongly dominated by the cognitive pattern of analysing and then "compartmentalizing" every statement he made in terms of what it "really" meant. I was therefore startled when all of a sudden he intently looked at my hand, pointed to it, and said in the most surprised and incredulous fashion, "Isn't that your left hand not lifting? ... Yet? ... Now?" My recollection of the experience is still rather hazy. All I remember is seeing the room swimming about and feeling my hand beginning to involuntarily float upwards. I found myself look­ing right into Erickson's eyes as he said, "That's right, close your eyes and drop into trance nowww!!!" Believe me, I did so at once. He then added, "And let your unconscious do the work for you." I did that also. The most effective confusion techniques are those that use the very pattern that is keeping the person out of trance-in this case, my "com­partmentalization" processes-as the basis for the induction. Again, whatever the person is doing is exactly that which will allow him to experience trance.

Other confusion techniques involve overloading the subject's conscious processes. For example, a double induction is a process in which two hypnotists perform simultaneous inductions on one subject. The hyp­notists play off each other, both verbally and nonverbally. After a while, most subjects find it nearly impossible to continue to pay full attention to all they are experiencing. Some simply give up and retreat into trance; others become so disoriented that simply instructing them to "let go fully and simply drop all the way into trance" is usually quite effective.

Many clinicians tell me that they like this double induction technique, but they can't use it because they work alone. There is no need for despair. A modified procedure is to instruct the subject to pay close attention to a taped induction. While the tape is playing, you do a "live" induction in the other ear.

Confusional overload can also be accomplished by telling stories in­volving spatial and/or temporal disorientation. One story I have found to be particularly effective involves an automobile trip in which the driver is unclear about the exact sequence of directional turns. An ab­breviated example of this technique, which I call the autohypnosis direc­tional manoeuvre, is as follows:

(After about 15 minutes of general inductional communications) And there are so many directions you can follow when you allow your unconscious to do it for you ... just as there are many dif­ferent directions you can follow physically .... I'll give you an example .... Some summers ago, I was traveling all alone on the highway in my car, just paying dose attention to the sound of the engine, and knowing that slowly but surely I was heading into another state. And in that state there was a particular destination I was headed for, a particular person I wished to see, a particular experience I was looking forward to in that other state .... How­ever, while I knew the general set of directions regarding how to get to where I wanted to go, I could not for the life of me remember the proper order in which those turns occurred. I did know that from where I was there then, I thought to myself, I don't want to be here now; I want to be there now, and all I can remember is that to get there now, or at least soon from now from here, I take a combination of three right turns and three left turns ... but I don't know quite which is the right series of rights and lefts ... but I do want to get there and I am here now, and so I said, all right, pay attention very closely (embedded suggestion to subject), because we've got to make it right or we'll be left behind .... And then I said, all right, let's begin .... I'll take a right here (I think that's right), and then a left and now I'm left with two lefts and two rights. So all right, I'll take another left, which means I'm now left with a left and a right and a right. If I take a right, I'll be left with a right and a left, but if I take a left, I'll be left with a right and another right . ... But I don't think that is right, so I'll take a right first, and then a left, and now I'm left with a right, and so I take the right, and ... dead end. It's the wrong way. And so now I've got to go back to the starting point, so as not to get completely left be­hind ... so I begin to back track and now take three rights and three lefts again, except that each turn is now the opposite from the other direction .... Everything is reversed . ... Now which was then a right is now a left ... and that which was left then is now a right. ... so for every right then it is right now to take a left ... and for every left then it is right now to take a right, and now I'm back at the beginning, ready to begin again ... and so I begin ....

You can then repeat the story with a different sequence of directions and continue until the subject looks completely confused, at which point you can offer trance suggestions within the story. For example, to con­tinue from above:

... And after a while I became so tired, so confused, that I didn't know and didn't care where to turn next .... I couldn't tell a right from a left, nor a left from a left . ... l couldn't figure out whether taking a left was right, or whether taking a right was right. So I pulled off to the side of the road, turned off the engine, and sat there with my eyes closed, and said to myself, "To hell with trying to figure it out. Stop all this activity and just relax into a trance!!" (This statement is uttered in a slower, softer, but more intense and em­phatic fashion.) and I did. (The hypnotist now shifts to a more relaxed, almost relieved tone.) ... And I was able to just allow that trance to develop . ... There was the recognition that there is no need to pay attention to anything except the need to attend to one's own internal needs ... and what a nice thing to know that you can simply let your unconscious do the work for you.

All of these statements are valid and consistent with each other. Also, the effectiveness of the story depends in large part on the hypnotist's nonverbal communications. As with any Ericksonian technique, the hyp­notist needs to capture and maintain the subject's conscious attention and must therefore speak meaningfully, impressively, and congruently. In addition, because the intent is to create and then use informational overload, the hypnotist begins with a relatively quick tempo, increases and intensifies it even more when the subject starts to get confused, but then dramatically reduces it (to a slower, softer voice ) right at the point of utilization. Finally, it is quite useful to employ special tonal markings to subtly emphasize both (a) the directional and ambiguous terms (e.g., right/left) and (b) the several embedded suggestions regarding paying attention and dropping into trance. When these and other nonverbal techniques are judiciously applied, the story will usually work quite well as an induction device.

One final technique for de-potentiating conscious processes is bore­dom. As Erickson used to say, "I've got an unconscious mind, and they've got an unconscious mind. Therefore, as long as we're in the room together, sooner or later they'll go into trance. And if nothing else works, I'll bore them into trance. It might take them five minutes, 10 minutes, 30 minutes, one hour, several hours, or many hours. That's fine; I can wait." And, boy, could he ever wait. You might tell two or three hours of metaphorical stories, gradually wearing down the person to the point that he/she is unable or unwilling to offer any conscious resistances to shifting into trance. In fact, many people retreat into trance to get away from all those boring stories.

To summarize, induction is a process in which the hypnotist uses his body as a musical instrument, tuning it to get into rhythm with the "behavioral dance" of the subject. The hypnotist works to secure and hold the subject's attentional processes, thereby making it possible to access unconscious processes to develop hypnotic experiences. To the extent that the subject's conscious processes interfere with this devel­opment, the hypnotist uses distraction, confusion, and boredom tech­niques. In short, the most effective induction strategy is one that maximally uses the subject's ongoing experience as the basis for trance development.

The Integrity of the Hypnotist

Before closing, I'd like to comment briefly on the issue of integrity. Simply put, the principles, strategies, and techniques of the Ericksonian approach are incredibly powerful tools. And while tools are value-free, their capacity to enhance or create is equivalent to their potential to oppress or destroy. I think that one need only look at similarities in the communi­cation patterns of great humanitarians like Christ and great oppressors like Hitler to realize this. The important point here is that the effect of a tool on the quality of human experience depends on its user. Con­sequently, the integrity of the hypnotist is a major issue.

Incidentally, I don't think you can ignore this issue, even if you try. As Bateson, Haley, and others have pointed out, you cannot not affect another person's behavior. In this sense, all behavior is manipulation. What the Ericksonian approach does is make explicit a lot of the ways in which we are constantly influencing each other. By becoming aware of such patterns, you can use them systematically; that is, you can align your behavior with your intent, thereby making you a powerful com­municator. What becomes critical, then, is getting clear about your in­tent.

This is not a trivial matter to be sidestepped or disregarded. In training mental health professionals, I have noticed that failing to come to grips with it creates many problems. Some trainees have difficulty acknowl­edging that they can and do powerfully influence human behavior and thus find themselves unable to use Ericksonian techniques in any pow­erfully effective fashion. Other trainees are initially overpowered by an insecure need to prove themselves and consequently wield techniques in a domineering and insensitive fashion. Both types of student are controlled by their ability to manipulate, the former by attempting to dissociate from it, the latter by using it irresponsibly. In both cases, the true power to enhance experience is stifled.

Once a person becomes aware of the intent and effect of his behavior, he can use communication in powerful manner. Here the issue of in­tegrity becomes particularly important. By integrity I mean the degree to which the hypnotist is able to refrain from imposing his own solutions and beliefs on the subject, to refrain from having to prove his own worth at the subject's expense, and instead fully to support the person in his/her quest for change.

The hypnotist's integrity has many practical consequences. Lacking integrity, even the highly skilled hypnotherapist ,,vill find that his clients can develop hypnotic phenomena but not hypnotherapeutic changes; or they will become impressed with his abilities but not their own; or they will try to take on his beliefs and life-style rather than developing their own. In short, the hypnotist lacking integrity ,-viii be in no position to really help the client.

Conversely, the hypnotist operating with integrity can easily secure rapport with the client. By trusting the hypnotist, the client begins to trust himself more. He consequently becomes more willing to examine his shortcomings and more able to develop new ways of being. He also becomes more willing, both in trance and waking states, to comply with directives, no matter how strange or bizarre they may seem. This is important to the Ericksonian practitioner, who uses many unorthodox strategies.

In fact, I firmly believe that the most powerful aspect of Erickson's communication was his integrity. Before training with him, I would read about all these wild things he did with his patients and I could never quite figure out how he could get these people to cooperate with him. After watching him in action, it became crystal clear that he had an unwavering intention to fully respect and support his patients and stu­dents. He wasn't out to manipulate or control for his own personal gains. Consequently, people would really let go and fully cooperate with him.

In conclusion, this whole issue of integrity needs to be thought about long, hard, and often. You must clearly decide whether you wish to support or oppress others. Of course, the second choice cannot always be implemented. Most hypnotic subjects will quickly learn to distrust and hence not cooperate with a non-supportive hypnotist. Choosing to support the subject is a lot easier, since there really can be no "resistance" when one is totally aligned with another individual. Besides, it's a far more personally satisfying and professionally effective position. Simply stated, the more integrity you develop, the more fun and success you are likely to experience, and I think that's what "it" is all about.

 

 

References

 

Bandier, R. & Grinder, J. Patterns of the Hypnotic Techniques of Milton H. Erickson, M.D. Vol.

1, Cupertino: Meta Publications, 1975.

Erickson, M.H. & Rossi, E. Hyp,zotherapy: An Exploratory Casebook. New York: lrvington

Publishers, Inc., 1979.