Book Reviews

Ericksonian Elicitation: A Book Review

Milton Erickson was a titan of psychological research. He’s also a personal hero. His most important paper on trance makes the firm statement that the therapist’s highest priority is to protect the integrity of the subject’s personality. For me, this commitment has been central to the development of clinical rapport. We can analyze technique and method, but I read Erickson’s papers and understand that his intuition was guided by people that wanted to reveal themselves to him. His phrasing of suggestions reflects the tenderness with which he confirmed their invitation.

Erickson’s impact upon his students was profound. One of them – Jeffrey Zeig – peppers “The Induction of Hypnosis: An Ericksonian Elicitation Approach” with personal vignettes. The instruction that follows makes evident his devotion to Erickson’s memory. A whole chapter celebrates his impact on the history of psychology following World War II.

For the professional, the development is a little slow. In part this follows from ambiguity in the definition of hypnosis. For the first six chapters, Zeig offers metaphors and stories in building a procedural definition rooted in the experience of the subject. The subject experiences, in order:

  1. Modified awareness – even something as simple as becoming aware of their breathing.
  2. Altered intensity – noticing the correlations between focused attention and experience.
  3. Avolitional experience – being guided into awareness without conscious ratification.
  4. Avolitional response – responding to experience without conscious ratification.
  5. Ratification of hypnosis – the operator bringing these elements into awareness and labelling them as “hypnosis” or “trance.”

The goal is for the subject to become receptive to suggestions from the operator. This requires agency on both sides: the subject trusts, and the operator builds rapport. On the operator’s side, Ericksonian phrasing makes the transition extremely comfortable. The pattern is pace, lead, and motivate. In pacing, the operator offers truisms – observations that are natural to the situation. Having attained that agreement, the subject is then led into the next step of the elicitation. Finally, they are offered a statement that aligns the step with their motivations. When the step is taken, it seems not only natural but as though it always was that way.

Zeig guides the reader through the grammar of Ericksonian elicitation. This is a finicky subject, and while clearly described, actual use of the grammar requires extended practice. This is emphasized: Zeig cautions that the operator should not be thinking “This would be a good place for a presupposition. Oh, and then I can offer an embedded command!” Instead, the operator is tracking the subject’s descent into hypnosis, and intuitively offers statements that serve the elicitation. To facilitate the development of that intuition, Zeig analyzes transcripts for study – all involving students that offer intelligent analysis of their experience. That is no substitute for immediate practice.

As a professional, I found myself wanting more at the end of the book. Zeig does a detailed deconstruction of a “traditional” model of hypnosis that I would characterize as a “straw man.” Zeig focuses on scripts. While the structure of a session does follow the pattern Zeig lays out, non-Ericksonian therapy does not require scripts – and even when I reference a script I rarely follow it slavishly.

Having demolished his straw man, Zeig promotes a core virtue of Ericksonian therapy: a session begins with elicitation. Unfortunately, the shift to therapy takes us out of the pattern of elicitation, into (progressively) 1) confusion and destabilization, 2) perceptual alteration, and 3) disassociation. The goal is to identify the mechanisms held in the subject’s mind that allow behaviors to be adapted. Sensory metaphors figure prominently, each wrapping a suggestion to create, modify, or delete an experience or behavior. Once disassociation is attained, those mechanisms can then be used to alter behaviors independently of the rest of the mind.

Zeig allows that to survey the subject’s inventory of adaptive mechanisms involves several sessions before therapy can proceed. Unfortunately, that procedure is not developed in depth, leaving the professional to wonder what to do after hypnosis is elicited.

The focus on disassociation is also troubling. Disassociation allows the subconscious to control movement and sensation without conscious awareness. In his writings, Erickson was proud of automatic writing and waking hallucinations. But ultimately the subject must integrate their experience and learnings. That may be accomplished by reinforcement as the subject is brought back into the normal state. Erickson never addressed this point, and neither does Zeig. What Erickson reported was, in fact, that by use of these disassociation he could create long-term syndromes in colleagues .

At the conclusion, Zeig’s writing left me a little flat. In attacking the methods that I use every day, Zeig showed a lack of respect for the work that has been done in the “traditional” model to assimilate Erickson’s central tenet: protecting the integrity of the subject’s personality. That includes:

  • offering the subject’s conscious mind a simple explanation of the therapeutic process,
  • the origination of free-style imagery in which the subject has autonomous engagement with their subconscious as the unified mind seeks for healing, and
  • allowing that the subject may evolve new behavioral development strategies.

More daunting, however, is Zeig’s observation that Erickson seemed to make it up as he went along – and that his most impressive elicitations involved unspoken elements. Erickson may not have been a therapist in the normal sense – he may have been a guru.  Zeig steers safely clear of those waters.

Basics

Is Hypnotherapy Expensive?

Most hypnotherapists will charge anywhere from $75/hr to $250/hr. The rate depends upon experience, talent and locale.

Prospective clients may be surprised at these numbers, often because they are used to insurance co-pays for mental health services. Hypnotherapy is not covered by most insurance plans because we don’t often deal with mental illness. We are dealing with optional, quality-of-life concerns – things that can be avoided by taking a different route to the store or seeking a different job. They are also far more common than mental illness, which is why they are excluded from insurance coverage.

Unfortunately, those optional concerns can become the seed from which true mental illness is born. Remember when the uninsured would wait until they were sick enough to get admitted to the emergency room? It’s something like that. Sometimes literally so: failure to deal with cigarette, alcohol or drug addiction can lead to serious long-term medical consequences. In the arena of mental health, failure to deal with a phobia can build until the client can’t leave their home. The quality-of-life issue becomes a mental illness.

But still, if the issue is not yet that severe when we start work with a client, why should hypnotherapists charge rates similar to those charged by doctors and lawyers?

The reason we do is because you are asking us to help you care for your mind. If you don’t value your mind, then the subconscious is going to pick up on that and not buy into doing the work.

Your subconscious is seven times more powerful than your conscious mind. I don’t want to have to fight its lethargy, so I charge enough money to ensure that the subconscious knows that success is important – and as soon as possible.

It’s also enough that every client should take picking their therapist seriously. Interview more than one, and from more than one school of treatment. Here in Ventura, we have graduates of the Hypnosis Motivation Institute, including myself, drawing upon over a thousand hours of training. That training emphasizes the importance of protecting the integrity of the client’s personality and is reflected in the way we interview, customize therapy to the client, and use dreams. Our rates reflect our skills – and our investment in caring.

The least sophisticated practitioners will use one-size-fits-all methods and scripted therapies. Those are effective for many clients, and particularly so if you feel that you have good rapport with the therapist. In between is a spectrum – you’ll almost always be able to find someone that you’re comfortable with.

But if the therapy doesn’t work, don’t let yourself be told that “You can’t be hypnotized.” That’s not true: you just need a more sophisticated practitioner.

Basics

Personal Development: Table of Contents

While we are all unique, life imposes certain facts upon us. We are born, grow, learn, create and relate to those around us. Each opportunity builds upon those that come earlier.

For the fortunate, life becomes deeper and richer with age. For others, life is a rut that can’t be escaped. In either case, just as a map guides a mountain climber, so a basic map of personal development guides our growth to maturity.

This blog series builds a road map around the relationship between the conscious and subconscious mind – the relationship managed most directly through hypnotherapy. The mind divides in childhood to soften conflict between the self and the world. Unfortunately, that division generates internal conflicts. Which creates conflict with the world, leading to conflict with the self, and on and on until we realize that we need to include others in our circle of concern. As harmony is rebuilt, the mind reunites, and we enter the realm of spiritual experience.

Part 1: Change Matters – Unlike most animals, humans make their most important changes in the mind.
Part 2: Theory of Mind – Explaining why the mind is divided between conscious and subconscious.
Part 3: Path to Maturity – Laying out the steps toward maturity and the roles characteristic to each stage.
Part 4: Survival (dependent) – We are social creatures: survival depends upon partnership. The first partnership is with our parents. When family experience is painful, hypnotherapy can help limit the impact on our adult lives.
Part 5: Sex (hedonist) – The sexual urge drives us out of the home and into peer relationships. Again, many of us have work to do as adults to heal the damage caused in those chaotic years.
Part 6: Exchange (consumer) – Euphoria and fear control our preferences, but also bias our behavior when we expect one more than the other. That bias arises in infancy, making it hard for us to adjust our patterns when they cause problems.
Part 7: Healing and Trust (healer) – When we come to accept that our bias is our problem, sympathy for ourselves extends to include others, and we begin the work of building relationships around trust. This is the sweet-spot for hypnotherapy.
Part 8: Truth (partner) – Life involves many relationships, and only in honoring the truth are we able to sustain true partnerships. Hypnotherapy allows us to smooth over any rough edges carried forward from the past.
Part 9: Creativity (inventor) – In the security of partnerships, we get to choose both who we want to be and what we wish to accomplish. Sustaining harmony is the challenge, as trauma disrupts everyone’s plans. Hypnotherapy helps both with harmony and healing.
Part 10: Imagination (liberator) – This final post looks (somewhat speculatively) at the final step into maturity. The barrier between conscious and subconscious dissolves, and we enter a realm of spiritual development that is qualified by our ability to sustain harmony in the realm of ideas.

Basics

Personal Development: Part 10

Imagination

Our journey of personal development has reached its end-point. Thus far, the journey has been incremental, each step building upon prior progress. In a broad sense, we can see that in the first three stages (survival, sex and exchange) the goal is to explore opportunities for personal expression. The second three stages (healing/trust, truth and creativity) shift to collaboration and social responsibility.

Hewing to the priorities of the hypnotherapist, our focus has been on changes in behavior. That growth may bring conflict with the self or others. Each segment has surveyed the tools hypnotherapists may offer to support those struggling with a transition.

Psychiatry offers some detailed insights. The brain also changes as we mature. When learning to survive, the brain is designed to capture as much experience as possible. Neurons form dense webs of interconnection. During adolescence and early adulthood (sex and exchange), the brain sheds many of those connections, focusing its energy toward identifying and amplifying social advantages.

Along with those gross changes, the brain develops new structures. Reason and relationships are our highest cognitive functions, and as we learn neurons are recruited to their service. Each new node requires the services of its predecessors. The highest relationship function – altruism – often develops only in our mid-twenties (in the region called the posterior superior temporal sulcus).

From these insights, however, we have no reason to expect that the basic model of behavior development might begin to break down. Remember how this goes: due to the complexity of social existence, around eight years of age the brain divides into the conscious and subconscious, with exchange mediated by the critical mind. Could it be possible that as we age, the more powerful subconscious might come to trust our abilities to survive in society, and come back into the light?

Such a change is not incremental. It completely upends our concept of self.

This is the nature of the final stage of personal development, the stage of imagination.

The dissolution of the critical mind begins in dreaming. Dreams are the forum in which the subconscious invents new behaviors, free from the prejudices of the conscious mind. But the process is inefficient at best and often obscure. Many remembered dreams are vague if not incoherent. But if through dream analysis we cultivate a dialog, the subconscious learns to be more precise. And when that dialog is pursued gently and respectfully, it eventually begins to call upon the conscious mind during sleep, allowing it to help resolve choices. This is called lucid dreaming.

Dream researchers and enthusiasts have developed methods to cultivate lucid dreaming. The first wanted accurate descriptions of the content of dreams and later discovered that it could be used to overcome trauma. The second enjoyed the thrill of the dream. It is important to remember, however, that unstructured dreaming is a critical part of behavior development. My recommendation is to allow the subconscious to open the door naturally, according to its own understanding of the benefits of greater conscious participation.

Beyond lucid dreaming, however, comes lucid waking. Trust works both ways, and when the conscious mind respects the creative powers of the subconscious, it can facilitate their activation without falling asleep. This is the natural state of many artists: they switch rapidly between abstract analysis and physical sensation as they work. Hypnotherapists call this mental pattern “somnambulism,” and discovered that many neuroses are related to “hypersuggestibility”: the tendency for the subconscious to reinforce negative thought patterns. But when the conscious mind is disciplined to cultivate positive thoughts, when a new opportunity presents itself it can drop into a meditative state to ask the subconscious “Where does this lead?” A rich set of possibility are presented immediately.

As the critical mind continues to dissolve, eventually a new brain state emerges: the gamma state. Observed in dedicated meditators and religious devotees, the gamma state appears to be the most highly energized of the known brain states, operating almost 50% higher than the beta state that we entered when alarmed.

These experiences all lead to increased imaginative capacity. But there is far more open to us in the space of imagination.

To understand the richness of that experience, I must challenge the psychiatric model of thought. Observing that damage to the brain causes loss of cognitive function, psychiatrists believe that all thinking occurs in the brain. Another possibility, however, is that the brain is an interface to the soul. Damage to an interface also causes loss of function.

My experience of the space of imagination led me to that second model: the brain is a kind of multi-channel receiver that tunes into a realm of ideas. In that space, injection of noise is the worst disaster. It disrupts the coherence of ideas. To gain full access, therefore, we must learn to sublimate our concern for the physical self, guarding against the impulses of greed, anger, fear, envy, lust, etc. In fact, failure to do so activates powerful intellectual antibodies that hurt our brains.

Psychologists might recognize my “space of ideas” as Jung’s “collective unconscious.”

Now ideas obviously strive for expression, and with our complex brains, human beings are a wonderous partner in the evolution of ideas. Unfortunately, we are still in transition from the long era of biological evolution (running back almost three billion years) that was driven by competition, conflict and pain – sources of noise that degrade the coherence of ideas. Intellectual evolution took root in us only when we learned to moderate our primitive impulses. That evolution, unfortunately, is a known threat to our evolutionary predecessors – including people that were not raised into intellectual opportunity. To avoid extinction, they are suspicious of intellectual change.

Our religious avatars explore the path through this thicket of mistrust. Buddha offered the concept of “compassion for all sentient beings.” Christ went further, promising “unconditional love.” In both cases, the avatar achieved intellectual authority only by resolving to witness sorrow as an intermediary for ideas that accumulate power from the gratitude of those that receive healing. Buddha tortured himself to achieve that status; Christ surrendered himself to death at the hands of those he loved.

The ongoing work done by our avatars is a transformation of the spiritual ecology in the space of ideas. Unconditional love seeks virtue in all things, transforming eventually even our vices. Anger becomes passion; destruction becomes creative transformation. Of course, the primitive impulses resist that transformation. Their program of repression, however, is frustrated by the sacred martyr, who endures physical wounds as a method of infecting the motivating ideas with love’s virtue.

Trapped in the world of material exchange, such acts seem insane. What history teaches us, however, is that material exchange is a dead end. It creates nothing that endures. Despite all the promotion and wailing of the 20th century, the most enduring personalities in our cultures are our religious avatars. When I was a child in the 1960’s, we still hated Hitler. Now only a few remember him, and increasingly they are ridiculed as anachronisms.

The future lies in acceptance and celebration of our differences – differences that permutate in the space of ideas to build ever richer possibilities for the expression of love.

Which brings us back to sex. Sex has a biological expression in male and female forms. That expression has a parallel in the space of ideas, in principles that I call “masculine” and “feminine.” The masculine principle facilitates change and must achieve temporal and spatial isolation to accomplish that end. The feminine principle sustains continuity through temporal and spatial diffusion. Even in our age, few appreciate the transformative power of their integration: transformation under the guidance of prescient intuition. The possibilities are literally magical.

But I have drifted into speculation, and the reader, following experience, must be wondering what hypnotherapy has to offer in this process. The answer, unfortunately, is “nothing.” Hypnotherapy is necessary only to divided minds. Those operating in the space of imagination no longer suffer from that limitation.

Of course, a hypnotherapist operating in the realm of imagination is an incredibly powerful aid to personal development. John Kappas and Milton Erickson are recent examples. I am suspicious, reading the reports of his faith healings, that Jesus also deserved the title.