Milton H. Erickson

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Milton H. Erickson

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Title: Milton H. Erickson

1

Milton H. Erickson
Unorthodox psychiatrist, congenial family doctor,
ingenious strategic psychotherapist and master
hypnotherapist, Milton Erickson's influence has
revolutionised Western psychotherapy. Thanks
largely to Erickson the subject of hypnosis has
shed its shackles of superstition and is now
widely recognised as one of the most powerful
tools for change.

Within his own life, Milton Erickson had many
personal disabilities to contend with, which he
often stressed helped him become proficient at
practical problem solving for his clients. His
'problems' began early. Born into a poor farming
community in Nevada, Erickson didn't speak until
he was four. Later, he was found to have severe
dyslexia, to be profoundly tone deaf and colour
blind. At the age of seventeen, he was paralysed
for a year by a bout of polio so bad that his
doctor was convinced he would die.

Milton H. Erickson
Milton H. Erickson is probably best remembered as
the hypnotherapist who revolutionized
hypnotherapy not only by developing new
therapeutic techniques but also by evolving his
own unique epistemology and ontology. Many
attempts have been made to present and describe
his main principles and practical approach in a
coherent form. O'Hanlon has summarized twelve
different frameworks for Ericksonian therapy and
hypnosis, including one of his own (O'Hanlon,
1987).

Despite his handicaps (or perhaps because of),
Milton Erickson went on to qualify as a medical
doctor and psychiatrist. In the following years
he became the World's greatest practitioner of
therapeutic hypnosis and one of the most
effective psychotherapists ever.

It was perhaps Erickson's farming background
which caused him to approach psychotherapy in
such a practical way. Anyone who is interested in
relieving human misery and developing human
potential will benefit greatly from reading about
and learning from this remarkable man.

When Erickson was in his fifties he was struck
by a second bout of polio that caused him a great
deal of physical pain. Even this he was able to
turn into a learning opportunity as he became
highly effective at treating other people's pain
with hypnosis. He details many of his approaches
to sensory alteration and pain control in
'Hypnotic alteration of sensory, perceptual and
psychological processes' by Milton Erickson.

Despite severe illness in his old age, Milton
Erickson continued to teach, demonstrate and
practice his remarkable skills as a therapist,
even when eventually confined to a wheelchair. He
died at the age of seventy nine.

It was perhaps Erickson's farming background
which caused him to approach psychotherapy in
such a practical way. Anyone who is interested in
relieving human misery and developing human
potential will benefit greatly from reading about
and learning from this remarkable man.

He is noted for
His often unconventional approach to
psychotherapy, such as described in the book
Uncommon Therapy, by Jay Haley, and the book
Hypnotherapy An Exploratory Casebook, by Milton
H. Erickson and Ernest L. Rossi (1979, New York
Irvington Publishers, Inc.)
His extensive use of therapeutic metaphor and
story as well as hypnosis
coining the term Brief Therapy for his approach
of addressing therapeutic changes in relatively
few sessions

His use of interventions that influenced the
strategic therapy and family systems therapy
practitioners beginning in the 1950s including
Virginia Satir and Jay Haley
His conceptualization of the unconscious as
highly separate from the conscious mind, with its
own awareness, interests, responses, and
learnings. For Erickson, the unconscious mind was
creative, solution-generating, and often
positive.
His ability to "utilize" anything about a patient
to help them change, including their beliefs,
favorite words, cultural background, personal
history, or even their neurotic habits.
His influence on Neuro-linguistic Programming
(NLP), which was in part based upon his working
methods 1.

Milton H. Erickson
Milton H. Erickson is probably best remembered as
the hypnotherapist who revolutionized
hypnotherapy not only by developing new
therapeutic techniques but also by evolving his
own unique epistemology and ontology. Many
attempts have been made to present and describe
his main principles and practical approach in a
coherent form. O'Hanlon has summarized twelve
different frameworks for Ericksonian therapy and
hypnosis, including one of his own (O'Hanlon,
1987).

Erickson's practical approach is defined as the
techniques and skills he used during therapy
while the main principles are defined as the
beliefs that he held in relation to doing
therapy. Erickson sometimes said he didn't
understand his own work

Main Principles of Erickson Hypnotherapy

Erickson did not believe it was necessary for
himself or his patient to understand the cause of
a problem in order to resolve it. In his words
"Etiology is a complex matter and not always
relevant to getting over a problem" (Hayley,
1973). This belief is a major shift in thinking
away from a search for independent cause or
truth a search that permeates our modern culture
and one that has perpetuated since the time of
Aristotle (1953).

Erickson also believed that "insight" was an
unimportant and even unnecessary part of therapy,
stating that
"Many psychotherapists regard as almost axiomatic
that therapy is contingent on making the
unconscious conscious. When thought is given to
the immeasurable role the unconscious plays in
the total experiential life of a person from
infancy on, whether awake or asleep, there can be
little expectation of doing more than making
small parts of it conscious" (Erickson, 1980).

Another important element of Erickson's
epistemology was his emphasis on treating each
person as an individual, and not according to
preconceived theories of personality or by
utilizing a rigid approach to therapy. Erickson
had no particular theory or hypothesis about
problems and had no set method of working and
consequently had the flexibility to allow for
alternative explanations and to change his
behavior to match the needs of the individual
client. In addition, he also recognized that
"Your patient is one person today, quite another
person tomorrow, and still another person next
week, next month, next year" (Erickson, 19851).

Erickson also believed in what has been called a
naturalist approach to therapy. His belief was
that people are not only capable of going into
trance and experiencing all possible trance
phenomena but also that they have the natural
abilities needed to overcome their difficulties.

Similarly, Goldstone reports that "Another
important element of Dr. Erickson's work was his
deeply held belief that people innately have
within themselves the strengths, skills,
abilities, talents, resources and knowledge they
need to make whatever kinds of changes they wish
to make" (1998).

Erickson believed that people not only have all
the resources they need but also that "people
will make the best choices they have learned how
to make" (Lankton, 1998), even if they are not
conscious of this or of their process of making
these choices.

Erickson believed that the responsibility for
change rests entirely with the client and the
role of the therapist to create a state of
expectation of change and to provide the climate
in which change can take place. As Erickson
states "In psychotherapy you change no one.
People change themselves. You create
circumstances under which an individual can
respond spontaneously and change. And that's all
you do. The rest is up to them" (O'Hanlon,
1987).

Finally, Erickson believed that his work was
complete when the presenting problem was
resolved. Thus, his premise was that the
long-term goal should always be the immediate
goal and he did not spend time what was "behind"
a symptom.

Practical Approach of Erickson Hypnotherapy
Erickson defined hypnosis as "a state of
special awareness characterized by a
receptiveness to ideas" (Erickson, 19852).
Essentially this state was elicited using
techniques such as suggestion and confusion to
focus or distract the client's conscious
attention in such a way that Erickson could
communicate directly with a client's
unconscious mind. The client would then be able
to learn new behaviors and new ideas from what
was presented. This learning took place in a
trance state in which the client was attentive to
all the information set out and demonstrated by
Erickson the client could then take on board as
much or as little as was appropriate for them.

In order to elicit trance states and to
facilitate change, Erickson utilized whatever the
client brought into therapy, whether it was
beliefs, behaviors, demands or resistance. His
advice was never to reject or try to the behavior
that the client showed in the office. He advised
that "you look at it, you examine it, and you
wonder how you use it" (Erickson, 19852). For
example, if a child sucks his thumb then which
thumb he suck? The left or the right? And
shouldn't he suck the other one? And what about
sucking the fingers? Which one first? After
Erickson repeatedly asked these sort of questions
to one little boy, the boy told his
grandmother "This is making me want to dislike
sucking my thumb!" (Erickson, 19852).

Erickson's acceptance of the patient's ideas and
behaviors for what they were, rather than
rejecting, contradicting or judging them,
contributed to his ability to quickly build
rapport with the patient. He also made use of
biorapport, which is the rhythmical alignment of
some part of his behavior to that of the
client's. Examples are breathing in time
with the client and making movements at the same
time as the client.

Another technique used by Erickson was that of
the double bind. This was asking a question that
gave the illusion of choice, when in fact
whatever choice was made, it would lead to the
desired result. To a patient who said Erickson
could not hypnotize them, Erickson said "I want
you to stay awake, wider and wider awake, wider
and wider awake" (Haley, 1963). Whatever this
client did he was co-operating with Erickson in
the trance induction.

One specific form of double bind was symptom
prescription. According to Watzlawick, Bavelas
and Jackson (1967) this term was first introduced
in the work of the Bateson "Family Therapy in
Schizophrenia" project. This involved prescribing
the symptom but in an exaggerated, modified or
paradoxical way. Erickson once treated a married
couple who had both been bed-wetters for many
years. He had them set their alarm clock to wake
up in the middle of the night and instructed them
both to deliberately wet their bed if their bed
was dry. Thus, Erickson was modifying the
patients' symptoms to make it harder easier
surely for them to do their problem and
also teaching them how to have control over their
symptoms.

Erickson would make use of this sort of specific
task assignment as well as using generic ones so
as to facilitate therapeutic change. The
bed-wetting example above is a specific task.
However, Erickson would often ask a client to
perform a generic task like climbing a local
mountain while thinking about their problem and
then reporting their thoughts back to him.

The use of Metaphors was used by Erickson to
communicate with his clients and he often told
anecdotes from his own experience, about other
clients or simply made them up. His hope was that
the experience of another in overcoming a
problem, which is similar to the client's own,
would suggest ways in which the client could deal
with their situation.

Erickson made use of the processes of framing,
deframing and reframing to alter a client's
perception about a given situation. A frame being
defined as an added meaning given to a sensory
experience. Thus, framing is the process of
giving a meaning where none already exists,
deframing is the process of challenging or
casting doubt on the client's current meaning and
reframing is the process of providing a new or
alternative meaning.

As a hypnotist, Erickson made use of many
hypnotic phenomena. Analgesia was used to teach
clients that they could control when and where
they experienced pain. Amnesia was used to
prevent a client's conscious mind from
interfering with hypnotherapeutic work (Erickson,
19852) and to overcome learned limitations.
According to Erickson "All hypnotic
phenomena are made up of normal everyday patterns
of behavior, organized to serve intentional
purposes for the patient" (Erickson, 19852).

Confusion was another important technique used
by Erickson to contend with the client's
conscious mind, and thereby bypass it. When
solving problems, the person's mind was most
frequently concerned with limiting beliefs and
ideas about how change was not possible. Hence,
Erickson emphasized "that the person's conscious
mind has to be contended with in some manner in
order to gain access to the person's unconscious
abilities" (Erickson, 19851).

In addition, Erickson also developed a state of
confusion in his clients' minds from which they
were more likely to accept what he suggested as a
means of replacing the uncomfortable state of
confusion with a more comfortable state of
understanding. As pointed out by Lankton "a
client will develop a particular receptivity to
incoming information at a point in therapy when
the normal framework has been disrupted and
suspended by an unconditioned stimulus such as a
paradoxical prescription" (1998).

Erickson used both direct and indirect
suggestions to achieve therapeutic goals. In
general, he was very directive when dealing with
symptoms and getting people to do things but very
indirect in how people would resolve their
symptoms and how they would live their lives
afterwards. A direct suggestion might have been
to tell the client to perform a specific
therapeutic task, like buying new clothes or
walking a different way to work. An
indirect suggestion might have been to say
something like "I don't know how quickly you can
learn". This statement indirectly suggested
that the client will learn, it was just a
question of how quickly.

In contrast to many other therapeutic approaches
that focus on exploring the past, Erickson worked
in both a future oriented and goal oriented
manner, eliciting agreed goals with patients and
working together with the patient to
achieve them. As stated by Erickson
"Psychotherapy is sought not primarily for
enlightenment about the unchangeable past but
because of dissatisfaction with the present and a
desire to better the future" (Watzlawick,
Weakland and Fisch, 1974).

Conclusion

Erickson once said "I don't try to structure my
psychotherapy except in a vague, general way"
(O'Hanlon, 1987). Compromises have been made in
deciding what to include and what to omit and
also in deciding the length of each description,
some of which are necessarily brief. In
conclusion, Erickson's own advice was to "Develop
your own technique. Don't try to use somebody
else's technique...Don't try to imitate my voice
or my cadence. Just discover your own. Be your
own natural self" (O'Hanlon, 1987).

Trance and The Unconscious Mind
Erickson believed that the unconscious mind was
always listening, and that, whether or not the
patient was in trance, suggestions could be made
which would have a hypnotic influence, as long as
those suggestions found some resonance at the
unconscious level. The patient can be aware of
this, or she can be completely oblivious that
something is happening. Erickson would see if the
patient would respond to one or another kind of
indirect suggestion, and allow the unconscious
mind to actively participate in the therapeutic
process. In this way, what seemed like a normal
conversation might induce a hypnotic trance, or a
therapeutic change in the subject. It should be
noted that "Erickson's conception of the
unconscious is definitely not the one held by
Freud."5
Erickson was an irrepressible practical joker,
and it was not uncommon for him to slip indirect
suggestions into all kinds of situations,
including in his own books, papers, lectures and
seminars.

Erickson also believed that it was even
appropriate for the therapist to go into trance.
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 maintained that trance is a common,
everyday occurrence. For example, when waiting
for buses and trains, reading or listening, or
even being involved in strenuous physical
exercise, it's quite normal to become immersed in
the activity and go into a trance state, removed
from any other irrelevant stimuli. These states
are so common and familiar that most people do
not consciously recognise them as hypnotic
phenomena.

The same situation is in evidence in everyday
life, however, whenever attention is fixated with
a question or an experience of the amazing, the
unusual, or anything that holds a persons
interest. At such moments people experience the
common everyday trance they tend to gaze offto
the right or left, depending upon which cerebral
hemisphere is most dominant (Baleen, 1969) and
get that faraway or blank look. Their eyes
may actually close, their bodies tend to become
immobile (a form of catalepsy), certain reflexes
(e.g., swallowing, respiration, etc.) may be
suppressed, and they seem momentarily oblivious
to their surroundings until they have completed
their inner search on the unconscious level for
the new idea, response, or frames of reference
that will restabilize their general reality
orientation. We hypothesize that in everyday life
consciousness is in a continual state of flux
between the general reality orientation and the
momentary microdynamics of trance...

Indirect Techniques
Where 'classical' hypnosis is authoritative and
direct, and often encounters resistance in the
subject, Erickson's approach is permissive,
accommodating and indirect. For example, where a
classical hypnotist might say "you are going into
a trance", an Ericksonian hypnotist would be more
likely to say "you can comfortably learn how to
go into a trance". In this way, he provides an
opportunity for the subject to accept the
suggestions they are most comfortable with, at
their own pace, and with an awareness of the
benefits. The subject knows they are not being
hustled, and takes full ownership of, and
participation in their transformation.

Erickson maintained that it was not possible to
consciously instruct the unconscious mind, and
that authoritarian suggestions were likely to be
met with resistance. The unconscious mind
responds to openings, opportunities, metaphors,
symbols, and contradictions. Effective hypnotic
suggestion, then, should be 'artfully vague',
leaving space for the subject to fill in the gaps
with their own unconscious understandings - even
if they do not consciously grasp what is
happening. The skilled hypnotherapist constructs
these gaps of meaning in a way most suited to the
individual subject - in a way which is most
likely to produce the desired change.

For example the authoritative "you will stop
smoking" is likely to find less leverage on the
unconscious level than "you can become a
non-smoker". The first is a direct command, to be
obeyed or ignored (and notice that it draws
attention to the act of smoking), the second is
an opening, an invitation to possible lasting
change, without pressure, and which is less
likely to raise resistance.
Richard Bandler and John Grinder identified this
kind of 'artful vagueness' as a central
characteristic of their 'Milton Model', a
systematic attempt to codify Erickson's hypnotic
language patterns.

Confusion Technique
In all my techniques, almost all, there is a
confusion.7
A confused person has their conscious mind busy
and occupied, and is very much inclined to draw
upon unconscious learnings 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.

James Braid, who coined the term 'hypnosis,'
claimed that focused attention ("look into my
eyes...") was essential for creating hypnotic
trances, indeed, his thesis was that hypnosis was
in essence a state of extreme focus. But it can
be difficult for people wracked by pain, angst or
suspicion to focus on anything at all. Thus other
techniques for inducing 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...

The Handshake Induction
Confusion is the basis of Erickson's famous
hypnotic handshake. Many actions are learned and
operate as a single "chunk" of behavior shaking
hands and tying shoelaces being two classic
examples. If the behavior is diverted or frozen
midway, the person literally has no mental space
for this - he is 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". A skilled hypnotist
can often use that momentary confusion and
suspension of normal processes to induce trance
quickly and easily.

By interrupting the pattern of a 'normal'
handshake in some way, the hypnotist causes the
subject to wonder what is going on. If the
handshake continues to develop in a way which is
out-of-keeping with expectations, a simple,
non-verbal trance is created, which may then be
reinforced or utilized by the hypnotist. All
these responses happen naturally and
automatically without telling the subject to
consciously focus on an idea.

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.

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 a 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.
strong push or nudge is required, check for
anaesthesia.

Utilization Any utilization leads to increasing
trance depth. All utilization 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

Richard Bandler was a keen proponent of the
handshake induction, and developed his own
variant, which is commonly taught in NLP
workshops.
Any habitual pattern which is interrupted
unexpectedly will cause sudden and light trance.
The handshake is a particularly good pattern to
interrupt because the formality of a handshake is
a widely understood set of social rules. Since
everyone knows that it would be impolite to
comment on the quality of a handshake, regardless
of how strange it may be, the subject is obliged
to embark on an inner search (known as a
transderivational search, a universal and
compelling type of trance) to identify the
meaning or purpose of the subverted pattern.

Resistance
Erickson recognised that many people were
intimidated by hypnosis and the therapeutic
process, and took care to respect the special
resistances of the individual patient. In the
therapeutic process he said that "you always give
the patient every opportunity to resist". Here
are some more relevant quotes pertaining to
resistance
Whatever the behaviour offered by the subjects,
it should be accepted and utilized to develop
further responsive behaviour. Any attempt to
"correct" or alter the subjects' behaviour, or to
force them to do things they are not interested
in, militates against trance induction and
certainly deep trance experience.

If the patient can be led to accept one
suggestion, they will more readily accept others.
With resistant patients, it becomes necessary to
find a suggestion that they can accept.
Resistance is always important, and should always
be respected, so if the resistance itself is
encouraged, the patient is made to feel more
comfortable, because they know that they are
allowed to respond however they wish.
Many times, the apparently active resistance
encountered in subjects is no more than an
unconscious measure of testing the hypnotist's
willingness to meet them halfway instead of
trying to force them to act entirely in accord
with his ideas.

Although the idea of working with resistance is
essentially a hypnotic one, it goes beyond
hypnosis and trance. In a typical example, a girl
that bit her nails was told that she was cheating
herself of really enjoying the nail biting. He
encouraged her to let some of her nails grow a
little longer before biting them, so that she
really could derive the fullest pleasure from the
activity. She decided to grow all of her nails
long enough that she might really enjoy biting
them, and then, after some days, she realised
that she didn't want to bite them anyway.

Ericksonian Therapy
Erickson is most famous as a hypnotherapist, but
his extensive research into and experience with
hypnosis led him to develop an effective
therapeutic technique. Many of these techniques
are not explicitly hypnotic, but they are
extensions of hypnotic strategies and language
patterns. Erickson recognised that resistance to
trance resembles resistance to change, and
developed his therapeutic approach with that
awareness.

Jay Haley identified several strategies, which
appeared repeatedly in Erickson's therapeutic
approach.
Encouraging Resistance - For Erickson, the
classic therapeutic request to "tell me
everything about..." was both aggressive and
disrespectful, instead he would ask the resistant
patient to withhold information and only to tell
what they were really ready to reveal
I usually say, "There are a number of things that
you don't want me to know about, that you don't
want to tell me. There are a lot of things about
yourself that you don't want to discuss,
therefore let's discuss those that you are
willing to discuss." She has blanket permission
to withhold anything and everything. But she did
come to discuss things. And therefore she starts
discussing this, discussing that. And it's always
"Well, this is all right to talk about." And
before she's finished, she has mentioned
everything. And each new item - "Well, this
really isn't so important that I have to withhold
it. I can use the withholding permission for more
important matters." Simply a hypnotic technique.
To make them respond to the idea of withholding,
and to respond to the idea of communicating.

Many people's reaction to a direction is to think
"why should I?" or "You can't make me", called a
polarity response because it motivates the
subject to consider the polar opposite of the
suggestion. The conscious mind recognizes
negation in speech ("Don't do X") however the
unconscious mind pays more attention to the "X"
than the injunction "Don't do". Erickson used
this as the basis for suggestions that
deliberately played on negation and tonally
marked the important wording, to provide that
whatever the client did, it was beneficial "You
don't have to go into a trance, so you can easily
wonder about what you notice no faster than you
feel ready to become aware that your hand is
slowly rising....."

Providing a Worse Alternative (The 'Double Bind')
- Example "Do you want to go into a trance now,
or later?" The 'double bind' is a way of
overloading the subject with two options, the
acceptance of either of which represents
acceptance of a therapeutic suggestion.
My first well-remembered intentional use of the
double bind occurred in early boyhood. One winter
day, with the weather below zero, my father led a
calf out of the barn to the water trough. After
the calf had satisfied its thirst, they turned
back to the barn, but at the doorway the calf
stubbornly braced its feet, and despite my
fathers desperate pulling on the halter, he
could not budge the animal. I was outside playing
in the snow and, observing the impasse, began
laughing heartily. My father challenged me to
pull the calf into the barn. Recognizing the
situation as one of unreasoning stubborn
resistance on the part of the calf, I decided to
let the calf have full opportunity to resist,
since that was what it apparently wished to do.
Accordingly I presented the calf with a double
bind by seizing it by the tail and pulling it
away from the barn, while my father continued to
pull it inward. The calf promptly chose to resist
the weaker of the two forces and dragged me into
the barn.10

Communicating by Metaphor - This is explored
extensively in Sydney Rosen's 'My Voice Will Go
With You', but a beautiful example is given in
the first chapter of David Gordon's book Phoenix
I was returning from high school one day and a
runaway horse with a bridle on sped past a group
of us into a farmer's yard looking for a drink of
water. The horse was perspiring heavily. And the
farmer didn't recognize it so we cornered it. I
hopped on the horse's back. Since it had a bridle
on, I took hold of the tick rein and said,
"Giddy-up." Headed for the highway, I knew the
horse would turn in the right direction. I didn't
know what the right direction was. And the horse
trotted and galloped along. Now and then he would
forget he was on the highway and start into a
field. So I would pull on him a bit and call his
attention to the fact the highway was where he
was supposed to be. And finally, about four miles
from where I had boarded him, he turned into a
farm yard and the farmer said, "So that's how
that critter came back. Where did you find him?"
I said, "About four miles from here." "How did
you know you should come here?" I said, "I didn't
know. The horse knew. All I did was keep his
attention on the road."

Encouraging a Relapse - To bypass simple
short-lived 'obedience' which tends to lead to
lapses in the absence of the therapist, Erickson
would occasionally arrange for his patients to
fail in their attempts to improve, for example by
overreaching. Failure is part of life, and in
that fragile time where the patient is learning
to live, think and behave differently, a random
failure can be catastrophic. Deliberately causing
a relapse allowed Erickson to control the
variables of that failure, and to cast it in a
positive therapeutic light for the patient.

Encouraging a Response by Frustrating It - This
paradoxical approach acts directly on the
patient's own resistance to change. Obese
patients are asked to gain weight, or in a family
therapy session, a stubbornly silent family
member is ignored until the frustration obliges
them to blurt out some desperate truth. Once
again, this approach has its roots in Erickson's
hypnotic language patterns of the form "I don't
want you to go into a trance yet".

Utilizing Space and Position - Hypnosis and
therapy are experienced subjectively by the
patient, and any part of their total experience
can be used to reinforce an idea. The physical
position or even the posture of the patient can
be a significant part of the subjective
experience. Manipulating these factors can
contribute to a therapeutic transformation.
If I send someone out of the room - for example,
the mother and child - I carefully move father
from his chair and put him into mother's chair.
Or if I send the child out, I might put mother in
the child's chair, at least temporarily.
Sometimes I comment on this by saying, 'As you
sit where your son was sitting, you can think
more clearly about him.' Or, 'If you sit where
your husband sat, maybe it will give you somewhat
of his view about me'. Over a series of
interviews with an entire family, I shuffle them
about, so that what was originally mother's chair
is now where father is sitting. The family
grouping remains, and yet that family grouping is
being rearranged, which is what you are after
when changing a family."11

Emphasizing the Positive - Erickson claimed that
his sensory 'disabilities' (dyslexia, colour
blindness, being tone-deaf) helped him to focus
on aspects of communication and behavior which
most other people overlooked. This is a typical
example of emphasizing the positive.Erickson
would often compliment the patient for a symptom,
and would even encourage it, in very specific
ways. In one amusing example, a woman whose
parents-in-law caused her nauseous feelings in
the gut every time they visited unexpectedly was
'taught' to puke spectacularly whenever the
visits were especially inconvenient. Naturally
the parents-in-law would always sympathetically
help her clean up the vomit. Fairly soon, the
annoying relatives started calling in advance
before turning up, to see if she were 'well
enough' to see them.The subject of dozens of
songs, 'emphasizing the positive' is a well known
self-help strategy, and can be compared with
'positive reformulation' in Gestalt Therapy.

Prescribing the Symptom and Amplifying a
Deviation - Very typically, Erickson would
instruct his patients to actively and consciously
perform the symptom that was bothering them (see
the nailbiting example under Resistance),
usually with some minor or trivial deviation from
the original symptom. In many cases, the
deviation could be amplified and used as a
'wedge' to transform the whole behaviour.

INTERVIEWER Suppose someone called you and said
there was a kid, nineteen or twenty years old,
who has been a very good boy, but all of a sudden
this week he started walking around the
neighborhood carrying a large cross. The
neighbors are upset and the family's upset, and
would you do something about it. How would you
think about that as a problem? Some kind of
bizarre behavior like that.
ERICKSON Well, if the kid came in to see me, the
first thing I would do would be to want to
examine the cross. And I would want to improve it
in a very minor way. As soon as I got the
slightest minor change in it, the way would be
open for a larger change. And pretty soon I could
deal with the advantages of a different cross -
he ought to have at least two. He ought to have
at least three so be could make a choice each day
of which one. It's pretty hard to express a
psychotic pattern of behavior over an ever
increasing number of crosses.12

Seeding Ideas - Erickson would often ensure that
the patients had been exposed to an idea, often
in a metaphorical form (i.e. hidden from the
conscious mind) in advance of utilizing it for a
therapeutic purpose. He called this 'seeding
ideas', and it can be observed to occur at many
levels both coarse and fine grained, in many of
his case histories. In a simple example, the
question "Have you ever been in a trance before?"
seeds the idea that a trance is imminent - the
presupposition inherent in the word before is
"not now, but later".

Avoiding Self-Exploration - In common with most
brief therapy practitioners, Erickson was
entirely uninterested in analysing the patient's
early psychological development. Occasionally in
his case histories, he will briefly discuss the
patient's background, but only as much as it
pertains to the resources available to the
patient in the present.
INTERVIEWER You don't feel that exploring the
past is particularly relevant? I'm always trying
to get clear in my mind how much of the past I
need to consider when doing brief therapy.
ERICKSON You know, I had one patient this last
July who had four or five years of psychoanalysis
and got nowhere with it. And someone who knows
her said, "How much attention did you give to the
past?" I said, "You know, I completely forgot
about that." That patient is, I think, a
reasonably cured person. It was a severe washing
compulsion, as much as twenty hours a day. I
didn't go in to the cause or the etiology the
only searching question I asked was "When you get
in the shower to scrub yourself for hours, tell
me, do you start at the top of your head, or the
soles of your feet, or in the middle? Do you wash
from the neck down, or do you start with your
feet and wash up? Or do you start with your head
and wash down?"
INTERVIEWER Why did you ask that?
ERICKSON So that she knew I was really
interested.
INTERVIEWER So that you could join her in this?
ERICKSON No, so that she knew I was really
interested.13

Shocks and ordeals
Erickson is famous for pioneering indirect
techniques, but his shock therapy tends to get
less attention, perhaps because it is
uncomfortable for us to hear such
uncharacteristic stories about an inspirational
and gentle healer. Nonetheless, Erickson was
prepared to use psychological shocks and ordeals
in order to achieve given results

When the old gentleman asked if he could be
helped for his fear of riding in an elevator, I
told him I could probably scare the pants off him
in another direction. He told me that nothing
could be worse than his fear of an elevator.
The elevators in that particular building were
operated by young girls, and I made special
arrangements with one in advance. She agreed to
cooperate and thought it would be fun. I went
with the gentleman to the elevator. He wasn't
afraid of walking into an elevator, but when it
started to move it became an unbearable
experience. So I chose an unbusy time and I had
him walk in and out of the elevator, back in and
out. Then at a point when we walked in, I told
the girl to close the door and said, "Let's go
up."

She went up one story and stopped in between
floors. The gentleman started to yell, "What's
wrong!" I said, "The elevator operator wants to
kiss you." Shocked, the gentleman said, "But I'm
a married man!" The girl said, "I don't mind
that." She walked toward him, and he stepped back
and said, "You start the elevator." So she
started it. She went up to about the fourth floor
and stopped it again between floors. She said, "I
just have a craving for a kiss." He said, "You go
about your business." He wanted that elevator
moving, not standing still. She replied, "Well,
let's go down and start all over again," and she
began to take the elevator down. He said, "Not
down, up!" since he didn't want to go through
that all over again.
She started up and then stopped the elevator
between floors and said, "Do you promise you'll
ride down in my elevator with me when you're
through work?" He said, "I'll promise anything if
you promise not to kiss me." He went up in the
elevator, relieved and without fear - of the
elevator - and could ride one from then on.14

References
Gorton, Gregg E (2005). Milton Hyland Erickson
The American Journal of Psychiatry. Washington.
Vol.162, Iss. 7 pg. 1255, 1 pgs
Autohypnotic Experiences of Milton H. Erickson
(Milton H. Erickson and Ernest L. Rossi), The
American Journal of Clinical Hypnosis, July. 1977
20, 36-54, reprinted in Collected Papers Volume
1.
Autohypnotic Experiences of Milton H. Erickson
(Milton H. Erickson and Ernest L. Rossi), The
American Journal of Clinical Hypnosis, July. 1977
20, 36-54, reprinted in Collected Papers Volume
1.
Rosen, S. My Voice Will Go With You
Andre M. Weitzenhoffer (1976)
Introduction/forward in Hypnotic Realities
Erickson Rossi
Erickson Rossi Two-Level Communication and
the Microdynamics of Trance and Suggestion, The
American Journal of Clinical Hypnosis, 1976
Reprinted in Collected Papers Vol.1
Erickson Rossi - Hypnotic Realities
Erickson Rossi - Hypnotic Realities
Transcription of Interview with Erickson quoted
in Uncommon Therapy by Jay Haley.
Varieties of Double Bind Erickson Rossi, The
American Journal of Clinical Hypnosis, January
1975.Reprinted in 'Collected Papers' Volume 3.
Erickson quoted in Uncommon Therapy by Jay
Haley.
Erickson quoted in Uncommon Therapy by Jay
Haley.
Interview with Erickson transcribed in Uncommon
Therapy by Jay Haley.
Erickson quoted in Uncommon Therapy by Jay
Haley.

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Despite its detractors, well run government saved
America during the depression. Though some blame
the democrats for creating the welfare state, it
pulled the country out of a devastating
depression, and is directly responsible for a
good deal of the wealth of today. Things such a
dental care, public health, public education,
public higher education, good water systems, all
came out of the New Deal, Public Works Projects
and other governmental programs that began in the
1930s under FDR. These were very brave ideas at
the time and fit a spirit of entrepreneurship.

Profit, nonprofit and private not for profit
organizations
Business has fundamental differences with
governmental parameters. At the heart of business
is profit while service is at the heart of
government. Business gets is revenue from profits
or sales, while government gets it from taxes.
The priority for a government work is to not make
a mistake that gets him noticed. For the business
man it is to make a profit, regardless of how
many mistakes he makes. The concept of risk is
vastly different.

Privatization of human service organizations

This has been a push for the past several
decades. One thought is that privatization puts
money directly into the local economy through
private providers and that this should always be
viewed as the preferred function of government.
The counter to this is that when private
providers are used that there is a presumption
that profit is being made in the delivery of
services to the public and that his can lead to
price gouging or conflict of interest. (ie. That
the private provider would tend to maximize those
services that provided the provider with the
highest profit, further the provision of services
by a provider would more likely tend to meet the
bid specs vs the true need in a dynamic society,
locking the system in place long after the need
had changed or been eliminated.) A counter
argument can be made for government in this area.

For instance we still have an agency who ensures
that we keep national helium reserves dating back
to the days of the dirigibles or blimps incase
the government ever decides to float a fleet of
them again. One argument for privatization is
the idea that private business can alter or
retool more quickly in its provision of services
than government and that their motivation to
change can be more readily affected, that they
will tend to be more aware of the needs of the
customer. It is rare private business that does
not take pains to ensure that its product is what
the customer wants. The watch word for the 1990s
was viewing the recipient of services as a
customer and react accordingly. Some compromise
is clearly needed. We want the best of good
business operating with the understanding of good
government of the particular needs of the
populace.

Alternatives to standard service delivery
Traditional functions
Creating legal rules and sanctions
Regulation or deregulation
Monitoring and investigation
Licensing
Tax policy
Grants
Subsidies
Loans
Loan Guarantees
Contracting

Innovative
Franchising
Public-private partnerships
PubicPublic partnerships
Quasi-public corporations
Public enterprise
Procurement
Insurance
Rewards
Changing public investment policy
Technical Assistance
Information
Referral
Volunteers
Vouchers
Impact fees
Catalyzing nongovernmental efforts
Convening nongovernmental leaders

Avant-Garde
Seed money
Euity investments
Voluntary associations
Coporductoin or self-help
Quid Pro Quos
Demand management
Sale, exchange, or use of property
Restructuring the market

Is your organization open to new ideas from all
levels, or must ideas come up through the chain.
Can one part of an organization meet with another
and share ideas or enter a joint venture or try
out a new idea together. Vertical organizations
have a top down chart. Information travels down
from boss to boss to boss and information travels
up the same way. In a horizontal organization
there is a presumption that every one knows their
respective jobs and is competent and motivated to
do it, so the typical management structure is
much less needed. Much as a chief of staff at a
hospital. Yes the chief manages, but he does not
attempt to tell the doctors under him what to do,
the management is more directed to coordination
of ideas and methods, not enforcing methods. Some
jobs are more open to this sort of management.
The argument is that all jobs would benefit from
more of the horizontal approach as the vertical
arrangements tend to smother creativity.

Agency study methodology
Total Quality management processes
Quality circles
Bottom up assessment, customer sensitivity.

Organization
social units deliberately constructed and
reconstructed to seek specific goals.
an organization is a collection of people
engaged in specialized and interdependent
activity to accomplish a goal or mission.
as systems of continuous, purposive,
goal-oriented activity involving two or more
people.
Note that any group can be considered an
organization. In this context the key is
together toward a goal, a goal directed group.
This could be a Seal Team from Rainbow Six, a
garden club, a Sunday School class.

Important are the rules that the group sets for
itself and how it elects to make decisions. In
systems theory we have seen how the system can be
greater than its parts, or a system can develop a
life of its own. The organization theory holds
the same for the organization of group. There are
many instances in human history that reflect
this. The ice age mastodon hunters were able to
bring down an animal hundreds of times their size
through an organized approach, doing something a
single person could never do. Imagine for a
minute why this might be possible.

Consider a troup of 100 spear wielding people
attacking a mastodon one at a time with no
organization. 100 flattened corpes left, 1 mildly
bored mastodon. With organization (read clan of
the cave bear), a few brave and quick hunter can
amplify the strength and catch the animal in
areas of vulnerability. How did this occur? Did a
wise iceman suddenly see how it might be done?
Anthropologists suggest that this behavior came
to the ice age people from viewing the wolf
packs. Fossil and cave paintings reflect the
reverence for wolves. They dressed in their skins
and performed ritualized dances in honor of the
wolf. It would much less of a jump for a poorly
organized troup to learn from observing a wolf
pack bringing down a large bison or elk and from
there make tentative attempts with larger animals
by mimicking the same strategies.

Are we then a modern pack of wolves and have this
in our heritage? The definition of an
organization goal fits this model the desired or
intended ends or results to be achieved by an
organization or as a desired state of affairs
which the organization attempts to realized, can
be well viewed through the eyes of the wolf pack,
the ice mens tribe, the Seal team, the workers
in a unit, the community group, the union
members, Sunday school class, or the Optimist
club. Each form from shared goals and are the
most effective when they share a vision that
contributes to the overall survival and
maintenance of the organization.

Social care goals are those directed to changing
the environment in order for people to improve
the quality of their lives and reach maximum
potential.

Social control relates to control of other who
might interfere with their own goals or the goals
of others.
Rehabilitation are those directed toward changing
individuals so they will have improved quality of
life and better opportunity to reach their
fullest potential.

Goal Displacement is when a new goal contradicts
an existing one.
Goal succession is when one goal is replaced by
another, such as when a drunk challenges someone
to step out side and when the other stands,
reveals that he is 68 and weighs 250 with no
neck and his goal alters to finding a back door
to slip out quietly.

Scientific or classical management theory
Frederick Taylor, an engineer, cir 1895, put
forth this model for organizational management.
Efficiency
Effectiveness

Science of work
Scientific selection and training of staff
Managements work with staff in implementation
Managements planning and development of
procedural rules for staff to follow

Bureaucracy
Classic model of organizations put forth by Max
Weber (1864-1920)
It can be synonymous with organization.
stable and officially stated structure of
authority, an organizational chart.
a hierarchy clearly defines who is over whom
a record of transactions, regulations, and
policies kept over time
specialized training for management
official duties take precedence
follows stable rules
career oriented approach to work
management is apart from owners
management has authority to delegate resources

Why does it now have a negative stereotype?
During the late 1940s and through the 1950s in
America there was much more exposure to heavy
industry than ever before for most of Americans.
During the building of heavy industry for WWII
there was a tremendous growth in companies. Small
machine shops that had ten to 20 workers suddenly
faced staffing major production lines of hundreds
and even thousands of employees. This required a
tremendous shift in the development of rules and
policies that felt to be necessary in the
maintenance of large production lines and large
numbers of staff. With the downsizing that came
following the end of the war and even more
following the end of the Korean conflict, these
massive bureaucracies were viewed from the
smaller, newer companies that took the place of
the larger more well established company.

Also, the new business climate was much
different. Instead of building more of what was
being built, new ideas resulted in new inventions
and new wealth (the 1950s were a time of great
prosperity, due in part to the energy of men
returning from the war who came back trained,
used to a certain life style, exposed to new
ideas, and the GI bill). With new wealth came
demand for goods, both new and old. People wanted
new cars with new and better options, new
refrigerators, newly designed radios, recording
processes, television, color television, etc. all
required a different sort of company, one that
could adjust to a new product, envision a new
product based on its need, get the new product
into production and into the market quickly.
Companies had to be able to completely retool in
a matter of months or even weeks, a task that
used to take years if not end the life of most
companies.

This requires a much more flexible approach to
management and some of the regulations became to
be seen in a negative light, as standing in the
way of progress. The Old guard was often let go
as they had difficulty letting loose of the tight
strands of red tape that held the old
organization (and their positions in it in place.

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This set the stage for human relations theory of
organizational management. The old operated on
the notion of X or Y theory. The management
viewed production staff as only interested in
tangible rewards or punishments in terms of how
they would respond to management. This was called
X theory of management. At the other end of the
spectrum was the career management person who was
felt to be in his place due to company loyalty
and a shared vision. This reflected the Y theory,
that someone does something for more intrinsic
rewards instead of extrinsic rewards.

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X inherent dislike for work must be forced or
threatened directly with job loss or pay loss
inherent preference for being directed and shuns
responsibility. Security critical
(better fits with the classical approach)

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Y expects to work as a part of life goals self
directed to objectives to which they are
commited self actualization is highest goal
wants responsibility untapped creativity pool
untapped potential in everyone.
(better fits with the human relations approach)