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Hope and Resiliency: Understanding the Psychotherapeutic Strategies of Milton H. Erickson

By Dan Short, Ph.D., Betty Alice Erickson, M.S., L.P.C. and Roxanne Erickson Klein, R.N., Ph.D.

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Published by Crown House Publishing, Ltd., Wales, U. K.


Copyright 2006

Reviewed by Judith E. Pearson, Ph.D., L.P.C.

Followers of Dr. Milton H. Erickson are sure to find pleasure and education in Hope and Resiliency, a new analysis of his philosophy and work. Dr. Dan Short has teamed up with two of Erickson's daughters to write this book that is based on case histories, Erickson's own writings, and personal anecdotes from Betty Alice Erickson and Roxanne Erickson Klein. The book begins with a biographical history of Erickson's life and then explains six therapeutic strategies that the authors consider to be the basic cornerstones of his professional success with clients for whom he was often a "last resort."

Biographical History

Milton H. Erickson was born in 1901 in the Nevada Sierras in a log cabin with a dirt floor, the second of nine children born to Albert and Clara Erickson. His was a farming family. At age 19 he was stricken with polio and the paralysis left him an invalid; so ill in fact that at one point the family doctor told his mother that her son would die by the next morning.

Through an arduous year of self-rehabilitation, the young Erickson learned to walk again and attended the University of Wisconsin, graduating in 1927 with a medical degree in psychiatry. He held many appointments at prestigious institutions; his last spanned 14 years at Wayne County Hospital near Detroit.

He had three children by his first marriage and five more by his second wife, Elizabeth, his life-long partner. In the late 1940s he moved to Phoenix, Arizona and began a private practice. He also traveled as a lecturer, writer, and consultant and was a nationally-recognized expert on clinical hypnosis. In 1957 he founded the American Society of Clinical Hypnosis.

During the last three decades of his life, post-polio syndrome brought constant, debilitating pain and paralysis. Nevertheless, he continued working from his home, even while confined to a wheelchair. Throughout those years he exuded a love of life, a delight in simple pleasures, a quick wit, a sharp mind, and a keen sense of humor. His life was characterized by hope and resiliency and these were the gifts he gave to colleagues, patients, and students.

Erickson's Approach to Psychotherapy

Part II of Hope and Resiliency describes Erickson's therapeutic approach: the fundamental dynamics of healing and the clinical relationship as Erickson saw them and applied them. Erickson, for example, did not promote the concept of "cure". Instead, he was interested in helping people adjust to their circumstances. While he worked to reduce suffering, he did not expect perfection from his patients. He encouraged them to make small changes that often led to bigger accomplishments.

He recognized that learning requires effort and exhorted his patients to take action to solve their problems, no matter how small or insignificant those actions might seem. Erickson took a holistic view of physical and mental health, always working from within each patient's frame of reference. He respected the right of personal choice. He re-educated his patients through experiential learning.

Erickson favored and fostered a relationship of trust and collaboration with his patients (even children) believing that the therapist should "always let patients follow their own spontaneous ways of doing things." His style was to offer possibilities, support individual growth, and let each person find a unique path to healing. Respect for individuality was Erickson's hallmark.

Six Core Clinical Strategies

"It is difficult to find another single approach to psychotherapy that incorporates as many strategies for healing as the Erickson approach." (p. 37)

The authors delineate six core clinical strategies that Erickson used as the foundation of his work. A chapter is devoted to each strategy. These six strategies are listed below, with brief definitions.

Distraction: This strategy relies on directing the patient's attention away from the problem toward a seemingly irrelevant task, another problem or challenge, a capability, or another aspect of the problem previously not considered. The shift in attention often solves the original problem or causes the patient to move beyond a limitation, by doing something that previously seemed impossible.

Partitioning: This process involves re-chunking and restructuring the symptom in terms of complexity, goals, duration, resources and attention. By breaking the problem into smaller unites, small successes are more easily achieved. One example is "splitting": proposing the existence of opposites as two or more components of the problem or solution, each of which can be addressed separately.

Progression: This method employs the incremental use of assignments and/or instructions to increase the patient's response. Erickson had his patients start out with small successes and discoveries that gradually led to larger ones. He once stated, "Even the smallest breakthrough can serve as the foundation on which other accomplishments are built."

Suggestion: Essentially, suggestion is the basis of all therapy. Erickson made the point that the therapist's confidence in his or her ability conveys a powerful suggestion that the patient will be helped.

Reorientation: This is assigning new interpretations of events, creating new meanings and asking questions that create insights. Additional methods include externalizing the problem, and changing one's perspective with respect to time (age regression, age progression, and time distortion).

Utilization: This is recognizing and using the patient's behavioral, emotional and intellectual predispositions as a fundamental treatment component. "A previously unrecognized potential is employed to achieve any outcome that will be helpful or appealing to the individual." (p. 189)

The authors note that the six strategies are not mutually exclusive and do not constitute an exhaustive list of Erickson's methods, but are only a "brief introduction" to the full range of Erickson's work. The authors prudently discuss contraindications for each strategy. They remind readers of the principal directive of Erickson's teachings: Structure each therapeutic intervention for the needs and personality of the individual.

Referring to the title of this book, the authors point out that hope promotes healing and reduces suffering. Erickson inspired hope by engaging patients in the therapeutic process---giving them tasks to perform and implying that by performing such tasks the client would derive beneficial results. Erickson encouraged resiliency by helping patients find an inner source of personal strength and capability, even in the face of disability.

Conclusion

Erickson-inspired therapists will truly enjoy Hope and Resiliency as an addition to the ever-expanding body of literature on the world's best known hypnotherapist. This book's unique contribution is the thorough description of the six core strategies of Erickson's work. The case studies and anecdotes from the Erickson archives make for good reading as well as apt illustrations of the strategies.

This book shows that Erickson used more than hypnosis in his approach. His ability to align himself with his patients, assess their personalities and eccentricities, put their symptoms and strengths into new perspectives, and his creativity in prescribing solution-oriented assignments were as essential to his many successes as his skill in clinical hypnosis. The authors give insights into Erickson's reasoning as well as the manner in which he laid the groundwork to ensure each patient's compliance and acceptance.

Even 25 years after his death, there is still a fascination with the genius of Milton Erickson and as Short, Erickson, and Klein prove, there is still more to learn about this remarkable physician.

To purchase Hope and Resiliency, go online and visit  HYPERLINK http://www.crownhouse.co.uk" www.crownhouse.co.uk (for readers in the U.K. and Europe) or  HYPERLINK "http://www.CHPUS.com" www.CHPUS.com (for readers in the U.S. and Canada).