November
2018
Uncommon Therapy,
the Psychiatric Techniques of Milton H. Erickson, is the title of a book by
Jay Haley on the strategies and practices of Erickson, the father of modern
hypnotherapy. Fundamental to how
Erickson worked was just getting to know how the patient thought and interacted
in their world, their potential, the things that mattered to them and then utilizing
this knowledge in therapy. For him, the patient was unique, first and foremost.
He said that the therapist needs to be flexible conceptually and behaviourally
to respect, respond, or redirect the patient’s potential to the full benefit of
themselves.
A lot of
therapeutic practices are driven by theory and preconceived classifications and
notions of what good therapy should be so the perspectives of the therapist
tends to dominate where the therapy goes. I’m thinking here of certain aspects of psychoanalysis,
or the medical model and increasingly the health insurance model that utilizes
psychiatric classifications of mood and behavioural problems as set entities,
or the idea that mere symptom control is sufficient in every situation, or that
therapy needs to be swift and superficial all the times, etc. For some practitioners of these one-size-fits-all
therapies, an alternative model based on the fact that each case, each person,
is unique tends to be seen as bizarre.
Erickson
(1901-1980), an American psychiatrist and psychotherapist, went elsewhere. He
chose a therapeutic approach particular to the individuality of the person
before him and worked that way. Unique people require unique therapeutic
approaches that utilize their uniqueness and we are all unique. This took the
form of traditional sessions in his consulting room, or he insisted a client
climb a particular Arizonian peak or visit a botanic garden, or he invited his
patient to watch television at a set time each day with his family (shock,
horror), or to work in his garden, or home visits, and so on. This was very
much uncommon therapy. It was flexible, it listened to the hang-ups, the
foibles, the strengths, the frailties, the needs as well as the non-needs of
each person and utilized them. But
before doing therapy of this kind, Erickson needed to be with the person’s experience,
to listen, to question, to get a feel for the person.
It is
interesting that, in a desire to practically bottle Erickson’s presence and approach,
numerous of his followers tried to pin what he did down to a formulation of his
style and personality to be imitated by others, as though this was even
possible. Erickson, like you, like me, was unique. He lived according to
himself. He could not hear tonality in speech and music was dead to him, he was
colour blind (able to see only the colour purple), he had been crippled by
polio and post-polio syndrome in his 50s, he was talented, flawed, obstinate,
highly intelligent, dogged, frail, methodical, practical, scientific even. What
he did was listen to what people said and how they said it, he interacted with
them (and the therapeutic relationship is critical to effective work), he
supported, he created safety, he held back from getting in the way of good
therapy and he did what was required. But not always. He sometimes missed the
mark, just like all therapists.
His was an
uncommon therapy. He used a more traditional hypnotic induction techniques in
his work, but not always. Sometimes he just did an ordinary act differently in
order to get a person out of their conditioned, trancelike way of thinking. Sometimes
he just talked of ordinary things a patient loved to do, like growing tomatoes
that had the effect of reconnecting the person to other parts of their lives
and thus initiating their psychological healing. In other words, Erickson
played with the known and the unknown and thus stimulated change.
I like
Erickson’s thinking and the freedom he has brought to me through his writing
and my contact with therapists trained by him to work according to the me-ness
of me, and not as a tired imitation of him, or anybody else. This is what
drives me: to meet with my patients where they are and where I am in these
unchartered waters of an uncommon therapy and work there effectively.
