Erickson's use of interventions influenced the strategic therapy and family systems therapy practitioners beginning in the 1950s among them, Virginia Satir and Jay Haley. He was noted for 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.
Through conceptualizing the unconscious as highly separate from the conscious mind, with its own awareness, interests, responses, and learnings, he taught that the unconscious mind was creative, solution-generating, and often positive.
He was an important influence on Neuro-linguistic Programming (NLP), which was in part based upon his working methods .
Erickson grew up in Lowell, Wisconsin in a modest farming family, and intended to become a farmer like his father. He was a late developer, and was both dyslexic and color blind. He overcame his dyslexia, and had many other inspirations via a series of spontaneous autohypnotic "flashes of light" or "creative moments", as described in the paper Autohypnotic Experiences of Milton H. Erickson
At age 17, he contracted polio, and was so severely paralysed that the doctors believed he would die. On the critical night where he was at his worst, he had another formative "autohypnotic experience".
E: As I lay in bed that night, I overheard the three doctors tell my parents in the other room that their boy would be dead in the morning. I felt intense anger that anyone should tell a mother her boy would be dead by morning. My mother then came in with as serene a face as can be. I asked her to arrange the dresser, push it up against the side of the bed at an angle. She did not understand why, she thought I was delirious. My speech was difficult. But at that angle by virtue of the mirror on the dresser I could see through the doorway, through the west window of the other room. I was damned if I would die without seeing one more sunset. If I had any skill in drawing, I could still sketch that sunset.
R: Your anger and wanting to see another sunset was a way you kept yourself alive through that critical day in spite of the doctors' predictions. But why do you call that an autohypnotic experience?
E: I saw that vast sunset covering the whole sky. But I know there was also a tree there outside the window, but I blocked it out.
R: You blocked it out? It was that selective perception that enables you to say you were in an altered state?
E: Yes, I did not do it consciously. I saw all the sunset, but I didn't see the fence and large boulder that were there. I blocked out everything except the sunset. After I saw the sunset, I lost consciousness for three days. When I finally awakened, I asked my father why they had taken out that fence, tree, and boulder. I did not realize I had blotted them out when I fixed my attention so intensely on the sunset. Then, as I recovered and became aware of my lack of abilities, I wondered how I was going to earn a living. I had already published a paper in a national agricultural journal. "Why Young Folks Leave the Farm." I no longer had the strength to be a farmer, but maybe I could make it as a doctor.
Recovering, still almost entirely lame in bed, and unable to speak, he became strongly aware of the significance of non-verbal communication - body language, tone of voice and the way that these non-verbal expressions often directly contradicted the verbal ones.
I had polio, and I was totally paralyzed, and the inflammation was so great that I had a sensory paralysis too. I could move my eyes and my hearing was undisturbed. I got very lonesome lying in bed, unable to move anything except my eyeballs. I was quarantined on the farm with seven sisters, one brother, two parents, and a practical nurse. And how could I entertain myself? I started watching people and my environment. I soon learned that my sisters could say "no" when they meant "yes." And they could say "yes" and mean "no" at the same time. They could offer another sister an apple and hold it back. And I began studying nonverbal language and body language.
I had a baby sister who had begun to learn to creep. I would have to learn to stand up and walk. And you can imagine the intensity with which I watched as my baby sister grew from creeping to learning how to stand up.
He began to recall "body memories" of the muscular activity of his own body. By concentrating on these memories, he slowly began to regain control of parts of his body to the point where he was eventually again able to talk and use his arms. Still unable to walk, he decided to train his body further, by embarking - alone - on a thousand mile canoe trip with only a few dollars. After this grueling trip, he was able to walk with a cane. This experience may have contributed to Erickson's technique of using "ordeals" in a therapeutic context. (See below).
Erickson was an avid medical student, and was so curious about and engaged with psychiatry that he got a psychology degree while he was still studying medicine.
Much later, in his fifties he developed post-polio syndrome, characterized by pain and muscle weakness caused by the chronic over-use of partially paralyzed muscles. The condition left him even more severely paralysed, but having been through the experience once before, he now had a strategy for recovering some use of his muscles, which he employed again. After this second recovery, he was obliged to use a wheelchair, and suffered chronic pain, which he controlled with self-hypnosis:
It usually takes me an hour after I awaken to get all the pain out. It used to be easier when I was younger. I have more muscle and joint difficulties now... Recently the only way I could get control over the pain was by sitting in bed, pulling a chair close, and pressing my larynx against the back of the chair. That was very uncomfortable: But it was discomfort I was deliberately creating.
In the early 1950s, anthropologist/cyberneticist Gregory Bateson involved Erickson as a consultant as part of his extensive research on communication. The two had met earlier, after Bateson and Margaret Mead had called upon him to analyse the films Mead had made of trance states in Bali. Through Bateson, Erickson met Jay Haley, Richard Bandler and John Grinder, amongst others, and had a profound influence on them all. They went on to write several books about him.
In 1973, Jay Haley published Uncommon Therapy, which for the first time brought Erickson and his approaches to the attention of those outside the clinical hypnosis community. His fame and reputation spread rapidly, and so many people wished to meet him that he began holding teaching seminars, which continued until his death.
Milton H. Erickson died in March 1980, aged 78, leaving four sons, four daughters, and a lasting legacy to the worlds of psychology, psychiatry, psychotherapy, pedagogics and communications.
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 person's interest. At such moments people experience the common everyday trance; they tend to gaze off to 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...
Because Erickson expected trance states to occur naturally and frequently, he was prepared to exploit them therapeutically, even when the patient was not present with him in the consulting room. He also discovered many techniques for how to increase the likelihood that a trance state would occur. He developed both verbal and non-verbal techniques, and pioneered the idea that the common experiences of wonderment, engrossment and confusion are, in reality, just kinds of trance. (These phenomena are of course central to many spiritual and religious disciplines, and are regularly employed by evangelists, cult leaders and holy men of all kinds).
Clearly there are a great many kinds of trance. Many people are familiar with the idea of a "deep" trance, and earlier in his career Erickson was a pioneer in researching the unique and remarkable phenomena that are associated with that state, spending many hours at a time with individual test subjects, deepening the trance.
That a trance may be "light" or "deep" suggest a one dimensional continuum of trance depth, but Erickson would often work with multiple trances in the same patient, for example suggesting that the hypnotised patient behave "as if awake", blurring the line between the hypnotic and awake state.
Erickson believed there are multiple states that may be utilized. This resonates with Charles Tart's idea (put forward in the book Waking Up) that all states of consciousness are trances, and that what we call "normal" waking consciousness is just a "consensus trance". NLP also makes central use of the idea of changing state, without it explicitly being a hypnotic phenomenon.
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.
In all my techniques, almost all, there is a confusion.
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 of 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...
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.
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.
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.
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.
Jay Haley identified several strategies, which appeared repeatedly in Erickson's therapeutic approach.
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....."
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 father's 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.
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."
Compare this with "Prescribing the Symptom" (below).
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.
This may be directly compared with Fritz Perls' use of an "empty chair" as a context for imagined interactions (where the client was often invited to occupy the chair and thus take on the role of the person imagined to be sitting there); Bert Hellinger's approach, which requires the client to arrange family members (played by volunteers) in a row or pattern which matches the client's internal understanding, and then to reorganise the row; and Virginia Satir's work with tableaux and posture.
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 in-laws 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 in-laws 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.
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.
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.
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.
In the sphere of business coaching and training, he influenced the methods that behaviour training companies, such as Krauthammer, Gustav Käser Training International or Dynargie used in communicating with coachees and training participants.
His clinical papers have been collected into a four volume work:
- note, these four volumes are sometimes made available digitally under the misleading (and erroneous) name 'Complete Works'.
Some books collecting transcriptions of his lectures and seminars:
Other Works which collect specific parts of Erickson's output
Many books have been written about Erickson and his techniques, which typically include extended citations from his papers, lectures and workshops, including: