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Born	Milton Hyland Erickson 5 December 1901 (1901-12-05) Aurum, Nevada, U.S.
Died	25 March 1980 (1980-03-26) (aged 78) Phoenix, Arizona, U.S.
Occupation	Psychiatrist and psychotherapist
Spouse(s)	Helen, Elizabeth

Milton Hyland Erickson (5 December 1901 – 25 March 1980) was an American psychiatrist and psychologist specializing in medical hypnosis and family therapy. He was founding president of the American Society for Clinical Hypnosis and a fellow of the American Psychiatric Association, the American Psychological Association, and the American Psychopathological Association. He is noted for his approach to the unconscious mind as creative and solution-generating. He is also noted for influencing brief therapy, strategic family therapy, family systems therapy, solution focused brief therapy, and neuro-linguistic programming.

Early life and education
Hypnosis
See also

Early life and education

Biographical sketches have been presented in a number of resources, the earliest being by Jay Haley in Advanced Techniques of Hypnosis and Therapy which was written in 1968 and in collaboration with Erickson himself. Though they never met Erickson, the authors of The Worlds Greatest Hypnotists did a thorough job of researching the details of his biography. The following information about his life is documented in that source. Currently the most comprehensive information is available through The Milton H. Erickson Foundation in Phoenix, Arizona, a non-profit founded the year prior of his death.

Milton Hyland Erickson was the second child of nine of Albert and Clara Erickson. Born in a mining camp in Aurum, Nevada where his father mined silver, the family moved to the farming community of Beaver Dam, Wisconsin when he was quite young. The family settled on a modest farm, and the children (two boys and seven girls) all attended the one-room schoolhouse in nearby Lowell. The family farm was very demanding of physical labor.

Erickson was late in learning to speak and had difficulties in reading, which he described as dyslexia. He was also color blind and tone deaf. Later in life, when he explained what seemed to be extraordinary abilities, he stated that the disabilities (dyslexia, color blindness, being tone-deaf) helped him to focus on aspects of communication and behavior which most people overlooked. This is a typical example of emphasizing the positive, which is characteristic of his overall approach.

Though the family valued education, books were scarce. Erickson's desire to learn led him to repeatedly read the dictionary from front to back, along with the few other texts that the family treasured. He claimed to have overcome his dyslexia and described the pivotal moments in a paper entitled "Auto-hypnotic Experiences of Milton Erickson," which is found in The Collected Works of Milton H. Erickson, MD. He later characterized his early moments of creative change (which he described as a "blinding flash of light") as an early spontaneous auto-hypnotic experience.

Erickson became interested in hypnosis at an early age when a traveling entertainer passed through the area. According to his later description, he felt that hypnosis was too powerful a tool to be left to entertainers. He decided to bring this tool into the realm of scientific evaluation as well as into the practice of medicine. Erickson already admired the local community doctor and had committed himself to becoming a physician.

At age 17, he contracted polio which left him with additional lifelong disabilities. Having long been interested in hypnosis, the year of his recovery gave him the opportunity to explore the potential of self-healing through hypnosis. He began to recall "body memories" of the muscular activity of his own body. By concentrating on these memories, he slowly learned to tweak his muscles and to regain control of parts of his body, to the point where he was eventually able to talk and use his arms. Still unable to walk, he decided to further train his body 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. He continued to use a cane throughout his adult life, requiring a wheelchair only in his last decade of life. Erickson attributed his own self-healing to giving him additional insight into hypnosis.

After recovering his ability to walk Erickson attended the University of Wisconsin, where he attained graduate degrees in both psychology and medicine. There he also embarked on formal studies of hypnosis in the laboratory of Clark Hull. However, because his ideas were somewhat different from Hull's, Erickson independently embarked upon rigorous scientific explorations regarding the nature of hypnosis. He received his M. D. degree from the University of Wisconsin School of Medicine with an emphasis on Neurology and Psychiatry in 1928. Between 1929 and 1948, Erickson then took a series of positions at state hospitals that facilitated active research. He continued research in hypnosis as he refined his practical therapeutic skills. He was already a prolific writer focusing primarily on case studies and experimental work. These earlier writings greatly advanced the general understanding of hypnosis and are included in The Collected Works of Milton Erickson, M.D.

During WWII, Erickson conducted physical and mental examinations of soldiers. Eventually the U.S. intelligence services asked him to meet with other experts in an effort to better understand the psychological and mental factors involved in communications relating to combat. In this capacity, Margaret Mead and Gregory Bateson were among those with whom Erickson worked and with whom he developed lifelong friendships. Over the subsequent decades these scholars collaborated on numerous projects.

In his late 40s Erickson developed post-polio syndrome. This resulted in additional muscle loss and pain. At that time Erickson, his wife Elizabeth, and his family of five children left Detroit and his position at Eloise State Hospital and relocated in Phoenix, Arizona, where they believed the weather conditions would be conducive to his healing. There Erickson established himself in private practice, working out of his home for the remainder of his life.

In Phoenix, Erickson became active in the Society for Clinical and Educational Hypnosis (SCEH). This organization promoted research and taught physicians how to use clinical hypnosis. Due to personality clashes and strong feelings regarding the most effective ways in which to bring clinical hypnosis into the hands of practicing physicians and dentists, Erickson broke away from the SCEH and formed the American Society of Clinical Hypnosis (ASCH) in July 1957. For a decade he was the founding editor of the American Journal of Clinical Hypnosis and had at least one article in every issue. He dedicated the next two decades of his life to professional writing, teaching other professionals, and maintaining a private practice. This was a productive period during which he developed and refined his own unique style of hypnotherapy, which caught the attention of other notables.

His ongoing relationship with Gregory Bateson led some to take an interest in Erickson's unique communication skills and therapeutic approaches. In 1973 Jay Haley published Uncommon Therapy, a book that first brought Erickson and his approaches to the attention of those outside the clinical hypnosis community. Erickson's fame and reputation spread rapidly, and so many people wished to meet him that he began holding teaching seminars. These continued until his death.

Throughout his professional career Erickson collaborated with a number of serious students. Colleagues who recognized the uniqueness and effectiveness of Erickson's approaches collected his publications into many volumes. His weekly workshops remained popular until his death. Towards the end of his life, Erickson's students began to formulate conceptual frameworks for his work and to explain and characterize it in their own way. Those efforts have influenced a vast number of psychotherapeutic directions, including brief therapy, family systems therapy, neuro-linguistic programming, to name only a few.

Milton H. Erickson died in March 1980, aged 78, leaving behind his wife Elizabeth, four sons, four daughters, and a lasting legacy to the worlds of psychology, psychiatry, psychotherapy, hypnotherapy, pedagogics and communications.

Hypnosis

Milton Erickson dedicated his professional career to the advancement of the use of hypnosis in the context of medicine. He was committed to scientific methodology and a staunch advocate of the regulated professional training for practitioners. The investigations of Erickson in the first half of the 20th century were particularly influential on the second half. Erickson's clinical innovations on the practice of hypnosis are credited with inspiring its renaissance and arousing a new generation of practitioners.

Trance and the unconscious mind

Erickson's view of the unconscious mind was distinctly different from that of Freud whose ideas dominated the context of the times. Zeig quotes Erickson as describing "The unconscious mind is made up of all your learnings over a lifetime, many of which you have forgotten, but which serve you in your automatic functioning". Andre Weitzenhoffer points out: "The Ericksonian 'unconscious' lacks in particular the hostile and aggressive aspects so characteristic of Freud's system".

It is clear from Erickson's writing that he relied on a supposition of an active, significant, unconscious. It was Erickson's perspective that hypnosis provided a tool with which to communicate with the unconscious mind and access the reservoir of resources held within. He describes in a 1944 article on unconscious mental activity, "Since hypnosis can be induced by trance and manifests the unwarranted assumption is made that whatever develops from hypnosis must be completely a result of suggestion, and primarily an expression of it". In the same publication Erickson repeatedly comments about the autonomy of the unconscious mind and its capacity to solve problems.

Erickson was an irrepressible practical joker. The essential element of Erickson's jokes was not hostility, but surprise. It was not uncommon for him to slip indirect suggestions into a myriad of situations. He also included humor in his books, papers, lectures and seminars.

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; 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 re-stabilize 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 micro-dynamics of trance.

Many people are familiar with the idea of a "deep" trance, and early 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 subjects, deepening the trance. Erickson's work on depth of trance is detailed in his 1952 paper in which he provides history, justification, and ideas about its use. Trance states for therapeutic reasons can be either light or deep, depending on such factors as the personality of the patient, the nature of the problem and the stage of therapeutic progression.

Where traditional 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 participates in, their transformation. Because the induction takes place during the course of a normal conversation, Ericksonian hypnosis is often known as conversational hypnosis. In a 1976 paper, Erickson describes his developments of indirect suggestions.

Techniques

While Erickson explored a vast arena of induction methodologies and techniques of suggestions, there are certain areas where his name is known as key in the development or popularity of the approaches. He used direct and indirect approaches, though he is most known for his indirect and permissive suggestion techniques.

Indirect suggestions

Erickson maintained that it was not consciously possible to instruct the unconscious mind, and that authoritarian suggestions were likely to be met with resistance. The unconscious mind responds to opportunity, metaphors, symbols, and contradictions. Therefore, effective hypnotic suggestion 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.

Erickson developed both verbal and non-verbal techniques and pioneered the idea that the common experiences of wonderment, engrossment and confusion are, in fact, just kinds of trance. An excellent example of this can be viewed in the documentary film.

Metaphor

Erickson sometimes instructed people to climb a mountain or visit a botanical garden. His narrative and experiential metaphors are explored extensively in Sydney Rosen's My Voice Will Go With You, but an example is given in the first chapter of David Gordon's book Phoenix.

Interspersal technique

Erickson describes hypnotic technique as a means to an end while psychotherapy addresses guidance of the subject's behaviors. As such, the same hypnotic technique can be applied towards diverse patient concerns. In his discussion of the applications of the interspersal technique, Erickson offers two case examples in which a similar application of the technique was made. One patient was suffering from intolerable malignant pain from a terminal condition, while the other subject was an intelligent though illiterate man who sought to relieve a disabling symptom of frequent urination. Erickson provides an interesting case write up for each of the cases chosen to illustrate his use of the interspersal technique. Erickson provides a transcript for the induction in which he interwove personalized therapeutic suggestion, selected specifically for the patient, within the hypnotic induction itself. The transcript offered illustrates how easily hypnotherapeutic suggestions can be included in the trance induction along with trance-maintenance suggestions. In the follow-up case discussions Erickson credits the patients' positive responses to the receptivity of their unconscious minds: they knew why they were seeking therapy, they were desirous of benefiting from suggestions. Erickson goes on to state that one should also give recognition to the readiness with which one's unconscious mind picks up clues and information. Erickson stated that "Respectful awareness of the capacity of the patient's unconscious mind to perceive the meaningfulness of the therapist's own unconscious behavior is a governing principle in psychotherapy. The patient's unconscious mind is listening and understanding much better than is possible for his conscious mind".

Confusion technique

"In all my techniques, almost all, there is a confusion". – Milton H. Erickson

Erickson describes the confusion technique of hypnotic induction that he developed as being done either through pantomime or through plays on words. Spoken to attentive listeners with complete earnestness, a burden of constructing a meaning is placed upon the subject, and before they can reject it another statement can be made to hold their attention. One example is offered in which he uses verb tenses to keep the subject "…in a state of constant endeavor to sort out the intended meaning". He offers the following example: One may declare so easily that the present and the past can be so readily summarized by the simple statement "That which is now will soon be yesterday's future even as it will be tomorrow's was. Thus the past, the present, and the future all used in reference to the reality of today". Erickson describes the second element of confusion to be the inclusion of irrelevancies and non-sequiturs. Taken in context these verbal distractions are confusing and lead progressively to the subject's earnest desire for and an actual need to receive some communication they can readily understand. A primary consideration of the confusion technique is the consistent maintenance of a general causal but definitely interested attitude and speaking in a gravely earnest and intent manner expressive of a certain utterly complete expectation of the subject's understanding. Erickson wrote several articles detailing the technique and results that can be achieved. This succinct overview comes from a 1964 article, one of several detailing the technique, the justification and the responses that could be achieved.

Handshake induction

Erickson describes the routine as follows:

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 under-surface 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
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 strong push or nudge is required, check for anesthesia.

Hand levitation

Erickson was the first to describe the hand levitation method of induction, described as being broadly applicable. Weitzenhoffer describes the technique as broadly applicable and quotes a colleague as describing Erickson's demonstration as "the best of all induction procedures. It permits the participation in the induction process by the patient and lends itself to non-directive and analytic techniques" It is however, the most difficult of methods and calls for greater endurance on the part of the hypnotist". A transcript of Erickson demonstrating this technique script is included. The nature of the induction is for the hypnotherapist to repeatedly suggest a lightness in the hand, which results in a dissociative response and the hand elevating unconsciously.

Resistance

In the book Uncommon Therapy, Jay Haley identified several strategies that appeared repeatedly in Erickson's therapeutic approach. For Erickson, the classic therapeutic request to "Tell me everything about ...," was both aggressive and disrespectful. Some people might react to a direction by thinking "Why should I?" or "You can't make me." This is 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") but according to Erickson, the unconscious mind pays more attention to the "X" than the injunction "Don't do." Thus, 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 would be 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."

Double bind

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.

Erickson provides the following examples: "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".

Shocks and ordeals

Erickson is famous for pioneering indirect techniques, but his shock therapy tends to get less attention. Erickson was prepared to use psychological shocks and ordeals in order to achieve given results: The ordeal process is different from other therapeutic techniques originated by Erickson. Extending the dissociative effects of paradox and non sequitur, wherein confusion is used only as an entry to a trance state, the technique of ordeal superimposes a distressing but achievable challenge over the therapeutic aim such that the achievement of the former implies a positive outcome in the latter. Hence ordeal therapy is not merely an induction technique but a theory of change. The therapist's task is to impose an ordeal, appropriate to the problem the person wishes to change, an ordeal more severe than the problem. The main requirement is that it cause distress equal to or greater than that caused by the symptom. It is also best that the ordeal is good for the person. The ordeal must have another characteristic: it must be something the person can do. It must be of such a nature that the therapist can easily say "This won't violate any of your moral standards and is something you can do". The final characteristic is that it should not harm anyone else. One final aspect of the ordeal is that sometimes the person must go through it repeatedly to recover from the symptom.

Influence on others

One of Erickson's first students and developers of his work was Jay Haley. Other important followers who studied directly with Erickson include Ernest Rossi, Stephen Gilligan, Jeffrey Zeig, Bill O'Hanlon, Michele Ritterman, Stephen Lankton, Richard Landis, Jane Parsons-Fein, Herb Lustig, Alex & Annellen Simpkins and Sidney Rosen. The majority of today's Ericksonians consist of individuals who have never known Erickson. Today, and for some time now, much of the teaching of the Ericksonian approach is and has been done by individuals who have acquired their knowledge second and third hand. Some of those who did spend time with Erickson, like Jeffrey Zeig, Ernest Rossi, and William O'Hanlon have tried, to present and preserve as much as they could what they believed and have understood Erickson's thought and methods to be. They have succeeded to do so to a fair degree. Others, like Richard Bandler and John Grinder have on the other hand, offered a much adulterated, and at times fanciful, version of what they perceived Erickson as saying and doing guided by their personal theorizing. Further distortions have resulted outside of the United States due to translation problems as well as for other reasons. More and more the Ericksonians have become a heterogeneous group of practitioners.

Jay Haley told of sending a group of his students to see Erickson. When they returned, one student was particularly touched at Erickson's sensitivity to his own issues. The student then related one of the stories that Erickson had told the group. He says he knew this story was intended specifically for him. Another student corrected him and said that the story was for her, not for him. She pointed out a few of its features that addressed her issues. Haley said he found that very strange. He had heard that same story years earlier and knew that Erickson had created it especially for him!

Erickson eschewed rigid approaches to therapy and thus never accepted a binding framework or schematic set of procedures during his lifetime, though a multitude of other approaches grew from his perspective and practice. He had a strong influence on the diverse areas of Strategic therapy, Family Systems, Brief Therapy, Ordeal Therapy, Narrative Therapy, and Neuro-Linguistic Programming.

Ericksonian approaches

Following Erickson's death in 1980, The Erickson Foundation lead by Jeffrey Zeig held a conference which at the time was the largest professional hypnosis conference ever held. Afterward, many participants began to teach Erickson's ideas in their own way. It was not until after Erickson's death that the word Ericksonian was used to describe his methodology. Over the decades that followed, there were various attempts to identify the key components that bring together the individual styles of an Ericksonian. In an attempt to identify the key elements of Erickson's work, Stephen Lankton contributed an extensive overview of Erickson's ideas and techniques which he referred to as the "Ericksonian Footprint". More recently, the development of Ericksonian Core Competencies spearheaded by Dan Short and Scott Miller defines Ericksonian approaches in a manner that makes it amenable to evidence-based studies.

Lankton and Matthews state that perhaps Erickson's greatest contribution to psychotherapy was not his innovative techniques, but his ability to de-pathologize people and consider a patient's problematic behavior as indicative of a best choice available to the individual. His approach was to facilitate the patient's access to inner resources to solve the problems.

The concept of utilization in psychotherapy is identified primarily with the work of Milton Erickson. More than any other therapist, he taught us to appreciate everything the client brings and whatever the client brings should be regarded as valuable. Perhaps Erickson's struggles with polio as a teenager impressed on him the value of regarding everything as a potential asset. All weaknesses can become strengths in the same way a negative can become a positive. Many imperfections can be altered slightly so that they become endearing. Some things can be highlighted while others can be de-emphasized. To recognize and use the qualities of the individual and the situation is to affirm something in which they have already invested.

A 1954 article by Erickson describes his technique of utilizing a patient's own personality and ideas, "Doing it His Own Way", in which a patient requested hypnosis for the explicit purpose of ceasing his reckless driving, and the patient did not want psychotherapy for any other purpose. Erickson worked with him and provided a summary of the case, after carefully assessing the patient's potential for safe practices, as well as his motivation for change. The discussion of working with the patient while allowing him to guide his own healing is a clear example of the concept of utilization for which Erickson has become known. Another key principle that is associated with Erickson's techniques is described in his 1964 paper entitled the "Burden of Effective Psychotherapy" whereby he describes the essential nature of the investment of the subject in the experiential process of healing.

An entry in the prestigious American Psychological Association Dictionary of Psychology defines Ericksonian psychotherapy. Based on the work of Milton Erickson, this approach to psychotherapy is described as a "form of psychotherapy in which the therapist works with the client to create, through hypnosis and specifically through indirect suggestion and suggestive metaphors and real life experiences, intended to activate previously dormant intra-psychic resources".

Core competencies of Ericksonian approaches

The Core Competencies Manual was a joint endeavor between the Erickson Institute of Phoenix, and The Milton H. Erickson Foundation to define Ericksonian approaches in a manner that makes it amenable to evidence-based studies. Using the wisdom of individual professionals who studied with Erickson, the organizers developed a matrix of features associated with what they had learned from Erickson about his approaches. The developers then developed a matrix to evaluate clinical approaches used to ascertain whether or not a style of therapy could be considered Ericksonian. The elements involved included four skills: Observation, Validation, Cultivation, and Challenge, combined with six competencies: Tailoring, Utilization, Strategic, Competency, Destabilization, Experiential, Naturalistic. This resource is available for a free download, and its founders are supportive of research-controlled studies to further evaluate the utility of the model.