Dr. Milton Erickson, who died in the 1980s, was widely acknowledged as a leading practitioner of medical hypnosis. However, Dr. Erickson's individual approach to psychotherapy and his early contribution to the understanding of Neuro Linguistic Programming (NLP) is less well-known.
The essence of Erickson's technique was his gentle induction of the client into an hypnotic trance. Erickson's use of reframing (where metaphors such as "challenge" are substituted for "problem") and his use of tasking, where a client is engaged in activity prescribed to surface hidden resources, reflected his belief that individuals possess an extra level of unacknowledged and unrecognized personal resources.
Unfortunately, hypnosis has long suffered from the suspicions of the uninformed and its usage has been inhibited to the prevention of smoking and a limited range of habit disorders. The restricted research that has been carried out has found that hypnosis when used as a technique in the treatment of addictive behavior, facilitates greater self control and self discipline. It also disqualifies the usual pattern of behaviors, thus allowing the intervention of healthier alternatives originating from the sub-conscious mind and bringing with it a defect level of emotional satisfaction for the client.
Client referred to me are usually in a state of considerable disarray. Therapy begins immediately with the gathering of sensory specific information combined with constant reframing together with creative visualization and hypnosis to reduce stress levels.
Tasking has been used extensively by therapists to restrict alcohol intake and in an attempt to change established habits. Individuals pass through a number of recognizable stages in their decision to break a damaging habit, namely:
The individual seeks information about the harmful effects of consuming alcohol. Sometimes the risk is acknowledged but there is no serious wish to change.
The individual possesses, and has considered, the relevant information but needs further facts on harm, cost and reasons to change.
Action / Maintenance:
The individual attempts to reduce alcohol consumption but may need reasonable support.
Significant changes to harmful and destructive behaviors can be accomplished through hypnotherapeutic reframing of specific event via age regression, incorporating the client's need at appropriate cognitive emotional levels, unification of ego states by way of arm levitation and building anticipation for a successful presence and future by pseudo orientation in time methods.
To illustrate this procedure, the following case study features the broader principles of the Ericksonian technique which have been adapted to treat addictive behavior.
"Mr. R, a 28 year old married man with two children, was referred to me by his psychiatrist. His presenting problems included a long history of drug and alcohol abuse, resulting in drug related legal problems, combined with long-standing domestic difficulties He lacked self esteem and self-confidence, had no real goals in life and was unable to relax.
The client was in a depressed and lethargic state, frequently referring to his lack of energy and ongoing lack of success.
The treatment plan was essentially twofold:
1. The psychiatrist supplied 60 mg of Methadone per day and also performed relapse prevention.
2. I provided Ericksonian hypnotherapy coupled with cognitive behavioral therapy, which highlighted the client's denial of alcohol related problems and his lack of assertiveness.
Reframing began by exploring his skills base. The minority use of a possible frame helped identify several skills related to his trade of carpentry.
Hypnosis and the use of arm catalepsy suggested strength and direction while the hypnotic state immediately reduced the client's fear level. During hypnosis, I used a metaphor involving a wise old man. As the client's trance deepened, 'Wise Old John' bestowed a gift which was secret between himself and the client. This metaphor appeared to have a positive effect on the client.
During the latter part of the therapy I employed several NLP techniques including a six step reframe, from which optimism and self esteem began to emerge.
Self hypnosis appeared to blunt Mr. R 'excessive craving while the reality of his former condition continued to be addressed in a positive cognitive behavioral manner. "
It remains to be seen whether Mr. R progress can be maintained but it has to date remained free of drug and alcohol abuse. This is particularly significant as prior to treatment he arguably could not sustain a period of 18 hours without resorting to the fuse of alcohol or drugs. The client's relationship with his wife has also improved and he is more confident and assertive.
Not every case presented to me has such a successful outcome, relapses and disappointments being a fact of life. There has, unfortunately, been a rapid increase of addictive incident and somewhat 'hit and miss' rates of success. In my own experience physical, psychological and social deprivation are commonalities of drug and alcohol abuse but added to these are the personal traumas and emotional need drives of the individual. The "traditional" treatments of psychotherapy, counseling and detoxification have their vital role but the disappointing rates of success suggest these boundaries should be further expanded. Significantly, those few who have successfully followed the Ericksonian routes were themselves rejected of these conventional treatments. I look forward with optimism to a gentle break through for some others!