Utilization Approaches to Hypnotherapy

The papers of this section all demonstrate Erickson's approach to a variety of psychological problems. Utilization theory emphasizes that every individual's particular range of abilities and personality must be surveyed in order to determine which preferred modes of functioning can be evoked and utilized for therapeutic purposes. of the own attitudes becomes a basic approach for circumventing what most other therapists term "resistance." The therapeutic process then ideally unfolds as follows: (1) The therapist provides fresh ideas and situations to break through the limiting precon- ceptions that have blocked the patient's own problem-solving abilities (stages one and two of the of trance and as outlined in Volume One of this series), thus evoking (2) unconscious processes of search and solution (stages three and four of the micro- dynamics of trance and that lead patients to (3) their own problem in their own way. is an edited version of a taped dialogue that occurred in 1973 between and the editor illustrat- ing this approach.

An expert carpenter lost the first three fingers of his right hand. He came out of the hospital and asked me, "What am I going to do to earn a living? How am I going to hold a I responded first task you have is to learn how to shake hands without letting the other fellow know that you've lost three fingers.

He learned how to shake hands without letting the other person discover the missing fingers. He learned how to apply just the right amount of pressure with his thumb, palm, and little finger so the other fellow never realized anything was missing. When he had learned that, his unconscious automatically know how to hold a hammer. You cannot explain that to anyone.

So your hypnotherapy is almost the exact opposite of most conventional hypnotic approaches. Other hypnotherapists believe they have to specify exactly what the patient is supposed to do. But you just open a patient up to knowledge that is within, together with new life experiences, rather than trying to program him with your version of how you believe he ought to behave.

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E: Too many hypnotherapists take you out to dinner and then tell what to order. 1 take a patient out to a psychotherapeutic dinner and I say, "You give your order." The patient makes his own selection of the food he wants. He is not hindered by my instructions, which would only obstruct and confuse his inner processes.

One of my daughters had a tongue-thrusting problem during swallowing that was interfering with the formation of her teeth. The dentist showed her the more natural way of swallowing and contrasted it with her way. He then told her to go home and practice both. And sure enough, after a while my daughter selected, on her own, the natural, correct way to swallow.

R: She was not following any rigid prescription for behavior change given to her by the dentist. He her alternatives that her to make her own choice based on her own actual experience.

E: Yes, providing the patient with alternatives sets the stage for inner search and creative problem-solving.

R: You did not tell the carpenter he would have to hold the hammer in exactly such and such a manner, applying pressure here and there in a certain way. He could not learn in such a fashion. The conscious effort to learn your way would have interfered with his own unconscious manner of learning to deal with his own handicap. You simply gave him a task that would stimulate his inner capacities.

14. Special Techniques of Brief Hypnotherapy

Milton

The development of neurotic symptoms constitutes behavior of a defensive, protective character. Because it is an unconscious process, and thus excluded from conscious understandings, it is blind and groping in nature and does not serve personality purposes Rather it tends to be handicapping and disabling in its effects. Therapy of such distorted behavior ordinarily presupposes that there must be a correction of the underlying causation. However, such correction, in turn, presupposes not only a fundamental willingness on the part of the patient for adequate therapy but also an actual opportunity and situation conducive to treatment. In the absence of one or both of these requisites, psycho- therapeutic goals and methods must be reordered to meet as adequately as possible the total reality situation.

In attempting such modified psychotherapy the difficult problem arises of what can really be done about neurotic symptomatology where the realities of the patient and his life situation constitute a barrier to comprehensive treatment. Efforts at symptom removal by persuasion, reconditioning, etc. are usually futile. Almost invariably there is a return to the symptomatology in either the same form or another

with increased resistance to therapy.

Equally futile, under such limiting circumstances, is any effort to center treatment around idealistic concepts of comprehensiveness, or, as is unfortunately too often the case, around the therapist's conception of what is needed, proper, and desirable. Instead, it is imperative that recognition be given to the faci that comprehensive therapy is unaccepta- ble to some patients. Their total pattern of adjustment is based upon the continuance of certain maladjustments which derive from actual Hence, any correction of those maladjustments would be undesirable if not actually impossible. Similarly, the realities of time and situational restrictions can render comprehensive therapy impossible and hence frustrating, unacceptable, and intolerable to the patient.

Therefore, a proper therapeutic goal is one that aids patients to function as adequately and as constructively as possible under those

Quoted from the Journal of and Experimental Hypnosis, 1954, 2, 109-129.

150 Innovative Hypnotherapy internal and that constitute a part of their life situations and

Consequently, the therapeutic task becomes a of intentionally utilizing neurotic symptomatology to meet the unique needs of each patient. Such utilization must satisfy the compelling desire for neurotic handicaps, the limitations imposed upon therapy by external forces, and, above all, provide adequately for constructive adjustments aided rather than handicapped by the continuance of neuroticisms.

Such utilization is illustrated in the following case reports by special hypnotherapeutic techniques of symptom substitution, transformation,

and the induction of corrective emotional response.