Strategic therapy; techniques used by Milton Erickson

Whilst looking at my blog stats, it came to light that many people had arrived here whilst searching for information on the therapeutic techniques used by Milton Erickson. I recently had to write about them myself, and became aware that there are not that many online resources for this information; particularly ‘simple’ ones, that aren’t buried deep in the middle of other (wonderful, of course) academic works. It is with this in mind that I have decide to post a small extract from one of my essays about him, in the hope that it will prove useful to any other out there who find themselves in the situation I was in – hope it helps! 

Jay Haley, the popular proponent for this approach, wrote “Strategic therapy isn’t a particular approach or theory, but a name for the types of therapy where the therapist takes responsibility for directly influencing people” It is developed from the work of  Milton H. Erickson MD, one of the world’s leading hypnotists and psychiatrists. Erickson believed that within one’s consciousness, everyone has the power to heal himself or herself, and he used some quite revolutionary techniques to facilitate the client’s acknowledgment of these resources.

His work with hypnosis continued directly from  Freud’s early findings, where the procedure was initially used, but abandoned in favour of other unconscious delving methods such as free-association. Traditional psychoanalytic techniques, although effective, are time consuming, often taking many months for therapeutic progress to be made; psychoanalysis can take years. Erickson wanted a faster moving approach. He believed that the unconscious mind was always alert and listening to the world whether a trance state or waking state;  it was said that he could make suggestions that would lead to a hypnotic state without the client being aware of ‘being put under’ or any such process that could feel unusual or uncomfortable in any way. It must be noted that as the word hypnosis” is used here, it does not apply to a ritual but to a type of communication between people. Milton Erickson explored an almost infinite variety of ways of inducing hypnotic trance and he used this knowledge to engage in what seemed to be perfectly normal conversations with clients however these speech communications would induce a trance.

Acknowledging that both hypnosis and therapy require persuasion, a degree of cooperation and motivation from the client, Erickson recognised that even when motivated, clients would still resist the benefits offered by the practitioner. There are two main types of resistance: not being quite cooperative enough, and being too cooperative. When a subject does not respond quite as he should, the therapist accepts that response, and encourages it so that the client finds himself caught; his attempt to resist is now defined as cooperative behaviour; No matter what he does, he is following the therapist’s suggestion, obliging is unavoidable, and once that is acknowledged it makes the whole process clearer. Once the client and counsellor are truly working together the new desired behaviours can be introduced and accepted.

Reframing would be used to recast a particular conflict or situation in a less threatening light. For instance; a father who constantly pressures his son regarding his grades may be seen as a threatening figure by the son. Reframing this conflict would involve gently steering the conversation into focusing on the father’s concern for his son’s future and helping the son to “hear” his father’s concern instead of constant demands for improvement.

Another technique he used, providing a worse alternative; directing the patient in one direction in such a way that he is provoked to go in another. He might ask for a response the subject does not care for, and the subject will then choose an alternative in which he participates fully. We commonly call that ‘reverse psychology’, and although with our traditional views on therapy it may seem odd for a therapist to practise in this way, Erickson proved that using this technique can sometimes provide the jolt a client needs to stimulate their autonomy kicking into action.

Sometimes when a client is particularly resistant, Erickson tried communicating in metaphor; when A is resisted, the therapist can talk about B, and unconsciously realising that the two are connected, the client can do the processing at a more comfortable level for the client.

He also advocated encouraging relapse in clients that were ‘too receptive’. He was aware of the potential for transference within the client/counsellor relationship providing a situation where the client may want to please the therapist, often through ‘over cooperating’. By encouraging the client to revert to previously discarded behaviours, he created a situation where they have either have to resist (thus breaking that transference, and pushing the client into independence) or comply, whereby he can ascertain that the therapy hadn’t been truly effective and then work with the client to find other ways of achieving the desired result, in a more effectual way.

These techniques lend themselves particularly well to group therapy, and as such Brief Strategic Therapy is commonly used as a family therapy. The therapist can take the directive, creating the right circumstances for clients to really get a feel for the point of view and feelings of the others within the group and challenging the group into working together as a team (or not). The therapist can use his powers of guidance to deal with the issues and perspectives he deems necessary, with his objective perspective.

 

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