The Practical Application of Medical and Dental Hypnosis

481 Pages·2010·11.51 MB·English

by  Milton H. Erickson

of
The Practical Application
Medical and Dental
HYPNOSIS
Milton H. Erichon, M. D
Part President and Co-founder; ASCH
Seymour Hershman, M.D.
Part President and Cofounder; ASCH
Irving 1 Setter, D. D.S.
Past President and Historian, ASCH
BRUNNERIMAZEL Publishers New York
216x138 PB
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Library of Congress Cataloging-in-Publication Data
Erickson, Milton H.
The practical application of medical and dental hypnosis I Milton
H. Erickson, Seymour Hershman, Irving I. Secter.
p. cm.
Includes bibliographical references.
ISBN 0-87630-570-2
1. Hypnotism-Therapeutic use. 2. Hypnotism. I. Hershman,
Seymour. 11. Secter, Irving I. 111. Title.
RC495.E725, 1989
615.8'512 -dc20 89-23918
CIP
Copyright @ 1961 by Milton H. Erickson, M.D.,
Seymour Hershman, M.D., and Irving I. Secter, D.D.S.
Copyright @ 1990 by BrunnerIMazel, Inc.
All rights reserved. No part of this book may
be reproduced by any process whatsoever without
the written permission of the copyright owners.
Published by
BRUNNERIMAZEL, INC.
19 Union Square
New York, New York 10003
Manufactured in the United States of America
1 0 9 8 7 6 5 4 3 2 1
Foreword
The history of twentieth century hypnosis primarily reflects
the contributions of the late psychiatric genius Milton H.
Erickson, M.D. If one were to list the important historical
figures in hypnosis, in the eighteenth century one would
name Mesmer; in the nineteenth century, Braid, Esdaile,
LiCbault, Bernheim, and Charcot; and in the twentieth
century, Erickson. Erickson dominated modern hypnosis and
almost single-handedly legitimized it and brought hypnosis
into a state of respectability in the professional community.
In the process, he revolutionized its practice.
Previous to Erickson, the practice of hypnosis was regarded
as an authoritarian, operator-based model where direct
suggestions were "implanted" into a passive subject. Erickson
FOREWORD
developed a patient-based model of tailoring indirect
hypnotherapy to elicit strengths (dormant resources) that
could be utilized in strategic steps. Thereby, he changed the
direction of hypnosis. In traditional practice, hypnosis was
directed from the outside in, that is, hypnosis was conducted
as a series of commands dictated from the operator to the
subject. Erickson's work was from the inside out: indirect
methods were used to elicit strengths from the patient rather
than force-feeding suggestions into the passive subject.
Erickson formulated the central concepts of modern hypnosis..
His contributions seem to have sprung de novo; he did not
build on the work of predecessors.
However, there were many junior colleagues and students
of Erickson who followed his lead and built the application
of his methods in far-reaching ways. Early prot6gCs were the
co-authors of this book, Seymour Hershman, M.D., a
physician in general practice, and Irving I. Secter, D.D.S.,
M .A., a dentist and Master's level psychologist. These three
were the backbone of the Seminars on Hypnosis Foundation,
a group who traveled the country in the early and mid-1950s
to teach workshops on clinical hypnosis to professionals. In
1957 the practitioners who taught for the Seminars on
Hypnosis Foundation were instrumental in forming the
American Society of Clinical Hypnosis (ASCH), and the
Seminars on Hypnosis Foundation eventually merged into
the educational arm of the ASCH. Other notable lecturers
of the Seminars on Hypnosis group included William Kroger,
M.D., Edward E. Aston, D.D.S., David Cheek, M.D., and
Leslie LeCron.
In the 1950s the attendees at these seminars were mostly
physicians and dentists, and this book was directed to that
FOREWORD
audience. Currently, hypnotic practice has shifted and
become- the purview of psychotherapists such as psychologists
and Master's level mental health professionals. The teaching
of the Seminars on Hypnosis Foundation group on the
Ericksonianlindirect approach to hypnosis is, however,
valuable for all medical, dental, and psychotherapeutic
clinicians.
In this book you will encounter fundamental principles of
Ericksonian hypnosis of which I have listed ten important
postulates:
I. Use indirection.
Consider the following passage:
In contrasting [direct and indirect approaches], one
might employ the following direct approach to the
production of hypnotic deafness: "When I count to ten,
you will find yourself getting more and more deaf, until
finally, at the count of ten, you will be unable to hear
anything at all."
On the other hand, the indirect approach might
proceed in this fashion: "I wonder how it feels to a person
who is about to lose his hearing. I wonder if he notices
the fact that sounds seem to grow very, very slightly less
distinct at first, if he finds that they seem to be fading
off into the distance? And I wonder if the person then
sits in his chair, leaning forward toward the sound. . . ."
(PP. 274-275)
This indirect method may stand as the greatest contri-
bution that Erickson made to the field of hypnosis and
FOREWORD
psychotherapy. It deserves careful study by practitioners in
all health fields.
2. Make hypnosis interactional.
Milton Erickson invented the interactional trance. It
continues to be the case that the vast majority of practitioners
of hypnosis, even those using the indirect method, carry out
their work on patients who are essentially passive. To
Erickson, trance was bilateral communication. Hypnotized
patients would have extensive ongoing dialogue with
Erickson. It was presupposed that this dialogue would
enhance the trance and in no way interfere with the devel-
opment of even somnambulistic (deep trance) states. In this
book you will find transcripts that elucidate the interactional
trance that was one of the hallmarks of Erickson's formal
induction technique. A distinction between the master
practitioner and the journeyman is that the master uses inter-
actional trance, whereas the journeyman continues to work
with a relatively quiescent patient.
3. Move in small, directed steps.
Reading Erickson's cases is often like reading 0. Henry
short stories: there is a discrete denouement and suddenly the
symptom is resolved. However, Erickson was more akin to
a master craftsman-he worked meticulously in small steps.
By building in a directed fashion, he asked patients to do
tasks that were eminently possible. After doing these minor
tasks, the patient would "suddenly" realize major change.
4. Focus on the symptom.
Hypnosis is a symptomatic therapy. However, it is not a
superficial approach. People benefit immeasurably by gaining
FOREWORD
control of their symptoms. There can be a snowballing effect
even from a small salutory change in a symptom.
5. Have respect for the patient.
As a humanist, Erickson recognized the fact that the
therapy should focus on the patient, not on the therapist. He
admonished therapists to think, "What does my patient want
to do next?" rather than to think, 'What shall I, the therapist,
do next?" At the same time, Erickson was supremely confi-
dent. He wanted his patients to know that they could do
things, such as develop anaesthesias. Erickson's confidence
and interest in the patients' ability to succeed was com-
municated verbally and nonverbally.
6. Recognize that hypnosis is cooperation.
The induction of hypnosis is primarily the induction of
cooperation. It is a way in which therapist and patient join
forces to surmount the patient's difficulty. Hypnosis secures
the attention of the patient to maximize constructive
collaboration with the therapist.
7. Communicate precisely.
Erickson admonished his students that "the hypnotist must
be constantly aware of just what he is saying to the subject"
(p. 59). Erickson used communication with the precision
of a surgeon using a scalpel. He focused the words, the
implication of the words, the nonverbal behavior, and the
implication of the nonverbal behavior.
8. Utilize the symptoms.
Erickson advised his students to utilize symptoms.
Carefully consider the case reported on page 326 of a child
FOREWORD
who regularly made squeaking noises. Rather than chal-
lenging the symptom, Erickson sent the boy to his room until
the boy could increase the frequency of the sound. That new
frequency could be continued for a full day. Subsequently,
it was indirectly suggested that the squeaking behavior could
be increased even more. Within a week's time, the boy
discarded the habit when he realized, to his own credit, how
cumbersome it would be to maintain.
9. Tailor the hypnotherapy.
By studying Erickson's transcripts in this book, it will be
apparent that he worked hard to individualize his approach.
He assiduously avoided cookbook approaches by champion-
ing the importance of individual differences: Erickson created
free-form hypnosis and therapy to fit the values and the styles
of the individuals with whom he worked.
10. Point the therapy to the future.
Erickson's approach to psychiatry was practical. He set
about helping patients to secure the best possibilities for living
effectively. Promoting change took precedence over acquiring
insight into an unchangeable past. Consider the following
quote: "One of the purposes hypnosis and hypnotherapy
should accomplish is to make plain to the patient that he has
not only a past that is highly important to him; he also has
a present that is more important, and a future even more so
than the present or the past" (p. 324).
The Practical Application of Medical and Dental Hypnosis is
interesting from a historical perspective. One can see how
hypnosis has evolved in the almost thirty years since the
FOREWORD
original publication of this text. While the vast majority of
information contained herein is refreshingly up-to-date
and eminently useful, some concepts are antiquated. For
example, hypnosis is operationally defined as an increased
susceptibility to suggestion. In his later work, Erickson de
emphasized the importance of suggestion as a central concept
in hypnosis. As Erickson progressed, he promoted the
importance of identifying, accessing, developing, and
utilizing strengths. Also, in some of the induction transcripts,
the practitioners suggest that patients go "deeply asleep."
Modern practitioners rarely use this metaphor.
This book contains a wealth of practical information.
There are commonsense tips on working with all types of
clinical problems. Through actual transcripts, one can see
how Erickson conducted hypnosis and taught students.
Practitioners from all fields will learn not only important
methods of hypnosis, but also ways to communicate with
patients more effectively.
October 1989 jEFFREY K. ZEIG, PH.D.
Director
The Milton H. Erickson Foundation
lX