Core Competences in Ericksonian Psychotherapy

Milton Erickson

Disclaimer: The article presents some notes, taken at the second annual training, led by Consuelo Casula, president of European Society of Hypnosis (ESH), in Sofia, Bulgaria, 2017-th, May. The notes does not represent  any detailed or exhaustive view on the workshop, but just few cursory strokes.

Consuelo Casula, President of ESH

Topic: Core Competences in Ericksonian Psychotherapy

“I love my daughter, but I do not like her!” – The difference between unconditional empathy and sympathy.

N.B.: The pyramid of needs and values of Maslow as motivational levels theory.

According to Milton Erickson:

-          Altruism

-          Meaning

-          Novelty and creativity

-          Belonging

-          Survival

Doing novelty, disorientation , confusion, creating paradox, as opening free for change space in the patient.

Therapy as Problem Solving

Pathology centered problem solving versus needs and solutions problem solving. Problems as opportunities to learn, integrate and achieve higher values.

Therapy as process of experiment and discovery.

The problem is a challenge, leading to solution. We elicit the resources already hidden in the patient. We ask the person what he’s already done – if it doesn’t work, we change the direction of thought, emotional perception and actions/ deeds.

Paradoxical intention – sometimes we throw the patient into greater fear, in order to pilot him through his contemporary fear. Often the person asks as to help him to become same as before – that is impossible. We can help him become his new self.

Theory of change

-          Change is natural, physiological, and inevitable.

-          All people possess self-organizing, adaptive abilities that should be evoked and brought to service in therapy.

-          Psychotherapy involves hidden processes of reorganization, re-association and adaptation.

-          In psychotherapy we awake previously unknown capabilities, in order to realign and reorganize preexistent internal resources.

Theory of progress

-          Nonlinear paradigm of learning

-          Transformation is paradoxical process that begins with acceptance.

-          Go backwards in order to move forward.

-          Gain control over involuntary behavior by doing it intentionally – prescription of the symptoms.

-          Failure is necessary for the sake of progress.

Confusion is necessary for learning.

Ericsonian approach is mostly pragmatical, focused in the results, not so much in philosophy or theory.

The magical question of Steve de Shaser (creator of solution focused therapy) – motivation for change by the future.

“Peter Levin never uses the word hypnosis, but who cares when he applies it massively?!” C. Casula

„Follow your psychotherapeutic intuition, but on the foundation of your deep and encompassing therapeutic knowledge!” – C. Casula

Important message to the patient: trust me, I am with you, I love you, I care for you, even when I take you out of your comfort zone!

The importance of double mirroring – seeing behind the expressed information.

The problem as satisfying some need through secondary gain. The  symptom or some addictive behavior satisfies malnourished need.

Justified, real fears and irrational, subjective fear – in psychotherapy we check the reality and work mostly with the subjective anxiety and exaggerated real fears.

Interpersonal attitude

-          Observation – intimately perceptive in relation to the patient.

-          Validation – acceptance, empathy, support.

-          Cultivation – inspiring and evoking patient’s potentials, resources. Evoking change with naturalistic approach, destabilization with desensitization, rearranging, upgrade.

-          Challenge – challenging and motivational attitude. Includes destabilization at first.

Core Competences

-          Tailoring – individualization of treatment. Rapport and calibration.

-          Utilization – readiness to utilize intrapersonal and interpersonal dynamics as well as situational factors.

-          Destabilization – disrupting stable maladaptive psychological patterns to encourage flexibility and learning. Breaking the usual patterns, leading the patient out of the comfort zone. Creating confusion and reimprinting, rearranging the cognitive patterns.

-          Naturalistic strategic approach – a readiness to create a self-organized problem-solving context. Giving not a fish, but fishing tackle Creating the expectation that change will occur and already occurs naturally and automatically.

“My powerful guide is reality test!” Milton Erickson

„All sorrows can be borne and managed if you can put them into a story!” Karen Blixen (Isak Dinesen), nobelist. So, in psychotherapy and especially in hypnotherapy we ought to be proficient story tellers.

Utilization

-          Utilization is a strategy that engaged habits, beliefs, perceptions, symptoms, resistance, outward changes in service of trance eliciting or problem resolution.

-          The therapist uses strategically the stimuli that comes from the subject or the environment, in order to redirect them for therapeutic purpose.

-          Utilization also gains rapport and aids to be present in the moment.

Validation

-          Acceptance, support, empathy, unconditional love. Empathy is greater than sympathy. We can dislike someone and disagree with his values and deeds, but to maintain empathetic attitude and unconditional acceptance.

Five petals: body identity, social identity, professional identity, spiritual identity, secret identity (shadow, ancestral memory, hidden secrets).

Consuelo gives special talk about prescription of the symptom…  Prescription, in the context of unconditional empathy, but sometimes extremely challenging. Prescription of fainting, trembling, exposure, dizziness, anxious breathing, etc.

Footprints

Colorful (9 colors, infinite possibilities - Susan Dowell, author of the prints) footprints are presented to the patient. We can name one color for the fear, another for love, third for the doubt, so on… We localize them in different proximity and time frames in the past and the future. In such way we assist the awareness, decision making process, assertive motivation toward chosen direction.

One can use the footprints to represent the five petals identities. The chosen colors also matter. 

Consuelo does not recommends psychoanalytic interpretations during or after the experiments. My opinion is that interpretations and benevolent feedbacks have their moderate significance in the therapeutic process, when it is focused in solution and the possibility of learning by the neurotic state.

The work with the footprints is performed in upright position. Nevertheless the psychotherapist conducts  Ericksonian hypnotherapeutic experience, elicits trans, uses nlp, matrix reimprinting, EFT, solution focused, etc.  technologies.

Using the footprints can take one entire session.

“The trauma commence when one cannot neither fight, nor run, but freeze into helplessness.” Consuelo Casula

Consuelo is talking about trauma overcoming, by combining hypnosis with body oriented work, such as trauma releasing exercise, breathing, eye movements, psycho theater, audial expressions, etc.  

„The therapist ought to be emotionally intelligent, lexithymic! He have to be able to realize, track and verbalize his own feelings, emotions, senses.“ Consuelo  Casula

Age progression

-          As if…

-          The miracle question.

-          The climber strategy – one is on the top of the mountain, observing the past and the forthcoming path of yours…

-          The crystal balls – from the dream of the soap bubble, toward the crystal ball of the strong intention and clear vision.

-          Evolutionary beliefs – survival, experience, creativity, risk management…

-          Multiple suggestions.

Thank you enormously, dear Consuelo Casula!

Orlin Baev