Onwards to Erickson - British Association of Medical Hypnosis

WINTER 1994/1995
Hypnotic History – 3
The third and concluding chapter of Ronald
Shone’s History of Hypnosis goes on to examine
briefly the roles played in the development of hypnotherapy by Freud, Breuer, Coué and the New
Nancy School.
The author looks at the significance of the cry for
experimentation and empirical research led by
Skinner in the human sciences and then proceeds to
outline the various responses to that cry which came
from those such as Hull, Weitzenhoffer and
Hilgard.
Finally, the author brings the story of hypnosis up
to the present day with its extensive use of
Onwards to Erickson –
and hypnotherapy
comes of age
B
By
Ronald Shone
Ericksonian techniques – and ends appropriately by
suggesting a possible path for the future.
y the late nineteenth century, hypnosis had reached the
stage where it was being used as a direct method of
symptom removal, but was not dealing with causes.
Charcot was practising in Paris and was at the height of his
influence over the medical profession when he met a young
doctor who became enthralled by his methods and who
offered to translate one of Charcot’s works into German.
This young man was Sigmund Freud (1856-1939).
Freud was to have a huge influence on hypnosis. Through his
observations of Charcot’s work he realised that there could be
deep mental processes in each of us of which the individual
remained unaware.
The debate between the Salpetrière and the Nancy School was
still raging but Freud was fully convinced by neither, though he did
enter the debate; however, in 1889 he visited the Nancy School in
the hope of improving his hypnotic technique. While there he spent
time with both Bernheim and Liebeault; Freud, under their influence
(and with the weight of evidence beginning to support their view),
eventually came out in support of the Nancy School although he
retained throughout both a neurophysiological and psychological
stance about hypnosis.
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Ronald Shone
is Senior Lecturer in Economics at
the University of Stirling.
During a long involvement in hypnosis he has published three books on
the subject – Autohypnosis (1982);
Creative Visualization (1984) and
Advanced Autohypnosis (1985), all
published by Thorsons. Both
Autohypnosis and Creative
Visualization have been translated
into several languages. More recently
Aquarian Press has published his
First Steps to Freedom (1991).
Over the years he has lectured and
given public demonstrations on hypnosis and creative imagery. Outside
of economics, he is presently working
on two further books: one on creative
imagery and another on hypnosis
and self -hypnosis.
Ronald Shone was born in Liverpool
in 1946, obtained his BSc in
Economics at the University of Hull
and his MA at Essex University.
He is married to Anne Thomson and
lives in Stirling, Scotland.
WINTER 1994/1995
Hypnotic History – 3
Breuer and Freud used hypnosis to unlock unconscious
repressions
Around the same time Josef Breuer (18421925) was eliminating the symptoms of hysteria by an indirect method – he got his patients
to verbalize their problems while in a hypnotic
state. Freud and Breuer met at Brucke’s
Physiological Institute in the late 1870s and
they soon became very good friends, sharing
each other’s scientific interests.
Development of Psychoanalysis
Freud hypothesized that the same must be true of
his non-hypnotisable patients and that another
method was needed to unlock the unconscious
thoughts. Furthermore, he was having doubts about
the suitability of hypnosis for symptom removal,
since he found that in some cases removing one
symptom simply led to another in its place. Thus
emerged Freud’s free association analytic method
and his analysis of dreams.
As Freud was developing his psychoanalytical
method, interest in hypnosis continued at
Nancy but taking on a different approach
based on the work of Emile Coué
(1857-1926). Like Freud, Coué
became interested in hypnosis
after seeing the work of
Liebeault. His main ideas, however, were made popular by
Baudouin - just as Liebeault’s
ideas were made popular by
Bernheim.
Freud, however, was slow to implement Breuer’s
method on his return to Paris (no doubt because
Charcot did not much approve). He began to do so
in 1889 on a woman patient whom he found to be
somnambulistic; but his first full length treatment using Breuer’s method did not
occur until 1892.
Freud began to use hypnosis on
hysterical patients as a means of
helping them recall the precise
circumstances which led to their
symptoms, publishing his
experiences and those of
Breuer in his “Studies on
Hysteria”. Of importance to
our study is the fact that
Breuer and Freud used hypAutosuggestion
nosis to unlock unconscious
repressions which had been
The ideas of the New
the cause of mental illness.
Nancy School, as it became
By 1887 Freud was using
known, were set out in
hypnosis on his patients
Baudouin’s Suggestion and
almost exclusively – though
Auto-suggestion. In brief, the
with varying success. Some
New Nancy School argued that
were not hypnotisable, others did
the main factor in hypnosis was
not go deep enough – he, and othautosuggestion.
ers, thought that a deep somnambuAn immediate consequence of this
listic state was necessary to obtain a
was that in some circumstances it was
cure.
possible to elicit a cure without another
person making suggestions, i.e. without
Dr Sigmund Freud
Freud was discovering that hypnosis
hetero-suggestion.
did have its drawbacks for purposes of
therapy, but while visiting Burnheim he
Second, the ‘law of reverse effect’ was
was informed that although somnambulists did not
of fundamental importance to success. Third, the
normally recall what took place under hypnosis
main effects of autosuggestion occurred at the
when they were in their normal waking state, they
unconscious level.
could be instructed to do so!
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WINTER 1994/1995
Hypnotic History – 3
The British Medical Association
published a report which concluded that
hypnosis was a real phenomenon . . .
These developments, although not inconsistent
with psychoanalysis, were overshadowed by it.
They did, however, indicate that self-hypnosis was
possible. Until this time all hypnosis had been heterohypnosis – largely because it was believed it must be
induced by someone else.
If – as the New Nancy School argued – hypnosis
involved autosuggestion, then heterohypnosis was
simply one form it could take. There should, in principle, be no difficulty in a person inducing hypnosis in
themselves if they believed in it sufficiently.
In 1892 the British Medical Association published a
report which concluded that hypnosis was a real phenomenon which could be beneficially used on some
patients. They emphasised particularly its therapeutic
value in the control of pain, in inducing sleep, and
other problems of a non-physical nature. The report
was largely ignored.
A resurgence of interest in hypnosis arose during the
First World War when there was need for a quicker
cure for wartime neuroses. Hypnosis was found to be
most effective in relieving symptoms through reliving
war experiences. The same was true during and after
the Second World War and the Korean War.
The Period of Experimentation
These developments were still following the
approach that hypnosis was a method of dealing with
psychological problems – what is known now as hypnotherapy. But the rise of behaviourism, due to the
work of B.F. Skinner, encouraged a general move
towards a more scientific (empirical) approach in all
the human sciences.
This trend was reflected in hypnosis, with a preference for experimental work such as that shown in the
investigations of Clark L Hull, and published in his
“Hypnosis and suggestibility: an experimental
approach” in 1933. This was the first major work to
apply the experimental and statistical methods of psyEUROPEAN JOURNAL OF CLINICAL HYPNOSIS, VOL2: NO.2
44
chology to hypnosis and suggestibility. The work
attempted to study some of the major claims that were
being made about hypnosis.
It will be recalled that the group at Salpetrière
argued that hypnosis was pathological and only individuals with hysterical dispositions could be hypnotised. The New Nancy view, however, was that hypnosis was a normal process, that suggestibility was at the
heart of the phenomenon and therefore almost everyone could be hypnotised, since everyone under suitable conditions would manifest some degree of suggestibility.
Suggestibility Scales
Hull and his colleagues began with a scale in which
various suggestibility phenenomena were arranged in
observed order of difficulty from simple relaxation to
amnesia and hallucination. This was the beginning of
the suggestibility scales that have now become prominent.
Although finding no evidence for the transcendence
of normal activity Hull did, nonetheless, verify many of
the classical phenomena observed under hypnosis.
The experimental approach expanded further in the
1950s and 1960s with the work of Theodore X. Barber,
Ernest. R. Hilgard, Martin T. Orne and Theodore R.
Sarbin.
A major emphasis of this period was the construction
of normalised suggestibility scales, of which the
Barber scale and the Stanford hypnotic suggestibility
scales devised by A. M. Weitzenhoffer and Ernest
Hilgard are the best known and most widely used. The
experimental approach has continued in the areas of
hypnosis and pain and personality correlates with hypnosis.
The experimental investigation into pain and
hypnosis highlights some of the issues.
WINTER 1994/1995
Hypnotic History – 3
We have already pointed out that both Elliotson and
Esdaile performed surgery on patients who were
under hypnosis with the result that the patients felt no
pain. For the moment let us agree that the subjects
were not lying or pretending. The question then is
whether they actually felt no pain or whether they simply reported that they felt no pain.
How can this be tested? Pain is a sensation felt in
the nervous system which sends messages to the
brain.
One conjecture is that if no message is sent to the
brain then no pain can be ‘felt’ – the individual will not
be conscious of any pain.
In a famous experiment Hilgard first hypnotised a
subject and then by suggestion ‘removed’ any sense
of pain. The subject reported no sense of pain.
However, through automatic writing, where the subject was not aware of what he wrote, he did admit to
feeling pain. This suggests that hypnotic anaesthesia and analgesia are dissociative phenomena.
The experimental approach has its limitations.
The object of hypnosis is to suspend the analytical faculties and the experimental approach
makes this extremely difficult, except in the most
suggestible of subjects.
Even so, these researches have provided some
invaluable insights into the hypnotic state.
When the subject matter of hypnosis was focused
on the hypnotist and the hypnotic technique a certain
domain and set of constant techniques were implied.
However, a switch of focus to the subject meant that
the hypnotist had to become more flexible, more
adaptable and more dynamic: both in terms of hypnosis and in terms of therapy.
It has been argued that this is why Erickson
often succeeded with difficult subjects where
other hypnotherapists failed.
Although this approach creates problems in the
experimental study of hypnosis, it has profound implications for hypnotherapy.
The Work of Milton Erickson
There was little change in the study and practice of
hypnosis for 200 years until the recent work of Milton
Erickson. He developed a new approach to hypnosis
which has now spawned a vast literature and is the
basis of neuro-linguistic programming (NLP).
The essential ingredient of the ‘Ericksonian
approach’ is that the hypnotist interacts with the mode
of thought, speech and mannerisms of the subject.
Suggestions are made indirectly, often in a roundabout way, leaving the subject to interpret them in an
appropriate way – which means that every response is
a valid one.
It is a dynamic approach to hypnosis, especially to
hypnotic induction, where the hypnotist is constantly
having to adapt his or her technique in line with the
demands, expectations and wishes (conscious or
unconscious) of the subject. There is, therefore, a
shift of focus from the hypnotist to the subject.
Milton Erickson
There has always been a debate in the social sciences concerning generalised theories versus the
case study approach. Hypnosis has certainly not produced generally accepted theories and it has also suffered from the lack of a general framework for case
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WINTER 1994/1995
Hypnotic History – 3
Accepting just one explanation of hypnosis
– whether Freudian, Jungian or Ericksonian
– can only straight-jacket the therapist
simply rules for good rapport does not detract from the
fact that it has given a new and refreshing life to the
subject of hypnosis.
Unfortunately, like many other schools of thought,
the disciples of Erickson have accepted his approach
almost without question, and disregard all that has
gone before. The Ericksonian approach does have
something to offer but, as this history makes clear, it is
not the whole explanation of hypnosis and therefore
cannot be the only technique to follow or use.
Until we understand the phenomenon of hypnosis
more fully it would be foolhardy to accept just one
view, just one explanation, of hypnosis to the exclusion of all else. Accepting just one, whether Freudian,
Jungian or Ericksonian, can only straight-jacket the
therapist.
If the Ericksonian approach teaches anything, it is
that the therapist must be open minded and flexible
and must not bring his or her own prejudices into the
therapeutic session.
The Ericksonian approach lends itself very well to a
detailed case study approach. Generalisations can be
made, based on such case studies, but general theories are not possible at present. Given that the focus
of hypnotism is on the subject then the case study
approach is inevitably the most appropriate one.
General Princples
There is, of course, the possibility that ‘anything
goes’, thus rendering the approach vacuous, like a
‘theory’ which applies to all in all circumstances – it
becomes no theory at all!
This is not the case with the Ericksonian
approach. There are general principles underlying
it.
This was demonstrated by Grinder and Bandler and
by Rossi. Elements in the approach include:
l
l
l
l
l
l
Permissive use of language.
Allowing people to be as they are and
utilizing what they are and how they
think.
Approaching hypnotic induction in a
‘naturalistic’ manner and utilizing the
subject’s inner world.
Language and behaviour of the therapist being based on supposing what
will happen is going to happen.
Matching the responses (verbal and
nonverbal) of the subject.
Approaches such as splitting (e.g.
conscious and unconscious) and linking.
Present and future
The emphasis of hypnosis today is on its therapeutic use. Hypnotherapy is a tool used for a wild field of
conditions, from more clinical uses such as in dentistry
and obstetrics to a variety of problems such as diet,
skin disorders or sexual dysfunction.
Equally significant is its growing use in dealing with
stress and related problems: hypnotherapy is a coping
empowerer. It has been used for some time to effect
behaviour modification, but this aspect has really only
relatively recently been seen as a means of realising
potential in many aspects of daily life.
In other words, hypnotherapy implies that hypnosis
is used for overcoming some ‘problem’ which requires
‘therapy’. Achieving full potential is not a problem per
se and so the use of hypnosis in this regard (especially self hypnosis) should not be thought of as ‘therapy’
– more as an aid to self-development.
As I see it, the main evolution of hypnosis will occur
in the realms of self-development and as a non-toxic
means of dealing with stress.
What is apparent from this list is that they all involve
means of good communication, of achieving a good
rapport with the subject.
Rapport has always been important for hypnosis,
but what constitutes good rapport has been hard to
define. It is possible to argue that the Ericksonian
approach, rather than being completely new, is simply
a very good set of guidelines for achieving good rapport with a subject.
Whether it represents a brand new approach or
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