Therapeutic Trances The Cooperation Principle in

Ericksonian Hypnotherapy, 1st Edition

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Contents

Acknowledgments vi
Introduction to the Classic Edition vii
Foreword by Jeffrey K. Zeig x
Introduction xiii

1 The Ericksonian Approach to Hypnosis 3

2 The Experience of Trance 31

3 The General Approach of the Ericksonian Hypnotherapist 63

4 Cooperation Strategies 98

5 Creating a Context for Therapeutic Trance 148

6 Associational Strategies for Developing Therapeutic

Trance181

7 Depotentiating Conscious Processes: Confusion

Techniques235

8 Balancing Associational and Dissociational Strategies:

Practical Issues Regarding Therapeutic Inductions 299

Epilogue 347
References 349
Index 355
Acknowledgments

Many people have participated in the birth of this book, and special thanks go to
the following:

• to those colleagues who read and provided feedback on the manuscript, espe-
cially Chris Beletsis, Lisa Chiara, Steve Dwoorman, Hank Freedman, John
Klinkert, Barbara Larocca, Marc Lehrer, Carol Locke, Neil Perrine, Eileen
Shields, and Jeff Zeig;
• to Julianna St. John, who helped considerably with her secretarial skills;
• to Ann Alhadeff of Brunner/Mazel, who contributed invaluable editorial
assistance;
• to Paul Carter, who was my teaching partner for most of the years in which
the manuscript was being written and who therefore contributed meaning-
fully to the ideas presented below;
• to my students and clients, without whose partnership I would have learned
nothing;
• to Denise Ross, my wife and soul mate, whose love and presence inspired me
at a time when the manuscript was in danger of never being completed;
• and to Milton Erickson, whose unorthodox and multifaceted ways trans-
formed all my images and ideas of therapy, not to mention life itself.

To all of these individuals and then some, I would like to say, “Thank you.”
Introduction to the Classic Edition

It’s been over 30 years since the first edition of Therapeutic Trances was pub-
lished. I was a much younger man, barely over 30 years old, still an intensely
devoted student of Milton Erickson. A lot has happened since then, and my work
has evolved beyond Erickson, though my respect for his legacy has only deep-
ened. I started studying with him when I was 19; he was really my first major
psychotherapy influence, and so I didn’t have that many bad habits to overcome.
One of the major things he taught me was that creativity is the major skill we’re
looking to activate in our clients, and that therapeutic trance is a major modality
for achieving that.
When we talk about creativity in a therapy or coaching session, we mean it in
a practical way: How does a person create new relationships, new identities, the
new parts of their being needed to move forward in a positive life? And when
we talk about trance as a medium for that process, we’re not talking about an
artificial trance where a client is “put to sleep” and told what to do, but a natural
trance wherein a person’s unique values and experiential patterns are welcomed
and stirred into the “quantum soup bowl” of therapeutic trance, to mix and morph
into new identity mosaics that, in Erickson’s words, best express the needs and
competencies of the present self. My appreciation for these ideas has only deep-
ened over 40 years of professional and personal life, and so I’m happy to see this
second edition of the very first book I wrote.
Creativity has been studied extensively over the past century, with most theo-
retical models strongly influenced by the 4-step model proposed by the American
psychologist Graham Wallas (1926). The first step is preparation, where con-
scious effort defines and explores a problem or goal. At the point of an impasse, a
second step of incubation occurs, wherein creative people take a break—a nap, a
walk, playing music, socializing, whatever pleasurable activity provides rest and
release from stickiness. If you’re lucky and well prepared, a third step of illumina-
tion occurs: The light bulb goes off, and an answer suddenly “flashes” into aware-
ness. (Some of my most pleasurable and creative moments in writing have come
in the hot tub late at night, after a long day of working on the manuscript.) You’re
not out of the woods yet—a fourth step of verification is needed, where a lot of
work is required to translate the inner realization into an outer sustainable reality.
viii Therapeutic Trances

We can see these four steps really as an alternation between two ways of think-
ing. The first is what in hypnosis we call the conscious mind. This is the effortful
machinations of the verbally dominated social cognitive intellect, which is able
to focus attention, set goals, move in sequences, consider new meanings, and so
forth. The second type of intelligence is what might be called the creative uncon-
scious, which provides the complementary intelligence of nonlinear, experiential
symbolic thinking. As in a dream or in play, the creative unconscious is able to
go anywhere from anywhere, and anything can turn into anything. For any sort
of sustainable creativity, there usually needs to be a good reciprocal relationship
between these two minds.
That means, for example, that a learning process starts with some intention:
There’s something I want to experience or achieve in my life. You do your best
to get there, but at some point you get stuck and find yourself sensing, I don’t
know what to do next. Most of the time we try harder, so much so that an idiom
developed to remind us: If you find yourself in a hole, stop digging! This point of
not-knowing is when and why trance is helpful: It’s a signal to open up to new
possibilities. This is what a therapeutic trance helps you to do: safely surrender
to a deeper creative intelligence within in order to allow a new self to emerge.
Once this inner shift occurs, you still need to exercise it through commitment and
practice.
For example, a middle-aged woman, a mathematics professor, reported strug-
gling with the sudden passing of her father. She shared how her father had been
the most positive person in her life, and how she couldn’t imagine how to move
forward in her life without him. I asked if this meant that she wanted to move for-
ward, but didn’t know how, and she agreed. I asked her to attune to that inten-
tion, and then notice any experiential responses in her body. She said she felt
tremendous anxiety in her chest. Taking a few moments to positive attune to that
somatic experience, I gently “welcomed” it into our conversation, and asked if
there were any images connected with it. The client said, It’s like an elephant’s
foot is stepping on my chest. Staying in that “experiential resonance” mode with
the client, I gently suggested that it was likely bringing an important resource to
her. The woman closed her eyes in an inward response, quiet for a few moments
before breaking out into a laugh. She reported observing the elephant stand up,
turn around so its truck pointed outwards from my client’s heart, before waving
it and bellowing loudly into the world. The woman noted she had been reading
about Ganesh, the Hindu “elephant God,” also known as the clearer of obstacles,
and this elephant was apparently there to help her clear the path forward for the
next step of the journey.
This small example suggests one of the main values of hypnotic trance work
in psychotherapy: It opens new creative pathways when a person is stuck. This
is where and why trance is used: When a person consciously does not know how
to positively respond to a challenge, trance opens a safe space for the creative
unconscious to give a “second opinion” on the issue at hand. This allows a person
 Introduction to the Classic Edition ix

to feel the partnership of the “conscious” and “creative unconscious” minds as the
most important relationship for health, happiness, and creative living.
This is what I learned from Erickson, and this book describes the careful and
generative framework that Dr. Erickson developed from over 50 years of psychi-
atric practice. I hope the work is as inspirational and helpful to you as it has been
for me.
Stephen Gilligan
Ph.D.
February 12, 2018
Wallas, G. (1926)
The Art of Thought. New York: Harcourt, Brace and Co.
Foreword

I had the good fortune to serve with Stephen Gilligan on the faculty of the 1986
Second Annual San Diego Conference on Hypnotic and Strategic Interventions
sponsored by The Milton H. Erickson Institute of San Diego. During one of his
presentations, Gilligan told this joke: “How many Ericksonians does it take to
change a light bulb? Why, eight: one to change the bulb and seven to tell meta-
phors about how Erickson would have done it better.”
Fortunately, this is not a book about how Milton H. Erickson did it bet-
ter. In fact, it is not even about Erickson. Although the central topic is Erick-
sonian hypnotic induction, this is actually a manual about psychotherapeutic
change—a book that teaches you as a therapist to improve your ability as a
communicator.
Certainly all psychotherapists can benefit from improving their communication
skills. One of the exciting aspects of this trade is that we have no tangible tools—
only our artistry at communication. Our only tool is ourselves.
In order to communicate therapeutically, one needs to grow increasingly aware
of the effect of one’s message and the effect one’s message can have. And so this
book is about Erickson in a way, because there is no one who was a better model
of communication than Erickson. He spent his career improving his awareness of
and power at interpersonal effect.
Many sought out Erickson and were intrigued by his original and enduring
contributions, including Jay Haley, Ernest Rossi, Richard Bandler and John
Grinder, Stephen and Carol Lankton, Michele Ritterman, and Bill O’Hanlon.
Subsequently, these experts developed models to help practitioners manifest in
their own clinical work some of the spectacular effects that Erickson achieved.
Even the great anthropologists, Margaret Mead and Gregory Bateson, contacted
Erickson to study his methods.
In Therapeutic Trances, Gilligan brings to bear his training as an experimental
psychologist and synthesizes the approaches of his mentors, Erickson, Bandler and
Grinder, and Bateson. From these three well-springs he creates his own model—
fresh and new. But his approach bears the imprint of the lessons he learned well:
generative creativity, boldness, and intellectual incisiveness—how to effectively
join hypnosis, linguistics, and philosophy.
 Foreword xi

Gilligan is not a mere synthesizer. He is a pioneer and developer. His contribu-

tions to psychotherapy are original and enduring, just as the contributions of this
book are original and enduring.
In order to place Therapeutic Trances in historical perspective, we need to
understand some things about the phenomenon that was Milton Erickson. Erick-
son was a psychiatrist who has been dubbed both the father of modern hypnosis
and its offspring, brief strategic psychotherapy. He was a master therapist who
used hypnosis because it was a model par excellence of influence communication.
Erickson was known for his use of indirect, hypnotically based methods, and he
used this technique because it was the most effective way to get patients to realize
their power to change—and to elicit their cooperation.
One of the main problems in therapy is to increase patient compliance. Patients
often come to therapy because they have lost the ability to cooperate within them-
selves and among important people. They are lost in recursive patterns of limited
choice and have lost track of intrinsic abilities to change.
Hypnotic induction definitely promotes cooperation, and this is true even with
direct suggestions. For example, if a patient is told, “Cigarette smoke will taste
bad,” it is more likely the response will be positive if the suggestion follows an
effective hypnotic induction. In fact, during his middle years, Erickson noted that
the main purpose of induction was to elicit patient cooperation.
Gilligan helps us to understand how to effectively tailor nonconventional Erick-
sonian therapeutic communication, especially in inducing trance states. Induction is
a procedure by which the therapist helps the patient to pattern a new flexible per-
spective; the patient learns how to elicit trance phenomena such as perceptual altera-
tions, automatic (nonvolitional) behavior, altered memory function, and so forth.
When one examines the effects that can be achieved by hypnosis, one can see a
striking similarity between symptoms and trance phenomena. For example, a pho-
bic patient could scare himself by vividly (and even nonvolitionally) imagining
“horror movies” about the future. However, in hypnosis, the same patient could
imagine a pleasant scene with equal vividness.
Erickson used a phrase to describe the underlying principle: “If you can have
phantom pain, you can have phantom pleasure.” Following in Erickson’s foot-
steps, I have pointed out that the mechanism by which a problem is maintained is a
mechanism of solution. Actually, the mechanism is always benign. The end result
(presenting complaints) might be problematic, but just because the end point is a
problem doesn’t mean the therapist should throw out the baby with the bath water.
The well-developed symptom strategies in the patient can be conceived as benign
or even positive. Because these strategies are well developed, it is better to use
them rather than to try to tear them down and resurrect new ones.
Like no previous writer, Gilligan elaborates and develops the similarities
among mechanisms to maintain problems, generate trance phenomena, and gen-
erate solutions. It is an important concept and by itself it would make studying
this book invaluable. However, there are other important contributions. Notable
examples are the explication of the “both/and” reasoning of the hypnotized patient,
xii Therapeutic Trances

associational and dissociational strategies, and the confusion technique. In fact,

Gilligan’s chapter on confusion is the most important advance on this technique
since Erickson’s original article more than two decades ago. It is astonishing that
more has not been written about therapeutic confusion, because Erickson consid-
ered it one of the most important techniques he contributed to hypnosis. Gilligan’s
chapter mines a rich therapeutic vein and will be cited for years to come.
Another exceptional quality of this book is that it is the closest one can come
to experiencing Gilligan without attending one of his internationally renowned
workshops. In his workshops, Gilligan stresses the growth and development of
the therapist.
This book is similar. It is the first hypnosis book that focuses as much on the
therapist as it does on the patient, problem, technique, or theory. Actual methods
are presented for the therapist to maintain an effective externally directed trance
and to deal with “unacceptable experiences,” for example, the problems the thera-
pist brings to the situation.
Therapeutic Trances is a manifesto of the fundamentals of Ericksonian
hypnotherapy—fundamental principles and fundamental techniques. It is a trea-
sure trove of practical ideas, giving therapists specific questions to ask and general
therapeutic ideas to pursue. Scholarly and well-written concepts are developed in
a logical and orderly fashion. We are privy to actual transcripts so that techniques
are demonstrated rather than explained. At a time when Ericksonian methods
have brought interest back to hypnosis, this book will stimulate its growth and
development.
So, how many Ericksonians does it take to change a light bulb? The answer is
one. But it sure helps to have Gilligan show us how we can do it better.
It is a pleasure to learn from Gilligan and I look forward with anticipation to
the sequel to this book.
Jeffrey K. Zeig
Ph.D., Director
The Milton H. Erickson Foundation
Phoenix, Arizona
August 1986
Introduction

This is a book about the therapeutic use of trance states. It is written primarily
for therapists, although other health professionals may find applications as well.
Based on the seminal work of Milton H. Erickson, M.D., it is intended to provide
a sense of how therapists may cooperate with clients to translate problems into
solutions.
A major premise of the book is that hypnosis is an excellent model for describ-
ing how experience is generated. Hypnosis is conceptualized as an experientially
absorbing interactional sequence that produces an altered state of consciousness
wherein self-expressions begin to happen automatically (i.e., without conscious
mediation). As we will see, this naturalistic approach enables both the induction
of “out-of-control” symptoms and the induction of therapeutic trance states to
be described with a common language; thus, an orientation to a problem is an
orientation to a naturalistic “hypnotic induction” already in effect (cf. Ritterman,
1983). Using the same language to describe problems and solutions allows the
hypnotic induction and other therapeutic communications to be fashioned directly
from the “problem induction” employed by the client. In this way, the Ericksonian
practitioner utilizes the very patterns by which the client is maintaining limiting
realities to expand the range of possibilities.
Another major premise underlying this view is that the value of an experience
depends primarily on its context. For example, a young woman entered therapy
with the complaint that for several months she had, upon closing her eyes and
trying to relax, been confronted by an intense “pair of eyes.” These eyes were
disembodied (i.e., disconnected from a face or body), staring steadfastly at her
until she opened her eyes and reoriented externally. The experience was becom-
ing increasingly troubling to the woman, so she sought therapeutic assistance in
dealing with it.
Interestingly enough, a similar phenomenological experience was reported sev-
eral months later in a therapist training group in Germany. During a group trance
process, it was generally suggested that participants could develop an enjoyable
dissociation state (“the Middle of Nowhere”), wherein their unconscious minds
might share with them a meaningful symbol for further self-development. When
the trance was concluded and experiential reports were solicited, a woman raised
xiv Therapeutic Trances

her hand to disclose an experience of great value to her. She described developing
a pleasurable immersion in a “voidlike” state during the trance, then gradually
becoming aware of a pair of eyes slowly moving towards her from a distance.
She sensed that this unusual experience was somehow deeply meaningful, as if
“something or somebody was returning back” to her. Deeply moved and touched,
she felt no need to consciously analyze the experience.
Thus, the same trancelike phenomenon of “disconnected eyes” was experi-
enced by two different people. For one it was a problem, for the other a solution.
The “difference making the difference” (cf. Bateson, 1979), it will be argued, can
be summarized in a word: Context. As we will see, context (“that which goes with
the text or story”) can be described in multiple languages: (1) bio-logic (the expe-
riential presence and rhythms of participants), (2) socio-logic (the community in
which an expression is offered), (3) ideo-logic (the intentions or ideas to which
a person or community is committed), and (4) psycho-logic (the structures by
which a person represents and makes sense out of an experience).
Depending on the values of these various contexts, a phenomenological expe-
rience can take on radically different meanings. For example, the “disconnected
eyes” phenomenon was experienced as a problem within a context involving
arrhythmic biological patterns (e.g., suspended breathing and tense muscle tone),
no community support, no sense of asking the eyes to appear, and a sense of need-
ing to relate to the eyes by avoiding them. In vivid contrast, the same phenom-
enon was experienced as a solution within a context distinguished by balanced
biological rhythms, community support and acknowledgment, a sense of inviting
an unusual symbol to emerge, and relationship patterns emphasizing acceptance
and appreciation of whatever occurred.
All this suggests that the task of the therapist is to recontextualize problem-
atic processes so they can function as “valueable” solutions in the developmen-
tal growth of the person. With the woman troubled by the eyes, for example,
I first secured her attention in a soft yet absorbing fashion. After receiving a
detailed description of her experience (such as when, where, how, with whom
the eyes showed up), I asked her to keep her eyes open and look at mine as
hypnotic communications were offered. These communications elaborated how
absorption in my eyes could remain constant, even as my face might change in
a variety of surprising yet secure ways. By thus disengaging (my) eyes from
face, the disembodied eyes technique she developed naturalistically was expe-
rientially recreated within the therapeutic relationship. Further hypnotic sug-
gestions described the many possible ways that her unconscious could begin
to explore and relate to the eyes as a means of secure self-discovery and self-
development, knowing that she could use my voice as a guide and security
anchor throughout the explorations. In this way, the problem was experientially
reconstructed as an opportunity to master a meaningful hypnotic process devel-
oped by her unconscious.
This paradoxical approach of translating problems into solutions via the hyp-
notherapeutic relationship is elaborated over the following eight chapters. The
 Introduction xv

first chapter develops a general framework for understanding the Ericksonian

approach to hypnotherapy. It contrasts the more traditional views of the authori-
tarian approach (emphasizing the hypnotist’s “power”) and the standardized
approach (emphasizing the subject’s “susceptibility”) to the interactional view
of the Ericksonian approach (emphasizing the cooperative relationship between
hypnotist and subject). The chapter then identifies other key ideas underlying
Ericksonian hypnotherapy: (1) each person is unique; (2) hypnosis is an experi-
ential process of communicating ideas; (3) each person has generative resources;
(4) trance potentiates resources; (5) trance is naturalistic and biologically essen-
tial; (6) Ericksonian approaches orient to solutions more than to problems;
(7) a person’s uniqueness may be appreciated at many levels; and (8) the uncon-
scious can operate generatively.
Chapter 2 explores the experience of trance. Theories and metaphors used to
describe trance are first overviewed, followed by a naturalistic view of trance
as a cross-contextual and biologically essential process serving multiple func-
tions. Phenomenological characteristics of the trance experience (e.g., effortless
expression, time/space variability, trance logic) are then identified. This chapter
elaborates how symptom phenomena and hypnotic phenomena are the same phe-
nomena expressed in different contexts, such that the therapeutic context can be
used to translate liabilities into assets.
Chapter 3 overviews the general approach of the Ericksonian hypnotherapist,
developing three key ideas in the process. First, integrity is an essential context
for therapeutic effectiveness. Second, the hypnotherapist may develop an “inter-
personal trance” with the client as a means for stimulating unconscious creativity
and achieving therapeutic outcomes. Third, the principle of cooperation (that is,
accepting and utilizing the client’s reality) is the primary basis for all techniques.
Throughout the chapter, the need for flexibility and sensitivity to ongoing pro-
cesses is underlined.
Chapter 4 details how this adaptation to another person’s reality may be
achieved on multiple levels. Methods of joining and directing a person’s behavior
via verbal and nonverbal channels are identified, followed by a discussion of how
to observe and utilize micro-behavioral (“minimal”) cues. Application of cooper-
ation principles to macro-behaviors (e.g., symptoms, lifestyles, skills, and assets)
is then explored. Throughout, the notion of hypnotic communication as unfolding
within a experiential feedback loop is emphasized.
Chapter 5 focuses on the more specific area of the initial phase of hypnotherapy.
This phase includes the complementary processes of (1) gathering information
about how a client generates and maintains a reality and (2) introducing the expe-
riential and naturalistic process of therapeutic trance. Thus, the hypnotherapist
seeks to identify invariant values in the client’s world (e.g., social relationships,
intentions, fixed behavioral patterns, beliefs), then uses these values to develop
experiential processes within the therapeutic field.
Chapter 6 details ways to elicit hypnotic responses. Specific accessing tech-
niques include asking questions, interspersing suggestions, presupposing hypnotic
xvi Therapeutic Trances

responses, speaking generally, telling stories, using associational cues, devel-

oping new associational bondings, pacing and leading dominant cognitive modal-
ities, and framing and ratifying hypnotic responses. All of these techniques use
naturalistic communications within a sensitive interpersonal feedback loop to
immerse a person in experiential realities conducive to both trance development
and therapeutic change.
Chapter 7 discusses how the client’s responses may interfere with the straight-
forward development of therapeutic trance, and how the therapist may utilize
such responses as the basis for hypnotic confusion techniques. These “deframing”
techniques, pioneered by Milton Erickson, involve aligning with client patterns
and then either interrupting or overloading the patterns to initiate hypnotic recep-
tivity. The importance of contextual factors (relationship, nonverbal communica-
tion, etc.) is emphasized throughout the discussion.
The final chapter seeks to demonstrate how the principles and techniques
explored in the various chapters come together in various areas of practical appli-
cation. A detailed transcript of an induction is first examined, followed by discus-
sions of applications with children, psychotics, emergency situations, and groups.
Finally, a series of questions for identifying where a hypnotherapist may be stuck
in relating to clients is offered.
Throughout the book there is an emphasis on unconscious generativity, both in
the therapist and the client. It is argued that creative solutions to vexing problems
can emerge when therapist and client trust their unconscious processes to cooper-
ate in a joint endeavor. Because some mistakenly assume that this view advocates
the mindless and narcissistic free association of the therapist, it should be made
clear from the outset that nothing could be further from the heart of the matter.
The approach outlined in the following pages requires the therapist’s complete
commitment to the client, involving a full experiential presence as well as the
ability to join and differentiate patterns at many levels. Dedication and rigor are
needed as the therapist discovers how to be “a part of and apart from” the client’s
reality in this process of “controlled spontaneity.” As we will see, therapists must
be in tune with and draw on both their own and their clients’ unconscious capaci-
ties if this process is to succeed.
As a final note, it should be emphasized that the book is neither exhaustive nor
definitive. It is one possible approach to Ericksonian therapy; different perspec-
tives have been outlined by others (see Zeig, 1985a, 1985b). Furthermore, this
volume is the first in a planned series; additional volumes will elaborate hyp-
notherapy structures and psychotherapy models helpful in applying Ericksonian
principles and processes in “variable” fashions. Having stated these caveats,
I invite you to explore the book at your own rate and style. Whether you find the
various techniques relevant or not, my major hope is that you sincerely consider
the principle of cooperation as the basis for transformational change, not only in
therapy but also in other areas of human interaction.
Therapeutic Trances
The Cooperation Principle in
Ericksonian Hypnotherapy