National Board for Certified

Clinical Hypnotherapists

Strategic Pattern Interruption

 

By: Ron Klein, CAAC, NBCCH

www.ronklein-online.com

 

Over the years I have come to believe that one of the most important values Dr. Milton H. Erickson held was, “keep it simple.”  He regularly suggested that his students interrupt or break the habitual sets of their patients. Moreover, many of his interventions seem designed to simply change the order or syntax of their patterns of thinking and/or behavior.

On one occasion he instructs a depressed, lonely older woman who rarely leaves her house, to give her African Violets as gifts to people in her home town when ever they celebrate graduations, weddings, births, etc.  Her depression lifts as she gets out and makes friends with hundreds of folks throughout the community.  In another case, he startles a student at one of his teaching seminars, and shouts for her to jump out of her chair, leaving her phobia for flying behind.  She reports enjoying flying home from his class and warns the students the next time she attends a workshop, that  no one should sit in that chair because they will be infected with her phobia.

“…And then what you need to do is to try to do something that induces a change in the patient – any little change.  Because the patient wants a change however small, and he will accept that as a change…and then follow that change and the change will develop in accordance with his own needs.  It’s much like rolling a snowball down a mountain side.  It starts out a small snowball, but as it rolls down it gets larger and larger…and starts an avalanche that fits to the shape of the mountain.”  (-Milton H. Erickson, 1978 (Gordon and Myers-Anderson))

“Milton Erickson was working with an alcoholic.  The guy was an ace in World War I and he comes in with an album of photographs of himself, newspaper clippings, and he'’ a lush.  He wants to be cured of being a lush.  He shows this book to Milton.  Milton picks it up and throws it in the wastepaper basket.  '‘It’s nothing to do with you, that.'’ Then after various exchanges, Milton asks him how he always starts on a binge.  ‘Well, I set up two boiler makers, and I drink one and wash it down with a beer, and then I drink the other and wash it with the second beer, and I’m off to the races.’   Okay,’ says dr. Erickson, ‘you just go ahead and leave my office, proceed to the nearest bar, and order your two boiler makers.  Go ahead and finish off the first and as you do, toast by saying, “Here’s to that bastard Dr. Erickson.”  When you lift the other drink say,  ”Here’s to that bastard Erickson, may he rot in hell.”  Good Night.’  The patient came back a year later, sober.”  (Bateson, 1975)

 In conversations with his students he states that the way people move their eyes, move their bodies, gestures they make, the way they breath, carries a lot of information.  Perhaps Dr. Erickson is inviting us not only to watch the eye scanning patterns or other behaviors, but may be inviting therapists to suggest  the client  altering the way, or the sequence of these patterns.

…Maladies, whether psychogenic or organic, followed definite patterns of some sort..... that a disruption.....could be the most therapeutic measure; and that it often matters little how small the disruption was…”  (Milton H. Erickson, 1953)

“Symptoms tend to occur in patterned ways.  They typically occur at certain times of the day and not at other times, with a certain frequency, at certain intervals, in certain locations and not others, with some person(s) present and not others.  They endure for some length of time, have affective, cognitive, physiological, perceptual components, and are characterized by observable behaviors…” (Bandler and Grinder, 1979).

“To intervene, it is recommended that the therapist gather very specific information on how the symptom always occurs, how it usually occurs and how it never occurs.  This could be done by direct observation (where feasible) and by gathering the data from the client’s (or other’s) verbal reports.  It is important to obtain a sensory-based description, e.g., “three times a week” as opposed to “a lot”. (Bandler and Grinder, 1975).

As Erickson said, “Human beings being human tend to react in patterns and we are governed by patterns of behavior…you don’t realize how very rigidly patterned all of us are…” (Gordon and Myers-Anderson, 1981).  Only when there is a symptom present is it recommended that the rigid patterns are altered and even then only the ones surrounding the symptom, not every rigid unconscious pattern needs to be changed.  As the popular saying goes, “If it works, don’t fix it.” (Bill O’Hanlon 1984)

Symptoms are not only maintained by patterns, the pattern is operationally equivalent to the symptom.  That is, if one could alter the pattern that surrounds and includes the symptom with, again in Bateson’s words. “a difference that makes a difference”, the symptom would no longer maintained. (Bill O’Hanlon 1984)

There is no need, according to this view, to determine “why” the pattern or symptom has come to exist or what function (either intrapsychic or interpersonal) it fulfills.  Both symptomatic and non-symptomatic experience, perception, behavior and interaction are patterned.  Why that should be the case is a matter of speculation and is considered irrelevant for the pragmatic goal of therapeutic change.  The patterns that occur around the symptom can be divided into two types:  personal and interpersonal.  Information about both can be gathered  (as above) by direct observation and by eliciting sensory-based reports from clients and/or significant others.  (Bandler and Grinder 1976)

Clients tend to use certain phrases, analogies, metaphors and verbal patterns to describe their symptoms (Bandler and Grinder, 1975); (Grinder and Bandler, 1976; Weintraub, 1980).  In addition, non-verbal elements tend to be patterned in predictable, rigid ways around the patterns.  These patterns include breathing rate/depth, eye-scanning movements {emphasis added}, voice tone, body posture, muscle tonus, body symmetry, etc.  “…any of these he patterns may be changed or broken by addition, by repetition by anything that will force you to a new perception of it, and those changes can never be predicted with absolute certainty because they have not yet happened…”  (Gregory Bateson, 1979 Mind and Nature.)

What follows are classes of interventions that from the systematic study of Erickson’s work.  They delineate different options for intervention in personal and interpersonal patterns of perception, behavior and experience.

       Change the frequency/rate of the symptom/pattern.

       Change the intensity of the symptom/pattern.

       Change the duration of the symptom/pattern.

       Change the time (hour/time of day/week/month/year) of the symptom/pattern.

       Change the location (in the world or in the body) of the symptom/pattern.

       Change some quality of the symptom/pattern.

       Perform the symptom without the pattern; short circuiting.

       Perform the pattern without the symptom.

       Change the sequence of the elements in the pattern.

       Interrupt or otherwise prevent the pattern from occurring.

       Add (at least) one new element to the pattern.

       Break up any previously whole element into smaller elements.

       Link the symptom/pattern to another pattern/goal.

 

Interventions are made in the symptom or the pattern using these generic intervention guidelines until an intervention is found that abolishes the symptomatic pattern.  It is not necessary to discover the cause or function of the symptom, it is enough to discover a “difference that makes a difference”.  (Bill O’Hanlon 1984)

I propose to my students at the American Hypnosis Training Academy, that the goal of the therapist should be to effect a well-formed change in every session.  Eric Berne, M.D. suggested that therapy should take no more that 30 minutes.  He said that if the therapist didn’t believe that was a possibility, psychotherapy would be unnecessarily prolonged .

Years ago I found a quote that expresses another aspect of Dr. Erickson’s approach the Psychotherapy.  Unfortunately, I can’t find the source.

The perception of the client that the therapist holds in mind, is the prophecy the client will fulfill.

The perception of her/himself the client holds in mind, is the prophecy the client is fulfilling when she/he comes to therapy.

When the client and the therapist hold the same perception of the client in mind, the fulfilling of the shared prophecy is inevitable.

 

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