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The Ericksonian Approach 
by Zainal Abidin Rahman

In the NLP and psychotherapy communities, the name Milton Erickson evokes feelings of awe and reverence.  Steve Lankton, who studied directly with Erickson, said he used to read a chapter about Erickson at the start of his trainings and would invariably weep at the memories. 

How did Erickson become such a genius?  Confronted with patients and clients who other doctors and psychologists have given up hope, how did he know exactly what to do with them that they got better within a short time?

His training as a medical doctor undoubtedly helped.  But there is more to it. It’s what we call the Ericksonian Approach.  It is an approach which has been instrumental in the development of many therapeutic and human potential technologies such as Solution Focused Therapy and Neuro Linguistic Programming.

Taken and adapted from the work of Jeffrey Zeig, PhD, the Ericksonian Approach can be summarised as follows:

1        Humanism

Milton Erickson had a genuine care and concern for the people he worked with.  Erickson’s children reported that it was normal for patients to move about in the living room and kitchen of the family home and interact with them.  One patient from out of town was even allowed to set up camp in the back garden because he could not afford to stay in a hotel.  

Erickson would call to give Christmas greetings or gifts to former patients even years after they had recovered just to enquire how they were getting on.  Erickson’s idea of a patient being well was when they had a decent job, got married with several children and send him Christmas cards!  He enjoyed that.

1        Utilization.

Unlike many psychiatrist or psychologists, Erickson had a strong aversion to theories and therefore wasn’t into analysing the reasons why someone was in a stuck state.  He utilized any behaviour that’s presented to him by his clients – most frequently by referring or talking about them.  In one case, a patient had been left in a hospital for many years and no doctors knew how to treat him.  The patient had the unusual affliction of speaking in “word salad” which was speaking words that were out of normal syntax.  He therefore didn’t make sense to anyone.  For example, instead of saying “There is a cat in my attic” he could be saying “cat there in is attic a” in a most convincing manner.

After Erickson met the patient, he instructed a clerk to transcribe the word salad for several days. He studied the patterns of the word salad and when he was ready he met the patient and said something like “observing find you I  and interesting you been have.”  Soon the two of them were deep in an animated word salad conversation, talking to each other with complete conviction.  Save for the uniform, nurses couldn’t make out who was the doctor and who was the patient!

Over the next few weeks the two of them could be heard making such exchanges. Over time, the patient started to talk in normal sentences and nurses and doctors were able to communicate with him.

The maxim of an Ericksonian is: “Utilise, don’t analyze”.

2        Sensory Perceptiveness

Erickson was a master of perceptiveness when interacting with people. There are tons of stories about how Erickson could detect the smallest cues and could assess a person’s character barely 5 minutes into meeting him.  This ability obviously was instrumental in helping him assess the best way to change the client.  One of the best sources of these stories is The Uncommon Casebook – The Complete Clinical Work of Milton H Erickson MD by O’Hanlon and Hexum.

3        Ordeals

Erickson frequently gave tasks for his clients before they could see him for the first appointment.  Such tasks which are symbolic in nature were intended to help clients work out their motivation.  In Erickson’s time, it was fashionable to suggest they climb up Squaw Peak , a small hill like Bukit Timah Hill in Singapore , but enough to get the climbers break into a sweat.  Or they were tasked to grow cactus plants and distribute them to strangers, or observe the different shapes of grasses in their gardens.

5        Thoroughness

In his younger days, Erickson agonised over such simple things as the choice of words to use with his patients.  Before meeting a patient, he wrote pages and pages of scripts, which he would pare down until he had the essence of his thoughts in only 1 page.  If he was still not satisfied with the script, he would cut that further to one paragraph, and ultimately one sentence.  Such thoroughness in preparation!

As he grew older, these early rigorous preparation paid off and he could say the right word to a patient in a split of a second as the event was unfolding before him.

6        Humour

Despite the insufferable pain which he suffered as a result of polio in his old age, Erickson had a great sense of humour.  I cannot resist sharing with you a story Zeig told us. 

Once, before beginning a lecture to a group of medical students Erickson bent forward with a gleam in his eyes and asked almost in a whisper, “Do you want to know the secret for longevity?

The students opened up their eyes and together said “Yes!”

Erickson took his time, scanned the room and when he saw the students were eagerly waiting for the answer, he intoned, “Wake up every morning.”

There was an audible groan among the students.

After a pause, he continued, “And do you want to know the secret for waking up in the morning?

The groan stopped and again the students were all ears.

“Drink lots of water just before going to sleep”.

You can imagine the rush for the dorm toilets at 5 every morning.