GRAND DELUSIONS

Psychotherapies Without Feeling

by Dr. Arthur Janov

Posted June 2005 on primaltherapy.com

Chapter 5: Reinforcing Neurosis with Hypnotherapy

As far back as 1958, the American Medical Association recognized the use of hypnosis by physicians and psychologists as a valid therapeutic modality.[1] Since then, hypnosis has become one of the most oft-used forms of therapy in pain management and psychotherapy.[2]

Are the changes effected by hypnosis permanent?  And if it is possible to effect permanent change in symptoms with hypnotherapy, is it desirable to do so, given the physiologic stress that results from maintaining the dissociation?

Whenever we consider hypnosis we must understand that however sophisticated the explanation, it is still repression that is at its core; a matter of narrowed perception; a constricted perceptual field.  Just as it is possible to make a person unaware of physical pain, it is possible to dissociate him from feelings of anxiety, low self-esteem, and depression. Someone can think his emotional problems have vanished when they have not. A person can believe that his feelings of inferiority have been resolved even while he admonishes his children to be the best in everything. While the hypnotic reality constructs one world -- "I feel relaxed," "I am not compulsive anymore," "I feel worthwhile," "I want the best for my kids" -- the actual physiologically engraved reality (necessarily) constructs another world of referred tensions, substituted symptoms, and projected emotions. The first logical extension of this fact is that applying hypnosis in psychotherapy means utilizing the same dissociative conditions of consciousness that characterize neurosis. The second logical extension is that hypnotherapy reinforces rather than resolves neurosis

Utilizing key neurotic mechanisms to treat neurosis is at the very least contradictory. But before examining these hypotheses, let us take a look at how two prominent hypnotherapists apply their views of hypnotherapy to their patients.

Different Views of Hypnotherapy: The Ericksonian Approach

Despite his death in 1980, Milton H. Erickson's approaches to hypnosis have swept the field. "Ericksonian Hypnotherapy" is a recognized area of specialization for therapists, and Ericksonian training centers and foundations exist across the country. Psychotherapists from other specialties -- psychoanalysis, behaviorism, gestalt, etc. -- also draw from Ericksonian methods.

Erickson led the field in developing a vast array of techniques that were often highly innovative, and sometimes shocking and incomprehensible. Several of his colleagues spent much time and effort studying and observing his techniques, trying to find out what he did and how he did it. Foremost among them was psychologist Ernest Rossi. Rossi was with Erickson during much of the last decade of his life and wrote several books (with Erickson as co-author) that attempted to systematize and conceptualize Erickson's hypnotic approaches. The only relatively simple part of Erickson's work was his theory of the "conscious and unconscious minds," but how he applied that theory clinically with patients remained highly unusual and virtually non-reproducible.  The crux of Erickson's viewpoint is the belief that the "unconscious mind" can heal the patient without the "conscious mind" ever being involved. According to Erickson, the conscious mind is often a barrier to healing.  In his view, the unconscious mind and its reception of repressive suggestions can do, as he demonstrated, is aid in the job of repression, so that symptoms are brought under control. "You will forget. You will not feel pain. You won't have migraines anymore."

In the hypnotic trance state, the conscious mind can be bypassed and the unconscious mind given free rein.  According to Erickson, the conscious mind contains the "learned limitations" and "negative life experiences" that prevent us from enjoying ourselves and using our given potentials. The unconscious mind, on the other hand, contains the answers and untapped potentials for us. In Erickson's view, by bypassing or "depotentiating" consciousness, the unconscious is allowed to solve and heal. This does not mean that consciousness is kept out entirely, for it may be brought in at the end in a very secondary position:

The patient doesn't consciously know what the problems are, no matter how good a story he tells you, because that's a conscious story. What are the unconscious factors? You want to deal with the unconscious mind, bring about therapy at that level, and then translate it to the conscious mind...One tries to do hypnotherapy at an unconscious level, but to give the patient an opportunity to transfer that understanding and insight to the conscious mind as far as it is needed.[3]

In other words, consciousness may be included in therapy, but it need not be. It certainly is not to be trusted, since "the patient doesn't consciously know what the problems are, no matter how good a story he tells you..." Hypnotherapy is effective when it occurs on an unconscious level, and may then be brought into consciousness, but only "as far as it is needed."

Erickson's approach to hypnotherapy was a distinctly cognitive one:

We view hypnotherapy as a process whereby we help people utilize their own mental associations, memories, and life potentials to achieve their own therapeutic goals. Hypnotic suggestions can facilitate the utilization of abilities and potentials that already exist within a person but that remain unused or underdeveloped because of a lack of training or understanding.[4]

In Erickson's terms, trance is a time during which "the limitations of one's usual frames of references and beliefs are temporarily altered so one can be receptive to other patterns of association and modes of mental functioning that are conducive to problem-solving."[5] Hypnotherapy, then, is a "learning process for the patient, a procedure for re-education.[6] [Emphasis added] Erickson's approach deals with the casualties of neurosis (the "learned limitations"). He believed that it was his role to actively change patients -- to use hypnosis and post-hypnotic amnesia to help them restructure their thinking.

Prominent psychotherapist and researcher Jay Haley studied Erickson extensively. The titles of two of his books on Erickson -- Uncommon Therapy: The Psychiatric Techniques of Milton H. Erickson, M.D. (1973), and Ordeal Therapy (1984) -- suggest the idiosyncratic nature of Erickson's techniques. For example, Erickson had a propensity to employ sexist language, verbal assaults, and other bullying approaches when treating women.[7] He was also an authoritarian therapist, as seen in the terms he dictated to a "plump," unhappy, unkempt, and unloved 35-year-old woman who had come to him for treatment:

These terms are absolute, full, and complete obedience in relation to every instruction I give you regardless of what I order or demand...You will be told what to do, and you will do it. That's it. If I tell you to resign your position, you will resign. If I tell you to eat fresh garlic cloves for breakfast, you will eat them...I want action and response -- not words, ideas, theories, concepts...Once you come, you are committed to therapy, and your bank account belongs to me as does the registration certificate for your car...I will tell you what to do and how to do it, and you are to be a most obedient patient.[8]

To "re-educate" this patient, from whom he had demanded complete obedience, Erickson induced a trance and then said to her:

"You are five feet three inches tall, and you weigh about 130 pounds; you have trim ankles, an excellent figure, a beautiful mouth and beautiful eyes..." Then, in a tone of voice of utter intensity, in the manner of conveying a vitally important message, she was asked the following question: "Ann, did you know that you have a pretty patch of fur between your legs?" For some minutes Ann stood staring at the author, blushing deeply and continuously, apparently too cataleptic to close her eyes or to move in any way. "You really have, Ann, and it is definitely darker than the hair on your head. Now at least an hour before bedtime, let us say at nine o'clock tonight, after you take your shower, stand in the nude before the full length mirror in your bedroom. Carefully, systematically, thoroughly examine your body from the waist down...Try to realize how much you would like to have the right man caress your pretty pubic hair and your softly rounded belly. Think of how you would like to have him caress your thighs and hips..."[9]

Erickson's theories and techniques notwithstanding, a person's self-image does not remain poor, nor do her abilities remain undeveloped, because of limited "frames of reference" or "a lack of training or understanding." Adult neurosis is not the result of cognitive distortions; it is the product of correct cognition which is out of context. Childhood trauma alters one's perceptions to accommodate the Pain.  When one's perception is altered, one sees hurt as an adult where none exists. "Can I help you?" becomes, "You think I'm helpless, don't you?" Furthermore, spontaneity and free feeling are not something we "learn"; children simply are spontaneous and free feeling until deprivation and injury intervene. A child whose father is too busy to notice him does not have "learned limitations"; he has the raw feeling of neglect. The child who is physically or sexually abused does not have "learned limitations"; she has the brutal pain of assault and violation. Her underlying fear and therefore distorted perceptions later on reflect an original situation that engendered lifelong fear. To be afraid of airplanes is to have fear from the past placed out of context in the present.

Learned limitations are the last outcrops of the neurotic process. They represent what Freud called the Superego. They are the acquired inhibitions impressed into the child's brain by parents when at last she has sufficient intellect to register and code inhibition. A stern look by a parent every time the child cries is an example. She "learns" not to cry on an emotional level without any words being spoken. The implicit factor here is fear of loss of love of the parents. If there is no real contact between parent and child, there will be little learned inhibition. Love has already been lost.                                                                                                                                                                         

  To assume that changing one's beliefs about oneself involves reeducation, training, or problem-solving is to assume incorrectly that beliefs, particularly about oneself, are rooted solely in cognition. Beliefs are the product of our experiences, and the source of "limiting beliefs" is a childhood with inculcated prohibitions about everything from how one eats to how one holds one's jaw.

A great deal of Erickson's hypnotherapy centered around the development of indirect suggestions that would "bypass" the conscious mind and lodge squarely and educationally in the unconscious mind. Since intellectual language is the province of the cortical mind, using language to bypass it requires some very clever wording. Erickson's skill at devising these clever linguistic loopholes, termed indirect suggestions, was unparalleled. Moreover, his use of indirect suggestions to bypass consciousness has become a model for much of the hypnotherapeutic community. This is the cognitive approach taken to its limit: there are suggestions called "double dissociation double binds" and those termed "conscious-unconscious double binds" -- not to mention compound, contingent, and associational suggestions. All in all, Rossi organized Erickson's indirect forms of suggestion into some 30 different categories, which he arrived at by simply analyzing the linguistic structure of the suggestion.

Erickson fully believed that suggestions which could not be understood by the conscious mind would be understood and acted upon by the benevolent unconscious mind. Indeed his trust in the unconscious was almost childlike:

You don't have to listen to me because your unconscious is here and can hear what it needs to, to respond in just the right way. And it really doesn't matter what your conscious mind does, because you don't have to listen to me because your unconscious is here and can hear what it needs to, to respond in just the right way. And it really doesn't matter what your conscious mind does, because your unconscious can find the right means of coping with that pain.[10]

Somehow the unconscious would then understand the message of a follow-up suggestion such as, "You can as a person awaken, but you do not need awaken as a body"[11] -- even as the conscious mind puzzled and fretted over its cryptic meaning. For Erickson, indirect suggestion was a cognitive means of bypassing cognition en route to a more beneficent unconscious which could hear, comprehend, decipher, solve, and heal all that consciousness could not. The problem with this viewpoint is that it is contradictory. On one hand, Erickson believed that consciousness could be bypassed by using intricate linguistic devices (ambiguities, metaphors, paradoxes, etc.) in the form of indirect suggestions which the conscious mind could not decipher. On the other hand, he assumed that the unconscious mind would be able to magically sift out the hidden meaning that had so eluded consciousness. The first contradiction is that he attempted to reach the non-verbal levels of the unconscious by using complex verbal techniques. The second contradiction is that in bypassing conscious-awareness, he was bypassing the one level of consciousness that contains the cognitive skills to actually comprehend his suggestions. And in bypassing consciousness he was bypassing exactly the element needed to stimulate the processes of healing and repair

None of this matters much to a person in Pain, and Erickson's viewpoint certainly spoke to the pained child in any adult. However simplistic or contradictory it might have seemed upon close intellectual scrutiny, his notion of the unconscious was comforting and promising. Indeed, it was made even more comforting (and believable) by virtue of Erickson's own personality and history.

In the last three decades of his life, Erickson was a living picture of the wise and comforting grandfather -- white-haired, penetrating, jocular, kindly, and crippled. Of far greater impact was the fact that he had lived out in a very poignant way the archetype of the wounded physician who learns to heal others by first learning to heal himself. At the age of 17, Erickson had almost died from an attack of polio that left his entire body paralyzed. As a teenage farm boy with nothing more than a rural education behind him, who was now still able to speak and see but unable to move any part of his body, he managed to find ways to use his mind to rejuvenate his muscular and motor abilities. Within a year-and-a-half of his attack he was able to walk unaided. Soon thereafter he entered medical school. Then at the age of 52 he experienced the rare medical tragedy of a second attack of polio, which robbed him of his upper-body strength and left him permanently confined to a wheelchair. He lived in constant pain and discomfort in the last decade of his life, but he continued to create ways to deal hypnotically with his disability and the physical pain it caused him. Patients knew this, and few remained untouched or uninfluenced by it.

The great poignancy in Erickson's history and physical presence must be taken into consideration in evaluating both his viewpoints and his impact. It would indeed be unfortunate if the course of psychotherapy as a field veered off into hypnotic realms in the hope of duplicating the often unprecedented results Erickson achieved professionally after coping with his own personal afflictions. His simplistic view of the unconscious has tended to be accepted uncritically, for example, by virtue of the results he achieved (by his own accounts) in applying it clinically. The question remains as to whether patients were responding to an intrinsic principle of consciousness rightly perceived and utilized by Erickson, or were they responding to the influence of an inspiring and seminal personality

Part of the trouble with Erickson's approach to therapy lies in his assuming the role of an omniscient, infallible figure. Jay Haley describes Erickson as "the first major clinician to concentrate on how to change people...influencing people with hypnosis, persuasion, or directives, Erickson...seems to have been the first major therapist to expect clinicians to innovate ways to solve a wide range of problems and to say that the responsibility for therapeutic change lies with the therapist, rather than with the patient."[12] Should a psychotherapist really be so concerned with "influencing" and "changing" his patients? When you combine this attitude with the needs of a patient, you have a formula for continued repression.

Herbert Spiegel

Another well-known hypnotherapist is psychiatrist Herbert Spiegel. In the forefront of hypnosis research for decades, Spiegel taught a graduate course on the medical and therapeutic uses of hypnosis at Columbia University's College of Physicians and Surgeons.  Originally trained as a psychoanalyst, Spiegel had become frustrated by the lengthy psychoanalytic process. He found that hypnosis could effect much speedier results.

According to Spiegel, hypnosis is a special state which we naturally slip into and out of throughout the day, and which the hypnotist merely utilizes:

All hypnosis is self-hypnosis. All that any "hypnosis" does is tap the natural capacity of an individual for focusing, for concentrating, for imagining, for visualizing, for blocking out distractions, for increasing awareness, for achieving greater control over the body's involuntary functions, for entering a different order of consciousness. The individual, in short, is not given anything new; he is simply helped to engage the means he already possesses in order to alter attention and perception and to influence his emotional and biological reactions.[13]

The primary significant point of departure between Erickson and Spiegel is in the area of trance induction. Whereas Erickson was noted for his indirect techniques, Spiegel prefers a straightforward approach. This difference, though, is really not significant in terms of a fundamental view of hypnosis: both leading hypnotherapists agree that hypnosis is an "ability" or "talent" or "capacity" of the human mind to alter reality in ways that are beneficial and healing. Spiegel frequently talks about "self-mastery" and how "trance as an art form" can best aid us in this struggle.

The core of Spiegel's approach is well captured in a chapter from a book detailing his work entitled, "Mastering Symptoms."[14] Although both Erickson and Spiegel use a cognitive approach, there is an interesting difference in the type of cognitive process employed. Where Erickson would typically use a complex double binding statement to confuse or startle the patient, Spiegel will present a simple, comprehensible, linear line of thought. With overweight patients, for example, Spiegel carefully explains that

(1) overeating is poison for the body;

(2) they need their body to live;

therefore

(3) they should protect and respect their body

by eating less.[15]

The overweight patient is then given the friendly advice "to reacquaint himself with his body so that when he meets it at his ideal weight, it will be like a reunion with an old friend."[16]

In contrast to Spiegel's rational approach, Erickson treated a 270-pound woman for her obesity by suggesting to her in trance: "Bearing in mind that you now weigh 270 pounds, I want you to overeat throughout the week enough to support 260 pounds."[17] The next week the patient was told to overeat sufficiently to support 255 pounds, and so forth. These suggestions are typical example of Erickson's use of the double bind whereby the patient was bound to overeat and bound to lose weight.  Although Erickson was often indirect, he was not without a direct approach. To another overweight patient he suggested:

I really don't think you know how unpleasant your fatness is to you...so tonight when you go to bed, first get in the nude and stand in front of a full-length mirror and really see how much you dislike all that fat you have. And if you think hard enough and look through that layer of blubber that you've got wrapped around you, you will see a very pretty feminine figure, but it is buried rather deeply. And what do you think you ought to do to get that figure excavated?[18]

Superficial differences between Spiegel and Erickson in style of suggestion are typical of the types of differences that exist among hypnotherapists.  The main categories include direct versus indirect suggestion, and an overall approach that is authoritarian versus permissive-naturalistic. Most well-trained hypnotherapists would probably use all four factors, depending upon the patient. Some patients respond better to suggestions given in an authoritarian manner; others are more receptive to suggestions that hook into their ongoing, natural behaviors, and so on.

Types of suggestion and styles of approach are incidental to the underlying agreement that hypnosis is beneficial. Types of suggestion may vary according to superficial personality characteristics, but the underlying intent remains the same: all hypnotherapists attempt to engage and utilize a condition of dissociation.

Amnesia

Hypnosis knocks out memory and the meaning of experience. You have amnesia, an experience without recall. In many cases, a partial or complete amnesia is suggested for any traumatic material that arises. Amnesia is considered useful because supposedly a person can undergo a traumatic but curative emotional experience on an unconscious level and not have to cope with it consciously. Trauma can be siphoned off while consciousness rests in its disconnected state of trance reverie. This goes hand-in-hand with the view that reliving or recalling a traumatic experience can be disintegrating, so amnesia is used as a kind of protective shield.

The integration of pain, however, absolutely requires full cortical consciousness. The reason experience is not integrated is because the message relay centers toward the cortex were blocked from transmitting the message to consciousness; instead shunting the message to other non-healing brain structures. The reason is that the message was too much to handle without totally disrupting cortical functioning.

In a way, amnesia is a form of double-barrelled hypnosis: the person is partially unconscious to begin with by virtue of being in a trance, after which a total unconsciousness for events is suggested by the hypnotherapist.

In hypnotherapy, amnesia is induced as a supposedly desirable way of getting the patient to unconsciously rid himself of trauma and therefore of his neurosis. The diabolic aspect of all this is that the reason one cannot get rid of the Pain is because it is unconscious. So long as it remains unconscious it will stay forever. The hypnotherapist believes that the patient can go through all sorts of experiences in the hypnotic session, have no memory of them whatsoever, and then leave transformed.  But in fact when you induce amnesia what actually happens is that the patient leaves therapy not only not transformed but more repressed. 

In introducing a particular case report, Erickson clearly describes the hypnotherapeutic ideal: a distinctive split between intellect and emotion, mind and body, carefully controlled by the hypnotherapist.[19]

You point out to a patient that it is perfectly possible to remember the intellectual facts of something but not the emotional content, and vice versa. You point out that once, when you felt down-hearted and blue, you couldn't for the life of you figure out why, but there must have been a reason in the back of your mind. You experienced the emotions but you didn't have intellectual content. In recovering a traumatic memory you can uncover deep emotions and not intellectual content. If you want to, you can remember the actual intellectual content; you need not remember whether you felt sad, mad, or glad. It will be just a memory, as if it happened to somebody else.

One of Erickson's students was in danger of flunking out of medical school because he "absolutely and irrationally" refused to attend dermatology class. Erickson tells the student, Bob, that there has to be some explanation for this, some past event he has forgotten. He asks him if he can use him as a hypnosis demonstration subject in class, and tells him to spend the next week trying to remember what he had forgotten. A week later, Bob says: "How on earth do you go about remembering something you forgot a long time ago? You don't even know where to look!...It's gone!"

After putting Bob in a trance in order to find such a memory, Erickson describes to him how a memory is like a jigsaw puzzle, which you can put together piece by piece; how you can put the puzzle together right side up or upside down; and how the picture side of the puzzle represents the "intellectual content" of the memory while the blank side represents the "emotional foundation." He then leaves Bob with the choice of how to assemble the puzzle of a repressed memory (which had some role in producing his inability to attend dermatology lectures) in a meaningful way. When Bob, in a trance, does not know how to do this on his own, Erickson says to him:

"Suppose you haul out from your unconscious just a few little pieces of that unpleasant memory." Bob thought a minute and then perspiration began to form on his forehead. I asked, "What is it Bob?" He said, "I'm feeling sick in a funny sort of way. I don't know what kind of a way." I said, "That's fine, so you're feeling sick in a funny sort of way; you don't know in what kind of a way. All right forget about it." With that Bob developed an amnesia for the material that was making him feel funny. I then continued, "Suppose you reach down into your repressions and bring up a few pieces of the picture." Bob did essentially that and said, "Well, there is water and there is something green. I suppose that is grass, but that green isn't grass." I said, "That is fine, now you shove that down. Now bring up some more pieces of emotion." Bob brought up some more emotion and then said, "I'm scared, I'm scared. I want to run," and he was really perspiring and trembling. I said, "Shove it down again. Let's bring up a few other picture pieces.

We see how Erickson uses the technique of dissociating intellect and emotion. As more associations rise to consciousness, Erickson helps Bob repress them "when the emotion became too threatening." Meanwhile, while briefly feeling these emotions, Bob sweats profusely. Erickson periodically brings him out of the trance, lets him rest, and hypnotizes him again. At one point he tells Bob to "put all the blank sides together again," which he does. Erickson writes:

You should have seen him trembling and perspiring. He was actually shivering, so periodically I gave him a suggestion to blank it out and rest: "Take another deep breath and look at that blank reverse side of the jigsaw puzzle with the amnesic traumatic experience." He said, "Whatever is on the other side of that is something awful--it's just awful." I then told him to forget the entire emotional side. We'd turn the jigsaw puzzle over and see it intellectually only, without emotions. He described, "Two little boys, about eight or nine years old, they looked like cousins -they're playing in a barn, they are wrestling. Oh! Oh! One is getting mad with the other. Now they are hitting at each other. Now they grabbed some forks, they start stabbing at each other. Oh! Oh! One of them stabbed the other in the leg. That one is running into the house to tell. The one that stabbed him is a little bit afraid. He runs along, too. The boy's father isn't mad; the mother isn't mad; they are calling the doctor. The boy's father makes him sit on a chair to wait. There is the doctor driving in. The doctor is going to stick something in the boy. Oh, my goodness, what a funny thing. Look at that boy's face. He is lying there.

His face is swelling up, his eyes are swelling shut, his skin is turning a funny color, his tongue is so thick, and the doctor is scared. He is getting something else. He's got -- it looks like a needle or a pump of some kind, and he is pumping something into the boy, and now that swelling in the boy's face is getting less, his tongue is getting smaller, he is opening his eyes, and everybody is breathing deeply. The father grabs the other boy and takes him down to the horse trough. The father sits on the horse trough, hauls the boy over his lap, and starts spanking him, and he is really spanking him hard. The boy is looking down in the horse trough and he sees that green slime on the water and he is crying. There is something awful bad about this, and I don't know what it is. There is something awful bad."

I said, "Well let one corner of the back of it soak through, and then another corner, let the back of it soak through, soak trough, soak through." You should have seen poor Bob as he began uniting the ideational content with the affect. Shuddering, trembling, crying out, horrified, he said "I can't stand it."

I again told him to develop a complete amnesia. "Take a rest Bob. You have a little more work to do. Maybe if you rest five minutes, we'll have enough strength to do a little more of the work."

Erickson flipflops the patient back and forth between feeling and not feeling; between recalling a repressed childhood trauma with intellectual detachment and feeling the emotions associated with it in bits and pieces. Erickson contends that the amnesic behavior is really under the patient's control because he is responding to suggestion. But according to Erickson's description, the experience sounds like a finely orchestrated one-man play for which he provides the controlling "strings" of suggestion. Now the patient recalls a few memories; now represses them. A bit more here, and then "shove it down again."

...I asked him to continue. He dropped the amnesia until he couldn't stand it any longer, and then another amnesia, a rest, and then again another recovery until finally he said, "That little boy that stabbed the other one is me. That's my cousin and that was the fork we used for cleaning out the barn, and the doctor comes and gives him an anti-tetanus shot. He gets an anaphylactic reaction with all that edema, and everybody expects him to die including me. Then the doctor gave him adrenalin and he recovered, and then my father took me down to the horse trough and spanked me. I couldn't even stand the way my cousin looked, and there was my father spanking me and that nasty green slime on the water in the trough -- that horrible green slime and that horrible color of my cousin's face. No wonder I couldn't study my dermatology." That was the end of that. No wonder he didn't like dermatology.

In the final outcome Bob has retrieved the entire traumatic memory but has no recall of it -- or of the six-hour session he has experienced in front of an entire classroom of people. In other words, whatever traumatic emotions were recovered in the trance state were then re-covered by the amnesia. Yet, if we are to believe Erickson's account, through hypnosis Bob's traumatic memory had been shorn of its power to affect him. The next day, he showed up for dermatology. "It was almost a week before Bob recalled that he was attending dermatology. He just simply took it so matter-offactly that he didn't realize he had missed previous lectures and clinics."

In analyzing this case, Erickson asserts that it's a mistake to try to recover an entire traumatic experience all at once. He goes on to say that therapists can utilize the way people often have, in everyday life, an "intellectual appreciation of their position but an emotional indifference." This "detachment" is what helps the subject develop amnesia, which, according to Erickson, is "just as effective as a repression," in that it permits the traumatic material to be "available for examination...in small portions in relation to emotional healing and the ideational content."

Of course, it is not an examination of one's history that is needed, but feeling and integrating the feeling into the body’s system versus repressing it. The emotional aspect of suffering must be released from the limbic storehouse and raised into consciousness. That can only be done bits at a time. But it is the amount of Pain one can feel that is the limiting factor, not the cognitive aspect.

 The active inducement of amnesia by hypnotherapists suggests to me a distrust of consciousness. It implies that there is something about the patient's experience which consciousness cannot handle. The assumption seems to be that either the emotions are too threatening, or cognition is not equipped to give them accurate meaning. In the above case, Erickson actively worked to dissociate intellect from emotion. But dissociating feeling from intellect is what gives neurosis its start in the first place: the meaning of the child's trauma, "I can never be loved for who I am,", is lost. Because the real meaning is lost, a symbolic one is substituted. With Erickson's patient, the fear is projected onto the field of dermatology -- a far cry indeed from the original trauma of stabbing his cousin in the leg.

Recovering the meaning of a trauma is an inextricable part of removing repression because it is eventually the meaning "They hate me and don't want me around" that sums up years of childhood experience with the parent.  Repression of a trauma cannot be removed by simultaneously suggesting a repression of the memory of that recovery! To do so only ensures the continuance of repression and neurosis.

At best, amnesia is a safety valve for the patient. It is a kind of self-protective mechanism that inhibits the onslaught of too much Pain at one time. The point is that amnesia is the patient's defense rather than the therapist's tool. It is part of the problem, not part of the solution. It is something to be respected when it occurs spontaneously within a patient, but it is not something to be encouraged or suggested. Suggestions for amnesia are really suggestions for continued neurosis which ultimately deepen rather than integrate the existing fissures in consciousness.

Back to Table of Contents   |   Next chapter >>


[1]American Medical Association: Medical use of hypnosis. Journal of the Medical Association 1958, 168: 186-189.

[2]54% of 1,000 respondents to a recent survey agreed that "hypnosis can be used to recover memories of actual events as far back as birth." 97% felt hypnosis is a worthwhile tool for psychotherapy. (Yapko, M., Suggestibility and Repressed Memory of Abuse: A Survey of Psychotherapists' Belief. American Journal of Clinical Hypnosis, 36 (3), 1/94, 163-171.

[3]Milton H. Erickson, "Hypnotic Approaches to Therapy." In The Collected Papers of Milton H. Erickson on Hypnosis, Vol. IV, pp. 76-95. Edited by Ernest L. Rossi (NY: Irvington), 1980. Originally published in The American Journal of Clinical Hypnosis, 1977, 20, 20-35.

[4]Milton H. Erickson and Ernest L. Rossi, Hypnotherapy: An Exploratory Casebook (New York: Irvington), 1979, p. 1.

[5]Ibid., p. 3.

[6]Ibid., p. 9.

[7]See Masson, J., Against Therapy: Emotional Tyranny and the Myth of Psychological Healing. New York: Atheneum, 1988, 224-234.

[8]Innovative Hypnotherapy: The Collected Papers of Milton H. Erickson on Hypnosis, vol. 4, ed. by Ernest L. Rossi (New York: Irvington, 1980), 482-90.

[9]Innovative Hypnotherapy, 482-490.

[10]Erickson and Rossi, Hypnotherapy..., p. 45.

[11]Ibid., p. 47.

[12]Jay Haley, ed. Conversations with Milton H. Erickson, M.D., vol. 1, Changing Individuals (New York: Triangle Press, 1985), vii.

[13]Donald S. Connery, The Inner Source: Exploring Hypnosis with Dr. Herbert Spiegel (New York: Holt, Rinehart & Winston), 1982.

[14]Ibid.

[15]Ibid., p. 225.

[16]Ibid., p. 225.

[17]The Lectures, Seminars, and Workshops of Milton H. Erickson (Vol. I), edited by E. Rossi, M. Ryan, & F. Sharp. New York: Irvington, 1983, p. ??

[18]Ibid., Vol. II, p. ??

[19]Milton H. Erickson and Ernest L. Rossi, Hypnotherapy: An Exploratory Casebook. (New York: Irvington, 1979), 348-352.