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Rock, Paper, Scissors: Learning from Erickson’s Use of Pen and Paper in Therapy by Annette Poizner, MSW, Ed.D., RSW

I’m remembering recess in the schoolyard. We are in the process of deciding who gets to go first and we play the game of Rock-paper-scissors. Each child assumes a hand posture resembling either a rock, piece of paper, or scissors. According to the rules of the game, each of these items “can “defeat” one of the other items and the remaining one is the winner. For example, scissors “beat” paper; rock “beats” scissors. These relationships make perfect sense, given that scissors cut paper and rocks can smash scissors. Yet, one of the relationships spelled out in this childhood game is counter intuitive: paper rules over rock. But doesn’t a heavy rock rule paper? An anonymous comment on the Internet sheds light on this issue: Paper rules rock because paper represents the realm of higher knowledge. We master the world of physicality symbolized by the rock, by using principles of higher knowledge. Ah yes, paper does, in fact, rule rock!

Given the importance of paper, we shouldn’t be surprised that pen and paper are useful in the therapeutic endeavor, despite the fact that most therapists limit its use to process notes. In fact, Erickson frequently brought pen and paper into the therapy process. At times, he would have his patients journal their life story, or he would give homework assignments, having a bed wetter woken up early in order to practice handwriting. Other times, Erickson would utilize automatic writing, wherein hypnotic subjects would respond to hypnotic suggestions to produce meaningful writing or drawings, all outside of conscious awareness. One fascinating case bears reviewing. Erickson and Kubie (1938)1 reported the case of a 24-year-old woman who volunteered to be a hypnosis subject. She explained that in recent months she had been overcome with feelings of agitation, and simultaneously found herself mindlessly drawing pictures and doodling whenever she was studying or sitting in class. She was puzzled by this new habit, and by her agitated state, and she wished to find meaning in her illustrations.

In a subsequent interview, she recounted her history. She was raised as an only child in a happy home with two loving parents. She reflected that the only problems on her mind of late were feelings of resentment about the growing emotional distance between her and her best friend from childhood. Throughout the interview, the woman nervously doodled.

Erickson scheduled a follow-up appointment and gave her specific hypnotic suggestions: that her unconscious mind would organize the material she hoped to access, while her conscious mind would be busy with school and social activities. She would report on her conscious activities when she attended her next appointment. Feeling incredibly well at the next appointment, the woman described the story line of a novel she had been reading. While giving a verbal report of the book, she picked up a pen and doodled, first penning the usual scattering of lines and shapes, but ultimately making a singular, unified drawing that integrated all the elements that she had been randomly drawing. Yet, she was not able to interpret the picture for Erickson. In response to questioning, she gave Erickson a pack of matches from her pocket, then left abruptly. Of note, these matches advertised a local hotel.

Over the next several weeks, the young woman dropped by for a series of visits. Erickson recounts the gradual process by which the woman retrieved awareness of the meaning of the drawing, ultimately leading to a revelation: Her father was having an affair with her girlfriend. Father had been bringing matches home from the hotel where he had frequent encounters with his mistress and all this was ultimately confirmed by the girlfriend, who was eventually brought to a meeting with Erickson!

The case report documents the nuanced way people first hide, then later reclaim knowledge that is difficult to bear. In this particular case, the revelation brought an end to the young woman’s agitation. The case also demonstrates the use of pen and paper in therapy. Clients can spontaneously draw or write material, which can then be analyzed to better access material that has been, for one reason or other, hidden from consciousness.

In the end, we may learn a thing or two from the game of Rock-paper-scissors. It can be a reminder that the seemingly innocuous sheet of paper is more powerful than it looks. It can serve as a proverbial blank slate, and much can be achieved if we will bring it into the clinical context.

Annette Poizner, MSW, Ed.D, RSW serves on the Board of Directors of the Milton H Erickson Institute of Toronto and is the author of “Clinical Graphology: An Interpretive Manual for Mental Health Practitioners” published by Charles C Thomas Publishers.

1 Erickson, Milton & Kubie, Lawrence (1938). Psychoanalytic Quarterly, 7, pp. 443-466.

Utilization — the Virtues of Faults Excerpts from the Erickson Foundation Archives

By Jeffrey K. Zeig, Ph.D.

Case One: The Right “Spell”

My son, Robert, asked me when he was attending grade school, “My two best friends can’t spell; [their papers are] marked 10, 15, or 20, and my spelling [lessons are] marked, 85, 90, or 95. Now, will you teach them how to spell?” I said, “I can’t really do that Robert without consulting their parents…I’ll tell you what to do. You make sure you have your spelling lesson with you and your friends have their spelling lessons with them — a marked copy corrected by the teacher. I’ll come over and pick you up and drive you home, and I’ll [also] offer to drive the boys home. And, as we’re riding along, you tell me what mark you got on your spelling lesson. I’ll pull up to the curb and go over your spelling lesson. [When Erickson did this, he said to Robert,] “You got this word right, and this word right, and this, this, and this.” And I graded [his lesson] and it was 98. I turned to one of the boys and said, “Have you got your spelling lesson with you? I’d like to see it.” He didn’t want to show it to me, but I insisted. I looked at it and said, “My goodness…a ‘ck’ in ‘chicken’ is the hardest part of the word to spell — and you got that right.” I looked at the next word and there were three letters correct and [I] said, “[That’s] the hardest part of that word to spell…” Now the second boy handed me his spelling lesson [and] I pointed out the letters he got [right, too.]

A short time later, I asked Robert, “What happened to those little boys after that day?” He said, “They are spelling correctly.”

I merely showed them how to look at their spelling lesson and see the right part of their spelling. [But,] adults will look at the failures, without realizing that failures are always an opportunity to learn.

Case Two: Appreciable Curves

Hans (a student asking for help with a case): I had a woman client who came in with her husband. She has scoliosis, which means she has a very rounded back and is much smaller than she would be if she didn’t have it. Other than that, she’s a beautiful woman, but the couple has the same difficulty I told you about before: the man is no longer turned on by his [wife]. He says it does not have to do with her back, but I still think it has something to do with it. He simply tries not to think about it, and the woman gets depressed a lot because she thinks her rounded back is the reason why her husband doesn’t like her anymore — that he no longer accepts her as a woman.

Erickson: Now my [question] to the woman would have been, “Madam, aren’t you aware that all men [think] curves are wonderful?” If the woman has an extra curve, I’d [ask] the man, “What do you want — a flattened board? As a man you are supposed to enjoy [all kinds of] curves.” [This puts] him on the defensive, and when he admits liking some curves, [he’ll] admit to a predilection for [all] curves, [there- fore viewing] his wife’s scoliosis through different eyes.

Cases Three and Four: The Body of Knowledge

Erickson speaking to students at a teaching seminar:

I’ll give you two other cases from my [experience working with the WWII] induction board. A handsome young man came through [in] good physical condition, and he had Jayne Mansfield [a buxom actress of the era] beat with his [enormous] breasts. My medical students looked at him in horror, [but were even] more horrified when I wrote a red “A” on the chart, which meant [he was] accepted. I let the medical students wonder for a while, [and] then I said, “The medical students are concerned because I’ve accepted you for the Army. They think that with those great big breasts of yours you’re unfit for the Army. Now, I’ll ask you a question and your answer will reassure [them]: “When you take a shower with the boys and they see your great big breasts, and they start to rib you [and] tease you, what are you going to tell them?” He said, “I’ll tell anybody who stares at my breasts that I brought them along for the homesick boys.” There was no question why [this man would] be accepted. And his composure was excellent.

The next selectee squirmed while I did the psychiatric examination, [but] I didn’t find anything wrong with him. I accepted him and [asked], “Now, why were you so afraid I wouldn’t accept you for the Army?” He said, “Well, I’ve got a problem: I can urinate only when sitting down.” The medical students looked concerned, so I said, “All right. When you’re marching and the sergeant says, ‘At ease, relieve your- selves,’ and you squat down to urinate, what are you going to say to your fellow soldiers?” He said, “If they fault me [for] squatting down, I’ll tell them, ‘Anything good enough for my mother is good enough for me.’”

 

 

 

Building Bridges: Between Rogers and Erickson

By Mike Moss, MBACP

I recently presented a workshop called “Building Bridges,” held at a conference organized by the UK Association for Solution Focused Practice. As a counselor and psychotherapist trained in solution-focused brief therapy and person-centered therapy, I felt compelled to offer a workshop that would explore an imagined bridge with Milton Erickson on one side and Carl Rogers on the other. Although there are differences between these two master therapists, I wanted to focus on their similarities, to try and understand how they inform my practice. In this article I hope to offer a taste of some of the concepts I explored.

Sidney Rosen’s book, My Voice Will Go With You: The Teaching Tales of Mil- ton H. Erickson, offers a good analogy. (Rosen, 1982) I imagine Erickson on one side of a bridge calling out to his patients, “My voice will go with you.” And on the other side of the bridge, Rogers calling out to his clients, “Your voice will go with you!”

Both men grew up on farms in the Midwestern United States and seem to have had a similar view of the natural order of things. (Gunnison, 2003) As a child, Rogers once observed potatoes stored in a shed, and with no apparent source of light, the potatoes were still able to grow spindly shoots. This impressed him, and he knew it was an example of the potential of life. He began to believe in an inherent growth-promoting force, which he later described as the “actualizing tendency.” (Rogers, 1961) Erickson also had rural experiences. When he was a boy he came across a horse that suddenly appeared outside his family farm. Erickson was able to easily lead the horse back to its owner because he trusted that it would know the way, which it did. He utilized the obvious, observing and embracing the situation in a creative and unique way. He trusted the instincts of the horse, which later helped him to understand and trust his patients. When a patient seemed lost, he trusted that he or she would also eventually find the way home.

Both Rogers and Erickson discovered something in life that they could trust and which made sense to them, and they brought these simple ideas to their work as psychotherapists. And even though their approaches were different — Rogers could be described as non-directive and Erickson as directive — both men were linked by a fundamental desire to help clients find their own resources to promote change.

“Both [Erickson and Rogers] emphasized and sensed the uniqueness of each living thing and prized above all those differences.” (Gunnison, 2003)

Rogers likened Erickson’s understanding of the unconscious to the “actualizing tendency,” and noticed that although there were differences in their work, both relied on a directional tendency of the patient toward change, and both believed that the patient would have the wisdom to make beneficial choices. (Gunnison, 2003)

Rogers believed there was a tendency that exists in every individual which can be buried under layers of psychological defenses that “awaits only the proper conditions to be released.” (Rogers, 1961) And Erickson’s view of the unconscious has also been described as “…the core or center of the person” where there is “…a repository of all past experiences and learning” where the source of growth lies mostly beneath the unconscious level. (Rosen, 1982)

I sometimes use visualization in my work, and more recently I also close my eyes with some clients. I ask permission to be alongside them in their imagined world and offer Rogers’ core conditions in a profound way. My experience in doing this can be described as entering an imagined world where I feel a powerful, deep empathic resonance. It’s as if there is a new realm where both the client and I are active agents in the territory of the imagination. The depth of this kind of therapeutic relationship can provide access to a bridge from the unconscious to aware- ness where we can both meet and there is potential for healing and growth. This connection during hypnotic trance feels like a person-centered approach in action.

Looking at Rogers and Erickson on the same bridge reveals that there could have been a kind of creative guidance, with both doing what they intuitively felt was right. They both experienced a directional flow of potential or actualization in their therapy to promote healing in others. And perhaps by just holding an aware- ness of the possibility that there is a directional flow or presence which helps us to connect with change and growth from our own potential to facilitate healing may reveal there is a greater wisdom guiding us.

In his book, A Way of Being, Rogers maintains that the human organism’s potential for change is connected to what he calls an “evolutionary flow,” which he recognized as “…part of a formative tendency in our universe.” (Rogers, 1980) And, that there may be an energetic current of potential in the universe flowing to- ward growth, which can somehow be accessed within the self. This could be sim- ilar to Erickson’s use of utilization, whereby he makes use of what is present in the therapeutic encounter, both in him and in the client and beyond, and within the power of the imagination, that can be accessed and used as a creative force for change. (Leva, 1987). And, this energy stored up in all of us is waiting to be re- leased.

The “actualizing tendency” from both Rogers’ and Erickson’s perspective may be described as the process of become whole. The client is continually in this process, guided by an innate wisdom and utilization, moving in a creative direction inspired by both therapist and client, which seems to fit and connect to the client’s unique way of becoming the person he or she desires. I believe this “greater wisdom” may be experienced as a presence for both therapist and client — of there being something more in the therapeutic relationship. I have written about this sense of there being something more and have called it “directional presence.”

By the very nature of our intention to help, I believe something may emerge, assisted by being in an in-depth relationship, where more than we know may be helping the process in which all is being attended.

The power of the imagination is well understood in both cognitive and humanistic therapies, however, I would suggest there is perhaps the potential of an untapped resource, whereby direct contact by client and therapist can be made in the realm of the imagination. And I wonder, like Rogers and Erickson meeting on a bridge, if there is an opportunity for therapists of both approaches to begin a dialogue where we can discover new elements in working closely with clients, utilizing the unconscious using the core conditions, and accessing the imagination through person-centered visualization. Perhaps we are all on the same bridge, with some of us in the middle or closer to one side, and that’s okay because we are all traveling from one side to another and we all know the way.

References:

Rosen. S. (1982) My Voice Will Go With You: The Teaching Tales of Milton H. Erickson. W.W. Norton & Co

Gunnison. H. (2003) Hypnocounseling: An Eclectic Bridge Between Milton Erickson and Carl Rogers. PCCS Books

Rogers. C.R. (1961) On Becoming a Person. London Constable. . Rogers. C.R. (1980) A Way of Being Houghton & Miflin Co. Psychotherapy: The Listening Voice. Rogers & Erickson

Moss. M (2017) “On Becoming More, in the Therapeutic Relationship: An exploration of directional presence” COSCA Counseling in Scotland, Journal (Spring Ed.)

Mike Moss is a full-time counselor for Children and Young People, West Lothian Council. He lives in Edinburgh, Scotland and has a small private practice offering supervision and training. Moss can be contacted at: mike.moss@outlook.com

Ed. Note: At the 1985 Evolution of Psychotherapy Conference, Carl Rogers compared himself with Erickson and Kohut. The audio is available for streaming at: catalog.erickson-foundation.org/speaker/carl-rogers