Once Erickson has fixated and focused a patient’s attention with a question or general context of interest (e.g., ideally, the possibility of dealing with the patient’s problem), he then introduces a number of approaches designed to depotentiate conscious sets. By this we do not mean there is a loss of awareness in the sense of going to sleep; we are not confusing trance with the condition of sleep. In trance there is a reduction of the patient’s foci of attention to a few inner realities; consciousness has been fixated and focused to a relatively narrow frame of attention rather than being diffused over a broad area, as in the more typical general reality orientation (Shor, 1959) of our usual everyday awareness. When fixated and focused in such a narrow frame, consciousness is in a state of unstable equilibrium; it can be “depotentiated” by being shifted, transformed, or bypassed with relative ease.

Erickson believes that the purpose of clinical induction is to focus attention inward and to alter some of the individual’s habitual patterns of functioning. Because of the limitations of patients’ habitual frames of reference, their usual everyday consciousness cannot cope with certain inner and/or outer realities, and they recognize that they have a “problem.” Depotentiating patients’ usual everyday consciousness is thus a way of depotentiating facets of their personal limitations; it is a way of deautomatizing (Deikman, 1972) an individual’s habitual modes of functioning so that dissociation and many of its attendant classical hypnotic phenomena (e.g., age regression, amnesia, sensory-perceptual distortions, catalepsies, etc.) are frequently manifest in an entirely spontaneous manner (Erickson and Rossi, I 975). Depotentiating the limitations of the individual’s usual patterns of awareness thus opens up the possibility that new combinations of associations and mental skills may be evolved for creative problem solving within that individual.

Erickson’s approaches to depotentiating conscious sets are so subtle and pervasive in the manner with which they are interwoven with the actual process of induction and suggestion that they are usually unrecognized even when one studies a written transcript of his words. In order to place them in perspective we have outlined the microdynamics of induction and suggestion in Table I as: (I) the Fixation of Attention; (2) Depotentiating Conscious Sets; (3) Unconscious search; (4) Unconscious Processes; and (5) Hypnotic Response. We have also listed a number of Erickson’s approaches to facilitating each stage. Most of these approaches are illustrated in this volume and are discussed in more detail elsewhere (Erickson and Rossi, 1974; Erickson and Rossi, 1975; Haley, I 967; Rossi, 1973). Although we may outline these processes as stages of a sequence in Table I for the purpose of analysis, they usually function as one simultaneous process. Because of this, and in order to distinguish these processes from the broader dynamics of induction and mediating variables previously outlined (Barber and DeMoor, 1972) we designate ours as “microdynamics.” When we succeed in fixating attention, we automatically narrow the focus of attention to the point where one’s usual frames of reference are vulnerable to being depotentiated. At such moments there is an automatic search on the unconscious level for new associations that can restructure a more stable frame of reference through the summation of unconscious processes. There is thus certain arbitrariness to the order and the headings under which we assign some of the approaches Erickson used in Table 1. He could equally well begin with an interesting story or pun as with a shock, surprise, or a formal induction of trance. Once the conditions in the first three columns have been set in motion by the therapist, however, the patient’s own individual unconscious dynamics automatically carries out the processes of the last two columns.

A number of Erickson’s most interesting approaches to facilitate hypnotic response are the hypnotic forms listed in column 3 of table 1. All these approaches are designed to evoke a search on the unconscious level. Allusions, puns, metaphors, implications, and so on are usually not grasped immediately by consciousness. There is a momentary delay before one “gets” a joke, and in part, that is what is funny about it. In that delay period there obviously is a search and processes on an unconscious level (column 4) that finally summate to present a new datum to consciousness so that it gets the joke. All the approaches listed in column 3 are communication devices that initiate a search for new combinations of associations and mental processes that can present consciousness with useful results in everyday life as well as in hypnosis. The hypnotic forms listed in columns 2 and 3 are also the essence of Erickson’s indirect approach to suggestion. The study of these approaches may be regarded as a contribution to the science of pragmatics: the relation between signs and the users of signs (Watzlawick, Beavin, and Jackson, 1967). Erickson relies upon the skillful utilization of such forms of communication, rather than hyper suggestibility per se, to evoke hypnotic behavior.

As noted in Chapter One, it is important to recognize that while Erickson thinks of therapeutic trance as a special state (of reduced foci of attention), he does not believe hyper suggestibility is a necessary characteristic of such trance (Erickson, 1932). That is, just because patients are experiencing trance, it does not mean they are going to accept and act upon the therapist’s direct suggestions. This is a major misconception that accounts for many of the failures of hypnotherapy; it has frustrated and discouraged many clinical workers in the past and may have impeded the scientific exploration of hypnosis in the laboratory. Therapeutic trance is a special state that intensifies the patient-therapist relationship and focuses the patient’s attention on a few inner realities; trance does not ensure the acceptance of suggestions. Erickson depends upon certain communication devices such as those listed in column 3 to evoke, mobilize, and move a patient’s associative processes and mental skills in certain directions to sometimes achieve certain therapeutic goals. He believes that hypnotic suggestion is actually this process of evoking and utilizing a patient’s own mental processes in ways that are outside his usual range of ego control. This utilization theory of hypnotic suggestion can be validated if it is found that other therapists and researchers can also effect more reliable results by carefully utilizing whatever associations and mental skills a particular patient already has that can be mobilized, extended, displaced, or transformed  to achieve specific “hypnotic” phenomena and therapeutic goals.

In the therapeutic trance situation the successful utilization of unconscious processes leads to an autonomous response; patients are surprised to find themselves confronted with a new datum or behavior (column 5). The same situation is in evidence in everyday life, however, whenever attention is fixated with a question or an experience of the amazing, the unusual, or anything that holds a person’s interest. At such moments people experience the common everyday trance; they tend to gaze off (to the right or left, depending upon which cerebral hemisphere is most dominant, (Baken, 1969; Hilgard and Hilgard, 1975) and get that “faraway” or “blank” look; their eyes may actually close, their body tends to become immobile ( a form of catalepsy), certain reflexes (e.g., swallowing, respiration) may be suppressed, and they seem momentarily oblivious to their surroundings until they have completed their inner search on the unconscious level for the new idea, response, or frames of reference that will restabilize their general reality orientation. We hypothesize that in everyday life consciousness is in a continual state of flux between the general reality orientation and the momentary microdynamics of trance as outlined in Table I. The well-trained hypnotherapist is acutely aware of these dynamics and their behavioral manifestations. Trance experience and hypnotherapy are simply the extension and utilization of these normal psychodynamic processes. Altered states of consciousness-wherein attention is fixated and the resulting narrow frame of reference is shattered, shifted, and/or transformed with the help of drugs, sensory deprivation, meditation, biofeed­back, or whatever-follow essentially the same pattern but with varying emphasis on the different stages. We may thus understand Table I as a general paradigm for understanding the genesis and microdynamics of altered states and their effects upon behavior.

This excerpt has been extracted from Hypnotic Realities by Milton H. Erickson and Ernest Rossi’s Collected Works, Chapter 6: Facilitating Hypnotic Learning.