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by Lori Greenleaf, Ph.D., MFT Estimated reading time: 3 minutes, 28 seconds.

Dr. Jim, a sweet-faced, middle-aged man, arrived, referred for treatment of anxiety by a previous hypnosis patient. When I ask him what form the anxiety takes, he says he is a good doctor with a healthy practice, confident in his skills and in his marriage relationship. He describes his wife, Beth, in loving terms. He wants to please her.

His wife had convinced him to take dancing lessons with her so they could enjoy learning together, and he consented. She is a very adept, fluid, and comfortable dancer. He had to work hard at the lessons to be a good partner, and his lessons went well. But, like all beginners, he sometimes stumbled. → Read more

Literalness and the Use of Trance in Neurosis Milton H. Erickson and Ernest L. Rossi

Estimated reading time: 3 minutes, 15 seconds.

Dialogue between Milton H. Erickson and Ernest L. Rossi, 1973.

ERICKSON: The conscious mind already has its own set ideas about the neurosis. It has its fixed, rigid perceptions that constitute a neurotic set. It’s very difficult to get people at the conscious level to accept an alteration of their general thinking about themselves. You use the trance state so that you can get around the self protection which the neurosis provides on an unrecognized level. The neurotic is self-protective of the neurosis.

ROSSI: How does trance get around that self-protective aspect of neurosis?

ERICKSON: The literalness of the trance state causes the patient to have a new pattern of listening. He listens to the words in the trance state rather than to the ideas.

ROSSI: The therapeutic words that the therapist says?

ERICKSON: Yes. The patient gets those individual words and can hear the therapist say, for example, “you … don’t … want … to … smoke.” In the ordinary waking state he only hears, ”You … don’t.” He feels that is condemnatory, as if he is being attacked. So he becomes defensive and is unable to hear the rest of the sentence.

ROSSI: So trance gives the patient a chance to hear your entire message, to hear exactly what you are saying without screening out any elements.

ERICKSON: Without screening and without lifting or activating defense mechanisms. When you hear a pleading tone in the patient’s voice, for example, when he says, “I just can’t stop smoking … ,” that is a signal to make use of his unconscious by letting him go into trance because consciously he cannot listen to you.

ROSSI: He has a      pleading tone because his conscious mind is distressed?

ERICKSON: Yes. When you hear this conscious distress

ROSSI: That means consciousness is in a weak position relative to the forces of neurosis, and it needs help.

ERICKSON: Yes, it needs help, and that help can be given so much more easily and directly in trance.  You drop the patient into a trance state and you say, “You came to me, you stated your problem as ‘I don’t want to smoke,’ [spoken as a weak plea] and  you  have a lot of feeling in your voice. A lot of meaning in that tone of your voice. You put it there. It’s your meaning. Now think it over and recognize the meaning that you put there.”  That begins his inner recognition, “I don’t want to smoke! [spoken firmly and with conviction] rather than a plea of distress.

ROSSI: You let him think quietly at that point in trance?

ERICKSON: That’s right.

ROSSI: And then does he talk to you about what conclusion he came to? What’s the next step?

ERICKSON: Patients’ reactions vary tremendously. Some will ask, “Have I got the strength?” rather than making a piteous plea. Another will ask, “What approach should I take?” ”Will I get fat?” etc. The answer to the last question is, ”You don’t want any problem.” You see, that’s a very comprehensive statement.

ROSSI: Because that statement is made in the trance state, it helps free the patient from “any problem.”

ERICKSON: Yes. ”What you really want is the comfort of enjoying not smoking.” That helps him focus on comfort as he gives up smoking rather than looking for other problems.

ROSSI: You give the patient an alternative that is better than the problems.

ERICKSON: An alternative that you have defined in such general terms: ”You don’t want any problem. You want the enjoyment that is rightfully yours.”

ROSSI: A general suggestion given in a positive way. ERICKSON: But it seems so specific when you listen to it.

ROSSI: Because the patient applies it to specifics (such as the things he wants to enjoy) within himself.

ERICKSON: Yes. You make general statements that a person can apply to specifics within his own life.

ROSSI: This is a general approach that could be applicable to a great variety of neurotic problems.

ERICKSON: That’s right!

Acquired Control of Pupillary Responses Milton H. Erickson

Estimated reading time: 5 minutes, 34 seconds.

Reprinted with permission from The American Journal of Clinical Hypnosis, January, 1965, 7, 207-208.

An eight-year-old girl with a marked visual defect in one eye and a strabismus of that eye was under the care of an ophthalmologist. He had prescribed various eye exercises and the wearing of an eye-patch over the stronger eye to correct the suppression of vision in the weak eye. The girl performed her exercises faithfully, sitting in front of a mirror so that she could see what she was doing. During the course of therapy she became much interested in her pupils and soon discovered the papillary responses to bright and dimmed lights. Since she was an excellent somnambulistic hypnotic subject and had had extensive experience with suggested visual hallucinations, some of which she intentionally remembered subsequent to arousal from the trance state, she became greatly interested in watching her eyes while ”I thought different things.” The wearing of the eye-patch was “thought about,” and she watched the pupils of her eyes as she did this “thinking.” She would “think about” bright lights, semidarkness, and visual hallucinations close m her eyes and far off in the distance. She became markedly aware of the difference in the visual acuity between her eyes, and she would hallucinate an eye-patch over her eye. She learned to dilate and to contract her pupils at will. Then she became interested in unilateral papillary responses. This, she explained, was harder to learn, therefore more interesting. To accomplish this she “imagined” wearing an eye-patch and seeing with only the weaker eye. Then, undoubtedly aided by the learnings effected by the suppression of the vision in the weaker eye, she “imagined” seeing with only the normal eye while she “stopped looking” with the weaker eye. This uniocular effort of hers may also have been aided by a possible central fusion defect, which the ophthalmologist had suggested as distinctly a possibility during his first studies of her vision. In furthering uniocular behavior the girl had called upon her hypnotic experience to hallucinate a patch over one eye and a bright light in front of the other. There were variations of this, such as “imagining looking at something close by with one eye and at something else far away with the other,” an item of behavior highly suggestive of the accomplishment of students who learn to look through a microscope with one eye while using the other in reading or sketching.

When it came time for a reexamination of her eyes, she sat demurely in the chair while the ophthalmologist proceeded with the task. After an initial look at both eyes, he made a careful study of the right eye, making notations of pupillary size and of other findings. Then he turned to her left eye and was startled to see the pupil widely dilated. He glanced hurriedly at the right eye and then made an intense, searching examination of the left eye, carefully recording his findings including pupillary measurements. Then he leaned back in his chair to study and compare the separate data he had noted. Much puzzled, he glanced reflectively at her eyes and was again startled, this time because both pupils were equally widely dilated. He promptly reexamined the right eye, discovering nothing new except the dilation of the pupil. Again he studied his notations and again looked up to find that the right pupil was this is a dilation of the pupils particularly in the somnambulistic state still dilated but that the left was markedly contracted.

His facial expression of astonishment and bewilderment was too much for the little girl, and she burst into giggles, declaring, “I did that.” “But you can’t, nobody can,” was his reply. “Oh yes I can, you just watch.”

Thereupon she demonstrated bilateral and unilateral pupillary behavior, doing so in accord with specific requests from him. She explained to him, “All you have to do is look in a mirror and see your pupils and then you imagine you are in a trance and then you imagine looking at different things. You can look at different things that you imagine with one eye and at something else with the other, like looking at a bright light with one eye and the clouds in the sky when it’s almost dark with the other, and you can look at things far off and right close by. You can imagine a patch over one eye and just seeing with the other. You can imagine all kinds of different things to look at in different kinds of ways with each eye.”

Years later, at a seminar on hypnosis where she was present, this matter of pupillary control was mentioned. Several physicians challenged the possibility. Upon their request she obligingly demonstrated. At the time of the writing of this paper she was asked to read it for possible alteration s or additions. When she finished, she remarked, “I haven’t done that for years. I wonder if I can do it now.” She began reminiscing about the framed mirror into which she had gazed, the overhead light she had used, the window beside which she had sat, and as she did so she   demonstrated a  retention of her original skill. She also added the comment that she could still, as she remembered doing previously, feel the contraction of the pupil, although the dilation as such was not felt. She could not explain better than to say, “You  just feel something happening to that eye, but you cannot name the sensation.”


 At first thought one would not think this sort of pupillary control possible, until reflection brings to mind the ease with which a     conditioned response   can be induced by a related light-sound stimulus, the   evocation of the papillary response by the sound stimulus alone, and then a reconditioning   of   the    pupillary   response   to   a   related  sound-tactile stimulus with  the  papillary  response  then  being  elicited by the tactile stimulus alone, etc.

Also, undoubtedly important is the fact that many hypnotic subjects manifest  altered  papillary  behavior  in  the   trance state. Most frequently this is a dilation of the pupils particularly in the so somnambulistic state and the pupillary size changes when visual hallucinations    are   suggested at various distances. There are also pupillary changes that accompany suggestions of fear and anger states, and of the experience of pain. Also pertinent is the fact that this young girl was later discovered to be remarkably competent in developing autohypnotic trances to obliterate pain, disturbing sounds when studying, and to  establish  hyperacousia when background noises interfered with her normal hearing

In   brief  summary,   the  report  indicates  that papillary responses ordinarily regarded as reflexes not accessible to voluntary control are, in fact, subject to intentional control.