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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!