By Milton H. Erickson, M.D.
From the Erickson Archives
Estimated Reading Time: 7 minutes, 42 seconds
I have been asked to make a recording of an induction technique. After much thought on this matter, I believe I can be of much more service in another way. My own induction techniques are expressive to me, of my timing, of my rhythm, my personality, my emotional feeling, my attitude toward my patient. So it is with anybody else, and so it should be with anybody else. An induction technique is not a series of words, phrases, or sentences. Nor is it just a matter of suggestions, intentions, inflections, pauses, and hesitations. An induction technique is both simply and complexly a matter of communication of ideas and understandings and attitudes by the doctor to his patient.
Instead of an induction technique, what I wish to present to you is my understanding of how the doctor should feel when undertaking to induce a trance; what he should understand about the situation; what he should know about himself; what he should understand and know about the patient. I wish to make clear that the induction technique situation actually is what the doctor should knowingly and understandably expect of himself, and what he should reasonably expect of his patient. Only by having full awareness of the nature and character of the induction situation and of the nature and character of an induction technique itself, and by having a full clear awareness of himself and his patients as participants in a common undertaking, can the doctor establish for himself and for his patient an intercommunication of understandings and expectations basic to the induction of hypnotic states.
In that communication, there needs to be freely an awareness by the doctor of many things. First of all, he needs to be aware that the patient is seeking his help because the patient does not understand or cannot help himself in his needful condition. One must always, with utter intensity, view the patient as someone who is seeking help from the doctor because he honestly believes that the doctor can be helpful to him. Not to be continuously aware of this aspect or of the interpersonal relationship renders defective the very foundation of any induction technique.
Next of importance in establishing a good interpersonal relationship with the patient is the need to be continuously aware and alert to the patient’s own need to say, to tell, to ask, to advise, to request, to verbalize in some manner, or if not that, by facial expression, by gesture, by hesitancy, even by bated breath. To communicate in some way something the patient considers important to the patient and therefore important to the doctor. Simply to take charge of the total situation and to reassure the patient that the total situation is well in hand is not enough to develop a good climate for an induction. The patient needs to know from the doctor’s manner, hearing, alertness, attentiveness, that every word, phrase, sigh, wince, expression of any kind, whether verbal, a gesture, hesitation, tension, or whatever form the communication may take, will be noted and respected and examined carefully, and that more information will be sought if necessary so that the patient can feel completely secure in his understanding that the doctor is in charge, is adequate to meet the situation and its demands intelligently and with a full willingness to know all that is needful.
One builds an induction technique upon this kind of an interpersonal relationship of full readiness and willingness for complete interpersonal communication, whether verbal or symbolic, between the doctor and the patient.
By virtue of the doctor gently, willingly, with simple quietly emphatic assurance and comfort, taking over the awareness of the needfulness of full interpersonal communication, there is established a most favorable situation for a trance induction. From the very beginning of the patient-doctor relationship, there needs to be given simply, quietly, gently but emphatically, and best by manner and attitude, an assurance of the doctor’s complete interest in and awareness of all the communication, verbal or symbolic, that the patient feels is necessary. One can say meaningfully to the patient that he should try hard to communicate all those obscure and difficult matters that might be overlooked in a careful search hindered by needless emphasis upon the obvious, and nothing he says should then be brushed aside as inconsequential.
Next of importance in the essential setting for a good induction technique is the doctor’s own awareness of his own ability, his knowledge, and his skill, and his full awareness that his own personal honesty will lead him to call in others available should he himself lack any special knowledge. To confess a weakness is not a sign of inferiority. Only the weakling dares not admit to a weakness. The strong man can and does and thereby wins and deserves respect. With this inner feeling of self-respect, the doctor can view his patient with a ready awareness of what he can do and sense within himself a feeling of confidence in his abilities and a willingness to do his task, and if needful, to call in others. Thus, he knows that he will not remain in a state of doubt and uncertainty, to be communicated to his patient should there be something he cannot do. Every doctor needs, in his dealing with a patient, to have as a full part of his self-awareness, an intense feeling of “this I can do, and this other I can have done, and all the rest, if there is anymore, lies in the hands of fate aided by all the good that I can do.” Out of such an attitude as this, the doctor can then begin an induction with an appropriate and full self-confidence.
Also to be realized as a part of the foundation for a good induction technique is the doctor’s awareness that no matter who his patient is or what his patient’s condition is, he still knows more, is better prepared, is more competent than anybody else in that situation. Therefore, because he is the only one present at the place and time who is knowledgeable and competent and because he can comprehend the needs of the situation, he is entitled rightly, justly, properly, to have a full and ready confidence in his ability to meet the situation and to provide intelligently for the patient’s needs. To be simply earnestly and fully aware of this is most vital for a technique of induction that will inspire a patient with confidence.
Next of basic importance is the doctor’s own understanding of hypnosis as a phenomenon in itself. He should know with absolute certainty that hypnosis is a phenomenon common in human experience both as an induced and as a spontaneous development. He should know with utter certainty that hypnosis has been induced in many different people, in many different times, and in many different situations; that hypnosis is possible for the old and the young, the sick and the well, that all of human history discloses that hypnosis is a phenomenon common to all people. With this will in mind, he can reasonably expect his patient to do the same thing that countless of thousands have done throughout history, what countless of thousands of patients are doing today, tomorrow, and next week, are doing every day for his colleagues throughout the world. With this in mind and with full respect for his patient, he can confidently expect of his own patient a better accomplishment than that of patients in less tutored hands.
Knowing that then he can reasonably and rightly expect his patient to accomplish as much as thousands of other average patients achieve, he can radiate full confidence and expectation to his patient as a non-verbal but highly effective communication which in turn will affect most favorably the effectiveness of the induction technique.
Of basic importance in any induction technique is that the doctor, from the very beginning of his induction realizes that what is needful for his patient is not the words, not the tones, but the understanding of hypnosis as a state of learning and being. It is not the words used that induce the trance; rather it is the understandings given to the patient that a trance state is needful, and the words serve no more than a means of helping him learn an inner process of self-experience. To induce a trance, one needs to communicate by words, bearing, manner, emotional attitude, intellectual awareness that the patient is really and truly expected, confidently expected, to be as able to learn how to develop a trance as readily and as well as any of his fellows. That it is not a matter of argument or elaborate explanation any more than is pain and distress, that with attention given, the patient’s mind, by itself, can use the words employed to discover its own understandings of what is necessary in that needful situation to develop a trance. Thus, by manner, attitudes, and bearing, in every conceivable way of expression, one simply expects and wants the patient to develop a trance and the words employed are thus only the means of communicating these expectations and confidence.
This excerpt has been extracted from Volume 40, Issue No. 3 of The Milton H. Erickson Foundation Newsletter.
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