Posts Tagged ‘Erickson Foundation’

TIME, OCTOBER 22, 1973

Estimated reading time: 3 minutes, 18 seconds.

A shy, gap-toothed young woman arrives at the simple home of a doctor in Phoenix, Ariz. She says she is em­barrassed about her teeth and bashful with men. Then, with sudden force and apparent malice, the doctor commands her to practice spurting water through her teeth until she is sure she can hit the young man who often meets her at the office watercooler. Soon after, the woman carries out her mission. The next day, the young man lies in wait for her with a water pistol. Eventually they marry. Her problem seems to have van­ished magically.

This and many other oddly simple cures are credited to the foxy grandpa of American hypnotism, Milton H. Er­ickson. At 71, Erickson stands in the forefront of a revival of hypnotherapy -in eclipse since Freud rejected it as too superficial and impermanent. “Er­ickson is the most innovative practi­tioner of hypnosis since Mesmer,” says Dr. Thomas Hackett, chief of the psy­chiatric consultation service at Mas­sachusetts General Hospital. Although Erickson sometimes uses deep hypnotic trances to work his will on his psy­chiatric patients, he often limits him­self to straightforward commands. He does not, however, explain the exact cures.

Erickson’s successes have been de­scribed in a new and hagiographic book,  Uncommon Therapy: the Psychiatric Techniques of Milton H. Erickson, M.D.  (Norton; $8.95), written by Jay Haley, his longtime colleague and admirer. Ha­ley shows how, out of hypnosis, Erick­son has drawn a whole bag of ploys that persuade the patient to change himself rapidly. For example, a 250-lb. woman says she is “a plain, fat slob.” Erickson takes over: “You are not a plain, fat, dis­gusting slob. You are the fattest, home­liest, most disgustingly horrible bucket of lard I have ever seen, and it is ap­palling to have to look at you.” He con­tinues insulting her-agreeing with her self-image and exaggerating it. The woman reduces to 140 lbs., finds work as a fashion artist and becomes engaged.

As a hypnotist, Erickson often re­inforces his control over his subject by challenging him to wake up. For exam­ple, he might say: “I want you to try to open your eyes and find that you can­not.” Similarly, performing therapy without hypnosis, Erickson will say: “I want you to go back and feel as badly as you did when you first came in with the problem, because I want you to see if there is anything from that time that you wish to recover and salvage.” Thus, his directive to the patient to relapse actually prevents a relapse.

True Grit. Los Angeles Psychiatrist William Kroger credits Erickson with being one of the first to develop behav­ioral therapy, which tries to alter be­havior patterns without dealing with the unconscious mind. But in addition to his hypnotic techniques, Erickson seems to affect patients through sheer force of personality. He is a man of true grit, who pulled himself through two attacks of polio (after the second, he hiked on canes in Arizona’s Kofa Mountains).

He obviously had no trouble dom­inating the patients in the cases report­ed by Haley. Says one fellow therapist disapprovingly: “I had an ex-patient of his come to me; he had reduced her ego to nothing. He’s a strong, powerful, char­ismatic man. The older he’s got, the more authoritarian he’s become.” Psy­chiatrist Ira Glick of the school of med­icine at the University of California in San Francisco says, moreover, that Er­ickson does not have a high standing among many therapists because “he has only described a few cases, and he nev­er, never describes any failures.”

Even though Erickson’s practices and claims are sometimes called into question, many doctors give him credit for sticking with hypnosis at a time when it was considered merely a showman’s trick. “Some types of disorders need a certain kind of therapist. Hypnosis is fine for those it helps,” says Psychiatrist Jack Ewalt of the Harvard Medical School. In today’s more open-minded approach to therapy, hypnosis-and its sister principle of strong suggestion-is again finding a place.

Utilization: A Seminal Contribution, a Family of Ideas, and a New Generation of Applications By, Barry L. Duncan, Scott D. Miller, & Susanne T. Coleman

Milton Erickson was unencumbered by the prevailing orthodoxy of his time. His creativity continues to reverberate profoundly in often unacknowledged ways. Perhaps the most important of Erickson’s principles is utilization. Consider the following vignettes.

Erickson saw Kim, a teacher troubled by nude young men hovering just above her head. She told Erickson not to take her young men away, but rather stop their interference with her everyday life. He suggested that Kim leave the nude young men in a closet in his office where they would be secure and not interfere with her teaching. She checked on the young men at first, but gradually stopped. Much later, Kim moved to another city and worried about her “psychotic episodes.” Erickson suggested that she put her psychotic episodes in a manila envelope and mail it to him. Occasionally, she would send Erickson a psychotic episode and meanwhile continued a productive life (Erickson, 1980).

Erickson saw Bob, who requested that his irresponsible, reckless, driving be corrected. Erickson asked what he could do to be helpful and Bob’s answer was that Erickson could do nothing that Bob would have to do it his own way. Erickson asked how soon he wished to make the changes and Bob said that by the next month he should be driving properly. Bob’s statement that he would have to quit in his own way was repeated in various ways over two sessions. Two weeks later, Bob reported jubilantly that he had handled things in his own way. He had driven so recklessly that at one point he had to abandon his car just before it hurtled down a mountainside. Since that incident, he stated, he had been driving safely and within legal speed limits.

Consider these cases in the context of the following descriptions of utilization. “Exploring a patient’s individuality to ascertain what life learnings, experiences, and mental skills are available to deal with the problem … (and) then utilizing these uniquely personal internal responses to achieve therapeutic goals” (Erickson & Rossi, 1979, p. 1).

“These methods are based on the utilization of the subject’s own attitudes, thinking, feeling, and behavior, and aspects of the reality situation, variously employed, as the essential components of the trance induction procedure” (Erickson, 1980, p. 205).

“Utilization theory emphasizes that every individual’s particular range of abilities and personality characteristics must be surveyed in order to determine which preferred modes of functioning can be evoked and utilized for therapeutic purposes” (Rossi, 1980, p. 147).

“The therapist’s task should not be a proselytizing on the patient with his own beliefs and understandings. What is needed is the development of a therapeutic situation permitting the patient to use his own thinking, his own understandings, his own emotions in the way that best fits him in his scheme of life” (Erickson, 1980, p. 223).

Erickson’s brilliance transcended clever tasks or magical inductions and is best reflected in the principle of utilization. The utilization method encompasses an unwavering belief in the client’s self-healing, his or her regenerative capabilities. Erickson counted on Kim’s and Bob’s inherent abilities to provide direction in attaining their desired goals. Such a belief fits 40 years of outcome data demonstrating the client to be the most important component of the change process, accounting for 40% of outcome variance (Assay & Lambert, 1999; Tallman & Bohart, 1999). Research makes it abundantly clear that the client is the star of the therapeutic drama.

Utilization requires an intense focus on clients’ views of their concerns, their goals for therapy, and their ideas about change. Erickson understood the importance of not attempting to eliminate Kim’s nude men or confronting Bob’s desire to “do it his own way.” This focus includes an uninhibited determination (considered reckless abandon by some) to work within and respect the client’s world view. Erickson did not become mired in his own fears (e.g., that he might be “reinforcing Kim’s delusions”) or a priori treatment preferences (e.g., that he needed to do “something” with Bob). Erickson kept Kim’s envelopes in case she showed up to look at them- and she did. This stance of putting the client’s view first is also supported by outcome research. In total, client perceptions of the relationship account for 30% of positive outcome. Indeed, client ratings of the alliance are the best predictor of success (Bachelor & Horvath, 1999). This chapter connects Erickson’s principle of utilization to a community of both theoretical and empirical ideas, and suggests yet another application. Much has been written about the utilization of client resources and competencies by the therapist (e.g., Berg & Miller, 1992). Less often discussed is the utilization of the client’s perceptions of the presenting complaint, and how therapy and the therapist may best address the client’s goals and expectations of therapy – what we call the client’s theory of change.

UTILIZING THE CLIENT’S THEORY OF CHANGE: A COMMUNITY OF IDEAS

The notion that client perceptions of problem formation and resolution have important implications for therapy has a rich, although somewhat ignored, theoretical heritage. Many have noted the clinical wisdom in attending to the client’s own formulations about change in therapy. As early as 1955, Hoch stated:

There are some patients who would like to submit to a psychotherapeutic procedure whose theoretical foundations are in agreement with their own ideas about psychic functioning. We feel that it would be fruitful to explain patients’ own ideas about psychotherapy and what they expect from it. (p. 322)

Later, Torrey (1972) asserted that sharing similar beliefs with clients about both the causes and treatment of mental disorders is a prerequisite to successful psychotherapy. Wile (1977), too, believed that clients enter therapy with their own theories about their problems, how they developed, and how they are to be solved. Wile stated that “many of the classic disputes which arise between clients and therapists can be attributed to differences in their theories of [etiology and] cure” (p. 437). Similarly, Brickman, Rabinowitz, Karuza, et al. (1982) hypothesized that “many of the problems characterizing relationships between help givers and help recipients arise from the fact that the two parties are applying models that are out of phase with one another” (p. 375).

Building on Erickson’s tradition of utilization, the Mental Research Institute (MRI) (Watzlawick, Weakland, & Fisch, 1974) developed the concept of position, or the client’s beliefs that specifically influence the presenting problem and the client’s participation in therapy (Fisch, Weak­ land, & Segal, 1982). The MRI recommended rapid assessment of the client’s position so that the therapist could tailor all intervention accordingly. Similarly, Frank and Frank (1991) suggested that “ideally therapists should select for each patient the therapy that accords, or can be brought to accord, with the patient’s personal characteristics and view of the problem” (p. xv).

Held (1991) separates therapist and client beliefs into two categories. Formal theory, held by therapists, consists of predetermined explanatory schemes (e.g., fixated psychosexual development, triangulation) addressed across cases to solve problems. Informal theory, held by clients, involves their specific notions about the causes of their particular complaints. Held suggests that strategies may be selected from any model based on congruence with the client’s informal theory. Duncan, Solovey, and Rusk (1992) clinically demonstrate such a selection process in their “client-directed” approach.

Duncan and Moynihan (1994) assert that utilizing the client’s theory of change facilitates a favorable relationship, increases client participation, and, therefore, enhances positive outcome. Duncan, Hubble, and Miller (1997) view the client’s theory of change as holding the keys to success regardless of the model used by the therapist, and especially with “impossible” cases. Similarly, Frank (1995) concludes: I’m inclined to entertain the notion that the relative efficacy of most psychotherapeutic methods depends almost exclusively on how successfully the therapist is able to make the methods fit the patient’s expectations” (p. 91). Scholars representing a wide variety of clinical orientations tend to agree that the client’s perceptions about a problem’s etiology and resolution are likely to affect the process and outcome of therapy. Do these hypothesized impacts have empirical support?

UTILIZATION-RELATED RESEARCH: A BRIEF SAMPLE

Attribution research has an important bearing on the theoretical issues raised above. Claiborn, Ward, and Strong (1981) placed clients in conditions that were either discrepant or congruent with the therapist’s beliefs about problem causality. Clients in the congruent condition showed greater expectations for change, achieved more change, and rated higher levels of satisfaction than did those in the discrepant condition. Tracey (1988) investigated attributional congruence with regard to responsibility for the cause of the problem, and found that agreement between the therapist and client was significantly related to client satisfaction and client change, and inversely related to premature termination. Two studies (Atkinson, Worthington, Dana, & Good, 1991; Worthington & Atkinson, 1996) found that clients’ perceptions about the similarity of their causal beliefs to those of their therapists were related to ratings of therapist credibility and how satisfied the clients were with therapy. Similarly, Hayes and Wall (1998) found that treatment success depends on congruence between clients’ and therapists’ attributions concerning client responsibility for a problem. They suggest that attending carefully to clients’ attributions and tailoring interventions accordingly enhances effectiveness. Client expectancies and beliefs about the credibility of specific therapeutic procedures may be an important factor in predicting who will benefit from therapy. For example, Hester, Miller, Delaney, and Meyers (1990) compared traditional alcohol treatment with a learning-based approach. Clients who believed that alcohol problems were caused by a disease were much more likely to be sober at six-month follow-up if they had received the traditional alcoholic treatment. Clients who believed that alcohol problems were a bad habit were more likely to be successful if they had participated in the learning-based therapy. It was the congruence between client beliefs and expectations and therapeutic approach that proved crucial. Finally, Crane, Griffin, and Hill (1986) found that how well treatment seemed to “fit” clients’ views of their problems accounted for 35% of outcome variance. It seems to be a recurring finding that the degree of credibility of the intervention, or fit, or match with the client’s theory of change is a variable worthy of attention. The alliance provides further support of the importance of utilizing the client’s theory of change to effect a positive outcome.

ALLIANCE

Contrast the position of utilizing the client’s theory with the stance of applying the therapist’s orientation across cases. For Erickson, theoretical loyalty could lead to oversimplifications about people, close off possibilities for change, and promote technical inflexibility: “Each person is an individual. Hence, psychotherapy should be formulated to meet the uniqueness of the individual’s needs, rather than tailoring the person to fit the Procrustean bed of a hypothetical theory of human behavior” (Zeig & Gilligan, 1990, p. xix). Rather than reformulating the client’s complaint into the language of the therapist’s orientation, the data suggest the opposite: that therapists elevate the client’s perceptions above theory, and allow the client to direct therapeutic choices. Such a process all but guarantees the security of a strong alliance. Gaston (1990) summarizes the alliance into four components: (1) the client’s affective relationship with the therapist, (2) the client’s capacity to work purposely in therapy, (3) the therapist’s empathic understanding and involvement, and (4) client-therapist agreement as to the goals and tasks of therapy. Whereas items 1 and 3 reiterate the importance of the relationship, the client’s participation in and agreement on goals and tasks refer to the congruence between the client’s and the therapist’s beliefs about how people change in therapy (Gaston, 1990). Utilizing the client’s theory, therefore, proactively builds a strong alliance by promoting therapist agreement with client beliefs about change, as well as about the goals and tasks of therapy. The therapist and client work jointly to construct interventions that fit the client’s experience and interpretation of the problem. In this way, interventions represent an instance of the alliance in action.

UTILIZING THE CLIENT’S THEORY: PRACTICAL GUIDELINES

Within the client is a uniquely personal theory of change waiting for discovery, a framework for intervention to be unfolded and utilized for a successful outcome. To learn the client’s theory, therapists may be best served by viewing themselves as “aliens” seeking a pristine understanding of a close encounter with the clients’ interpretations and cultural experiences. Clinicians must adopt clients’ views on their terms, with a very strong bias in their favor. After direct inquiries about the client’s goals for treatment are made, questions regarding his or her ideas about intervention are asked. What the client wants from treatment and how those goals can be accomplished may be the most important pieces of information that can be obtained. Recall how Erickson asked Bob about his view of change and how he could be helpful to Bob. Client responses to similar questions provide a snapshot of the client’s theory and a route to a successful conclusion.

• What ideas do you have about what needs to happen for improvement to occur? • Many times people have a pretty good hunch not only about what is causing a problem, but also about what will resolve it. Do you have a theory of how change is going to happen here? •In what ways do you see me and this process as helpful to you in attaining your goals?

It is also of help simply to listen for or inquire about the client’s usual method of or experience with change. The credibility of a procedure is enhanced when it is based on, paired with, or elicits a previously successful experience of the client. Recall how Erickson utilized Kim’s previously helpful solution of containing the nude young men in the closet in his suggestion to put the psychotic episodes in an envelope.

• How does change usually happen in the client’s life? • What do the client and others do to initiate change?

Utilizing the client’s theory occurs when a given therapeutic procedure fits or complements the client’s preexisting beliefs about his or her problems and the change process. We, therefore, simply listen and then amplify the stories, experiences, and interpretations that clients offer about their problems, as well as their thoughts, feelings, and ideas about how those problems might be best addressed. The degree and intensity of our input vary and are driven by the client’s expectations of our role. The client’s theory of change is an “emergent reality” that unfolds from a conversation structured by the therapist’s curiosity about the client’s ideas, attitudes, and speculations about change. As the client’s theory evolves, we implement the client’s identified solutions or seek an approach that both fits the client’s theory and provides possibilities for change.

THE CASE OF TOM

For five years, Tom, an 18-year-old college student, had been becoming increasing distressed by thoughts about having sex with young boys.

Session One

C: I am physically attracted to children, but I haven’t acted on my thoughts. I’m a pedophile. I’ve done lots of reading about pedophiles. You can wean yourself out of your behavior if you’re young and willing to do it. But just in case, I’m looking into chemical castration. But I know if I got help from an expert, my chances might improve. You know, a normal person’s mind doesn’t function like that, dreaming about children. It’s programmed into my mind. Tom shared his beliefs about his problem (he is a pedophile), how change will happen (wean himself out of it), and the role of the therapist (expert). Although the therapist did not believe Tom to be a pedophile, she did not challenge his view.

T: Since you have given it much thought and research and you have your own diagnosis, have you given thought to how you would accomplish your goals? C: Yes. It will take time. All I want is to meet a woman who is very special to me. Someone who cares about me, someone with whom I feel comfortable and safe. But first I need to focus on the thoughts.

The client’s theory of change is crystallizing. He will wean himself off his thoughts of children by meeting someone who will care about him. But first, Tom said, he needed to focus on the thoughts; therefore, he was assigned the task of embracing his thoughts and learning from them.

Session Two

C: I’ve learned there is something missing from my life. I need some­one besides my family to share my life, a relationship. But I really don’t know where to start. T: So do you think that if you find a relationship, the thoughts of children will go away? C: Yes, I do-yes, I am convinced. Tom’s theory of change has unfolded. Finding a relationship is his chosen method of eliminating the thoughts. The therapist assigns another task that gives credibility to Tom’s beliefs regarding the problem and its solution. Building on Tom’s research skills and his success with therapeutic tasks, he is asked to observe relationships to identify the type that he would like to have.

Session Three

C: I looked into relationships, talked to people, and found some interesting books. I wanted to tell you that if the situation were to present itself, I wouldn’t do anything with a child. Dreams are dreams and actions are actions. There has been positive change. I thought I was a pedophile. Now I know that I am a fantasizer. All I do is fantasize, and I could probably fantasize about anything. Tom, without confrontation of his belief, shifts his view of himself as a pedophile. The therapist amplifies and empowers the change and Tom discusses his plan to talk to women. The therapist follows the client’s lead.

Session Four

C: I gave a girl a kiss! I was talking to her and she put her cheek down and I gave her a kiss. It was fun and felt good. I know I’m interested in girls and I think things are changing, but how can I be sure? T: Have your thoughts decreased? C: I think so, but I’m not sure.

Tom shared his exciting news and his uncertainty about the extent of the change. The therapist again highlighted the change and reinforced the connection between finding a relationship and reducing the thoughts. To measure Tom’s progress, he was asked to monitor and rate his thoughts.

Session Five

C: I completed the assignment and I found that my thoughts have substantially decreased. If I dream of a kid, I can now immediately transfer my thinking to a woman. I get turned on by my thoughts of women. I’ve reprogrammed my thinking. It feels great. Tom had his own theory on how to resolve his problem, and honoring that theory created a space for him in which to employ his strengths. Throughout the therapy, the client’s ideas directed the process; the therapist utilized Tom’s theory of change to direct therapeutic actions. Follow­up revealed Tom’s continued attraction to, and pursuit of, women.

ERICKSON WAS ON TO SOMETHING

This brief historical review revealed a rich theoretical tapestry made up of different orientations woven together by their consistent agreement on the importance of matching the client’s ideas about problem formation and resolution. We briefly sampled the attribution, expectancy, and alliance literatures and established that these disparate literatures are in concert in their empirical support for utilizing (matching, fitting, sharing attributions with, being credible to, etc.) the client’s theory of change. Historically, mental health discourse has relegated clients to playing nameless, faceless parts in therapeutic change. This attitude is changing. No longer interchangeable cardboard cutouts, identified only by diagnosis or problem type, clients emerge as the source of wisdom and the solution. They are the true heroes and heroines of the therapeutic drama. Unfolding the client’s map reveals not only the desired destination for the therapeutic journey, but also possible paths to get there. In that endeavor, our clients have shown us trails we never thought existed.

Evolving Client-Directed, Outcome-Informed Discourse

While a client-directed discourse is familiar landscape to many, it remains uncharted as to how that discourse may legitimize our efforts to third-party payers. We believe that further utilization of the client’s ideas and perceptions holds the key. The assessment and utilization of outcome information as defined by the client may be the best possibility for proving the value of our services to managed care. Developing such an outcome-informed discourse need not be complicated or time-consuming. Therapists can simply choose from measures already in existence that are standardized, take only minutes to administer, and are accompanied by normative data for comparative purposes. Rather than repeating the failures of the past and attempting to determine “what approach works for which problem,” these methods focus on whether or not a given encounter is working for an individual client at a given point in time. They focus on the factors that research has shown really do make a significant contribution to outcome: incorporation of client strengths and ideas and the development of a strong therapeutic alliance (Hubble, Duncan, & Miller, 1999). Using standardized measures would also eliminate “treatment plans” containing sensitive and potentially damaging personal information. Information learned from these instruments is “fed back” throughout the therapy process itself (Duncan & Miller, in press). This radical departure from the traditional use of assessment instruments gives clients a new way in which to look at and comment on their own progress and their ongoing therapy. The process is simple: clients who are informed, and who inform, feel connected to their therapist and the therapy process; their participation is courted and utilized as a pivotal component of change itself (Duncan, Sparks, & Miller, in press). The client has been woefully left out of the loop regarding outcome and service accountability. Using measures that acknowledge the client’s experience of progress and satisfaction would allow clients to really direct their therapy. The client’s voice would be formally utilized in all aspects of therapy, thereby establishing an entirely different discourse-not a pathology or treatment approach, but the discourse of the client.

UTILIZING THE CLIENT’S THEORY OF CHANGE

• Think of oneself as an alien seeking a pristine understanding of the client and his or her culture of change. • Explore client stories, experiences, and interpretations particularly relevant to the problem and its resolution. • Ask about and listen for the client’s goals for therapy and ideas about change. • Ask about and listen for how change has previously happened, including previous attempts at change. • Ensure that the therapy amplifies, fits, or complements the client’s preexisting beliefs about the problem and the change process.

References

Asay, T., & Lambert, M. (1999). The empirical case for the common factors in therapy. In M. Hubble, B. Duncan, & S. Miller (Eds.), The heart and soul of change. Washington, DC: APA Books.

Atkinson, D., Worthington, R., Dana, D., & Good, G. (1991). Etiology beliefs, pref­ erences for counseling orientations, and counseling effectiveness. Journal of Coun­ seling Psychology, 38, 258-264.

Bachelor, A., & Horvath, A. (1999). The therapeutic relationship. In M. Hubble, B. Duncan, & S. Miller (Eds.), The heart and soul of change. Washington, DC: APA Books.

Berg, I. K.& Miller, S. D. (1992). Working with the problem drinker. New York:Norton.

Brickman, P., Rabinowitz, V., Karuza, J., Coates, D., Cohn, E., & Kidder, L. (1982). Models of helping and coping. American Psychologis 37, 368-384.

Claiborn, C., Ward, S., & Strong, S. (1981). Effects of congruence between counselor interpretations and client beliefs. Journal of Counseling Psychology, 28, 101-109.

Crane, R. D., Griffin, W., & Hill, R. D. (1986). Influence of therapist skills on client perceptions of marriage and family therapy outcome: Implications for supervi­sion. Journal of Marital and Family Therapy, 12, 91-96.

Duncan, B., Hubble, M., & Miller, S. (1997). Psychotherapy with “impossible” cases. New York: Norton.

Duncan, B., & Miller, S. (in press). The heroic client. San Francisco: research: Intentional utiliza­ tion of the client’s frame of reference. Psychotherapy, 31(2), 294-301.

Duncan, B., Solovey, A., & Rusk, G. (1992). Changing the rules: A client-directed approach. New York: Guilford.

Duncan, B., Sparks, J., & Miller, S. (in press). Recasting the therapeutic drama:Aclient-directed, outcome-informed approach. In F.

Datillio and L. Bevilacqua (Eds.), Comparative treatment in couples relationships. New York: Springer.

Erickson, M. (1980). The nature of hypnosis and suggestion: The collected papers of Milton H Erickson on hypnosis (Vol. 1, E. L. Rossi, Ed.). New York: Irvington.

Erickson, M. H., & Rossi, E. L. (1979). Hypnotherapy: An exploratory casebook. New York: Irvington.

Fisch, R., Weakland, J., & Segal, L. (1982). The tactics of change: Doing therapy briefly. San Francisco: Jessey-Bass.

Frank, J. D. (1995). Psychotherapy as rhetoric: Some implications. Clinical Psycholo­gy: Science and Practice, 2, 90-93.

Frank, J. D., & Frank, J.B. (1991). Persuasion and healing (3rd ed.). Baltimore: John Hopkins University Press.

Gaston, L. (1990). The concept of the alliance and its role in psychotherapy. Psycho­therapy, 27, 143-152.

Hayes, J., & Wall, T. (1998). What influences clinicians’ responsibility attributions? The role of problem type, theoretical orientation, and client attribution. Journal of Social and Clinical Psychology, 17, 69-74.

Held, B. S. (1991). The process/content distinction in psychotherapy revisited. Psy­chotherapy, 28, 207-217.

Hester, R., Miller, W., Delaney, H., & Meyers, R. (1990, November). Effectiveness of the community reinforcement approach. Presented at the 24th annual meeting of the Association for the Advancement of Behavior Therapy. San Francisco.

Hoch, P. (1955). Aims and limitations of psychotherapy. American Journal of Psychi­atry, 112, 321-327.

Miller, S., Duncan, B., & Hubble, M. (1997). Escape from Babel. New York: Norton. Rossi, E. L. (1980). Innovative hypnotherapy by Milton Erickson. New York: Irving­ton.

Tallman, K., & Bohart, A. (1999). The client as a common factor. In M. Hubble, B. Duncan, & S. Miller (Eds.), The heart and soul of change. Washington, DC: APA Books.

Torrey, E. (1972). The mind game. New York: Emerson Hall.

Tracey, T. (1988). Relationship of responsibility attribution congruence to psycho­ therapy outcome. Journal of Social and Clinical Psychology, 7, 131-146.

Watzlawick, P., Weakland, J., & Fisch, R. (1974). Change: Problem formation and problem resolution. New York: Norton.

Wile, D. (1977). Ideological conflicts between clients and psychotherapists. American Journal of Psychotherapy, 37, 437-449. Worthington, R., & Atkinson, D. (1996). Effects of perceived etiology attribution similarity on client ratings of counselor credibility. Journal of Counseling Psychology, 43, 423-429.

Zeig, J. K., & Gilligan, S. G. (Eds.). (1990). Brief therapy: Myths, methods, and meta• phors. New York: Brunner/Maze!.

Suggested Readings Dolan, Y. (1985). Ericksonian utilization and intervention techniques with chronical­ly mentally ill clients. In J. Zeig (Ed.), Ericksonian psychotherapy (Vol. 2). New York: Brunner/Maze!

Duncan, B., Hubble, M., & Miller, S. (1998). Is the customer always right? Maybe not, but it’s a good place to start. Family Therapy Networker, March/April, 81-90.

Duncan, B., Hubble, M., Miller, S., & Coleman, S. (1998). Escaping the lost world of impossibility: Honoring clients’ language, motivations, and theories of change. In M.A. Hoyt (Ed.), Handbook of the constructive therapies. San Francisco: Jossey-Bass.

Gilligan, S. (1987). Therapeutic trances. New York: Brunner/Mazel.

Stern, C. (1985). There’s no theory like no-theory: The Ericksonian approach in per­spective. In J. Zeig (Ed.), Ericksonian psychotherapy (Vol. 1). New York: Brun-ner/Mazel.

Yapko, M. (1985). The Erickson hook. Values in Ericksonian approaches:In J. Zeig (Ed.), Ericksonian psychotherapy (Vol. 1). New York: Brunner/Mazel.

By Marnie McGann

Milestones in life are often reached by a number, more specifically, one’s age in decades. Turning 20, 30, 40, 50 and 60 and beyond all resonate as if we are passing through an invisible wall and stepping into a new realm of maturity with another decade of life experience under our belt. We join those on “the other side” and hope that the new decade serves us well.

This year, Jeff Zeig passed through another invisible wall when he turned 70 on November 6th. In each decade of his life, he continues to grow and share his wealth of knowledge and experience; his 70s will be no exception. And despite his many accomplishments, he humbly and gracefully continues to offer guidance through therapy and training. At the Foundation, he is our fearless leader, treating all staff members with kindness and respect. He is the Founder and Director of The Milton H. Erickson Foundation, which will reach its own milestone in 2019, when we will celebrate our 40th anniversary. It has been nearly 40 years since Jeff commenced organization of the first of many conferences – a Congress held in December 1980. Since then, he has been the architect of the Couples Conference, the Brief Therapy Conference, the Evolution of Psychotherapy Conference, and the Intensives training in Phoenix, held in consecutive weeks three times throughout the year.

There are many more accomplishments, including more than 20 books on psychotherapy that appear in 14 languages. But, this article is more about who Jeff Zeig, the man, is and what makes him tick. So I felt the best way to know him was to listen.

A Conversation with Jeff Zeig:

Marnie McGann: First off, happy 70th birthday Jeff, and thank you for agreeing to be the subject of this article. As Founder and Director of the Erickson Foundation, you’ve spent nearly 40 years creating an organization that’s known throughout the world. But, I can’t even say for sure where you were born. So let’s start with that. Could you please share a bit about your childhood?

Jeff Zeig: I was born in the Bronx, New York, and spent my first 10 years of life living in an apartment with one bedroom that my sister and I shared. My parents slept on a roll-out couch in the living room. My father was a postman and took the subway to Manhattan every day for work. Coincidentally, my sister eventually had an office in the building where he used to deliver mail. After apartment life, my family moved to Long Island into a Levitt home. My father eventually took a job as a salesman for a home improvement company and we entered the middle class. I grew up in a child-centered Jewish family. My parents were adamant that my three sisters and I would have the opportunities that my parents never had. They were the children of Jewish immigrants and their parents mostly spoke Yiddish. My maternal grandmother came alone from Russia at age 18 and worked in sweatshops to earn funds to bring her siblings and her father to the U.S. My paternal grandparents were matched by a matchmaker on their wedding day! Needless to say, it was not a match made in heaven.

MM: I know you enjoy flying sail planes, are a bronze life master at bridge, and have been writing book after book. What else do you enjoy doing in your limited spare time?

Jeff Zeig: I exercise daily for more than 45 minutes. Usually during that time, I either talk to my love, who does not live nearby, or I educate myself by listening to tapes from Erickson, previous conferences, or online courses. I also listen to audiobooks; currently, it’s Resurrection by Tolstoy and A Tale of Two Cities by Dickens. I also listen to audiobooks when traveling and just finished “The Body Keeps the Score,” by Bessel Van der Kolk. Right now, I am taking a course in linguistics. Another positive addiction is taking Spanish lessons, which I love, but lack competence. I gifted the Erickson Foundation staff with private Spanish lessons. We take the classes online with a teacher in Mexico. Then, there’s my 2-year-old granddaughter, Lily Beth… Relaxation would be a good hobby, but the concept escapes me, as does watching television.

MM: What makes you happy?

JZ: Learning and Loving. The goal of living is to grow.

MM: What three words describe you best?

JZ: Driven, Driven, and Driven.

MM: Would you say that you’ve achieved your dream professionally?

JZ: More than I ever expected.

MM: What is your greatest achievement and how has it shaped you?

JZ: The Evolution Conference is my greatest professional achievement. Promoting integration and discovering the commonalities that makes therapy work.

MM: What is your greatest failure, and how did you overcome it?

JZ: When I graduated with my PhD in 1977, I wanted to be an academic and applied for more than 50 positions. I didn’t get any of the jobs I really wanted, but since then, some of those schools have hired me to do workshops. I took a job as a child psychologist at the Arizona State Hospital, but it was my last choice. Erickson advised me by telling me a story about his son, Bert, who came back from the Army only to face unemployment. The refrain of the story was to strictly do a professional job. So I did, and it worked.

MM: Have you ever taken a giant leap of faith?

JZ: Yes, by moving to Phoenix in 1978 to be close to Erickson. And, doing a clover leaf in a glider.

MM: What has been most satisfying for you in your life?

JZ: Service.

MM: How do you deal with stress?

JZ: I thrive on it. I live with it. I invite it. And I harness it to pursue what is most meaningful to me.

MM: What book, poem, piece of music, painting or other work of art has moved you the most?

JZ: I had a hobby of memorizing poetry and can still quote quite a few poems. I have been most inspired by e.e. cummings.

MM: How do you make your therapy an art?

JZ: I improvise. I study the evocative nature of all art, and apply it to helping clients and therapists access adaptive states.

MM: Do you have any current goals that you are working toward?

JZ: Loving the important people in my life. Professionally, writing more books. Reading more literature. Staying healthy.

MM: If you could do one thing over, what would it be?

JZ: I would learn how to play music, but I am tonally challenged.

MM: Where do you see yourself in the next five years, 10 years?

JZ: Contributing as much as possible. Loving to the limit.

MM: Milton Erickson was your mentor and left a legacy. What do you hope is your legacy?

JZ: Making the world a little better by virtue of my time on this planet.

MM: What does turning 70 mean to you?

JZ: I have less tread on the tires.

MM: Do you have any advice for young therapists?

JZ: Study and incorporate into your life, Erickson’s utilization orientation.

Jeff has recently begun working on Season 2 of his 5 Minute Therapy Tips video series on YouTube. These 5-minute videos deal within the general areas of client problems, professional issues, clinical concerns, and methodology with specific focus on anxiety, grief, depression, pain, smoking cessation, and much more. View the video below, or click here to view the entire series.