Legacy of Milton H. Erickson: Selected Papers of Stephen Gilligan, The

American Journal of Clinical Hypnosis, Jul 2004 by Hollander, Harriet E

The Legacy of Milton H. Erickson: Selected Papers of Stephen Gilligan. Stephen Gilligan. Phoenix, AZ: Zeig, Tucker, & Thiesen, Inc. (2002). 346 pages.

Milton H. Erickson made a lifelong impression on the physicians, psychiatrists, dentists, psychologists, and social workers who attended his lectures and workshops. However, only a few of those who came to learn were granted entry to his clinical practice as observers and students. Stephen Gilligan was one of the chosen. In this book, he describes Erickson's approach to patients, as seen through the lens of his personal experiences with him.

Each paper has been previously presented at a workshop, printed in proceedings, or in an edited volume and provides abrief exposition of Gilligan's concepts. Collectively, they represent his personal odyssey as therapist. The book begins with "Ericksonian Approaches to Clinical Hypnosis," an excellent introduction to hypnotic induction and the principle of utilization.

In this first chapter, Gilligan describes a mindset that helps the therapist apprehend the client's reality as Erickson did, and respectful ways to pace and lead that reality. The therapist develops what he designates as an externally oriented trance to establish a deep, accepting rapport with the client. The therapist's trance-focused on the subject, but also incorporating internal prompts-creates a secure relationship that allows the therapist to elicit unconscious responses and minimize resistance due to fear that psychological safety will be compromised in hypnosis.

Subsequent chapters provide a window into the way Gilligan began to integrate what he learned from Erickson with his own concepts of the role of hypnosis. Although many clinicians will disagree with him, he dismisses the DSM as a compilation of self-devaluing terms; his point is that treatment consists of changing self-devaluing views, or what he calls self-devaluing trances into self-valuing solutions.

In "Symptom Phenomena as Trance Phenomena" he makes a powerful argument for helping the client to broaden negative views of self and life situation through the use of trance. Trance permits multiple and opposite views to be held simultaneously, thereby facilitating mental shifts and transformation of rigid and stuck positions. The therapist particularly makes note of the client's symptom trances involving "both/and" logic (I don't want to smoke but I smoke) and the client's use of paradoxical injuctions (I want to get well but I don't want to change). The unique contribution here is Gilligan's emphasis on the relationship the therapist establishes with the client. The therapist enters the client's trance without violating the client's boundaries, to repattern devaluing trances (i.e., symptoms) and change them to self-valuing experiences.

The nucleus of Gilligan's unique formulation of the therapeutic process is contained in an early paper, "Generative Autonomy." It is not an easy read; others-"Primary Process in Brief Therapy;" and "Fight Against Fundamentalism"-are more accessible. They give a view of the diverse sources that have informed his view of the self, the relational field of self and the nature of therapy. He often cites T. S. Eliot regarding the human condition; Gary Zukav about the nature of the universe; Gregory Bateson's analysis of the double bind and complementarity; Jung's theories of archetypes; and Buddhists' concepts of self, relative to the larger universe.

In his conceptual formulation, experience is generated through the marking out of distinctions-of figure and ground. The most important of these is the distinction of "self," part of a larger context, a relational field. Distinctions to protect the self, can lead to integration or growth, or become self-defeating and dissociative.

Frozen in self-defeating patterns, unable to use conscious reasoning to resolve inner conflict, a person goes into a hypnotic state which lends itself to "both/and" processes-the simultaneous consideration of figure and ground or the capacity to accept the difficulty of a problem while standing outside it. The therapist softens the process of making distinctions; accessing his/her own unconscious while becoming absorbed in the client's patterns; and yet remaining apart from them. Emphasis is given to "sensing the self," and visualizing a desired, symptom free, autonomous future, as a way of stepping outside habitual, limiting, self-defeating patterns. In the context of hypnotherapy, it is neither the hypnotic experience of the client nor the therapeutic relationship that restores generativity and autonomy but "both/and."

The author marks his distinction from Erickson, his teacher and mentor, in a section called the "Post Ericksonian World." Here, Gilligan's newer concepts are crystallized and, though historically related to Erickson, carry a highly original stamp. The new perspective focuses on the "relational self." In "Post Ericksonian World" he undertakes a reformulation of the idea of the unconscious, a term too limited for "therapeutic flexibility" and connoting something apart from or outside of the client's known experience. He prefers to frame the dynamics of unconscious functioning as a search for the "center," as defined in the performance of aikido-a felt sense of intelligence that permits relational creativity and calmness