Brief Therapy

I have been asked by Gil Levin to write about Brief Therapy, the topic of the August 26-30, 1998, conference organized by the Milton H. Erickson Foundation, to be held in New York City. In 1988, the first Brief Therapy Conference was held, and it remains the premier multidisciplinary congress on the topic.

The three issues I wish to address here are: first, the fact that Brief Therapy is not central to contemporary practice; second, the importance of the person of the therapist as a focal point in the change process; and third, the grammar of change.

Brief Therapy is an appurtenance, not a quiddity in contemporary practice. Perhaps this seems strange idea for a leading proponent to suggest. Let me explain:

When I initially conceived the idea of the Brief Therapy Conference, I discussed it with my friend and colleague, Nick Cummings, Ph.D. I was a little heady about the concept, thinking that Brief Therapy was timely in consideration of the development of managed care. Nick casually informed me that my idea was faulty. Brief Therapy, he maintained, was not the answer. Rather, he asserted, practitioners need to know how to practice in the contemporary environment.

Well, I did not cancel the conference, and, in fact, the Erickson Foundation has continued to hold the event every three years. I did, however, agree with Nick, and consequently changed my orientation.

Practice has changed radically in the twenty years since I earned my Ph.D. No longer are we a self-regulating cottage industry. Accountability, for example, has taken on new meaning and emphasis.

The August Brief Therapy conference, therefore, will focus on the truly salient issues given the current environment, including: How does one balance the requirements of effective practice and the requirements of managed care How can clinicians be accountable without feeling confined? How is Brief Therapy be used with various client types?

My own area of inquiry in Brief Therapy has been the person of the therapist. At first glance, this topic may sound like an anachronism in the protocol-driven world of today’s psychotherapy.

I maintain, however, that we must be better therapists, not merely do therapy. In my past teaching, I emphasized such techniques as how to do hypnosis, how to work with metaphors, how to use Erickson’s interspersal method. Currently, in my teaching, I emphasize therapist development. I am curious about the postures that exemplary clinicians develop, and how they can be incorporated into the unique style of the average clinician.

Consider, for example, the utilization method, which is central to Ericksonian practice. There is the famous case where Erickson approached a bothersome schizophrenic patient who was proselytizing on the inpatient ward, attempting to convert all in sight to Christianity. He knew he was Jesus Christ. Erickson addressed the patient confidently, “Sir, I understand that you have experience as a carpenter.” Upon getting an affirmative reply, Erickson waltzed the patient to the woodshop to help others. Erickson utilized the patient’s metaphor to effect change.

Now, utilization can be considered a technique, but that makes it difficult to teach. Rather, I think of it as a posture that must be assumed, much like riding a bike is something that must be accomplished by learning an orientation, a posture. Utilization must be learned experientially, not didactically. Therefore, I have developed a system of exercises to help therapists incorporate and practice useful postures. I call the system Psychoaerobics™, and I will be teaching it at the August meeting.

Now to the grammar of change: It is not only therapists, but also patients who need experiential methods of change.

Let us consider the grammar of therapy. Patients speak in implied exclamation points. They tell us about their imperative experiences. Therapists commonly speak in soft question marks, e.g., “Can you tell me more about that?” Match the question mark to the exclamation point and tell me which is more powerful!

When we provide patients with experiences of change, we are speaking at the level at which problems are generated, the experiential level. It is at this level that generative change most commonly takes place.

For example, I conducted a little drama with a patient filled with remorse about her failure to act assertively. I had her recite the event twice, the second time in the first person, present tense. I was treating the event as if it were a dream, and as if I were embarking on Gestalt dream work. I then placed a number of objects on her lap. She passively accepted them, and looked at me curiously, waiting for direction. Her lap filled with objects, including my shoe, I hovered over her and announced, “If you are walking down the street and someone gives you a gift and you don’t want it, do you have to accept it?” She shook her head and I continued, “Then, if you are walking down the street and someone gives you a bag of shit …”. I let her fill in the blank. She then gave me back the objects. Next, I asked her to sculpt me into the posture of an Amazon Warrior, which she did with a little prompting. Subsequently, I had her close her eyes and symbolically bring that Warrior into her heart. Then, she retold the “dream” from the position of the Amazon.

We called the therapy “Amazon.com.” Follow-up indicated that one session accomplished her goal.

In that interview, many “voices” spoke through me, including those of Erickson, Fritz Perls, Bob and Mary Goulding, and my friend and colleague, Michael Yapko. I took many postures and a number of judicious risks.

Want to learn more about these ideas? Here are a number of sources:

(1) Visit the Forum on Ericksonian practice that Stephen Lankton and I conduct here at BOL.

(2) For information about the Erickson Foundation

(3) Join the new Erickson mailing list: Write to LISTSERV@HOME.EASE.LSOFT.COM and, in the text of your message (not the subject line), write: SUBSCRIBE ERICKSON and add your name. Please specify your full name, e.g., SUBSCRIBE ERICKSON Mary H. Smith. The list is open to mental health and health professionals and graduate students. This discussion group is sponsored by the Milton H. Erickson Foundation, and administered by Jim Keim.

(4) Attend the August Brief Therapy Conference. Here is an announcement:

THE BRIEF THERAPY CONFERENCE

The Milton H. Erickson Foundation is sponsoring The Brief Therapy Conference entitled, “Brief Therapy: Lasting Impressions,” in New York City, August 26-30, 1998.

Confirmed invited faculty include David Barlow, Ph.D.; Laura Brown, Ph.D.; Simon Budman, Ph.D.; Nicholas Cummings, Ph.D.; Steve de Shazer, MSSW; Albert Ellis, Ph.D.; Betty Alice Erickson, M.S., LPC; Richard Fisch, M.D.; Stephen Gilligan, Ph.D.; Mary Goulding, MSW; Lynn Hoffman, MSW.; Michael Hoyt, Ph.D.; Robert Langs, M.D.; Stephen Lankton, MSW;Joseph LoPiccolo, Ph.D.; Camillo Loriedo, M.D.; Michael Mahoney, Ph.D.;William Matthews, Jr., Ph.D.; Leigh McCullough, Ph.D.; Monica McGoldrick, MSW.; Scott Miller, Ph.D.; John Norcross, Ph.D.; Maureen O’Hara, Ph.D.; Peggy Papp, ACSW; James Prochaska, Ph.D.; Ernest Rossi, Ph.D.; Michael Yapko, Ph.D., and Jeffrey K. Zeig, Ph.D. Keynote speakers include Aaron Beck, M.D.; Helen Fisher, Ph.D.;Arnold Lazarus, Ph.D.; and Frank Sulloway, Ph.D. Accepted papers also will be presented.

For information and a complete brochure contact:

The Milton H. Erickson Foundation
3606 N. 24th Street
Phoenix, AZ 85016 USA
Tel: (602) 956-6196
Fax: (602) 956-0519
e-mail: office@erickson-foundation.org
website: https://www.erickson-foundation.org

Thanks for listening. Post your comments at the Erickson Forum, please.
Jeffrey K. Zeig, Ph.D.
Director
The Milton H. Erickson Foundation