Milton H. Erickson & Wilhelm Reich : The Art of Psychotherapy - Similarities and Differences - by Daniela Ripetti-Pacchini. (English version)

Beyond the ‘magical circle’ of traditional epistemology

Although Erickson and Reich came from different clinical and theoretical backgrounds, through their uncommon therapeutic approaches, similar in some respects, they contributed greatly to break new ground in psychotherapy and in the theory of therapy.

If Reich refused to use schematic techniques and to conform to a school and to a rigid theory (Ripetti-Pacchini,1985), Erickson even more radical and more or less consciously, questioned the theoretical monism and the ‘enchanted cage’ of methodology, going beyond the epistemology of Thomas Khun and perhaps that of Imre Lakatos.

“He developed a new theory for each person" (Stern,1985) and “spoke many theoretical languages” (Haley,1982).

Aware of the fact that “the theory often becomes a learned limitation” (Stern,1985), Erickson came closer with his theory of no-theory and his multifarious approaches, to the theoretical anarchism and the ‘Dadaism’ of Paul Feyerabend.

Of course just as it is necessary to “examine without prejudice what Erickson did” (Haley,1967), so it is necessary to read  Reich without reducing the complexity of his work. 

Evolution of the therapeutic setting

Another element which this two therapists have in common, is the fact they were concerned with producing changes in their clients’ current situation focusing on the context, on the interpersonal nature of psychological distress.

It was Erickson however, by using more sophisticated language patterns, who developed the psychotherapeutic setting even farther.

He unveiled indirectly, through the metaphorical ‘veil’ of his original hypnotherapy, that the so-called ‘psychotherapy’ is mainly an art of communication and rhetoric.

Both in Erickson and in Reich we also find a decrease in importance of the method of ‘interpretation' which in Reich became ever more decentralised compared to the weakening of ‘resistances’, while in Erickson it was abandoned, at least in its original form. (May be we can consider the ‘reframing’ as a form of interpretation).

After establishing the appropriate context, both of them preferred to activate new alternatives and an ‘experiential’ awareness in their patients rather than a purely intellectual consciousness, leaving as much room as possible to their clients’ self-regulatory inner resources.

Erickson and Reich have in fact another point in common : trust in the Unconscious and its ‘alternative’ autoregulatory capabilities, both of them having overcome some limitations of Freud’s Unconscious theory. (Actually this theory implies antagonist relations between the conscious and the unconscious mind). And in this they were validated by an extensive scientific literature.

These two authors had clearly understood the subtlety and plasticity of the automatic behaviour, whose rigidity would merely be a dysfunction and a pathology.

The open-ended suggestions of Milton Erickson or the emphasis laid on flexibility by him and Reich were not fortuitous.

Making therapy therefore means drawing from the source of the Unconscious, overcoming rigidities, one-sidedness and reintegrating.

And is this not one of the aims of the religious process, whose etymological meaning is also to ‘re-bind’, to ‘tie together again’?

And is this not, for example, the sense of the interpenetration of Yin and Yang or the function of certain Yoga exercises with the flexible utilization of various types of  representation and symbolic systems and the interchangeable use of the left and right sides of the brain?

Indeed is this not also, in many aspects, the function of the lyrical synthesis and of the bipolar or multipolar structure of every genuine cultural creation?

More than in other practices we find expressed this vital function of resynthesis in Erickson’s and Reich’ strategies.

But in order to reactivate the inter-intrapersonal contact by means of the therapeutic process, it seems to be necessary, as in other strategies of change, first to ‘pace’ the client’s experience which one wants to change, then in some cases to ‘disrupt’ a pattern of unwanted behaviour, and  finally to ‘lead’ or ‘allow’ the process of ‘re-binding’.

Language games and creative ploys

Languages games explored by the two therapists were numerous and original with this aim in view.

Erickson above all was master of the unexpected and of flexibility in his ‘ploys’. He often used such unexpectedness to achieve change.

A reading of the patient’s overall language, verbal and non verbal, is important in order to ‘pace’ him.

Both authors provided examples of great perceptiveness in reading and answering the many and contradictory paramessages they received.

They were also masters at utilizing their clients’ behaviour.

This tactic, like some moves found in the martial arts of the Far East, can serve to weaken the ‘resistances’ (understood as attitudes which contrast with and limit the fullness of a particular and creative way of being).

‘Pacing’ and the ‘utilization techniques’ are characteristic of all Erickson’s approaches.

As far as Reich is concerned , I would like to recall as an example, the case of the masochist patient (“Der masochistische karakter”, 1932). 
Reich blocked this patient’s repetitive behavioural pattern, by using imitation. In other words, by mirroring non verbally his attitude of resistance. 
He facilitated new forms of interaction, by, in a certain sense, ‘stealing’ the symptom.

In this ploy we also find the use of ‘surprise’, ‘confusion’ and ‘shock’ caused by the sudden change in the interaction patterns, a tactic which was also fundamental in Erickson work. It was important however in in Reich’s work as well.

As early as 1922, he was using the ‘analytic shock’ based on the circumscription of the contrary attitudes and resistances of ‘narcissistic types’ of patients in the therapeutic Temenos.  

 Erickson used similar processes to place the patient in a state of fluctuation, in a 'dissipative’ condition (to quote a term by Ilya Prigogine).

If necessary, he strengthened tensions present in his patient, to then discharge them along more appropriate paths.

And with this, he created the psycho-physiological context of the emotional-behavioural learning.

But this closely resembles also Reich’s ‘vegetotherapeutic technique’ of letting the ‘vegetative brakes intensify’ and then releasing them.

This tactic is, by the way, very similar to those in other practices for regulating tension, for instance E. Jacobson’s “Progressive relaxation”.

Apart from ‘shock’, other communication patterns used by Erickson (paradoxes, nonsense, homogeneity and heterogeneity saturation, etc.), tend to cause ‘disruptions’ and ‘shifts’ in the integration circuits, producing moments of depression and elicitation of the functions of both the left and right hemispheres.
Ernest Rossi quite rightly points out that the phenomena of trance are analogous to dysfunctions of the left and right hemispheres (Rossi,1976). 
And also the very ritual of hypnotic induction favoured Erickson in this process of destructuring.
Thus for example, on the importance in hypnosis of keeping arms and legs apart, Erickson said : “One thing I found important, is not to allow hands to be in contact with each other. I don’t know how this contact precisely interferes.”

I believe that letting one’s arms and legs lie loose or staring fixedly, serve above all to produce a momentary reduction in the capacity for dialogue between the right and the left hemispheres. In fact, in this way, unifying factors such as body movements (which allow each hemisphere to be informed immediately about what is happening in the other), are prevented.

On one side there is then this dissociative action of hypnosis, on the other there is a function of resynthesis, because the various stages and degrees of the hypnotic process, thanks to their resemblance to other hypnoid, oneiric states and to older modes of neural integration, give the opportunity to transfer, process and integrate, various types of experiences ( see the ‘state bound learning’).

The ‘shock’ as well, may create  a neurophysiological context facilitating the transfer between emotional experiences of the waking state and the paradoxical stage of sleep.

During these states, in fact, similar phenomena like the rhythmicalization of the allocortex and the electrophysiological flattening of the isocortex occur (Jung,1976). Therapeutic shock would therefore predispose the nervous structure and the appropriate relationship framework for a deep emotional processing and a ‘second-order change’.

Indirect approaches : Erickson the Storyteller

While Reich in his methods ‘disruption’ and ‘resynthesis’ was sometimes too intrusive, Erickson produced a great technical innovation thanks to the richness of his indirect approaches.

In a certain way he put into practice that ‘indirect communication’ theorized in the West by Soren Kierkegaard in his “Exercise of Christianity”.

The wide variety of such indirect approaches forces me to mention only one other, which he expressed magnificently : the ‘method’ of storytelling.

This approach distingueshed him from nearly all traditional Western therapists, making him seem closer to certain Zen masters (geniuses in paradox, surprise and anecdote) and showed further how his extremely modern therapeutic narration, the breath, the way of telling it, was rooted in ancient initiation practices, prayer and healing 1). It also showed him to be a subtle and rare storyteller (in Walter Benjamin’s sense) of short endless stories, which I have defined ‘circular creative narrations’, facilitating, because of their circularity, amnesias and space-time distortions.

But as is probable (see for example the mandala dreams referred to by Carl Gustav Jung, the soft round movements of Tai Chi, or the researches of the school of Tartu and Mosca) the circle also reconnects to the right hemisphere and like some ‘circular narratives’ of  F. Chopin, Erickson’s induction is a special form of...music.

So he is a sort of Dylan Thomas of hypnotic narrative, and listening to his inductions is like “entering a building, with a serious of rooms, one after another, where one comes across objects seen before and others whose use one cannot recognize, with openings onto wide views, real or false, with constant repetitions of wholes and details in the furnishings…Where one turns, looks, touches, listens…One’s memory is constantly stimulated by similarities, one’s imagination by oddities…Once outside again, one may not understand the layout of the maze, or its purpose…but the perception of a feeling remains vivid.” 2)

1) For example, the way of exhaling sometimes used by Erickson is similar to that suggested by Ignatius of Loyola.

2)   Variation on the Preface by Ariodante Marianni to The Poems of  Dylan Thomas.

See also my video : 
"Milton H. Erickson & Wilhelm Reich : The Art of Psychotherapy"  https://www.youtube.com/watch?v=n_TLBaZFFxo

Italian version of this paper (versione italiana) on Academia.edu :

http://www.academia.edu/7843401/Milton_H._Erickson_and_Wilhelm_Reich_-_Affinit%C3%A0_e_Differenze._Dal_Congresso_Internazionale_di_Ipnosi_e_Terapia_della_Famiglia_Il_modello_terapeutico_di_M.H.Erickson_


                                                         REFERENCES  

Bassin, F.V. (1972). Il problema dell’inconscio, Roma : Editori Riuniti

Erickson, M.H., Rossi, E.L., Rossi,S. (1976). Hypnotic realities : The induction of clinical Hypnosis and suggestion. New York : Irvington.
Feyerabend, P. (1975) Against Method : Outline of an Anarchist Theory of Knowledge. ISBN 0-391-00381-X.

Haley, J.(Ed.).(1967). Advanced techniques of hypnosis and therapy : Selected papers of Milton H. Erickson M.D. New York : Grune & Stratton.

Jung, C.G. (1944). Psychologie und Alchimie. (1981). Psicologia e Alchimia, Torino: Boringhieri Editore.

Jung,R. (1967). Neurophysiologie und Psychiatrie : Vol.II. Berlin : Springer.

Kierkegaard, S. (1972). Opere, Firenze : Sansoni Editore.

Lotman, J.M.; Nikolaenko, N.(1983). "Zolotoe secenie i problemy vnutrimozgovogo dialoga". Decorativnoe Iskustvo, 8
Prigogine, I ; Stengers,I (1984). Order out of Chaos : Man's new dialoque with nature. Flamingo. ISBN 0-00-654115-1 

Reich, W. (1975). Early Writings.Toronto : McGraw-Hill Ryerson Ltd.

Reich, W.(1949). Character Analysis. New York : Orgone Institute Press.

Reich, (1948). The function of the Orgasm, New York : Orgone Institute Press.

Reich,W. (1960) Selected Writings. New York : Ferrar, Straus & Cudahy.

Ripetti Pacchini, D. (1973-'74). "L'esperienza d'integrazione - The experience of integration" (A study at the  Department of Psychophysiology - University of  Rome).

Ripetti Pacchini, D (1986)"Evoluzione del setting terapeutico e della teoria della terapia attraverso l'analisi caratteriale reichiana". Giornale storico di Psicologia Dinamica, Volume X : Gennaio 1986, fasc.19 ISBN : 9788820715199 

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

Stern, C.R. (1985). "There's No Theory Like No.Theory : The Ericksonian Approach in Perspective". Ericksonian Psychotherapy. Vol. II : Structures. Jeffrey K. Zeig (Ed.). New York : Brunnel/Mazel, Publishers.

This paper, from the International Congress on Hypnosis and Family Therapy - Ericksonian Methods (Rome 1985), was published in Italian language in Atti del Congresso Internazionale di Ipnosi e Terapia della Famiglia (Il modello terapeutico di Milton H. Erickson) - Ed.  L'Antologia, Napoli (1987). 
ISBN 8885855032. BN 90-604


© Dr.Daniela Ripetti Pacchini