Customized treatment

Therapy is not just a profession, an occupation, it is an art. And as with all art, only few reach the highest levels. That is fine. We also need people who write advertising bulletins, newspaper reports and online posts, not just Dostoevskys. Many decent therapists who do their jobs well are needed, even if they lack genius.

It seems that one of the genius therapists was Milton Erickson. In his original thinking capacity, Erickson offered an innovative model of therapy: a treatment that is completely adapted to the patient, rather than to predetermined rules. He was able to see the patient, to formulate his or her problem deeply, and then think of the quickest way to solve this problem, a way that was almost always unexpected (since the patient has apparently tried all the expected ways, unsuccessfully). 

Erickson’s approach is instructive – the therapist should be the one who directs the encounter. Karen Horney once said: “Patients come to therapy not to cure their neuroses but to perfect them.” If the patients are the ones who determine what is happening in the therapy session, almost everyone will unconsciously do everything necessary to prevent real therapeutic change. When a patient goes about in a useless way, Erickson said, the therapist has to distract him, for example by making an irrelevant remark, such as “I know what you think. I like trains as well.” Then the patient can be directed to a more fruitful path. 

Erickson quoted Adler as saying: “Therapy is like spitting into the patient’s soup. He can continue to eat it, but he can no longer enjoy it.” An example of such a ‘spit’ is to take a symptom and turn it into a task; Instead of trying to fight it – actually reinforce the symptom absurdly. Thus, for example, Erickson weaned a 15-year-old girl from sucking a finger – by making thumb-sucking obligatory. 

The reading of Erickson’s heroic stories arouses much appreciation, as well as a measure of despair – his way of action requires a rare talent. Nevertheless, he provides exceptional inspiration for seeking a different approach to treatment problems. It should be remembered that one of Erikson’s main teachings to his students was: “Do not try to be like me, be who you are, at your best.”

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