The Approach

Recrafting a Life: Solutions for chronic pain and illness represents an approach that combines three (parallel) intervention paths in treating individuals suffering from chronic conditions. These interventions – Solution focused therapy, Ericksonian hypnosis, and the implementation of self care regimes - are integrated into a unified treatment approach that facilitates the creation of individualized strategies that facilitate symptom relief, health and healing. When applied to chronic pain and chronic illness this integrative approach increases the probability of clinical success while reducing the amount of energy patients expend to simply manage their chronic condition.

Solution focused therapy - One size fits one!

Solution focused therapy (SFT) originated at the Brief Family Therapy Center in Milwaukee (BFTC), Wisconsin. Evolving out of the early brief therapy contributions of Milton Erickson and the Mental Research Institute the founders -Steve de Shazer and Insoo Kim Berg - discovered that shifting from a traditional pathology-oriented approach to one that focused on strengths and resources yielded considerably better therapeutic results in a significantly shorter amount of time.

This radical shift represented a significant departure from traditional psychotherapy that made basic assumptions about patients’ essential character. Instead of seeking to change patients’ (perceived faulty) character traits while endlessly speculating on their causality, de Shazer and Berg completely reversed the interview process by beginning the first clinical interview by asking patients to describe a (detailed) resolution to the problem that brought them into therapy. Supplementing this fundamental shift was the belief that psychological change as a dynamic process. Instead of assuming that by its very nature, real psychological change was a slow and belabored process (if possible at all) often dependent on the patient’s insight, they viewed it as an inevitable and dynamic part of the life.

Endorsing philosopher Heraclitus’ famous statement, “You can’t step in the same river twice,” de Shazer and Berg discovered that utilizing the inherent dynamic nature of change substantially shortened the time that patients required to solve their problems. This resulted their adoption of Milton Erickson’s principle of “inventing a new theory for each patient (see below),” rather than limiting themselves to one particular theoretical model. We were attracted to this individualized “one size fits one” approach for chronic pain and chronic illness suffers because it values the patient’s values and experience while respectfully orienting therapy to the patient’s “voice” rather than assuming that she is her diagnosis.

More information on solution focused therapy

Or, for information about differences and similarities to Ericksonian approaches

Clinical Hypnosis – The genius of Milton H. Erickson, MD

Clinical hypnosis is the second path in our approach. For centuries, hypnosis has had a long and sometimes controversial history within the healing arts. In the last 60 years, however, this treatment modality has made significant strides in its acceptance and utilization in the treatment of individuals suffering from chronic pain and illness.

Given the numerous current available models of hypnosis, we chose the Ericksonian path because of its therapeutic sensibility and respectful approach to patients. In addition to being inspired by Erickson’s personal struggles (see below), we believe that his approach most closely matches the needs and resources of patients suffering from a chronic condition and chronic pain. Moreover, his focus on the future and facilitation of the unique resources of the patient make it a perfect complement to its offspring, Solution Focused therapy.

Milton H. Erickson, MD was profoundly influenced by his own personal story of addressing chronic pain and illness. This not only informed his hypnotherapeutic approach, but his personal values and common sense philosophy as well. A Wisconsinite, like de Shazer and Berg, he was struck at the age of seventeen with polio. Isolated, many miles from any rehabilitation clinic, he had no choice but to invent his own self-care routine if he were to recover from this devastating illness. Unacquainted with hypnosis, through trial and error, he learned to evoke of a variety of helpful altered states of consciousness with the hope of improving his physical and emotional condition.

During this rehabilitation period, Erickson discovered an ability to convert his past memories (a classic hypnotic phenomenon) of muscular movement into the extremely small motions while he sat in his rocking chair. As a means to reduce his pain he recalled memories of becoming fatigued after exercise and vigorous activity. Ultimately, after achieving many very small daily victories, he was able to learn how to walk again. These experiences of observing, accessing, and utilizing resource states would later become the foundation of his pioneering work in the field of psychotherapy and hypnosis.

During his long and varied career Milton Erickson was generally acknowledged to be the world's leading practitioner of hypnosis. He authored 150 professional journal articles and worked with over 30,000 patients as well as authoring and co-authoring numerous books. Additionally, he was widely considered to be a major innovator in the practice of strategic and brief psychotherapy. He was the founding president of the American Society for Clinical Hypnosis as well as the founder of the Society's professional journal. Today, the Milton H. Erickson Foundation, located in Phoenix Arizona continues to carry on his work, teachings, and research.

Milton Erickson’s work, both hypnotic and psychotherapeutic, integrates seamlessly with the solution focused therapy and self care strategies (see below) presented in Recrafting a Life. In addition to the sheer brilliance of his hypnotic techniques, his respect for unique resources, specific context, and values of the patient remind us of the importance viewing the patient as a person and not a diagnosis.

Click here for more on clinical and Ericksonian hypnosis.

Or, for information about differences and similarities to solution focused approaches

Self Care

Self-care is the third path in our integrated approach. Exploring different models of self-care, we differentiate between self-care and care of the Self. Our therapeutic model of care is grounded in the delicate and ever-changing balance between caring and self-care, between what can best be developed in relationship and the strategies patients often develop in highly personal and unique ways.

Our model focuses on self-care for two reasons. First, the approach is highly consistent with the philosophy; second, managing any chronic condition requires awareness about the ways we take care of ourselves and an expansion of our self-care skills, precisely at a time when the energy required may seem inaccessible. In many ways, we view our role is that of becoming a compassionate “self-care coach."

Self-care resources are either internal or external. These may include internal resources, such as specific skills, abilities, or past experiences that can be built on, as well as external resources such as social support, concrete forms of assistance, and material resources. In a healing relationship, then, the role of the health care provider is to facilitate and enhance patients’ self-care regime. Helping patients recognize and develop their unique resources and knowledge is more important, from this perspective, than “patient education” approaches that presume what they need to know.

Many of the experiments in Recrafting a Life (Part III) are ways to facilitate self-care actions. Our approach utilizes several strategies for facilitating self-care, including solution focused interviewing, self- hypnosis, employing self-care checklists, keeping self-care diaries or journals, or engaging in wide variety of self-care “experiments” to expand one’s repertoire of self-care strategies.

Click here for more on Self-care