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The second major point is that living requires effort. This is often overlooked
in a culture of modern conveniences. In addition to being
imperfect, people need to work hard in order to function well.
Healthy muscles require constant exercise. Healthy brains require
ongoing stimulation and effortful processing. Healthy families
require constant attention and involvement. In most of his clinical
work, Erickson rarely used words or phrases that implied a passive
role for the patient. He found stimulating ways of encouraging
patients to be actively engaged in their own healing processes.
Having grown up on a farm, he fully appreciated the meaning of,
"You must do your share of the work." He understood the feeling
of satisfaction that comes after a hard day's toil.
Accordingly, Erickson put a great deal of time and energy into
each clinical case. He kept meticulous notes, writing down everything
that was said during a session. Then he planned and
reviewed every word and action that might occur in following sessions
and what impact it might have. In some cases, he drove to
patients' houses in order to better understand the setting from
which they came. What this meant was that Erickson often spent
more time preparing for a session than in the sessions themselves.
Erickson's opinion was that the results of each problem-solving
endeavor will be proportional to the amount of effort invested in
finding a solution (Hughes and Rothovius, 1996, p. 236).
In the case of the man with arthritis, Erickson put him to work first
exercising his thumb. This eventually progressed into painting
houses. Engaging the patient in productive effort, as small as it initially
was, eventually produced a profound effect. Similarly,
Erickson taught other patients with severely debilitating pain to
take advantage of moments when they are feeling better in order
to be productive (Erickson-Klein, 1990).
Regardless of the disability or state of health, a lack of effort results
in lack of progress. Perhaps this is why many clinicians wisely
avoid enabling passivity by adhering to the maxim, "Never work
harder than the patient." As Erickson (1952/2001b) explains,
"Whatever the part played by the hypnotist may be, the role of the
subjects involve [sic] the greater amount of active functioning-
functioning which derives from the capabilities, learnings, and
experiential history of their total personalities" (p. 27). Because the
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