Milton Erickson utilized symbolic communication and therapeutic rituals in his counseling; one significant difference between him and tribal healers is that he was not interested in a spiritual dimension. He said "I have worked for over fifty years to disassociate the study of hypnosis from mystical and unscientific connotations". According to Zeig (1997), "Erickson did not discuss spirituality . . . . he was a rationalist and did not have truck with transpersonal explanations. He maintained that what he did and experienced could be described in concrete, scientific terms without the necessity of using esoteric reasoning".
Although he had no interest in the supernatural, Erickson believed there was a role for the irrational in psychotherapy. He said that "Sometimes . . . therapy can be firmly established on a sound basis only by the utilization of silly, absurd, irrational, and contradictory manifestations". Presumably Erickson believed that symbolic healing methods worked (when they worked) due to the client's belief in their power to heal. This process may be poorly understood, but it is well established that a great variety of healing rituals can relieve suffering and demoralization.
Rationalists assume that there is a good scientific explanation for how various forms of symbolic healing work, and that there is no need to resort to supernatural explanations. But the supernatural or spiritual beliefs of clients can be utilized to promote their psychological healing, whether or not those beliefs can be proven to be true.
Betty Alice Erickson (2004) has noted that while traditional psychotherapy seeks theory, explanations and hypotheses, shamanic traditions welcome mysteries, and use prayer, music, and dancing to create altered states of consciousness and new possibilities.
Just as many of Milton Erickson's homework tasks for clients made no logical sense, Native American healers sometimes give their clients tasks that make no logical sense, but that are meant to operate on a spiritual level (or what Euro-American psychologists might call an unconscious level).
For the most part the Ericksonian psychotherapist operates within the traditional individualistic Euro-American therapeutic model. The therapist talks with the client and the relief of suffering results from the client being guided by the therapist (either directly or indirectly) in how to think, feel, or behave differently. In contrast, the Native American healer operates within the context of a tribal society, and shares a belief system with the client. The ceremonies and rituals are presumed to have healing potential due to their linkage with the supernatural world. In both situations, the psychological healing that is hoped for can be explained rationally as the result of the healing power of nonspecific factors such as belief in the process, faith in the healer, and the expectation of benefits.