A Bucket for Your Tears

Among the many stories Milton Erickson told his students, one of the best known involves a man who came to him for help with his drinking.

Erickson didn’t lecture him about his liver, or warn him about where his life was heading. As Erickson told the story, he gave the man an assignment. He was to go to the Desert Botanical Garden in Phoenix and look at the cactuses: plants that can survive for years in the desert with almost no water. Then he was to think about that.

That was it. No contract, no programme, no list of rules. Just a strange errand, and an image the man would carry home with him: something living, thriving, in conditions where you’d expect it to wither for lack of a drink.

In Erickson’s telling, it worked. Whether it worked exactly as he remembered it, decades later, we can’t know. Like many of his teaching tales, this one comes to us through his own retelling. But the story has survived because it captures something that researchers have spent the last thirty years confirming: what we pay attention to shapes what we crave, and changing the picture in someone’s mind can be more powerful than arguing with them.

Why send someone to a garden?

The assignment wasn’t unusual for Erickson. He regularly gave patients tasks that seemed odd, or even pointless, at first.

His son Allan Erickson has described how, because the family living room doubled as his father’s waiting room, he often learned what jobs patients had been given. Some made obvious sense as a first step towards healing. Others were harder to understand. One woman was sent to the Phoenix bus station to meet every arriving bus for three days.

The Botanical Garden was one of Erickson’s favourite destinations. Allan recalls that his father would send patients there with a challenge: without asking anyone or reading any signs, find and correctly identify a particular, unusual plant called the Boojum tree. It sounded impossible, but every patient who tried managed it.

These errands did several things at once. They got people out of the house and moving. They gave them a small success. And they handed them an experience they would remember, rich with images, sensations and meaning, which Erickson could draw on later. The cactus assignment was a suggestion delivered not in words, but in a landscape.

Where attention goes, craving follows

Erickson relied on intuition. Today we have laboratory evidence.

Researchers have found that people with alcohol problems develop a set of automatic mental habits around alcohol. As a team led by Dutch psychologist Reinout Wiers has described it, these include an attentional bias, in which the eye is drawn to alcohol-related cues; a memory bias, in which alcohol-related associations spring to mind; and a tendency to approach alcohol automatically.

These habits operate below awareness. A person walking into a supermarket may notice the wine aisle before they’ve consciously thought about it. By the time they’ve decided anything, their attention has already been captured.

That’s what makes Erickson’s cactus such an elegant move. He didn’t try to win an argument with the man’s conscious mind. He gave his attention somewhere new to go.

Retraining the pull

If those habits are automatic, can they be retrained? In 2011, Wiers and his colleagues tested that idea with 214 people in inpatient alcohol treatment in Germany. Some patients were trained, in four short sessions, to push a joystick away whenever they saw a picture of alcohol. Others received no training or a fake version.

The results were striking. In the trained groups only, patients’ automatic tendency to approach alcohol turned into a tendency to avoid it. A year later, the trained patients had done better: relapse was about 13 percentage points lower than in the control groups.

It isn’t a magic fix. A later study found that the same kind of retraining was ineffective for heavy-drinking young adults who weren’t in treatment. The approach seems to work best as part of a wider treatment programme, for people who’ve already decided to change. But the principle holds: where the mind automatically goes can be changed.

“When I walk into a store…”

A second line of research explains why a simple, specific instruction can be so powerful.

The psychologist Peter Gollwitzer has shown that a general intention (“I want to drink less”) often fails, because people struggle with the moments where it matters. What helps is an implementation intention: a plan that spells out the when, where and how in advance, in the form “If situation Y happens, I will do X.”

In a 2006 review of 94 independent tests, Gollwitzer and Paschal Sheeran found these if-then plans had a medium-to-large effect on reaching goals. They helped people get started, protected their goals from distractions, and made the planned response close to automatic when the moment arrived.

A real case from the Milton H. Erickson Foundation’s newsletter shows the same idea in therapy. The therapist Eugene Don was treating a 23-year-old woman who had been drinking daily for months. Among other things, he gave her a plan for the moment of greatest temptation: whenever she walked into a store, she was to look for the juice section instead of the alcohol. It was an implementation intention in all but name. It worked as part of a wider treatment: Don saw her three times a week for more than a month, and involved her partner in her recovery.

Gentle beats harsh

Erickson’s cactus was indirect. He didn’t tell the man he was wrong. He gave him something to look at and left the conclusion to him. That choice turns out to matter.

For much of the twentieth century, addiction treatment often relied on direct, aggressive confrontation, on the theory that a drinker’s “denial” had to be broken down. In 1993, William Miller and his colleagues put that idea to the test. They randomly assigned 42 problem drinkers to receive a brief “check-up” in either a directive-confrontational style or a client-centred one.

Both groups cut their drinking substantially. But the confrontational style produced much more resistance from clients, and that resistance predicted worse outcomes a year later. Most striking of all, one therapist behaviour stood out: the more the counsellor confronted the client, the more the client drank.

Reviewing decades of research in 2007, Miller and the addiction historian William White concluded that no clinical trial had shown confrontational counselling to be effective, while several had documented harm. The most effective counsellors were those with an empathic, supportive style.

Erickson could be very direct when he judged it necessary. But the cactus shows his more characteristic approach: he respected the person’s own ability to reach a conclusion, and simply arranged the experience that would lead them there.

Can hypnosis help?

What about hypnosis itself? The evidence is still thin. A Norwegian research team noted in 2019 that, although hypnotherapy has been used for alcohol problems, only two randomised controlled trials had previously been carried out.

Their own trial was small but interesting. Thirty-one patients in a six-week programme received either five individual sessions of hypnotherapy or five of motivational interviewing, on top of intensive group therapy. The hypnosis they used was specifically Ericksonian, permissive hypnosis. The therapists even asked patients when and where they bought alcohol, and how they drank it, so that the visualisations could target those exact moments.

Both groups cut their drinking significantly. At a one-year follow-up, the hypnotherapy group did marginally better. The researchers were candid that the study was too small to be sure the difference was real, but concluded that hypnotherapy appeared to be at least as effective as motivational interviewing.

That’s a modest result, but an honest one. It places hypnosis where the evidence currently supports it: a reasonable option within proper treatment, not a miracle cure on its own.

What the cactus teaches

Put the story and the science side by side, and the pieces fit together:

Give attention somewhere new to go. Craving is partly a habit of attention. The cactus, and the juice aisle, redirect it.
Plan for the moment that matters. A specific “if this, then that” plan does more than good intentions.
Lead, don’t push. Confrontation tends to provoke resistance. An image, a story or an experience lets people reach their own conclusions.
Combine it with real support. None of these ideas works in isolation. In every case that succeeded, they were part of a wider treatment.

Erickson never published a controlled trial of his cactus assignment. But he seems to have grasped something researchers would later measure: you can’t always argue someone out of a craving, but you can change what they see.

The Cactus Cure

Why send someone to a garden?

Where attention goes, craving follows

Retraining the pull

“When I walk into a store…”

Gentle beats harsh

Can hypnosis help?

What the cactus teaches

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