Essentials: Using Hypnosis to Enhance Mental & Physical Health & Performance | Dr. David Spiegel
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In this episode of Huberman Lab Essentials, Dr. David Spiegel defines hypnosis not merely as a stage act but as a state of highly focused attention where individuals enter an imagined world devoid of critical judgment or evaluation. He contrasts clinical self-hypnosis with stage hypnosis, emphasizing that while the latter often mocks participants and induces fear regarding loss of control, true therapeutic hypnosis enhances cognitive flexibility by allowing people to shift perspectives easily. Dr. Spiegel explains that this state involves turning down activity in the dorsal anterior cingulate cortex (DACC), a conflict detector within the salience network, which reduces distraction. Simultaneously, functional connectivity increases between the dorsolateral prefrontal cortex (DLPFC) and the insula—a key region for mind-body control—enabling profound somatic regulation. For instance, studies have shown that highly hypnotizable individuals can increase gastric acid secretion by 87% simply by imagining eating their favorite foods or decrease it significantly when instructed to relax, demonstrating the brain's remarkable ability to command bodily functions like digestion without physical input. The discussion further explores how hypnosis alters connectivity between the DLPFC and the posterior cingulate cortex (PCC), a component of the default mode network responsible for self-referential thought. By reducing activity in this area during deep hypnosis, individuals can experience dissociation from their own identity or memories without emotional distress, fostering a state where actions are performed without worrying about personal implications. This mechanism is particularly relevant for treating conditions like ADHD and phobias; by narrowing focus on specific tasks, people can enter "game-like" states of flow that enhance productivity. Dr. Spiegel notes that while some individuals with obsessive-compulsive disorder (OCD) may be less hypnotizable due to their hyper-controlled, evaluative nature, hypnosis remains a powerful tool for stress reduction and sleep induction by dissociating somatic reactions from psychological triggers. He illustrates this through the "floating" technique, where patients imagine themselves in safe environments while visualizing stressors on an imaginary screen, allowing them to manage physical responses like sweating or heart rate increases without feeling overwhelmed. A significant portion of the interview addresses trauma treatment and state-dependent memory, a concept championed by cognitive psychologist Gordon Bower. Dr. Spiegel describes hypnosis as "unsystematic desensitization," where changing mental states facilitates therapeutic potential similar to that seen with ketamine for depression. He recounts a case involving a woman who survived an attempted rape but could not recall the attacker's face due to trauma-induced dissociation; by guiding her into a hypnotic state congruent with her traumatic experience, he helped her restructure her narrative and realize she had fought back effectively rather than just being a victim. This process allows patients to confront painful memories while maintaining control, preventing them from freezing up or losing articulation during therapy sessions. The efficacy of this approach is supported by randomized trials showing that adding hypnosis to PTSD treatment improves outcomes faster than traditional psychotherapy alone, helping individuals reprocess traumatic events and replace negative associations with positive ones through the activation of mesolimbic reward systems. Dr. Spiegel also highlights the critical role of breathing in shifting brain states during induction, noting that patterns involving longer exhalations can induce parasympathetic activity to slow heart rates and promote relaxation. He emphasizes that hypnosis is not about absolute control but rather learning to manage signals from both the mind and body as tools for understanding one's environment. This principle applies broadly to pain management, where patients learn to categorize pain signals—distinguishing between injury requiring attention and healing processes—to modify their emotional response. The conversation extends to children, who can be effectively hypnotized with proper structure; a randomized trial demonstrated that using hypnosis before cystourethrogram procedures reduced procedure time by 17 minutes and significantly lowered anxiety in pediatric patients. Additionally, Dr. Spiegel mentions his work with metastatic breast cancer groups where collective hypnosis sessions fostered shared social experiences and improved well-being among participants. For those interested in applying these tools, Dr. Spiegel points to the Reverie app as a resource for self-hypnosis exercises ranging from 15 minutes down to quick 2-minute refreshers that reinforce neural pathways through long-term potentiation. He advises seeking licensed professionals with training in clinical hypnosis from organizations like the Society for Clinical and Experimental Hypnosis or the American Society for Clinical Hypnosis, especially before attempting treatments for complex issues like chest pain where underlying medical conditions must be ruled out first. While about one-third of adults may score low on hypnotizability tests such as the Spiegel Eye Roll Test—where eye movements while closing eyelids indicate susceptibility—the benefits are accessible to most people who understand their capacity and practice self-regulation. Ultimately, Dr. Spiegel concludes that hypnosis is a scientifically grounded method for enhancing mental and physical health by leveraging the brain's innate ability to regulate itself when guided correctly, offering hope for performance enhancement and healing in an increasingly complex world.
Read the full video transcript
Welcome to Huberman Lab Essentials,
where we revisit past episodes for the
most potent and actionable science-based
tools for mental health, physical
health, and performance.
I'm Andrew Huberman and I'm a professor
of neurobiology and ophthalmology at
Stanford School of Medicine. And now for
my discussion with Dr. David Spiegel.
David, thank you so much for being here.
Andrew, my pleasure. Can you tell us
what is hypnosis? Hypnosis is a state of
highly focused attention. Uh it's
something like looking through the
telephoto lens of a camera in
consciousness. What you see, you see
with great detail, but devoid of
context. If you've had the experience of
getting so caught up in a good movie
that you forget you're watching a movie
and enter the imagined world, you're
part of the movie, not part of the
audience, you're experiencing it, you're
not evaluating it. That's a
hypnotic-like experience that many
people have in their everyday lives. If
I'm watching a sports game and I'm
really wrapped up in the game, but I'm
also in touch with how it makes me feel
in my body, kind of registering the
excitement or the anticipation.
Is that a state of hypnosis also? To the
extent that your somatic, your body
experience is a part of the the sport
event that you're engaged with, I'd say
that is a self-altering hypnotic
experience.
If your physical reactions are
distracting you or
make you think about something else,
that's when uh it's it's less
hypnotic-like and more just one of a
series of experiences. I think for most
people when they hear hypnosis or they
think about hypnosis, they think of
stage hypnosis. I think of somebody with
a pendant going back and forth. Could
you contrast the sort of hypnosis that
you do in the clinical setting with the
sort of hypnosis that a stage hypnotist
does? I don't like stage hypnosis.
You're making fools out of people um and
you're using the fact and that's what
scares people about hypnosis. They think
you're losing control. You're gaining
control. Self-hypnosis is a way of
enhancing your control over your mind
and your body.
It can work very well, but because it
gives you a kind of cognitive
flexibility, you're able to shift sets
very easily. To give up judging and
evaluating the way you usually do and
see something from a different point of
view. That's a great therapeutic
opportunity, but if misused, it could be
a danger, too. And that's what scares
people about it. It's It is that very
ability to suspend critical judgment and
just have an experience and see what
happens. It's an ability that if people
learn to recognize and understand it,
can be a tremendous therapeutic tool. Do
we know what sorts of brain areas are
active during the induction, the
let's call it the deep hypnosis, and
then what's shutting off or changing as
people exit hypnosis? The first is
turning down activity in the dorsal
anterior cingulate cortex. So, the DACC
is in the central front middle part of
the brain, as you you well know. And
it's it's part of what we call the
salience network. It's a conflict
detector. So, if you're you know,
engaged in work and you hear a loud
noise that you think might be a gunshot,
that's your anterior cingulate cortex
saying, "Hey, wait a minute. There's a
potential danger over there. You better
pay attention to it." So, it's a It
compares what you're doing with what
else is going on and helps you decide
what to do. And as you can imagine,
turning down activity in that region
make it less likely that you'll be
distracted and pulled out of whatever
you're in.
So, two other things happen when people
are hypnotized. One is that that DLPFC
has higher functional connectivity with
the insula, another part of the salience
network. It's a part of the mind-body
control system, sensitive to what's
happening in the body. It's part of the
pain network as well, but it's also a
region of the brain where you can
control things in your body that you
wouldn't think you could. For example,
we did a study years ago where we took
people
who were highly hypnotizable, hypnotized
them, and told them to imagine we went
on an imaginary culinary tour. So,
we would they would eat their favorite
foods, and we found that they increased
their gastric acid secretion like by
87%. So, their stomach was acting as
though it was about to get I mean, there
was one woman it was so vivid for her
that halfway through she said, "Let's
stop. I'm full." You know, eating these
imaginary
>> eaten Having never eaten actual food.
No. Incredible. And then we got them to
relax and think of anything but food or
drink,
and we got like a 40% decrease in
gastric acid secretion. So, they could
and that was DLPFC through the insula
telling the stomach you're getting food
or you're not getting food. And even we
injected them with pentagastrin, which
triggers gastric acid release, and even
then in the hypnosis condition they had
a 19% reduction in gastric acid. So, the
brain has this amazing ability to
control what's going on in the body in
ways that we don't think we have ability
to control. That's just one example. So,
that's the DLPFC insula connection. The
third thing that happens is you have
inverse functional connectivity between
the DLPFC and the posterior cingulate
cortex. The posterior cingulate is part
of the default mode network. It's in the
back of the brain.
And it's it's an an area whose activity
goes down, for example, in meditators.
And in meditation you're supposed to be
selfless. You're supposed to that the
self is an illusion. You're supposed to
let it dissolve and just experience
things. And when you're doing that that
posterior cingulate is decreasing in
activity. The inverse connection is I'm
doing something, but I'm not thinking
about what it means for me. I may not
even remember much of it. If I do, I
don't care that much about it. And so,
that is part of the dissociation that
occurs with hypnosis. So, it's how you
put things outside of conscious
awareness and don't worry about what it
means. It also adds to cognitive
flexibility. You know, if you're
thinking, well, people like me don't
usually do this, that may inhibit you
from
enacting a new form of psychotherapy,
for example, that you've never done
before.
Um but if you're having this decreased
activity in the part of your brain that
reflects on what it means,
um you're more likely to be cognitively
flexible and willing to give it a try.
And that's one of the therapeutic
advantages of hypnosis as well. Do
people with ADHD
um display disruptions in elements of
these networks? And has hypnosis ever
been used to enhance people's ability to
focus and hold attention um because
that's such a built-in component of the
hypnotic state. There's sort of two ways
to think about it. In terms of enhancing
focus, yes, it has been very helpful um
in teaching people to just prepare your
mind to narrow in and focus on
something. And when you know, when
you're really engaged in reading
something or you're writing a pa- I
mean, I'll have that Sometimes I'm
thinking, oh god, I I have to do this
for another hour. Other times, an hour
will go by and I'll think, hey, great,
because when you're in the it feels
game-like to you, you know, you're just
assembling the parts of the puzzle and
putting them together. It's fun. You
just get absorbed there. For me, that's
a hypnotic-like experience. When I'm
having trouble, when I'm struggling,
sometimes doing things like
self-hypnosis can help. It's possible
that for some people with that disorder,
training in self-hypnosis might help,
but we'd have to see how hypnotizable
they were and take it from there. What
sorts of um things have you used
hypnosis successfully for or have others
used clinical hypnosis um for? And are
there any particular areas of of
psychiatric
challenges or illnesses, I guess they're
called, um that are particularly
um
amenable to hypnotic treatment? Yes,
there are. Uh we found it very helpful
for stress reduction. That mind-body
connection is very helpful because um
part of the problem with stress is your
perception. You mentioned it earlier in
a sort of good sense. You're at a you
know, a football game or something and
you feel the physical reaction. That can
be a reinforcing thing. Wow, this is
exciting. Let's do it. It can also be
very distracting. You notice it in your
body. Your body tenses up. Uh you start
to sweat. The sympathetic nervous system
goes. Your heart rate goes up. When you
notice that, you think, "Oh god, this is
really bad."
And then you feel worse. So, it's like a
snowball rolling downhill. Hypnosis can
be very helpful in dissociating somatic
reaction from psychological reaction.
So, we teach people to imagine their
body floating somewhere safe and
comfortable like a bath, a lake, a hot
tub, or floating in space. And then
picture the problem that they're that's
stressing them on an imaginary screen
with the rule, "No matter what you see
on the screen, you keep your body
comfortable." So, at this point you
can't you still can't control the
stress, but you can control your
physical reaction to it. And that starts
you feeling more in control. At least
there's one thing I can manage. And then
you can use it to think through or
visualize through one thing you might do
about that stressor. So, hypnosis is
very helpful in controlling mind-body
interaction in relation to stress. Um
it's very helpful for people to get to
sleep. I've I'm getting emails from
people who said, "You know, I haven't
slept right in 15 years and now for the
first time um you know, I'm listening to
your app and I can sleep good night."
I've been using the uh
self-hypnosis for sleep for a long time
um and now the Reverie app and we'll
talk about our relationship to the
Reverie app and its uses. I find it
incredibly useful. It's kind of a
training up of these networks. Right.
That's right. Um so, with repeated uh
use of self-hypnosis,
um
one could imagine that these networks
are getting stronger. I would I would I
would think so. We don't have evidence
of that yet. Um but um you know,
long-term potentiation provides a
pathway and you've described them on
your program a number of times that
allow for repeated activation of a
network to actually build new
connections that that work. And at the
least, even from a learning and memory
point of view, if you start to acquire
memories about a problem. So, one thing
we use hypnosis for is treating phobias,
for example. And the problem with people
who have phobias, like airplane phobias
or, uh, you know, crossing a bridge or
being up high,
is that the more they avoid it, the more
the only source of associations and
memories
is their fear. They don't have any good
experiences with it cuz they avoid it.
You know, it's like get back on the
horse after you fall off kind of thing.
And and with hypnosis, if you can start
people able to manage their anxiety
enough that they can have more of wider
array of experiences, they start to have
a network of associations that isn't so
negative and may even be positive. In
therapy, the
narrative is a huge component. And in
hypnosis, narrative is a huge component.
Right. So, it must be that the brain
state is what is really different
because, you know, I think people who
have trauma or phobias certainly, um,
could have a conversation about it. They
Some of them might freeze up. Some of
them might lose their articulation and
so forth. But, what is different about
that state that combines with narrative,
you think, to allow these underlying
neural networks to to engage or to
change? I think of this as unsystematic
desensitization because you're changing
mental states. And if And I think
there's more and more evidence that
mental state change itself has
therapeutic potential. We're seeing that
with ketamine treating depression, a
dissociogenic drug. Um,
we see it We know it every morning when
we wake up that problem, you know, you
made the mistake of reading a nasty
email at 11:00 p.m. You don't know what
to do. You wake up in the morning think,
oh that idiot. Yeah, here's what I'm
going to do. You know, so just changing
mental state itself has therapeutic
potential. And I think we underestimate
our ability to regulate and and change
responses to be cognitively,
emotionally, and somatically flexible.
And so, we do things, you're right, that
follow similar principles of facing a
problem, seeing it from a different
point of view, and then find some way to
reconnect to it, to substitute something
that can make you feel good rather than
bad. Um, so that you activate other
centers of the brain like mesolimbic
reward system. And so, I do that with
hypnosis and you can do it much faster.
People don't think they can, but they
can. If you're having right now that
physical experience, I'm thinking about
this, but I'm not feeling as bad as I
used to,
um, that can be a powerful thing. And
you can do it with hypnosis. So, I had a
a woman came to see me who had suffered
an attempted rape. It was getting dark.
She was coming back from the grocery
store and this guy grabs her and wants
to get her up into her apartment. It's
outside of her apartment. And she starts
fighting with him. And she winds up with
a basilar skull fracture. He runs away.
Um, the cops come. Since she hadn't been
raped, they left. They weren't
interested. And she wanted to use
hypnosis to get a better image of what
this guy looked like. Which is a
painful, upsetting thing. So, she was
quite hypnotizable. I got her floating.
I said, you're safe and comfortable now.
Nothing can happen that will harm your
body.
But on on the left side of the screen, I
want you to picture this guy and he's
approaching and what's happening. And
she said, I really the light was it was
getting dark. I really can't see much of
his facial features. But I do recognize
something I hadn't allowed myself to
remember.
If he gets me upstairs, he doesn't just
want to rape me, he's going to kill me.
And
so, in some ways what she was seeing was
even worse. So, you know, you're
thinking, "Good Spiegel, you made her
even more frightened than she was
before." But, as you had pointed out in
your PTSD stress lecture, you've got to
confront the trauma to to restructure
your understanding of it. So, on the
other side of the screen, I had her
picture um um "What what are you doing
to protect yourself?" And everybody in a
trauma situation engages in some
strategy of self-protection. You know,
that's the salience network kicking in.
And um she said, "You know what? He's
surprised that I'm fighting that hard.
He didn't think I would."
And so, she realized on the one hand
that it was even worse than she thought
it was, but on the other hand that she
actually probably saved her life.
And so, it was a way of helping her
restructure her experience of the trauma
and make it more tolerable. So, that
helped with her She didn't recognize She
She couldn't identify the guy, but it
helped her
restructure and understand her
experience. And that's something that
you can do in just talking straight-out
psychotherapy, but sometimes you can do
it a hell of a lot faster and more
efficiently using hypnosis. And there is
one randomized trial out of Israel that
shows that adding hypnosis to PTSD
treatment actually improves outcome. So,
uh it's it's it's a way of accomplishing
things that we understand in the broader
psychotherapy world, but much more
quickly and and sometimes effectively.
There's one thing I might add into and
that is, you know, there's a notion the
late Gordon Bower, brilliant cognitive
psychologist, one of the founders of
cognitive psychology uh at Stanford.
Gordon helped establish the concept of
state-dependent memory, that when you're
in a certain mental state, you enhance
your ability to remember things about
it. And the sort of the bad example of
that is the drunk who hides the bottle
and can't remember where he put it until
he gets drunk again, that he's in that
same mental state.
People go into dissociative states uh
when they're traumatized. So, in a way,
hypnosis is helping them remember and
deal with the memories better because
they're more in the mental state that is
more like what happened. And most rape
victims will tell you, "I was floating
above my body feeling sorry for the
woman being assaulted below." Um uh
people in traumatic episodes, they just
say, "You know, I blank out. I don't
know what's happening. I'm on
autopilot." And that's a kind of
self-hypnotic state. So, when you use
hypnosis to help them deal with the
traumatic memory, you're making the
state they're in right there in your
office with you more congruent to the
state they were likely in when the
trauma happened. And I think that is
part of what helps facilitate treatment
of trauma-related disorders. In a way,
the principle, Andrew, is like you need
to reconfront a traumatic situation
before you can modulate your
associations to it. And then figure out
how you can approach that problem or how
you did approach that problem from a
different point of view. And I think
what happens is that people are
sometimes too good at being able to
separate themselves from the
recollection. So, it's in there
somewhere. It doesn't It's out of sight,
but it's not out of mind. It's having
effects on you, but you can't deal with
it. You can't reprocess it. The issue is
control. And hypnosis, which has this
terrible reputation of taking away
control, is actually a superb way of
enhancing your control over mind and
body. It reminds me that naming is so
important. You almost wonder if um
self-hypnosis and clinical hypnosis had
been called something else that it would
have um been separated out from stage
hypnosis in a way that would make it um
less uh
you know, less scary, weird, um
complicated for people to embrace. Uh
but Yeah. you know, the part of the
reason for having this discussion is I I
would I've had great experiences with
hypnosis. I've seen the data. Uh you
know, we're talking about a lot of
clinical examples. It's incredibly
powerful. And it boils right down to
neural brain states. Right. Um and, you
know, I think in the years to come it's
going to become uh more widespread. Uh
you've described some um examples of
people getting relief very quickly.
Right. How permanent are those changes?
Um
is there a need for follow-up? And then,
is it necessary to work with a clinical
hypnotist? And is it better to do that
than self-hypnosis and so on and so
forth? Um most people start by coming to
see a clinician like me, it's better to
see someone who's li- has licensing and
training in their professional
discipline.
Somebody who can really assess what your
problem is and make sure that you're not
talking someone into reducing their
chest pain rather than getting their
coronary artery problem Cuz they could
have a real issue there.
>> right. Hypnosis might adjust, but
wouldn't deal with the deeper underlying
issue. That's right. And typically, when
I use it with people, I often only see
them once or twice or periodically, but
not every week and certainly not every
day if they have a pain problem. And
hypnosis is very helpful for pain.
Um and and so
what I'm doing is
identifying how hypnotizable they are. I
give them a standard brief test of their
ability to experience hypnosis. And then
going through a self-hypnosis exercise
with them to deal with a problem, seeing
how they respond to it, and then
teaching them how to do it for
themselves. Now, we've developed an app
Reverie that that
can teach people and step them through
dealing with pain, stress, focus, uh
insomnia, and help people eat better,
and and stop smoking. Um and both we
have elements that take about 15 minutes
and elements that just take 1 or 2
minutes that people can refresh and
reinforce. So, the 2-minute hypnosis or
even 1 minute.
>> And we're finding that 2/3 of the people
find that even just the 1-minute
refresher
uh helps them feel better. They're
reporting they feel better. So, the nice
thing is you will know very quickly
whether it's likely to help you or not.
And if it is, you can learn to do it for
yourself. Is there any evidence that
hypnosis or self-hypnosis can be used
for dealing with obsessive thoughts?
Sometimes. There are some very
obsessional people who just turn out not
to be that hypnotizable for and it's not
random. They, you know, they tend to be
so over controlling of thought. They're
all busy evaluating rather than
experiencing.
It's kind of a balance we have to hit.
And some, you know, we sometimes we get
too emotional and too absorbed and you
don't
you're not with it enough to sort of see
other possibilities. That can be a
problem. But on the other hand,
sometimes you're too rigid and
controlled and you don't let your
emotions guide you to what you need to
do to protect yourself or protect
others. So, um I would say in general
that people with OCD are in the less on
the less hypnotizable side of the
spectrum. They're less likely to allow
themselves to engage in any And you
know, the typical example is the
checking with OCD, for example. They
don't remember,
you know, whether they, you know, locked
the door or turned off the gas in the
oven. And they keep going back and they
keep checking. So, there the evaluative
component of the brain kind of overrides
the experiential one. And um sometimes
people can get some benefit, but but it
they're not a group that I would select
for being the most likely to respond to
self-hypnotic approaches. Could you
please tell us, um
what hypnotizability is, how it's
evaluated, and what the Spiegel Eye Roll
Test is? Hypnotizability is just a a
capacity
to have hypnotic experiences. And we
have a test called the hypnotic
induction profile. We really give a
highly structured hypnotic experience.
About a third of adults are just not
hypnotizable. Two-thirds are. About 15%
are extremely hypnotizable. And we can
measure that and give it a number from
zero to 10. Um and that's very useful.
People who are low to moderate
hypnotizable like explanations about
what you're doing, but then they can
still get the benefits. So, it helps me
guide my the nature of my treatment with
these people. Now, the the eye roll is
my father
um used to use an eye fixation
induction. He used to say look up at the
ceiling. So, that people who are
listening what um might and and watching
on video. So, the speaker eye roll test
involves looking up at the ceiling. So,
it's tilting the head back I'm tilting
my chin back and looking up at the
ceiling now, but I'm also directing my
eyes upward and my eyes are open and
then the the eye roll test involves then
closing the eyelids while the eyes are
open and whether or not the eyes roll
back and as you said it then you see
sclera the white part.
>> the white part.
>> you're very hypnotizable or moderately
hypnotizable. Whereas if the eyes move
down and you see iris the colored part
of the eye as the eyes close less
hypnotizable.
>> Right. You're asking the brain to do
something difficult to to keep the eyes
up while closing the eyelid. And eye
movements have a lot to do with levels
of consciousness, you know, the
periaqueductal gray surrounds these
cranial nerve nuclei and um
when we you know, we close our eyes when
we sleep. We have rapid eye movement
when we dream. Most drugs that affect
level of consciousness can affect eyes
and eye movements either the dilation or
contraction of the pupils depending on
whether it's a stimulant or an opioid.
And there's a there's an old Zen
practice called looking at the third eye
where you're looking up in inside.
There's like there's a third eye between
the other two in your forehead. Um and I
think it's because we're visual
creatures, you know, we're we're pretty
pathetic from a physical point of view,
you know, many animals can outrun us,
you know,
um and or out smell us or see you eagles
can read could read the newsprint at a
100 yards and we can't, you know, it's
So, um
the our major defensive sensory input is
vision. But, the key issue is this, that
normally when we close our eyes also,
we're going to sleep. You know, you're
you're not worried about what's going on
in the world anymore. Here, you're
maintaining resting alertness. So,
you're you're focusing, but you're
turning inward. That's an unusual state.
Normally, we don't we close our eyes
periodically. We have to, but um when
you close your eyes for some period of
time, it's normally to go to sleep. And
you're not worried about, you know,
detecting risk or threat. Uh so, it's
it's an interesting state because you're
turning inward, basically. You're
looking up, you're shutting your eyes,
and you're allowing whatever happens
outside you to happen, and focusing on
what's going on inward. So, it's a I
think it's a signal to your brain to
turn inward. Something that's come up a
lot is this idea of getting close to the
phobia, getting close to the trauma,
re-experiencing it as a portal to then
adjusting the response to it and
rewiring something so the troubling
thing or the horrible thing is no longer
as horrible to us. I've heard you say
before that in terms of therapeutic
approaches, it's not just about the
state you get into, but whether or not
you brought yourself there voluntarily.
>> right.
>> So, the this element of of deliberate
self-exposure, deciding I'm going to
confront the trauma. I'm going to
confront the pain. I'm going to confront
the insomnia. I'm going to confront the
you know, and fill in the blank. And
then
readjusting one's emotional response
right up next to that troubling thing.
That seems to be the the hallmark of of
this treatment and pretty much all
treatments for getting over stuff. How
does one start to think about actually
dealing with something like this and
avoiding the hazards of just kind of
reactivating a lot of painful
experiences because a lot of being a
functional human being is also going to
work each day, interacting with people,
and not bringing one's trauma, you know,
and dumping it out all on the table, or
or being able to just function is so
crucial. So, how do you think about this
as a clinician? Well, you want to find a
way to feel in control of the access and
to define what happened on your own
terms. It's not a matter of are you
exposed to something that's upsetting,
but how do you handle it? What do you
make of it? It's a matter of thinking um
about a problem in a way that leaves you
feeling you understand it better, you're
in more control, you can turn it off
when you when you want, you can turn it
on when you want. And so, we have to in
life deal with stressful things. Mere
exposure to trauma or stress, it's a
part of living anyway. We can't avoid it
even if we'd like to, and um
it's not pleasant, it's not great, but
it's sometimes things you need to learn
about life. And if you can find an
algorithm for
facing it, putting it into perspective,
dealing with it, you become a stronger
person, not a weaker person.
>> I can see examples in hypnosis uh from
your descriptions of hypnosis where
uh
you want to unify the mind-body
connection, feel what you're thinking,
think what you're feeling, et cetera.
But, I could also um point to elements
within the hypnotic process in which you
are actively un- trying to uncouple
those. What What do you think is the
adaptive way to to conceptualize the
mind-body? I think
um
that it's a matter not of, you know,
absolute control, but more control that
that um
we need to think of our brain as a tool
and and our body's signals as tools as
well to help us understand um what's
going on in the world, what we need to
what matters, what's important, what
isn't.
Uh but, also something that can be
managed, not simply, you know, absorbed.
And so, hypnosis, I think, is a kind of
limiting case
where you can push it about as far as we
can push it uh in terms of regulating
pain. Pain is a you know is a good
example of that, you know. Obviously,
you need to pay attention if you just
broke your ankle, you better pay
attention to it and get help. Or you're
having crushing substernal chest pain,
you better do something about it. But
our brain is sort of programmed to treat
all pain signals as if they were novel
pain signals. If it's a sudden new
problem that needs to be attended to.
I teach people to to to think of the
pain and categorize it. See, it is it
does it does the pain mean that if you
put weight on this, you're going to
re-injure your ankle, for example, or
does it simply mean that your body is
healing and the pain is the sign that
gradually things are getting back to
normal. And and so, you can modify the
way you process pain based on what your
brain tells you
the pain means. And that's true for
emotional pain as well, and particularly
where I think a strategy that really
helps
is if you think of
uh an interpersonal problem or a threat
of something coming um as as a an
opportunity to do something to
ameliorate the situation. So, it's not
just it's happening to you, but
something that you can influence and do
something about. So, it's blending the
receptive with the active response that
I think can make a difference. So, you
try and process it in a way that gives
you a deeper understanding of what's
happening. You face it, but you also
say, "This is an opportunity for me to
do something about it." And the minute
you
realistically and hand And this doesn't
mean imagine away a heart attack, it
means
figure out how to rehabilitate from a
heart attack or a broken leg or
something like that in a way that you
get as much control into the situation
as you can. Can children be safely
hypnotized or do self-hypnosis? It's
sometimes harder for them to do
self-hypnosis. They need more structure
to do it. You've got to
uh share your dorsolateral prefrontal
cortex with them a little bit. But yes,
absolutely. Children can be very
hypnotizable. And um
I I know pediatricians who use it
wonderfully all the time. They get them
to focus on something else. Good
dentists can use it to help kids with
fear and pain. So yes, it can be very
effective for children. We did a
randomized trial. I have a publication
in Pediatrics. And the paper was
children having to undergo avoiding
cystourethrogram. So I would meet with
them and the mother the week before. We
find out from the kids where they like
to be. And I'd say, "You're going to
play a trick on your doctors. Your
body's there. You're somewhere else. Go
visit your friend. Go to Disneyland. Do
something else." And the mother would
work on this with me at the head of the
table.
And we found that these children were
much easier to image. 17 minutes shorter
procedures. And that's a long 17 minutes
for for a little kid. So it can be very
effective with children. They're less
anxious. They have less pain. And uh get
through these difficult procedures very
well. Has hypnosis ever been done in uh
for couples like couples therapy? Are
you aware of any coordinated hypnosis? I
mean I've done plenty of it in groups.
Not not with couples.
>> hypnotize large groups at once? The
metastatic breast cancer. And there was
a group of like 10 women who would meet
once a week. And we would all go into
hypnosis together. I didn't realize that
you were hypnotizing them collectively.
>> Yes. Yes. Right. Fascinating.
>> And and that you know, if anything, I
think it brings out the best in people's
abilities because it's a shared social
experience. And and they would talk
about it afterwards. And so yes, that's
absolutely doable. Yeah. Breathing
itself is um you've described as a
bridge between conscious and unconscious
states. Right. What is the role of
respiration in shifting the brain's
state
during a hypnotic protocol?
>> There are breathing patterns that may
increase sympathetic arousal
or may decrease it. May have been with
neo-cyclic sighing seems to actually
where you have more time spent exhaling
than inhaling.
Seemed and there's reason to believe
that it induces parasympathetic activity
cuz you're increasing pressure in the
chest.
And therefore
allowing the heart to slow down because
blood is being returned to the atrium
more easily. I do use it. I ask people
to take a deep breath as part of the
induction and then slowly exhale and
partly as a result of our research
together, I'm emphasizing the slow
exhale more
as part of an
some
to enhance the idea in the induction
that this is a period of relaxation cuz
I think they are inducing that and
perhaps perceiving it as well. So there
there's no
you're absolutely right that breathing
is very interesting cuz it's right at
the edge of conscious and unconscious
control that it will go on
automatically, but we can control it.
And so it's a kind of way for us to
demonstrate to ourselves
it
greater ways of of modulating our
internal state. So you can either do it
thinking about it the way we do with
pain control in hypnosis
or you can do it to some extent by
taking charge of your breathing and
doing things that will produce a change
that you want to see happen in your
body. Great. I'm really excited to see
where all of this goes.
>> Yes. Breathing, vision, bodily states.
Am I missing any any other ingredients?
Typically, you're in a physically
relaxed state.
But frankly, there are people at the
peak of performance including physical
athletic performance or musical
performance when they're in hypnotic
states too, you know, I've talked to
classical pianists who say I'm not think
if I start thinking about what my
fingers are doing now, I screw up, you
know, I'm floating above the piano
thinking about the the tone that I want
to feel exuding from the instrument. So,
that's a hypnotic-like state, too. And
and many athletes and who are at in peak
performance are just flowing with it.
They're they're not they're not thinking
step-by-step, what am I doing? And
that's when you're doing your best. Or,
you know, when when we're
working or
uh
giving a talk and doing it well,
we're in a hypnotic-like state. So, it
it doesn't it it usually
requires
uh but doesn't necessarily require
physical comfort or quietness. It can
sometimes be intense activity.
Um where can people learn more about how
they can get hypnotized? Uh we mentioned
Reverie. We'll put a link to it. It's r
e v e r i.com is the way to access that.
Or it's the Reverie app from the App
Store is the other way. Download the
Reverie app from the App Store. Great.
Is there a centralized resource that
people can go to to find um really
uh well-trained hypnotists? There are
two good professional organizations uh
that will help you with that. One is the
Society for Clinical and Experimental
Hypnosis, and I think that's s c e
h.u.s. And the American Society for
Clinical Hypnosis, and they both provide
referral services for professionals. In
general, look for someone who is
licensed and trained in their primary
professional discipline, psychiatry,
psychology, medicine, dentistry, um and
who has training and interest in using
hypnosis uh is is a way to do it. Great.
First of all, thank you so much for
being here today, for sharing your
knowledge. I hope we can do it again and
again. I hope so. Um it's an incredible
thing that in this
world where we are discovering so much
about how the body works, you know, the
mind is still rather mysterious, and
people are struggling with a lot of
things, but also I think people are
really excited about
uh applying tools like hypnosis to um
perform better, feel better mentally and
physically. And so you've pointed us to
a tremendous amount of resources and how
these tools work and where they've
already been demonstrated to work. So I
just
thank you. I know this is your your
life's professional uh commitment in
life and and we all benefit. Thank you
very much, David. Well,