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Speaker 1: What exactly is hypnosis? We've all heard about the circusy

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Speaker 1: versions of it, but is there something about hypnosis that

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Speaker 1: is real and that can be studied and leveraged by

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Speaker 1: psychiatrists and neuroscientists. Can attention and expectation change what we

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Speaker 1: feel like pain or anxiety? And how does that work?

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Speaker 1: What do suggestible states reveal about the brain's typical pathways

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Speaker 1: and what happens when we're knocked off of those, and

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Speaker 1: how does hypnosis compare to meditation or flow states or

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Speaker 1: psychedelic drugs. Today, join me as we talk with doctor

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Speaker 1: David Spiegel, Stanford psychiatrist and one of the world's experts

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Speaker 1: in hypnosis. Welcome to Innercosmos with me, David Eagleman. I'm

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Speaker 1: a neuroscientist and author at Stanford, and in these episodes

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Speaker 1: we sail deeply into our three pound universe to understand

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Speaker 1: how how we see the world, the outside world and

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Speaker 1: also the inside world. Okay, so first I'm going to

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Speaker 1: point out one of my central sources of amazement that

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Speaker 1: surfaces and all these episodes, the fact that inside each

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Speaker 1: of us there's an entire universe of eighty six billion neurons,

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Speaker 1: never seeing the light of day, pulsing in the dark,

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Speaker 1: and these are somehow weaving together your world, and in

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Speaker 1: ways we don't yet fully understand, we get all this

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Speaker 1: private subjective experience out of this, like color which doesn't

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Speaker 1: actually exist in the outside world, or pain, which is

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Speaker 1: just signaling along nerves, just like all the rest of

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Speaker 1: the signaling running around in your nerves, but somehow you

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Speaker 1: have the impression that it hurts. And somehow all the

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Speaker 1: act activities zooming around on all these little cables equals

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Speaker 1: your mind. Your thoughts are nothing but this electrochemical activity.

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Speaker 1: And we know this because if you ingest particular molecules,

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Speaker 1: that changes your thoughts, like if you consume alcohol or drugs,

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Speaker 1: or if you bunk your head on the cabinet, you

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Speaker 1: might lose consciousness and not have any thoughts for some minutes.

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Speaker 1: And when someone gets a neurodegenerative disorder, many of their

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Speaker 1: neurons die and that changes their thoughts. Same with tumors

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Speaker 1: or strokes or dozens of other things that we see

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Speaker 1: in the clinics every day. And that's how we know that.

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Speaker 2: You are your biology.

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Speaker 1: But the question is our thoughts the end consequence of

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Speaker 1: the activity, or do they somehow feedback in such a

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Speaker 1: way that they influence the activity. Now this is an

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Speaker 1: open question in neuroscience, but we do know that somehow

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Speaker 1: a change in expectation can reshape what we feel in

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Speaker 1: our own bodies, are pain or anxieties, our sense of self.

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Speaker 1: We get glimpses of this with let's say placebos. These

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Speaker 1: are things that should have no medical effect, but they

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Speaker 1: often have clinically significant effects on people. And what's weird

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Speaker 1: is that sometimes these work even when people know they

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Speaker 1: are placebos. And then you've got practices like meditation that

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Speaker 1: can alter attention and emotion and make subtle changes to

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Speaker 1: the structure of the brain over time. But there's one

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Speaker 1: laboratory of the mind where these questions become especially vivid,

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Speaker 1: where you can watch how a change and attention changes

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Speaker 1: the brain, and that laboratory is hypnosis. Now, let me

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Speaker 1: be crystal clear about something. I'm not talking about hypnosis

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Speaker 1: of the stage show stereotype. I'm not talking about mind

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Speaker 1: control or swinging watches. Instead. To psychiatrists, they're talking about

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Speaker 1: something when they use the term hypnosis, but it looks

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Speaker 1: more like a rearrangement of attention. The world narrows inner

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Speaker 1: experience becomes more vivid. External suggestions begin to feel more

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Speaker 1: like internal ideas, and a person can dissociate slightly from

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Speaker 1: their normal neural pathways. Think about it like this. If

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Speaker 1: you look at any ski mountain, there are only a

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Speaker 1: few runs going down the mountain, But in theory you

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Speaker 1: could ski down the mountain in lots of ways. You

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Speaker 1: don't have to stay right on those established runs. And

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Speaker 1: in our own brains we get these runs established in them,

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Speaker 1: and the question is how do we ever get off

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Speaker 1: our own beaten path? So my guest today has spent

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Speaker 1: his career at this frontier. David Spiegel is a psychiatrist,

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Speaker 1: a leading researcher on hypnosis in the brain at Stanford,

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Speaker 1: and a clinician who has leveraged these methods to help

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Speaker 1: lots of people manage pain, anxiety, trauma, illness, and the

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Speaker 1: breaking of habits. Through his work, we get a window

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Speaker 1: into how flexible our perceptions and physiology can be. So

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Speaker 1: let's step with David Spiegel in to the inner cosmos. So, David,

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Speaker 1: often when people think about hypnosis, they think about, you know,

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Speaker 1: a state fair, magic show or something like that, And

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Speaker 1: that's not what you do. Tell us how you define

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Speaker 1: hypnosis scientifically.

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Speaker 2: David, hypnosis is a state of highly focused attention. It's

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Speaker 2: like getting so caught up in a good movie that

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Speaker 2: you forget you're watching the movie. You enter the imagined world.

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Speaker 2: And to achieve that state of focus, you have to

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Speaker 2: do to other things. You have to dissociate, put outside

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Speaker 2: of conscious awareness, things that would ordinarily be in consciousness.

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Speaker 2: We're not aware of how much information our brains, as

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Speaker 2: you know better than anyone, is processing at any one time.

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Speaker 2: Right now. To listen to me, for example, you have

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Speaker 2: to ignore sensations in your body touching these very nice

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Speaker 2: chairs here. Hopefully you weren't aware of that until I

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Speaker 2: mentioned it. If you were, we could stop. Now you're

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Speaker 2: already born. So absorption, highly focused attention, dissociation, and the

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Speaker 2: other used to be called suggestibility. It's what scares people

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Speaker 2: about hypnosis. You know, the you know, the football coach

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Speaker 2: being made to dance like a ballerina in front of

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Speaker 2: an audience and all that. I don't like making fun

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Speaker 2: of people anyway, but it's different. It's cognitive flexibility. It

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Speaker 2: allows you to let go of presumptions of who you are,

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Speaker 2: what you are, what you can do. So the football

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Speaker 2: coach is not thinking of what he's going to get

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Speaker 2: in the locker room when he goes back after the performance,

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Speaker 2: but it allows him to do something different, to try

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Speaker 2: out being different. And as a psychiatrist and psychotherapist, I

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Speaker 2: love seeing people who are willing to try out being

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Speaker 2: different and who are surprised by themselves say my god,

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Speaker 2: I didn't think I could do that, and I did.

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Speaker 2: That's a great template for change.

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Speaker 1: What is the difference between a hypnotic state and let's

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Speaker 1: say meditation, a flow state, or an dissociative state.

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Speaker 2: Well, it is a kind of dissociative state. To focus

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Speaker 2: so intently, you have to put outside of conscious awareness

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Speaker 2: things that might ordinarily be in consciousness. And people who

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Speaker 2: have a dissociative disorder are usually highly hypnotizable, so they

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Speaker 2: go intensely. People with associative identity disorder, when they're being

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Speaker 2: one of their altars, they're not being all the other

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Speaker 2: parts of themselves, and it's a kind of firm boundary

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Speaker 2: between these different parts of themselves. Now, that's a mental

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Speaker 2: disorder usually associated with trauma. But hypnosis is a much

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Speaker 2: milder state of focused attention that is enabled by dissociation.

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Speaker 1: Okay, and how about a flow state or a meditative state.

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Speaker 2: So the flow state is kind of like the highly

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Speaker 2: focused attention.

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Speaker 1: And by the way, give an example of a flow.

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Speaker 2: Slow state is just getting so lost in an activity.

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Speaker 2: For example, that you're painting something. Let's say that you

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Speaker 2: realize you've missed an appointment with a friend, or you're

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Speaker 2: two hours late for dinner or something. You're just so

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Speaker 2: engaged in it. You check sent me Hi who wrote

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Speaker 2: the book Flow, and he used to call it an

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Speaker 2: autotellic state. It's one that is so enjoyable that you

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Speaker 2: would do it just to do it, regardless of what

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Speaker 2: the outcome of it is. And that's part of flow.

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Speaker 2: You're not doing it for a purpose. You're doing it

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Speaker 2: just to do it, to be in that state, to

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Speaker 2: be fully engaged.

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Speaker 1: What does autot mean.

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Speaker 2: Autotelic just means self rewardings. It's rewarding just for doing it,

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Speaker 2: not because it's going to get you somewhere into something.

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Speaker 2: Actors are like that, you know. The method in acting

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Speaker 2: is just you know, be that person. And when a

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Speaker 2: good actor does that and you say, hey, you were terrific,

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Speaker 2: that was a great performance, they say, what performance I

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Speaker 2: was just being that guy. You know, that's who I was.

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Speaker 2: So hypnosis is very similar to flow states in that

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Speaker 2: sense of being totally into it, being fully absorbed in it.

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Speaker 2: Now meditation there are similarities, but there are differences. Meditation

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Speaker 2: is more about being and hypnosis is more about doing so.

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Speaker 2: In meditation, there are three major components to meditation. There's

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Speaker 2: open presence, where you just let feelings and thoughts flow

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Speaker 2: through you. You don't try to judge them or use them.

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Speaker 2: You don't try to use it to solve a problem.

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Speaker 2: It's just it's to become a way of being where

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Speaker 2: you are more open to just whatever things are, let

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Speaker 2: them be. You do a body scan, which is a

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Speaker 2: little bit like hypnosis. You can become more connected with

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Speaker 2: things going on in your body or better control things

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Speaker 2: going on in your body, like pain, like the symptoms

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Speaker 2: of anxiety, for example. The third thing is compassion and

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Speaker 2: meditation where you try to have compassion for other people

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Speaker 2: compassion for yourself. And that's a good thing too, and

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Speaker 2: you can use hypnosis to enhance compassion. I can give

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Speaker 2: you some examples of that, but you don't use it

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Speaker 2: to solve a problem. I had a woman who was

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Speaker 2: a ten year meditator twice a day for ten years,

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Speaker 2: thirty minutes a day each time. And she said, but

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Speaker 2: I still have migrain headaches and they're driving me crazy

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Speaker 2: and I can't get rid of them. Would you help me?

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Speaker 2: So I hypnosis whether to imagine that she had a

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Speaker 2: cap full of ice on her head, and because people

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Speaker 2: with migraines often have vasodilitation in the scalp and they

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Speaker 2: feel hot and uncomfortable, and she imagined having this cap

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Speaker 2: of ice in her head. And she called me a

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Speaker 2: week later, as she said, doctor Spiegel, my migraines are gone.

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Speaker 2: Thank you, and thank you for freeing me to use

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Speaker 2: my intentionality. Wow, because you're not supposed to be intentional

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Speaker 2: in meditation, and you are intentional in hypnosis.

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Speaker 1: Oh, I see, I see. So vasodilation is where the

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Speaker 1: blood vessels are expand instead are contracted. But she was

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Speaker 1: able to use her intention to take control of the

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Speaker 1: diameter of her blood vessels as well.

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Speaker 2: I can't measure it, but I think it's probably the case.

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Speaker 2: There are situations where people you can see them if

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Speaker 2: they're concentrating on their hands being warm, you can see

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Speaker 2: them sort of flush on their hands. There was one

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Speaker 2: amazing study done a mass general years ago. They had

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Speaker 2: people in hypnosis. They instructed them. They had a bunch

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Speaker 2: of people who had body warts and they're unpleasant, but

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Speaker 2: there was word that you could use hypnosis to eliminate warts,

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Speaker 2: and they actually got people to eliminate warts on one

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Speaker 2: side of their body. Think about that. That's mind bending.

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Speaker 2: So but if you're thinking about the brain controlling the

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Speaker 2: nervous system, the nervous system is divided into branches, and

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Speaker 2: it occupies different parts of the body, and you can

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Speaker 2: imagine changes that may sometimes happen in the body.

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Speaker 1: What would curing warts look like? How does one intentionally

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Speaker 1: make that happen.

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Speaker 2: You instruct them to imagine that the warts are just

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Speaker 2: drying up and falling off, that they just disappear, and

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Speaker 2: for some people that actually happens.

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Speaker 1: How is hypnosis used in your practice, for example, for pain,

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Speaker 1: for anxiety, for trauma, for dealing with habits that people

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Speaker 1: want to break. Give us a sense of.

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Speaker 2: How sure I'll be glad to do that. The way

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Speaker 2: we use it is to first first I test people's hypnotizability,

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Speaker 2: because people differ in their ability to experience hypnosis, and

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Speaker 2: that helps me structure the way I approach it with them.

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Speaker 2: If you're highly hypnotizable, which about twenty five percent of

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Speaker 2: the population is, you just tell them to do it

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Speaker 2: and they do it like the ward thing you can.

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Speaker 2: And I'll tell you what the approach is with each

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Speaker 2: of these kinds of problems. Mid range you kind of

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Speaker 2: negotiate with them more and they try it and they

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Speaker 2: reflect on it. And with low hypnotizables, it's more of

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Speaker 2: a cognitive activity where you think about approaching the problem

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Speaker 2: in a different way. So don't fight the pain, but

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Speaker 2: learn to filter the hurt out of the pain, don't

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Speaker 2: let it get you angry, figure that you can find

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Speaker 2: a way to master it. So for you know, we

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Speaker 2: start from the body up with hypnosis, and this is

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Speaker 2: different from cognitive behavioral therapy, for example, where you kind

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Speaker 2: of think your way through the steps to the problem.

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Speaker 2: With hypnosis, if somebody is stressed, what I do is say,

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Speaker 2: there's one part of this stressor that's bothering you that

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Speaker 2: you can do something about right away before you figure

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Speaker 2: out actually how to get rid of the stressor or

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Speaker 2: deal with the stressor. And that is the effect of

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Speaker 2: the stress on your body. So when you feel stressed.

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Speaker 2: What happens you know what happens to you, David when

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Speaker 2: you get stressed physically?

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Speaker 1: Yeah, I think my muscles start to hurt.

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Speaker 2: Your muscles hurt, they get tense, you start to sweat,

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Speaker 2: you fidget. But there's a kind of snowball effect where

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Speaker 2: you start to feel that and you think, oh my god,

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Speaker 2: this must be really bad because my body's reacting, and

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Speaker 2: so you get more anxious, and then your body reacts

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Speaker 2: and on it goes. So with hypnosis, you start with

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Speaker 2: the excellent control you have over your body, and hypnosis

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Speaker 2: better than normally. And so I say, look up close

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Speaker 2: your eyes, take a deep breath, and imagine that you're

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Speaker 2: floating in a bath of lake, a hot tub, or

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Speaker 2: floating in space. And I teach them a breathing exercise

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Speaker 2: where you inhale through your nose, starting with your abdomen,

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Speaker 2: and then slowly exhale through your mouth. And if you

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Speaker 2: try that, you'll notice that very quickly your body. Do

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Speaker 2: you try it? Try it? Just inhale through your nose,

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Speaker 2: hold and then slowly exhale through your mouth. How's your

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Speaker 2: body feel?

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Speaker 1: Good?

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Speaker 2: Good? Good? It's a little different.

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Speaker 1: I don't think I was stressed before. But I'll try

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Speaker 1: that when I'm okay. But you're saying that I one

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Speaker 1: should be able to feel that difference. Right after how

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Speaker 1: many breaths.

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Speaker 2: Like three breaths, wow, is you start to feel it.

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Speaker 2: And so then you you with your eyes closed, you

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Speaker 2: imagine you're floating in a bath of lake, hot tubber,

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Speaker 2: floating in space, and typically people feel less physiologically aroused.

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Speaker 2: And then you say, okay, so you've already done one

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Speaker 2: thing about the stressor, which is the effects that's not

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Speaker 2: on your body. Now, picture in your mind's eye, an

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Speaker 2: imaginary screen could be a movie screen, a TV screen,

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Speaker 2: or a piece of clear blue sky. And and then

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Speaker 2: divide the screen in half, and on the left side,

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Speaker 2: picture that stressor one thing that's stressing you. But with

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Speaker 2: the rule that you keep your body floating while you

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Speaker 2: do it, so you're beginning to separate this feedback between

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Speaker 2: the mind and the body about stress. And then once

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Speaker 2: you've been able to do that, I say, now picture

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Speaker 2: on the right side of the screen. Make that your

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Speaker 2: brainstorming screen. One thing you could do to deal with

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Speaker 2: the stressor It may not be the best thing or

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Speaker 2: the only thing, but something you could do about it,

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Speaker 2: and so typically people will picture something. You know, I'll

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Speaker 2: explain to my boss why I was late, or I'll

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Speaker 2: make sure the kids wear their seat belts when they

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Speaker 2: get in the car, whatever it is. And then say,

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Speaker 2: notice how you've been able to think more clearly about

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Speaker 2: how to deal with the stressor once you're able to

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Speaker 2: separate the stress from your physiological reaction. And we found, David,

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Speaker 2: in studies of tens of thousands, like sixty eight thousand

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Speaker 2: of our Reverie users our self hypnosis app that within

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Speaker 2: ten minutes they get a fifty eighty percent reduction in

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Speaker 2: their stress levels pre to post. And that's not bad

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Speaker 2: for a treatment that has no side effects, hasn't killed

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Speaker 2: anybody yet, and is fast faster than going to a

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Speaker 2: pharmacy and getting a drug, so they immediately get an

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Speaker 2: immediate reaction. So I help people deal with stress in

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Speaker 2: that way from the body up rather than from the

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Speaker 2: head down.

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Speaker 1: That's amazing. So if we're talking pain, anxiety, trauma, things

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Speaker 1: like this, does this apply to all of the equally or.

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Speaker 2: Different approvals with different approaches. So for pain, common and

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Speaker 2: terrible problem that is very terribly treated in this country.

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Speaker 2: You know, last year one hundred and eighteen thousand Americans

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Speaker 2: died of opioid overdoses in the United States. You know,

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Speaker 2: opioids kill people, and so I built Revery, our hypnosis

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Speaker 2: app in part to stop that, to get into people's

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Speaker 2: hands and minds and intervention that they can use to

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Speaker 2: really help themselves. And there's tons of evidence We've done

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Speaker 2: randomized control trials showing that hypnosis can control pain. And

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Speaker 2: the fact that you can reduce your pain with hypnosis

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Speaker 2: doesn't mean the pain is all in your head. It

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Speaker 2: means that the strain in pain lies mainly in the

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Speaker 2: brain that does signal. An input signal is painful or not,

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Speaker 2: depending on how your brain promulgates it and classifies it.

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Speaker 2: And you can teach your brain to treat pain differently.

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Speaker 2: My lovely wife Helen, had both of our children with

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Speaker 2: self hypnosis as the soul anesthetic in childbirth and Dan

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Speaker 2: the first one was ten pounds, so it was serious,

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Speaker 2: you know, And this shit. At one point in the

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Speaker 2: middle of my having rhibnitize, I had her floating in

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Speaker 2: Lake Tahoe. She said, David, you know I teach pharmacologey

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Speaker 2: at Stanford. Are there are drugs for this? And I

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Speaker 2: said keep floating, cool, tailing, and and Dan was born fine,

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Speaker 2: and I had no pain at all, you know it

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Speaker 2: was so hypnosis really is a terrific treatment for pain.

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Speaker 2: And we have on our app four different approaches to it.

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Speaker 2: So one is just sensory alteration, filter the herd out

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Speaker 2: of the pain. Imagine whatever makes your body feel better.

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Speaker 2: And if you think about this, if you get pain

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Speaker 2: relief for whatever your problem is with an ice pack

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Speaker 2: or floating in a warm bath, that means that when

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Speaker 2: you are in one of those states, your brain is

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Speaker 2: in a certain state that interprets what's going on as

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Speaker 2: a comforting sensation overriding the pain. And there are pet

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Speaker 2: studies done at Maygill by per Rainville showing that if

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Speaker 2: you tell people to have the sensory alteration filter the

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Speaker 2: head out of the pain, you get reduced activity in

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Speaker 2: some metasensory cortex just where you would hope it would happen.

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Speaker 1: This is what is measuring the activity from your.

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Speaker 2: Body from your body in specific regions of the brain,

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Speaker 2: and as you feel the analgesia, you feel a reduction

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Speaker 2: in the in the cemetasensory cortex. I did an experiment

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Speaker 2: with a bunch of Stanford undergrads highly hypnotizable. We screened

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Speaker 2: them for that and I had we gave them shocks

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Speaker 2: to the forearm and they would report the pain, and

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Speaker 2: then I hypnotized them and said, you're a forearm is

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Speaker 2: an ice water cool tingling. They got the same shocks.

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Speaker 2: We were recording some metasensory event related potentials, and the

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Speaker 2: P one hundred disappeared the first tenth of a second.

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Speaker 2: The brain stopped the initial processing of the pain signal,

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Speaker 2: and the P two hundred and P three hundred, these.

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Speaker 1: Are EEG signals.

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Speaker 2: Collected EEG signals in response to a series of shocks

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Speaker 2: were half as big. So just telling them to do

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Speaker 2: that changed the way their brain transmitted the pain signal.

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Speaker 1: And I assume this wasn't just repetition suppression.

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Speaker 2: No.

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Speaker 3: No, We had a control group that wasn't hypnotized. Yeah,

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Speaker 3: and then they would get the same well they did

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Speaker 3: that group. They were their own control because when they

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Speaker 3: were not hypnotized and just feeling it, they got the

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Speaker 3: full sensation for the same period of time. They didn't

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Speaker 3: habituate to it a hypnosis, They just persistently and immediately

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Speaker 3: reduced the amplitude of the evoked response by overall fifty

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Speaker 3: percent starting with a tenth of the second. It wasn't

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Speaker 3: like it was rattling around the brain for a while.

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Speaker 3: It changed the settings for how you process those signals.

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Speaker 3: My colleague pr Rainville, when he studied activity in the

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Speaker 3: brain after a similar analgesic instruction, if instead of saying

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Speaker 3: filter the head out of the pain, your hands cold

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Speaker 3: and numb, he said it's there, but it won't bother you,

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Speaker 3: which is the way people on opioids sometimes respond, well,

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Speaker 3: I know there's a sensation there. And then he got

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Speaker 3: the same level of analgesia, but now the reduction was

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Speaker 3: in the dorsal anterior cingulate cortex, part of the salience

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Speaker 3: network that tells you whether something is a threat or not.

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Speaker 3: So you can change just the words you use in

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Speaker 3: hypnosis will change the part of the brain that reacts

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Speaker 3: to the analgesic construction.

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Speaker 1: Using people who are highly hypnotizable, this actually sounds like

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Speaker 1: a great advantage for them, and let's say the case

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Speaker 1: of pain. What about people who are not so hypnotizable.

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Speaker 1: Does that mean they can't help themselves there?

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Speaker 2: What we find is that the results are less dramatic,

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Speaker 2: but they get results, okay, in part because we're teaching

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Speaker 2: them a cognitive strategy. We're saying, look, you know, I'll

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Speaker 2: give you an example. I had a very lovely woman

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Speaker 2: came to me the other day who has chronic pain

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Speaker 2: and who said that it really inhibits what she can do.

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Speaker 2: She also had kind of a tick from an old

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Speaker 2: neck injury that she'd had, and it was getting worse

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Speaker 2: and worse, and she got more and more angry about it,

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Speaker 2: and it was inhibiting her life and what she could do.

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Speaker 2: And she turned out to be three out of ten

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Speaker 2: instead of seven out of ten, less hypnotizable on our measure,

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Speaker 2: the hypnotic conduction profile. And I said, you know, pain

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Speaker 2: and this tick that you have are like the noisy

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Speaker 2: kid in the classroom. You know, you pay more attention

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Speaker 2: to it than it deserves. You have other sensations, other

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Speaker 2: things you could think about, but you open into that.

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Speaker 2: She said, well, I'm a teacher. I was a teacher.

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Speaker 2: I taught for twenty seven years. I loved teaching best

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Speaker 2: part of my life. And I said, well, what did

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Speaker 2: you do with a noisy kid, a kid who was disruptive?

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Speaker 2: She said, well, I was pretty good with them. Actually

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Speaker 2: she was rather strict, you know, but she said I

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Speaker 2: would take their hand at a time when teachers finally

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Speaker 2: were allowed to touch a student, and I would hold

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Speaker 2: their hand, and I say, I know you're upset, and

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Speaker 2: I know this was bothering you, but there are better

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Speaker 2: ways to handle it, and I'm going to show you how.

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Speaker 2: And so, in a very kind, accepting, loving way, she

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Speaker 2: was saying, what you've been doing is no good, but

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Speaker 2: I will show you how to do it better. That's

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Speaker 2: a cognitive approach that keeps you from making things worse

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Speaker 2: by exacerbating the irritation you have. And I said so,

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Speaker 2: and she said, I was so good at it that

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Speaker 2: I got all the troublesome students in the school, you know,

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Speaker 2: and send them to me. But I love doing it.

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Speaker 2: And I said, so you know how to do it,

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Speaker 2: but why don't you use that same approach with your

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Speaker 2: own body? Because you get more and more frustrated the

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Speaker 2: more you have these ticks in this pain. And if

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Speaker 2: you can just treat your body the way you would

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Speaker 2: treat one of those students, I'll bet you feel better.

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Speaker 2: And she did. She found that the ticks were not

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Speaker 2: getting worse because they would, you know, the more it

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Speaker 2: would happen, the more she would shake because she was

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Speaker 2: so angry and frustrated that it was still happening, and

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Speaker 2: the more discomfort she had. So part of it is

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Speaker 2: using hypnosis to literally alter perception, and part of it

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Speaker 2: is taking an approach that involves focusing on what you're for, now,

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Speaker 2: what you're against, and then what you've written. I'm sure

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Speaker 2: you're familiar with this, that you exacerbate the problem by

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Speaker 2: fighting against it. We people and hypnosis say, the worst

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Speaker 2: thing you can tell somebody is don't think about purple elephants, right,

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Speaker 2: you know, And that's what you do. So you focus

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Speaker 2: on what you're for and you can modulate it, even

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Speaker 2: if you don't get as big a sensory alteration as

431
00:24:06,920 --> 00:24:08,560
Speaker 2: as you might otherwise have done.

432
00:24:08,760 --> 00:24:11,359
Speaker 1: In this example, what is the thing that you are

433
00:24:11,400 --> 00:24:14,320
Speaker 1: focused for? It's you can't say I want to be

434
00:24:14,359 --> 00:24:17,080
Speaker 1: free of pain, because interesting of the pain, what's there?

435
00:24:17,160 --> 00:24:19,640
Speaker 2: You're you're focusing on filtering the herd out of the pain,

436
00:24:19,800 --> 00:24:23,680
Speaker 2: soothing it. I say, imagine, treat your treat your body

437
00:24:23,720 --> 00:24:26,600
Speaker 2: as if it were your baby, your child, you know,

438
00:24:26,680 --> 00:24:29,840
Speaker 2: if your child were hurting if you were hurt, would

439
00:24:29,880 --> 00:24:31,960
Speaker 2: you get angry at him for crying and fussing? No,

440
00:24:32,200 --> 00:24:34,840
Speaker 2: they say, I'd I'd pick them up, I'd hug them,

441
00:24:34,880 --> 00:24:37,199
Speaker 2: I soothe them. So you know what, your body is

442
00:24:37,240 --> 00:24:39,479
Speaker 2: as innocent as your baby. You know it has to

443
00:24:39,560 --> 00:24:43,679
Speaker 2: deal with whatever happens to it. So focus on respecting

444
00:24:43,720 --> 00:24:46,159
Speaker 2: and protecting your body the way you would your child.

445
00:24:46,760 --> 00:24:49,600
Speaker 2: And that's the that's what you're for, is this respect

446
00:24:49,720 --> 00:24:52,840
Speaker 2: and protection of your body and not making it worse

447
00:24:53,240 --> 00:24:54,719
Speaker 2: by getting angry and frustrated.

448
00:24:55,000 --> 00:24:58,040
Speaker 1: How about anxiety? How is this using it?

449
00:24:58,160 --> 00:25:01,720
Speaker 2: Well? Anxiety disorders. Again, it's this sort of feedback between

450
00:25:02,480 --> 00:25:07,920
Speaker 2: between brain and body. And I have people, first of all,

451
00:25:08,000 --> 00:25:10,639
Speaker 2: deal with just the way what do you perceive in

452
00:25:10,680 --> 00:25:15,399
Speaker 2: your body when you're getting anxious and so imagine, you know,

453
00:25:15,760 --> 00:25:19,199
Speaker 2: feel that tension, but imagine that you can do something

454
00:25:19,320 --> 00:25:23,640
Speaker 2: or imagine the thing you do to keep from being anxious,

455
00:25:24,040 --> 00:25:27,960
Speaker 2: and then think about how you could approach that problem differently.

456
00:25:28,080 --> 00:25:30,960
Speaker 2: So I had a woman who was a CEO of

457
00:25:31,000 --> 00:25:34,399
Speaker 2: a company here, tough lady, but she had a terrible

458
00:25:34,440 --> 00:25:37,440
Speaker 2: dog phobia. She get awfully anxious when she got anywhere

459
00:25:37,440 --> 00:25:41,120
Speaker 2: near a dog. And I said, well, imagine. Let's imagine

460
00:25:41,119 --> 00:25:44,280
Speaker 2: that this guy is bringing his dog into your office.

461
00:25:44,359 --> 00:25:47,119
Speaker 2: And she said, no, I just freeze and see what

462
00:25:47,160 --> 00:25:49,440
Speaker 2: the dog is going to do. And I said, well,

463
00:25:49,480 --> 00:25:51,880
Speaker 2: if one of your employees who was performing badly walked

464
00:25:51,920 --> 00:25:54,919
Speaker 2: into your office, would you just freeze and see what

465
00:25:54,960 --> 00:25:57,600
Speaker 2: he'd do? She said, hell, no, I'd tell him off,

466
00:25:57,640 --> 00:25:59,439
Speaker 2: you know, I'd fire him. I'd do whatever I had

467
00:25:59,480 --> 00:26:02,639
Speaker 2: to do. So I said, so, why don't you instead

468
00:26:02,680 --> 00:26:06,600
Speaker 2: of freezing immobilizing yourself, which only amplifies the reason you

469
00:26:06,640 --> 00:26:09,600
Speaker 2: would be afraid, picture how you will handle the dog.

470
00:26:09,760 --> 00:26:13,000
Speaker 2: What will you do and decide, first of all, is

471
00:26:13,000 --> 00:26:14,879
Speaker 2: it really a physical threat to you or not? And

472
00:26:14,960 --> 00:26:18,680
Speaker 2: if it is, protect yourself. If it isn't, then decide

473
00:26:18,680 --> 00:26:20,480
Speaker 2: whether you want to just usher the dog out of

474
00:26:20,480 --> 00:26:22,080
Speaker 2: the office or call someone to get rid of it,

475
00:26:22,240 --> 00:26:26,720
Speaker 2: or whatever it is, and do it that way.

476
00:26:41,520 --> 00:26:44,240
Speaker 1: What is the difference between that and let's say cognitive

477
00:26:44,320 --> 00:26:45,240
Speaker 1: behavioral therapy.

478
00:26:45,720 --> 00:26:48,920
Speaker 2: Well, with cognitive behavioral therapy, you kind of think it through.

479
00:26:48,960 --> 00:26:53,639
Speaker 2: There's less about this sort of direct psychophysiological control. So

480
00:26:53,680 --> 00:26:55,439
Speaker 2: you're trying to think about it in a way that

481
00:26:55,600 --> 00:26:59,040
Speaker 2: is logical and maybe is less likely eventually to trigger

482
00:26:59,119 --> 00:27:02,200
Speaker 2: your anxiety, but we sort of go for the money.

483
00:27:02,280 --> 00:27:05,280
Speaker 2: We go for handling the way the body is reacting

484
00:27:05,320 --> 00:27:09,280
Speaker 2: first and teaching her that once she had this realization that, yeah,

485
00:27:09,359 --> 00:27:11,240
Speaker 2: there are times when you want to be afraid of

486
00:27:11,240 --> 00:27:13,600
Speaker 2: an animal, including a dog, but is this one of

487
00:27:13,640 --> 00:27:16,840
Speaker 2: those times? And so you're acknowledging the cause your anxiety,

488
00:27:16,880 --> 00:27:19,440
Speaker 2: but you're controlling the way your body feels. So your

489
00:27:19,440 --> 00:27:21,920
Speaker 2: body is floating and comfortable. You can picture it without

490
00:27:21,960 --> 00:27:26,200
Speaker 2: having that automatic, you know, physiological protection. And the funny

491
00:27:26,200 --> 00:27:29,080
Speaker 2: thing is about people with anxiety and phobias in particular,

492
00:27:29,160 --> 00:27:32,200
Speaker 2: they often don't have an event. It's not that they

493
00:27:32,200 --> 00:27:34,520
Speaker 2: were bitten by a dog a long time ago. It's

494
00:27:34,560 --> 00:27:37,240
Speaker 2: just that they have developed this. And what happens with

495
00:27:37,440 --> 00:27:40,159
Speaker 2: phobias in particular is the more you avoid it, the

496
00:27:40,160 --> 00:27:43,600
Speaker 2: worse it gets. And if you think about it, you

497
00:27:43,640 --> 00:27:46,960
Speaker 2: know what you do if you avoid it is you

498
00:27:47,040 --> 00:27:50,200
Speaker 2: reaffirm psychologically that there must be a reason for being

499
00:27:50,200 --> 00:27:52,879
Speaker 2: so scared of this, and that's why you avoid it.

500
00:27:53,119 --> 00:27:56,160
Speaker 2: And the other thing is you deprive yourself of success stories,

501
00:27:56,840 --> 00:27:58,960
Speaker 2: so you don't get close enough to a dog to

502
00:27:59,000 --> 00:28:00,880
Speaker 2: have a good experience. You know, he just licked your

503
00:28:00,880 --> 00:28:03,960
Speaker 2: hand and it was very nice. You just have the

504
00:28:04,040 --> 00:28:06,000
Speaker 2: fact that you got more and more anxious and more

505
00:28:06,040 --> 00:28:10,639
Speaker 2: and more avoidant, and it replicates itself. So it's not

506
00:28:10,760 --> 00:28:13,480
Speaker 2: about thinking it through or understanding what happened to you

507
00:28:13,600 --> 00:28:16,000
Speaker 2: early in life that led to this. It's a matter

508
00:28:16,040 --> 00:28:20,480
Speaker 2: of trying to intervene with the psychophysiological reaction that tends

509
00:28:20,520 --> 00:28:23,800
Speaker 2: to reinforce the strength of the phobia anxiety.

510
00:28:24,160 --> 00:28:25,679
Speaker 1: I want to take at tense for one second. I

511
00:28:25,720 --> 00:28:27,679
Speaker 1: was going to ask you about your origin story. So

512
00:28:27,720 --> 00:28:30,680
Speaker 1: your father did the exact same thing that you're doing.

513
00:28:30,880 --> 00:28:33,680
Speaker 2: Yeah, well, both of my parents were a psychiatrists psychoanalysts,

514
00:28:33,680 --> 00:28:35,160
Speaker 2: so they told me I was free to be any

515
00:28:35,240 --> 00:28:39,280
Speaker 2: kind of psychiatrist. I wanted to be here. I am.

516
00:28:39,600 --> 00:28:42,840
Speaker 2: But so the dinner table conversations were pretty interesting, and

517
00:28:43,120 --> 00:28:45,760
Speaker 2: I got to watch him make movies of patients who

518
00:28:45,800 --> 00:28:49,560
Speaker 2: had you know, had a woman who had pseudo seizures,

519
00:28:49,600 --> 00:28:53,800
Speaker 2: hysterical pseudo seizures, and he would hypnotize her and take

520
00:28:53,800 --> 00:28:55,640
Speaker 2: her back to the last time she had a seizure

521
00:28:55,680 --> 00:28:57,000
Speaker 2: and she would have another seizure.

522
00:28:57,120 --> 00:28:57,360
Speaker 3: You know.

523
00:28:57,920 --> 00:29:01,720
Speaker 2: So either way, he taught control, and I do this too.

524
00:29:02,240 --> 00:29:05,040
Speaker 2: Is not by telling them, don't make it happen, because

525
00:29:05,160 --> 00:29:08,240
Speaker 2: that's you know, don't think about purple elephants, but rather

526
00:29:08,520 --> 00:29:12,040
Speaker 2: make it happen. That's a way to have control, you know.

527
00:29:12,240 --> 00:29:14,520
Speaker 2: So she would think back to the last time she'd

528
00:29:14,560 --> 00:29:18,120
Speaker 2: have a seizure, and gradually they became milder and milder,

529
00:29:18,160 --> 00:29:20,920
Speaker 2: and instead of feeling frightened and angry and frustrated and

530
00:29:20,960 --> 00:29:23,720
Speaker 2: humiliated when it happened, it was kind of like, oh,

531
00:29:23,800 --> 00:29:25,920
Speaker 2: good for me. You know, I made it happen. So

532
00:29:25,960 --> 00:29:29,040
Speaker 2: you teach them a method of control. That's the opposite

533
00:29:29,160 --> 00:29:33,800
Speaker 2: of fighting it. And I had a woman from who

534
00:29:33,920 --> 00:29:36,280
Speaker 2: I lived up in Napa and was part of one

535
00:29:36,320 --> 00:29:40,200
Speaker 2: of these big wine families. She was having hysterical seizures

536
00:29:40,680 --> 00:29:44,360
Speaker 2: and we don't use that term anymore than's pseudo seizures now,

537
00:29:45,320 --> 00:29:50,360
Speaker 2: But it got bad when her daughter had her first

538
00:29:50,360 --> 00:29:53,040
Speaker 2: baby and the daughter said, Mom, you can't hold the

539
00:29:53,080 --> 00:29:55,920
Speaker 2: baby because I don't want you to have a seizure

540
00:29:55,920 --> 00:29:57,920
Speaker 2: and drop the baby. And that did it for her.

541
00:29:58,560 --> 00:30:02,960
Speaker 2: So it turned out that her problem was that she

542
00:30:03,280 --> 00:30:05,960
Speaker 2: was caught between two generations of a family that were

543
00:30:05,960 --> 00:30:08,760
Speaker 2: fighting one another. So the father was the originator of

544
00:30:08,760 --> 00:30:12,920
Speaker 2: the winery. The sons were fighting him in court over

545
00:30:13,000 --> 00:30:16,200
Speaker 2: the ownership and control of the winery, and she kept

546
00:30:16,200 --> 00:30:18,720
Speaker 2: trying to get them together for Thanksgiving and Christmas, and

547
00:30:19,040 --> 00:30:21,600
Speaker 2: both of them, both sides would be yelling at her.

548
00:30:22,000 --> 00:30:24,560
Speaker 2: And I said, she would call her father every day

549
00:30:24,600 --> 00:30:27,280
Speaker 2: and get yelled at again. And I said, I'll tell

550
00:30:27,280 --> 00:30:29,280
Speaker 2: you what. I'm going to teach you how to control

551
00:30:29,320 --> 00:30:31,520
Speaker 2: these seizures. But you have to do something else, and

552
00:30:31,600 --> 00:30:34,520
Speaker 2: that is, if your father starts screaming at you on

553
00:30:34,560 --> 00:30:38,080
Speaker 2: the phone, hang up, and sooner or later he will

554
00:30:38,160 --> 00:30:39,720
Speaker 2: learn that if he wants to talk to his daughter,

555
00:30:39,760 --> 00:30:43,840
Speaker 2: he better not yell at her. And after a while,

556
00:30:44,400 --> 00:30:46,640
Speaker 2: you know, there were a bunch of times where she

557
00:30:46,640 --> 00:30:48,680
Speaker 2: had to hang up, he stopped yelling at her. And

558
00:30:48,720 --> 00:30:51,760
Speaker 2: I said, it's not your responsibility to make these guys

559
00:30:51,840 --> 00:30:54,600
Speaker 2: stop fighting with each other. You do what you want

560
00:30:54,640 --> 00:30:56,560
Speaker 2: to do. If they come to Thanksgiving dinner, good if

561
00:30:56,600 --> 00:31:00,600
Speaker 2: they don't, okay, and learn to control this. And she's

562
00:31:00,800 --> 00:31:03,240
Speaker 2: she was holding the baby. You know she was able

563
00:31:03,280 --> 00:31:05,720
Speaker 2: and she felt good about it. So you're changing the

564
00:31:05,800 --> 00:31:09,800
Speaker 2: affective tone of the experience with the stimulus that is

565
00:31:09,840 --> 00:31:13,080
Speaker 2: making her anxious, and in this case, changing her ability

566
00:31:13,120 --> 00:31:17,760
Speaker 2: to manage the interactions that we're leading to this distress and.

567
00:31:17,800 --> 00:31:20,560
Speaker 1: Just going back to the origins for me, how old

568
00:31:20,800 --> 00:31:23,440
Speaker 1: is the h How old is this field of.

569
00:31:24,440 --> 00:31:27,440
Speaker 2: It's the oldest Western conception of a psychotherapy. It's two

570
00:31:27,520 --> 00:31:30,640
Speaker 2: hundred and fifty years old. Wow. It started with Franz

571
00:31:30,680 --> 00:31:33,760
Speaker 2: Anton Mesmer. You know the term mesmerized. He mesmerized me.

572
00:31:34,200 --> 00:31:37,680
Speaker 2: He was a Viennese physician who noticed that some of

573
00:31:37,720 --> 00:31:41,680
Speaker 2: his patients would suddenly go into one of these altered states,

574
00:31:41,720 --> 00:31:45,040
Speaker 2: like a pseudo seizure. And he thought that it may

575
00:31:45,080 --> 00:31:48,440
Speaker 2: have to do with badly acting magnetic fields in their bodies.

576
00:31:49,120 --> 00:31:51,400
Speaker 2: And he thought if he put his magnetic field, which

577
00:31:51,440 --> 00:31:54,560
Speaker 2: he thought was better, next to theirs, theirs would get better.

578
00:31:54,600 --> 00:31:57,239
Speaker 2: I don't know why his wouldn't get worse, but and

579
00:31:57,360 --> 00:32:01,480
Speaker 2: he then started He had these packets, these buckets full

580
00:32:01,520 --> 00:32:04,840
Speaker 2: of iron filings that were weakly magnetized, and he would

581
00:32:04,880 --> 00:32:06,760
Speaker 2: put them near that, and some would fall into a

582
00:32:06,800 --> 00:32:10,600
Speaker 2: trance state of some kind, and often they would get better. Actually,

583
00:32:10,920 --> 00:32:14,040
Speaker 2: so there's something about just altering your mental state that

584
00:32:14,160 --> 00:32:17,640
Speaker 2: allows you to just experience difficult things in a different way.

585
00:32:18,400 --> 00:32:21,120
Speaker 2: And he became so popular in Vienna that he left

586
00:32:21,120 --> 00:32:23,200
Speaker 2: his wife and family there and moved to Paris, where

587
00:32:23,240 --> 00:32:26,840
Speaker 2: he became like the celebrity doctor. And if you think

588
00:32:26,880 --> 00:32:28,600
Speaker 2: about it, two hundred and fifty years ago, what was

589
00:32:28,640 --> 00:32:30,800
Speaker 2: the major treatment in medicine. You know what? It was?

590
00:32:31,360 --> 00:32:34,920
Speaker 2: Blood letting. Yeah, let the bad humors out of your body.

591
00:32:35,000 --> 00:32:38,400
Speaker 2: So unless you happen to have polypythemia vira or congestive

592
00:32:38,400 --> 00:32:41,800
Speaker 2: heart failure, you were going to do worse. Seeing a doctor,

593
00:32:42,240 --> 00:32:44,600
Speaker 2: Voltaire wrote to his brother, We did everything we could

594
00:32:44,680 --> 00:32:47,440
Speaker 2: to save father's life. We even sent the doctors away.

595
00:32:49,560 --> 00:32:53,960
Speaker 2: And his office was cheerful. It was brightly lit. There

596
00:32:53,960 --> 00:32:56,680
Speaker 2: were patients hanging around, just helping other patients, talking to

597
00:32:56,720 --> 00:32:59,560
Speaker 2: them about how well they were doing. Regular doctor's officers

598
00:32:59,560 --> 00:33:01,760
Speaker 2: were great. There wasn't there. There wasn't a painting on

599
00:33:01,800 --> 00:33:04,280
Speaker 2: the wall. They were cold and dark, and you got

600
00:33:04,280 --> 00:33:06,360
Speaker 2: bad news and you got blood taken out of your body.

601
00:33:06,360 --> 00:33:09,280
Speaker 2: That was it. It wasn't much fun. So he was

602
00:33:09,640 --> 00:33:14,080
Speaker 2: the The other doctors complained to King Louis about him,

603
00:33:14,680 --> 00:33:20,760
Speaker 2: and he he convened a panel to investigate Mesmer, and

604
00:33:20,840 --> 00:33:23,800
Speaker 2: it included our own Benjamin Franklin, who was having a

605
00:33:23,840 --> 00:33:27,560
Speaker 2: good time in Paris. Back then, it included the famous

606
00:33:27,600 --> 00:33:32,920
Speaker 2: chemist Lauasier, who developed the principles of oxygen chemistry. Shortly

607
00:33:32,960 --> 00:33:36,680
Speaker 2: before he died, developed the idea of the gross national product.

608
00:33:36,760 --> 00:33:41,280
Speaker 2: Brilliant guy. He was beheaded in the revolution. And another

609
00:33:41,360 --> 00:33:47,880
Speaker 2: person on the panel was the inventor of the guilloteae,

610
00:33:48,040 --> 00:33:52,720
Speaker 2: doctor Guillotine too, and he kind of created the mind

611
00:33:52,760 --> 00:33:59,800
Speaker 2: Bobby body problem. And they concluded that hypnosis was nothing

612
00:33:59,840 --> 00:34:03,440
Speaker 2: but heeded imagination. Now, you know what, that's not a

613
00:34:03,520 --> 00:34:06,760
Speaker 2: terrible definition of hypnosis. It's highly focused attention. It's a

614
00:34:06,840 --> 00:34:09,200
Speaker 2: change in brain state. But that was the end of

615
00:34:09,280 --> 00:34:12,799
Speaker 2: Mesmer's career basically. And the problem is that there's been

616
00:34:12,840 --> 00:34:18,040
Speaker 2: one rejection after another. You know, a Scottish surgeon named

617
00:34:18,160 --> 00:34:21,840
Speaker 2: Isdale was traveling around India using hypnosis as general anesthesia.

618
00:34:21,920 --> 00:34:25,759
Speaker 2: You know what was anesthesia before ether? It was, you know,

619
00:34:25,880 --> 00:34:28,400
Speaker 2: getting people drunk and holding them down. It was terrible,

620
00:34:29,600 --> 00:34:34,440
Speaker 2: but hypnosis was actually very effective. It was. And I

621
00:34:34,480 --> 00:34:37,360
Speaker 2: gave a lecture mass general to ether Dome on tolari

622
00:34:37,360 --> 00:34:42,120
Speaker 2: Ago where ether was introduced here and a surgeon strode

623
00:34:42,160 --> 00:34:44,480
Speaker 2: to the front of the amphithiter efforts to say, gentlemen,

624
00:34:44,520 --> 00:34:48,400
Speaker 2: this is no humbug to distinguish hypnosis from ether. You know,

625
00:34:49,080 --> 00:34:55,200
Speaker 2: hypnosis is no humbug. It works, and you know, would

626
00:34:55,239 --> 00:34:57,239
Speaker 2: we use it all the time now, But I've used

627
00:34:57,320 --> 00:35:01,400
Speaker 2: hypnosis in surgical procedures where you don't use general anesthesia,

628
00:35:01,480 --> 00:35:03,960
Speaker 2: and it's an extremely effective analgesic.

629
00:35:04,160 --> 00:35:08,000
Speaker 1: Still incredible, but it depends on the suggestibility of the

630
00:35:08,040 --> 00:35:08,640
Speaker 1: pain part.

631
00:35:08,719 --> 00:35:11,360
Speaker 2: But even in randomized trials that include people of different

632
00:35:11,440 --> 00:35:14,440
Speaker 2: levels of hypnotizability, we show a significant difference. We did

633
00:35:14,480 --> 00:35:20,640
Speaker 2: one where they were injecting through arterial cutdowns in catheters,

634
00:35:20,960 --> 00:35:24,840
Speaker 2: chemo ambolizing tumors in the liver, expanding the renal artery,

635
00:35:25,400 --> 00:35:30,600
Speaker 2: and in all comers, we found if you randomized to

636
00:35:30,960 --> 00:35:34,800
Speaker 2: the standard care condition with able to push a button

637
00:35:34,840 --> 00:35:37,440
Speaker 2: and get opioids into your bloodstream, pain level at the

638
00:35:37,520 --> 00:35:40,120
Speaker 2: end of an hour and a half doing this was

639
00:35:40,360 --> 00:35:44,720
Speaker 2: five out of ten, if you had a supportive nurse

640
00:35:45,400 --> 00:35:50,160
Speaker 2: comforting you, three out of ten, hypnosis one out of ten. Wow,

641
00:35:50,320 --> 00:35:52,920
Speaker 2: and the hypnosis and they were all and the hypnosis

642
00:35:52,920 --> 00:35:55,759
Speaker 2: group was using half the amount of opioids that the

643
00:35:55,760 --> 00:35:58,879
Speaker 2: standard care group was using. And the procedures got done

644
00:35:58,960 --> 00:36:00,880
Speaker 2: seventeen minutes.

645
00:36:14,400 --> 00:36:16,440
Speaker 1: So what do you see as the thing that gets

646
00:36:16,440 --> 00:36:19,280
Speaker 1: in the way of hypnosis or why it gets rejected.

647
00:36:19,520 --> 00:36:21,880
Speaker 2: I don't know. I mean, we published that study in

648
00:36:21,920 --> 00:36:25,000
Speaker 2: the Lancet, you know, not yet big randomized trial. If

649
00:36:25,040 --> 00:36:27,920
Speaker 2: what we had used was a drug, everybody, every hospital

650
00:36:27,920 --> 00:36:31,160
Speaker 2: in the country would be using it now. And I think,

651
00:36:31,960 --> 00:36:33,839
Speaker 2: I think there are a couple of things, David. You know,

652
00:36:33,880 --> 00:36:36,400
Speaker 2: we're both in the psychiatry department at Stanford. We know

653
00:36:37,080 --> 00:36:40,600
Speaker 2: that psychiatry. You know, we're like the Rodney Dangerfield of

654
00:36:41,120 --> 00:36:44,040
Speaker 2: medical things. You know, we don't get no respect. You know.

655
00:36:44,640 --> 00:36:46,759
Speaker 2: He once said, they asked me to leave a bar

656
00:36:46,920 --> 00:36:52,040
Speaker 2: so they could start happy hour, you know. And people

657
00:36:52,160 --> 00:36:54,799
Speaker 2: have this prejudice against what goes on in the brain,

658
00:36:54,880 --> 00:36:57,920
Speaker 2: and they think if you use your brain to solve problems,

659
00:36:58,360 --> 00:37:01,520
Speaker 2: the problem started in your brain. Well that's not true.

660
00:37:01,680 --> 00:37:04,160
Speaker 2: You know, you have people, we have people who've had

661
00:37:04,360 --> 00:37:07,239
Speaker 2: injuries to their knees, have knee replacements, and they do

662
00:37:07,360 --> 00:37:11,279
Speaker 2: better with hypnosis plus other kinds of analgesia than those

663
00:37:11,280 --> 00:37:13,839
Speaker 2: who just have the standard analgesia, and they're less likely

664
00:37:13,880 --> 00:37:17,480
Speaker 2: to get addicted to opioids. It's teaching this brain is

665
00:37:17,520 --> 00:37:21,280
Speaker 2: this incredible instrument, as you have depicted beautifully in your writings,

666
00:37:22,320 --> 00:37:25,600
Speaker 2: that we don't that doesn't get the respect it deserves.

667
00:37:25,680 --> 00:37:29,120
Speaker 2: And we think that the only real interventions in medicine

668
00:37:29,160 --> 00:37:33,560
Speaker 2: are ingestion, injection or infusion, and that is not true.

669
00:37:33,640 --> 00:37:35,840
Speaker 2: You know, we do remarkable things with our brains that

670
00:37:35,920 --> 00:37:39,200
Speaker 2: can make our lives better. And so it's it's a

671
00:37:39,280 --> 00:37:41,279
Speaker 2: kind of prejudice that we have to get over, and

672
00:37:41,320 --> 00:37:43,520
Speaker 2: I'm sorry to see it, but that's what we're still

673
00:37:43,560 --> 00:37:43,960
Speaker 2: stuck with.

674
00:37:44,600 --> 00:37:48,320
Speaker 1: And have you you've done brain imaging in your Yeah.

675
00:37:48,120 --> 00:37:53,200
Speaker 2: I've done functional magnetic residence imaging. We've taken highly hypnatizable people,

676
00:37:53,760 --> 00:37:56,600
Speaker 2: put them in the scanner and compared to low hypnotizables.

677
00:37:57,040 --> 00:37:58,719
Speaker 2: Put them in the scanner, give them a bunch of

678
00:37:58,760 --> 00:38:02,440
Speaker 2: tasks and so control tasks, and then we look at

679
00:38:02,440 --> 00:38:04,640
Speaker 2: what are the things that happen only in the highly

680
00:38:04,680 --> 00:38:07,320
Speaker 2: hypotizable people and only when they're in a hypnotic state,

681
00:38:07,680 --> 00:38:11,160
Speaker 2: and we find three things happen. One is reduced activity

682
00:38:11,200 --> 00:38:13,920
Speaker 2: in the dorsal anterior cingulate cortex. So that's part of

683
00:38:13,920 --> 00:38:17,720
Speaker 2: the salience networks, the brain's alarm system. It does pattern matching,

684
00:38:17,960 --> 00:38:20,280
Speaker 2: and you hear a loud noise and you get distracted.

685
00:38:20,320 --> 00:38:23,440
Speaker 2: That's your dorsal anterior singular thing. There's trouble here. You

686
00:38:23,520 --> 00:38:27,160
Speaker 2: better divert what you're doing and focus on that. So

687
00:38:27,239 --> 00:38:30,080
Speaker 2: it's a it's a safety system for the body. If

688
00:38:30,120 --> 00:38:34,720
Speaker 2: you turn down activity there, you're allowing yourself to focus

689
00:38:34,800 --> 00:38:38,759
Speaker 2: more intently on other things. And that's what happens in hypnosis.

690
00:38:39,200 --> 00:38:45,600
Speaker 2: We found in another study that highly hypnotizable people have

691
00:38:45,760 --> 00:38:49,840
Speaker 2: more GABA menu butteric acid, the inhibitory neurotransmitter in the

692
00:38:49,840 --> 00:38:53,520
Speaker 2: brain than low hypnotizable people. So it's like having your

693
00:38:53,560 --> 00:38:56,799
Speaker 2: own little pharmacy on standby because what bendza diezepines do.

694
00:38:56,880 --> 00:39:01,120
Speaker 2: They increase GABA in the brain and so they can

695
00:39:01,200 --> 00:39:06,520
Speaker 2: mobilize more gabba to inhibit anxiety, inhibit pain response than

696
00:39:06,600 --> 00:39:10,080
Speaker 2: people who are less hypnotizable. So that's one thing. The

697
00:39:10,120 --> 00:39:13,680
Speaker 2: second thing that happens is more functional connectivity. So the

698
00:39:13,719 --> 00:39:16,400
Speaker 2: first thing I said was activity, How active is the area?

699
00:39:16,560 --> 00:39:19,360
Speaker 2: The second is when one area is active, is a

700
00:39:19,400 --> 00:39:22,680
Speaker 2: related area active or not? And we find more functional

701
00:39:22,680 --> 00:39:26,640
Speaker 2: connectivity between the prefrontal cortex, particularly on the left and

702
00:39:26,719 --> 00:39:29,720
Speaker 2: the insula, which is you know this insula means island

703
00:39:29,760 --> 00:39:32,440
Speaker 2: in Latin. This island of tissue in the middle of

704
00:39:32,480 --> 00:39:37,839
Speaker 2: the frontal cortex that is a mind body pathway. So

705
00:39:37,960 --> 00:39:40,560
Speaker 2: it's a way in which the brain controls the body,

706
00:39:41,040 --> 00:39:45,320
Speaker 2: and it's also a place where you have greater inter reception.

707
00:39:45,920 --> 00:39:48,080
Speaker 2: You're better able to perceive what's going on in your

708
00:39:48,080 --> 00:39:51,560
Speaker 2: body so that it makes sense in hypnosis. You can

709
00:39:51,840 --> 00:39:53,959
Speaker 2: better feel what's going on in your body and better

710
00:39:54,040 --> 00:39:57,040
Speaker 2: control what's going on in your body. We had a

711
00:39:57,080 --> 00:39:59,279
Speaker 2: group of students years ago that we brought in first

712
00:39:59,280 --> 00:40:01,759
Speaker 2: thing in the morning, no breakfast, and had them eat

713
00:40:01,800 --> 00:40:05,120
Speaker 2: imaginary meals for an hour. They would take we'd take

714
00:40:05,120 --> 00:40:08,600
Speaker 2: a gastronomictory of the Bay area, and Ken Klein was

715
00:40:08,600 --> 00:40:11,919
Speaker 2: a gastorineurologist worked with me, had a nasogastric tube down

716
00:40:12,440 --> 00:40:15,399
Speaker 2: and he would measure a gastrior gacid secretion. And one

717
00:40:15,440 --> 00:40:18,839
Speaker 2: woman was so caught up in this imaginary food that

718
00:40:18,920 --> 00:40:22,040
Speaker 2: she said, after about half an hour, let's stop. I'm full,

719
00:40:22,880 --> 00:40:26,360
Speaker 2: you know, So it seemed real. Those subjects had an

720
00:40:26,400 --> 00:40:30,000
Speaker 2: eighty nine percent increase in gastric acid secretion. So we're

721
00:40:30,080 --> 00:40:32,200
Speaker 2: narrowly David. You wouldn't think you could do that, but

722
00:40:32,280 --> 00:40:37,320
Speaker 2: you can. You can change your stomach's preparation for a meal.

723
00:40:38,160 --> 00:40:40,400
Speaker 2: We then did the opposite. We had them imagine and

724
00:40:40,520 --> 00:40:43,080
Speaker 2: hypnosis that they were on a desert island doing anything

725
00:40:43,080 --> 00:40:46,360
Speaker 2: but eating or drinking. Thirty nine percent decrease in gastrior

726
00:40:46,400 --> 00:40:50,479
Speaker 2: acid secretion, and then we injected them with pentagastrin, which

727
00:40:50,520 --> 00:40:54,480
Speaker 2: triggers maximal prietal cell output of gastric acid. We still

728
00:40:54,480 --> 00:40:58,080
Speaker 2: in the hypnosis condition had a nineteen percent decrease. So

729
00:40:58,560 --> 00:41:01,239
Speaker 2: the brain is much better better at controlling what's going

730
00:41:01,280 --> 00:41:04,040
Speaker 2: on in the body than we give ourselves credit for.

731
00:41:04,560 --> 00:41:07,560
Speaker 2: The third thing that happens in the MRI scanner, you

732
00:41:07,600 --> 00:41:12,600
Speaker 2: see inverse functional connectivity between activity and the prefrontal cortex

733
00:41:13,120 --> 00:41:16,120
Speaker 2: and activity in the posterior singulate. Now that is, you know,

734
00:41:16,160 --> 00:41:18,600
Speaker 2: as part of what we call the default mode network.

735
00:41:18,880 --> 00:41:21,239
Speaker 2: It's what your brain does when you're not working or

736
00:41:21,280 --> 00:41:24,680
Speaker 2: doing anything particular, but thinking about who you are, what

737
00:41:24,719 --> 00:41:26,520
Speaker 2: you are, what people think of you, what your mother

738
00:41:26,560 --> 00:41:28,399
Speaker 2: wanted you to be, all kinds of things like that,

739
00:41:28,880 --> 00:41:31,320
Speaker 2: and it's the thing that kind of keeps you on course.

740
00:41:31,360 --> 00:41:33,319
Speaker 2: Sometimes you know who you are and what you are

741
00:41:33,360 --> 00:41:37,319
Speaker 2: and what you're supposed to do. But it also can

742
00:41:37,520 --> 00:41:39,799
Speaker 2: keep you in a kind of rigid state where you

743
00:41:39,840 --> 00:41:42,239
Speaker 2: don't want to change. I should be like this, I

744
00:41:42,239 --> 00:41:45,520
Speaker 2: shouldn't be like that, And yeah, you know, I sometimes

745
00:41:45,520 --> 00:41:47,759
Speaker 2: call it the my fault mode network, where you just

746
00:41:47,840 --> 00:41:50,040
Speaker 2: you know, think about what's wrong with you. And so

747
00:41:50,360 --> 00:41:54,279
Speaker 2: when you're active in hypnosis, you're inhibiting activity in the

748
00:41:54,280 --> 00:41:58,320
Speaker 2: posterious singulate. Now, interestingly, that's the same thing that happens

749
00:41:58,360 --> 00:42:03,000
Speaker 2: in studies of long term meditators that they have lower

750
00:42:03,280 --> 00:42:07,240
Speaker 2: natural activity in the posterior singular cortex. And it's also

751
00:42:07,320 --> 00:42:09,280
Speaker 2: the major finding with psychedelics.

752
00:42:09,480 --> 00:42:11,719
Speaker 1: I was just going to ask about that. So your

753
00:42:11,760 --> 00:42:15,360
Speaker 1: interpretation of that is when the default mode network is

754
00:42:15,480 --> 00:42:19,040
Speaker 1: running strong, people are essentially running in the same loops.

755
00:42:19,239 --> 00:42:21,720
Speaker 1: Let's take the mountain analogy. You've got a certain number

756
00:42:21,719 --> 00:42:24,720
Speaker 1: of ski runs down the mountain, and everyone's just staying

757
00:42:24,719 --> 00:42:25,520
Speaker 1: in those ski runs.

758
00:42:25,560 --> 00:42:26,520
Speaker 2: That's exactly right.

759
00:42:26,800 --> 00:42:30,080
Speaker 1: But when you inhibit that, people think, oh, I can

760
00:42:30,120 --> 00:42:32,480
Speaker 1: actually ski down the mountain this other way that nobody's

761
00:42:32,520 --> 00:42:32,840
Speaker 1: taking with it.

762
00:42:33,880 --> 00:42:35,959
Speaker 2: Well, just you know, for example, you know I've been there,

763
00:42:36,080 --> 00:42:39,480
Speaker 2: you know where you think, oh god, that's steep. I

764
00:42:39,520 --> 00:42:41,360
Speaker 2: am not the kind of skier can do that. You know.

765
00:42:42,040 --> 00:42:45,080
Speaker 2: But if you're loosening up your default mode network, and

766
00:42:45,120 --> 00:42:47,480
Speaker 2: if you're getting more engaged in what you're doing, you say,

767
00:42:47,480 --> 00:42:49,799
Speaker 2: you know what if I take it this way in

768
00:42:49,800 --> 00:42:52,840
Speaker 2: that way, If I don't make this the bad skiers

769
00:42:52,880 --> 00:42:55,399
Speaker 2: mistake of leaning backwards going down the hill, which gives

770
00:42:55,400 --> 00:42:57,680
Speaker 2: me less control over the skis. But you allow yourself

771
00:42:57,719 --> 00:43:00,840
Speaker 2: to lean forward, the edges work better and you actually

772
00:43:00,840 --> 00:43:03,160
Speaker 2: have more control over how you're turning and how you

773
00:43:03,160 --> 00:43:06,040
Speaker 2: can stop if you need to. So I, when I

774
00:43:06,080 --> 00:43:09,240
Speaker 2: do that, I have to suppress activity in my default

775
00:43:09,280 --> 00:43:11,520
Speaker 2: mode networks is saying, are you crazy? You can't do that?

776
00:43:11,760 --> 00:43:14,839
Speaker 2: And give it a try. So that's right. And so

777
00:43:15,000 --> 00:43:19,760
Speaker 2: I actually think that hypnosis is a kind of less toxic,

778
00:43:20,600 --> 00:43:25,960
Speaker 2: much more controllable psychedelic experience where you just allow yourself

779
00:43:25,960 --> 00:43:28,400
Speaker 2: to try out things that are different and see what

780
00:43:28,440 --> 00:43:30,440
Speaker 2: it feels like. But you can turn it on and

781
00:43:30,480 --> 00:43:31,319
Speaker 2: you can turn it off.

782
00:43:32,360 --> 00:43:35,080
Speaker 1: Do you suppose if you look across the population, so

783
00:43:35,200 --> 00:43:38,440
Speaker 1: some people are more hypnotizable. I'm totally speculating here, but

784
00:43:38,480 --> 00:43:39,879
Speaker 1: do you suppose that those are the people that are

785
00:43:39,880 --> 00:43:43,880
Speaker 1: more attracted to literature? Because when I go into the bookstore,

786
00:43:43,920 --> 00:43:46,440
Speaker 1: I notice that some read fiction, some only go to

787
00:43:46,480 --> 00:43:49,200
Speaker 1: the nonfiction section, right, But for the people who are

788
00:43:49,200 --> 00:43:51,240
Speaker 1: going and they want to read a story and step

789
00:43:51,280 --> 00:43:53,800
Speaker 1: into the shoes of a protagonist and be someone else,

790
00:43:54,040 --> 00:43:55,560
Speaker 1: do you suppose it would be a correlation there?

791
00:43:55,600 --> 00:43:57,799
Speaker 2: I think so, I think. I mean, I haven't seen

792
00:43:57,840 --> 00:43:59,719
Speaker 2: a study like that, but I think, you know, in

793
00:44:00,239 --> 00:44:04,560
Speaker 2: role we actually it's interesting. On the every app we

794
00:44:05,040 --> 00:44:07,719
Speaker 2: call people who test out to be highly hypnotizable, the

795
00:44:07,760 --> 00:44:11,120
Speaker 2: poets that you know, they just the imagined world and

796
00:44:11,160 --> 00:44:13,480
Speaker 2: the real world can become the real world for you,

797
00:44:13,560 --> 00:44:15,840
Speaker 2: and so it's easy to go into that. Whereas we

798
00:44:15,920 --> 00:44:20,000
Speaker 2: call the low hypnotizables the researchers you know that, and

799
00:44:20,320 --> 00:44:24,280
Speaker 2: low hypnotizalar people that just you know, have to analyze

800
00:44:24,320 --> 00:44:26,880
Speaker 2: everything and read about it, just just what you're saying now.

801
00:44:26,880 --> 00:44:28,680
Speaker 2: They may read books, so they may be part of

802
00:44:28,680 --> 00:44:32,040
Speaker 2: who's populating the bookstores, but it's different kinds of books.

803
00:44:32,520 --> 00:44:34,719
Speaker 2: And the mid range people we call diplomats who will

804
00:44:34,760 --> 00:44:37,200
Speaker 2: try and experience and then step back and think about

805
00:44:37,360 --> 00:44:39,680
Speaker 2: what it's like. I had one day in the office

806
00:44:39,719 --> 00:44:43,120
Speaker 2: when it was perfect, you know, the first person was

807
00:44:43,120 --> 00:44:47,200
Speaker 2: at ten on the hypnotic in very hypnotizable. She had

808
00:44:47,320 --> 00:44:50,000
Speaker 2: some really bad neck pain and it just went away.

809
00:44:50,080 --> 00:44:52,520
Speaker 2: You know. I just had her imagine you had this

810
00:44:53,160 --> 00:44:55,560
Speaker 2: hot pack on your neck filter their head out of

811
00:44:55,560 --> 00:44:58,440
Speaker 2: the pain. Thank you doctor. She's out the door. She

812
00:44:58,520 --> 00:45:02,000
Speaker 2: loved it. The second patient with somebody who had had

813
00:45:02,040 --> 00:45:05,279
Speaker 2: a knee injury seven years earlier. He was carrying a

814
00:45:05,360 --> 00:45:08,400
Speaker 2: very heavy crate with a guy who dropped it and he,

815
00:45:08,960 --> 00:45:11,080
Speaker 2: you know, did real damage to his knee. And it's

816
00:45:11,080 --> 00:45:13,719
Speaker 2: seven years later and his knee still isn't working right.

817
00:45:14,080 --> 00:45:16,600
Speaker 2: But he've been going from one doctor to another who

818
00:45:16,640 --> 00:45:18,520
Speaker 2: all say, well, you know, you've got some problem there,

819
00:45:18,520 --> 00:45:20,400
Speaker 2: but it's not that bad. And he would say, no,

820
00:45:20,640 --> 00:45:22,239
Speaker 2: there's got to be a solution to this, you know.

821
00:45:22,760 --> 00:45:25,719
Speaker 2: And he was like a zero. He was just not hypnotizable.

822
00:45:25,719 --> 00:45:28,000
Speaker 2: And I said, you know, I don't know how much

823
00:45:28,120 --> 00:45:31,279
Speaker 2: I can help you, but I'm wondering if maybe your

824
00:45:31,320 --> 00:45:35,759
Speaker 2: doctor's are right, and it's your irritation at whatever limitation

825
00:45:35,880 --> 00:45:38,960
Speaker 2: you have that is really what's causing you more pain

826
00:45:39,120 --> 00:45:43,080
Speaker 2: than the actual pain itself. And he said, you know, Doc,

827
00:45:43,520 --> 00:45:45,440
Speaker 2: you're the first doctor who's ever told me that. And

828
00:45:45,520 --> 00:45:48,160
Speaker 2: I think you're right. See, I said, I think you're

829
00:45:48,200 --> 00:45:51,200
Speaker 2: just so irritated by it that even the slightest hint

830
00:45:51,280 --> 00:45:54,399
Speaker 2: and you go off the rails. And so I had,

831
00:45:54,600 --> 00:45:57,640
Speaker 2: you know, two people with opposite extreme. I was a

832
00:45:57,719 --> 00:46:02,440
Speaker 2: hypnotizability who be helped, but in rather different ways.

833
00:46:03,000 --> 00:46:06,640
Speaker 1: In general, if you're looking at this spectrum across the population,

834
00:46:06,920 --> 00:46:09,759
Speaker 1: from the zero to ten, the not so hypnotizable to

835
00:46:09,840 --> 00:46:13,719
Speaker 1: very hypnotizable, what are the pros and cons. Let's say

836
00:46:13,719 --> 00:46:15,279
Speaker 1: we're looking at the up end of the scale. If

837
00:46:15,280 --> 00:46:19,919
Speaker 1: you're a highly hypnotizable person just walking around in daily life,

838
00:46:19,960 --> 00:46:21,120
Speaker 1: what are the pros and cons of that?

839
00:46:21,400 --> 00:46:25,880
Speaker 2: Y you know, imaginative involvement. You can easily get into things,

840
00:46:25,920 --> 00:46:29,120
Speaker 2: and you can tune into people, and you can, you know,

841
00:46:29,560 --> 00:46:32,520
Speaker 2: see things from their point of view. They're often very intuitive,

842
00:46:32,800 --> 00:46:35,919
Speaker 2: they relate well to people, but sometimes they get kind

843
00:46:35,920 --> 00:46:37,839
Speaker 2: of taken in by it. You know, they can it's

844
00:46:38,040 --> 00:46:42,120
Speaker 2: they're so cognitively flexible that they can be talked out

845
00:46:42,120 --> 00:46:44,640
Speaker 2: of a position that they know is pretty good and

846
00:46:45,520 --> 00:46:49,520
Speaker 2: reasonable and affiliate with something that in the long run

847
00:46:49,560 --> 00:46:51,919
Speaker 2: may not be the right thing to affiliate with. They

848
00:46:51,960 --> 00:46:55,480
Speaker 2: tend to enjoy these sort of emotional experiences. They get

849
00:46:55,520 --> 00:46:58,560
Speaker 2: into movies in theater and things like that. The low

850
00:46:58,640 --> 00:47:02,120
Speaker 2: hypnotizables are more large, logical and rational and want to

851
00:47:02,160 --> 00:47:05,920
Speaker 2: think things through before they accept much of anything. And

852
00:47:06,239 --> 00:47:08,319
Speaker 2: the world needs people like that too. You know, they

853
00:47:08,360 --> 00:47:10,839
Speaker 2: don't they don't just give themselves to it, but they

854
00:47:10,920 --> 00:47:13,280
Speaker 2: can acquire it if they do it on their terms.

855
00:47:13,920 --> 00:47:15,920
Speaker 2: So it's a matter of, you know, sort of more

856
00:47:15,920 --> 00:47:18,360
Speaker 2: of the poet or more the researcher kind of approach,

857
00:47:18,440 --> 00:47:21,440
Speaker 2: but both people can do well. I had I'll tell

858
00:47:21,440 --> 00:47:24,480
Speaker 2: you I just I had a lawyer who had tenadis

859
00:47:24,520 --> 00:47:27,920
Speaker 2: for like five years. Was driving her nuts and she

860
00:47:28,040 --> 00:47:29,799
Speaker 2: told me, I said, what do you do that you enjoy?

861
00:47:29,920 --> 00:47:33,879
Speaker 2: I she's a scuba diver, and I said, okay, here's

862
00:47:33,880 --> 00:47:36,080
Speaker 2: what we're going to do. And I got her hypnotized,

863
00:47:36,120 --> 00:47:38,920
Speaker 2: and I said, I want you to imagine that the

864
00:47:39,000 --> 00:47:42,239
Speaker 2: tenadus is the sound of your the bubbles and your regulator,

865
00:47:43,040 --> 00:47:46,440
Speaker 2: and just picture how you feel. Because she loved diving

866
00:47:46,480 --> 00:47:48,880
Speaker 2: and she would go to the greatest places and just

867
00:47:49,120 --> 00:47:51,759
Speaker 2: enter that other world. And I want you to experience

868
00:47:51,800 --> 00:47:56,360
Speaker 2: it as the bubbles in your regulator. And she thanked me.

869
00:47:56,440 --> 00:47:59,160
Speaker 2: She said, this is the first time I felt comfortable

870
00:47:59,560 --> 00:48:00,400
Speaker 2: in five years.

871
00:48:00,840 --> 00:48:03,120
Speaker 1: The thing that gets people about tenetus is they pay

872
00:48:03,160 --> 00:48:05,600
Speaker 1: attention to it and they try to make it they're

873
00:48:05,640 --> 00:48:08,480
Speaker 1: fighting against it instead of thinking it's a very pleasant

874
00:48:08,480 --> 00:48:08,880
Speaker 1: sort of thing.

875
00:48:08,960 --> 00:48:09,640
Speaker 2: That's exactly.

876
00:48:10,280 --> 00:48:14,440
Speaker 1: Yeah. So what advice would you give to listeners here?

877
00:48:15,520 --> 00:48:21,320
Speaker 2: Well, you know, I've David found, you know, over fifty

878
00:48:21,400 --> 00:48:25,560
Speaker 2: years of doing work with using hypnosis and using it

879
00:48:25,600 --> 00:48:27,759
Speaker 2: with about seven thousand people, that it helps a lot

880
00:48:27,760 --> 00:48:31,000
Speaker 2: of people and it doesn't hurt anybody, and that's not

881
00:48:31,040 --> 00:48:33,200
Speaker 2: true of most of the things we do in medicine,

882
00:48:33,760 --> 00:48:36,799
Speaker 2: and so but I realized, I'm glad about that, but

883
00:48:37,120 --> 00:48:39,640
Speaker 2: so many more people could get help from this, you know,

884
00:48:39,800 --> 00:48:42,239
Speaker 2: and because they don't know about it, or what they

885
00:48:42,280 --> 00:48:45,320
Speaker 2: know is wrong, because of their prejudice against it, because

886
00:48:45,360 --> 00:48:47,920
Speaker 2: people think it's weird, or it's not possible that you know,

887
00:48:48,000 --> 00:48:49,799
Speaker 2: people could just do it with their head, or if

888
00:48:49,800 --> 00:48:52,480
Speaker 2: they do it was it wasn't real in the first place.

889
00:48:52,800 --> 00:48:55,120
Speaker 2: All of these misconceptions, a lot of people are missing

890
00:48:55,160 --> 00:48:59,040
Speaker 2: an opportunity to help themselves feel better and do better.

891
00:48:59,600 --> 00:49:03,040
Speaker 2: And so I thought, my legacy gift is going to

892
00:49:03,080 --> 00:49:05,840
Speaker 2: be making it available to anybody who wants it. So

893
00:49:06,080 --> 00:49:08,279
Speaker 2: about five years ago I was talking at a brain

894
00:49:08,320 --> 00:49:13,040
Speaker 2: Mind summit at Stanford, and Aeriel Pohlar, who's a helped

895
00:49:13,440 --> 00:49:16,600
Speaker 2: found Stravo, which is a really good, you know, cycling app,

896
00:49:17,480 --> 00:49:21,640
Speaker 2: came up to me in Stanford Business School mit and

897
00:49:21,680 --> 00:49:25,439
Speaker 2: he said, David, would you you want to try an app?

898
00:49:25,520 --> 00:49:27,600
Speaker 2: See if I could put it, put it on an

899
00:49:27,600 --> 00:49:29,280
Speaker 2: app and see what Amazon it is at a time

900
00:49:29,640 --> 00:49:32,080
Speaker 2: when Amazon was pushing Alexa and they were making it

901
00:49:32,120 --> 00:49:35,480
Speaker 2: easy to program your own app. So we did, and

902
00:49:36,000 --> 00:49:39,279
Speaker 2: I said, well, let's help people stop smoking. So the

903
00:49:39,600 --> 00:49:43,759
Speaker 2: approach there was focus on what you're for. So think

904
00:49:43,800 --> 00:49:47,000
Speaker 2: of this for my body smokings of poison. I need

905
00:49:47,000 --> 00:49:49,920
Speaker 2: my body to live. I owe my body respected protection.

906
00:49:50,719 --> 00:49:54,520
Speaker 2: You would never put hot air laced with tory nicotine

907
00:49:54,520 --> 00:49:57,960
Speaker 2: into your dog's lungs or your baby's lungs. Your body's

908
00:49:58,000 --> 00:50:02,160
Speaker 2: as innocent as they are, so protect and respect your body.

909
00:50:03,000 --> 00:50:07,719
Speaker 2: And so we had people do that, and one out

910
00:50:07,719 --> 00:50:10,759
Speaker 2: of four stopped after a single use of the of

911
00:50:10,800 --> 00:50:14,160
Speaker 2: the app, and the rest cut down their average cigarette

912
00:50:14,160 --> 00:50:18,360
Speaker 2: and consumption by about fifty percent. I had one social

913
00:50:18,400 --> 00:50:22,640
Speaker 2: worker who said I didn't even want to stop smoking.

914
00:50:22,680 --> 00:50:24,640
Speaker 2: I smoked for twenty five years. I signed up for

915
00:50:24,680 --> 00:50:27,680
Speaker 2: your study. I didn't like it the first time. The

916
00:50:27,719 --> 00:50:29,839
Speaker 2: second time, I looked at the cigarette and said, who

917
00:50:29,880 --> 00:50:32,600
Speaker 2: needs this? And I put it out and I haven't

918
00:50:32,600 --> 00:50:35,160
Speaker 2: had a cigarette since. My friends can't believe it. I

919
00:50:35,200 --> 00:50:39,200
Speaker 2: can't believe it. She said, this is some kind of

920
00:50:39,239 --> 00:50:41,279
Speaker 2: crazy as voodoo shit, and I mean that in a

921
00:50:41,320 --> 00:50:45,880
Speaker 2: good way. Said, so we figured it's working. So Ariel

922
00:50:46,040 --> 00:50:49,320
Speaker 2: and I formed a company where every stand or professor

923
00:50:49,480 --> 00:50:52,719
Speaker 2: like you has to have a startup. We do, and

924
00:50:53,040 --> 00:50:55,400
Speaker 2: we've had one point two million downloads. Now we have

925
00:50:55,440 --> 00:50:59,840
Speaker 2: a terrific team. We're using AI to manage my responses

926
00:51:00,120 --> 00:51:02,279
Speaker 2: that you can actually have an interaction with me as

927
00:51:02,320 --> 00:51:05,239
Speaker 2: if you were in my office. And you know, I

928
00:51:05,360 --> 00:51:07,680
Speaker 2: used to think, is it as good as being in

929
00:51:07,680 --> 00:51:10,200
Speaker 2: my office? While the smoking results were just the same.

930
00:51:10,840 --> 00:51:17,680
Speaker 2: And I want to leave this world with an opportunity

931
00:51:17,800 --> 00:51:21,879
Speaker 2: to manage these very common, very serious problems like pain

932
00:51:21,920 --> 00:51:26,080
Speaker 2: and anxiety and insomnia and bad habits in a way

933
00:51:26,120 --> 00:51:28,360
Speaker 2: that often helps and never hurts.

934
00:51:33,040 --> 00:51:35,520
Speaker 1: That was doctor David Spiegel for me. A few things

935
00:51:35,520 --> 00:51:38,279
Speaker 1: really stand out from the conversation. First, I have to

936
00:51:38,280 --> 00:51:41,279
Speaker 1: confess that I was surprised when I first learned about

937
00:51:41,280 --> 00:51:45,520
Speaker 1: a decade ago that one of my departmental colleagues studies hypnosis,

938
00:51:45,560 --> 00:51:47,919
Speaker 1: because my assumption had been that that was some sort

939
00:51:47,920 --> 00:51:51,480
Speaker 1: of party trick. But after talking with David Spiegel, one

940
00:51:51,560 --> 00:51:54,480
Speaker 1: learns that what he refers to as hypnosis is built

941
00:51:54,480 --> 00:51:59,640
Speaker 1: from the systems our brains use every day, attention, expectation, imagination.

942
00:52:00,400 --> 00:52:04,440
Speaker 1: What changes in hypnosis is how tightly those systems are linked,

943
00:52:04,520 --> 00:52:07,200
Speaker 1: which allows people, and some people more than others, to

944
00:52:07,320 --> 00:52:12,600
Speaker 1: really dissociate and ski down different parts of the mountain. Second,

945
00:52:12,640 --> 00:52:16,320
Speaker 1: on a brain level, we heard that hypnosis involves measurable

946
00:52:16,440 --> 00:52:20,720
Speaker 1: changes in specific networks, for example, regions that handle focus

947
00:52:20,760 --> 00:52:25,680
Speaker 1: and executive control, regions that monitor self reflection and mind wandering,

948
00:52:26,040 --> 00:52:30,280
Speaker 1: and areas that integrate body sensations and emotion. When these

949
00:52:30,360 --> 00:52:35,239
Speaker 1: networks reconfigure, people can experience what seem to be clinically

950
00:52:35,360 --> 00:52:40,080
Speaker 1: meaningful reductions in pain and anxiety and trauma. This is

951
00:52:40,120 --> 00:52:44,160
Speaker 1: observable in brain imaging and in clinical outcomes. I'm linking

952
00:52:44,200 --> 00:52:47,160
Speaker 1: several papers to the show notes. The third thing I

953
00:52:47,160 --> 00:52:49,960
Speaker 1: want to point out is that hypnotizability is a trait

954
00:52:50,040 --> 00:52:54,200
Speaker 1: with a whole spectrum of individual differences, influenced by how

955
00:52:54,280 --> 00:52:59,520
Speaker 1: your brain organizes attention and control. Some people are naturally

956
00:52:59,560 --> 00:53:02,880
Speaker 1: very wonts of others are less so, and everywhere along

957
00:53:02,880 --> 00:53:06,520
Speaker 1: the spectrum. I'm very interested to see how our science

958
00:53:06,600 --> 00:53:09,840
Speaker 1: develops an understanding of this, Like, are some people just

959
00:53:10,320 --> 00:53:14,120
Speaker 1: better at popping out of their default mode network? And

960
00:53:14,360 --> 00:53:17,399
Speaker 1: here's my silly hypothesis, are these the people who get

961
00:53:17,440 --> 00:53:21,080
Speaker 1: more deeply pulled into works of literature? Who knows if

962
00:53:21,080 --> 00:53:23,360
Speaker 1: that's right, But it'll be great to see how this

963
00:53:23,480 --> 00:53:27,359
Speaker 1: science evolves. We're just at the beginning of understanding how

964
00:53:27,400 --> 00:53:29,960
Speaker 1: all these networks work together. But as you heard from

965
00:53:30,040 --> 00:53:33,800
Speaker 1: David Spiegel today, hypnosis can be used as a serious

966
00:53:33,880 --> 00:53:36,760
Speaker 1: tool in medicine and mental health to help some people

967
00:53:36,840 --> 00:53:40,640
Speaker 1: manage pain, to reduce anxiety and distress, and to work

968
00:53:40,680 --> 00:53:44,239
Speaker 1: with aspects of trauma and habit breaking. Is it a

969
00:53:44,360 --> 00:53:47,160
Speaker 1: cure all No, It has its limits and is probably

970
00:53:47,200 --> 00:53:51,239
Speaker 1: best positioned side by side with other evidence based approaches.

971
00:53:51,560 --> 00:53:54,640
Speaker 1: But for me, the awe inspiring part is that hypnosis

972
00:53:54,680 --> 00:53:58,400
Speaker 1: gives us a small experimental window into how the brain

973
00:53:58,800 --> 00:54:02,920
Speaker 1: constructs reality. If your arm hurts, it seems like that

974
00:54:02,960 --> 00:54:05,560
Speaker 1: should just be a raw signal, but it's not. It's

975
00:54:05,600 --> 00:54:11,080
Speaker 1: a signal that gets interpreted through attention, through beliefs, through context.

976
00:54:11,080 --> 00:54:14,560
Speaker 1: If you change those ingredients in the right way, the

977
00:54:14,719 --> 00:54:19,320
Speaker 1: experience can change again. I'm linking papers that demonstrate this.

978
00:54:19,320 --> 00:54:22,880
Speaker 1: This doesn't mean that we can think away every symptom

979
00:54:22,960 --> 00:54:26,080
Speaker 1: or circumstance, but it does tell us that our experience

980
00:54:26,200 --> 00:54:29,600
Speaker 1: is slightly more adjustable than it may first appear. The

981
00:54:29,760 --> 00:54:35,000
Speaker 1: boundary between expectation and sensation just might be more flexible

982
00:54:35,440 --> 00:54:38,040
Speaker 1: than most of us were taught. If this episode was useful,

983
00:54:38,080 --> 00:54:41,920
Speaker 1: consider sharing it with someone who's dealing with pain or anxiety,

984
00:54:42,200 --> 00:54:45,320
Speaker 1: or who's simply curious about how much influence our thoughts

985
00:54:45,360 --> 00:54:53,319
Speaker 1: can have on our experience. Go to eagleman dot com

986
00:54:53,320 --> 00:54:56,480
Speaker 1: slash podcast for more information and to find further reading.

987
00:54:56,880 --> 00:54:59,759
Speaker 1: Join the weekly discussions on my substack and check out

988
00:54:59,840 --> 00:55:02,719
Speaker 1: some Pbscribe to Inner Cosmos on YouTube for videos of

989
00:55:02,760 --> 00:55:06,520
Speaker 1: each episode and to leave comments until next time. I'm

990
00:55:06,600 --> 00:55:09,080
Speaker 1: David Eagleman, and this is Inner Cosmos.