Speaker 1: What exactly is hypnosis? We've all heard about the circusy
Speaker 1: versions of it, but is there something about hypnosis that
Speaker 1: is real and that can be studied and leveraged by
Speaker 1: psychiatrists and neuroscientists. Can attention and expectation change what we
Speaker 1: feel like pain or anxiety? And how does that work?
Speaker 1: What do suggestible states reveal about the brain's typical pathways
Speaker 1: and what happens when we're knocked off of those, and
Speaker 1: how does hypnosis compare to meditation or flow states or
Speaker 1: psychedelic drugs. Today, join me as we talk with doctor
Speaker 1: David Spiegel, Stanford psychiatrist and one of the world's experts
Speaker 1: in hypnosis. Welcome to Innercosmos with me, David Eagleman. I'm
Speaker 1: a neuroscientist and author at Stanford, and in these episodes
Speaker 1: we sail deeply into our three pound universe to understand
Speaker 1: how how we see the world, the outside world and
Speaker 1: also the inside world. Okay, so first I'm going to
Speaker 1: point out one of my central sources of amazement that
Speaker 1: surfaces and all these episodes, the fact that inside each
Speaker 1: of us there's an entire universe of eighty six billion neurons,
Speaker 1: never seeing the light of day, pulsing in the dark,
Speaker 1: and these are somehow weaving together your world, and in
Speaker 1: ways we don't yet fully understand, we get all this
Speaker 1: private subjective experience out of this, like color which doesn't
Speaker 1: actually exist in the outside world, or pain, which is
Speaker 1: just signaling along nerves, just like all the rest of
Speaker 1: the signaling running around in your nerves, but somehow you
Speaker 1: have the impression that it hurts. And somehow all the
Speaker 1: act activities zooming around on all these little cables equals
Speaker 1: your mind. Your thoughts are nothing but this electrochemical activity.
Speaker 1: And we know this because if you ingest particular molecules,
Speaker 1: that changes your thoughts, like if you consume alcohol or drugs,
Speaker 1: or if you bunk your head on the cabinet, you
Speaker 1: might lose consciousness and not have any thoughts for some minutes.
Speaker 1: And when someone gets a neurodegenerative disorder, many of their
Speaker 1: neurons die and that changes their thoughts. Same with tumors
Speaker 1: or strokes or dozens of other things that we see
Speaker 1: in the clinics every day. And that's how we know that.
Speaker 2: You are your biology.
Speaker 1: But the question is our thoughts the end consequence of
Speaker 1: the activity, or do they somehow feedback in such a
Speaker 1: way that they influence the activity. Now this is an
Speaker 1: open question in neuroscience, but we do know that somehow
Speaker 1: a change in expectation can reshape what we feel in
Speaker 1: our own bodies, are pain or anxieties, our sense of self.
Speaker 1: We get glimpses of this with let's say placebos. These
Speaker 1: are things that should have no medical effect, but they
Speaker 1: often have clinically significant effects on people. And what's weird
Speaker 1: is that sometimes these work even when people know they
Speaker 1: are placebos. And then you've got practices like meditation that
Speaker 1: can alter attention and emotion and make subtle changes to
Speaker 1: the structure of the brain over time. But there's one
Speaker 1: laboratory of the mind where these questions become especially vivid,
Speaker 1: where you can watch how a change and attention changes
Speaker 1: the brain, and that laboratory is hypnosis. Now, let me
Speaker 1: be crystal clear about something. I'm not talking about hypnosis
Speaker 1: of the stage show stereotype. I'm not talking about mind
Speaker 1: control or swinging watches. Instead. To psychiatrists, they're talking about
Speaker 1: something when they use the term hypnosis, but it looks
Speaker 1: more like a rearrangement of attention. The world narrows inner
Speaker 1: experience becomes more vivid. External suggestions begin to feel more
Speaker 1: like internal ideas, and a person can dissociate slightly from
Speaker 1: their normal neural pathways. Think about it like this. If
Speaker 1: you look at any ski mountain, there are only a
Speaker 1: few runs going down the mountain, But in theory you
Speaker 1: could ski down the mountain in lots of ways. You
Speaker 1: don't have to stay right on those established runs. And
Speaker 1: in our own brains we get these runs established in them,
Speaker 1: and the question is how do we ever get off
Speaker 1: our own beaten path? So my guest today has spent
Speaker 1: his career at this frontier. David Spiegel is a psychiatrist,
Speaker 1: a leading researcher on hypnosis in the brain at Stanford,
Speaker 1: and a clinician who has leveraged these methods to help
Speaker 1: lots of people manage pain, anxiety, trauma, illness, and the
Speaker 1: breaking of habits. Through his work, we get a window
Speaker 1: into how flexible our perceptions and physiology can be. So
Speaker 1: let's step with David Spiegel in to the inner cosmos. So, David,
Speaker 1: often when people think about hypnosis, they think about, you know,
Speaker 1: a state fair, magic show or something like that, And
Speaker 1: that's not what you do. Tell us how you define
Speaker 1: hypnosis scientifically.
Speaker 2: David, hypnosis is a state of highly focused attention. It's
Speaker 2: like getting so caught up in a good movie that
Speaker 2: you forget you're watching the movie. You enter the imagined world.
Speaker 2: And to achieve that state of focus, you have to
Speaker 2: do to other things. You have to dissociate, put outside
Speaker 2: of conscious awareness, things that would ordinarily be in consciousness.
Speaker 2: We're not aware of how much information our brains, as
Speaker 2: you know better than anyone, is processing at any one time.
Speaker 2: Right now. To listen to me, for example, you have
Speaker 2: to ignore sensations in your body touching these very nice
Speaker 2: chairs here. Hopefully you weren't aware of that until I
Speaker 2: mentioned it. If you were, we could stop. Now you're
Speaker 2: already born. So absorption, highly focused attention, dissociation, and the
Speaker 2: other used to be called suggestibility. It's what scares people
Speaker 2: about hypnosis. You know, the you know, the football coach
Speaker 2: being made to dance like a ballerina in front of
Speaker 2: an audience and all that. I don't like making fun
Speaker 2: of people anyway, but it's different. It's cognitive flexibility. It
Speaker 2: allows you to let go of presumptions of who you are,
Speaker 2: what you are, what you can do. So the football
Speaker 2: coach is not thinking of what he's going to get
Speaker 2: in the locker room when he goes back after the performance,
Speaker 2: but it allows him to do something different, to try
Speaker 2: out being different. And as a psychiatrist and psychotherapist, I
Speaker 2: love seeing people who are willing to try out being
Speaker 2: different and who are surprised by themselves say my god,
Speaker 2: I didn't think I could do that, and I did.
Speaker 2: That's a great template for change.
Speaker 1: What is the difference between a hypnotic state and let's
Speaker 1: say meditation, a flow state, or an dissociative state.
Speaker 2: Well, it is a kind of dissociative state. To focus
Speaker 2: so intently, you have to put outside of conscious awareness
Speaker 2: things that might ordinarily be in consciousness. And people who
Speaker 2: have a dissociative disorder are usually highly hypnotizable, so they
Speaker 2: go intensely. People with associative identity disorder, when they're being
Speaker 2: one of their altars, they're not being all the other
Speaker 2: parts of themselves, and it's a kind of firm boundary
Speaker 2: between these different parts of themselves. Now, that's a mental
Speaker 2: disorder usually associated with trauma. But hypnosis is a much
Speaker 2: milder state of focused attention that is enabled by dissociation.
Speaker 1: Okay, and how about a flow state or a meditative state.
Speaker 2: So the flow state is kind of like the highly
Speaker 2: focused attention.
Speaker 1: And by the way, give an example of a flow.
Speaker 2: Slow state is just getting so lost in an activity.
Speaker 2: For example, that you're painting something. Let's say that you
Speaker 2: realize you've missed an appointment with a friend, or you're
Speaker 2: two hours late for dinner or something. You're just so
Speaker 2: engaged in it. You check sent me Hi who wrote
Speaker 2: the book Flow, and he used to call it an
Speaker 2: autotellic state. It's one that is so enjoyable that you
Speaker 2: would do it just to do it, regardless of what
Speaker 2: the outcome of it is. And that's part of flow.
Speaker 2: You're not doing it for a purpose. You're doing it
Speaker 2: just to do it, to be in that state, to
Speaker 2: be fully engaged.
Speaker 1: What does autot mean.
Speaker 2: Autotelic just means self rewardings. It's rewarding just for doing it,
Speaker 2: not because it's going to get you somewhere into something.
Speaker 2: Actors are like that, you know. The method in acting
Speaker 2: is just you know, be that person. And when a
Speaker 2: good actor does that and you say, hey, you were terrific,
Speaker 2: that was a great performance, they say, what performance I
Speaker 2: was just being that guy. You know, that's who I was.
Speaker 2: So hypnosis is very similar to flow states in that
Speaker 2: sense of being totally into it, being fully absorbed in it.
Speaker 2: Now meditation there are similarities, but there are differences. Meditation
Speaker 2: is more about being and hypnosis is more about doing so.
Speaker 2: In meditation, there are three major components to meditation. There's
Speaker 2: open presence, where you just let feelings and thoughts flow
Speaker 2: through you. You don't try to judge them or use them.
Speaker 2: You don't try to use it to solve a problem.
Speaker 2: It's just it's to become a way of being where
Speaker 2: you are more open to just whatever things are, let
Speaker 2: them be. You do a body scan, which is a
Speaker 2: little bit like hypnosis. You can become more connected with
Speaker 2: things going on in your body or better control things
Speaker 2: going on in your body, like pain, like the symptoms
Speaker 2: of anxiety, for example. The third thing is compassion and
Speaker 2: meditation where you try to have compassion for other people
Speaker 2: compassion for yourself. And that's a good thing too, and
Speaker 2: you can use hypnosis to enhance compassion. I can give
Speaker 2: you some examples of that, but you don't use it
Speaker 2: to solve a problem. I had a woman who was
Speaker 2: a ten year meditator twice a day for ten years,
Speaker 2: thirty minutes a day each time. And she said, but
Speaker 2: I still have migrain headaches and they're driving me crazy
Speaker 2: and I can't get rid of them. Would you help me?
Speaker 2: So I hypnosis whether to imagine that she had a
Speaker 2: cap full of ice on her head, and because people
Speaker 2: with migraines often have vasodilitation in the scalp and they
Speaker 2: feel hot and uncomfortable, and she imagined having this cap
Speaker 2: of ice in her head. And she called me a
Speaker 2: week later, as she said, doctor Spiegel, my migraines are gone.
Speaker 2: Thank you, and thank you for freeing me to use
Speaker 2: my intentionality. Wow, because you're not supposed to be intentional
Speaker 2: in meditation, and you are intentional in hypnosis.
Speaker 1: Oh, I see, I see. So vasodilation is where the
Speaker 1: blood vessels are expand instead are contracted. But she was
Speaker 1: able to use her intention to take control of the
Speaker 1: diameter of her blood vessels as well.
Speaker 2: I can't measure it, but I think it's probably the case.
Speaker 2: There are situations where people you can see them if
Speaker 2: they're concentrating on their hands being warm, you can see
Speaker 2: them sort of flush on their hands. There was one
Speaker 2: amazing study done a mass general years ago. They had
Speaker 2: people in hypnosis. They instructed them. They had a bunch
Speaker 2: of people who had body warts and they're unpleasant, but
Speaker 2: there was word that you could use hypnosis to eliminate warts,
Speaker 2: and they actually got people to eliminate warts on one
Speaker 2: side of their body. Think about that. That's mind bending.
Speaker 2: So but if you're thinking about the brain controlling the
Speaker 2: nervous system, the nervous system is divided into branches, and
Speaker 2: it occupies different parts of the body, and you can
Speaker 2: imagine changes that may sometimes happen in the body.
Speaker 1: What would curing warts look like? How does one intentionally
Speaker 1: make that happen.
Speaker 2: You instruct them to imagine that the warts are just
Speaker 2: drying up and falling off, that they just disappear, and
Speaker 2: for some people that actually happens.
Speaker 1: How is hypnosis used in your practice, for example, for pain,
Speaker 1: for anxiety, for trauma, for dealing with habits that people
Speaker 1: want to break. Give us a sense of.
Speaker 2: How sure I'll be glad to do that. The way
Speaker 2: we use it is to first first I test people's hypnotizability,
Speaker 2: because people differ in their ability to experience hypnosis, and
Speaker 2: that helps me structure the way I approach it with them.
Speaker 2: If you're highly hypnotizable, which about twenty five percent of
Speaker 2: the population is, you just tell them to do it
Speaker 2: and they do it like the ward thing you can.
Speaker 2: And I'll tell you what the approach is with each
Speaker 2: of these kinds of problems. Mid range you kind of
Speaker 2: negotiate with them more and they try it and they
Speaker 2: reflect on it. And with low hypnotizables, it's more of
Speaker 2: a cognitive activity where you think about approaching the problem
Speaker 2: in a different way. So don't fight the pain, but
Speaker 2: learn to filter the hurt out of the pain, don't
Speaker 2: let it get you angry, figure that you can find
Speaker 2: a way to master it. So for you know, we
Speaker 2: start from the body up with hypnosis, and this is
Speaker 2: different from cognitive behavioral therapy, for example, where you kind
Speaker 2: of think your way through the steps to the problem.
Speaker 2: With hypnosis, if somebody is stressed, what I do is say,
Speaker 2: there's one part of this stressor that's bothering you that
Speaker 2: you can do something about right away before you figure
Speaker 2: out actually how to get rid of the stressor or
Speaker 2: deal with the stressor. And that is the effect of
Speaker 2: the stress on your body. So when you feel stressed.
Speaker 2: What happens you know what happens to you, David when
Speaker 2: you get stressed physically?
Speaker 1: Yeah, I think my muscles start to hurt.
Speaker 2: Your muscles hurt, they get tense, you start to sweat,
Speaker 2: you fidget. But there's a kind of snowball effect where
Speaker 2: you start to feel that and you think, oh my god,
Speaker 2: this must be really bad because my body's reacting, and
Speaker 2: so you get more anxious, and then your body reacts
Speaker 2: and on it goes. So with hypnosis, you start with
Speaker 2: the excellent control you have over your body, and hypnosis
Speaker 2: better than normally. And so I say, look up close
Speaker 2: your eyes, take a deep breath, and imagine that you're
Speaker 2: floating in a bath of lake, a hot tub, or
Speaker 2: floating in space. And I teach them a breathing exercise
Speaker 2: where you inhale through your nose, starting with your abdomen,
Speaker 2: and then slowly exhale through your mouth. And if you
Speaker 2: try that, you'll notice that very quickly your body. Do
Speaker 2: you try it? Try it? Just inhale through your nose,
Speaker 2: hold and then slowly exhale through your mouth. How's your
Speaker 2: body feel?
Speaker 1: Good?
Speaker 2: Good? Good? It's a little different.
Speaker 1: I don't think I was stressed before. But I'll try
Speaker 1: that when I'm okay. But you're saying that I one
Speaker 1: should be able to feel that difference. Right after how
Speaker 1: many breaths.
Speaker 2: Like three breaths, wow, is you start to feel it.
Speaker 2: And so then you you with your eyes closed, you
Speaker 2: imagine you're floating in a bath of lake, hot tubber,
Speaker 2: floating in space, and typically people feel less physiologically aroused.
Speaker 2: And then you say, okay, so you've already done one
Speaker 2: thing about the stressor, which is the effects that's not
Speaker 2: on your body. Now, picture in your mind's eye, an
Speaker 2: imaginary screen could be a movie screen, a TV screen,
Speaker 2: or a piece of clear blue sky. And and then
Speaker 2: divide the screen in half, and on the left side,
Speaker 2: picture that stressor one thing that's stressing you. But with
Speaker 2: the rule that you keep your body floating while you
Speaker 2: do it, so you're beginning to separate this feedback between
Speaker 2: the mind and the body about stress. And then once
Speaker 2: you've been able to do that, I say, now picture
Speaker 2: on the right side of the screen. Make that your
Speaker 2: brainstorming screen. One thing you could do to deal with
Speaker 2: the stressor It may not be the best thing or
Speaker 2: the only thing, but something you could do about it,
Speaker 2: and so typically people will picture something. You know, I'll
Speaker 2: explain to my boss why I was late, or I'll
Speaker 2: make sure the kids wear their seat belts when they
Speaker 2: get in the car, whatever it is. And then say,
Speaker 2: notice how you've been able to think more clearly about
Speaker 2: how to deal with the stressor once you're able to
Speaker 2: separate the stress from your physiological reaction. And we found, David,
Speaker 2: in studies of tens of thousands, like sixty eight thousand
Speaker 2: of our Reverie users our self hypnosis app that within
Speaker 2: ten minutes they get a fifty eighty percent reduction in
Speaker 2: their stress levels pre to post. And that's not bad
Speaker 2: for a treatment that has no side effects, hasn't killed
Speaker 2: anybody yet, and is fast faster than going to a
Speaker 2: pharmacy and getting a drug, so they immediately get an
Speaker 2: immediate reaction. So I help people deal with stress in
Speaker 2: that way from the body up rather than from the
Speaker 2: head down.
Speaker 1: That's amazing. So if we're talking pain, anxiety, trauma, things
Speaker 1: like this, does this apply to all of the equally or.
Speaker 2: Different approvals with different approaches. So for pain, common and
Speaker 2: terrible problem that is very terribly treated in this country.
Speaker 2: You know, last year one hundred and eighteen thousand Americans
Speaker 2: died of opioid overdoses in the United States. You know,
Speaker 2: opioids kill people, and so I built Revery, our hypnosis
Speaker 2: app in part to stop that, to get into people's
Speaker 2: hands and minds and intervention that they can use to
Speaker 2: really help themselves. And there's tons of evidence We've done
Speaker 2: randomized control trials showing that hypnosis can control pain. And
Speaker 2: the fact that you can reduce your pain with hypnosis
Speaker 2: doesn't mean the pain is all in your head. It
Speaker 2: means that the strain in pain lies mainly in the
Speaker 2: brain that does signal. An input signal is painful or not,
Speaker 2: depending on how your brain promulgates it and classifies it.
Speaker 2: And you can teach your brain to treat pain differently.
Speaker 2: My lovely wife Helen, had both of our children with
Speaker 2: self hypnosis as the soul anesthetic in childbirth and Dan
Speaker 2: the first one was ten pounds, so it was serious,
Speaker 2: you know, And this shit. At one point in the
Speaker 2: middle of my having rhibnitize, I had her floating in
Speaker 2: Lake Tahoe. She said, David, you know I teach pharmacologey
Speaker 2: at Stanford. Are there are drugs for this? And I
Speaker 2: said keep floating, cool, tailing, and and Dan was born fine,
Speaker 2: and I had no pain at all, you know it
Speaker 2: was so hypnosis really is a terrific treatment for pain.
Speaker 2: And we have on our app four different approaches to it.
Speaker 2: So one is just sensory alteration, filter the herd out
Speaker 2: of the pain. Imagine whatever makes your body feel better.
Speaker 2: And if you think about this, if you get pain
Speaker 2: relief for whatever your problem is with an ice pack
Speaker 2: or floating in a warm bath, that means that when
Speaker 2: you are in one of those states, your brain is
Speaker 2: in a certain state that interprets what's going on as
Speaker 2: a comforting sensation overriding the pain. And there are pet
Speaker 2: studies done at Maygill by per Rainville showing that if
Speaker 2: you tell people to have the sensory alteration filter the
Speaker 2: head out of the pain, you get reduced activity in
Speaker 2: some metasensory cortex just where you would hope it would happen.
Speaker 1: This is what is measuring the activity from your.
Speaker 2: Body from your body in specific regions of the brain,
Speaker 2: and as you feel the analgesia, you feel a reduction
Speaker 2: in the in the cemetasensory cortex. I did an experiment
Speaker 2: with a bunch of Stanford undergrads highly hypnotizable. We screened
Speaker 2: them for that and I had we gave them shocks
Speaker 2: to the forearm and they would report the pain, and
Speaker 2: then I hypnotized them and said, you're a forearm is
Speaker 2: an ice water cool tingling. They got the same shocks.
Speaker 2: We were recording some metasensory event related potentials, and the
Speaker 2: P one hundred disappeared the first tenth of a second.
Speaker 2: The brain stopped the initial processing of the pain signal,
Speaker 2: and the P two hundred and P three hundred, these.
Speaker 1: Are EEG signals.
Speaker 2: Collected EEG signals in response to a series of shocks
Speaker 2: were half as big. So just telling them to do
Speaker 2: that changed the way their brain transmitted the pain signal.
Speaker 1: And I assume this wasn't just repetition suppression.
Speaker 2: No.
Speaker 3: No, We had a control group that wasn't hypnotized. Yeah,
Speaker 3: and then they would get the same well they did
Speaker 3: that group. They were their own control because when they
Speaker 3: were not hypnotized and just feeling it, they got the
Speaker 3: full sensation for the same period of time. They didn't
Speaker 3: habituate to it a hypnosis, They just persistently and immediately
Speaker 3: reduced the amplitude of the evoked response by overall fifty
Speaker 3: percent starting with a tenth of the second. It wasn't
Speaker 3: like it was rattling around the brain for a while.
Speaker 3: It changed the settings for how you process those signals.
Speaker 3: My colleague pr Rainville, when he studied activity in the
Speaker 3: brain after a similar analgesic instruction, if instead of saying
Speaker 3: filter the head out of the pain, your hands cold
Speaker 3: and numb, he said it's there, but it won't bother you,
Speaker 3: which is the way people on opioids sometimes respond, well,
Speaker 3: I know there's a sensation there. And then he got
Speaker 3: the same level of analgesia, but now the reduction was
Speaker 3: in the dorsal anterior cingulate cortex, part of the salience
Speaker 3: network that tells you whether something is a threat or not.
Speaker 3: So you can change just the words you use in
Speaker 3: hypnosis will change the part of the brain that reacts
Speaker 3: to the analgesic construction.
Speaker 1: Using people who are highly hypnotizable, this actually sounds like
Speaker 1: a great advantage for them, and let's say the case
Speaker 1: of pain. What about people who are not so hypnotizable.
Speaker 1: Does that mean they can't help themselves there?
Speaker 2: What we find is that the results are less dramatic,
Speaker 2: but they get results, okay, in part because we're teaching
Speaker 2: them a cognitive strategy. We're saying, look, you know, I'll
Speaker 2: give you an example. I had a very lovely woman
Speaker 2: came to me the other day who has chronic pain
Speaker 2: and who said that it really inhibits what she can do.
Speaker 2: She also had kind of a tick from an old
Speaker 2: neck injury that she'd had, and it was getting worse
Speaker 2: and worse, and she got more and more angry about it,
Speaker 2: and it was inhibiting her life and what she could do.
Speaker 2: And she turned out to be three out of ten
Speaker 2: instead of seven out of ten, less hypnotizable on our measure,
Speaker 2: the hypnotic conduction profile. And I said, you know, pain
Speaker 2: and this tick that you have are like the noisy
Speaker 2: kid in the classroom. You know, you pay more attention
Speaker 2: to it than it deserves. You have other sensations, other
Speaker 2: things you could think about, but you open into that.
Speaker 2: She said, well, I'm a teacher. I was a teacher.
Speaker 2: I taught for twenty seven years. I loved teaching best
Speaker 2: part of my life. And I said, well, what did
Speaker 2: you do with a noisy kid, a kid who was disruptive?
Speaker 2: She said, well, I was pretty good with them. Actually
Speaker 2: she was rather strict, you know, but she said I
Speaker 2: would take their hand at a time when teachers finally
Speaker 2: were allowed to touch a student, and I would hold
Speaker 2: their hand, and I say, I know you're upset, and
Speaker 2: I know this was bothering you, but there are better
Speaker 2: ways to handle it, and I'm going to show you how.
Speaker 2: And so, in a very kind, accepting, loving way, she
Speaker 2: was saying, what you've been doing is no good, but
Speaker 2: I will show you how to do it better. That's
Speaker 2: a cognitive approach that keeps you from making things worse
Speaker 2: by exacerbating the irritation you have. And I said so,
Speaker 2: and she said, I was so good at it that
Speaker 2: I got all the troublesome students in the school, you know,
Speaker 2: and send them to me. But I love doing it.
Speaker 2: And I said, so you know how to do it,
Speaker 2: but why don't you use that same approach with your
Speaker 2: own body? Because you get more and more frustrated the
Speaker 2: more you have these ticks in this pain. And if
Speaker 2: you can just treat your body the way you would
Speaker 2: treat one of those students, I'll bet you feel better.
Speaker 2: And she did. She found that the ticks were not
Speaker 2: getting worse because they would, you know, the more it
Speaker 2: would happen, the more she would shake because she was
Speaker 2: so angry and frustrated that it was still happening, and
Speaker 2: the more discomfort she had. So part of it is
Speaker 2: using hypnosis to literally alter perception, and part of it
Speaker 2: is taking an approach that involves focusing on what you're for, now,
Speaker 2: what you're against, and then what you've written. I'm sure
Speaker 2: you're familiar with this, that you exacerbate the problem by
Speaker 2: fighting against it. We people and hypnosis say, the worst
Speaker 2: thing you can tell somebody is don't think about purple elephants, right,
Speaker 2: you know, And that's what you do. So you focus
Speaker 2: on what you're for and you can modulate it, even
Speaker 2: if you don't get as big a sensory alteration as
Speaker 2: as you might otherwise have done.
Speaker 1: In this example, what is the thing that you are
Speaker 1: focused for? It's you can't say I want to be
Speaker 1: free of pain, because interesting of the pain, what's there?
Speaker 2: You're you're focusing on filtering the herd out of the pain,
Speaker 2: soothing it. I say, imagine, treat your treat your body
Speaker 2: as if it were your baby, your child, you know,
Speaker 2: if your child were hurting if you were hurt, would
Speaker 2: you get angry at him for crying and fussing? No,
Speaker 2: they say, I'd I'd pick them up, I'd hug them,
Speaker 2: I soothe them. So you know what, your body is
Speaker 2: as innocent as your baby. You know it has to
Speaker 2: deal with whatever happens to it. So focus on respecting
Speaker 2: and protecting your body the way you would your child.
Speaker 2: And that's the that's what you're for, is this respect
Speaker 2: and protection of your body and not making it worse
Speaker 2: by getting angry and frustrated.
Speaker 1: How about anxiety? How is this using it?
Speaker 2: Well? Anxiety disorders. Again, it's this sort of feedback between
Speaker 2: between brain and body. And I have people, first of all,
Speaker 2: deal with just the way what do you perceive in
Speaker 2: your body when you're getting anxious and so imagine, you know,
Speaker 2: feel that tension, but imagine that you can do something
Speaker 2: or imagine the thing you do to keep from being anxious,
Speaker 2: and then think about how you could approach that problem differently.
Speaker 2: So I had a woman who was a CEO of
Speaker 2: a company here, tough lady, but she had a terrible
Speaker 2: dog phobia. She get awfully anxious when she got anywhere
Speaker 2: near a dog. And I said, well, imagine. Let's imagine
Speaker 2: that this guy is bringing his dog into your office.
Speaker 2: And she said, no, I just freeze and see what
Speaker 2: the dog is going to do. And I said, well,
Speaker 2: if one of your employees who was performing badly walked
Speaker 2: into your office, would you just freeze and see what
Speaker 2: he'd do? She said, hell, no, I'd tell him off,
Speaker 2: you know, I'd fire him. I'd do whatever I had
Speaker 2: to do. So I said, so, why don't you instead
Speaker 2: of freezing immobilizing yourself, which only amplifies the reason you
Speaker 2: would be afraid, picture how you will handle the dog.
Speaker 2: What will you do and decide, first of all, is
Speaker 2: it really a physical threat to you or not? And
Speaker 2: if it is, protect yourself. If it isn't, then decide
Speaker 2: whether you want to just usher the dog out of
Speaker 2: the office or call someone to get rid of it,
Speaker 2: or whatever it is, and do it that way.
Speaker 1: What is the difference between that and let's say cognitive
Speaker 1: behavioral therapy.
Speaker 2: Well, with cognitive behavioral therapy, you kind of think it through.
Speaker 2: There's less about this sort of direct psychophysiological control. So
Speaker 2: you're trying to think about it in a way that
Speaker 2: is logical and maybe is less likely eventually to trigger
Speaker 2: your anxiety, but we sort of go for the money.
Speaker 2: We go for handling the way the body is reacting
Speaker 2: first and teaching her that once she had this realization that, yeah,
Speaker 2: there are times when you want to be afraid of
Speaker 2: an animal, including a dog, but is this one of
Speaker 2: those times? And so you're acknowledging the cause your anxiety,
Speaker 2: but you're controlling the way your body feels. So your
Speaker 2: body is floating and comfortable. You can picture it without
Speaker 2: having that automatic, you know, physiological protection. And the funny
Speaker 2: thing is about people with anxiety and phobias in particular,
Speaker 2: they often don't have an event. It's not that they
Speaker 2: were bitten by a dog a long time ago. It's
Speaker 2: just that they have developed this. And what happens with
Speaker 2: phobias in particular is the more you avoid it, the
Speaker 2: worse it gets. And if you think about it, you
Speaker 2: know what you do if you avoid it is you
Speaker 2: reaffirm psychologically that there must be a reason for being
Speaker 2: so scared of this, and that's why you avoid it.
Speaker 2: And the other thing is you deprive yourself of success stories,
Speaker 2: so you don't get close enough to a dog to
Speaker 2: have a good experience. You know, he just licked your
Speaker 2: hand and it was very nice. You just have the
Speaker 2: fact that you got more and more anxious and more
Speaker 2: and more avoidant, and it replicates itself. So it's not
Speaker 2: about thinking it through or understanding what happened to you
Speaker 2: early in life that led to this. It's a matter
Speaker 2: of trying to intervene with the psychophysiological reaction that tends
Speaker 2: to reinforce the strength of the phobia anxiety.
Speaker 1: I want to take at tense for one second. I
Speaker 1: was going to ask you about your origin story. So
Speaker 1: your father did the exact same thing that you're doing.
Speaker 2: Yeah, well, both of my parents were a psychiatrists psychoanalysts,
Speaker 2: so they told me I was free to be any
Speaker 2: kind of psychiatrist. I wanted to be here. I am.
Speaker 2: But so the dinner table conversations were pretty interesting, and
Speaker 2: I got to watch him make movies of patients who
Speaker 2: had you know, had a woman who had pseudo seizures,
Speaker 2: hysterical pseudo seizures, and he would hypnotize her and take
Speaker 2: her back to the last time she had a seizure
Speaker 2: and she would have another seizure.
Speaker 3: You know.
Speaker 2: So either way, he taught control, and I do this too.
Speaker 2: Is not by telling them, don't make it happen, because
Speaker 2: that's you know, don't think about purple elephants, but rather
Speaker 2: make it happen. That's a way to have control, you know.
Speaker 2: So she would think back to the last time she'd
Speaker 2: have a seizure, and gradually they became milder and milder,
Speaker 2: and instead of feeling frightened and angry and frustrated and
Speaker 2: humiliated when it happened, it was kind of like, oh,
Speaker 2: good for me. You know, I made it happen. So
Speaker 2: you teach them a method of control. That's the opposite
Speaker 2: of fighting it. And I had a woman from who
Speaker 2: I lived up in Napa and was part of one
Speaker 2: of these big wine families. She was having hysterical seizures
Speaker 2: and we don't use that term anymore than's pseudo seizures now,
Speaker 2: But it got bad when her daughter had her first
Speaker 2: baby and the daughter said, Mom, you can't hold the
Speaker 2: baby because I don't want you to have a seizure
Speaker 2: and drop the baby. And that did it for her.
Speaker 2: So it turned out that her problem was that she
Speaker 2: was caught between two generations of a family that were
Speaker 2: fighting one another. So the father was the originator of
Speaker 2: the winery. The sons were fighting him in court over
Speaker 2: the ownership and control of the winery, and she kept
Speaker 2: trying to get them together for Thanksgiving and Christmas, and
Speaker 2: both of them, both sides would be yelling at her.
Speaker 2: And I said, she would call her father every day
Speaker 2: and get yelled at again. And I said, I'll tell
Speaker 2: you what. I'm going to teach you how to control
Speaker 2: these seizures. But you have to do something else, and
Speaker 2: that is, if your father starts screaming at you on
Speaker 2: the phone, hang up, and sooner or later he will
Speaker 2: learn that if he wants to talk to his daughter,
Speaker 2: he better not yell at her. And after a while,
Speaker 2: you know, there were a bunch of times where she
Speaker 2: had to hang up, he stopped yelling at her. And
Speaker 2: I said, it's not your responsibility to make these guys
Speaker 2: stop fighting with each other. You do what you want
Speaker 2: to do. If they come to Thanksgiving dinner, good if
Speaker 2: they don't, okay, and learn to control this. And she's
Speaker 2: she was holding the baby. You know she was able
Speaker 2: and she felt good about it. So you're changing the
Speaker 2: affective tone of the experience with the stimulus that is
Speaker 2: making her anxious, and in this case, changing her ability
Speaker 2: to manage the interactions that we're leading to this distress and.
Speaker 1: Just going back to the origins for me, how old
Speaker 1: is the h How old is this field of.
Speaker 2: It's the oldest Western conception of a psychotherapy. It's two
Speaker 2: hundred and fifty years old. Wow. It started with Franz
Speaker 2: Anton Mesmer. You know the term mesmerized. He mesmerized me.
Speaker 2: He was a Viennese physician who noticed that some of
Speaker 2: his patients would suddenly go into one of these altered states,
Speaker 2: like a pseudo seizure. And he thought that it may
Speaker 2: have to do with badly acting magnetic fields in their bodies.
Speaker 2: And he thought if he put his magnetic field, which
Speaker 2: he thought was better, next to theirs, theirs would get better.
Speaker 2: I don't know why his wouldn't get worse, but and
Speaker 2: he then started He had these packets, these buckets full
Speaker 2: of iron filings that were weakly magnetized, and he would
Speaker 2: put them near that, and some would fall into a
Speaker 2: trance state of some kind, and often they would get better. Actually,
Speaker 2: so there's something about just altering your mental state that
Speaker 2: allows you to just experience difficult things in a different way.
Speaker 2: And he became so popular in Vienna that he left
Speaker 2: his wife and family there and moved to Paris, where
Speaker 2: he became like the celebrity doctor. And if you think
Speaker 2: about it, two hundred and fifty years ago, what was
Speaker 2: the major treatment in medicine. You know what? It was?
Speaker 2: Blood letting. Yeah, let the bad humors out of your body.
Speaker 2: So unless you happen to have polypythemia vira or congestive
Speaker 2: heart failure, you were going to do worse. Seeing a doctor,
Speaker 2: Voltaire wrote to his brother, We did everything we could
Speaker 2: to save father's life. We even sent the doctors away.
Speaker 2: And his office was cheerful. It was brightly lit. There
Speaker 2: were patients hanging around, just helping other patients, talking to
Speaker 2: them about how well they were doing. Regular doctor's officers
Speaker 2: were great. There wasn't there. There wasn't a painting on
Speaker 2: the wall. They were cold and dark, and you got
Speaker 2: bad news and you got blood taken out of your body.
Speaker 2: That was it. It wasn't much fun. So he was
Speaker 2: the The other doctors complained to King Louis about him,
Speaker 2: and he he convened a panel to investigate Mesmer, and
Speaker 2: it included our own Benjamin Franklin, who was having a
Speaker 2: good time in Paris. Back then, it included the famous
Speaker 2: chemist Lauasier, who developed the principles of oxygen chemistry. Shortly
Speaker 2: before he died, developed the idea of the gross national product.
Speaker 2: Brilliant guy. He was beheaded in the revolution. And another
Speaker 2: person on the panel was the inventor of the guilloteae,
Speaker 2: doctor Guillotine too, and he kind of created the mind
Speaker 2: Bobby body problem. And they concluded that hypnosis was nothing
Speaker 2: but heeded imagination. Now, you know what, that's not a
Speaker 2: terrible definition of hypnosis. It's highly focused attention. It's a
Speaker 2: change in brain state. But that was the end of
Speaker 2: Mesmer's career basically. And the problem is that there's been
Speaker 2: one rejection after another. You know, a Scottish surgeon named
Speaker 2: Isdale was traveling around India using hypnosis as general anesthesia.
Speaker 2: You know what was anesthesia before ether? It was, you know,
Speaker 2: getting people drunk and holding them down. It was terrible,
Speaker 2: but hypnosis was actually very effective. It was. And I
Speaker 2: gave a lecture mass general to ether Dome on tolari
Speaker 2: Ago where ether was introduced here and a surgeon strode
Speaker 2: to the front of the amphithiter efforts to say, gentlemen,
Speaker 2: this is no humbug to distinguish hypnosis from ether. You know,
Speaker 2: hypnosis is no humbug. It works, and you know, would
Speaker 2: we use it all the time now, But I've used
Speaker 2: hypnosis in surgical procedures where you don't use general anesthesia,
Speaker 2: and it's an extremely effective analgesic.
Speaker 1: Still incredible, but it depends on the suggestibility of the
Speaker 1: pain part.
Speaker 2: But even in randomized trials that include people of different
Speaker 2: levels of hypnotizability, we show a significant difference. We did
Speaker 2: one where they were injecting through arterial cutdowns in catheters,
Speaker 2: chemo ambolizing tumors in the liver, expanding the renal artery,
Speaker 2: and in all comers, we found if you randomized to
Speaker 2: the standard care condition with able to push a button
Speaker 2: and get opioids into your bloodstream, pain level at the
Speaker 2: end of an hour and a half doing this was
Speaker 2: five out of ten, if you had a supportive nurse
Speaker 2: comforting you, three out of ten, hypnosis one out of ten. Wow,
Speaker 2: and the hypnosis and they were all and the hypnosis
Speaker 2: group was using half the amount of opioids that the
Speaker 2: standard care group was using. And the procedures got done
Speaker 2: seventeen minutes.
Speaker 1: So what do you see as the thing that gets
Speaker 1: in the way of hypnosis or why it gets rejected.
Speaker 2: I don't know. I mean, we published that study in
Speaker 2: the Lancet, you know, not yet big randomized trial. If
Speaker 2: what we had used was a drug, everybody, every hospital
Speaker 2: in the country would be using it now. And I think,
Speaker 2: I think there are a couple of things, David. You know,
Speaker 2: we're both in the psychiatry department at Stanford. We know
Speaker 2: that psychiatry. You know, we're like the Rodney Dangerfield of
Speaker 2: medical things. You know, we don't get no respect. You know.
Speaker 2: He once said, they asked me to leave a bar
Speaker 2: so they could start happy hour, you know. And people
Speaker 2: have this prejudice against what goes on in the brain,
Speaker 2: and they think if you use your brain to solve problems,
Speaker 2: the problem started in your brain. Well that's not true.
Speaker 2: You know, you have people, we have people who've had
Speaker 2: injuries to their knees, have knee replacements, and they do
Speaker 2: better with hypnosis plus other kinds of analgesia than those
Speaker 2: who just have the standard analgesia, and they're less likely
Speaker 2: to get addicted to opioids. It's teaching this brain is
Speaker 2: this incredible instrument, as you have depicted beautifully in your writings,
Speaker 2: that we don't that doesn't get the respect it deserves.
Speaker 2: And we think that the only real interventions in medicine
Speaker 2: are ingestion, injection or infusion, and that is not true.
Speaker 2: You know, we do remarkable things with our brains that
Speaker 2: can make our lives better. And so it's it's a
Speaker 2: kind of prejudice that we have to get over, and
Speaker 2: I'm sorry to see it, but that's what we're still
Speaker 2: stuck with.
Speaker 1: And have you you've done brain imaging in your Yeah.
Speaker 2: I've done functional magnetic residence imaging. We've taken highly hypnatizable people,
Speaker 2: put them in the scanner and compared to low hypnotizables.
Speaker 2: Put them in the scanner, give them a bunch of
Speaker 2: tasks and so control tasks, and then we look at
Speaker 2: what are the things that happen only in the highly
Speaker 2: hypotizable people and only when they're in a hypnotic state,
Speaker 2: and we find three things happen. One is reduced activity
Speaker 2: in the dorsal anterior cingulate cortex. So that's part of
Speaker 2: the salience networks, the brain's alarm system. It does pattern matching,
Speaker 2: and you hear a loud noise and you get distracted.
Speaker 2: That's your dorsal anterior singular thing. There's trouble here. You
Speaker 2: better divert what you're doing and focus on that. So
Speaker 2: it's a it's a safety system for the body. If
Speaker 2: you turn down activity there, you're allowing yourself to focus
Speaker 2: more intently on other things. And that's what happens in hypnosis.
Speaker 2: We found in another study that highly hypnotizable people have
Speaker 2: more GABA menu butteric acid, the inhibitory neurotransmitter in the
Speaker 2: brain than low hypnotizable people. So it's like having your
Speaker 2: own little pharmacy on standby because what bendza diezepines do.
Speaker 2: They increase GABA in the brain and so they can
Speaker 2: mobilize more gabba to inhibit anxiety, inhibit pain response than
Speaker 2: people who are less hypnotizable. So that's one thing. The
Speaker 2: second thing that happens is more functional connectivity. So the
Speaker 2: first thing I said was activity, How active is the area?
Speaker 2: The second is when one area is active, is a
Speaker 2: related area active or not? And we find more functional
Speaker 2: connectivity between the prefrontal cortex, particularly on the left and
Speaker 2: the insula, which is you know this insula means island
Speaker 2: in Latin. This island of tissue in the middle of
Speaker 2: the frontal cortex that is a mind body pathway. So
Speaker 2: it's a way in which the brain controls the body,
Speaker 2: and it's also a place where you have greater inter reception.
Speaker 2: You're better able to perceive what's going on in your
Speaker 2: body so that it makes sense in hypnosis. You can
Speaker 2: better feel what's going on in your body and better
Speaker 2: control what's going on in your body. We had a
Speaker 2: group of students years ago that we brought in first
Speaker 2: thing in the morning, no breakfast, and had them eat
Speaker 2: imaginary meals for an hour. They would take we'd take
Speaker 2: a gastronomictory of the Bay area, and Ken Klein was
Speaker 2: a gastorineurologist worked with me, had a nasogastric tube down
Speaker 2: and he would measure a gastrior gacid secretion. And one
Speaker 2: woman was so caught up in this imaginary food that
Speaker 2: she said, after about half an hour, let's stop. I'm full,
Speaker 2: you know, So it seemed real. Those subjects had an
Speaker 2: eighty nine percent increase in gastric acid secretion. So we're
Speaker 2: narrowly David. You wouldn't think you could do that, but
Speaker 2: you can. You can change your stomach's preparation for a meal.
Speaker 2: We then did the opposite. We had them imagine and
Speaker 2: hypnosis that they were on a desert island doing anything
Speaker 2: but eating or drinking. Thirty nine percent decrease in gastrior
Speaker 2: acid secretion, and then we injected them with pentagastrin, which
Speaker 2: triggers maximal prietal cell output of gastric acid. We still
Speaker 2: in the hypnosis condition had a nineteen percent decrease. So
Speaker 2: the brain is much better better at controlling what's going
Speaker 2: on in the body than we give ourselves credit for.
Speaker 2: The third thing that happens in the MRI scanner, you
Speaker 2: see inverse functional connectivity between activity and the prefrontal cortex
Speaker 2: and activity in the posterior singulate. Now that is, you know,
Speaker 2: as part of what we call the default mode network.
Speaker 2: It's what your brain does when you're not working or
Speaker 2: doing anything particular, but thinking about who you are, what
Speaker 2: you are, what people think of you, what your mother
Speaker 2: wanted you to be, all kinds of things like that,
Speaker 2: and it's the thing that kind of keeps you on course.
Speaker 2: Sometimes you know who you are and what you are
Speaker 2: and what you're supposed to do. But it also can
Speaker 2: keep you in a kind of rigid state where you
Speaker 2: don't want to change. I should be like this, I
Speaker 2: shouldn't be like that, And yeah, you know, I sometimes
Speaker 2: call it the my fault mode network, where you just
Speaker 2: you know, think about what's wrong with you. And so
Speaker 2: when you're active in hypnosis, you're inhibiting activity in the
Speaker 2: posterious singulate. Now, interestingly, that's the same thing that happens
Speaker 2: in studies of long term meditators that they have lower
Speaker 2: natural activity in the posterior singular cortex. And it's also
Speaker 2: the major finding with psychedelics.
Speaker 1: I was just going to ask about that. So your
Speaker 1: interpretation of that is when the default mode network is
Speaker 1: running strong, people are essentially running in the same loops.
Speaker 1: Let's take the mountain analogy. You've got a certain number
Speaker 1: of ski runs down the mountain, and everyone's just staying
Speaker 1: in those ski runs.
Speaker 2: That's exactly right.
Speaker 1: But when you inhibit that, people think, oh, I can
Speaker 1: actually ski down the mountain this other way that nobody's
Speaker 1: taking with it.
Speaker 2: Well, just you know, for example, you know I've been there,
Speaker 2: you know where you think, oh god, that's steep. I
Speaker 2: am not the kind of skier can do that. You know.
Speaker 2: But if you're loosening up your default mode network, and
Speaker 2: if you're getting more engaged in what you're doing, you say,
Speaker 2: you know what if I take it this way in
Speaker 2: that way, If I don't make this the bad skiers
Speaker 2: mistake of leaning backwards going down the hill, which gives
Speaker 2: me less control over the skis. But you allow yourself
Speaker 2: to lean forward, the edges work better and you actually
Speaker 2: have more control over how you're turning and how you
Speaker 2: can stop if you need to. So I, when I
Speaker 2: do that, I have to suppress activity in my default
Speaker 2: mode networks is saying, are you crazy? You can't do that?
Speaker 2: And give it a try. So that's right. And so
Speaker 2: I actually think that hypnosis is a kind of less toxic,
Speaker 2: much more controllable psychedelic experience where you just allow yourself
Speaker 2: to try out things that are different and see what
Speaker 2: it feels like. But you can turn it on and
Speaker 2: you can turn it off.
Speaker 1: Do you suppose if you look across the population, so
Speaker 1: some people are more hypnotizable. I'm totally speculating here, but
Speaker 1: do you suppose that those are the people that are
Speaker 1: more attracted to literature? Because when I go into the bookstore,
Speaker 1: I notice that some read fiction, some only go to
Speaker 1: the nonfiction section, right, But for the people who are
Speaker 1: going and they want to read a story and step
Speaker 1: into the shoes of a protagonist and be someone else,
Speaker 1: do you suppose it would be a correlation there?
Speaker 2: I think so, I think. I mean, I haven't seen
Speaker 2: a study like that, but I think, you know, in
Speaker 2: role we actually it's interesting. On the every app we
Speaker 2: call people who test out to be highly hypnotizable, the
Speaker 2: poets that you know, they just the imagined world and
Speaker 2: the real world can become the real world for you,
Speaker 2: and so it's easy to go into that. Whereas we
Speaker 2: call the low hypnotizables the researchers you know that, and
Speaker 2: low hypnotizalar people that just you know, have to analyze
Speaker 2: everything and read about it, just just what you're saying now.
Speaker 2: They may read books, so they may be part of
Speaker 2: who's populating the bookstores, but it's different kinds of books.
Speaker 2: And the mid range people we call diplomats who will
Speaker 2: try and experience and then step back and think about
Speaker 2: what it's like. I had one day in the office
Speaker 2: when it was perfect, you know, the first person was
Speaker 2: at ten on the hypnotic in very hypnotizable. She had
Speaker 2: some really bad neck pain and it just went away.
Speaker 2: You know. I just had her imagine you had this
Speaker 2: hot pack on your neck filter their head out of
Speaker 2: the pain. Thank you doctor. She's out the door. She
Speaker 2: loved it. The second patient with somebody who had had
Speaker 2: a knee injury seven years earlier. He was carrying a
Speaker 2: very heavy crate with a guy who dropped it and he,
Speaker 2: you know, did real damage to his knee. And it's
Speaker 2: seven years later and his knee still isn't working right.
Speaker 2: But he've been going from one doctor to another who
Speaker 2: all say, well, you know, you've got some problem there,
Speaker 2: but it's not that bad. And he would say, no,
Speaker 2: there's got to be a solution to this, you know.
Speaker 2: And he was like a zero. He was just not hypnotizable.
Speaker 2: And I said, you know, I don't know how much
Speaker 2: I can help you, but I'm wondering if maybe your
Speaker 2: doctor's are right, and it's your irritation at whatever limitation
Speaker 2: you have that is really what's causing you more pain
Speaker 2: than the actual pain itself. And he said, you know, Doc,
Speaker 2: you're the first doctor who's ever told me that. And
Speaker 2: I think you're right. See, I said, I think you're
Speaker 2: just so irritated by it that even the slightest hint
Speaker 2: and you go off the rails. And so I had,
Speaker 2: you know, two people with opposite extreme. I was a
Speaker 2: hypnotizability who be helped, but in rather different ways.
Speaker 1: In general, if you're looking at this spectrum across the population,
Speaker 1: from the zero to ten, the not so hypnotizable to
Speaker 1: very hypnotizable, what are the pros and cons. Let's say
Speaker 1: we're looking at the up end of the scale. If
Speaker 1: you're a highly hypnotizable person just walking around in daily life,
Speaker 1: what are the pros and cons of that?
Speaker 2: Y you know, imaginative involvement. You can easily get into things,
Speaker 2: and you can tune into people, and you can, you know,
Speaker 2: see things from their point of view. They're often very intuitive,
Speaker 2: they relate well to people, but sometimes they get kind
Speaker 2: of taken in by it. You know, they can it's
Speaker 2: they're so cognitively flexible that they can be talked out
Speaker 2: of a position that they know is pretty good and
Speaker 2: reasonable and affiliate with something that in the long run
Speaker 2: may not be the right thing to affiliate with. They
Speaker 2: tend to enjoy these sort of emotional experiences. They get
Speaker 2: into movies in theater and things like that. The low
Speaker 2: hypnotizables are more large, logical and rational and want to
Speaker 2: think things through before they accept much of anything. And
Speaker 2: the world needs people like that too. You know, they
Speaker 2: don't they don't just give themselves to it, but they
Speaker 2: can acquire it if they do it on their terms.
Speaker 2: So it's a matter of, you know, sort of more
Speaker 2: of the poet or more the researcher kind of approach,
Speaker 2: but both people can do well. I had I'll tell
Speaker 2: you I just I had a lawyer who had tenadis
Speaker 2: for like five years. Was driving her nuts and she
Speaker 2: told me, I said, what do you do that you enjoy?
Speaker 2: I she's a scuba diver, and I said, okay, here's
Speaker 2: what we're going to do. And I got her hypnotized,
Speaker 2: and I said, I want you to imagine that the
Speaker 2: tenadus is the sound of your the bubbles and your regulator,
Speaker 2: and just picture how you feel. Because she loved diving
Speaker 2: and she would go to the greatest places and just
Speaker 2: enter that other world. And I want you to experience
Speaker 2: it as the bubbles in your regulator. And she thanked me.
Speaker 2: She said, this is the first time I felt comfortable
Speaker 2: in five years.
Speaker 1: The thing that gets people about tenetus is they pay
Speaker 1: attention to it and they try to make it they're
Speaker 1: fighting against it instead of thinking it's a very pleasant
Speaker 1: sort of thing.
Speaker 2: That's exactly.
Speaker 1: Yeah. So what advice would you give to listeners here?
Speaker 2: Well, you know, I've David found, you know, over fifty
Speaker 2: years of doing work with using hypnosis and using it
Speaker 2: with about seven thousand people, that it helps a lot
Speaker 2: of people and it doesn't hurt anybody, and that's not
Speaker 2: true of most of the things we do in medicine,
Speaker 2: and so but I realized, I'm glad about that, but
Speaker 2: so many more people could get help from this, you know,
Speaker 2: and because they don't know about it, or what they
Speaker 2: know is wrong, because of their prejudice against it, because
Speaker 2: people think it's weird, or it's not possible that you know,
Speaker 2: people could just do it with their head, or if
Speaker 2: they do it was it wasn't real in the first place.
Speaker 2: All of these misconceptions, a lot of people are missing
Speaker 2: an opportunity to help themselves feel better and do better.
Speaker 2: And so I thought, my legacy gift is going to
Speaker 2: be making it available to anybody who wants it. So
Speaker 2: about five years ago I was talking at a brain
Speaker 2: Mind summit at Stanford, and Aeriel Pohlar, who's a helped
Speaker 2: found Stravo, which is a really good, you know, cycling app,
Speaker 2: came up to me in Stanford Business School mit and
Speaker 2: he said, David, would you you want to try an app?
Speaker 2: See if I could put it, put it on an
Speaker 2: app and see what Amazon it is at a time
Speaker 2: when Amazon was pushing Alexa and they were making it
Speaker 2: easy to program your own app. So we did, and
Speaker 2: I said, well, let's help people stop smoking. So the
Speaker 2: approach there was focus on what you're for. So think
Speaker 2: of this for my body smokings of poison. I need
Speaker 2: my body to live. I owe my body respected protection.
Speaker 2: You would never put hot air laced with tory nicotine
Speaker 2: into your dog's lungs or your baby's lungs. Your body's
Speaker 2: as innocent as they are, so protect and respect your body.
Speaker 2: And so we had people do that, and one out
Speaker 2: of four stopped after a single use of the of
Speaker 2: the app, and the rest cut down their average cigarette
Speaker 2: and consumption by about fifty percent. I had one social
Speaker 2: worker who said I didn't even want to stop smoking.
Speaker 2: I smoked for twenty five years. I signed up for
Speaker 2: your study. I didn't like it the first time. The
Speaker 2: second time, I looked at the cigarette and said, who
Speaker 2: needs this? And I put it out and I haven't
Speaker 2: had a cigarette since. My friends can't believe it. I
Speaker 2: can't believe it. She said, this is some kind of
Speaker 2: crazy as voodoo shit, and I mean that in a
Speaker 2: good way. Said, so we figured it's working. So Ariel
Speaker 2: and I formed a company where every stand or professor
Speaker 2: like you has to have a startup. We do, and
Speaker 2: we've had one point two million downloads. Now we have
Speaker 2: a terrific team. We're using AI to manage my responses
Speaker 2: that you can actually have an interaction with me as
Speaker 2: if you were in my office. And you know, I
Speaker 2: used to think, is it as good as being in
Speaker 2: my office? While the smoking results were just the same.
Speaker 2: And I want to leave this world with an opportunity
Speaker 2: to manage these very common, very serious problems like pain
Speaker 2: and anxiety and insomnia and bad habits in a way
Speaker 2: that often helps and never hurts.
Speaker 1: That was doctor David Spiegel for me. A few things
Speaker 1: really stand out from the conversation. First, I have to
Speaker 1: confess that I was surprised when I first learned about
Speaker 1: a decade ago that one of my departmental colleagues studies hypnosis,
Speaker 1: because my assumption had been that that was some sort
Speaker 1: of party trick. But after talking with David Spiegel, one
Speaker 1: learns that what he refers to as hypnosis is built
Speaker 1: from the systems our brains use every day, attention, expectation, imagination.
Speaker 1: What changes in hypnosis is how tightly those systems are linked,
Speaker 1: which allows people, and some people more than others, to
Speaker 1: really dissociate and ski down different parts of the mountain. Second,
Speaker 1: on a brain level, we heard that hypnosis involves measurable
Speaker 1: changes in specific networks, for example, regions that handle focus
Speaker 1: and executive control, regions that monitor self reflection and mind wandering,
Speaker 1: and areas that integrate body sensations and emotion. When these
Speaker 1: networks reconfigure, people can experience what seem to be clinically
Speaker 1: meaningful reductions in pain and anxiety and trauma. This is
Speaker 1: observable in brain imaging and in clinical outcomes. I'm linking
Speaker 1: several papers to the show notes. The third thing I
Speaker 1: want to point out is that hypnotizability is a trait
Speaker 1: with a whole spectrum of individual differences, influenced by how
Speaker 1: your brain organizes attention and control. Some people are naturally
Speaker 1: very wonts of others are less so, and everywhere along
Speaker 1: the spectrum. I'm very interested to see how our science
Speaker 1: develops an understanding of this, Like, are some people just
Speaker 1: better at popping out of their default mode network? And
Speaker 1: here's my silly hypothesis, are these the people who get
Speaker 1: more deeply pulled into works of literature? Who knows if
Speaker 1: that's right, But it'll be great to see how this
Speaker 1: science evolves. We're just at the beginning of understanding how
Speaker 1: all these networks work together. But as you heard from
Speaker 1: David Spiegel today, hypnosis can be used as a serious
Speaker 1: tool in medicine and mental health to help some people
Speaker 1: manage pain, to reduce anxiety and distress, and to work
Speaker 1: with aspects of trauma and habit breaking. Is it a
Speaker 1: cure all No, It has its limits and is probably
Speaker 1: best positioned side by side with other evidence based approaches.
Speaker 1: But for me, the awe inspiring part is that hypnosis
Speaker 1: gives us a small experimental window into how the brain
Speaker 1: constructs reality. If your arm hurts, it seems like that
Speaker 1: should just be a raw signal, but it's not. It's
Speaker 1: a signal that gets interpreted through attention, through beliefs, through context.
Speaker 1: If you change those ingredients in the right way, the
Speaker 1: experience can change again. I'm linking papers that demonstrate this.
Speaker 1: This doesn't mean that we can think away every symptom
Speaker 1: or circumstance, but it does tell us that our experience
Speaker 1: is slightly more adjustable than it may first appear. The
Speaker 1: boundary between expectation and sensation just might be more flexible
Speaker 1: than most of us were taught. If this episode was useful,
Speaker 1: consider sharing it with someone who's dealing with pain or anxiety,
Speaker 1: or who's simply curious about how much influence our thoughts
Speaker 1: can have on our experience. Go to eagleman dot com
Speaker 1: slash podcast for more information and to find further reading.
Speaker 1: Join the weekly discussions on my substack and check out
Speaker 1: some Pbscribe to Inner Cosmos on YouTube for videos of
Speaker 1: each episode and to leave comments until next time. I'm
Speaker 1: David Eagleman, and this is Inner Cosmos.