back to indexDr. David Spiegel: Using Hypnosis to Enhance Health & Performance | Huberman Lab Podcast #60
link |
Welcome to the Huberman Lab Podcast,
link |
where we discuss science and science-based tools
link |
for everyday life.
link |
I'm Andrew Huberman,
link |
and I'm a professor of neurobiology and ophthalmology
link |
at Stanford School of Medicine.
link |
Today, my guest is Dr. David Spiegel.
link |
Dr. Spiegel is the Associate Chair
link |
of Psychiatry and Behavioral Sciences
link |
at Stanford University School of Medicine.
link |
He is also the Director of the Stanford Center
link |
on Stress and Health.
link |
Dr. Spiegel is both a researcher
link |
and a clinician, meaning he runs a laboratory
link |
that studies the brain and the body
link |
and neural mechanisms of how the brain and body interact.
link |
And he sees patients as a psychiatrist at Stanford.
link |
His work is incredibly unique
link |
in that it bridges mind and body,
link |
but it also has a particular focus
link |
on the clinical applications of hypnosis.
link |
As you'll learn today, hypnosis is a unique brain state
link |
in which neuroplasticity, the brain's ability to change
link |
in response to experience, may be heightened.
link |
And indeed, the use of clinical hypnosis
link |
by Dr. Spiegel and colleagues has been shown
link |
to improve symptoms of stress, chronic anxiety,
link |
chronic pain, and various other illnesses,
link |
including many psychiatric illnesses
link |
and even outcomes in cancer.
link |
Today, we discuss hypnosis in the context
link |
of what's called self-hypnosis
link |
to distinguish it from stage hypnosis.
link |
Many of you are probably familiar with stage hypnosis,
link |
which is really about a hypnotist getting a person
link |
to do things they would not otherwise do.
link |
In contrast, clinical hypnosis and the use of hypnosis
link |
for the treatment of various ailments of mind and body
link |
is vastly different.
link |
It involves getting people to change their brain state
link |
and to use that brain state as a portal
link |
to make adjustments in their brain and body
link |
and other aspects of their biology and psychology
link |
that benefit them.
link |
And it's been shown over and over again
link |
in studies by Dr. Spiegel and colleagues
link |
that those changes can occur extremely quickly.
link |
Now, not everybody can be hypnotized as readily as the next.
link |
And so today we also discuss a simple test developed
link |
by Dr. Spiegel that can help you determine
link |
whether or not you have a high, medium, or low degree
link |
of what we call hypnotizability.
link |
Dr. Spiegel is truly an expert in this area.
link |
He has published over 480 journal articles,
link |
170 book chapters on hypnosis,
link |
and on things like psychosocial oncology,
link |
which is the interaction of mind and body
link |
in the treatment of cancer and cancer outcomes,
link |
on stress physiology, trauma,
link |
and other aspects of psychotherapy.
link |
He's published 13 books.
link |
So he's truly the world expert in hypnosis
link |
and clinical applications of hypnosis for mind and body.
link |
I'm certain that in listening to today's episode,
link |
you're going to learn a tremendous amount
link |
about how the brain and body interact,
link |
about various treatments for all sorts of common ailments
link |
and you're going to get access to tools,
link |
in particular, a tool that was developed by Dr. Spiegel,
link |
which is the Reveri app, R-E-V-E-R-I.
link |
The Reveri app is currently only available for Apple,
link |
but will soon also be available for Android.
link |
It does carry a nominal cost,
link |
but there is a seven-day free trial.
link |
If you'd like to try it,
link |
we're providing a link in the show notes.
link |
The Reveri app is special in that it is based
link |
on clinical studies and research done
link |
in the Spiegel lab at Stanford.
link |
So unlike a lot of hypnosis apps out there
link |
and resources for hypnosis,
link |
it was developed with clinical treatments in mind.
link |
Today, we also discussed the use of breath work,
link |
and I'm very fortunate that my research lab at Stanford
link |
has been collaborating very closely with Dr. Spiegel
link |
in testing and developing specific breath work protocols
link |
to adjust mind and body for things like anxiety,
link |
improving mood, and improving sleep.
link |
Based on his incredible and unique expertise
link |
and the clarity with which Dr. Spiegel
link |
communicates information,
link |
I anticipate that you will really enjoy today's episode
link |
and that you'll come away from it
link |
with a lot of actionable tools.
link |
Some of you might be curious what a clinical hypnosis
link |
session looks like.
link |
And for that reason, we had Dr. Spiegel hypnotize me.
link |
A clip of that hypnosis session is going to be posted
link |
to the Huberman Lab Clips channel,
link |
which is available on YouTube.
link |
Before we begin, I'd like to emphasize that this podcast
link |
is separate from my teaching and research roles at Stanford.
link |
It is, however, part of my desire and effort
link |
to bring zero cost to consumer information about science
link |
and science-related tools to the general public.
link |
In keeping with that theme,
link |
I'd like to thank the sponsors of today's podcast.
link |
Our first sponsor is Athletic Greens.
link |
Athletic Greens is an all-in-one
link |
vitamin mineral probiotic drink.
link |
I've been taking Athletic Greens since 2012,
link |
so I'm delighted that they're sponsoring the podcast.
link |
The reason I started taking Athletic Greens
link |
and the reason I still take Athletic Greens
link |
once or twice a day is that it covers all of my foundational
link |
vitamin mineral probiotic needs.
link |
There is now ample evidence that probiotics
link |
can be very helpful for supporting
link |
what is called the gut microbiome.
link |
The gut microbiome is an aspect of our biology
link |
in which little gut microbiota live
link |
all along our digestive pathway
link |
and help support various aspects of our biology,
link |
including our immune system, our metabolic system,
link |
our hormones or endocrine system,
link |
as well as what's called the gut-brain axis,
link |
which is literally communication between the gut
link |
and the brain to support things like mood, motivation,
link |
and various other aspects of brain health.
link |
With Athletic Greens, I get the probiotics
link |
that I need to support a healthy gut microbiome
link |
and the vitamins and minerals tap off any deficiencies
link |
I might have based on lack of certain foods
link |
and lack of certain nutrients in my diet.
link |
If you'd like to try Athletic Greens,
link |
you can go to athleticgreens.com slash Huberman
link |
to claim a special offer.
link |
They give you five free travel packs
link |
plus a year supply of vitamin D3 K2.
link |
There's a lot of evidence now that vitamin D3
link |
is critically important for various aspects
link |
of immediate and long-term health.
link |
And while many people get enough vitamin D3,
link |
many people do not.
link |
So the year supply of vitamin D3 ought to be very useful
link |
And K2 has been shown to be important for calcium regulation,
link |
various aspects of metabolic health and so forth.
link |
So again, if you'd like to try Athletic Greens
link |
and get that special offer, the five free travel packs
link |
and year supply of vitamin D3 K2,
link |
go to athleticgreens.com slash Huberman.
link |
Today's episode is also brought to us by Thesis.
link |
Thesis makes custom nootropics.
link |
Nootropic is a smart drug.
link |
And personally, I'm not a big fan of the concept
link |
of a smart drug, at least not the way that most people
link |
talk about smart drugs or nootropics,
link |
for the following reason.
link |
Being smart involves various things.
link |
There is creativity, there's focus,
link |
there's task switching and so on.
link |
And each one of those involves different operations
link |
in the brain, different neural circuits,
link |
different neurochemicals have to be deployed
link |
in order for us to, for instance, be very focused
link |
or for us to be very creative
link |
or for us to be able to switch tasks easily.
link |
Thesis understands this.
link |
And for that reason, they've developed custom nootropics
link |
that are aimed at getting your brain and body
link |
into particular states for particular types of work
link |
or physical activity.
link |
In order to accomplish that,
link |
they created unique blends of high quality ingredients.
link |
And each of those blends is designed to get your brain
link |
and body into a particular mode, such as focus,
link |
clarity, or motivation.
link |
I've been using Thesis nootropics for over six months now.
link |
And I have to say, it's been a total game changer
link |
and very unique from the experience of using
link |
sort of what I call catch all nootropics.
link |
So with Thesis, it's really directed
link |
toward particular brain body states.
link |
I should also mention that they tailor
link |
those custom blends to you.
link |
So by taking a quiz on their site,
link |
they will tailor the blend to you and your specific needs
link |
and the things you don't want.
link |
So if you want to try your own
link |
personalized nootropic starter kit,
link |
you can go online to takethesis.com slash Huberman.
link |
You'll take a three minute quiz
link |
and Thesis will send you four different formulas
link |
to try in your first month.
link |
And then based on the outcomes with those,
link |
they can update your formulations for you.
link |
That's takethesis.com slash Huberman
link |
and use the code Huberman at checkout
link |
to get 10% off your first box.
link |
Today's episode is also brought to us by Roka.
link |
Roka makes eyeglasses and sunglasses
link |
that I believe are of the utmost quality.
link |
The company was founded by two all American swimmers
link |
from Stanford and everything about the design
link |
of Roka eyeglasses and sunglasses
link |
was created with performance in mind.
link |
There are a number of things about Roka sunglasses
link |
and eyeglasses that I particularly like.
link |
First of all, they're extremely lightweight.
link |
You basically forget that you're wearing them.
link |
Second of all, you can wear them for work,
link |
for going out to dinner, et cetera.
link |
They have great aesthetics, so you can wear them anywhere,
link |
but also for exercise.
link |
You can wear them when running or cycling.
link |
And even if you get sweaty,
link |
they're designed so that they don't slip off your face.
link |
Another terrific feature of Roka eyeglasses and sunglasses
link |
is that they were designed with the biology
link |
of the visual system in mind.
link |
We all have the experience of being in a shaded area
link |
and then going to a bright area.
link |
It takes some time for your eyes to adjust or to adapt.
link |
Many sunglasses make it hard to see
link |
as you move from one environment to the next
link |
and therefore you have to take on and off your sunglasses.
link |
With Roka sunglasses, you don't have to do that.
link |
You don't even notice the transitions
link |
between those bright areas and those dimmer areas.
link |
So you can wear them anywhere, anytime.
link |
And again, most of the time you don't even realize
link |
that they're on your face.
link |
If you'd like to try Roka eyeglasses and sunglasses,
link |
go to roka.com, that's R-O-K-A.com
link |
and enter the code Huberman to save 20% off
link |
Again, that's Roka, R-O-K-A.com
link |
and enter the code Huberman at checkout.
link |
And now for my discussion with Dr. David Spiegel.
link |
David, thank you so much for being here.
link |
Andrew, my pleasure.
link |
Can you tell us what is hypnosis?
link |
Hypnosis is a state of highly focused attention.
link |
It's something like looking through the telephoto lens
link |
of a camera in consciousness.
link |
What you see, you see with great detail,
link |
but devoid of context.
link |
If you've had the experience of getting so caught up
link |
in a good movie that you forget you're watching a movie
link |
and enter the imagined world, you're part of the movie,
link |
not part of the audience,
link |
you're experiencing it, you're not evaluating it.
link |
That's a hypnotic like experience
link |
that many people have in their everyday lives.
link |
So is any experience that really draws us in hypnotic
link |
Or let me give a different example.
link |
If I'm watching a sports game
link |
and I'm really wrapped up in the game,
link |
but I'm also in touch with how it makes me feel in my body,
link |
kind of registering the excitement or the anticipation,
link |
is that a state of hypnosis also?
link |
Because you mentioned there's kind of a narrowing
link |
of context, but a kind of losing of the self.
link |
Or do I have that right?
link |
Yes, it is true that to the extent that your somatic,
link |
your body experience is a part of the sport event
link |
that you're engaged with,
link |
I'd say that is a self-altering hypnotic experience.
link |
If your physical reactions are distracting you
link |
or make you think about something else,
link |
that's when it's less hypnotic like
link |
and more just one of a series of experiences.
link |
how did you get into this business of hypnosis?
link |
Because I think for most people,
link |
when they hear hypnosis or they think about hypnosis,
link |
they think of stage hypnosis.
link |
I think of somebody with a pendant going back and forth
link |
or people up on a stage,
link |
you're behaving abnormally for the entertainment of others.
link |
How did you get into hypnosis as an interest, as a practice?
link |
could you contrast the sort of hypnosis that you do
link |
in the clinical setting with the sort of hypnosis
link |
that a stage hypnotist does?
link |
Well, it is something of a genetic illness in my family.
link |
Both of my parents were psychiatrists and psychoanalysts
link |
and they told me I was free to be any kind of psychiatrist
link |
I wanted to be, so here I am.
link |
My father was training to be a psychoanalyst in 1943
link |
and he ran into a Viennese refugee
link |
who couldn't serve in the army but who had studied hypnosis.
link |
And actually it would interest you
link |
doing your ophthalmological research.
link |
He had a smallpox scar right in the middle of his forehead
link |
and he did forensic examinations
link |
and he noticed that some of the prisoners
link |
would focus on that spot on his forehead
link |
and then close their eyes and seem to go to sleep
link |
but they were in some altered state.
link |
So he got interested in hypnosis.
link |
He used it forensically.
link |
His name was Gustav von Aschaffenburg
link |
and he offered to teach young psychiatrists
link |
how to use hypnosis when they went off into the war.
link |
And so he trained my father
link |
and my father got off the analytic couch
link |
and the analyst mentioned it to him.
link |
That's how he found out about it.
link |
And my father said, did I say something wrong in analysis?
link |
Why is he talking to me now?
link |
And he found it very useful in helping soldiers
link |
who had acute pain when they were wounded
link |
and helping people with conversion
link |
post-traumatic stress disorders.
link |
And when he came back, he went back to his training
link |
but he still was sort of interested in it.
link |
And he had his, one of his supervisors
link |
was Frieda Fromreichmann who was a very famous psychoanalyst
link |
and he said that he had been told to stop doing hypnosis
link |
because it would ruin his reputation as an analyst.
link |
And she said to him, what are you so worried
link |
about your reputation for?
link |
You're gonna give a course at the institute in hypnosis
link |
and I know you're gonna do it because I'm gonna take it.
link |
So he was teaching Frieda Fromreichmann hypnosis
link |
and he just kept doing it and after a while
link |
he discovered that he was getting better results
link |
with a few sessions of hypnosis
link |
than he was with daily psychoanalysis with his patients
link |
and so he switched his practice.
link |
And so the dinner table conversations
link |
were pretty interesting and occasionally
link |
when he was making a movie of a patient,
link |
I would get to watch that.
link |
And so when I went to medical school,
link |
I figured I'll take a course.
link |
There was Tom Hackett who was a chair of psychiatry
link |
at Mass General was teaching it.
link |
It was a very interesting course.
link |
And the day that converted me was I was doing my rotation
link |
at Children's Hospital in Boston
link |
and the nurse is telling me,
link |
Spiegel, your next patient is an asthmatic
link |
in room 437 or something and I'm just following
link |
the sound of the wheezes down the hall.
link |
I go in the room, this is 16-year-old girl,
link |
knuckles white, bolt upright in bed, struggling for breath.
link |
You can hear the wheezing.
link |
She twice had subcutaneous epinephrine, didn't work.
link |
They were thinking about general anesthesia
link |
and starting her on steroids.
link |
And her mother's there crying.
link |
And I said, I don't know what else to do.
link |
So I said, you want to learn a breathing exercise?
link |
And she nods and I got her hypnotized.
link |
And then I realized we hadn't gotten
link |
to asthma in the course yet.
link |
So I made up something very complex.
link |
I said, each breath you take will be a little deeper
link |
and a little easier.
link |
And within five minutes, she's lying back in bed.
link |
Her knuckles aren't white, she's not wheezing.
link |
Her mother stopped crying.
link |
The nurse ran out of the room.
link |
And my intern comes to find me.
link |
And I figure he's going to pat me on the back
link |
and say, nice job, Spiegel.
link |
He said, the nurse has filed a complaint with a nursing
link |
supervisor that you violated a Massachusetts law
link |
by hypnotizing a minor without parental consent.
link |
And I thought, well, that's nice.
link |
I doubt there is a law like this.
link |
So the intern says, you're going to have
link |
to stop doing this with her.
link |
He said, it's dangerous.
link |
I said, you're going to give her generalized anesthesia
link |
and put her on steroids, and talking to her is dangerous?
link |
He said, well, you'll have to do it.
link |
And I said, I'll tell you what, take me off the case
link |
But I'm not going to tell a patient of mine
link |
anything I know is not true.
link |
So there was a battle over the weekend about what to do.
link |
And the intern, the chief resident, attending,
link |
we're all arguing about it.
link |
And on Monday, they came back with a radical idea.
link |
They said, let's ask the patient.
link |
I don't think this has ever been done at Children's Hospital
link |
And she said, oh, I like this.
link |
She'd been hospitalized every month for three months
link |
in status asthmaticus.
link |
She did have one subsequent hospitalization,
link |
but after that, went on to study to be a respiratory therapist.
link |
And I thought that anything that can help a patient that much,
link |
violate a nonexistent Massachusetts law,
link |
frustrate the nursing supervisor,
link |
had to be worth looking into.
link |
So I just kept doing it.
link |
I discovered that all of my classmates in medical school
link |
had just read the new issue of the New England Journal
link |
and had some new medication to suggest.
link |
And surgeons would say, look, if you
link |
can help this guy with his pain or his anxiety, anything
link |
above the neck, that's yours.
link |
So I was having fun and being able to learn
link |
how to help people in a way that just otherwise was not
link |
And so it got me thinking about the fact
link |
that we're born with this brain, but we don't
link |
have a user's manual for it.
link |
And we don't use it nearly as well as we can.
link |
And that's something your research is all about, too.
link |
And so I thought, I want to understand this better,
link |
and I want to see what we can do.
link |
Stage hypnotists drive me nuts.
link |
They make fools out of people.
link |
There was one, this is a case my father was involved.
link |
He got a call from, he was at Columbia.
link |
He got a call, Spiegel, you got to come see this woman.
link |
She's in the ER, and she's in some kind of weird upset state
link |
And it turned out she'd been on the show with a stage
link |
hypnotist who, and what they do, by the way,
link |
is they cycle around.
link |
They have, at the beginning of the show,
link |
they don't just grab somebody and say, we're doing this.
link |
They get a bunch of people up.
link |
They do what amounts to hypnotizability testing
link |
to see if people, and they get the ones who
link |
are the most hypnotizable.
link |
So she was the one.
link |
And he said, there's now a little bird in your hand,
link |
and you're going to play with a bird.
link |
And she starts to cry and scream.
link |
And he just gets her off the stage because it's
link |
And she's wandering around New York City
link |
in the middle of the night, dissociated,
link |
and brought to Columbia.
link |
And that's where my father saw her.
link |
She was still in a kind of uncomfortable,
link |
trance-like state.
link |
And it turned out that she was the trophy
link |
wife of a very wealthy guy.
link |
And she felt like a bird in a gilded cage.
link |
And so to her, that image just triggered
link |
all of this sense of dissatisfaction, discomfort,
link |
fear about her life.
link |
And he was able to get her reoriented and talk
link |
with her about what she was going to do with her life.
link |
But I don't like stage hypnosis.
link |
You're making fools out of people.
link |
And you're using the fact.
link |
And that's what scares people about hypnosis.
link |
They think you're losing control.
link |
You're gaining control.
link |
Self-hypnosis is a way of enhancing your control
link |
over your mind and your body.
link |
It can work very well.
link |
But because it gives you a kind of cognitive flexibility,
link |
you're able to shift sets very easily,
link |
to give up judging and evaluating the way you usually
link |
do, and see something from a different point of view.
link |
That's a great therapeutic opportunity.
link |
But if misused, it could be a danger too.
link |
And that's what scares people about it.
link |
It is that very ability to suspend critical judgment
link |
and just have an experience and see what happens.
link |
That can be a great therapeutic opportunity.
link |
But if somebody is misusing it, it can be a way to harm people.
link |
And there are plenty of examples of people
link |
having fantasies imposed on them that they
link |
come to think are realities.
link |
It's not unusual these days.
link |
So it's an ability that, if people
link |
learn to recognize and understand it,
link |
can be a tremendous therapeutic tool.
link |
I've been staged hypnotized.
link |
And I've been clinically hypnotized many times
link |
through a self-hypnosis app we'll talk about later.
link |
And then I know we have plans for you to hypnotize me today.
link |
You've done it once before.
link |
And I'm very hypnotizable, as we both know.
link |
We'll talk about how one can gauge their hypnotizability.
link |
But the staged hypnosis was interesting.
link |
This was in college.
link |
They brought someone out to the dormitory.
link |
And I recall being one of the people that was selected
link |
and engaging in very bizarre behavior.
link |
It wasn't thoroughly embarrassing,
link |
but it was pretty embarrassing.
link |
And then being sent off the stage,
link |
and as I was exiting, suddenly screaming something out
link |
because he had planted a suggestion of some sort.
link |
And then I was told to look in my pocket.
link |
And there was like, I think, a torn up dollar bill.
link |
There were a bunch of things
link |
that I have vague recollection of.
link |
But it raises a set of questions
link |
that really boil down to, as a biologist,
link |
I always think that there's no events in the brain.
link |
There are processes.
link |
And so hypnosis, we know, has an induction.
link |
Then one is hypnotized, I imagine.
link |
And then it sounds like this woman
link |
and this example of the bird
link |
and being distraught in New York City
link |
is a failure to exit the hypnotic state.
link |
Do we know what sorts of brain areas are active
link |
during the induction, the, let's call it the deep hypnosis,
link |
and then what's shutting off or changing
link |
as people exit hypnosis?
link |
We've studied that.
link |
We've been very interested in that.
link |
And so we did a study where we selected
link |
highly and non-hypnotizable people
link |
so we could do the comparison
link |
and then hypnotize them in the functional MRI scanner.
link |
And we found three things
link |
characterize the entry into the hypnotic state.
link |
The first is turning down activity
link |
in the dorsal anterior cingulate cortex.
link |
So the DACC is in the central front middle part
link |
of the brain, as you well know.
link |
And it's part of what we call the salience network.
link |
It's a conflict detector.
link |
So if you're engaged in work
link |
and you hear a loud noise
link |
that you think might be a gunshot,
link |
that's your anterior cingulate cortex saying,
link |
hey, wait a minute,
link |
there's a potential danger over there.
link |
You better pay attention to it.
link |
So it compares what you're doing
link |
with what else is going on
link |
and helps you decide what to do.
link |
And as you can imagine,
link |
turning down activity in that region,
link |
make it less likely that you'll be distracted
link |
and pulled out of whatever you're in.
link |
And in another study,
link |
we found that highly hypnotizable people,
link |
even without being hypnotized,
link |
have more functional connectivity
link |
between the DACC, the anterior cingulate cortex,
link |
and the left dorsolateral prefrontal cortex,
link |
which is part of a key region
link |
in the executive control network.
link |
So when you're engaging in tasks,
link |
you're enacting a plan,
link |
you're writing a paper,
link |
you're doing whatever you're doing,
link |
that's the prefrontal cortex is doing that.
link |
And so if that is coordinated,
link |
we found more functional connectivity.
link |
So when one is up, the other's up,
link |
when one is down, the other's down.
link |
That coordination implies that the brain is saying,
link |
okay, go ahead, I know what you're doing,
link |
carry out that plan
link |
and don't worry about other possibilities.
link |
So two other things happen when people are hypnotized.
link |
One is that that DLPFC
link |
has higher functional connectivity with the insula.
link |
Another part of the salience network,
link |
it's a part of the mind-body control system,
link |
sensitive to what's happening in the body,
link |
it's part of the pain network as well.
link |
But it's also a region of the brain
link |
where you can control things in your body
link |
that you wouldn't think you could.
link |
For example, we did a study years ago
link |
where we took people who were highly hypnotizable,
link |
hypnotized them and told them to,
link |
we went on an imaginary culinary tour.
link |
So they would eat their favorite foods.
link |
And we found that they increased
link |
their gastric acid secretion by 87%.
link |
So their stomach was acting as though it was about to get,
link |
I mean, there was one woman, it was so vivid for her
link |
that halfway through she said, let's stop, I'm full.
link |
Eating these imaginary foods.
link |
Having never eaten an actual food.
link |
And then we got them to relax
link |
and think of anything but food or drink.
link |
And we got like a 40% decrease in gastric acid secretion.
link |
So they could, and that was DLPFC through the insula
link |
telling the stomach you're getting food
link |
or you're not getting food.
link |
And even, we injected them with pentagastrin,
link |
which triggers gastric acid release.
link |
And even then in the hypnosis condition
link |
they had a 19% reduction in gastric acid.
link |
So the brain has this amazing ability
link |
to control what's going on in the body
link |
in ways that we don't think we have ability to control.
link |
That's just one example.
link |
So that's the DLPFC-insula connection.
link |
The third thing that happens,
link |
and this relates to what you did on the stage,
link |
is you have inverse functional connectivity
link |
between the DLPFC and the posterior cingulate cortex.
link |
The posterior cingulate is part of the default mode network.
link |
It's in the back of the brain.
link |
And it's an area whose activity goes down,
link |
for example, in meditators.
link |
And in meditation you're supposed to be selfless.
link |
You're supposed to, the self is an illusion.
link |
You're supposed to let it dissolve
link |
and just experience things.
link |
And when you're doing that, the posterior cingulate
link |
is decreasing in activity.
link |
The inverse connection is I'm doing something
link |
but I'm not thinking about what it means for me.
link |
I may not even remember much of it.
link |
If I do, I don't care that much about it.
link |
And so that is part of the dissociation
link |
that occurs with hypnosis.
link |
So it's how you put things outside of conscious awareness
link |
and don't worry about what it means.
link |
It also adds to cognitive flexibility.
link |
If you're thinking, well, people like me
link |
don't usually do this, that may inhibit you
link |
from enacting a new form of psychotherapy, for example,
link |
that you've never done before.
link |
But if you're having this decreased activity
link |
in the part of your brain that reflects on what it means,
link |
you're more likely to be cognitively flexible
link |
and willing to give it a try.
link |
And that's one of the therapeutic advantages
link |
of hypnosis as well.
link |
And it's really, I'm gonna put,
link |
I'm gonna embarrass you here a little bit
link |
in the positive sense.
link |
Your laboratory is really the one that's pioneered
link |
brain imaging of hypnotic states.
link |
And it sounds like that's my understanding.
link |
I mean, there are other people
link |
who've done excellent research too,
link |
but Pierre Rainville in Montreal and several other people,
link |
but we're one of the leading lamps
link |
in neuroimaging of hypnosis.
link |
I have to ask about attention deficit
link |
hyperactivity disorder.
link |
I get a lot of questions about this
link |
and I think a lot of people just struggle
link |
with holding attention nowadays
link |
because of interference with phones and devices.
link |
And of course there is a lot
link |
of clinically legitimate ADHD out there,
link |
but the way that you describe the dorsal
link |
and the anterior cingulate and the salience network
link |
and this conflict detector of am I focusing on something
link |
or am I splitting my attention?
link |
How distractible am I seems to relate to some extent
link |
to activity in the anterior cingulate cortex.
link |
Do people with ADHD display disruptions
link |
in elements of these networks
link |
and has hypnosis ever been used to,
link |
or self-hypnosis I should be,
link |
to distinguish from stage hypnosis,
link |
clinical and self-hypnosis has been used
link |
to enhance people's ability to focus and hold attention
link |
because that's such a built-in component
link |
of the hypnotic state.
link |
It's a great question.
link |
There's sort of two ways to think about it.
link |
In terms of enhancing focus, yes,
link |
it has been very helpful in teaching people
link |
to just prepare your mind to narrow in
link |
and focus on something.
link |
And when you're really engaged in reading something
link |
or you're writing a, I mean, I'll have that,
link |
sometimes I'm thinking, oh, God,
link |
I have to do this for another hour.
link |
Other times, an hour will go by and I'll think,
link |
hey, great, because when you're in the,
link |
it feels game-like to you.
link |
You're just assembling the parts of the puzzle
link |
and putting them together.
link |
You just get absorbed.
link |
For me, that's a hypnotic-like experience.
link |
When I'm having trouble, when I'm struggling,
link |
sometimes doing things like self-hypnosis can help.
link |
I'm not an expert on ADHD.
link |
My impression is that you're right
link |
that these are people who are constantly distracted
link |
The other part of it is they're easily distractible.
link |
They're very upset when they get distracted
link |
and they're rather rigid in what they want to attend to
link |
and what they can't, I think,
link |
as a way of controlling this distractibility, frankly.
link |
My guess is that many people with ADHD
link |
would not be that hypnotizable,
link |
but I haven't studied it.
link |
So it's possible that for some people with that disorder,
link |
training in self-hypnosis might help,
link |
but we'd have to see how hypnotizable they were
link |
and take it from there.
link |
I want to return to some of the underlying neural networks
link |
and the clinical applications,
link |
but what sorts of things,
link |
aside from the asthma,
link |
have you used hypnosis successfully for,
link |
or have others used clinical hypnosis for?
link |
And are there any particular areas
link |
of psychiatric challenges or illnesses,
link |
I guess they're called,
link |
that are particularly amenable to hypnotic treatment?
link |
Hypnosis is very good as a problem-focused treatment.
link |
It's really, it's the oldest Western conception
link |
of a psychotherapy,
link |
and it can be used for specific problems
link |
in a way that's very helpful.
link |
We found it very helpful for stress reduction,
link |
for helping people deal,
link |
we're all dealing with stress these days.
link |
that mind-body connection is very helpful
link |
because part of the problem with stress
link |
is your perception,
link |
you mentioned it earlier in a sort of good sense,
link |
you're at a football game or something
link |
and you feel the physical reaction.
link |
That can be a reinforcing thing.
link |
Wow, this is exciting, let's do it.
link |
It can also be very distracting.
link |
So you're worried about getting COVID
link |
or you're worried about some other physical problem you have
link |
and you notice it in your body.
link |
Your body tenses up, you start to sweat,
link |
the sympathetic nervous system goes,
link |
your heart rate goes up.
link |
And when you notice that,
link |
you think, oh God, this is really bad.
link |
And then you feel worse.
link |
So it's like a snowball rolling downhill
link |
and then you feel worse and then your body gets worse.
link |
Hypnosis can be very helpful
link |
in dissociating somatic reaction from psychological reaction
link |
so we teach people to imagine their body floating
link |
somewhere safe and comfortable like a bath, a lake,
link |
a hot tub or floating in space.
link |
And then picture the problem that's stressing them
link |
on an imaginary screen with the rule
link |
that no matter what you see on the screen,
link |
you keep your body comfortable.
link |
So at this point, you still can't control the stress
link |
but you can control your physical reaction to it.
link |
And that starts you feeling more in control.
link |
At least there's one thing I can manage.
link |
And then you can use it to think through
link |
or visualize through one thing you might do
link |
about that stressor.
link |
So hypnosis is very helpful in controlling mind-body
link |
interaction in relation to stress.
link |
It's very helpful for people to get to sleep.
link |
We're having a lot of fun with that.
link |
I'm getting emails from people who said,
link |
I haven't slept right in 15 years
link |
and now for the first time, I'm listening to your app
link |
and I can sleep at night.
link |
So it's very helpful.
link |
And again, if you wake up in the middle of the night,
link |
I tell people, don't look at the clock.
link |
That's an arousal cue.
link |
You'll just wake up more.
link |
But picture whatever you're thinking about
link |
or worrying about on that imaginary screen
link |
while your body's floating.
link |
So watch your own movie, but keep your body floating.
link |
And many people can use that to get back to sleep.
link |
I've been using the self-hypnosis for sleep
link |
And now the Reverie app, and we'll talk about
link |
our relationship to the Reverie app and its uses.
link |
I find it incredibly useful for falling back asleep
link |
in the middle of the night.
link |
And it raises a question I've found,
link |
and I think I understand this correctly,
link |
that one can do self-hypnosis during the daytime.
link |
And then if there's an issue that comes up later,
link |
like so for instance, do self-hypnosis for stress reduction
link |
away from the stressful event to prepare one
link |
to deal with stress better.
link |
Or do a hypnosis for improving the return to sleep.
link |
And that can be done when you actually want to go to sleep,
link |
but it's kind of a training up of these networks, right?
link |
So is there evidence that these brain networks
link |
actually form stronger connections
link |
when people do self-hypnosis over time?
link |
Well, there's a rule in neurobiology, as you know,
link |
that neurons that fire together wire together.
link |
Our friend, Carla Schatz.
link |
Not Donald Hebb, by the way.
link |
I keep trying to, there's a widespread myth in the world
link |
that is unfortunately all over the internet,
link |
which is that the word fire together, wire together
link |
was said by the psychologist Donald Hebb.
link |
Donald had many important things,
link |
but it is the neurobiologist, Carla Schatz.
link |
That's exactly right.
link |
Yes, is at Stanford, but was also at Berkeley and Harvard.
link |
So also decent schools.
link |
But is at Stanford who said fire together, wire together.
link |
And so she deserves the credit for that statement.
link |
Yeah, so with repeated use of self-hypnosis,
link |
one could imagine that these networks are getting stronger.
link |
We don't have evidence of that yet,
link |
but long-term potentiation provides a pathway,
link |
and you've described them on your program a number of times,
link |
that allow for repeated activation of a network
link |
to actually build new connections that work.
link |
even from a learning and memory point of view,
link |
our memory is all a network of associations.
link |
That's how we remember things.
link |
And the example I'd like to give
link |
is you go back to your grade school,
link |
and you see these little tiny lockers,
link |
and the size is all wrong,
link |
and you suddenly have a flood of memories
link |
that were obviously stored there,
link |
but you just didn't think of.
link |
So context and association is what memory is about.
link |
If you start to acquire memories about a problem,
link |
so one thing we use hypnosis for
link |
is treating phobias, for example.
link |
And the problem with people who have phobias,
link |
like airplane phobias, or crossing a bridge,
link |
or being up high, is that the more they avoid it,
link |
the more the only source of associations and memories
link |
They don't have any good experiences with it
link |
because they avoid it.
link |
It's like get back on the horse
link |
after you fall off kind of thing.
link |
And with hypnosis, if you can start people able
link |
to manage their anxiety enough
link |
that they can have more, a wider array of experiences,
link |
they start to have a network of associations
link |
that isn't so negative and may even be positive.
link |
So it's almost like a, sorry to interrupt,
link |
but I have to ask, it's almost like a exposure therapy
link |
I mean, it's always in the mind.
link |
I mean, even exposure to, if I have a snake phobia,
link |
which I don't, I don't like snakes,
link |
but I don't think it qualifies as a full-blown phobia.
link |
I think I have a healthy fear of snakes.
link |
But if, let's say I had a snake phobia,
link |
the typical approach would be cognitive behavioral
link |
approaches, right?
link |
Would be to show a picture of a snake
link |
or then a rubber snake, then a real snake.
link |
Eventually the person is holding a boa constrictor
link |
or something like that.
link |
That's all in the mind because it's all translated
link |
into nervous system signals.
link |
But with hypnosis, sounds like you can give
link |
a number of positive experiences
link |
without having to use any props,
link |
without having to bring any animals into the room
link |
to drive someone across the bridge.
link |
I had a woman who was a very successful businesswoman,
link |
high level in a corporation.
link |
I had a terrible dog phobia.
link |
And so I had her imagine that somebody brought in
link |
a dog to the room and I said, what are you doing?
link |
And you could see her getting tense.
link |
And she said, well, I'm waiting to see what the dog does.
link |
And I said, if somebody who works for you
link |
comes into your office, would you freeze
link |
and wait to see what they did?
link |
And she said, of course not.
link |
And I tell them what to do, you know.
link |
And I said, well, so you're immobilizing yourself.
link |
The power isn't with the dog, it's with you.
link |
So imagine what you might do to engage the dog
link |
and help control the situation.
link |
And she said, thanks.
link |
And this reminds me of one of my favorite stories
link |
about hypnosis that my father was seeing a woman
link |
who lived in Midtown Manhattan
link |
and had a horrible dog phobia.
link |
She'd drop things, she'd spill coffee, she saw a dog.
link |
She would time her trips to the store
link |
when she thought it was least likely
link |
that people would be walking dogs.
link |
Now that wouldn't be possible.
link |
Everyone, it's like a fleet of French bulldogs
link |
taking over New York City.
link |
So he taught her to think of a dog as a friend,
link |
have a neighbor who had a dog, bring the dog over,
link |
but hold the dog by the collar and make sure.
link |
And gradually she was able to stroke the dog
link |
and say, dog friend, and distinguish
link |
between wild and tame animals.
link |
There are animals, you should be afraid of this.
link |
So she seemed to be doing better.
link |
He called back about three months later
link |
and asked for her and said, well, who's calling?
link |
The son said, and he said, Dr. Spiegel.
link |
And the boy said, that's weird.
link |
And my father said, what's weird?
link |
He said, Spiegel's in heat.
link |
She had bought a dog and named it Spiegel.
link |
Talk about transference.
link |
But it really speaks to the power of this.
link |
And it brings me back to this issue.
link |
So what is different about what your father did
link |
in that case with this woman,
link |
in terms of what happened in hypnosis
link |
that allowed her to go from being completely terrified
link |
of dogs to owning a dog and naming it after your father,
link |
which I find amusing.
link |
But that's different than just the two of them
link |
sitting down and talking about it, right?
link |
In therapy, the narrative is a huge component
link |
and in hypnosis, narrative is a huge component.
link |
So it must be that the brain state
link |
is what is really different,
link |
because we'll talk about trauma in a few minutes,
link |
but I think people who have trauma or phobias
link |
certainly could have a conversation about it.
link |
Some of them might freeze up.
link |
Some of them might lose their articulation and so forth.
link |
But what is different about that state
link |
that combines with narrative you think
link |
to allow these underlying neural networks
link |
to engage her to change?
link |
Because I find this so fascinating
link |
because every attempt at dealing with stress or phobia
link |
in the clinical setting involves some discussion
link |
But here we're not talking about any medication
link |
at least not in these particular circumstances.
link |
So I just, I realized it's kind of an obvious question
link |
like it has to be some difference in brain activity,
link |
but I find that to be incredible.
link |
The control variable there is the brain state.
link |
It's not what's spoken.
link |
You're raising a couple of very important issues, Andrew.
link |
We talked earlier about systematic desensitization
link |
where you sort of lay out a hierarchy of things
link |
and do it one at a time.
link |
I think of this as unsystematic desensitization
link |
because you're changing mental states.
link |
And I think there's more and more evidence
link |
that mental state change itself has therapeutic potential.
link |
We're seeing that with ketamine,
link |
treating depression as a sociogenic drug.
link |
We see it, we know it every morning
link |
when we wake up that problem.
link |
You made the mistake of reading a nasty email at 11 p.m.
link |
You didn't know what to do.
link |
You wake up in the morning and think,
link |
oh, that idiot, yeah, here's what I'm gonna do.
link |
So just changing mental state itself
link |
has therapeutic potential.
link |
And I think we underestimate our ability
link |
to regulate and change responses,
link |
to be cognitively, emotionally, and somatically flexible.
link |
And so we do things, you're right,
link |
that follow similar principles of facing a problem,
link |
seeing it from a different point of view.
link |
And you've done a really nice podcast on trauma and stress
link |
and how you have to expose yourself to it, not avoid it,
link |
as we talked about before,
link |
and then find some way to reconnect to it,
link |
to substitute something that can make you feel good
link |
rather than bad so that you activate other centers
link |
of the brain, like mesolimbic reward system.
link |
And so I do that with hypnosis,
link |
and you can do it much faster.
link |
People don't think they can, but they can.
link |
If you're having, right now, that physical experience,
link |
I'm thinking about this,
link |
but I'm not feeling as bad as I used to,
link |
that can be a powerful thing,
link |
and you can do it with hypnosis.
link |
So I had a woman came to see me
link |
who had suffered an attempted rape.
link |
It was getting dark.
link |
She was coming back from the grocery store,
link |
and this guy grabs her
link |
and wants to get her up into her apartment.
link |
It's outside her apartment.
link |
And she starts fighting with him,
link |
and she winds up with a basilar skull fracture.
link |
Since she hadn't been raped, they left.
link |
They weren't interested.
link |
And she wanted to use hypnosis
link |
to get a better image of what this guy looked like,
link |
which is a painful, upsetting thing.
link |
So she was quite hypnotizable.
link |
I got her floating.
link |
I say, you're safe and comfortable now.
link |
Nothing can happen that will harm your body.
link |
But on the left side of the screen,
link |
I want you to picture this guy
link |
and his approaching and what's happening.
link |
And she said, the light, it was getting dark.
link |
I really can't see much of his facial features,
link |
but I do recognize something
link |
I hadn't allowed myself to remember.
link |
If he gets me upstairs, he doesn't just wanna rape me.
link |
He's gonna kill me.
link |
And so in some ways,
link |
what she was seeing was even worse.
link |
So you're thinking good Spiegel.
link |
You made her even more frightened than she was before.
link |
But as you had pointed out in your PTSD stress lecture,
link |
you've got to confront the trauma
link |
to restructure your understanding of it.
link |
So on the other side of the screen, I had her picture.
link |
What are you doing to protect yourself?
link |
And everybody in a trauma situation
link |
engages in some strategy of self-protection.
link |
That's the Salience Network kicking in.
link |
And she said, you know what?
link |
He's surprised and I'm fighting that hard.
link |
He didn't think I would.
link |
And so she realized on the one hand
link |
that it was even worse than she thought it was.
link |
But on the other hand,
link |
that she actually probably saved her life.
link |
And so it was a way of helping her restructure
link |
her experience of the trauma and make it more tolerable.
link |
So that helped with her.
link |
She didn't recognize, she couldn't identify the guy,
link |
but it helped her restructure and understand her experience.
link |
And that's something that you can do
link |
in just talking straight out psychotherapy,
link |
but sometimes you can do a hell of a lot faster
link |
and more efficiently using hypnosis.
link |
And there is one randomized trial out of Israel
link |
that shows that adding hypnosis to PTSD treatment
link |
actually improves outcome.
link |
So it's a way of accomplishing things that we understand
link |
in the broader psychotherapy world,
link |
but much more quickly and sometimes effectively.
link |
Yeah, it sounds like going into,
link |
somewhat into the state that one is trying to deal with,
link |
but then dissociating from that state is key.
link |
And I could imagine,
link |
and I've been open about this on various podcasts.
link |
I've done a lot of analysis over the years.
link |
So, but I've experienced myself that in those sessions,
link |
depending on how I show up to them,
link |
I might just get in kind of a laundry list of what happened
link |
as opposed to actually feeling anything
link |
around what happened.
link |
And I think people probably varied
link |
in the extent to which they can drop into feeling states
link |
and it can depend on the day.
link |
It can depend on how well you slept the night before
link |
There's one thing I might add, Andrew,
link |
and that is, you know, there's a notion
link |
of the late Gordon Bauer.
link |
We just had a memorial for Gordon at Stanford.
link |
He died about a year ago.
link |
Brilliant cognitive psychologist.
link |
So one of the founders of cognitive psychology at Stanford
link |
and a great pitcher.
link |
He almost became a major league pitcher,
link |
but he decided to go to grad school instead.
link |
And I'm glad he did.
link |
But Gordon helped establish the concept
link |
of state-dependent memory,
link |
that when you're in a certain mental state,
link |
you enhance your ability to remember things about it.
link |
And the sort of the bad example of that
link |
is the drunk who hides the bottle
link |
and can't remember where he put it
link |
until he gets drunk again.
link |
That he's in that same mental state.
link |
People go into dissociative states when they're traumatized.
link |
So in a way, hypnosis is helping them remember
link |
and deal with the memories better
link |
because they're more in the mental state
link |
that is more like what happened.
link |
And most rape victims will tell you,
link |
I was floating above my body feeling sorry
link |
for the woman being assaulted below.
link |
People in traumatic episodes, they just say,
link |
you know, I blank out.
link |
I don't know what's happening.
link |
And that's a kind of self-hypnotic state.
link |
So when you use hypnosis to help them deal
link |
with the traumatic memory,
link |
you're making the state they're in right there
link |
in your office with you more congruent
link |
to the state they were likely in when the trauma happened.
link |
And I think that is part of what helps facilitate treatment
link |
of trauma-related disorders.
link |
So that makes me have to ask every question I have to ask
link |
because I really feel it as almost a compulsion.
link |
Then if dissociation during a traumatic episode
link |
is part of the adaptive strategy,
link |
but it creates certain issues.
link |
It creates problems, right?
link |
Why would something like ketamine,
link |
which creates a dissociative state,
link |
be useful for the treatment of trauma?
link |
This is what I'm confused about these days
link |
because our colleague, Carl Deisseroth,
link |
who's also been on this podcast
link |
and his coworkers have figured out,
link |
okay, there's these layer one networks in the neocortex,
link |
and those are involved in dissociative state.
link |
And so we're starting to gain some understanding
link |
of how ketamine works at a neural level.
link |
It does seem as if for certain populations,
link |
it can be a useful treatment.
link |
I don't know, I've never tried it.
link |
I don't know what the current status of that is,
link |
It is allowed, at least it's FDA approved and it's in use.
link |
Why would dissociative states be useful
link |
if some element of dissociation is what gave rise
link |
to the trauma memory in the first place?
link |
Well, yeah, Carl had a brilliant paper in Nature
link |
where it was from rats to humans in one paper.
link |
And he showed that there's this rhythmic discharge
link |
in the retrosplenial region that is associated,
link |
that is triggered by ketamine.
link |
And the rats actually showed dissociative-like behavior
link |
in that they would touch a hot pad
link |
that they ordinarily wouldn't,
link |
and they didn't seem to have much pain in their paw.
link |
And he then had a male subject
link |
who had implanted electrodes.
link |
A human subject, yeah, human subject.
link |
And the electrodes had picked up this rhythmic activity,
link |
and when they did, he would report
link |
being in a dissociative state.
link |
And his description was,
link |
it's like being a pilot of an airplane,
link |
and then I felt myself walking out of the cockpit,
link |
and the plane was still flying.
link |
That sounds terrifying to me.
link |
That sounds terrifying.
link |
I want to be in my body most of the time.
link |
That's right, but the point is,
link |
in a way, the principle, Andrew,
link |
is like the principle you said,
link |
that you need to re-confront a traumatic situation
link |
before you can modulate your associations to it.
link |
So you have to accept it, accept the arousal,
link |
put some boundaries around it,
link |
and then figure out how you can approach that problem,
link |
or how you did approach that problem
link |
from a different point of view.
link |
So it does not surprise,
link |
in fact, we've studied people who dissociated
link |
during the Loma Prieta earthquake
link |
and the Oakland-Berkeley firestorm.
link |
I remember both of those well.
link |
Earthquakes follow me.
link |
And then I move south, and then the northridge.
link |
I'm going to keep it right here.
link |
So there'll be one layer this afternoon.
link |
I'm starting to dissociate, Andrew.
link |
So dissociation does compartmentalize experience,
link |
but that means, from the point of view of treating trauma,
link |
it's an inhibition.
link |
You don't engage it.
link |
It's like it happened over there.
link |
And I think what happens is that people
link |
are sometimes too good at being able to separate themselves
link |
from the recollection, so it's in there somewhere.
link |
It's out of sight, but it's not out of mind.
link |
It's having effects on you, but you can't deal with it.
link |
You can't reprocess it.
link |
So I do think one reason ketamine might work
link |
is that, in fact, it allows you to keep,
link |
to re-approach the dissociative experience
link |
in a way that you can then start to think about
link |
and do something about it.
link |
And just the fact you can turn it on and off.
link |
And that's also where self-hypnosis is so helpful.
link |
It's not something that just comes over you
link |
and happens to you, it's something you can make happen.
link |
You can control it.
link |
You can do something with it.
link |
So you feel less helpless and out of control.
link |
The essence of trauma is helplessness.
link |
It's not fear, it's not pain, it's helplessness.
link |
You become an object.
link |
You become just your body.
link |
You don't control what's going on,
link |
and we're not used to that.
link |
You and I have discussed this brilliant paper
link |
on anticipation of breathing,
link |
and it's not whether you breathe,
link |
inhale or exhale or hold your breath.
link |
It's that if you think you can inhale and you can't,
link |
that is really upsetting, understandably.
link |
And so the issue is control.
link |
And hypnosis, which has this terrible reputation
link |
of taking away control, is actually a superb way
link |
of enhancing your control over mind and body.
link |
And it reminds me that naming is so important.
link |
You almost wonder if self-hypnosis and clinical hypnosis
link |
had been called something else,
link |
that it would have been separated out from stage hypnosis
link |
in a way that would make it less scary, weird,
link |
complicated for people to embrace.
link |
But part of the reason for having this discussion
link |
is I've had great experiences with hypnosis.
link |
I've seen the data.
link |
We're talking about a lot of clinical examples.
link |
It's incredibly powerful,
link |
and it boils right down to neural brain states.
link |
And I think in the years to come,
link |
it's going to become more widespread.
link |
Along those lines, how quickly,
link |
you've described some examples
link |
of people getting relief very quickly.
link |
How permanent are those changes?
link |
Is there a need for follow-up?
link |
And related to that,
link |
I'm sure a number of people are listening to this
link |
and thinking, wonderful, I'd love to get hypnotized
link |
for any number of different things by Dr. Spiegel
link |
or somebody else expert in clinical hypnosis,
link |
but they might not have access to you or somebody
link |
with similar training.
link |
So what is the power?
link |
So how quickly does it work?
link |
How long lasting are those changes?
link |
And then is it necessary to work with a clinical hypnotist?
link |
And is it better to do that than self-hypnosis
link |
and so on and so forth?
link |
Maybe you could just give us a contour of the landscape
link |
of directed and self-directed treatment.
link |
Well, typically most people start
link |
by coming to see a clinician like me.
link |
It's better to see someone who has licensing and training
link |
in their professional discipline,
link |
medicine, psychology, dentistry, whatever.
link |
Because there are a lot of hypnotists out there
link |
who are just hypnotists.
link |
And the key issue is somebody who can really assess
link |
what your problem is and make sure
link |
that you're not talking someone
link |
into reducing their chest pain
link |
rather than getting their coronary artery problem.
link |
Because they could have a real issue there.
link |
They could, right.
link |
Hypnosis might adjust but wouldn't deal
link |
with the deeper underlying issue.
link |
On the other hand, and typically when I use it with people,
link |
I often only see them once or twice or periodically
link |
but not every week.
link |
And certainly not every day if they have a pain problem.
link |
And hypnosis is very helpful for pain.
link |
And so what I'm doing is identifying
link |
how hypnotizable they are.
link |
I give them a standard brief test
link |
of their ability to experience hypnosis.
link |
And then going through a self-hypnosis exercise
link |
with them to deal with the problem.
link |
Seeing how they respond to it.
link |
And then teaching them how to do it for themselves.
link |
And in the old days I used to have them
link |
use their iPhone and record that part of the session
link |
so they could play back the hypnosis experience.
link |
Now we've developed an app, Reverie,
link |
that can teach people and step them through
link |
dealing with pain, stress, focus, insomnia,
link |
and help people eat better and stop smoking.
link |
And we have elements that take about 15 minutes
link |
and elements that just take one or two minutes
link |
that people can refresh and reinforce.
link |
So the idea- Two minute hypnosis.
link |
And it's one to two minutes now.
link |
And we're finding that two thirds of the people
link |
find that even just the one minute refresher
link |
helps them feel better.
link |
They're reporting they feel better.
link |
So the nice thing is you know right away
link |
whether it's likely to help you or not.
link |
And we've found, we've done studies looking at hypnosis
link |
for pain relief in acute medical procedures.
link |
We did a randomized trial that we published in The Lancet.
link |
Three conditions, people getting arterial cut downs
link |
to chemoembolized tumors in the liver
link |
or visualized renal artery stenosis.
link |
You don't use general anesthesia for this.
link |
It's very uncomfortable and people are anxious.
link |
And we had three conditions.
link |
One was standard care, they could push a button
link |
and get opioids, IV.
link |
Is during the surgery.
link |
During the surgery.
link |
The second is they could do that
link |
plus they had a friendly nurse comforting them.
link |
So we controlled for pleasant attention and support.
link |
And the third was we taught them self hypnosis
link |
So you're feeling, you can change the temperature.
link |
Your body is cool, tingling and numb.
link |
You're floating in ice water and feeling comfortable.
link |
Or go somewhere else.
link |
Leave your body here and go to a desert island
link |
and enjoy yourself.
link |
And we found that it's about two and a half hour procedure
link |
that by an hour and a half, the hypnosis group
link |
had reduced their pain by 80%
link |
compared to the standard care group
link |
using half the amount of opioids.
link |
They had fewer complications
link |
and the procedure took 17 minutes less time on average
link |
to get done because not only was the patient more relaxed,
link |
so was the treatment staff.
link |
They weren't dealing with someone
link |
who was struggling and uncomfortable.
link |
We measured their anxiety.
link |
And same thing, the hypnosis group,
link |
I was worried they were all dead.
link |
They had no anxiety after an hour and a half.
link |
They were saying I'm fine, you know.
link |
And they were fine.
link |
And the standard care group had five out of 10
link |
anxiety scores at that point.
link |
So we published that in The Lancet.
link |
Big randomized trial.
link |
If we had a drug that did that,
link |
every hospital in the country would be using it now.
link |
But there's no industry to push it.
link |
So that's part of what helped us decide
link |
that we needed to help people do this with Reverie
link |
and teach them how to do it
link |
and provide interactive support for them to do it.
link |
And the question, although, is does it work long term?
link |
Because what we can do acutely
link |
doesn't necessarily carry on.
link |
So we did a randomized trial of women
link |
with metastatic breast cancer.
link |
They had advancing disease.
link |
We met with them in a support group once a week
link |
and taught them self-hypnosis for stress and anxiety
link |
and pain control at the end.
link |
And by the end of a year,
link |
the treatment group had half the pain the control group did
link |
on the same and very low amounts of medication.
link |
And they would say when I felt that pain in my chest
link |
and thought it was a metastasis, I just did the exercise.
link |
I got myself in a warm bath and I felt fine.
link |
So it works because it becomes a skill that people acquire.
link |
But they can tell right away
link |
whether it's likely to help them working with a clinician
link |
or now using the app or other ways of helping them learn
link |
to use it as a skill.
link |
So the nice thing is you will know very quickly
link |
whether it's likely to help you or not.
link |
And if it is, you can learn to do it for yourself.
link |
And we will, again, there'll be a link to Reverie
link |
in the caption that's available for Apple and Android.
link |
And I think even though there's a nominal cost there,
link |
I think that, as you mentioned, medications
link |
and other approaches to dealing with these problems
link |
are quite expensive and have all the potential
link |
for side effects and things.
link |
Not that some of those aren't also useful.
link |
Could I, before you get to that, just one thing.
link |
We've worked very hard on the app.
link |
We have an iOS app for Apple.
link |
We decided to table for a moment redoing the Android app.
link |
So it's not, it was available when we were working
link |
through the Alexa platform.
link |
It's not at the moment, but it will be soon.
link |
So I just don't want people to be disappointed
link |
if they're looking for it for Android.
link |
It's on our agenda, but we don't have it at the moment.
link |
Great, thanks for that clarification.
link |
So hopefully in time for both.
link |
I get asked a lot about obsessive thoughts
link |
or intrusive thoughts.
link |
I also get asked a lot about OCD.
link |
Is there any evidence that hypnosis or self-hypnosis
link |
can be used for dealing with obsessive thoughts?
link |
There are some very obsessional people
link |
who just turn out not to be that hypnotizable,
link |
and it's not random.
link |
They tend to be so over-controlling of thought.
link |
They're all busy evaluating rather than experiencing.
link |
I know a few people like that.
link |
Sounds like a, it sounds like an adaptive mindset
link |
for a lot of professions in areas,
link |
and that we get trained up in that during school,
link |
how to obsess over the exam,
link |
obsess over our social interactions.
link |
I mean, it's part of becoming a functional human being,
link |
and yet you can take us down a different-
link |
We sometimes overdo it.
link |
I mean, I'll tell you one example from extreme situations,
link |
because you're judging, evaluating,
link |
you're not letting yourself experience,
link |
including emotionally.
link |
I know somebody who listens to the tapes from airplanes
link |
that they go down, so they get the black box
link |
and they listen to it, and he said to me, you know-
link |
That's his profession, or he does this recreationally?
link |
No, it's his profession, that's what he did,
link |
because they're trying to do accident prevention
link |
and how to handle things.
link |
And he said that you worry about people panicking, right?
link |
And here, these guys know that they've got 30 seconds,
link |
or some 45 seconds,
link |
and they're just going through their checklist.
link |
He said they don't panic enough.
link |
They're taught that this is what you do,
link |
and there is reason, there's good reason for it,
link |
but sometimes they overdo it.
link |
And it's painful to listen to this,
link |
because you know what's going to happen.
link |
So it's kind of a balance we have to hit,
link |
and sometimes we get too emotional and too absorbed,
link |
and you're not with it enough
link |
to sort of see other possibilities.
link |
That can be a problem.
link |
But on the other hand, sometimes you're too rigid
link |
and controlled, and you don't let your emotions guide you
link |
to what you need to do to protect yourself
link |
or protect others.
link |
So I would say in general that people with OCD
link |
are on the less hypnotizable side of the spectrum.
link |
They're less likely to allow themselves
link |
to engage in anything.
link |
And the typical example is the checking with OCD,
link |
They don't remember whether they locked the door
link |
or turned off the gas in the oven,
link |
and they keep going back, and they keep checking.
link |
So there, the evaluative component of the brain
link |
kind of overrides the experiential one.
link |
And sometimes people can get some benefit,
link |
but they're not a group that I would select
link |
for being the most likely to respond
link |
to self-hypnotic approaches.
link |
Are superstitions similar?
link |
Superstitions, I think that's more.
link |
There are people who are very hypnotizable
link |
who keep getting caught up in things like superstitions.
link |
And there, the imagination supplants the reality.
link |
And we've seen a lot of that happening recently.
link |
And so I think there it's possible
link |
that they could be helped by learning to sort of see it,
link |
but put it in context,
link |
see it from a different point of view.
link |
I developed a pretty vicious superstition
link |
when I was in college, and it was hard to break, actually.
link |
I always feel that when I talk to clinicians,
link |
I have to reveal certain things about my own pathology.
link |
You'll get my bill later.
link |
Yes, it's part of the reason I arranged this,
link |
I had a habit of knocking on wood for things,
link |
and I noticed it started to,
link |
I would sneak knocking on wood every once in a while,
link |
because I didn't want people to think I was doing too often.
link |
And then I started to realize
link |
that it was becoming a little bit of a reflex.
link |
And then I saw this incredible video
link |
from Ben Solevsky's lab at Harvard.
link |
He studies motor patterns.
link |
He has these rats that press different sequences
link |
of levers and turn dials in order to get a pellet of food.
link |
But that as they do that,
link |
they'll start to introduce these behaviors
link |
that have nothing to do with the actual lever pressing.
link |
They'll start scratching their hindquarters
link |
and things like that, and their head,
link |
excuse me, they don't wear hats, and flipping their ears.
link |
And this is just like a pitcher before throwing a baseball.
link |
We do this, we start to incorporate motor behaviors
link |
that are unrelated to the outcome,
link |
but our mind somehow starts to think
link |
that they're necessary for the outcome.
link |
And so then you incorporate it.
link |
So I decided to break it by simply forcing myself
link |
to not do it for about a week.
link |
And then it just seemed like a ridiculous thing to do.
link |
We call it response prevention, and it works.
link |
Because what you do is you set up a new context
link |
in your brain where you get the outcome you want
link |
devoid of the extraneous behavior.
link |
And I knew it was nuts, right?
link |
I knew it was illogical,
link |
but somehow these things take on meaning.
link |
So we talked about stress reduction,
link |
the utility of hypnosis for stress reduction,
link |
phobias, pain, possibly, we don't know,
link |
but for things like ADHD and OCD,
link |
it just will depend on hypnotizability.
link |
You talked about this beautiful study
link |
on the metastatic breast cancer outcome or patients.
link |
Hypnotizability is clearly a key variable.
link |
So could you please tell us what hypnotizability is,
link |
how it's evaluated, and what the Spiegel eye roll test is?
link |
So hypnotizability is just a capacity
link |
to have hypnotic experiences.
link |
And we have a test called the hypnotic induction profile,
link |
where we give a highly structured hypnotic experience.
link |
And you know, the old tradition in clinical hypnosis
link |
was that you try a bunch of different things,
link |
walking upstairs and downstairs and other images,
link |
and time what you say to the breathing of the subject
link |
And the more you change what you do as a clinician,
link |
the less you can make a variation in outcome.
link |
And it could take a long time, you know,
link |
20 minutes, 30 minutes.
link |
And I just view that as a kind of complex,
link |
not very effective way of assessing
link |
the person's hypnotic capacity.
link |
We know that the peak period of hypnotizability
link |
in the human life is the latency years in childhood.
link |
So every eight-year-old is in a trance all the time.
link |
You know, you call them in for dinner,
link |
they don't hear you, they're doing their thing.
link |
And that's why childhood is such a wonderful experience.
link |
Work and play are all the same thing, you know.
link |
And we try to make them into little adults,
link |
which I think is a terrible mistake.
link |
They, everything is fun for them.
link |
They enjoy learning, they enjoy everything.
link |
So what age are they in this?
link |
This is like six to 10, six to 11.
link |
They're playful, they enjoy everything.
link |
Everything is sort of a game and fun.
link |
And we try to make it miserable for them,
link |
but they've got it.
link |
And then when what Piaget called, you know,
link |
a more adult cognitive framework,
link |
where we learn abstract concepts,
link |
we learn that even if one bottle looks bigger than the other
link |
they can have equal volume.
link |
And so we start imposing logic.
link |
We're growing our DLPFC at that point,
link |
and imposing cognitive structure on experience.
link |
Some people start to lose that hypnotic ability.
link |
By the time you're in your early 20s,
link |
your hypnotized ability becomes extremely fixed.
link |
And there was a study done at Stanford,
link |
Ernest Hilgard, Phil Zimbardo did this,
link |
looking at, they tracked down students who were in Psych 1,
link |
had their hypnotized ability measured,
link |
and retested them blindly 25 years later.
link |
And the test-retest correlation was,
link |
you want to guess what it was?
link |
I'm guessing it's, I don't know, 0.6 something.
link |
It was 0.7, IQ would be 0.6 on a 25 year interval.
link |
So it's more stable than IQ over a 25 year interval.
link |
So once you're at that point, that's where you are.
link |
What are the factors that lead to that?
link |
Well, and so what it means is that about a third of adults
link |
are just not hypnotizable.
link |
Two thirds are, about 15% are extremely hypnotizable.
link |
And we can measure that and give it a number
link |
And that's very useful.
link |
For some of my patients when I do it,
link |
I say, look, I'm sorry, you're not hypnotizable,
link |
we're gonna do something else.
link |
Medication, systematic desensitization,
link |
mindfulness, other things.
link |
Or if they're very hypnotizable, I just go for it.
link |
I don't do a lot of explaining.
link |
People who are low to moderate hypnotizable
link |
like explanations about what you're doing,
link |
but then they can still get the benefits.
link |
So it helps me guide the nature of my treatment
link |
with these people.
link |
Now, the eye roll is,
link |
my father used to use an eye fixation induction.
link |
He used to say, look up at the ceiling
link |
and now close your eyes while you're looking up.
link |
You're very, yes, you're very hypnotizable.
link |
So he noticed, he had two patients back to back.
link |
And one was a woman who I'd seen him work with
link |
who had hysterical seizures.
link |
She would just suddenly start shaking.
link |
Real epileptic seizures.
link |
No, pseudo epileptics.
link |
I see, so hysteria.
link |
And although some people have both,
link |
that is for some people,
link |
real epilepsy becomes a framework
link |
that gets elaborated on for when you're stressed,
link |
you have seizures.
link |
She just had pseudo epilepsy, no EEG abnormalities.
link |
And she, it was really something to watch.
link |
Her husband had to move his workbench near the door
link |
so that if she started to have a seizure,
link |
he could run home and try and help her with it.
link |
And he noticed that when she did what you did,
link |
when she looked up, when she would have
link |
one of her seizure events, all you see is sclera.
link |
You don't see iris anymore.
link |
And she would start to see.
link |
So he did a great thing with her.
link |
He taught her to have seizures.
link |
Everybody else was telling her to stop.
link |
He made her have one.
link |
So he hypnotized her.
link |
Let's go back to the last time you had one.
link |
And sure enough, she'd start to shake.
link |
And gradually, he'd make them smaller and smaller.
link |
So she was learning.
link |
She could control.
link |
She'd have access.
link |
It's like with PTSD.
link |
You confront, you don't avoid it.
link |
You don't suppress it.
link |
You confront it and figure out how to deal with it.
link |
The next patient he had
link |
was a rigid, obsessional businessman
link |
who wanted to stop being so controlling and all this.
link |
Remind me, there was a New Yorker cartoon of a driver
link |
who comes to a yield sign and he yells, never.
link |
It's always being controlled.
link |
Sounds about right.
link |
You're a New Yorker.
link |
I'm a New Yorker, right.
link |
And so this guy, when he tried to look up,
link |
he couldn't keep his eyes up while he closed them.
link |
And so my father started testing people.
link |
And it seemed that there is a rough correlation
link |
between the capacity to keep your eyes up
link |
while you close them and measured hypnotizability.
link |
So that people who are listening
link |
and watching on video.
link |
So the Spigot eye roll test involves looking up
link |
So it's tilting the head back.
link |
I'm tilting my chin back and looking up at the ceiling now.
link |
But I'm also directing my eyes upward and my eyes are open.
link |
And then the eye roll test involves then
link |
closing the eyelids while the eyes are open.
link |
And whether or not the eyes roll back.
link |
And as you said, then you see sclera, the white part.
link |
You see sclera, the white part.
link |
That means you're very hypnotizable
link |
or moderately hypnotizable.
link |
Whereas if the eyes move down and you see iris,
link |
the colored part of the eye, as the eyes close,
link |
less hypnotizable.
link |
And you can look this up online there.
link |
You just put Spigot eye roll test and you'll find it.
link |
And we are also gonna do an actual example
link |
of hypnosis on video later.
link |
Right, so you're asking the brain to do something difficult
link |
to keep the eyes up while closing the eyelids.
link |
And so that's contradictory signals for the third,
link |
fourth, and sixth cranial nerve nuclei
link |
that control eye movement.
link |
You said the third?
link |
Fourth and sixth cranial nerve nuclei.
link |
And so you're suspending one activity while asking them
link |
to do another, and eye movements have a lot to do
link |
with levels of consciousness.
link |
The periaqueductal gray surrounds
link |
these cranial nerve nuclei.
link |
And when we close our eyes when we sleep,
link |
we have rapid eye movement when we dream.
link |
Most drugs that affect level of consciousness
link |
can affect eyes and eye movements,
link |
either the dilation or contraction of the pupils,
link |
depending on whether it's a stimulant or an opioid.
link |
Stimulants make the pupils big.
link |
Yeah, like cocaine, amphetamine.
link |
Things of that sort.
link |
And opioids, you get constricted pupils.
link |
This is what parents, you know,
link |
the parents looking at their kids
link |
coming in the door late at night,
link |
they're looking for substance abuse.
link |
So there's something about the eyes
link |
that has a lot to do with level of consciousness.
link |
I mean, obviously, you close your eyes when you go to sleep,
link |
you have rapid eye movement when you're dreaming.
link |
So it's not surprising.
link |
And there's an old Zen practice
link |
called looking at the third eye.
link |
And I think part of the reason that this happens
link |
is where you're looking up inside.
link |
It's like there's a third eye
link |
between the other two in your forehead.
link |
And I think it's because we're visual creatures.
link |
You know, we're pretty pathetic
link |
from a physical point of view.
link |
You know, many animals can outrun us, you know,
link |
or outsmell us or see, you know,
link |
eagles could read the newsprint at 100 yards
link |
and we can't, you know, it's.
link |
So our major defensive sensory input is vision.
link |
And that's why, you know, animals, predator animals
link |
have eyes in the front of their head
link |
so that they have very good detailed vision of prey,
link |
whereas prey animals like deer
link |
have eyes on the side of their head.
link |
So they don't see things that well,
link |
but they have a much bigger range
link |
of potential to see threat.
link |
And we mainly use, and in fact, it's interesting,
link |
there have been social anthropologists that say,
link |
why do we gather where we do, you know, on coastlines
link |
and, you know, at the edge of a forest or something?
link |
It's because you've got protection in the back.
link |
Something can't attack you from one side
link |
and you have a big vision of what might threaten you.
link |
And we tend to like be attracted
link |
to those kinds of physical situations.
link |
And we love vistas.
link |
Vistas are very calming.
link |
They take us into that panoramic vision.
link |
I didn't know this, but it turns out
link |
that most of the scenic spots at any location
link |
in national parks were where people naturally aggregated.
link |
It wasn't, which makes sense, you know,
link |
but that those signs and locations
link |
were built up around people's tendency
link |
and animals' tendencies to aggregate there.
link |
Yeah, there's an interesting book
link |
on the history of the national parks
link |
that says that they didn't give a research study
link |
to support it, but there was no Google maps, obviously.
link |
That's very interesting.
link |
Yeah, panorama and visual boundaries
link |
are really interesting.
link |
I think, so the eyes, as we both know,
link |
are two pieces of the central nervous system
link |
of the brain outside the,
link |
I used to say that the eyes are outside the skull
link |
and a neuro-ophthalmologist wrote to me
link |
and vehemently pointed out
link |
that they are outside the cranial vault.
link |
So, you know, they're outside the cranial vault,
link |
but they are two pieces of brain.
link |
They're out there.
link |
And so you mentioned cranial nerves, three, four, and six.
link |
This isn't a neuroanatomy course,
link |
but maybe we could go a little deeper there.
link |
So there's, you said there's contradictory activity.
link |
Looking up is controlled by the one set of cranial nerves
link |
and then the closing of the eyelids
link |
is controlled by another cranial nerve.
link |
No, it's the same one.
link |
I think it's six that when you close your eyes,
link |
you activate, no, it's the facial,
link |
I guess it's the facial nerve.
link |
It's seven, seven, yeah.
link |
But you're looking up,
link |
you're activating the muscles
link |
that force your eyes to look up
link |
and closing your eyelids normally relaxes those,
link |
relaxes that upper movement
link |
because your eyes are closed and you don't need to do it.
link |
So you're breaking a usual customary pattern.
link |
It's like the rubbing, hey, I can't even do it.
link |
See, it's like the,
link |
rubbing your tummy and patting your head.
link |
There's a bit of a conflict there.
link |
But clinically it's been a good probe for you
link |
and for your father.
link |
So was it Spiegel Senior or Spiegel Junior?
link |
That's Spiegel Senior.
link |
That developed the Spiegel Eye Roll Test.
link |
But the key issue is this,
link |
that normally when we close our eyes also,
link |
we're going to sleep.
link |
You're not worried about what's going on
link |
in the world anymore.
link |
Here, you're maintaining resting alertness.
link |
So you're focusing, but you're turning inward.
link |
That's an unusual state.
link |
Normally we close our eyes periodically.
link |
We have to, but when you close your eyes
link |
for some period of time, it's normally to go to sleep.
link |
And you're not worried about detecting risk or threat.
link |
So it's an interesting state
link |
because you're turning inward basically.
link |
You're looking up, you're shutting your eyes
link |
and you're allowing whatever happens outside you to happen
link |
and focusing on what's going on inward.
link |
So I think it's a signal to your brain to turn inward.
link |
And meditation of course could be done with eyes open,
link |
but almost always is done with eyes closed.
link |
Yes, that's right.
link |
So you can very quickly determine
link |
whether or not someone is highly hypnotizable,
link |
not at all hypnotized.
link |
When you say about two thirds of people can be hypnotized,
link |
obviously a third cannot,
link |
but within the two thirds that can, there's a range.
link |
And you said 15% of people fall
link |
into this highly hypnotizable category
link |
that I seem to be a member of.
link |
And does repeated use of self-hypnosis
link |
or clinical hypnosis increase or change hypnotizability
link |
for those that can access it in the first place?
link |
I would say in general, it may increase a little bit,
link |
but not a hell of a lot.
link |
And it's not worth the effort
link |
to increase your hypnotizability at that point.
link |
It's worth trying to deal with the problem
link |
you're dealing with.
link |
So you can get better at using it
link |
at the level that you have.
link |
There was a study done in which they tried to train people
link |
to be more hypnotizable.
link |
And obviously there are subjective
link |
and behavioral components to the test.
link |
You can learn to do a little better on them.
link |
But what we found was when we reanalyzed this data,
link |
that we could account for three times the final score
link |
based on the initial hypnotizability measurement
link |
rather than whether or not
link |
they had been trained to do better.
link |
So you can improve it a little,
link |
but it's not worth the trouble.
link |
Along the lines of eyes and eye movements,
link |
a lot of interest out there about EMDR,
link |
eye movement desensitization reprocessing.
link |
Shapiro herself was working,
link |
she wasn't at Stanford directly,
link |
but was the local to Stanford, I think in Palo Alto.
link |
So what are your thoughts on EMDR?
link |
Where is it useful?
link |
Where do you think it's less useful?
link |
Are there things that EMDR could be combined with
link |
to make it more useful?
link |
The listeners of this podcast come to,
link |
I think come to the podcast with a range of backgrounds
link |
To me, it makes sense why EMDR lateralized eye movements
link |
might work given the newer data
link |
that it can suppress amygdala activity in some animals
link |
and animal models and in humans as well.
link |
But it really hasn't been explored much neurally.
link |
I've heard things like it coordinates
link |
the two sides of the brain,
link |
which to me is just a throwaway.
link |
I don't think there's any evidence
link |
that coordinating the two sides of the brain
link |
is better than not coordinating.
link |
I wouldn't be speaking right now
link |
if the two sides of my brain were well correlated
link |
because language is lateralized.
link |
So I've heard that it mimics rapid eye movements
link |
during sleep, but actually it doesn't.
link |
So, but I have heard people talk about
link |
their positive experiences with EMDR.
link |
What are your thoughts about EMDR?
link |
Yeah, you had a good comment on that
link |
in one of your recent podcasts.
link |
And I'll tell you, one way I sort of think about it
link |
from a bemused point of view is the old,
link |
you mentioned it earlier, the oldest sort of idea
link |
of a hypnotic induction was a dangling watch, right?
link |
You know, a watch.
link |
And in fact, there was enough concern about it
link |
that when automobiles were invented,
link |
there was a movement to prevent installing windshield wipers
link |
because people were afraid that they would be hypnotized
link |
if they watched the windshield wipers
link |
go back and forth on a car.
link |
Now it turns out fortunately that you tend not
link |
to look at the windshield wipers.
link |
You keep looking through the windshield.
link |
And so we have windshield wipers today.
link |
But that movement is what exactly
link |
used to be a hypnotic induction.
link |
I think there is a lot of hypnosis in EMDR.
link |
And I think it's a combination of that
link |
with exposure-based treatments
link |
where you use EMDR to think about it.
link |
You tend not to process the experience as much
link |
and just do the physical part of it,
link |
which I personally think is a drawback.
link |
And every study I've seen that was a dismantling study,
link |
there's no question that people who go through EMDR,
link |
many of them get better with trauma-related problems.
link |
And the VA has a big program using it and so on.
link |
But every program that has dismantled
link |
going through the treatment
link |
with having the lateral eye movement
link |
has shown that the lateral eye movement
link |
doesn't add anything to it.
link |
And toward the end of her career,
link |
Francine was doing now contralateral touching or something.
link |
It wasn't eye movements anymore.
link |
It was other things.
link |
So I tend to think that EMDR
link |
is another form of exposure-based therapy for trauma.
link |
But as you've implied,
link |
with the exception of this possible new data,
link |
it certainly doesn't have to do
link |
with rapid eye movement, sleep.
link |
And I don't think moving the eyes is the issue.
link |
I think it's a way of sitting down and confronting trauma.
link |
And I would rather that the trauma itself
link |
be processed a bit more than often happens
link |
So a lot of people have gotten therapy.
link |
Some of them have been helped.
link |
Francine used to originally claim
link |
that just one session would desensitize people and do it.
link |
And that's clearly not true.
link |
I see a lot of people who said,
link |
yeah, it helped for a while, but I need more.
link |
So I think it became a kind of overly simplistic approach
link |
to understanding brain physiology, and that part is wrong.
link |
And the interesting thing,
link |
you mentioned suppressing amygdala activity.
link |
It's very interesting.
link |
My late friend, Alan Hobson,
link |
who was a brilliant sleep researcher,
link |
you know Alan, yeah, yeah, yeah.
link |
Well, I don't know him,
link |
but I read his book when I was in college
link |
about the chemistry of sleep
link |
and the similarities between dream states and hallucinations.
link |
And it's one of the reasons I got into this business.
link |
Yes, well, I worked with him
link |
in a MacArthur MindBody Network for many years.
link |
And he's a brilliant guy,
link |
points out that we need to get into primarily
link |
a parasympathetic state to go to sleep,
link |
that we have to shut off the sympathetic nervous system.
link |
And that's why a loud noise wakes you up
link |
when your heart rate goes up and all this.
link |
So he was brilliant at documenting
link |
what happens in the brain of sleep.
link |
He pointed out something also very interesting about dreams,
link |
which is that the stories in dreams
link |
and even the images in dreams
link |
can change all over the place in crazy ways,
link |
but usually the affect is constant.
link |
So usually if it's a frustration dream,
link |
whatever happens, you wind up frustrated.
link |
And if it's a enjoyment dream,
link |
you enjoy whatever's going on.
link |
So there's a odd consistency and affect in dreams
link |
that you don't have in other states.
link |
And the idea of lateral eye movements
link |
suppressing amygdala activity would kind of fit with that,
link |
that you don't allow intrusions of fear and anger
link |
and upset in dreams.
link |
It may be there all the time,
link |
but it may not be there when you think it should be.
link |
So why is it that you can be falling off a building
link |
and somehow not that scared?
link |
You're just having this experience of flying in a dream.
link |
So I think there may be something going on
link |
about regulating affect,
link |
but we have elaborate and better ways to regulate affect.
link |
Great, so EMDR might incorporate some elements of hypnosis.
link |
So the lateral eye movements,
link |
perhaps by way of suppressing the amygdala,
link |
this fear associated center might bring people
link |
into a more parasympathetic calm state.
link |
So it might be pseudo hypnosis and then exposure therapy
link |
through the discussion about the issue.
link |
More research needed on EMDR out there.
link |
And obviously something that's come up a lot
link |
in this discussion and in our discussions
link |
that I have the great fortune of talking to you every week
link |
is, and working together,
link |
is this idea of getting close to the phobia,
link |
getting close to the trauma,
link |
re-experiencing it as a portal
link |
to then adjusting the response to it
link |
and rewiring something so the troubling thing
link |
or the horrible thing is no longer as horrible to us.
link |
That, but the repeating theme is we can't expect
link |
to get over something without getting really close to it,
link |
maybe even experiencing it somatically.
link |
Nowadays, we hear a lot about triggers and trigger warnings,
link |
and certainly one can understand why those are,
link |
why those exist, but it seems like there's a,
link |
in the general population,
link |
there's this idea that we want to move away
link |
from anything that upsets us.
link |
And yet I think it's fair to say,
link |
even though having gathered the statistics that on the whole
link |
that the human beings are becoming more and more anxious
link |
and more and more stressed, perhaps because of,
link |
but certainly in parallel with the fact
link |
that we're trying to move away
link |
from troubling things, troubling things.
link |
So I've heard you say before that it's,
link |
in terms of therapeutic approaches,
link |
it's not just about the state you get into,
link |
but whether or not you brought yourself there voluntarily.
link |
That's exactly right.
link |
So this element of deliberate self-exposure,
link |
deciding I'm going to confront the trauma,
link |
I'm going to confront the pain,
link |
I'm going to confront the insomnia,
link |
I'm going to confront the, you know, and fill in the blank,
link |
and then readjusting one's emotional response
link |
right up next to that troubling thing.
link |
That seems to be the hallmark of this treatment.
link |
And if I'm thinking about it correctly,
link |
of pretty much all treatments for getting over stuff,
link |
if people don't have access
link |
to a really good clinician like yourself,
link |
how should they carry these thoughts and these ideas?
link |
I mean, I think almost everybody of any reasonable age
link |
has memories or things that upset them,
link |
but we learn to suppress them.
link |
Obviously the Reverie app has approaches
link |
to dealing with some of this inside of the app,
link |
but how does one start to think about
link |
actually dealing with something like this
link |
and avoiding the hazards of just kind of reactivating
link |
a lot of painful experiences?
link |
Because a lot of being a functional human being
link |
is also going to work each day, interacting with people,
link |
and not bringing one's trauma, you know,
link |
and dumping it out on the table,
link |
or being able to just function is so crucial.
link |
So how do you think about this as a clinician?
link |
Well, you know, the image that comes to mind
link |
is the Greek myth of Pandora's box, you know,
link |
that it opened and the Furies got out
link |
and you couldn't put them back in.
link |
And we have this kind of fantasy
link |
that once you get into these memories,
link |
they'll take you over
link |
and you'll never get them back in the box.
link |
And I think that's wrong.
link |
You know, people who use hypnosis say
link |
that there are ways to present things to people
link |
that will be helpful in ways that won't.
link |
And one real mistake is to tell someone,
link |
don't think about purple elephants, you know,
link |
what are you thinking about?
link |
You know, it doesn't work.
link |
So you want to find a way to feel in control of the access
link |
and to define what happened on your own terms.
link |
And so I'm not a big fan of trigger warnings.
link |
I think we're going crazy over, you know,
link |
this could be upsetting, that could be upsetting.
link |
Yeah, there are lots of things that are upsetting.
link |
You know, the average kid has watched 20,000 murders
link |
by the time he's 20 years old
link |
watching television and movies these days.
link |
So, you know, we see terrible things
link |
and it's not a matter of,
link |
are you exposed to something that's upsetting,
link |
but how do you handle it?
link |
What do you make of it?
link |
And are you feeling in control?
link |
It's not like, you know,
link |
what Putin is doing to his rival in Russia, you know,
link |
forcing him to watch propaganda movies 10 hours a day
link |
while he's in prison.
link |
It's a matter of thinking about a problem
link |
in a way that leaves you feeling you understand it better,
link |
you're in more control,
link |
you can turn it off when you want,
link |
you can turn it on when you want.
link |
And so we have to, in life, deal with stressful things.
link |
There are studies,
link |
Karen Parker at Stanford has done some wonderful studies
link |
with primates about stress inoculation,
link |
that if you separate a baby monkey from his mother
link |
for two hours a day and then reunite them,
link |
and then you stress that baby monkey later,
link |
they actually handle stress better.
link |
There's less cortisol arousal in the face of the stress.
link |
Stress inoculation has been called.
link |
So mere exposure to trauma or stress,
link |
it's a part of living anyway.
link |
We can't avoid it even if we'd like to.
link |
And it's not pleasant, it's not great,
link |
but it's sometimes things you need to learn about life.
link |
And if you can find an algorithm for facing it,
link |
putting it into perspective, dealing with it,
link |
you become a stronger person, not a weaker person.
link |
So this idea that college students are such fragile flowers
link |
that if you talk about a sexual assault or something,
link |
you're doing something terrible to them, it's just wrong.
link |
And I think we need to build our ability
link |
to recognize and manage stress.
link |
And you can't do that without doing it.
link |
You can't learn or you can't ride a bicycle
link |
without taking the risk of falling off it.
link |
And so I think that's the way I think
link |
of dealing with stress.
link |
Yeah, I really appreciate you saying that.
link |
You and I were both at a gathering,
link |
let's say where this issue was being discussed
link |
and around an issue of a publicized sexual trauma.
link |
And you made an excellent case for why
link |
this stuff can't be pushed under the rug.
link |
And that actually, in my observation,
link |
led to a lot of healing for the people that,
link |
and the families of people that suffered from this.
link |
I do think people are resilient,
link |
but we don't really teach how to think about feelings.
link |
You know, we're told that we need to feel our feelings,
link |
but then again, we are also told that feelings
link |
don't hold all the information.
link |
And so I think that, as you mentioned,
link |
there's no operating or user's manual
link |
for this nervous system thing.
link |
Brings me to another issue,
link |
which is the mind-body connection,
link |
something that we're very interested in.
link |
And you've done extensive work on.
link |
We all like to think that getting more in touch
link |
with our body would be a great thing.
link |
Learning to intercept, paying attention
link |
to our internal landscape would be a great thing.
link |
But as we often discuss, when we're feeling lousy,
link |
then being really in touch with that lousy feeling
link |
may or may not be a good thing, right?
link |
So how should we think about mind-body?
link |
I can see examples in hypnosis,
link |
from your descriptions of hypnosis,
link |
where you want to unify the mind-body connection,
link |
feel what you're thinking,
link |
think what you're feeling, et cetera.
link |
But I could also point to elements
link |
within the hypnotic process in which you are actively
link |
trying to uncouple those.
link |
So it sounds to me like this whole mind-body thing
link |
is a bit more like a car.
link |
You can't say that 40 miles per hour is the optimal speed.
link |
It kind of depends on the road you're on
link |
and the turn you may or may not be taking.
link |
But how should we think about mind-body
link |
in terms of navigating daily life?
link |
What do you think is the adaptive way
link |
to conceptualize the mind-body?
link |
It's a big question.
link |
It is, it's a very interesting one.
link |
I guess I think that it's a matter
link |
not of absolute control, but more control,
link |
that we need to think of our brain as a tool.
link |
And our body signals as tools as well
link |
to help us understand what's going on in the world,
link |
what we need, what matters, what's important, what isn't.
link |
But also something that can be managed,
link |
not simply absorbed.
link |
And so hypnosis, I think, is a kind of limiting case
link |
where you can push it about as far as we can push it
link |
in terms of regulating pain.
link |
Pain is a good example of that.
link |
Obviously, you need to pay attention.
link |
If you just broke your ankle,
link |
you better pay attention to it and get help,
link |
or you're having crushing substernal chest pain.
link |
You better do something about it.
link |
But our brain is sort of programmed
link |
to treat all pain signals as if they were novel pain signals
link |
if it's a sudden new problem that needs to be attended to.
link |
I teach people to think of the pain and categorize it.
link |
See, does the pain mean that if you put weight on this,
link |
you're gonna re-injure your ankle, for example,
link |
or does it simply mean that your body is healing
link |
and the pain is a sign that gradually
link |
things are getting back to normal?
link |
And so you can modify the way you process pain
link |
based on what your brain tells you the pain means.
link |
And that's true for emotional pain as well.
link |
And particularly where I think a strategy that really helps
link |
is if you think of an interpersonal problem
link |
or a threat of something coming as an opportunity
link |
to do something to ameliorate the situation.
link |
So it's not just it's happening to you,
link |
but something that you can influence and do something about.
link |
So it's blending the receptive with the active response
link |
that I think can make a difference.
link |
So you try and process it in a way
link |
that gives you a deeper understanding of what's happening.
link |
You face it, but you also say,
link |
this is an opportunity for me to do something about it.
link |
And the minute you realistically enhance,
link |
and this doesn't mean imagine a way, a heart attack,
link |
it means figure out how to rehabilitate from a heart attack
link |
or a broken leg or something like that
link |
in a way that you get as much control
link |
into the situation as you can.
link |
Grief, grief is one of those states
link |
that is very hard to remove oneself from.
link |
And a lot of people ask me, how do I deal with grief?
link |
And I'm not a clinician, so I'm deferring to you.
link |
On the one hand, actually someone at Stanford recently
link |
came to me and said, my mother passed away
link |
and I had a sibling that passed away
link |
and they were the only people that I had.
link |
And I'm also living alone
link |
and I'm challenged with a number of things.
link |
And they looked like they were holding it together
link |
very well, in fact, given what they were describing.
link |
And on the one hand,
link |
well, I certainly pointed out that I'm not a clinician,
link |
but I said, on the one hand,
link |
you could imagine that it would be necessary and useful
link |
to go into the grief state
link |
if you want to transition through it.
link |
On the other hand, I've heard before
link |
that the cathartic model of just really diving
link |
into an emotion can also be potentially hazardous
link |
if you don't have any anchors to grab onto.
link |
What is the view of psychiatry or your view of grief
link |
and how to deal with grief?
link |
Because I think grief is one of those
link |
all-encompassing emotions for many people.
link |
It is, and it's a very important,
link |
natural, necessary stage of life.
link |
And the reason we have all these grief rituals
link |
from burials and memorials and headstones
link |
and sitting Shiva and other things that people do,
link |
it's a way of making it real,
link |
that an incomprehensible loss has to be comprehended.
link |
You have to realize that you're now gonna have to live life
link |
without your loved one, your parent, your sibling, whoever.
link |
And we've all gone through this at one time or another.
link |
And it's very hard to just come to terms with,
link |
but one principle is to sort of say,
link |
it's never all or none, it's more or less.
link |
So yes, it's all or none that you've lost a loved one.
link |
But I ask people as part of their grieving
link |
to say to themselves,
link |
and I do this in hypnosis sometimes too,
link |
you've lost them, but what have they left you with?
link |
What have they bequeathed to you even though they're gone?
link |
And I'll sometimes ask them to say,
link |
if your mother could be here right now,
link |
what would she say to you?
link |
How would she feel about your life now?
link |
What would she advise you to do?
link |
So in our support groups for women
link |
with advanced breast cancer, we lost people.
link |
And I gotta tell you that we were warned by oncologists
link |
that we demoralize people that,
link |
I mean, they were wonderful oncologists,
link |
but there were some that were very afraid
link |
that we would harm them in some way
link |
because the mortality rate is fairly high
link |
with metastatic breast cancer.
link |
They're gonna watch people die of the same disease
link |
and you'll demoralize them.
link |
So we actually measured their emotion
link |
and the content of speech every five minutes
link |
throughout a bunch of groups
link |
to make sure that wasn't happening.
link |
What we found was that they talked about more serious issues
link |
but the mood didn't actually get worse.
link |
And we found in general that expressing negative emotion
link |
on the long run helps people be less anxious
link |
and depressed over time.
link |
And we've shown this in randomized clinical trials,
link |
so it's not just my clinical impression.
link |
And what we try to get them to do is to face a loss,
link |
live with the emotion that comes with it,
link |
but also see that the reason it hurts so much
link |
is how much that person gave you.
link |
So we would do a self-hypnosis exercise
link |
at the end of the group and say,
link |
I want you to get your body floating safe and comfortable.
link |
Now picture Mary and sit with the feeling of sadness
link |
that she's no longer with us.
link |
And we do that for a few minutes.
link |
And then we'd say on the other side,
link |
picture one thing she left with you that you still have
link |
that you carry on in your heart
link |
her tradition of what she gave to you.
link |
And so just seeing it not as a complete loss,
link |
but as a real loss, a painful loss,
link |
but one that helps you to reflect on what you gained
link |
from her and knowing her,
link |
I think can be very helpful in the grieving process.
link |
That's very helpful, a way to conceptualize it.
link |
A couple of quick questions.
link |
Can children be safely hypnotized or do self-hypnosis?
link |
It's sometimes harder for them to do self-hypnosis.
link |
They need more structure to do it.
link |
You've gotta share your dorsolateral prefrontal cortex
link |
with them a little bit.
link |
But yes, absolutely, children can be very hypnotizable.
link |
And I know pediatricians who use it wonderfully all the time
link |
they get them to focus on something else.
link |
So they're gonna have to give them a shot
link |
or draw blood or something.
link |
And they'll say, I'm gonna press your happy button
link |
and presses their belly button
link |
and they start to giggle the way kids do.
link |
And meanwhile, the nurses drawing the blood
link |
and they don't even notice it.
link |
Dentists, good dentists can use it
link |
to help kids with fear and pain.
link |
So yes, it can be very effective for children.
link |
We did a randomized trial.
link |
I have a publication in pediatrics.
link |
My late sister who was a pediatrician
link |
and who always used to joke that she was the only one
link |
in our family who was a real doctor.
link |
I said, I got you, I got a paper in pediatrics.
link |
And the paper was children having to undergo
link |
avoiding cystourethrograms.
link |
So the anatomy of the kidney, if you'll forgive me,
link |
is sort of interesting in that the ureter
link |
that goes into the bladder
link |
normally goes into the bladder at an angle.
link |
And so that means that when the bladder contracts
link |
to expel urine, it automatically closes off the ureter
link |
because it's sideways to the bladder.
link |
Some kids are born with it perpendicular
link |
and then you'll get reflux into the kidney.
link |
And some children outgrow it.
link |
Some need pretty complicated surgery to fix that.
link |
And so you image them every year or so
link |
to see whether they're getting kidney damage or not.
link |
And it's a pretty miserable experience.
link |
You're a nine-year-old girl.
link |
You have to go and lie on a hard, cold table,
link |
have strangers pull your legs apart
link |
and stick a catheter into your urethra
link |
and hold in the bladder and then expel urine.
link |
And so you get into these struggling fights.
link |
And of course, the more they struggle,
link |
the more they constrict and it makes it harder to do it.
link |
So I was asked if we could test it.
link |
So we did a randomized trial at Children's Hospital.
link |
They either got training in self-hypnosis.
link |
I would meet with them and the mother the week before.
link |
We find out from the kids where they like to be.
link |
And I'd say, you're gonna play a trick on your doctors.
link |
Your body's there.
link |
You're somewhere else.
link |
Go visit your friend.
link |
Do something else.
link |
And the mother would work on this with me
link |
at the head of the table.
link |
And we found that these children were much easier to image.
link |
One got so relaxed that, so your guy would,
link |
he said, normally it takes us 10 minutes
link |
to get them to pee after they're doing this.
link |
She was so relaxed, she started peeing
link |
before I could even get the bedpan under her
link |
and I had to clean up the table, you know.
link |
And they also, 17 minutes shorter procedures.
link |
And that's a long 17 minutes for a little kid.
link |
So it can be very effective with children.
link |
They're less anxious.
link |
They have less pain
link |
and get through these difficult procedures very well.
link |
Has hypnosis ever been done for couples,
link |
like couples therapy?
link |
I'm thinking of pretty much every clinical setting here.
link |
Both people have to be hypnotizable, of course.
link |
But the reason I ask about this is next,
link |
I'm going to ask about psychedelics.
link |
And there's a lot of interest in coordinating states
link |
through the use of drugs of different kinds.
link |
We actually do this when we treat depression, right?
link |
You have a depressed person with a family members
link |
who are not depressed and you say, well,
link |
let's make them all not depressed, right?
link |
I mean, but in all, and I'm only half kidding there
link |
because that is kind of the underlying logic in some sense,
link |
but are you aware of any coordinated hypnosis?
link |
That's interesting.
link |
I've done plenty of it in groups, not with couples.
link |
You can hypnotize large groups at once?
link |
Are we hypnotized right now?
link |
I hope you've been enjoying it.
link |
But the metastatic breast cancer,
link |
and there was a group of like 10 women
link |
who would meet once a week
link |
and we would all go into hypnosis together.
link |
I didn't realize that you were hypnotizing them
link |
And that, you know, if anything,
link |
I think it brings out the best in people's abilities
link |
because it's a shared social experience
link |
and they would talk about it afterwards.
link |
And so, yes, that's absolutely doable, yeah.
link |
And I don't want to focus on psychedelics specifically,
link |
maybe that's a topic for a future episode,
link |
but is there any basis for combining hypnosis
link |
with drug therapies inside of the hypnotic episode?
link |
So I realize that some patients of yours
link |
might be prescribed a antidepressant
link |
or a medication for some purpose,
link |
maybe same or different than the hypnosis
link |
is being directed toward,
link |
but is there any evidence that if people are relaxed
link |
through the use of a Propranolol or some, you know,
link |
one of these many things in the psychiatrist's kit,
link |
that hypnosis can be more effective?
link |
Well, interestingly, one study that I haven't mentioned
link |
is we did spectroscopy on people who were hypnotized
link |
and we found that there was a correlation
link |
between hypnotizability and GABA activity
link |
in the anterior cingulate cortex,
link |
which fits with turning down activity.
link |
So to the extent that we can self-medicate
link |
and GABA receptors basically are doing
link |
what benzodiazepines do to the brain,
link |
that can happen when people are hypnotized.
link |
So you're saying inside of the hypnosis,
link |
you have neural evidence that there's a kind of
link |
a sedative effect of hypnosis at the chemical level?
link |
Yeah, right, right.
link |
The people who are more hypnotizable
link |
have more of those GABA receptors
link |
and it's related to the degree of their hypnotizability.
link |
In terms of, there have been studies
link |
where they try to give people medications as well.
link |
And the interesting thing with benzodiazepines,
link |
which activate inhibitory activity in the brain,
link |
if you're very anxious,
link |
it might improve your hypnotic response a bit
link |
if you're just so anxious and you can't do it.
link |
If you're not very anxious,
link |
it actually inhibits hypnotic activity
link |
because you get sort of sedated and just out of it
link |
and you can't focus your attention as well.
link |
So by and large, we don't use drugs
link |
as an adjuvant to hypnotic experience.
link |
Most of the time you don't need to
link |
and sometimes it can make it worse rather than better.
link |
There's some evidence that mild stimulants
link |
might enhance hypnotic responsiveness a little reliably,
link |
but too much will again scatter attention
link |
and you'll have less control over it.
link |
So they might be adjuvants,
link |
but I frankly think hypnosis is more of a replacement
link |
than a need of supplementation.
link |
Your laboratory, my laboratory have,
link |
well, sort of snuck into your lab
link |
and then trying to kind of merge the two.
link |
It's been a lot of fun and learning a lot
link |
about the power of respiration of breathing
link |
to shift brain states, not just during breathing protocols,
link |
And we will do an entire episode about those protocols,
link |
I think after those are published and so on.
link |
But breathing itself is,
link |
you've described as a bridge between conscious
link |
and unconscious states.
link |
And so I have to ask how important
link |
is the patient's breathing pattern?
link |
How closely are you monitoring their breathing pattern?
link |
How closely do you monitor your own breathing pattern
link |
as you're inducing hypnosis?
link |
Put simply, what is the role of respiration
link |
in shifting the brain's state during a hypnotic protocol?
link |
Yeah, that's very interesting.
link |
You had a great show with Jack Feldman.
link |
Jack Feldman, and he is.
link |
And the issue, I watch it, I try,
link |
the work that we're enjoying doing together
link |
shows that there are breathing patterns
link |
that may increase sympathetic arousal or may decrease.
link |
It may help in cyclic sighing,
link |
seems to actually where you have more time spent
link |
exhaling than inhaling.
link |
And there's reason to believe that it induces
link |
parasympathetic activity,
link |
because you're increasing pressure in the chest.
link |
And therefore, allowing the heart to slow down
link |
because blood is being returned to the atrium more easily.
link |
I do use it, I ask people to take a deep breath
link |
as part of the induction and then slowly exhale.
link |
And partly as a result of our research together,
link |
I'm emphasizing this slow exhale more
link |
as part of, to enhance the idea in the induction
link |
that this is a period of relaxation,
link |
because I think they are inducing that
link |
and perhaps perceiving it as well.
link |
So there's no, you're absolutely right
link |
that breathing is very interesting
link |
because it's right at the edge of conscious,
link |
and Jack talked about that too,
link |
of conscious and unconscious control,
link |
that it will go on automatically, but we can control it.
link |
And so it's a kind of way for us to demonstrate
link |
to ourselves greater ways of modulating our internal state.
link |
So you can either do it thinking about it
link |
the way we do with pain control and hypnosis,
link |
or you can do it to some extent
link |
by taking charge of your breathing
link |
and doing things that will produce a change
link |
that you want to see happen in your body.
link |
So I like it because it's right at that margin
link |
where you can enhance, for me,
link |
I like that as a way of augmenting hypnosis
link |
more than medication.
link |
I think this is a powerful way of doing that.
link |
Great, I'm really excited to see where all of this goes.
link |
Breathing, vision, bodily states, clearly the,
link |
and directed mental focus
link |
seem to be the key elements of hypnosis.
link |
Am I missing any other ingredients?
link |
Yeah, I think that's right.
link |
Breathing, vision.
link |
Breathing, vision, how you change your vision.
link |
And you don't, typically you're in a physically relaxed state
link |
but frankly there are people at the peak of performance
link |
including physical, athletic performance
link |
or musical performance
link |
when they're in hypnotic states too.
link |
I've talked to classical pianists who say,
link |
I'm not thinking, if I start thinking
link |
about what my fingers are doing now, I screw up.
link |
I'm floating above the piano thinking about the tone
link |
that I want to feel exuding from the instrument.
link |
So that's a hypnotic like state too.
link |
And many athletes who are in peak performance
link |
are just flowing with it.
link |
They're not thinking step by step, what am I doing?
link |
And that's when you're doing your best.
link |
Or when we're working or giving a talk and doing it well,
link |
we're in a hypnotic like state.
link |
So it usually requires,
link |
but doesn't necessarily require physical comfort
link |
It can sometimes be intense activity.
link |
Well, this has been an amazing discussion.
link |
I've learned so much as I always do from you.
link |
Where can people learn more
link |
about how they can get hypnotized?
link |
We mentioned Reveri, we will put a link to it.
link |
It's R-E-V-E-R-I.com is the way to access that.
link |
Or it's the Reveri app from the app store is the other way.
link |
Reveri.com is the website, you can get to it through that
link |
or download the Reveri app from the app store.
link |
So currently on Apple, hopefully soon, also on Android.
link |
But in the meantime,
link |
what if people are interested in exploring clinical hypnosis
link |
working with you or somebody similar?
link |
Is there a centralized resource that people can go to
link |
to find really well-trained hypnotists?
link |
There are two good professional organizations
link |
that will help you with that.
link |
One is the Society for Clinical and Experimental Hypnosis.
link |
And I think that's S-C-E-H dot U-S is their website.
link |
We'll look it up and provide a link.
link |
And the American Society for Clinical Hypnosis.
link |
And they both provide referral services for professionals.
link |
You can look it up.
link |
I would just say in general,
link |
look for someone who is licensed and trained
link |
in their primary professional discipline,
link |
psychiatry, psychology, medicine, dentistry,
link |
and who has training and interest in using hypnosis
link |
is a way to do it.
link |
And then one more question, and then a comment.
link |
The question is, will you be my psychiatrist?
link |
I'm honored, I'm honored.
link |
I might be the most stubborn patient.
link |
I think the hardest work's already been done, Andrew.
link |
I appreciate that.
link |
Well, and the final thing is a comment.
link |
First of all, thank you so much for being here today,
link |
for sharing your knowledge.
link |
I hope we can do it again and again.
link |
I love working with your laboratory and with you.
link |
Because when you speak, I learn,
link |
and I know others do as well.
link |
We will put resources to get to you.
link |
But I also just want to say thank you
link |
for doing the work that you do.
link |
It's an incredible thing that in this world
link |
where we are discovering so much about how the body works,
link |
the mind is still rather mysterious
link |
and people are struggling with a lot of things.
link |
But also I think people are really excited
link |
about applying tools like hypnosis to perform better,
link |
feel better mentally and physically.
link |
And so you've pointed us to a tremendous amount of resources
link |
and how these tools work
link |
and where they've already been demonstrated to work.
link |
So just thank you.
link |
I know this is your life's professional commitment in life
link |
and we all benefit.
link |
So thank you so much.
link |
But it's been a real joy for me
link |
to be collaborating with you
link |
and for you to be using your precision and knowledge
link |
about neuroanatomy, neurobiology to address problems
link |
that often people who are that disciplined
link |
in the primary neurobiological end
link |
aren't as interested in as you are.
link |
And so it's really been a pleasure to try
link |
and bring together what we both know
link |
from these different perspectives
link |
to build something that neither of us could do alone.
link |
And so it's been a real joy for me to do it.
link |
Thank you very much, David.
link |
Thank you for joining me today
link |
for my discussion with Dr. David Spiegel.
link |
I hope you found it as fascinating as I did.
link |
And if you'd like to see the video
link |
of Dr. Spiegel hypnotizing me
link |
in what constitutes a abbreviated clinical hypnosis session,
link |
you can go to the Huberman Lab Clips channel on YouTube.
link |
Also, if you'd like to check out the Reverie app
link |
for self-hypnosis designed by Dr. Spiegel and colleagues,
link |
you can go to Reverie, that's R-E-V-E-R-I.com
link |
to see the Reverie app.
link |
There's also other information there
link |
about the scientific studies that support the Reverie app.
link |
If you're enjoying and or learning from this podcast,
link |
please subscribe to our YouTube channel.
link |
That's a terrific zero cost way to support us.
link |
In addition, please subscribe to the podcast
link |
on Apple and or Spotify.
link |
And on Apple, you have the opportunity
link |
to leave us up to a five-star review.
link |
Please also leave us comments and feedback
link |
as well as suggestions for guests
link |
that you'd like us to host on the Huberman Lab podcast
link |
in the comment section on our YouTube channel.
link |
Please also check out the sponsors
link |
mentioned at the beginning of today's episode.
link |
That's the best way to support this podcast.
link |
We also have a Patreon,
link |
that's patreon.com slash Andrew Huberman,
link |
and there you can support the podcast
link |
at any level that you like.
link |
On many previous episodes of the Huberman Lab podcast,
link |
we discussed supplements.
link |
While supplements aren't necessary for everybody,
link |
many people derive tremendous benefit from them
link |
for things like enhancing sleep and focus
link |
and various other aspects
link |
of brain and body health and performance.
link |
One issue with supplements, however,
link |
is that many of the supplements out there
link |
simply do not contain what's listed on the bottle
link |
and or the quality of the ingredients is not very high.
link |
That's why we partnered with Thorne supplements.
link |
Thorne supplements are used by all the major sports teams
link |
and they partnered with the Mayo Clinic.
link |
The reason they have so many high-level partners
link |
is that Thorne supplements
link |
are of the very highest quality ingredients.
link |
They also are extremely precise
link |
in terms of what's listed on the bottle
link |
is always what's in the bottle.
link |
If you'd like to see the Thorne supplements that I take,
link |
you can go to Thorne, that's thorne.com
link |
slash the letter U slash Huberman,
link |
and there you can see the Thorne supplements that I take
link |
and get 20% off any of those supplements.
link |
Also, if you navigate deeper into the Thorne site
link |
through that portal, thorne.com
link |
slash the letter U slash Huberman,
link |
you can also get 20% off any of the other supplements
link |
that Thorne makes.
link |
If you're not already following us on Instagram and Twitter,
link |
It's Huberman Lab on both Instagram and Twitter,
link |
and at those channels,
link |
I cover science and science-related tools,
link |
some of which overlap with the content of this podcast,
link |
other of which does not and is unique content.
link |
So once again, thank you for joining me
link |
for my discussion with Dr. David Spiegel,
link |
and last, but certainly not least,
link |
thank you for your interest in science.
link |
I'll see you in the next one.