Welcome to the huberman Lab podcast, where we discuss science and science based tools for everyday life. I'm Andrew huberman, and I'm a professor of neurobiology and Ophthalmology at Stanford school of medicine. Today. My guest is dr. David Spiegel. Dr. Spiegel is the associate chair of Psychiatry and Behavioral Sciences at Stanford University, School of Medicine. He is also the director of the Stanford center on stress and health. Dr. Spiegel is both a researcher and the
And meaning he runs a laboratory that studies the brain and the body and neural mechanisms of how the brain and body interact and he sees patients as a psychiatrist at Stanford. His work is incredibly unique in that it Bridges, mind and body. But it also has a particular focus on the clinical applications of hypnosis. As you learn today. Hypnosis is a unique, brain state in which neuroplasticity, the brain's ability to change in response to experience, maybe heightened and indeed the United.
Use of clinical hypnosis by dr. Spiegel and colleagues has been shown to improve symptoms of stress, chronic anxiety. Chronic pain and various other illnesses, including many psychiatric illnesses, and even outcomes in cancer. Today. We discuss hypnosis in the context of what's called self-hypnosis to distinguish it from stage. Hypnosis. Many of you are probably familiar with stage hypnosis, which is really about a hypnotist getting a person to do things that they would not, otherwise do in contrast clinical.
Moses and the use of hypnosis for the treatment of various ailments of mind and body is vastly different. It involves getting people to change their brain State and to use that brain State as a portal to make adjustments in their brain and body, and other aspects of their biology and psychology that benefit them. And it's been shown over and over again, in Studies by dr. Spiegel, and colleagues that those changes can occur extremely quickly. Not everybody can be hypnotized as readily as the next. And so today, we also
Gus a simple test developed by dr. Spiegel that can help you determine whether or not you have a high medium or low degree of what we call hypnotizability. Dr. Spiegel is truly an expert in this area. He has published over 480 Journal articles 170 book chapters on hypnosis. And on things like psychosocial oncology, which is the interaction of Mind and Body in the treatment of cancer and cancer outcomes on stress physiology trauma and other aspects of psychotherapy. He's published
Inbox, so he's truly the world expert in hypnosis and clinical applications of hypnosis for mind and body. I'm certain that in listening to today's episode. You are going to learn a tremendous amount about how the brain and body interact about various treatments for all sorts of common ailments of mind and body and you are going to get access to Tools in particular. A tool that was developed by dr. Spiegel, which is the reverie app. Are EV ER, I the reverie app is currently only available for Apple but will soon also be available.
Abel for Android. It does carry a nominal cost but there is a 7-Day free trial. If you'd like to try it. We're providing a link in the show notes. The reverie app is special in that it is based on clinical studies and research done in the Spiegel Lab at Stanford. So unlike a lot of hypnosis apps out there and resources for hypnosis. It was developed with clinical treatments in mind today. We also discussed the use of breath work and I'm very fortunate that my research lab at Stanford has been collaborating. Very closely with dr. Spiegel in
Testing and developing specific breathwork protocols to adjust mind and body for things like anxiety, improving mood and improving sleep based on his incredible and unique expertise, and the clarity with, which dr. Spiegel communicates information. I anticipate that you will really enjoy today's episode and they all come away from it with a lot of actionable tools. Some of you might be curious what a clinical hypnosis session looks like, and for that reason, we had dr. Spiegel, hypnotize, me a clip of that hypnosis session is going to be
Posted to the huberman lab Clips Channel, which is available on YouTube. Before We Begin, I'd like to emphasize that this podcast is separate from my teaching and research roles at Stanford. It is however, part of my desire and effort to bring zero cost to Consumer information about science and science related tools to the general public in keeping with that theme. I'd like to thank the sponsors of today's podcast. Our first sponsor is athletic greens. Athletic greens is an all-in-one vitamin mineral, probiotic drink. I've been taking atletic green since 2012, so I'm delighted that.
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20% off your first order. Again. That's Roca are okay, a.com and enter the code huberman at checkout and now for my discussion with dr. David Spiegel, David, thank you so much for being here.
Andrew my pleasure.
Can you tell us what is hypnosis?
Hypnosis is a state of Highly focused attention. It's something like looking through the telephoto lens of a camera in Consciousness. What you see? You see with great detail, but devoid of
If you've had the experience of getting so caught up in a good movie that you forget, you're watching a movie and enter the Imagine World your part of the movie, not part of the audience, you're experiencing it. You're not evaluating it. That's a hypnotic like experience that many people have in their everyday
lives. So is any experience that really draws Us in? Hypnotic in that sense? Or let me give a different example. If I'm watching a sports game and I'm really
wrapped up in the game, but I'm also in touch with how it makes me feel in my body kind of registering, you know, the excitement or the anticipation is that a state of hypnosis also. Because you mentioned there's kind of a narrowing of context but it kind of losing of the self. Or is it did have that right?
Yes. It is true that your to the extent that you're as somatic your body experience is a part of the sport event that you're engaged with. I'd say that is
Self altering hypnotic experience. If your physical reactions are distracting you or make you think about something else, that's when it's less hypnotic, like, and more just one of a series of
experiences. Okay, so I have to ask, how did you get into this business of hypnosis? Because I think for most people, when they hear hypnosis or they think about hypnosis, they think of stage hypnosis, right? I think of somebody with a pendant going back and
Fourth, or people up on a stage. You behaving abnormally for the entertainment of others. Yeah. How did you get into hypnosis as an interest, as a practice? And if you would, could you contrast the sort of hypnosis that you do in the clinical setting with the sort of hypnosis that a stage? Hypnotist.
Sure. Well, it is something of a genetic illness in my family. Both of my parents.
Were psychiatrist and psychoanalyst. And they told me I was free to be any kind of psychiatrist. I want it to be. So here I am. My father was training to be a psychoanalyst in 1943 and he ran into a Viennese Refugee who couldn't serve in the Army, but who had studied hypnosis and actually, it would interest you doing your ophthalmological research. He had a
Smallpox car right in the middle of his forehead and he did forensic examinations and he noticed that some of the prisoners would focus on that spot on his forehead and then close their eyes and seemed to go to sleep, but they were in some altered state. So he got interested in hypnosis. He used it forensically and his name was Gustav Von hoffenberg and he offered to teach young psychiatrist how to use hypnosis when they went off into the war and
No, he trained my father and he my father got off the analytic couch and asked, you know, met the, the analyst mentioned it to him. That's how he found out about it. My father said, did I say something wrong in analysis? Why is he talking to me? Oh, and he found it very useful and helping soldiers, who had acute pain when they were wounded and helping people with conversion post-traumatic stress disorders, and when he came back he went back to his training, but he still was sort of interested in it and
He had his one of his supervisors, was freed her from reichman who was a very famous psychoanalyst. And he said that he had been told to stop doing hypnosis because it would ruin his reputation as an analyst and she said to him. What are you? So worried about your reputation for you're going to give a course at the institute in hypnosis, and I know you're going to do it because I'm going to take it. So he was teaching freedom from reichman hypnosis, and he just kept doing it and after a while he discovered that he was getting better results with a few sessions of.
Is then he was with daily psychoanalysis with his patients. And so he switched his practice. And so the dinner table conversations were pretty interesting and occasionally, when he was making a movie of a patient. I would get to watch that. And so, when I went to medical school, I figured, I'll take a course. They would. Tom hack. It was a chair of Psychiatry at Mass General was teaching. It. Was it very interesting course and the day that converted me was I was doing my rotation.
Children's Hospital in Boston. And the nurse is telling me yes. Spiegel. Your next patient is an asthmatic and room for 37 or something. And I'm just following the sound of the wheezes down the hall. I go in the room. This is sixteen year old girl knuckles. White bolt upright in bed struggling for breath. You can hear the wheezing. She twice had subcutaneous epinephrine didn't work. They were thinking about general anesthesia and starting her on steroids and her mother's. They're crying and I said, I don't know what else to do. So I said I want to learn to breathing.
Sites and she nods. And I got her hypnotized. And then I realized we hadn't gone to asthma in the course yet. So, I made up something very complex. I said, each Breath, You Take, will be a little deeper and a little easier. And within five minutes. She's lying back in bed. Her Knuckles aren't white. She's not wheezing her mother stopped crying. The nurse ran out of the room and the intern, my intern comes to find me, and I figure, he's going to Pat me on the back and say, nice job Spiegel. He said, the nurse has filed a complaint with the nursing supervisor that you violated a, Massachusetts.
Law by hypnotizing a minor without parental consent and I thought, you know, oh that's nice. You know, I doubt there is a law like this. So the intern says you're going to have to stop doing this with her and I said why you said it's dangerous. I said, you're going to give her generalized seizure and put her on steroids and talking to her is dangerous, you know. Said, well you'll have to do it and I said, I'll tell you what, take me off the case if you want, but I'm not going to tell a patient of mine. Anything I know is not true. So there was a battle over the weekend.
What to do, when the the intern, the chief resident, tending were all arguing about it and on Monday, they came back with a radical idea. They said, let's ask the patient. I don't think that ever been done at Children's Hospital before and she said, oh, I like this, you know, she'd been hospitalized every month for three months, in status asthmaticus. She did a one subsequent hospitalization, but after that went on to study to be a respiratory therapist, and I thought that anything that can help a patient that much violate a non-existent, Massachusetts law.
Frustrate the nursing supervisor had to be worth looking into. So I just kept doing it. I discovered that there were, you know, all of my classmates in medical school had just read the new issue of the New England Journal and had some new medication to suggest and I would, you know, surgeons would say look if you can help this guy with his pain, or is anxiety anything above the neck. That's yours Dua. Spiegel. So, I, you know, I was having fun and being able to learn how to help people in a way that just otherwise was not being done. And
So it got me thinking about the fact that, you know, we're born with this brain, but we don't have a user's manual for it and we don't use it nearly as well as we can. And that's something your research is all about to. And and so I thought, I want to, I want to understand this better, and I want to see where we can do stage. Hypnotist drive me nuts, you know, they make fools out of people. There was one, my, this is a case. My father was involved. He got a call from, he was a Columbia. He got a call Spiegel. You got to come see this woman. She's
He's in the ER and she's in some kind of weird upset state that happened and it turned out she'd been on the show with a stage hypnotist. Who, and what they do, by the way, is they cycle around? You know, they have a, the beginning of the show. They don't just grab somebody and say we're doing this, they get a bunch of people up. They do what amounts to hypnotizability testing to see if people and they get the ones who are the most different sizable. So she was the one and he said, there's now a little bird.
In your hand and you're going to play with the bird and she starts to cry and scream and he just gets her off the stage because it's very upsetting and she's wandering around New York City in the middle of the night dissociated and brought to Columbia. And that's where my father saw her. She was still in a kind of uncomfortable, trance-like State. And it turned out that she was the trophy wife of a very wealthy guy, and she felt like a bird in a gilded cage. And so to her that image, just triggered all
Of this sense of dissatisfaction discomfort fear about her life and he was able to get her reoriented and talk with her about what she was going to do with their life, but I don't like stage hypnosis, you're making fools out of people and you're using the fact and that's what scares people about. Hypnosis. They think you're losing control, you're gaining control self, hypnosis is a way of enhancing your control over your mind, and your body, it can work very well. But because it gives you a kind of cognitive flexibility. You're
Will to shift sets very easily to give up judging and evaluating the way you usually do and see something from a different point of view. That's a great therapeutic opportunity. But if misused, it could be a danger to and that's what scares people about it. It's it is that variability to suspend critical judgment and just have an experience and see what happens. That can be a great therapeutic opportunity. But if somebody's misusing, it can be a way to harm people. And you know, there are plenty of examples of people.
The having fantasies imposed on them that they come to think, or realities. It's Not Unusual these days. So it's an ability that if people learn to recognize and understand, it can be a tremendous therapeutic
tool. I've been stage hypnotized, and I've been clinically hypnotized many times through self, hypnosis app will talk about later and then I know we have plans for you to hypnotize me today.
You've done it once before and I'm very hypnotizable as we both know, right? We'll talk about how one can gauge their hypnotizability sure, but the stage hypnosis was interesting. This was in college, you know, they brought someone out to the dormitory and recall. Being one of the people that was selected and and engaging in very bizarre behavior, right? It wasn't thoroughly embarrassing but it was
Pretty embarrassing. And then being sent off the stage. And as I was exiting suddenly screaming something out because he had planted a suggestion of some sort. And then I was told to look in my pocket and there was like a I think a torn-up dollar bill, there were a bunch of things that I have vague recollection of but it raises a set of questions that really boil down to, you know, as a biologist. I always think that, you know, there's no, there's no way
It's in the brain. There are there processes and so hypnosis we know has an induction, then one is hypnotized. I imagined. And then it sounds like this woman and this example of the bird and being in being distraught in New York, City is a failure to exit the hypnotic state. Do we know what sorts of brain areas are active during the induction? The let's call it. The Deep hypnosis and then what's shutting off, or changing as people exit
hypnosis.
Yes. Yes, we do. We've studied that. We've been very interested in that. And so we did a study where we selected highly and non hypnotizable people, so we could do the comparison and then hypnotize him in the functional MRI scanner and we found three things characterized the entry into the hypnotic State. The first is turning down activity in the dorsal anterior, cingulate cortex. So the dacc is in the central front middle part of the brain, as you well, know. And it's
It's part of what we call the salience network. It's a conflict detector. So if you're, you know, engaged in work and you hear a loud noise, that you think might be a gunshot. That's your anterior cingulate cortex saying, hey, wait a minute. There's a potential danger over there. You better pay attention to it. So it's a it Compares. What you're doing with what else is going on. And helps you decide what to do. And as you can imagine, turning down activity in that region, make it less likely that
That you'll be distracted and pulled out of whatever you're in. And in another study. We found that highly hypnotizable people. Even without Billy being hypnotized have more functional connectivity between the dacc, the anterior, cingulate cortex, and the left dorsal lateral. Prefrontal cortex. So, which is part of the icky region in the executive control Network. So when you're engaging in tasks, your enacting a plan, you're writing a paper, you're doing whatever you're doing. That's the the prefrontal cortex is doing that.
And so if that is coordinated, we found more functional Quantic connectivity. So when one is up the others up and one is down the others down that coordination implies that the brain is saying, okay. Go ahead. I know what you're doing, carry out that plan and don't worry about other possibilities. So, two other things happen. When people are hypnotized one is that, that DLP of see has higher functional connectivity with the insula, another part of the salience network. It's a part of the mind-body control system.
I'm sensitive to what's happening in the body. It's part of the pain Network as well. But it's also a region of the brain where you can control things in your body that you wouldn't think you could. For example, we did a study years ago where we took people, Riley, massage will hypnotize them. And told them to imagine, we went on an imaginary culinary tour. So we would, they would eat their favorite foods and we found that they increase their gastric acid secretion like by 87%. So,
Our stomach was acting as though it was about to get, I mean there was one woman. It was so vivid for her that halfway through. She said, let's stop. I'm full, you know, eating these events, never eaten having never eaten an actual, no incredible. And then we got them to relax and think of anything but food or drink and we got like a 40% decrease in gastric acid secretion. So they could. And that was DLP of see through the insula, telling the stomach, you're getting food or you're not getting food and even we injected them with
Gastrin, which triggers, gastric acid, release. And even then, in the hypnosis condition. They had a 19 percent reduction in gastric acid. So the brain has this amazing ability to control what's going on in the body, in ways that we don't think we have ability to control, that's just one example. So, that's the deal. PFC insular connection, the third thing that happens and this relates to what you did on the stage, is you have inverse functional connectivity between the DLP of c and the posterior
You look or text. The posterior, cingulate is part of the default mode Network. It's in the back of the brain and it's an area whose activity goes down. For example, in meditators. And in meditation, you're supposed to be selfless. You're supposed to do self is an illusion. You're supposed to let it dissolve and just experience things. And when you're doing that, that poster is saying that is decreasing in activity. The inverse connection is, I'm doing something but I'm not thinking about what it means for me. I may not even remember much of
Vit, if I do, I don't care that much about it. And so, that is part of the dissociation that occurs with hypnosis. So, it's how you put things outside of conscious awareness and don't worry about what it means. It also adds to cognitive flexibility, you know, if you're thinking well, people like me, don't usually do this. That may inhibit you from enacting a new form of psychotherapy, for example, that you've never done before. But if you're having this decreased activity in the part of your brain that reflects on,
It means you're more likely to be cognitively flexible and willing to give it a try. And that's one of the therapeutic advantages of hypnosis as well,
fascinating. And it's really going to put an embarrassing, you hear a little bit in the positive sense. It's a, your laboratory is really the one that's pioneered brain Imaging of hypnotic States, and it sounds like, that's my understanding. Is that is that
correct? Yeah. I mean, there are other people who have done, excellent research to be sure but your rainbow and Montreal and several other.
People but we're one of the leading lamps and neuroimaging of hypnosis.
I have to ask about attention deficit. Hyperactivity disorder. I get a lot of questions about this and I think a lot of people just struggle with holding attention nowadays because of, you know, interference with phones and devices. And and I've, of course, there is a lot of, clinically legitimate ADHD out there, but the way they describe the dorsal anterior, cingulate and the salience network and this conflict detector.
You know my focusing on something or am I splitting my attention? How distractible a my seems to relate to some extent to activity in the dorsal anterior. Cingulate cortex do people with ADHD display disruptions in elements of these networks, and has hypnosis ever been used to or self-hypnosis. I should be to distinguish from stage, hypnosis clinical and self-hypnosis been used to enhance people's ability to focus and hold.
Detention because that's such a built-in component of the hypnotic State.
It's a great question. There are, there's sort of two ways to think about it in terms of enhancing Focus. Yes. It has been very helpful in teaching people to just prepare your mind too narrow in and focus on something. And when you know, when you're really engaged in reading something, or you're writing a path, I mean, I'll have that sometimes. I'm thinking. Oh God, I have to do this for another hour other times an hour ago by and all that. Hey, great. Because when your
In that it feels game like to you know, you're just assembling the parts of the puzzle and putting them together. It's fun. You just get absorbed that for me. That's a hypnotic like experience when I'm having trouble when I'm struggling. Sometimes doing things like self, hypnosis can help. I'm not an expert on ADHD. My impression is that you're right. That these are people who are constantly distracted and rather rigid. The other part of it is they're easily distractible. They're very upset when they get distracted and to rather rigid and
What they want to attend to and what they can't. I think as a way of controlling this distractibility, frankly. I my guess is that many people with ADHD would not be that hypnotizable, but I haven't even studied at. So it's possible that for some people with that disorder training and self-hypnosis might help but we'd have to see how hypnotizable they weren't, take it from
there.
I want to return to some of the underlying neural networks and the clinical applications, but what sorts of things aside from the asthma, have you used hypnosis successfully for it or have others used clinical hypnosis for and are there any particular areas of psychiatric challenges or illnesses? I guess they're called that are particularly.
Um, amenable to hypnotic treatment.
Yes, there are. Hypnosis is very good as a problem focused treatment. It's really, it's the oldest western conception of a Psychotherapy and it can be used for specific problems in a way. That's very helpful. We found it very helpful for stress reduction, for helping people deal. We're all dealing with stress these days and it's helpful. That mind-body connection is very helpful because part of
Of the problem with stress is your perception. You mentioned it earlier in a sort of good sense. You're at, if you know, football game or something and you feel the physical reaction that can be a reinforcing thing. Wow. This is exciting. Let's do it. It can also be very distracting. So you're worried about getting covid or you're worried about some other physical problem you have, and you notice it in your body, your body tenses up, you start to sweat sympathetic nervous. System goes your heart rate goes up.
And when you notice that, you think, oh God, this is really bad. And then you feel worse. So it's like a snowball rolling downhill and and then you feel worse and then your body gets worse. Hypnosis can be very helpful in dissociating somatic reaction from psychological reactions. So we teach people to imagine their body floating somewhere, safe and comfortable like a bath. Alayka Hot Tub were floating in space, and then picture the problem that they're the stressing them on an imaginary screen with the rule in no matter what you see on the
Green, you keep your body comfortable. So, at this point you can't you still can't control the stress, but you can control your physical reaction to it. And that starts you feeling more in control. At least. There's one thing I can manage and then you can use it to Think Through where visualized through one thing you might do about that stressor. So if gnosis is very helpful in controlling mind-body, interaction, in relation to stress. It's very helpful for people to get to sleep. We're having a lot of fun with that. I I'm getting emails.
It's from people who said, you know, I haven't slept right in 15 years. And now for the first time, you know, I'm listening to your app and I can sleep at night, you know, so it's very helpful. And again, you know, if you wake up in the middle of the night, you know, I you I tell people don't look at the clock. That's an arousal Q, you know, you're just wake up more but I'm at picture whatever you're thinking about a worrying about on that imaginary screen while your body is floating. So watch your own movie, but keep your body floating and many people.
Is that to get back to sleep? I've been using
the self hypnosis for sleep for a long time. And now, the reverie app and we'll talk about our relationship to the reverie app and its use. As I find, incredibly useful for falling back asleep, in the middle of the night and it raises a question. I found. And I think I understand this correctly. That one can do self hypnosis during the daytime and then if there's an issue that comes up later, like so for
Instance, do self hypnosis for stress reduction away, from the stressful event to prepare, one to deal with stress better or do hypnosis for improving the return to sleep and that can be done when you actually want to go to sleep. But it's a kind of a training up of these networks, right? Right. Is so is there evidence that these brain networks actually form stronger connections when people do self-hypnosis over time.
Well, there's a rule in neurobiology.
As you know that neurons that fire together wire together our friend Carla shots. Yeah, it's
got Donald Hebb. By the way, I think trying to there's a there's a, there's a widespread myth in the world. That is unfortunately all over the Internet, which is that the fire together wire together was said by the psychologist Donald Hebb. Donald had many important things, but it is the neurobiologist Carlos. Yeah. That's exactly right. Yes, is that Stanford? But was also a Berkeley and Harvard. So that's right, decent schools, that but is that Stanford?
Bird who said fire together wire together and surviving deserves the righty credit for that statement. Yes. So with repeated use of self hypnosis one, could imagine that these networks are getting stronger.
I would, I would think so. We don't have evidence of that yet. But you know, long-term potentiation provides a pathway and you've described them on your program. A number of times that allow for repeated activation of a network to actually
New connections, that that work and at the least even from a learning and memory point of view, you know, are, you know, memory is all a network of associations. That's how we remember things. And, you know, the example, I like to give is you go back to your grade school and, and you see these little tiny lockers and the, you know, size is all wrong. And you suddenly have a flood of memories that you were obviously stored there, but you just didn't think of. So it context and Association is what memories about. If you
Start to acquire memories about a problem. So one thing we use hypnosis words, treating phobias for example, and the problem with people who have phobias, like airplane phobias or you know, crossing a bridge or being up high. Is that the more they avoid it, the more the only source of associations and memories is Their Fear. They don't have any good experiences with it because they avoid it, you know, it's like get back on the horse after your fall off kind of thing and and with hypnosis, if you can
Are people able to manage their anxiety enough that they can have more of wider? Array of experiences. They start to have a network of associations. That isn't so - and may even be positive.
So it's almost like a sorry to interrupt, but I have to ask it's almost like a exposure therapy done in the mind. Yeah. It's always in the mind. I mean even exposure to, if I have a snake phobia, which I don't, I don't like snakes but I don't think it qualifies as a full-blown phobia thing of a healthy fear of snakes.
Eggs, but if let's say I had a snake phobia it, the typical approach in would be cognitive behavioral approaches, right? Would be to show a picture of a snake or than a rubber snake than a real snake. Eventually. The person is, you know, holding a boa constrictor or something like that with that's all in the mind because it's all translate into nervous system signals, but with hypnosis sounds like you can give a number of positive experiences without having to use any props without having to bring
Animals into the right. I drive someone across the bridge. Is that, right?
Yes. I had a woman who was a very successful businesswoman, high level in a corporation. I had a terrible dog phobia. And so, I had her imagine that somebody brought in a dog to the room and I said, what are you doing? And you could see you're getting tense. And she said, well, I'm waiting to see what the dog does. And I said, if somebody who works for you comes into your office, would you freeze and wait to see what they did? And she said, of course not. I tell him what to do.
You know, and I said, well, so you were mobilizing yourself. The power isn't with the dog. It's with you. So imagine what you might do to engage the dog and and help control the situation. And she said, thanks and this reminds me of one of my favorite stories about hypnosis that my father was seeing a woman and who lived in Midtown Manhattan and had a horrible dog phobia, you know, she dropped things. She'd spilled coffee, you know, she saw a dog. She would time her trips to the store when she thought it was least likely that people be
In dogs. Now, that wouldn't be possible to everyone and everything.
It's like a fleet of French Bulldog, right together,
exact York city, so he taught her to think of dog as a friend, have a neighbor who had a dog, bring the dog over, but hold the dog by the collar and make sure and gradually. She was able to stroke the dog and say, dog friend and distinguish between wild and tame animals. There are animals. You should be afraid of us isn't so she seem to be doing better. He called back about three months later.
And asked for her. And I said, well, who's calling? The son said, he said dr. Spiegel, and the boy said that's weird. And my father said what's weird? He said Spiegel's in heat. She had bought a dog, a lot of it and named his feel talk about transference. I love
it, what, but it really speaks to the power of this and it brings me back to this issue. So what is different about what your father did in that?
Is with this. With this woman in terms of what happened in hypnosis that allowed her to go from being completely terrified of dogs to owning a dog and naming it after your father. Look, I find amusing but that's different than just the two of them sitting down and talking about it, right, you know in therapy either narrative is a huge component and in hypnosis narrative is a huge component, right? So it must be that the
Brain state is, what is really different because we'll talk about trauma in a few minutes. But, you know, I think people who have trauma or phobias, certainly could have a conversation about it. They some of them might freeze up. Some of them might lose their articulation and so forth. But what is different about that state that combines with narrative? You think to allow these underlying neural networks to to engage her to change as I find this so fascinating because we're
Every attempt at dealing with stress or phobia in the clinical setting involve some discussion about what it is. Yeah, but here, we're not talking about any medication being introduced at least not in these particular circumstances. And so I just, I realized it's kind of an obvious question. Like he has to be some difference in brain activity, but I find that to be incredible. The control variable. There is the brain State. It's not what spoken.
You're raising a couple of very important issues, Andrew. I, you know, we talked earlier about systematic desensitization, where you, you know, sort of layout, hierarchy of things and do it one at a time. I think of this as a nun, systematic desensitization because you're changing, mental States. And if, and I think there's more and more evidence that mental state change itself, has therapeutic potential. We're seeing that with ketamine treating, depression and Associate genic drug we
We know at every morning, when we wake up that problem when you know, you made the mistake of reading a nasty email at 11 p.m., You don't know what to do. You wake up in the morning thinking. Oh, that idiot. Yeah, here's what I'm going to do, you know, so just changing mental, state itself has therapeutic potential and I think we underestimate our ability to regulate and and change responses to be cognitively emotionally and somatically flexible. And so we do things you write that follows similar principles of facing a
A problem seeing it from a different point of view, and you've done a really nice podcast on trauma and stress, and how you have to expose yourself to it, not avoid it as we talked about before, and then find some way to reconnect to it to substitute. Something that can make you feel good rather than bad. So that you activate other centers of the brain like Muhlenberg reward system. And so I do that with hypnosis and you can do it much faster, people. Don't think they can.
But they can't, if you're having right now that physical experience, I'm thinking about this, but I'm not feeling as bad as I used to, that can be a powerful thing and you can do it with hypnosis. So I had a woman came to see me who had suffered an attempted rape. It was getting dark. She was coming back from the grocery store. And this guy grabs her and wants to get her up into her apartment. It's outside of her apartment. And she starts fighting with him and she winds up with a basilar skull fracture, he runs away.
The cops come, since she hadn't been raped. They left, they weren't interested in, she wanted to use hypnosis to get a better image of what this guy looked like, which is a painful upsetting thing. So she was quite hypnotizable. I got her floating. I say you're safe and comfortable. Now, nothing can happen that will harm your body. But on, on the left side of the screen, I want you to picture this guy and his approaching what's happening and she said, I really the light with it was getting dark. I really can't see much of his facial features, but I do.
You guys something. I hadn't allowed myself. To remember, if he gets me upstairs. He doesn't just want to rape me. He's going to kill me. And so, in some ways what you were seeing was even worse. So, you know, you're thinking good Spiegel, you made her even more frightened than she was before. But as you had pointed out in your PTSD stress, lecture, you've got to confront the trauma to, to restructure your understanding of it. So, on the other side of the screen, I had her picture. What?
What, what are you doing to protect yourself? And everybody in a trauma situation, engages in some strategy of / self-protection, you know, that's the salience network kicking in and she said, you know what, he surprised and I'm fighting that hard. He didn't think I would. And so, she realized on the one hand that it was even worse than she thought it was. But on the other hand, that she actually probably saved her life. And so it was a way of helping her restructure, her experience at a trauma and make it more tolerable. So,
That helped with her. She didn't recognize you. She couldn't identify the guy, but it helped her restructure and understand her experience. And that's something that you can do in just talking straight out psychotherapy. But sometimes you can do what a hell of a lot faster and more efficiently using hypnosis, and there is one randomized trial out of Israel, that shows that adding hypnosis to PTSD treatment, actually, improves outcome. So it's, it's a way of accomplishing things that we
Understand in the broader Psychotherapy world but much more quickly and and sometimes effectively
yeah, it sounds like going into somewhat into the state. That one is trying to deal with but then dissociating from that state is key and I can imagine and you know, I've been open about this on various podcast. I've done a lot of analysis over the years. So in but in the experience myself that in those sessions, depending on how I show up to them, I might just get in kind of a
Every list of what happened as opposed to actually feeling anything around what happened, right? And I think people probably vary in the extent to which they can drop into feeling States and can depend on the day. It can be depend on how well you slept the night before and so on.
There's just one thing I might add and doing that is, you know, there's a notion of the late Gordon Bauer he did. We just had a memorial for Gordon at Stanford. He died about a year ago. Brilliant cognitive psychologists are one of the founders of cognitive psychology.
She at Stanford and a great picture. He almost he almost became a major league pitcher, but he decided to go to grad school instead and I'm glad he did. But Gordon helped establish the concept of state-dependent memory. That when you're in a certain mental state, you enhance your ability to remember things about it. And the sort of the bad example of that is the drunk who hides the bottle, and can't remember where he put it until he gets drunk again that he's in that same mental state people. Go into dissociative States.
They're traumatized. So in a way, hypnosis is helping them remember and deal with the memories better because their morale in the mental state, that is more like what happened and most rape victims will tell you. I was floating above my body, feeling sorry for the woman being assaulted below people in traumatic episodes. They just say, you know, I blank out. I don't know what's happening. I'm on autopilot, and that's a kind of self hypnotic state. So when you use hypnosis to help them deal with the trauma,
medic memory, you're making the state. They're in right there in your office with you more congruent to the state. They were likely in when the trauma happened. And I think that is part of what helps facilitate treatment of trauma Related Disorders. See,
that makes me have to ask every question. I have to ask that because I really feel it as almost a compulsion. Then if dissociation during a traumatic episode is, it's a part of the Adaptive strategy, right? Um, but it creates certain,
Shoes, it creates problems. All right, why would something like ketamine which creates a dissociative State be useful for the treatment of trauma? This is what I'm confused about these days, because our colleague, Carl died sir. Authors also been on this podcast and his co-workers have figured out. Okay, there's these layer one networks in court in the neocortex. And those are involved in dissociative State. And so we're starting to gain some understanding of how ketamine works at a neural level, right? It does seem
as if for certain populations, it's a can be a useful treatment. I don't know. I've never tried it. I don't know what the current status of that is, but it is legal. It is allowed at least in its FDA approved and it's in use. Why would dissociate dissociative States be useful? If this, if some element of dissociation is what gave rise to the trauma. Trauma memory in the first
place. Well, you had Carl had a brilliant paper in nature where he was from from rats to humans and one paper and he showed
That there's this rhythmic discharge and the Retro spleen, you'll region that is associated with that is triggered by ketamine. And and the Rats actually showed dissociative like behavior in that they would touch a hot pad that they ordinarily wouldn't. And they didn't seem to have much pain in their paw and he then had a male subject who had implanted electrode, human human subject. Yeah. Human subject. And the electrodes had picked up this rhythmic activity and
When they did, he would report being in a dissociative State and his description was, it's like being a pilot of an airplane and then I felt myself walking out of the cockpit and the plane was still flying and it sounds terrifying. It does. Tara something going to be in
my body most of the time
it's right. But the point is in a way. The principal Andrew is like the principal you said that you need to re confront a traumatic situation before you can modulate your associations to it.
So you have to accept it. Accept the arousal, put some boundaries around it and then figure out how you can approach that problem or how you did approach that problem from a different point of view. So it does not surprise. In fact, we've studied people who dissociated during the Loma Prieta earthquake and the Oakland Berkeley fire storm. Remember, both the well, yeah, that's
Quakes follow me. And then I move South and then the Northridge, I'm going to keep the everyone later this afternoon.
I'm starting to dissociate him. So,
Dissociation does compartmentalize experience. But that means from the point of view of treating trauma. It's an it's an inhibition. You don't engage. It's like it happened over there. And I think what happens is that people are sometimes too good at being able to separate themselves from the recollection. So it's in there somewhere. It doesn't. It's out of sight but it's not out of mind. It's having effects on you, but you can't deal with it. You can't reprocess it. So I do think, one reason ketamine might work.
Is that in fact it allows you to keep to re-approach the dissociative experience in a way that you can then start to think about and do something about it and just the fact you can turn it on and off and that's also where his self hypnosis is so helpful. It's not something that just comes over you and happens to you. It's something you can make happen. You can control it, you can do something with it. So you feel less helpless and out of control. The essence of trauma is helplessness. It's not fear. It's not pain, its helplessness.
You become an object. You become just your body. You don't control what's going on at. We're not used to that. You know, you and I have discussed this, this is This brilliant paper on anticipation of breathing and it's not whether you breathe, inhale, or exhale or hold your breath. It's that if you think you can inhale and you can't, that is really upsetting understandably. And so it's the, the issue is control and hypnosis, which has this terrible reputation of taking away control is actually
A superb way of enhancing your control over mind and
body.
I love that and it reminds me that naming is so important. You almost wonder if self-hypnosis and clinical hypnosis had been called something else that it would have it separated out from stage hypnosis in a way that would make it less, you know, less scary, weird complicated for people to embrace. But, you know, the part of the reason for having this discussion is I I've had great experiences with hypnosis. I've seen the data, you know, we're talking about a lot of clinical.
Examples, it's incredibly powerful and it boils right down to neural brain States. And you know, I think in the years to come, it's going to become more. Widespread along those lines. How quickly, you've described some examples of people getting relief very quickly. How permanent are those changes. Is there a need for follow-up and related to that. I'm sure a number of people are listening to this and thinking, wonderful, I'd
of to get hypnotized for any number of different things by dr. Spiegel or somebody else expert in clinical hypnosis, but they might not have access to you or somebody with similar training. So what is the power? So how quickly does it work? How long lasting are those changes and then is it necessary to work with a clinical hypnotist? And is it better to do that than self-hypnosis and so on and so forth. Maybe you could just give us a contour of the of the landscape of directed and and
Directed treatment. Well, typically, most people start by coming to see a clinician like me. It's better to see someone whose life has licensing and training in their professional. Discipline medicine, psychology Dentistry, whatever it is there a lot of businesses
out there who are just hypnotist hypnotists. Oh,
okay, and and the key issue is somebody who can really assess what your problem is and make sure that you're not talking someone into reducing their chest pain rather than getting their coronary.
Artery problem because they
could have a real issue there that could write gnosis might adjust. But wouldn't deal with the deeper underlying
issue. That's right on the other hand. And typically when I use it with people, I often only see them once or twice or periodically but not every week and certainly not every day. If they have a pain problem, hypnosis is very helpful for pain. And and so what I'm doing is identifying how hypnotizable they are. I'd give them a standard brief test of their ability to experience.
Gnosis and then going through a self hypnosis exercise with them to deal with the problems seeing how they respond to it and then teaching them how to do it for themselves. And in the old days. I used to have them use their iPhone and record, you know, the that part of the session so they could play back the hypnosis experience. Now, we've developed an app reverie that can teach people and step them through dealing with pain stress.
Otis insomnia and help people eat better and and stop smoking and boat. We have elements that take about 15 minutes and elements that just take one or two minutes that people can refresh and reinforced. So, the idea of gnosis. Yes, one. Yes, and it. It's 12 to wear one to two minutes now, and we're finding that two-thirds of the people find it. Even just the one minute refresher, helps them feel better. They're reporting. They feel better. So the nice thing is, you know, right away. Whether it's likely
To help you or not. And we found. We've done studies looking at hypnosis for pain relief in acute medical procedures. We did a randomized trial that we published in the Lancet. Three conditions people getting arterial, cut Downs to chemo. Embolized tumors in the liver or visualize renal artery stenosis. You don't use general anesthesia for this. It's very uncomfortable and people are anxious and we had three conditions, one was standard care. They could push a button and get opioids IV is
During the surgery during the
surgery. The second is they could do that. Plus. They had a friendly nurse comforting them. So we controlled for Pleasant attention and support and the third was, we taught them self hypnosis for pain control. So you're, you're feeling you can change the temperature, your body is cool, tingling. And now you're floating in ice water, and feeling comfortable, or go somewhere else, leave your body here and go to a desert island and enjoy yourself. And we found that at, it's about two and a half hour, Percy.
You're that effort by The End by an hour and a half, the hypnosis group had reduced their Pain by 80%. Compared to the standard Care Group using half the amount of opioids. They had fewer complications and the procedure took 17 minutes less time on average to get done. Because not only was the patient more relaxed. So was the treatment staff they could. They were dealing with someone who's struggling and uncomfortable. We measured their anxiety. And same thing. They have no sister. I was worried. They were all dead. They had no anxiety.
After an hour and a half, they were saying, I'm fine, you know, and they were fine and they end the standard Care Group had five out of ten anxiety scores at that point. So, we published that in the Lancet, big randomized trial, if we had a drug that, did that every hospital in the country would be using it now, you know, but there's no industry to push it. So that's part of what helped us decide that we needed to help people, you know, do this with with reverie and teach them how to do it and provide.
Interactive support for them to do it, and does it, you know, the question although is, does it work long-term? Because what we can do, acutely, doesn't necessarily carry on. So, we did a randomized trial of women with metastatic breast cancer. They had advancing disease. We met with them in a support group once a week and taught them self hypnosis for for Stress and Anxiety and pain, control it in. And by the end of the year, the treatment group had half the pain, the control group did on the same, in very low amounts of medication.
Ocean. So it lasts and they would say when I felt that pain in my chest and thought it was a metastasis. I just did the exercise. I got myself in a warm bath and I felt fine. So it works because it becomes a skill that people acquire but they can tell right away whether it's likely to help them working with a clinician or Now using the app or your other ways of helping them learn to use it as a skill. So the nice thing is you will know very quickly whether it's likely to help you or not. And if it is,
Can learn to do it for
yourself. That's great. And we will again they'll be linked to reverie in the caption. It's available for Apple and Android and I think even though there's a nominal cost there. I think that, you know, the as you mentioned medications and other approaches to dealing with these problems are quite expensive and and potential have all the potential for side effects and things. Not that some of those aren't also
useful. Could I before you get to that just one thing we
We've worked very hard on the app. We have an IOS app for Apple. We decided to table for a moment, redoing the Android app. So it's not, it was available. When we were working through the Alexa platform. It's not at the moment, but it will be soon. So I just don't want people to be disappointed. If they're looking for it for Android. It's on our agenda, but we don't have it at the
moment. Great. Thanks for that clarification. So hopefully, in time for both, I get asked a lot about
Obsessive thoughts or intrusive thoughts. I also get asked a lot about OCD. Is there any evidence that hypnosis or self? Hypnosis can be used for dealing with obsessive thoughts.
Sometimes there are some very obsessional people who just turn out not to be that hypnotizable for and it's not random. They you know, they tend to be so over controlling of thought they're all busy evaluating rather than experiencing. So and so few people like that.
Sounds like, it sounds like an Adaptive mindset for a lot of professions then areas and that we get trained up in that. Yeah, during school, you know how to obsess over the exam. Obsess over the
our
social interactions. I mean, it's part of becoming a functional human being and yet you can take us down a
different. We sometimes I overdo it. I mean, I'll tell you one example from extreme situations could you know, you're judging evaluating, you're not letting yourself experience including emotionally?
I know somebody who listens to the tapes from airplanes to go down, so they get the black box and they listen to it. And he said to me, you know, it's his
profession or he does this record, you
know, it to know his profession. That's what he did and because they're trying to do accident prevention and how to handle things and he said that you worry about people panicking, right, you know, and here these guys know that, you know, they've got 30 seconds or some 45 seconds and they're just going through their checklist. He said they're in if they
Panic enough, they're taught that this is what you do and there is reason there's good reason for it. But sometimes they overdo it and you know, it's painful to listen to this because you know, what's going to happen. So it's kind of a balance. We have to hit and some you know, we sometimes we get too emotional and too absorbed and you don't you're not with it enough to sort of see other possibilities that can be a problem. But on the other hand, sometimes you're too rigid and controlled and you don't let your emotions guide you to what you need to do.
Do to protect yourself or protect others. So I would say in general that people with OCD are in the less on the less hypnotizable side of the spectrum. They're less likely to allow themselves to engage in any and you know, the typical example is the checking with OCD. For example, they don't remember, you know, whether they, you know, lock the door or turn off the gas and the oven, and they keep going back and they keep checking. So they're the evaluative component of the brain kind of overrides the experiential.
One, and sometimes people can get some benefit. But but they're not a group that I would select for being the most likely to respond to self-hypnotic,
approaches are people are Superstition
similar.
Superstitions there. I think that's more. There are people who are very hypnotizable who keep getting caught up in things like superstitions and their the imagination supplants, the reality. And we've seen a lot of that happening recently. And so I think they're it's possible that they could be held by learning to sort of see it, but put it in context, you know, see it from a from a different point of
view. I developed a pretty
It's just Superstition when I was in college and it was hard to break. Actually, I always feel when I talk to clinicians. I have to reveal certain things about pleased ethology. And so you'll get my bill
later. Thank you. Yes,
it's part of the reason. I arranged this God. I'm just kidding. Yeah, I did. I had a habit of knocking on wood for things and I noticed his started to I would I would I would sneak knocking on wood every once in a while because I didn't want people to think I was doing too often that I started to realize that I was becoming a little bit.
Of a reflex. And then I saw this incredible video from been, so alive, skis Lab at Harvard. He studies motor patterns. He has these rats that press different sequences of of levers and turn dials in order to get a pellet of food, but that, as they do that, they'll start to introduce these behaviors that have nothing to do with the actual lever pressing, like they'll start scratching their and their hindquarters and things like that, and there had and their head. Scuse me, don't wear hats and flipping their ears. And this is just like a picture before throwing
Baseball that we do this. We start to incorporate motor behaviors that are unrelated to the outcome, but we are mine. Somehow starts to think that they're necessary for the outcome. And so then you incorporate it. So I decided to break it by simply forcing myself to not do it for about a week and then it just seemed like a ridiculous thing
to do. Yeah. Well week on, would we call and response prevention and it works because you said it, what, what you do is you set up a new context in your brain where you get the outcome you want.
Devoid of the the extraneous
behavior. And I knew it was it was nuts, right? I knew as a logical, right? But somehow these things take on meaning, right? So we talked about stress reduction, the utility of hypnosis for stress reduction, phobias pain, possibly. We don't know, but for things like ADHD and OCD, it just will depend on hypnotizability, right? You talked about this beautiful study on the metastatic breast cancer.
Our outcome or patients hypnotizability is clearly a key variable. Yeah. So could you, please tell us what hypnotizability is how it's evaluated and what the Spiegel I roll test is. So
guys. We're so hypnotizability is just a capacity to have hypnotic experiences and we have a test called the hypnotic induction profile. We were give a highly structured hypnotic experience and you know,
No, the the old tradition and clinical hypnosis was that you try a bunch of different things. Talking walking upstairs and downstairs and other images and time what you say to the breathing of this subject and all that and the more you change what you do as a clinician, the less you can make a variation and outcome. So and it could take a long time, you know, 20 minutes, 30 minutes. And I just view that as a kind of complex not very effective way of assessing the person's hypnotic capacity.
You know that the peak period of hypnotizability in the human life is the latency years in childhood. So every eight year old is in a trance all the time, you know, you call him in for dinner. They don't hear you there doing their thing and that's why childhood is such a wonderful experience, working player, all the same thing, you know, and we try to make them into little adults, which I think is a terrible mistake. They in everything is fine for that. They enjoy learning, they enjoy
everything. So what age are they
in this very? This is like 6 to 10 6 to 11.
They're playful. They enjoy everything. Everything is sort of a game and fun and we try to make it miserable for them, but they've got it. And then when what Piaget called, you know, a more adult cognitive framework where we learn abstract Concepts. We learned that even if one bottle looks bigger than the other that can have equal volume. And so we start imposing logic. We're growing our DLP FC at that point and imposing cognitive structure on experience, some
Start to lose that hypnotic ability by the time you're in your early 20s, your hypnotizability becomes extremely fixed and there was a study done at Stanford Ernest Hill guard for the Phil, zimbardo. Did this looking at, they tracked down students, who were in Psych one had their hypnotizability measured and retested them blindly 25 years later. And the test-retest correlation was, you want to guess what? It
was.
I'm guessing it's I don't know, .6 something. Yeah, very close. It was
point 7 IQ would be point six on the 25 year old. So it's more stable than IQ over twenty five year intervals. So once you're at that point, that's where you are. What are the factors that lead to that? Well and it's so what it means. Is it about a third of adults are just not a Batali ssible. Two-thirds are about, 15% are extremely humid as well and we can measure that and give it a number from
02:10, and that's very useful for some of my patients. When I do it. I say, look, I'm sorry, you're not even ties but we're going to do something else, you know, medication, systematic desensitization, mindfulness, other things or if they're very hypnotizable. I just go for it. You know, I don't do a lot of explaining people who are low to moderate hypnotizable like explanations about what you're doing, but then they can still get the benefits. So it helps me guide my the nature of my treatment with these people. Now the
The I roll, is my father used to use an eye fixation induction used to say, look up at the ceiling, and now, close your eyes, while you looking at go, you're very much, you're very, but yeah, so he noticed, he had two patients back-to-back. And one was a woman who I'd seen him work with who had historical seizures. She would just suddenly start shaking and if you real soon uptick seizures, no pseudo epileptics. I see, so hysteria Hysteria.
And although some people have both that is the, for some people real epilepsy becomes a framework that gets elaborated on for when you're stressed. You have seizures. She just had pseudo epilepsy. No, a EEG abnormalities and she was really something to watch. Her husband had to move his work bench near the door so that if she started have a seizure, he could run home and try and help her with it. It was that bad and he noticed that when she went she did he she did what you did when she looked up when she would have won.
Have her seizure events. All you see is sclera. You don't see Iris anymore and she would start to see. So he he did a great thing with her. He taught her to have seizures. Everybody else was telling her to stop. He made her have one. So he hypnotized her and let's go back to the last time you had one at sure enough. She start to shake and gradually. He'd make them smaller and smaller. So she was learning, she could control, she'd have access. It's like with PTSD, you know, you confront, you don't avoid it. You don't suppress it. You confront it and figure out how to deal with it.
The next patient he had was a rigid. Obsessional businessman who wanted a stop, you know, being so controlling and all this remind me. There was a New Yorker cartoon of a driver who comes to a yield sign and he yells never, you know, it's always been concerns about right here in New York. I'm a New Yorker. And so this guy when he tried to look up, he couldn't keep his eyes up while he closed them. And so, my father started testing
In people. And it seemed that there is a rough correlation between the capacity to keep your eyes up while you close them and measured hypnotizability.
So that people who are listening, what might and and watching on video. So this big wide world test involves looking up at the ceiling says, tilting the head back. I'm tilting my chin back and looking up at the ceiling now, but I'm also directing my eyes upward, and my eyes are open. And then the, the eye roll test involves then closing the eyelids while the eyes.
Owner of and whether or not the eyes roll back and as you said it, then you see, sclera the white Mark where the white part means you're very hypnotizable or moderately hypnotizable. Right? Whereas if the eyes move down and you see Iris, the colored part of the eye, as they eyes closed, less hypnotized running correctly. And you can look this up online there. You just put Spiegel, I roll test and and you'll find it. And and we are also going to do an actual example of hypnosis on video later,
right? So
Is it, you're asking the brain to do something difficult to to keep the eyes up while closing the eyelids. And so that's contradictory signals for the third fourth, and sixth cranial nerve nuclei that control eye movement. He
said the third fourth and
six. Yeah, cranial nerve nuclei. And, and so there, there you're suspending, one activity, while asking them to do another and eye movements have a lot to do with levels of consciousness, you know, the periaqueductal gray.
These cranial nerve nuclei. And when we, you know, we close our eyes. When we sleep, we have rapid eye movement, when we dream, most drugs, that affect level of Consciousness can affect eyes and eye movements, either the dilation or contraction of the pupils depending on whether it's a stimulant or an opioid
stimulants, make the pupils big, right? Yeah. This cocaine
amphetamine, right? Exactly. That's Orion and opioids, you get constricted pupils.
This is what parent, you know, parents looking at their kids coming in the
Or late at night. There are looking for right, substance
abuse. That's right. So, so there's something about the eyes that has a lot to do with level of Consciousness. That, I mean, obviously you close your eyes. When you go to sleep, you have rapid eye movement when you're dreaming, so, it's not surprising. And there's, there's an old zen practice called looking at the third eye. And I think part of the reason that this happens is where you're looking up in inside. There's like, there's a third eye between the other two in your forehead and I think,
Because we're visual creatures, you know, we're we're pretty pathetic from a physical point of view, you know, many animals can outrun us, you know, and or out smell us or see you Eagles. Can read could read the news printed 100 yards and we can't you know, it's so the are major defensive sensory input is vision and that's why, you know, animals Predator animals have eyes in the front of their head so that they have very good.
Good detailed division vision of prey, whereas prey animals, like deer have eyes on the side of their head. So they don't see things that well, but they have a much bigger range of potential to see threat and we mainly use. In fact, it's interesting. There have been social Anthropologist to say, why do we gather where we do, you know, on coastlines and you know, at the edge of a forest or something. It's because you've got protection in the back. Something can't attack you from one side and you have a big vision.
Of what might threaten you and we tend to like be attracted to those kinds of physical situations,
soul of Vistas. We love this. This is a very calming they take us into that panoramic Vision. That's right, and I didn't know this but it turns out that most of the scenic spots at any location in national parks, and we're where people naturally aggregated. It wasn't, which makes sense, you know, but that those signs and locations were built up around people's tendency and animals
These oh really want to aggregate their? Yeah. There's a very interesting book on the history of the national parks that says that they didn't give a research study to support it, but there was no Google Maps obviously, but it's very interesting. Yeah. Panorama and and visual boundaries are really interesting. I think so that the eyes as we both know, our two pieces of the central nervous system of the brain, right side. The right, I used to say that the eyes are outside the skull and and a inner ophthalmologist said, there wrote to me and
Vehement Lee pointed out that they are outside the cranial Vault. So, you know, they're outside the cranial Vault but they are two pieces of brain, they're out there. And so you mentioned cranial nerves, 3 4, and 6, this isnt a neuroanatomy course, but but maybe we could go a little deeper there. So there's you said, there's contradictory activity looking up is controlled by the one set of cranial nerves. And then the closing of the eyelids is closed is controlled by another cranial
nerve. No, it's the same one. I think it's six that you you
You close it. When you close your eyes. You activate. No, it's the face. I guess it's the facial nerve. It's 77. Yeah. Yeah, but you're looking up, you're activating the muscles that force your eyes to look up and the, the closing, your eyelids, normally relaxes. Those relaxes that upper movement because your eyes are closed and you don't need to do it. So you're breaking a usual customary.
The rubber ring that right? Hey, I can't even do it seems like the yeah,
it's a grabbing, your tummy
and patting your head. It's a bit. There's a bit of a conflict there. Right? But clinically it's been a good probe for you and after your father, so was it Spiegel seniors,
beagles, beagles and Spiegel senior, that developed his be viral test. And but the key issue is this that normally, when we close our eyes, also, we're going to sleep, you know, you're not worried about what's going on in the world anymore here. You're maintaining resting a little
Alertness, so, you're focusing, but you're turning inward. That's an unusual State. Normally. We don't, we close our eyes, periodically, we have to. But when you close your eyes, for some period of time, it's normally to go to sleep. And you're not worried about, you know, detecting risk or threat. So, it's an interesting State because you're turning inward. Basically, you're looking up, you're shutting your eyes and you're allowing, whatever happens, outside you to happen, and focusing on what's going on in word. So, it's AI, think it's
Signal to your brain to turn inward.
Very interesting and meditation. Of course, could be done with eyes open, but almost always is done with eyes closed. Yes. That's right. Very interesting. So you can very quickly determine whether or not someone is highly hypnotizable. Not at all hypnotized. We said about two-thirds of people can be hypnotized, right? Obviously a third cannot and but within the two thirds, that can there's a range and you said 15% of people fall into this highly hypnotizable.
Global category. As I seem to be a member of and does repeated use of self hypnosis, or clinical hypnosis increase or change hypnotizability for those that can access it in the
first place. I would say. In general, it may increase a little bit but not a hell of a lot and it's not worth the effort to increase your mental stability. At that point. It's worth trying to deal with the problem you're dealing with so you can get better at using it at the level that you have. There was a study done in.
They tried to train people to be more intelligible and, you know, obviously they're subjective and behavioral components to the test. You can learn to do a little better on them. But what we found was, when we re analyze this data that we could account for 3 times to final score based on the initial hypnotizability measurement, rather than whether or not they had been trained to do better so you can improve it a little bit. It's not worth the trouble. Got
it along the lines of eyes and eye movements lot of
Just out there about EMDR eye movement. Desensitization. Reprocessing. Shapiro herself was working. Not she wasn't at Stanford directly. What was the local to Stanford? Yeah, thinking in Palo Alto. So what are your thoughts on EMDR? Where is it? Useful? Where do you think it's less useful? Are there things that EMDR could be combined with to make it more useful, you know, we get, you know, the listeners of this podcast, come to, I think them to the
Podcast with a range of backgrounds and interests to me, and make sense, why EMDR lateralized eye movements might work? Given the newer data that it can suppress, amygdala activity and some animals and animal models and in humans as well, but it really hasn't been explored much, Nur Ali. I've heard things like it, coordinates the two sides of the brain which it to me. Is a is just a throwaway. A, I don't think there's any evidence that coordinating. The two sides of the brain is better than not coordinating. I wouldn't be speaking right now.
The two sides of my brain. We're well correlated because language is lateralized. So I've heard that it mimics rapid eye movements during sleep, but actually, it doesn't so right? But I have heard people talk about their positive experiences with EMDR.
What are your thoughts? Yeah, you had a good comment on that in one of your recent podcasts. And I I'll tell you, you know, one way I sort of think about it from a bemused point of view is the old. You mentioned it earlier the
Sort of idea of a hypnotic. Induction was a dangling watch. Right, you know and watch and in fact there was enough concern about it that when automobiles were invented, there was a movement to prevent installing windshield wipers because people were afraid that they would be hypnotized. If they watch the windshield wipers go back and forth on a car. Now. It turns out fortunately that you tend not to look at the windshield wipers. You keep looking through the windshield.
Old. And so we have windshield wipers today, but that movement is what exactly used to be a hypnotic induction. I think there is a lot of hypnosis in EMDR and I think it's a combination of that with, you know, exposure based treatments where you use embr to think about it that you tend not to process the experience as much and just do the physical part of it, which I personally think is a drawback and every study I've seen that was a dismantling study it.
No question that people who go through MDR, many of them get better with trauma related problems, in the VA, has a big program using it, and so on, but every program that has dismantled going through the treatment with having the lateral. Eye movement has shown that the lateral eye movement, doesn't add anything to it and toward the end of her career, Francine was doing now contralateral touching or something. It was an eye movements anymore. It was other things. So I tend to think
That EMDR is another form of exposure based therapy for trauma. But as you've implied with the exception of this possible, new data, it certainly doesn't have to do with rapid eye movement, sleep and I don't, I don't think moving the eyes is the issue. I think it's a way of sitting down at confronting trauma and I would rather that the trauma itself be processed a bit more than often happens in EMDR. So a lot of people have gotten therapy. Some of them have been helped, Francine used to
Only claim that just one session, would desensitize people and do it. And that's clearly not true. I see a lot of people who said, yeah, it helped for a while, but I, you know, I need more. So I think it became a kind of a, you know, overly simplistic approach to understanding brain, physiology, and that part is wrong. And, and, you know, the interesting thing, you know, you mentioned suppressing, amygdala activity. It's very interesting that my late friend Alan Hopson.
Who's a brilliant sleep research? You know, Alex is yeah. Well, I don't know him, but
I read his book when I was in college about the chemistry of sleep, right? And the similarities between dream states and hallucinations. Yeah, and it's one of the reasons I got into this
business. Yes. Well, I worked with him in a MacArthur mind-body Network for many years. The brilliant guy points out that we need to get into primarily a parasympathetic state to go to sleep. That we have to shut off. Shut off the sympathetic nervous system.
And that's why a loud noise wakes you up when your heart rate goes up and all this. So he was a brilliant at documenting. What happens in the brain asleep. He pointed out something also very interesting about dreams, which is that the stories and dreams and even the images and dreams can change all over the place in crazy ways. But usually the effect is constant said, usually if it's a frustration dream, whatever happens you will end up frustrated. And if it's a, you know, enjoyment dream, you enjoy, whatever is going on. So there's a
Odd consistency and effect and dreams that you don't have in other states and the idea of lateral eye movement suppressing. Amygdala activity, would kind of fit with that that you don't allow intrusions of fear and anger and upset injury. There may be there all the time, but it may not be there when you think it should be. So why is it that you can be falling off a building and somehow not that scared. You know, you're just having this experience of flying in a dream. So I think there are
Maybe something going on about regulating effect. But there were we have elaborate and better ways to regulate
effect. Right? So EMDR might incorporate some elements of hypnosis by. So the lateralized eye movements, perhaps by way of suppressing, the amygdala this fear Associated Center might bring people into a more parasympathetic, calm state. So might be pseudo hypnosis and then exposure therapy through the discussion about the issue, right? Okay. More research needed on EMDR out there and
Obviously something that's come up a lot in this discussion and in our discussions that have the great Fortune of talking to every week is and working together. Is this idea of getting close to the phobia, getting close to the trauma, re experiencing it as a portal to then adjusting the response to it and rewiring something. So the troubling thing or the horrible thing is no longer hard as horrible to us that
But that the repeating theme is we can't expect to get over something without getting really close to it. Maybe even experiencing it somatically nowadays. We hear a lot about, you know, triggers and Trigger warnings and certainly one can understand why those are why those exist, but it seems like there's a in the general population. There's this idea that we want to move away from anything that upsets us and yet I think it's fair to say even though I haven't gathered.
The statistics that on the whole that the human beings are becoming more and more anxious and more and more stressed, perhaps because of, but certainly in parallel, with the fact that we're trying to move away from troubling things troubling things. So I've heard you say before that, it's in terms of therapeutic approaches. It's not just about the state you get into but whether or not you brought yourself there voluntarily so exactly right. So this element of
Deliberate self-exposure deciding, I'm going to confront the trauma. I'm going to confront the pain. I'm going to confront the insomnia. I'm going to confront the, you know, in fill in the blank and then readjusting one's emotional response.
Right up next to that troubling thing. That seems to be the Hallmark of of this treatment and if I'm thinking about it, correctly of pretty much all treatments for getting over stuff. If people don't have access to a really good clinician like yourself, how should they carry these thoughts and these ideas? I mean, I think almost everybody of any reasonable age has memories or things that upset them, but we learn to suppress them. What?
One do obviously the reverie app has approaches to dealing with some of this inside of the app, but how does one start to think about actually dealing with something like this and avoiding the hazards of just kind of reactivating, a lot of painful experiences because a lot of being a functional human being is also going to work each day. Interacting with people and not bringing one's trauma and dumping it out all on the table or or being able to just function is so crucial. So, how do you think about this as a clinician?
Well, you know, I the image that comes to mind is the Greek myth of Pandora's Box, you know that it opened and the Furies got out and you couldn't put them back in and we have this kind of fantasy that once you get into these memories, they'll take you over and you'll never get them back in the box. And I think that's wrong. You know, we people who use hypnosis say that there are ways to present things to people, that will be helpful in ways. That won't and one real mistake is to tell someone don't think about purple elephants. You know, what do you thinking about, you know?
Doesn't work. So you want to find a way to feel in control of the access and to Define what happened on your own terms. And so I'm not a big fan of trigger warnings. I think we're going crazy over, you know, this could be upsetting, that could be upsetting. Yeah, there are lots of things that are upsetting, you know, the average kid has watched twenty thousand murders. And by the time he's 20 years old, watching television, and movies these days. So, you know, we see terrible things and and it's not a matter of. Are you exposed to
Thing, that's upsetting, but how do you handle it? What do you make of it? And are you feeling in control? It's not like, you know, what, what Putin is doing to his rival in Russia, you know, forcing him to watch propaganda Movies, 10 hours a day while he's in prison. It's a matter of thinking about a problem in a way that leaves you feeling you understand it better your in more control. You can turn it off. When you when you want. You can turn it on when you want. And so we have
In life deal with stressful things. There are studies Karen Parker at Stanford has done some wonderful studies with primates about stress inoculation that if you separate a baby monkey from his mother for two hours a day and then reunite them. And then you stress that baby monkey later. They actually handle stress better. There's less cortisol arousal, and the face of the stress stress inoculation. It's been called, so mere exposure to trauma or stress. It's a part of living. Anyway, we can't avoid
Avoid it even if we'd like to and it's not pleasant. It's not great. But it's sometimes things you need to learn about life. And if you can find an algorithm for facing it, putting it into perspective, dealing with it. You become a stronger person on a weaker person. So, this idea that college students are such fragile flowers that if you talk about a sexual assault or something, you know, you're doing something terrible to them. It's just wrong. And and I think we need to build our ability to recognize and
And it's stress and you can't do that without doing it. You can't learn or you can't ride a bicycle without taking the risk of falling off it you know, and so I think that's the way I think of dealing with the
stress. Yeah. I'm really appreciate you saying that. I was you and I were both at a gathering. Let's say where this issue was being discussed and around an issue of a publicized sexual trauma and you made an excellent case for why it this stuff can't be pushed under the rug and
And that actually in my observation led to a lot of healing for the people that and the families of people that suffered from this. And the I do think people are resilient they but we don't really teach how how to think about feelings, you know, we don't, you know, we're told that we need to feel our feelings. But then again we are also told that feeling is don't hold all the information and so I think that as you mentioned, there's no operating or user's manual for this nervous system thing brings me to another issue, which is the
Connection something that we're very interested in and you done extensive work on, you know, we all like to think that getting more in touch with our body would be a great thing, learning to intercept, paying attention to our internal landscape would be a great thing. But as we often discuss, when we're feeling lousy than being really in touch with that lousy feeling may or may not be a good thing. So, how should we think about Mind Body? It, I can see examples in hypnosis from your descriptions of hypnosis.
This where you want to unify the mind-body connection feel, what you're thinking, think what you're feeling etcetera, but I could also point to elements within the hypnotic process in which you are actively untried to uncouple those. So it sounds to me like this whole Mind Body thing is a bit more like a car. You can't say that 40 miles per hour is the optimal speed. It kind of depends on the road you're on and the the turn you may or may not be taking right? How should we
Think about Mind Body, in terms of navigating daily life. What do you think is the Adaptive way to, to conceptualize the mind-body. It's a big question. It is, it's,
it's a very interesting one. I guess. I think that it's a matter not of, you know, absolute control, but more control that we need to think of our brain, as a tool and and our body signals is too.
tools as well to help us understand what's going on in the world, what we need, what matters, what's important, what isn't but also something that can be managed not simply, you know, absorbed and so hypnosis I think is a kind of limiting case where you can push it about as far as we can push it in terms of regulating pain, pain is as you know is a good example of that, you know, obviously you need to pay attention if you just broke your ankle you better pay
Attention to it and get help or you're having crushing substernal chest pain. You better do something about it. But our brain is sort of programmed to treat all pain signals as if they were novel pain, signals if it's a sudden new problem that needs to be attended to. I teach people to think of the pain and categorize it C is it does it does the pain mean that if you put weight on this, you're going to re-injure your ankle, for example, or does it simply mean that your body is healing and the paint is assigned that gradually
We things are getting back to normal. And and so you can modify the way you process pain based on what your brain tells you the pain means. And that's true for emotional pain as well. And particularly where I think a strategy that really helps is if you think of an interpersonal problem or a threat of something coming as an opportunity to do something to ameliorate the situation, so it's not just it's happening.
You but something that you can influence and do something about. So it's blending. The receptive with the active response that I think can make a difference. So you try and process it in a way that gives you a deeper understanding of what's Happening. You face it but you also say this is an opportunity for me to do something about it and the minute you realistically in hand and this doesn't mean imagine a way heart attack. It means figure out how to rehabilitate from a heart attack or
Broken leg or something like that. In a way that you get as much control into the situation as you
can. I love it. Grief grief is one of those states that is very hard to remove oneself from, you know, and a lot of people ask me. How do I deal with grief, and I'm not a clinician. So I'm deferring to you on the one who actually someone at Stanford recently came to me and said, you know, my mother passed away and I had a sibling
The passed away and they were the only people that I had and I'm also living alone and I'm challenged with a number of things and they look like they were holding it together very well. In fact, given what they were describing and on the one hand. Well, I certainly point out that I'm not a clinician but I said on the one hand, you could imagine that it would be necessary and useful to go into the grief state, if you want to transition through it, right?
On the other hand, there. I've heard before that the cathartic model of just really diving into an emotion. Can also be potentially hazardous. If you don't have any anchors to grab onto, what is the view of Psychiatry, or your view of grief, and how to deal with grief, because I think grief is one of those all-encompassing emotions for many people. Yeah,
it is. And it's a very important natural necessary stage of
And the reason we have all these grief rituals, you know, from burials and memorials and headstones and sitting shiva and other things that people do, it's a way of making it real that in in comprehensible loss has to be comprehended, you know, you have to realize that you're now going to have to live life without your loved one, your parent, your sibling, whoever and we've all gone through this at one time or another, I certainly have and it's very hard to just come to terms.
Terms with but one principle is to sort of say it's not it's never all or none. It's more or less. So yes, it's all or none that you've lost a loved one. But I ask people as part of their grieving to say to themselves and I do this in hypnosis sometimes to you've lost them but what have they left you with? What have they bequeathed to you? Even though they're gone and I'll sometimes ask them to say if your mother could be here right now. What would she say to?
You, how would you feel about your life? Now? What, which he advise you to do? So, in our support groups for women with Advanced Breast Cancer, we lost people. And I got to tell you that we were warned by oncologist that we demoralize people that I mean, there are wonderful oncologist, but there are some that we're very afraid that that we would harm them in some way because they, you know, the mortality rate is fairly high with metastatic breast cancer. They're going to watch people died of the same disease and you'll demoralize them.
And I so we actually measured their emotion and the content of speech every five minutes throughout a bunch of groups, to make sure that wasn't happening. What we found was that they talked about more serious issues, but the mood didn't actually get worse and we found in general that expressing negative. Emotion on the long run, helps people be less anxious and depressed over time. And we've shown this in randomized clinical trial. So it's not just my clinical impression. And, and what we what we try to get them to do is to
Face a laws live with the emotion that comes with it, but also see that the reason it hurts so much is how much that person gave you. So we would do a self hypnosis exercise. At the end of room, say I want you to get your body floating safe and comfortable. Now picture Mary and and sit with the feeling of sadness that she's no longer with us and we do that for a few minutes and then we'd say on the other side picture, one thing, she left with you that you still have that you carry on in your heart, her.
Isshin of what she gave to you? And so, just seeing it not as a complete loss. But as a real loss, a painful loss. But one, that helps you to reflect on what you gained from her and knowing her, I think can be very helpful in the grieving
process. It's very helpful that way to conceptualize it a couple quick questions can children be safely hypnotized or do self
hypnosis.
They it's sometimes harder for them to do self hypnosis. They need more structure to do it. You've got to share your dorsal lateral. Prefrontal cortex with him a little bit. But yes, absolutely children can be very hypnotizable and I know pediatricians who use it. Wonderfully all the time. They get them to focus on something else. So they're going to have to give them a shot or draw blood or something, and they'll say, I'm going to press your happy button and
Presses their belly button, and they start to giggle the way kids do. And meanwhile, the nurses drawing the blood, and they don't even notice. It dentists. Good dentist can use it to help kids with fear and pain. So yes, it can be very effective for children. We did a randomized trial. I have a publication in Pediatrics, my late sister, who was a pediatrician who and who always used to joke that she was the only one in our family. Who was a real doctor. You know. I said, I got you. I got a paper in Pediatrics and, and the
Was children having to undergo, avoiding Sisto urethra G. So there, the, the anatomy of the kidney, if you'll forgive me, is sort of interesting and that the ureter that goes into the bladder, normally goes into the bladder at an angle. And so that means that when the bladder contracts to expel urine, it automatically closes off the ureter because it's sideways to the bladder. Some kids are born with it, perpendicular and then you'll get reflux into the kidney and some children out.
Grow at some need, pretty complicated surgery to fix that. And so you, you image them every year or so to see whether they're getting kidney damage or not. And it's a pretty miserable experience. You're a nine-year-old girl. You have to go online in a hard cold table, have strangers, pull your legs apart, and stick a catheter into your urethra and hold in the bladder and then expelled urine. And so you get into these struggling fights and of course, the more they struggle, the more they constrict and it makes it harder to do it. So
Asked if we could test it. So we did a randomized trial at Children's Hospital. They either got training in self-hypnosis. I would have meet with them and the mother that week before we find out from the kids where they like to be. And I'd say, you're going to play a trick on your doctor's. Your body. Is there, you're somewhere else, go visit your friend, go to Disneyland, do something else and the mother would work on this with me at the head of the table. And we found that these children were much easier to image one got so relaxed. That so you guy with, he's a normally, it takes us, 10 minutes.
To get them to pee. After they're doing this. She was so relaxed. She started peeing before. I could even get the bedpan under her and I had to clean up the table, you know, and they also 17 minutes shorter procedures and that's a long 17 minutes for a little kid, so it can be very effective with children. They're less anxious. They have less pain and get through these difficult procedures. Very
well. That's great. Has hypnosis ever been done in for couples like couples therapy. I'm thinking of pretty much every
Setting here, both people have to be hypnotizable, of course. But yeah, the reason I asked about this is next. I'm going to ask about psychedelics and there's a lot of interest in coordinating States through the use of drugs of different kinds. We actually do this, when we treat depression, right? You have a depressed person with a family members who are not depressing, you say. Well, let's make them all not depressed. All right, I mean, but in all, and I'm only half kidding there because that is kind of the underlying logic in some sense, but
Are you aware of any of any coordinated
hypnosis? That's interesting. I mean, I've done plenty of it in groups. Not now with couple, you
can hypnotize a large group. So, yeah, once yeah, yeah,
we have advised right now. Yeah, you are. I hope you've been enjoying it. But the the metastatic breast cancer there was a group of like ten women who would meet once a week and we would all go into hypnosis
together. I didn't realize that you were hypnotizing them
collectively. Yes. Yes, right.
Estimate and and that, you know, if anything, I think it brings out the best in people's abilities because it's a shared social experience and and they would talk about it afterwards. And so yes, that's absolutely doable.
Yeah, and I don't want to focus on psychedelics specifically maybe that's a topic for a future episode. But is there any basis for combining hypnosis with drug therapies inside of the hypnotic episode? So I realize that some patients of yours might be prescribed.
Antidepressant or a medication for some purpose may be same or different than the hypnosis is being directed toward. But is there any evidence that if people are relaxed through the use of a Propranolol or someone, you know, one of these many things in the psychiatrist kit that hypnosis can be more
effective. Well interestingly one study that I haven't mentioned as we did spectroscopy on people who were hit
Ties. And we found that there was a correlation between hypnotizability and Gaba activity in the anterior cingulate cortex which fits with turning down activity. So to the extent that we can self-medicate, and Gaba receptors basically are doing what benzodiazepines do to the brain that can happen when people are hypnotized.
So you're saying, inside of the hypnosis, you have neural evidence that there's a kind of a
sedative effect of hypnosis at the chemical
level. Yeah, right. I mean I said people who are more hypnotizable have more of those Gaba receptors and it's related to the degree of their hypnotizability. So, in terms of there have been studies where they try to give people medications as well. And the interesting thing with benzodiazepines which activate inhibitory activity in the brain. If you're very anxious, it might improve your hypnotic responsive it if you're just so anxious and you can't do it if you're
Not very anxious. It actually inhibits hypnotic activity because you get sort of sedated and just out of it and you can't focus your attention as well. So by and large we don't use drugs as an adjuvant to hypnotic experience. Most of the time you don't need to and sometimes it can make it worse rather than better. Some, there's some evidence that mild stimulants might enhance hypnotic responsiveness a little reliably but too much. Well, again, scatter attention and you'll have less control.
All over it. So they might be a events. But I frankly think hypnosis is more of a replacement than a need of supplementation.
Your laboratory. My laboratory have, well, sort of snuck into your lavender, trying to merge the two. It's been a lot of fun, and it's perhaps learning a lot about the power of respiration of breathing to shift, brain States, not just during breathing protocols, but at all times and we will do an entire episode about
Those protocols, I think rule we add after those are published and and so on but breathing itself is you've described as a bridge between conscious and unconscious States, right? And so I have to ask how, how important is the patient's breathing pattern. How closely. Are you monitoring their breathing pattern? How closely do you monitor? Your own breathing pattern as you're inducing? Hypnosis put simply. What is the role of respiration in shifting?
The brains State during a hypnotic protocol.
Yeah, that's very interesting. You had a great show with Jack. Yeah, Jack Feldman. And he is. And, and the, the issue I watch it. I tried the work that we're enjoying doing together, shows that there are breathing patterns that may increase sympathetic arousal, or may decrease. It may have been, but, you know, cyclic,
Lying seems to actually where you have more time spent exhaling than inhaling seemed and there's reason to believe that it induces parasympathetic activity because you're increasing pressure in the chest and therefore allowing the heart to slow down because blood is being returned to the atrium more easily. I do use it, I ask people to take a deep breath as part of the induction and then slowly, exhale, and partly as a result of our research together. I'm emphasizing this low exhale.
Elmore as part of an a, some to enhance the ID in the induction that this is a period of relaxation because I think they are inducing that and perhaps perceiving it as well. So there's no, you're absolutely right. That breathing is very interesting because it's right at the edge of conscious and Jack talked about that to of conscious and unconscious control that are Will Go On automatically, but we can control it. And so it's a kind of way for us to demonstrate to ourselves.
Greater ways of an modulating, our internal state, so you can either do it thinking about it. The way we do with pain control in hypnosis, or you can do it to some extent by taking charge of your breathing and doing things that will produce a change that you want to see happen in your body. So, I like it because it's right at that margin where you can enhance for me. I like that as a way of augmenting, hypnosis more than medication. I think this is a
A powerful way of doing
that great. I'm really excited to see where all of this goes. Yes breathing Vision, bodily States clearly that and directed mental focus seem to be the key elements of hypnosis. Am I missing any any other ingredients?
Yeah. It's I think that's right. Arenas Vision. Breathing Vision. How you change your vision and you don't, you know, typically you're in a physically relaxed state.
But frankly, there are people at the peak of performance including physical athletic performance or musical performance when they're in hypnotic states to, you know, I've talked to classical pianist, who say, I'm not think if I start thinking about what my fingers are doing. Now, I screw up, you know, I'm floating above the piano thinking about the nature of the tone that I want to feel exude in from the instrument. So that's a hypnotic like state to and and many athletes in who are in Peak Performance are just
just flowing with it. They're they're not they're not thinking step-by-step. What am I doing? And that's when you're doing your rest or you know, when we're working or giving a talk and doing it. Well, we're in a hypnotic like state. So it doesn't it usually requires but doesn't necessarily require physical Comfort or quietness. It can sometimes be intense activity
incredible. Well,
This has been an amazing discussion. I've learned so much as I always do from you. Where can people learn more about how they can get hypnotized. We mentioned reverie. We will put a link to its are. EV ER, i.com is the way to access that
or it's the reverie app from the App Store is the other way where every.com is the website. You can get to it through that or download the river e app from the
App Store. Great. So currently on Apple hopefully soon also on Android.
Ed. But in the meantime, what if people are interested in exploring clinical hypnosis working with you or somebody similar, is there a centralized resource that people can go to, to find really well-trained hypnotists? There are two good
professional organizations that will help you with that one is the society for clinical and experimental hypnosis. And I think that's seh dot U, s-- is there. We will prove it will look it up and provide a link and the
Society for clinical hypnosis and they both provide referral services for professionals. You can look it up. I would just say in general look for someone who is licensed and trained in their primary professional discipline, Psychiatry psychology medicine, dentistry and who has training an interest in using hypnosis is a way to do
it. Great. And then one more question and then a comment, the question is, will you be my
psychiatrist?
I'm honored. It's a tall task. I might be that
the most stubborn batian. I
think the hardest Works already been done Andrew. Thank you. Find
that. Well, and the final thing is a comment. First of all, thank you so much for being here today for sharing your knowledge. I hope we can do it again. And again, I hope so. I love working with your laboratory and with likewise
because when you speak, I
learn and I learned and I know others do as well. We will put
Courses to get to you, but I also just want to say thank you for doing the work that you do. It's an incredible thing that in this world where we are discovering so much about how the body works, you know, the mind is still rather mysterious and people are struggling with a lot of things. But also I think people are really excited about applying tools like hypnosis to perform, better feel better, mentally, and physically. And so you've pointed us to a tremendous amount of resources and how these tools work, and where they've already been.
And demonstrate to work. So just thank you. I know this is your life's professional commitment in life and we all benefit.
So, well, thank you, but it's been a real joy for me to be collaborating with you and for you to be using your precision and knowledge about neuroanatomy neurobiology to address problems. That often people who are that disciplined in the primary nor biological and aren't as interested in as you are. And so it's really been a pleasure to try and you know, bring together. What we both know.
From these different perspectives to build something that neither of us could do alone. And so, it's been a real joy for me to do
it. Thank you. I'm honored. Thank you. Thank you very much, David Walton.
Thank you for joining me today for my discussion with dr. David Spiegel. I hope you found it as fascinating as I did, and if you'd like to see the video of dr. Spiegel hypnotizing. Me in what constitutes a brief eiated clinical. Hypnosis session. You can go to the huberman lab Clips Channel on YouTube. Also, if you'd like to check out the reverie app for self-hypnosis designed by dr. Spiegel and colleagues, you can go to reverie. That's our EV ER i.com to see the reverie app. There's also other information there about the scientific studies that
Port the reverie app. If you're enjoying an or learning from this podcast, please subscribe to our YouTube channel. That's a terrific. Zero cost way to support us. In addition, please subscribe to the podcast on Apple and or Spotify and on Apple. You have the opportunity to leave us up to a five star review, please also leave us comments and feedback as well as suggestions for guessed that you'd like us to host on the huberman Lab podcast in the comment section on our YouTube Channel, please also check out the sponsors mentioned at the beginning of today's episode. That's the best way to support this.
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And get 20% off any of those supplements. Also, if you navigate deeper into the thorn site, through that portal thr any.com / the letter U /, hubermann, you can also get 20% off any of the other supplements that foreign makes. If you're not already following us on Instagram and Twitter, please do so. It's huberman. Lab on both Instagram and Twitter and at those channels, I cover science and science related tools, some of which overlap with the content of this podcast other of which does not as unique content. So once again, thank you for joining me.
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