You’re familiar with hypnosis, of course. Something along the lines of: Look into my eyes — you’re getting sleepy, very sleepy… when I snap my fingers, you’ll wake up and think you’re a chicken.
Wait a minute… backup. We’re not talking about clichéd, variety-show hypnosis.
We’re talking about real-deal, scientifically backed up hypnosis. The kind that can numb pain, help you quit smoking, and control an asthma attack.
With all the research showing that hypnosis is an incredible tool to treat pain and addiction — not to mention boosting focus and performance — “the fact that we still associate it with dangling watches is unfortunate,” in the words of Dr. David Spiegel, Professor at Stanford University.
Listen to Episode 141 for a double interviewee whammy, with both Dr. Spiegel and Jeff Jordan, the world’s tallest hypnotist (but how can you look into his eyes when he’s towering above you?) explaining the ins and outs of hypnosis.
Does Hypnosis Really Work?
In short: yes.
That said, not everyone is hypnotizable. About one-third of adults are not hypnotizable, with the rest ranging from highly hypnotizable to not-so-much.
Interestingly, everyone is hypnotizable as children. This has to do with how highly involved in imagination children are. But something happens to some of us as we grow up, and imagination, along with the ability to be hypnotized, gets locked away.
What’s the difference between people who are easily hypnotizable and those who aren’t
Brain scans of people with a high ability to be hypnotized showed a significant difference in levels of functional connectivity, with high levels of communication between two parts of the brain even during rest:
- The dorsolateral prefrontal cortex, which helps us plan and think
- The dorsal anterior cingulate, which is part of our worry network
So, in highly hypnotizable people, the part of the brain that worries about what you’re thinking is constantly coordinating with the part of the brain that is doing the thinking.
What does that mean in practice? People who are easily hypnotizable also easily get lost in a book or movie, forgetting that they are reading or watching. It’s the “flow” state, where you are entirely in the present activity.
Want to find out how hypnotizable you are? Find someone to administer the Hypnotic Induction Profile, a 5-minute test of hypnotizability.
Controlling Your Mind With… Your Own Mind
Much of your ability to be hypnotized is innate and is a fixed trait as an adult. That said, you can train to improve your skills. If you’re at least somewhat hypnotizable, you can learn to use it, especially if you’re motivated.
If you want to learn to be hypnotized, you don’t need someone else to do it for you. The ability to be hypnotized resides in the individual, not the hypnotist.
Of course, if you have no experience with hypnosis, getting started with a trained professional can make things easier. And once someone has helped take you into an experience of hypnosis, it will be easier for you to return to that state of mind on your own.
Here are some resources to get you started:
Using Hypnosis in the Real World
As a pain control method hypnosis is extremely helpful; you can tolerate an enormous amount of pain under hypnosis. It’s even reduced signs of swelling and physical trauma.
But you can also improve physical and cognitive performance under hypnosis in a way that would be impossible or very difficult consciously. Says Dr. Spiegel: “We can use hypnosis to change the way we use our brains, to change brain function, in ways that classical psychology used to think was impossible.”
Once example is the Stroop Test. You’re probably familiar with the concept, if not the name. The Stroop Test consists of colors written out in text of a different color. So, for example, the word might be “red,” but the text will be blue. You then have to say the color the word is printed in. Almost everyone experiences a delay of 300 milliseconds before being able to answer because of how difficult it is to inhibit processing of the word itself. Even with practice you can’t change this number.
But if you hypnotize people to believe they can’t read, this delay disappears.
The Limits of Hypnosis
There are limits to hypnosis. One, of course, is how hypnotizable the individual is. But much also depends on how far an action is from the person’s normal moral code, i.e. how much do they actually want to do what the hypnotist is suggesting they do. Hypnosis may be able to extend a person’s limits, but they still exist.
For any Charles Manson wannabes out there reading this: sorry, but you’re not going to be able to hypnotize people to commit murders (unless they want to).
Learn More About How Hypnosis Works
|1:43||This Week in Neuroscience: Opposites attract – unless you’re in a relationship|
|4:11||The audience interaction section|
|7:04||Intro to Dr. David Spiegel and Jeff Jordan|
|8:14||Dr. Spiegel and Jeff Jordan’s respective backgrounds in hypnosis|
|11:38||How did medical hypnotism begin?|
|14:15||Are people more and less hypnotizable than others?|
|18:33||All hypnosis is self-hypnosis|
|19:04||Can people learn how to becoming more hypnotizable?|
|21:35||Training children to be hypnotizable|
|22:40||The Stroop testand hypnosis|
|25:20||Limitations of hypnosis|
|27:41||How did being hypnotizable develop as a useful trait?|
|29:21||Why is hypnosis still so rarely used in the medical world?|
|31:03||Practice makes perfect|
|32:48||Mindfulness and hypnosis|
|33:48||How you can learn to self-hypnotize|
|34:49||Can people more accurately self-diagnose in a hypnotic state?|
|37:22||Ruthless Listener-Retention Gimmick: Flashing lights and music turn rats into problem gamblers|
PS: When we snap our fingers, you will sign up for our weekly Brain Breakfast emails.
Episode Transcript hideshow
— This Week in Neuroscience --
Jesse: So, researchers at Charles University in the Czech Republic recently published an interesting study about how a person’s relationship status, whether they are in a committed relationship or not with a romantic partner, can affect the type of people that they view as physically attractive. In particular, they were wondering about that old truism, "Opposites attract," and how true that really is. So they took a bunch of photographs—photographs of both people involved in the study and photographs of a group of strangers—they used digital computer morphing to make some photos look a little bit more like the person doing the rating and a little bit less like the person doing the rating. So if you were one of the students doing the study—all these people, by the way, were between the ages of 21 and 29, so kind of like that young adult age where you might be looking for a romantic partner, somebody to breed with. So they’d take a stranger’s face and then they would blend it with your face a little bit, or maybe not at all, and see how the subtle blendings of making a person look a little bit more or less like you would affect how you rated that person as being visually attractive.
They did this with people both of the same sex and people of the opposite sex, and they broke down the type of attractiveness into a couple of different things. They would ask about sexiness, they would ask about do they look "nice" and do they look trustworthy, and the statistically significant results were in the "nice" and sex categories, that people would tend to find self-similar faces—in other words, people who look more like you—would get less attractive if you were single. This preference for people that do NOT look like you would disappear once you were in a relationship—statistically speaking; I mean, this was a big average sample size. Now, this backs up the scientists’ assumption that when looking for a mate, we take as an attractiveness cue if somebody doesn’t look too much like us, so they’re likely not close blood relatives or kin. There’s also the speculation that this preference for people that do not look like us might have something to do with teenage rebellion and kids and their parents getting into fights when the kid is kind of at that age where they should be breaking away and going off into their own in the world.
Finally, although their findings were significant, the preference for dissimilarity could also be overshadowed by overall attractiveness. So even if somebody looks a lot like you, which would be a disincentive if you’re looking for a mate, if that person is really, really attractive, that might be enough to overshadow any queasy feeling. The next thing that the scientists want to study is, for people who are in relationships, how the level of commitment, whether they’re really serious about their relationship or they kind of have one foot out the door and they’re still looking, how that might affect a person’s preferences for self-resemblance or resembling somebody else.
— Main Interview --
Jesse: Okay, so we’re about to be speaking with a couple of different hypnotists, you’ll be hearing them intercut in this interview, and it’ll probably always be obvious which is which. Dr. David Spiegel teaches at Stanford University, where he is the medical director of the Center for Integrative Medicine, the associate chair of the Psychiatry and Behavioral Sciences School and the director of the Center on Stress and Health, among other titles. He has been working in medical psychotherapy for over 40 years and is one of the leading names in the academic study of hypnotism. Just this past week actually in the New York Times science section, there was an article entitled, "Is Hypnosis All In Your Head? Brain Scans Suggest Otherwise," and Dr. Spiegel was one of the main names quoted in that interview appropriately enough, as it was based on research coming out of his lab.
We are also going to be talking with Jeff Jordan. Jeff Jordan is a decidedly non-academic hypnotist. If you go to his website, you will see him holding fingers to his eyebrows, looking very much like he is trying to read your mind through the web browser. He has billed himself as the World’s Tallest Hypnotist. I actually neglected to ask him how tall he is in this interview, so you will need to use your imagination… But I thought it would be great to get both ends of the hypnotism spectrum here. And you’ll actually hear a lot of similarities and agreements between what Dr. Spiegel and what Jeff Jordan have to say. So, let’s go ahead and dive in now with Dr. David Spiegel and Jeff Jordan.
Dr. Spiegel: It’s something of a genetic illness in my family, because my both my parents were psychiatrists. My father learned to use hypnosis in World War 2, actually. There was a refugee from Germany who was a forensic psychiatrist who started doing hypnosis because he’d had smallpox as a kid and had a big scar on his forehead, and he noticed some of these prisoners he was examining would sort of look at his forehead and go into some kind of dreamy state, and he realized that initially, unwittingly, he was hypnotizing them, and then he got interested in it. And when he came to the US, he volunteered to train army psychiatrists to use hypnosis. My father was getting analytic training and at the end of one of his sessions his analysts said, "Do you want to learn something about hypnosis?" My father wondered what that really meant. So he learned it and used it in combat and he found it one of the most useful things he had been trained to do.
Jeff: I was living in Las Vegas and I was keeping in martial arts tournaments, jiu jitsu tournaments. I injured my knee, tore my meniscus, and I realized I had to have surgery. I looked for a hypnotist to help me heal my body faster before the surgery and after the surgery.
Dr. Spiegel: I took a course when I went to medical school and I think the day that decided me was when I was a medical student at Children’s Hospital in Boston, I was told my next patient was an asthmatic who was thinking of general anesthesia to break the attack. And there’s this 15-year-old girl in bed, knuckles white, struggling to breathe, I could hear the wheezing down the hall, her mother was crying. I said, "You want to learn a breathing exercise?" and she nodded.
Jeff: I was fortunate enough to be living in Las Vegas and I had just started searching and seeing who was kind of doing the latest hypnosis teaching. I found this group of street hypnotists and performers called the Head Hackers putting on these trainings, and I just started going to these trainings and learning from a mix of very interesting hypnotists and hypnotherapists and magicians…
Dr. Spiegel: So then I realized that I’d learned how to hypnotize people but we hadn’t gotten to asthma in the course yet. So I cooked up some very clever line, I said, "Each breath you take will be a little deeper and a little easier," and within five minutes the wheezing was gone, she was lying back in bed, her mother stopped crying. The nurse ran out of the room and filed a complaint with the nursing supervisor that I had violated a Massachusetts law by hypnotizing a minor without parental consent.
Jeff: And then it’s led me to hypnotherapy techniques, and I started helping people quit smoking and lose weight, get over fears and phobias and that sort of thing, and then it’s led me to more of the sports specialization, which I’m really—I just love doing it. I love working with fighters, MMA fighters particularly, getting a crystal clear vision of their goal to win.
Dr. Spiegel: Massachusetts has a lot of crazy laws; that is not among them. So, my intern tells me, "You have to stop hypnotizing," and I said, "Oh really, why?" and he said, "Because it’s dangerous." I said, "You’re going to put her on steroids and you think this is dangerous?" He said, "You can’t follow her," and I said, "While I’m in Boston, I’ll follow her as long as she wants. You can take me off the case, but I’m not going to tell a patient of mine anything that isn’t true and this is not dangerous, it’s helping her." There were two more days of arguing and finally the chief resident came up with a radical idea: he said, "Let’s ask the patient." I don’t think that had ever been done before. And she said, "Oh, I like this." So, I kept doing it. She’d been hospitalized once a month for three months. She had one subsequent hospitalization, wasn’t hospitalized after that, and I figured that anything that could help a patient that much, frustrate the hell out of the head nurse and the chief resident, and violate some non-existent Massachusetts law had to be worth looking into. So, I kept doing it.
Jesse: Let me ask you this: The idea of mesmerism from the 19th century sort of seems like, in the popular imagination, it kind of led or dovetailed into hypnotism, and there’s still I think a lot of public skepticism and unawareness of what hypnotism really is capable of. Where did the modern study of academic or medical hypnotism really begin?
Dr. Spiegel: Well, the depiction of it is quite accurate, and the funny thing is that there’s more weirdness associated with this Western form of altered mental state than there is with Eastern forms, like mindfulness and meditation, which have equally unusual traditional histories. The scientific study of it really began in this century with the development of scales to measure hypnotizability and reputable psychologists who were interested in it and wrote about it. It’s really the first Western conception of a psychotherapy, it’s the first time that a talking interaction between a doctor and a patient who sought that therapeutic benefit—and it does. So, the fact that we still associate it with dangling watches and stage shows and magicians and things like that is unfortunate.
And some of Mesmer’s original theories were wrong. He would put his magnetic field near your magnetic field and yours would get better instead of his getting worse. A French commission convened by King Louis that included our own Benjamin Franklin and the famous chemist, Lavoisier, as well as a doctor known for his work in pain control, Dr. Guillotin, it concluded that hypnosis was nothing but heated imagination. Which is probably true, but at the time, it was considered a devastating attack because of Mesmer’s Magnetic Theory. But he was outcompeting, he was like the go-to physician in Paris, was outcompeting French physicians who were mostly doing bloodletting. Voltaire wrote to his brother, "We did everything we could to save Father’s life, we even sent the doctors away," and it happened that you were more likely to be killed than helped by going to a French physician back then. The same problem exists now with the opioid disaster going on right now. Doctors are the biggest drug pushers and people in chronic pain are getting hooked on opiates are overdosing or dying from opiates the way Prince did, and yet people are skeptical about techniques like hypnosis, which is remarkably effective as a pain control technique.
Jeff: Hypnosis was certainly used as a pain control technique for major surgeries, amputations. And not only was it an analgesic, they showed reduced signs of swelling and reduced bleeding. They were given these suggestions that their body will just react and respond in the best positive way.
Dr. Spiegel: Modern medicine has done a whole lot of wonderful things. I’m proud to be a physician, but there are things that we can do using the whole brain, instead of stimulating pieces of it, that are more effective, and yet we’re not making enough use of it.
Jesse: What do we know about the differences between people with high and low abilities to be hypnotized, and are there some people who really seem like they cannot be hypnotized at all, and why might that be?
Dr. Spiegel: Yes, first of all, high hypnotizable people, as adults it’s a very stable trade in adult life, it’s more stable than IQ in adult life. About a third of the adult population are just not hypnotizable. Two-thirds are, ranging from low to extremely hypnotizable.
Jeff: I try to offer hypnosis up as a very straightforward process that anyone can experience if they lend me their attention and just lend me their focus. And it seems to work. It certainly doesn’t work all the time. It’s one of those things where I’ll say I’m a hypnotist and someone will literally put their hand over their eyes and say, "Don’t look at me! Don’t look into my eyes!" So it’s just one of those things, right?
Dr. Spiegel: It seems to have something to do with early life experiences, of imaginative involvement, parents who read stories to you when you went to sleep. Liking to use your imagination, kids do that all the time; all eight-year-olds are in trances all the time—you call them in for dinner, they don’t hear you. And that’s why work and play are the same for a child, because they get so engaged in what they’re doing. But some of us lose that ability as we grow up. The ones who had positive experiences of imaginative involvements tend to remain hypnotizable. Also ones who use it as a way of protecting themselves. Children who have been mistreated physically or emotionally are often more highly hypnotizable as adults. We now know that there are brain differences.
We did a study using fMRI, we put extremely low and extremely highly hypnotizable adults in the scanner. The main difference was that, at rest, the highs had what we call functional connectivity that is similiar levels between two parts of the brain. One is the dorsolateral prefrontal cortex on the left, that’s the part of the brain that helps us plan and think and prepare. And the dorsal anterior cingulate, it’s right smack in the front-middle part of the brain, and it’s part of our worry network or salience network, it’s a part of the brain we use when we’re concerned about something bad happening or what we need to do, it’s what air traffic controllers are using when three planes are on the same flight path. And what we find is those two coordinate spontaneously in people who are highly hypnotizable, so it means what they’re thinking about and how worried they are about not thinking about something else are coordinated, and that’s what you see in people who are highly hypnotizable. It’s like getting so caught up in a good movie, you forget you’re watching a movie and you enter the imagined world. You’re part of the movie rather than the audience. Or it’s like looking through a telephoto lens in a camera. What you see, you see in great detail, but you’re less aware of the context. So, the parts of the brain that worry about what you’re doing are coordinated with the parts of the brain that are doing the thinking. That is what you see in high hypnotizables but not in low hypnotizables.
Jesse: That almost sounds a little bit like some of the descriptions of the flow state if you subtract the hypnotist.
Dr. Spiegel: Yes, I think you’re right. It’s an interesting point in two ways. I know Csikszentmihalyi and we’ve talked about this, and there is a flow-like quality to hypnosis, and I know that many good athletes are highly hypnotizable.
Jeff: And that leads into the next step, where I use my hypnosis skills. I get them into that super-focused, relaxed state, and then I kind of narrate them. I tell them you’re going to be feeling as confident as you’ve ever felt before, I boost up their confidence, and then I kind of narrate them walking from the back of the change room or wherever they’ve gotten ready, to the ring, and that confidence just building, and then them just executing their perfect performance.
Dr. Spiegel: I had one football player from Stanford who was a great wide receiver in a year when there wasn’t else much good to say about the football team. I loved watching him play, and he would tell me that when he was on, he was aware of two things: he was aware of the ball and the defender. And the other 20 very large guys on the field were not in his thinking, and 60,000 people screaming at him he didn’t notice. And the thing is, if you’re hypnotizable, you don’t need a person inducing hypnosis to get you into a hypnotic state. There’s evidence that those people who are highly hypnotizable, get so caught up in movies, they forget they’re watching a movie or they’ll read a novel for hours and forget they missed dinner or something like that, or when they’re working they get so engaged that they forget about everything else. That state, this flow state, you don’t need a formal hypnotic induction to get into a state like that, and people who are hypnotizable, either spontaneously or can learn to use that ability to narrow the focus of their attention.
Jesse: Should we really consider hypnosis and self-hypnosis to be the same thing? It sounds like the answer is a definitive "yes."
Dr. Spiegel: The answer is yes, all hypnosis is really self-hypnosis. Hypnosis resides in the recipient, in the person who’s doing it, not in the person who’s inducing it. It can be induced with the help of somebody teaching or showing you what to do or telling you what to do, but it’s not necessary.
Jeff: When someone else can take you into that experience, it allows you to take yourself back to that same state of mind, back to that same place easier on your own.
Jesse: So if somebody is a let’s say sort of a run-of-the-mill average level of hypnotizability, they’re not on either end of the spectrum, is this a learnable skill that a person can get better at, that they can seek to improve?
Jeff: So they did show that people can be, even just by watching videos of other people being hypnotized, they can improve on their hypnotizability, they can associate themselves into that role. I think it is a learnable skill.
Dr. Spiegel: There are studies that have tried to show improvements, and you can improve your scores a little bit. But if you look at the effect of training vs. the effect of ability, the ratio is about 1:3, so your ability counts for a lot more than your experience of training. The real issue is more this, Jesse: How do you use it and what do you use it for?
Jeff: A good perspective would be if people, whenever people can, wrap their mind around one single idea and really use their power of focus and then add a little bit of imagination to that process, we are capable of amazing things.
Dr. Spiegel: Someone who is moderately hypnotizable can get plenty of benefit from it in controlling pain or anxiety or treating a phobia or stopping smoking. Response is correlated with hypnotizability, but that’s not the whole story. It’s a combination of your ability, the kind of therapeutic strategy you’re using, and your motivation to get better. So, if you’re at least somewhat hypnotizable, you can learn to use it. And for the people who aren’t hypnotizable, I say, "You’re not. Let’s do something else." I’m a physician, I’m a psychiatrist, I train people in systematic progressive muscle relaxation or other techniques if they’re not hypnotizable. So, there are ways to help people with or without hypnosis, but you don’t have to be extremely hypnotizable to get benefit from it.
Jeff: And like anything else, it is a new skill that most people have to learn, but it’s really a simple process, and if a person isn’t too resistant, it’s pretty easily accomplishable.
Jesse: How do you go about performing that test when you first come across a new patient?
Dr. Spiegel: We use a scale that we’ve developed called a Hypnotic Induction Profile, it takes five minutes. It is a structured hypnotic induction in which I teach people how to enter a hypnotic state within a matter of a few seconds if they’ve got the ability. I give them instructions about changing sensation in their left hand and arm, that it’ll feel light and buoyant and float up, and after the formal hypnosis is over, I pull it down and see whether it goes up by itself. If they feel less control, if they have this sense of dissociation, that arm feels different from the other arm, you score it on a scale of 0 to 10, and it’s a highly reliable and stable measure of hypnotizability. And the nice thing is also it’s a test, so it doesn’t become a battle of wills, "Can you get me into hypnosis or not?" My job is not to get them hypnotized, it’s to set the context. In this sense, it’s like any other test in medicine or psychiatry.
Jesse: Given the potential benefits to somebody being able to get into a hypnotic state as an adult, do you think it would make sense to actually train kids at a point when they’re still mentally trainable in that way, to be able to make sure that their brains are going to be able to get into deep levels of hypnosis later in life?
Dr. Spiegel: It’s an interesting question about whether that would actually increase hypnotizability later in life. I think of it as a skill and a useful ability, and I think, frankly, it wouldn’t be a bad idea. I think it would be worth training children to maintain and better utilize their imagination. There are other educational techniques for doing that. But teaching people how to use their imagination could be a very interesting part of a good education.
Jesse: Is there like an earliest age in which a kid becomes hypnotizable? Like, is there a psychological threshold at some point, or do we not really know?
Dr. Spiegel: Well, below age 3 or 4 I don’t usually try. Kids between 6 and 10 are very hypnotizable, and good pediatricians use techniques like this all the time. They’ll call it funny things, you know, "I’m going to touch your belly button and nothing is going to bother you when I push your belly button," and you’re suturing them up or doing something, and that works, it’s worked great with kids.
Jesse: When I was doing some research on hypnosis prior to this talk, one of the things I came across that I hadn’t heard about and I thought it was super interesting was the Stroop Test and hypnosis. I was wondering if you could just explain that to people. I thought that was a really interesting example of somebody being able to improve their performance under hypnosis in a way that they couldn’t do consciously.
Dr. Spiegel: Yeah, so this true color naming task is one of the classics in psychological physics, and the idea is basically if you present a person with words composed of a bunch of dots of a certain color, and you ask them to read the word, the word red or purple or green, you’re telling them, "What color is the word printed in?" And so sometimes you have congruent colors, so the word purple is in colored purple dots. Sometimes it’s incongruent. So, you say, "What color is the word printed in?" and the word is purple, that’s the word that’s written, but the dots are green. You get about a 300 ms delay because people have great difficulty inhibiting their processing of reading the word. And so the idea is the brain is just wired that way, there’s nothing you can do. You see it everywhere, it’s about the same length of inhibition time, you can’t do anything about it. Except, if you hypnotize people and you say, "These words are written in a foreign language that you don’t read," so they’re written in English, the person knows English, but if they’re hypnotized to believe they can’t read, you will eliminate the Stroop Effect, and we’ve done that in our laboratory. So, there is no delay in processing their naming the color of the word when they’re reading it in a contradictory word if they’ve been hypnotized and told that they can’t read the language that the words are presented in. So, we can use hypnosis to change the way we use our brains, to change brain function in ways that classical psychologists used to think was impossible.
Jesse: Could you also flip that, and rather than telling the person that they don’t read the language, telling them they’re color blind, for example?
Dr. Spiegel: Oh yeah, you can do that. One of the classic things is innumeracy. You tell them that they will not recognize the number 4, and you show them numbers from 1 to 10, you have them read it, and they’ll go 1, 2, 3, 5, 6, 7, 8… And then you’ll have them do addition, "What is 2+2?" and they’ll say "5," or, "I don’t know," or something like that. So yeah, you can tweak the circuits so that they respond taking into account this new instruction, and it will distort their other cognition and perception.
Jeff: When I do a show, I do not give the suggestion to my volunteers, I do not give the suggestion that they will not remember anything, right? But I always get several volunteers at the end that say, "I don’t remember anything!" And so, that’s the perfect expectation that they brought to the show, right? They’re just sort of like, "That was powerful! I don’t remember anything!" It’s always so interesting to get that response.
Jesse: Tell us about some of the limitations of hypnosis. I guess this would be when a person is being hypnotized by a third party. You couldn’t hypnotize somebody to go murder their mom or whatever unless they wanted to to begin with. Where is that dividing line between what a hypnotist could or could not get a person to willingly go along with?
Dr. Spiegel: Well, one of the factors is how hypnotizable the person is. So the more hypnotizable they are, the more likely they are to go along. One of the limitations is, as you said, if they really want to murder somebody or not. So, how far is it from your normal moral code, and also how much coercion there is. Jeff: Yeah, that’s an interesting question. I do a routine on the stage where I stick a person’s hand to their own leg, and then I stick their other hand to that hand, so they’re in this situation where their hands are locked together and they’re on their leg, and then I’ll pile up some cash on their other leg. That sort of seems to go against their best interest, when they can’t unstick their hands and grab that cash.
Dr. Spiegel: We know about things like Stockholm Syndrome, where people who have been taken hostage start to actually identify with the hostage-takers, people who are threatening their lives. If you have total control over somebody’s environment and their life, you can exert more influence on them, and so that’s part of it, too. The real issue is not that people lose their will and they can’t disagree, but they’re less likely to. We’ve all had that "It seemed like a good idea at the time" experience and you look back and say, "Why in the hell did I do that? Johnny said do it, so I did it." We’re social creatures. So to some extent, we all suspend our critical judgement. In hypnosis, you do more of that; you’re more likely to suspend critical judgement, and that’s why in these stage shows a football coach will try to dance like a ballerina and make a fool of himself. It means that, uncomfortably, sometimes people will do things that later on they look at and regret or it’s just plain wrong. So it is possible for people to be influenced to do bad things under hypnosis. If they’re hypnotizable and it’s not, from their point of view, that bad anyway, they’re more likely to do it.
But it doesn’t mean that people can’t say, "To hell with you." There’s a famous story of Charcot, the great French neurologist, demonstrating hypnosis. Typically in those days, the routine things like inducing and ending hypnosis were done by lower level people and he would come in and the subject had been hypnotized. And so his students decided after he left that this very pretty young woman would have one more suggestion, which was she was getting ready to go to bed and would take off her clothes. And she opened her eyes and told them to go to hell and walked out of the room. So, there are limits, but hypnosis sometimes extends the limits.
Jesse: Why might this trait exist? Where along the line did having the ability to go into a hypnotic state become an evolutionary advantage? Or is this something like a belly button, just a fluke of evolution that’s not useful in its own right?
Dr. Spiegel: Yeah, I don’t think it’s a belly button, or a spandrel, as what Stephen Jay Gould used to call them. I don’t know. But look, as physical creatures, we’re fairly pathetic, right? We don’t run very fast, eagles see better than we do, and dogs smell better than we do. There are all kinds of things that we don’t do all that well. Our main advantage is the opposable thumb, which is useful, and a large brain. I think one of the things the brain allows us to do is modulate perception. So, you can tolerate an enormous amount of pain. People have gone through major surgery with hypnosis as the soul anesthesia. And I think, if you’ve been wounded for example, if you’ve been injured, it is to your survival advantage to not act like you’ve been injured, to suppress or even eliminate the pain and lie very still because predators look for movement.
So, I think one of the things that hypnosis allows us to do, which is modulate perceptions like pain, is something with a survival advantage. And also the capacity to focus intently, forget about everything else. So like what good athletes do, what we were talking about before, that can also keep you alive. I talked to people getting out of the World Trade Center when it was attacked who said that they had just thought, "If I just get down to the ground floor, I’ll be okay. I didn’t think about anything else." Many rape victims will tell you they experienced the rape as if they were floating above their bodies, feeling sorry for the person being assaulted. That’s got survival advantage. You don’t want the big picture, you don’t want to think how close you are to being killed. And so I think that ability to narrow the focus of attention, to reduce pain and anxiety, is something that probably allowed our forebearers to survive.
Jesse: Why do you think it is, despite the fact that probably every man, woman, and child over the age of 5 has heard of hypnosis or seen it on TV or cartoons or whatever, why is it still so relatively little that it’s actually practiced? At least in the US, I’m not sure if it’s the same in other parts of the world.
Dr. Spiegel: Yeah, it is. Jesse, I don’t know. It’s one of the major frustrations of my life. I used to think, "Build it and they will come," that we needed more science to prove that it works and how it works, evidence-based treatments and all of that. And I’ve been doing that for 40 years, I love doing it. We have built—and not just me, but many of my colleagues—have built a huge database of evidence. But it still, I think, has a bit of that whiff of hocus pocus and snake oil and magic stuff and all that, purple robes and dangling watches. Other things have come along that use aspects of this but are packaged differently, like mindfulness. I think also doing what I teach people to do and it’s not that hard for me to teach it, but it’s harder than writing a prescription.
And the other problem is there’s no intervening industry to push it. There’s no pharma industry to send good-looking drug reps around to talk you into doing it. Nobody makes dangling watches anymore, and we don’t use them much, so the watch industry isn’t interested in it. So, I think part of it is that the way medicine has developed is selling stuff, and we don’t have anything to sell. And it takes more effort on the part of patients. One of the knocks on hypnosis is it’s taking away control. It isn’t, it’s adding control, but that means you’ve got to use it. So now when I hypnotize my patients, I have them record the therapeutic part of the hypnosis on their iPhones and listen to it; I give them written instructions. But they’ve got to do it to make it work, and some people do that and some won’t. So, it’s more work than taking a pill but not a whole lot more work, and there’s far fewer side effects.
Jesse: From what you’re saying, it sounds like some of the therapeutic applications of hypnosis wouldn’t be a one-time thing but would be something where you would need to continue to actually actively practice the hypnotic routine.
Dr. Spiegel: Right, every one to two hours or any time that pain gets worse or any time you have an urge to smoke or when you’re having a flashback about being assaulted, yes, you’ve got to do the self-hypnosis. But that’s true with mindfulness, too. There it’s like 30 minutes twice a day, which is quite a commitment. But yes, it requires some effort and changing your pattern of habits, and some people do it and do very well, and some don’t.
Jesse: Is there something like the equivalent to a chemical half-life for hypnosis? Let’s say that I only get one session of pain therapy hypnosis. Does my pain at some point come back to full levels all at once, or is it kind of a gradual slide back to baseline?
Dr. Spiegel: It’s more of a slide. People will tell me that their pain is reduced like from an 8 to a 3 or a 2 during the hypnosis, and when it’s over it may be creeping back up to a 4 or a 5. So, it tends to be a more intense effect while you’re doing it, and you often need to reinvest in doing it to continue to maintain the effect. But for some people after a while, their average pain level is down. Because if you think about it, pain, for example, is partly signals you’re getting from your body that something is wrong, but partly the way you react to it, and many of my chronic pain patients say, "If I can just get it down to a level of a 3 or 4, I can live with it, it’s fine. It’s when it’s a 7 or an 8…" And so when the pain triggers your sense of alarm that you’re going to be in horrible misery for the next couple hours, it’ll tend to make it worse because you’ll end up paying more attention to it. But if you know that you can manage it, you know it’s there, "Okay, I’ll deal with it," and it doesn’t escalate the way it otherwise might.
Jesse: It seems like within the past five years or so, maybe I’m just aware of it, but it seems like in general society there’s a lot more appreciation and awareness of meditation and mindfulness. It kind of seems like if somebody is willing to take 20 minutes a day to sit on a pillow and meditate, that convincing that same person to spend 20 minutes a day on self-hypnosis and have a little bit more of a directed goal for something that they’re doing with their mind isn’t a stretch. Do you think there might be a way of tying those two things together?
Dr. Spiegel: I hope so, Jesse. We’re actually now engaged in a study where we’re using the fMRI scanner to see similarities and differences between hypnosis and mindfulness. I don’t have those results yet, but we’re trying to do that. I completely agree with you, I think mindfulness is another way of doing it. But it’s interesting, the context is different, and you’re absolutely right. In the West, we’re goal-directed, we’re driven, and so you use it for a purpose. "Here’s how to reduce your pain, here’s how to handle your anxiety, here’s how to help yourself stop smoking." Whereas with mindfulness, you focus on your breathing, you witness your emotions flowing by like a storm, and by the way, something good may happen. But the idea there is you don’t do it to solve that problem, you just learn to do it and the problem will get better, and that’s a very Eastern way of approaching the problem.
Jesse: Yeah, I think a lot of people probably that listen to this show, myself included, are more inclined towards the problem-solving approach. If somebody wants to learn how to self-hypnotize, what are the best resources for that?
Dr. Spiegel: Well, one way is to go to a licensed and trained professional, a psychiatrist, psychologist, physician, dentist who uses it in their practice, and they can show you how to do it. We’ve written a book called Trance and Treatment: Clinical Uses of Hypnosis that was meant as a text for professionals but is pretty accessible for people who are interested in learning more about the phenomenon. There are lots of other publications. There are two professional organizations that have information for the public, one is the Society for Clinical and Experimental Hypnosis, it has a website, SCH.us, and the American Society for Clinical Hypnosis, ASCH, and it also has a website, ASCH.net. Those are places to go to either get referrals or get more good information about hypnosis. And a lot of people are into the literature now. There’s an International Journal of Clinical and Experimental Hypnosis, and an American Journal of Clinical Hypnosis that has good recent articles.
Jesse: I guess as my belief, one of the things that hinders people is we don’t have a very accurate view of ourselves. Sometimes your best friend can tell you something about you that you don’t know, and if you’d known that sooner, you could’ve made changes a lot faster. In a hypnotized state, are people able to more accurately self-diagnose where they might be underperforming, or things that they could do to make improvements?
Dr. Spiegel: Well, it’s interesting. We say that hypnosis has three main components. There’s absorption, which I’ve talked about, this intense focus of attention. To do that, you have to dissociate, you have to put outside of conscious awareness things that would ordinarily be in consciousness. And suggestibility, the tendency to respond to cues without judging and evaluating them. The dissociation part is pretty interesting, because people who are hypnotized will say, "You know my left hand doesn’t feel as much a part of my body as my right," but you may also feel sort of detached from yourself in some way, and be able to look at yourself from a different point of view. So if you said to someone, "Picture yourself as you ordinarily see yourself and then picture yourself," and I’ve used this therapeutically, "as other people might see you," and you’re better able to disconnect from your usual view of yourself and say, "You know, I can understand why people see me as pushy and arrogant, although I don’t see myself that way, because I sometimes do things that may intimidate or compete with other people." So yeah, I think it’s possible to use it to get a second look at yourself from a different point of view.
Jesse: So, thank you so very much to both Dr. David Spiegel and Jeff Jordan for lending their thoughts on hypnosis. I thought maybe the most interesting point actually in that entire conversation was the observation that hypnosis is, in a lot of ways, almost like the Western version of meditation, a little bit more of a hands-on, "hands on the steering wheel" approach to what could probably have some similar outcomes. I also think it’s just fascinating to consider the power that our minds really do have. If you put together the ideas like that the Stroop Test, things where people under hypnosis can actually perform at a higher level than an unhypnotized person could, and then if you combine that with what Jeff Jordan said about how so many people blank out their own memories, not because that’s what hypnotism automatically does but because that’s what their belief, what their preconceived notion about what hypnotism does, it really makes you wonder about how much our expectations as we go through everyday life, that we might not even realize our assumptions, how much those things might be affecting how our brains operate, or levels of performance, all that stuff. Lots of really interesting possibilities, and I’m trying to think if there’s anything in my own life that I would want to try to use hypnosis for. I don’t have any surgeries or childbirths or anything like that coming up, but I must admit, I’m kind of tempted to try to find an application just so I can give hypnosis a "day at court." But that is all for our interview. Let’s move along now to the Ruthless Listener-Retention Gimmick.
— Ruthless Listener-Retention Gimmick --
So, along with velvet Elvis paintings, probably one of the most popular pieces of ornamentation in the average man cave would be one of those paintings of a bunch of dogs playing poker. But normally we do not think of animals as gambling. But if you want to try to get to the bottom of what makes humans susceptible to gambling addiction, it’s great if you could try to find an animal model of gambling. And so scientists at the University of British Columbia recently did this, they set up sort of a food reward-based game for rats, where some behaviors were riskier than others, some were safer, you might lose a little bit of food, gain a couple more food pellets. That rats could figure out the rules, and just like human gamblers in a gambling game, some strategies would be lower risk, lower reward, others would be higher risk, higher reward.
And then they got down to business, testing what they were really curious about, which was how do all the extra cues in a normal gambling environment, like we would have at a casino, actually affect the brains of the gamblers. They had a suspicion that the giant barrage of sensory stimuli that sort of attacks you the moment you walk into a casino, all the flashing lights and buzzers and sounds, all that stuff might have an effect on gambling responses or the risk aversion responses of the people that enter casinos. So they taught the rats these basic gambling games, and then they let them gamble in a couple of environments, one that was kind of like just a boring normal rat cage, and another that was more like the casino rat cage, with some flashing lights that would come along with the food pellets and sound cues—they actually created some rat music. Anyway, the scientists were expecting that they might observe some changes in the rats’ behavior with these extra distracting cues going on, that this might have some bearing on the rat's’ decision-making processes. They wound up being flabbergasted by the actual magnitude of the changes.
One of the lead researchers in the study, Catharine Winstanley, said, "It seemed, at the time, like a stupid thing to do, because it didn’t seem like adding lights and sound would have much of an impact. But when we ran the study, the effect was enormous." The rats placed in the casino cage exhibited much riskier behavior, almost exactly like human problem gamblers. Apparently all this extra stimulation is causing an over-release of dopamine, both in rats and presumably also in humans. They were able to test this in the rats by blocking a dopamine D3 receptor, and when they did that, they would see the rats even in the casino cage revert to a normal level of risk assessment. In other words, the rats who had their dopamine D3 receptors blocked could go into the casino cage and they would gamble the same as they did in the regular boring old cage. The rats whose dopamine D3 receptors were fully functional, you could take them out of the boring cage, put them into the casino cage, and you would start seeing them behave more like problem gamblers. Said another researcher, Djavad Mowafaghian, "Anyone who’s ever designed a casino game or played a gambling game will tell you that of course sound and light cues keep you more engaged, but now we can show it scientifically."
This raises the question, and I mean it almost answers the question before it raises it: is it any coincidence that casinos have flashing lights and loud sounds and all these things which seem optimally primed to make people behave in riskier ways? Odds seem pretty good that somebody has done this research in a non-academic setting a long time ago, and that the modern research at the University of British Columbia is only catching up with what the gambling industry could’ve told us many, many decades back. Echoing that sentiment, Winstanley says, "I often feel that the scientific models are decades behind the casinos. I do not think it’s an accident that casinos are filled with lights and noise."