Kind: captions
Language: en
but hypnosis is more problem focused
it's saying use it to control stress use
it to control pain you go into a state
of self hypnosis you're floating in
water you can transform the pain into a
sense of cool tingling numbness and
learn to filter the hurt out of the pain
dr david spiegel welcome to the show
thank you tom glad to be here i'm very
excited so this is a topic hypnotism
that i have long been fascinated by but
never met the right person
that was taking a serious look at it so
i've had obviously encounters with stage
hypnotism which is fun
but not exactly the kind of thing where
i want to rush up on stage and have
somebody hypnotize me and so
in the episode today i want to really
understand
what hypnotism is what it's good for how
it relates to
an analytic tradition you talk about
freud in the book it was really
interesting you you elevated my thinking
around what hypnotism is and what it
could be used for
um and
i have a quote from the book that i want
to start with and i thought that this
will set the stage well
if you can measure it it's science
everything else is poetry yet assessment
techniques have limitations in the
therapeutic odyssey the clinician is
best guided by both the science of
apollo and the poetry of dionysus
hypnosis is a fertile phenomenon for
exploration by both the researcher and
the clinician it is a style of
concentration not a therapy a capacity
not just a mystery when the therapist
employs trance and treatment he is
making maximum use of his patients
hypnotic capacity and motivation for
change
all right that's a pretty heady
exploration that comes at the end of the
book so i had had a lot of lead up
before i heard that passage yeah but
what does that mean exactly
well tom i'm glad you uh pointed that
out and
it is hypnosis
is
a state of highly focused attention it's
a naturally occurring state it's an
ability that many of us have and we
underutilize you know we don't our
brains are the most powerful organ in
our bodies uh but they don't come with a
user's manual and so there are a lot of
things that our brains can do that we're
not fully aware of so when you get so
caught up in a good movie or a play that
you forget you're watching the movie you
enter the imagined world not the real
world
that's a form of self-hypnosis and one
of the things that people misunderstand
is because in states like that you tend
to suspend judgment you have great power
to do things you may not have thought
you could do like what well right now
you have sensations in your bottoms
touching the chair and hopefully you
weren't aware of that until i mentioned
it if i did we could stop now
we do it all the time your brain has the
ability to say this sensation is
important that one's irrelevant
don't bother with it to dissociate
aspects of sensory or cognitive
experience and we can learn to employ
that and control it it's where people
make a big mistake about hypnosis they
think it's losing control it's actually
a powerful means of gaining control it
doesn't look like that from the outside
i've heard you say that before and later
so you and i checked before we started i
did not think i was hypnotizable right
because of an earlier experience that i
had
and you said that given the real fast
test that i actually may be quite
hypnotizable yeah which is exciting for
me yes but from the outside
looking at it it looks like people are
losing control like they even talk
differently
like it feels like some part of them is
gone
and so i'm
very curious
in what way is it us
gaining additional control well it's a
way of discovering other aspects of
yourself that you may not be fully aware
of if something is gone something else
is there and what we found is that
hypnosis is really a form of cognitive
flexibility your very ability to take in
a different perspective a different
point of view to experience writing
about a rainstorm as if it were raining
outside when it isn't
is a skill it's an ability you can use
it doesn't mean you're weak minded it
means you're flexibly minded and so
what's good about hypnosis is that you
can take on different ways of
approaching a problem you can think of a
difficulty like pain in a different way
it's a signal it's a signal from neurons
in your body but how you interpret the
signal is very different depending on
whether you're having crushing
substernal chest pain and you're having
a heart attack or whether the same old
achy back is bothering you again you can
react to that to the same pain signals
the same way but if you're cognitively
flexible about it you can experience
them differently
okay
very interesting all right so
talk to me about the relationship
between hypnosis and therapy you say
it's not a therapy right that it's just
focused attention right but
you talk a lot about how the the moment
that psychoanalysis really
first became something that this could
really work was tied to hypnosis
so
if hypnosis is not a therapy unto itself
what is it doing
that allows psychoanalysis or other
methods to work
well hypnosis is a state of open
generally accepting concentration but it
means that you have to have a strategy
along with it to have a therapeutic
benefit now freud in his early work in
his studies in hysteria the first
uh book that he wrote he was he learned
to use hypnosis from the great
friendship into john martin charcoal
and he was using it to help patients
relive earlier events in their life that
he thought might be related to their
current symptomatology
and he he says in his autobiography that
one moment i was relieved
of a difficult situation by the entrance
of a manservant my patient threw her
arms around my neck during hypnotic
trance and he said i was modest enough
not to attribute this to my own
irresistible personal attractiveness i
discovered the mysterious element at
work beneath hypnosis so he thought that
it was transference that when you have
these intense experiences you may
transfer feelings you have about them to
your therapist now we know that that
happens in therapy all the time if you
see a therapist for post-traumatic
stress disorder you may suddenly become
afraid
that the therapist is doing something to
harm you so part of the work then is not
just using the hypnosis to relive the
memories
but therapeutically suggesting to the
patient that the feelings that are
coming up are related not to the present
situation directly but to the the fears
that come up when you think about early
traumatic experience so you're reliving
it but you're restructuring it and
that's where hypnosis can be very
helpful is to bring up issues but then
see them from a new point of view
so you've done a lot of brain imaging
uh on people in hypnotic states right in
china and i really want to understand
that are things turning off in the brain
when you go into hypnosis or are they
turning on uh it's not quite that simple
but close there we found that when
people go into hypnotic state three
things happen
one is you turn down activity in what's
in the anterior cingulate cortex it's
this a a brain structure like this right
down in the middle center of your brain
it's part of the salience network so if
we suddenly heard a loud noise we
thought was a gunshot we'd suddenly
change our attention that's the salience
network saying this could be trouble you
better pay attention it's what um many
um social media
um uh approaches use to get your
attention they talk about a threat you
know and so suddenly you're scared and
you pay attention to something bleeds it
leads right exactly so you turn down
activity in that area you're not worried
about the fact that you're narrowing the
focus of attention you then connect the
dorsal lateral prefrontal cortex part of
the executive control network to the
insula which helps to regulate the body
and is part of the salience network and
you disconnect the dorsolateral
prefrontal cortex from the posterior
cingulate that's a part of the brain
called the default mode where you just
reflect on yourself and who you are
activity there is turned down during
meditation for example so you're you're
worrying less about what else you might
be thinking about and you're allowing
your executive control network to strong
more strongly connect with your body
so it's a state of highly focused
attention
dissociation of things that ordinarily
would be in consciousness and
sensitivity to input that really
represents cognitive flexibility
okay so that's a that's a complex bundle
let's talk about disassociation right
that sounds bad i have a negative
connotation in my mind somebody goes
through a traumatic something they
disassociate
do we have that from an evolutionary
standpoint so that we can deal with
trauma or is there a beneficial take to
that you know tom that's a very astute
point you know i i've sometimes wondered
why did we evolve to have this ability
and if you think about it
we're we're pretty pathetic physical
species you know we're not that big
we're not that strong
we don't see as well as eagles we don't
smell as well as bears you know we don't
hear things that well we see we do see
things pretty well though that's our
major defense
and so it it's important uh for us to
use the capacities we have to protect
ourselves now
predators who usually have eyes in the
front of their heads like tigers and
lions
and prey that have eyes on the side of
their heads so that they have a wider
visual range
are more keen to picture a predator
coming but predators detect motion
that's how predators find prey and if
you are good at staying very still when
you're in danger or when you're hurt
you're more likely to evade a predator
and so there is real adaptive value to
being able to inhibit the urge for
motion to control anxiety and to can to
reduce your ability to experience pain
to control pain too so i think that this
capacity to regulate concentration had
real evolutionary adaptive value and
that's why we are this way but we don't
use it nearly as much as we could
all right so i'm simultaneously
disassociating but i'm also paying
closer attention to my body exactly yes
it may be your body it may be something
else so didn't you say though that part
of it is that a region becomes active
that is dealing with paying attention to
your body or no yes it is well it
connects your executive control network
more strongly to the part of your brain
that controls your body okay so that
means you can turn things on there or
you can sign them more in control of my
body from an executive that's correct
man that feels like the opposite of what
that is the opposite of what i think
about with hypnosis where it's like
you're having the person razor oh my god
it's like it's working without me yes
help me reconcile that well you're
the dissociation of your arm means that
you can disconnect control systems that
involve
your hand floating up in the air and
it'll float back up if you pull it down
but it doesn't mean you don't control it
you just control it in a different way
so you discover that you have two
different control systems for your
different arms and one is the usual and
the other is the unusual and that's just
enhancing your array of abilities it's
not saying you're really out of control
you're not you're just have a more
complex set of control systems than you
realize that's so intriguing do you know
what tumor is
tumult so wim hof uses tumult so he can
heat up like the palm of his hand right
and so there were these monks that were
studied because they claimed that they
could like melt the snow around them
that they could make one hand warm in
the other hand cold and people like
there's no way and so they went and
measured it and they actually can do it
it's really impressive and then wim hof
has probably been the one that's been
studied the most and they've submerged
him in ice and he can maintain his core
temperature
long past where he should be in
hypothermia i mean it's really
impressive
and it seems like because i know you've
studied like if you
put somebody in a hypnotic state and
then walk them through eating an
imaginary meal that the gastric juices
will actually spark as if they have
eaten a meal which is right insane in
fact walk us through that because i know
there was more depth to that study well
i know in your career you've been more
than a little bit interested in
nutrition and how the gastrointestinal
system works as lisa has
and um what we found we got people to
not eat you know to to be
without food in the morning
i met with them uh we hypnotized them we
had them eat imaginary meals so we'd
spend an hour i got hungry just
listening to it you know but they would
uh go to alice waters restaurant and you
know have a good meal there and one
woman after about 30 minutes said let's
stop i'm full you know just eating
imaginary meals and and we had uh a 200
increase in gastric acid secretion we
put down an ng tube and measured their
gastric acid secretion we then did the
contrary we had them eat
think about anything except food
and we had a 30 percent decrease in
gastric acid secretion and even if we
injected pentagastrin which stimulates
gastric parietal cell output we still
had a significant decrease in
their gastric acid secretion so we could
change it in either direction
in rather remarkable ways and that
suggests that we have a much more
detailed control system in our brain
about how our body reacts then we give
ourselves credit for
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[Music]
yeah that was one of the more surprising
things in the book is so anything that
gives me the ability to influence my
what i think of as my subconscious is
probably more sophisticated than that
but anything that allows me to do that
becomes really um enticing because when
i'm anxious
i feel completely like i can't get my
body to do what i want
and it's
it's weird so the way that it manifests
for me when i feel anxious it is exactly
the way that i feel when i'm cold so i
feel unmoored is the easiest way to
explain it i just feel
like i'm not grounded i feel a little
jittery and it i can feel the blood
leaving the prefrontal cortex you know
it's like i can just i'm not at my
sharpest and i can recreate that feeling
by getting cold because i now associate
anxiety with that feeling so it's really
weird that i can in some ways i suppose
hypnotize myself into thinking i'm
anxious when really i'm just cold which
is bizarre but the idea of being able to
go in and slow that down stop it
like get the blood flowing in my brain
the right way again slow my heart rate
slow my breathing
that would be incredible
now is so
your ability to be hypnotized you said
is more consistent throughout your
lifetime than even your iq
that's right but
can i
get better at that autonomic
regulation
over time or is that just like yeah once
you hypnotize that sort of it no you can
use it better whatever your level of
ability is you can learn to use it
better so what you just described for me
tom is a typical thing that happens to
people when they get anxious which is
one way they notice it is their body
feels more uncomfortable and you
mentioned you feel cold you may start to
shake a little bit muscles tense up and
then you notice that and you say oh my
god this is going to be bad you know i'm
getting anxious again and what does that
make you do it makes you more anxious so
your brain is sending you the signal
it's like a snowball rolling downhill so
the way we use hypnosis for that often
is to teach you how to focus first on
making your body feel more comfortable
and then on the problem that's making
you anxious
but
it'd be why that's really interesting
because i
the you may not be able to control
what's making you anxious
but you can control how your body's
feeling you can control how your body is
reacting to the stressor and that by
itself starts to make you feel better
because what bothers us about stressors
is they're threats
that we're not sure we can control and
so you st we often start out with this
associated learned helplessness where we
feel the signals that come when our
bodies are telling us you're anxious
you're stressed there's a problem and so
the way we work at it is to say let's
control the thing we know you can learn
to control and that's how your body's
reacting and that gives you a platform
on which you can then approach the
problem and try to deal with it
differently
yeah that's really intriguing
so i've always attacked it from the
breath perspective
meditation changed my life because it
while not as effective as i would want
it to be if i'm in the throes of like a
moment it's not like i can hey just give
me a second let me meditate for you know
10 minutes right but
the ability to breathe from my diaphragm
having practice sort of letting it go
um that makes such a big difference so
anything that gives me this other path
to being able to address
things that i think of as happening at
an autonomic level that should be
theoretically outside of my reach
that gets really intriguing really fast
sure well autonomic doesn't mean
automatic
you can learn to control autonomic
activity and breath work can be one way
without limit
no not without limit there are limits
but you can do it we tend to think it's
something happening to us because it's
happening to our body but our bodies are
controlled every part of our body is
controlled by our brain and there are
ways of managing how the body is
responding you know breath work is a
very interesting thing too because
breathing is normally an automatic
function but we can take it over and do
it anytime we want so and the control
system for it is right
below the brainstem in the brainstem and
it it's a place where
it's right at the edge of conscious and
unconscious control and so taking
control and breathing can be very
helpful yeah no doubt
so
as people begin to explore this it seems
like at least if they fall into the
category of people that are able to do
it because i know about a third of
people can't right um
that it it seems to have a pretty
profound impact why then does hypnosis
have the sort of weird reputation that
it has and why is it if it was being
used pretty um out in the open i mean so
you have a guy named mesmer which is
where we get the phrase mesmerized that
was back in what the late 1800s it's
been around for a long time so why has
it struggled to gain i'll call it
legitimacy well hypnosis
is the oldest western conception of a
psychotherapy it's the first time that a
talking interaction between a doctor and
a patient was thought to have
therapeutic benefit but and who was it
was that freud um
well it was mesmer mesmer
you know he demonstrated that people
could go and have these pseudo seizures
and all kinds of things he became the
go-to physician in paris for a long time
until the other physicians got unhappy
about how much of their business he was
taking
and he was discredited because of his
theory of why hypnosis worked he called
it animal magnetism he thought there
were magnetic fields in the therapist
body that influenced the magnetic fields
in the patient's bodies and corrected
them
even though he was using hypnotism did
he understand what he was doing
he had a theory and he he knew that he
was influencing people he knew it could
change things that happened in their
body would he have them stare at a
single point or watch a watch he would
he would sometimes do that he would but
he also put them next to what they
called pacquays in france they were
tubs filled with magnetic filings and
the idea was a weak magnetic field and
maybe the magnetism would change the
magnetic fields in their bodies um that
wasn't true and so a french commission
that included our own benjamin franklin
who was having fun in paris the
brilliant chemist lavoisier and the
doctor well known for his work in pain
control dr guillotan the inventor of the
guillotine he kind of created the
mind-body problem
they were all on this panel they decided
that he was wrong about magnetic fields
which he was wrong about but they kind
of threw out the baby with the bathwater
and it unfortunately a lot of hypnosis
has been associated with stage hypnosis
with people who don't know anything
about doing psychotherapy or assessing
medical problems
and so it got a bad rap but then you
know there have been bad drugs too there
have been snake oil salesmen forever and
somehow we don't see medication as
necessarily being bad in the same way
that we have with hypnosis so it got a
bad rap but it's still around because
there's something powerful and helpful
about it
yeah it's really interesting so one
thing that stage magicians do that the
post-hypnotic suggestion where it's like
hey you're going to go back to your seat
and when you hear me say chicken you're
going to yell out
hey is that real does that work
and if it does work
why well it has to do with
uh your openness to incorporating novel
cues
um and dissociation and people know that
like if if somebody is hypnotizing you
give them a post-synodic suggestion do
they know that they're going to have
that reaction or are they a surprise
well they know when they don't know part
of their brain knows because some of
them do it not everybody by any means
you know the stage hypnotists
the beginning of any of these shows
they'll get people cycling on and off
the stage because only about one in ten
people are so hypnotizable that they'll
do stuff like that right so they they
filter them around until they get the
few who will but
the ones who do
have taken in the information but don't
consciously remember
the instruction episode and so when they
hear the cue they do it not everybody
does but some people do so the
information is there but the awareness
of how and when they got it and what it
means is not there for the moment you
know i think it's one of the things that
scares people about hypnosis is that it
shows us how susceptible to influence we
are
and i wish people in this country were a
little more aware of how susceptible to
strain all kinds of strange weird
influences than we are tell me more what
do you mean
well people are willing to believe just
flat out lies you know they're willing
to believe stuff that we are they
hypnotizing themselves because they
don't want to believe it i think i think
some of them are i think a lot of the uh
people are just it's they're going with
the ins the content rather than the
context of what they should know is
going on so they're dissociating what
they say they think is true from what
they know couldn't possibly be true
that's really interesting so you've
referenced hypnosis being like looking
through a telephoto lens right where you
see with more clarity something but it's
completely devoid of context that's
exactly right and so if you strip away
the context
or alter the context you may think
things are true that simply
are not and you know going back to your
your magic thing you know there's a
magic wand and there is some connection
between the magic wand and the hypnosis
you know the old idea of the dangling
watch which is you get somebody to pay
attention to what you want them to pay
attention to and not what else is going
on around so it clicks them into that
narrowed focus exactly right okay
and so simply the act of narrowing one's
focus puts you into a hypnotic state if
you are if you're hypnotizable yes it
does and that's what you do in a
hypnotic induction
you get people to focus on a very narrow
set of things
see what you can observe and feel about
them and that can be an induction into a
hypnotic state and it can occur in a
matter of seconds it doesn't take
minutes or hours to do okay so we get in
this hypnotic state
in fact
this may be interesting to combine these
two things so you've said basically all
kids are hypnotizable right and from the
age of five to ten six to eleven
somewhere around in there it's just like
maximum hypnotizable you you call your
kid into dinner he doesn't hear you he's
out playing he's and that's what's so
wonderful about childhood is work and
play are all the same thing you just get
totally absorbed in it and so yes most
most eight-year-olds are in trances most
of the time kids are little sponges they
want to take in everything they don't
judge it and keep it at a distance they
just take in whatever is going on it's a
wonderful learning strategy and children
you know
human children have the most profound
periods of dependence of any creature so
they have to learn how to live and being
open and accepting
concentrating very intently is a good
learning strategy and so i think that's
one reason that children are so much
like that but as they go through
adolescence and they learn what we call
formal operations they learn logic you
know that a tall skinny jar doesn't hold
any more water than a short fat one
they tend to employ critical judgment
more their prefrontal cortexes are
growing at that time and so they learn
to balance taking in new information
with evaluating and thinking about it
which is also a very useful human skill
so some people retain that kind of more
childlike ability to just take it in and
go wow and feel absorbed in it and other
people develop a more logical orderly
step-by-step process of learning and
that can work too
okay so talk to me about how we go about
the reframe the re-contextualization
hypnosis is used a lot in pain it's used
a lot in trauma right age regression
like all of this stuff
so there might be two things there so
one you've got reframing which i assume
would need a therapist
and then the other one is accessing
something in a context-dependent state
or a conditionally dependent state i
forget the words you use in the book but
like that you have to
re-be in that same disassociative state
or whatever to remember
right what what is that well
i think that when many people are
traumatized they will often say that
they
everything else disappeared
some many sexual assault victims say
they experienced the rape as if they
were floating above their bodies feeling
sorry for the person who was being
assaulted
you see pictures of people after 9 11
covering their mouths and unable to say
anything you go into an altered mental
state and so one reason that hypnosis
can be so helpful in with people who
have been traumatized is that they can
get into the congruent mental state and
they will sometimes tell you that they
remember things or aspects of the trauma
that they had not thought of in the
interim period and you can also help
them see it from a different point of
view so for example i i was asked to see
a woman who had been through a violent
sexual attempted sexual assault
she wanted to picture better picture the
assailant's face it was getting dark
and
as we went back and relived it she's
clearly getting upset again the way she
was at the time she said you know i
realized something that i didn't let
myself see before he doesn't just want
to drag me upstairs and rape me he's
going to kill me
and so i asked her to just try and stay
with that feeling for a little bit and
then i said now i want you to picture
something else on the other side of this
imaginary screen your body is safe and
comfortable you're not going to be hurt
now i want you to picture what you did
to protect yourself
and many assault victims don't think of
that but everybody has a strategy to try
and stay alive
and she said you know what he's
surprised that i'm fighting that hard he
didn't think i would
now she wound up with a basilar skull
fracture as a result of fighting him off
but she realized you know i may have
saved my life
and so it gave her a different
perspective on the traumatic experience
and hypnosis can help you do that
in a hurry to get
allow yourself to be aware in a
controlled way where you know it you can
turn it on but you can turn it off and
then picture also a different aspect of
the traumatic experience we call that
restructuring cognitive restructuring of
what the event is and that's a way to
help people deal with trauma
so what do people
mostly come to you or any clinician that
uses hypnosis for
and is it something they have to keep
coming back or how does that well what i
try to do tom is
they come for problems like pain
stress anxiety insomnia difficulty
sleeping uh they they come to stop
smoking uh to eat better to to lose
weight um and eat more more healthily
and um i assess their hypnotizability
teach them how to use self-hypnosis i
will sometimes see them several times
for people with complex trauma histories
i'll often see them many times to try
and help them work through the trauma
but what we tried to do is come up with
a way that they could still get much of
the benefit of working through the
experience but not have to keep come see
me or another clinician so with the
revery app they can hear my voice go
through the same procedure but modify
depending on how they're reacting to it
and put themselves to sleep um
we had one woman who said she was a
little upset with how the app was
working but she said i want to tell you
it's the first time i've slept in 15
years so i really
want to make sure that this works as
best as possible so it's a kind of
compromise where they can get the
benefit of the expertise without having
to keep going to and paying
a clinician to do it time and again
because it really is learning to use
your own internal ability and once
you've learned that people do it for
themselves i have cancer patients whose
pain over a period of a year got reduced
by 50 on the same medications just when
they feel that pain in their chest and
they think it's another tumor they just
go into a state of self hypnosis imagine
they're floating in a bath a lake a hot
tub or floating in space that's floating
it you know what it's just it i i've
known a few people who don't like it but
most people have pleasant associations
they take a bath they get in the hot
when i have trouble falling asleep and
this is without ever being prompted i
imagine myself
floating in the ocean sinking i don't
know why sinking
but i imagine myself floating to the
bottom of the marianas trench
and that should be terrifying yeah but i
imagine the water is warm and there's
just something so enveloping i don't
know if it's like a womb thing oh that's
sort of what i've always
read out of like my own desire to
imagine myself completely encased in
water and just sinking sinking sinking
of course i have to tell myself before i
start this is weird but i have to tell
myself you can breathe underwater no
that's so that i feel completely relaxed
as i'm sinking so it's not a threatening
feeling it's just anyway it just you you
always mention this idea of floating
floating floating i was just curious
because that resonates with me so well i
just didn't know why it's so universal
so listen folks you know he'd you'd be a
really good hypnotist because you give a
very nice description and the fact that
you think about that concrete potential
problem you know how could you be
floating down under the ocean and still
breathing and you take care of that is
exactly what is needed for people who
are letting themselves go and allowing
themselves to feel this alteration in
sensation so that's that's good hypnotic
instruction and it obviously works for
you
yeah it's interesting it it works
sometimes
but i would really like to get way
better at it sure hello my friend you
know that i believe success requires you
to see failure as the ultimate learning
tool success requires you to be
disciplined and gritty and to never ever
quit on your dreams i say all of that
because one thing is certain the road to
achieving your goal is not smooth or
linear i wish it was but it's not it's
going to be bumpy sometimes scary some
days you'll take two steps forward and
slide 10 steps back and that's why
success also requires you to know how to
pull yourself out of a rut and get
unstuck fast life is short you can't be
messing around with your goals you've
got to make progress every single day so
i've pulled a class from impact theory
university called how to get unstuck
which you can watch for free with the
link on your screen or by clicking below
when you join me for that free preview
of that workshop from impact through
university i'm going to teach you my
strategy for how to
understand exactly where you need to be
going how to identify the obstacle
that's blocking you and the best way to
make the most progress towards that goal
and keep your momentum right click that
link and let's get to work all right
i'll see you on the inside
all right so going back people come in
they come in for all these things you
tell them to imagine themselves floating
and then we were just about to get into
how that helps well that's one of the
things i mean it depends on what the
problem is but typically
um for stress management for example
i'll say imagine you're floating in a
bath like a hot tub or floating in space
now notice how quickly and easily you
can use your store of memories and your
imagination to help yourself and your
body feel better so we get them
immediately and one of the wonderful
things about hypnosis when it works is
it works right away you know you don't
have to wait you don't have to take it
on faith that if you keep doing this for
three weeks you know you'll start to
feel better
you can see whether or not it's helping
you and if you feel that sense in your
body you say you know if i can make my
body feel better in this way sometimes
the way i'm approaching problems may
make it feel worse so you're learning
that there are ways that you can control
your body and then i have
people picture on an imaginary screen
on the one side something that's
stressing them out right now but with
this rule keep your body floating so
you're floating at the bottom of the
ocean but you're picturing this problem
your body's feeling better now and then
i say on the other side of the screen
picture one thing you can do
to help with that stressor it may not be
the perfect thing but it's something so
you're beginning to control how your
body reacts and you're beginning to
control your mental strategy for dealing
with whatever the stressor is
and so it's teaching you to step-by-step
enhanced control take stock of it how
well you're doing and then continue to
use it to better solve the problem
yeah it's so interesting to be
methodical to just keep coming back to
it it reminds me so much of meditation
in fact
what
what are the differences between
meditation and hypnosis and are they the
same
well they're similar and there's
something about changing mental states
by itself
that can be therapeutic so you know
if you make the mistake of reading a
really nasty email at 11 pm
you think oh god what am i going to do
you have trouble going to sleep and the
next morning you've got a night's sleep
you say oh that that guy again i can
deal with that you know and so changing
mental states changes your perspective
on situations so that by itself is good
hypnosis is more western it's problem
solving you know it's done for a purpose
whereas mindfulness is meant to be a way
of being training your brain to have
open presence to just experience things
without judging them uh to develop a
sense of compassion for other people to
do a body scan and check out different
parts of your body but it's it's not per
se designed to solve problems it's
designed to just be differently and then
if you are you may solve problems i have
great regard for that but hypnosis is
more problem focused it's saying use it
to control stress use it to control pain
you go into a state of self hypnosis
you're floating in water you can
transform the pain into a sense of cool
tingling numbness and learn to filter
the hurt out of the pain
or you can say you know i'm going to use
dissociation i'm going to leave my body
here floating and i'm going to go
somewhere else i'd rather be and and you
find that that's another way that you
can disconnect yourself
from the pain cessation so it's it's
similar but it's not the same and
different parts of the brain to some
extent are involved
mindfulness is more turning down
activity in the posterior cingulate
cortex turning down your awareness of
self and what it means whereas hypnosis
is more turning down that salience alarm
network
and saying yes it may be there but it's
not going to bother me as much as it did
before
all right let's talk about the three
personality types because it has pretty
big implication into
who's hypnotizable some potential
pathologies that people might have so
you've got the apollonian right the uh
dionysian and the
odisian odysian yeah
uh what's the difference so the
dionysian dionysus was the god of
pleasure and celebration and greece i
like him already there you go you're
there and and the idea is these are
people who lead with their feelings who
have experiences who can fully absorb
themselves in experiences and that's
like people who are very hypnotizable
they just get totally engaged and
engrossed in the experience and just the
experience itself is its own reward it's
an autotelic or self-rewarding
experience people like being there
because it just feels good to do it
on the other extreme you have the
the apollonians
apollo was the god of reason they value
rationality overall else they don't
believe anything they haven't read
somewhere and they
think through everything logically and
have trouble allowing themselves to put
feelings first and just think things
through
and those people tend not to be very
hypnotizable and i approach i treat them
but i in a much more step-by-step
logical linear way the odisians for
odysseus who would have these grand
adventures and then come back and
reflect on what they meant
are sort of more in between where
they'll allow themselves to feel
but then pull back and wonder feel bad
about it
uh they can be prone to depression you
know they reflect on what happened and
they're unhappy about it so those tend
to be the three personality types that
we identify with uh the the odisians are
mid-range in hypnotizability the
dionysians are high and the apollonians
are low
okay and so where does this start to get
into pathology
well we find
that people who are
mid-range the the odisians tend to mean
we're vulnerable to depression if
anything
uh the the because they ruminate yeah
because they ruminate about the they
have the experiences but then they
ruminate about them and go over and over
and sometimes have a lot of negative
self-talk about why did i let myself do
this
what kind of person am i they over
generalize a bad experience to be a
judgment about who they are and they
start to feel hopeless helpless and
worthless so it can degenerate into a
kind of depression
the dionesians are more prone to
um
psychosomatic disorders to uh what we
used to call hysteria they conversion
disorders they'll have conversations
non-epileptic
it's now called functional neurological
disorders where they'll
they may be people who have a seizure
disorder but they'll have non-epileptic
seizures where they're they suddenly
start to shake as if they're having a
seizure and it becomes a dramatic
expression
of a conflict so uh i had a patient who
um was a member of a very fancy wine
family in in the napa valley and she was
the only one in the two generations that
would talk to both sides because the
fathers and the sons were in court
fighting with each other all the time
and she started to develop these caesars
she was trying to just make peace and
get everybody together for thanksgiving
dinner
and people were everybody was yelling at
her and she decided she had to do
something when her daughter had a baby
and they wouldn't let her hold the baby
because they were afraid she'd have a
seizure so i did two things she was very
hypnotizable i had her bring on a
seizure she made it happen
and then i taught her to make it weaker
and weaker so you can you can't stop it
right now but you can start it and
that's a way of teaching you control and
i said the other thing is
when your father calls you and starts
yelling at you on the phone hang up on
him she was calling him every day and
he'd always yell at her i said you don't
have to take that so teach him a lesson
and just don't talk to him until he
stops doing it and she's now holding the
baby the kids are growing up and she's
doing fine so she could express herself
more in action than in words and i was
trying to help her
learn to provide structure to that
situation all right we get our hooks
into this through different means so it
could be meditation it could be hypnosis
it could be a psychoanalytic tradition
but finding ways to
acknowledge i'm putting that i you never
said that so i'm putting those words in
your mouth but that seems like you can
get on board with that uh and then
reframing it and that hypnosis is a
great way to get us into a hyper sense
of concentration but with some
disassociation in there so that we're
altering the way that we perceive things
and then we can reinforce this in
ourselves and we can get better at
doing this whether it's reducing pain
reducing anxiety reducing the tremors
whatever the case may be
by practicing this now when we're in
self-hypnosis would we be repeating in
our heads the kind of thing that you say
like i'm floating i'm going down
i'm feeling calm and safe and on this
side of the screen i'm going to imagine
this and over here is that what you're
doing or is it once it becomes the
self-reinforcing part does it take on a
different approach well it
it's good to have a structure like that
to start with and to start out doing and
again we can
allow people to hear that again and
again if they want using the revery app
um or seeing other people who practice
hypnosis if they want um but yes it is
it's a starting point if you have a
structure you can learn how to get there
you can see what you can do and then you
can develop on it you can say well you
know i feel better rather than floating
i like to imagine not being in the ocean
but floating in space or i can be
somewhere else like lying on the beach
in the sun where i feel comfortable so
they can elaborate on it and and use it
in a different way that they begin to
develop but it helps like with any
practice
to begin with a concrete example so you
can see what it feels like and then you
can start to
amplify it in various ways and a key
part of this is the sense of feeling
safe i imagine having to get people into
that state where they're calm they're
relaxed right and then you pull in
that idea now one thing that that makes
me think of is
doing treatment with drugs so mdma is
something that i've long promised myself
that i would try
uh i'm super like if i were going to do
a drug it would definitely be mdma at
least from what i hear
it sounds pretty extraordinary and the
way that i explained it to my wife is
imagine if i put you in a state where
you're just awash in serotonin
everything feels good and okay and
embraced with love and now i have you in
that state revisit a trauma and now it's
you know whether it's a deeper empathy
for yourself if it's something you blame
yourself for or
a greater understanding that you're
going to be okay now and that you can
move forward sort of in this light and
love
um i know you've looked at psilocybin
and the way that it can change people's
sense of what dying means
have you seen a similar kind of effect
from hypnosis
yes hypnosis can be helpful uh in
teaching people how to change their
both the their physical state how they
feel physically to control it even
without the drug but also the effect of
the drug so one of the things that mdma
does you know it's
called ecstasy it's the sort of
interpersonal connection drug you know
it helps you feel more connected with
other people now many people who've been
traumatized feel ashamed of what
happened they feel guilty we'd rather
feel guilty than helpless
and there was no that's a statement yeah
and it's people blame themselves for
events they had no control over why on
earth would we rather feel guilty than
helpless that's interesting because you
think if it was your fault
you could replay the the movie and make
it come out differently
trauma is in essence the experience of
being made into an object a thing you
have no control of what's happening to
your body and so you'd rather feel
you're in a situation where you were
still in control you could have made it
come out differently but you didn't do
the right thing part of it is to detach
yourself enough but approach it so that
you can get a truer perspective on what
happened and what you could do and what
you couldn't do so you don't blame
yourself for things
you don't control and there's a sense of
shame that comes with that so many
people are ashamed of whatever trauma
was done to them many sexual assault
victims
are ashamed about it even though they
have nothing to be ashamed about and so
a drug that helps you feel you can
reconnect with people can help to
counter that sense of shame and
isolation that many people who have been
traumatized have
yeah mdma is intriguing
now psilocybin though is a totally
different trip and
you said something that really resonated
with me which is if i were dying
the last thing i would think to do is
take something that i know could give me
a bad trip because i'm already freaking
out right and yet people that do it say
you know this is one of the four or five
most profound experiences of my life
it's helped me completely reshape this
do they have a bad trip though and it
just ends up being worth it or
well now the way that psilocybin studies
have been done and they've been doing
very well at hopkins and nyu and
elsewhere is they couple the drug with
four or five hours of supportive
psychotherapy so they try and keep
people from having a bad trip but the
interesting thing is most of them don't
anyway and part of it i think is and
i've worked a lot with dying breast
cancer patients without drugs
and we were told when we started this
that we'd give them and what amounts to
a bad trip they'd watch other people die
of the same disease and that they would
freak out but you know what death isn't
a novel concept it's just having the
ability to face it one of my patients
said it's like looking into the grand
canyon when you're afraid of heights you
knew if you fell you'd be a disaster but
you feel better about yourself because
you're able to look i can't say i feel
serene but i can look at it and i think
people
thinking about it on psilocybin say you
know this is a terrible thing but part
of what i'm experiencing is the
preciousness of the moment i can have
this negative feeling i'm still alive
i have the people that i've loved in my
life and
the fact that that happened isn't going
to go away even when i go away so they
see their death from a different
perspective and the capacity to see it
differently
makes it less overwhelming okay that
made me really emotional that's
interesting man that's heavy
that's so heavy why do you deal with
breast cancer patients
i
was a philosophy major in college and
believed what the existential
philosopher said that you don't really
live authentically until you face the
possibility of non-being
and so uh i started with the help of irv
vyalum who was a mentor of mine
a support group for women who were dying
of breast cancer and we were told that
we'd make them worse we'd demoralize
them but we wanted to see if it would be
a way to actually enrich their lives as
they were facing the end of their lives
and that's what we found
and we found that they were less anxious
and depressed they had less pain and in
fact in the first study we did we found
that the ones who were randomly assigned
to the group therapy actually lived 18
months longer than the control patients
now they weren't cured of breast cancer
but they lived longer so providing
intense emotional support can help
people help their bodies cope with even
a very serious illness
wow okay with that
you ready to i'm ready to try this okay
i'm so curious to see cool all right how
do i
like orient myself emotionally to
maximize the likelihood that this just
get as comfortable as you can and be
open to what you feel put one arm on
either leg like that do i need to lean
forward no you can just get comfortable
as you can you might take off your
eyeglasses if you don't mind i don't
mind watch that
all right so now please look straight
ahead
and now look up to the top of your head
all the way up high as you can and as
you look up slowly close your eyes
good take a deep breath
let the breath out let your eyes relax
but keep them closed and let your body
float
now as you concentrate on your body
floating into the chair i'm going to
concentrate on your left hand and arm
oops
in a moment
i'm going to stroke the middle of your
left hand middle finger of your left
hand when i do you'll develop a sense of
tingling and numbness and lightness and
you'll let it float upwards ready
this is an exercise in your imagination
just imagine your hand to be a big
buoyant balloon and let it float upwards
in the air higher and higher as the rest
of your body feels heavy and relaxed
that's good
all the way up
higher and higher
each breath deeper and easier hand
floating
higher and higher as the rest of your
body
feels heavy and relaxed
that's good all the way up the higher it
goes
the lighter it'll feel
each breath deeper and easier
that's good all the way up
the higher it goes the lighter it'll
feel
good now i'm going to position your arm
like so and give you this instruction
your hand will remain light and in this
upright position even after i give you
the signal for your eyes to open
if i pull your hand back down to your
leg it will float right back up to the
upright position
you'll find something pleasant and
amusing about this sensation
later when i touch your left elbow your
usual sensation and control will return
each time you go into this state of
concentration you'll find it easier and
easier to do
and you can use it to help you
concentrate on what's important to you
right now we'll come out of this state
of concentration together by counting
backwards from three to one on three
you'll get ready on two with your
eyelids closed roll up your eyes and one
let your eyes open ready three
two one
good now stay in this position please
and describe what physical sensations
you're aware of now in your left hand
and arm
it feels
light light and
weird it changed while it was moving at
first i felt
it was really subtle really just
but now it actually feels buoyant it
feels buoyant yeah uh is it um does your
left hand feel as if it's not as much a
part of your body is your right hand
it feels the same but it feels like it's
being
altered by something
it feels buoyant
it still feels like mine yeah but it
feels like i don't feel like i'm holding
it up
good all right well now note this
see it feels
like it wants to move but not enough to
actually lift
well turn your head look at your left
hand and watch what's going to happen
and see now now it doesn't feel like my
hand which is weird like looking at it
does not feel like mine
that's super bizarre and while you're
looking at your hand just imagine it to
be a big buoyant balloon
that's it and while you imagine it to be
a balloon permit it to act out as if it
were a balloon be big about it
can you describe what that feels like
feels like it's just
lightning
good
now as your left hand continues to go up
by way of comparison tom raise your
right hand
put your right arm down
are you aware of a relative difference
in sensation in your left hand going up
yes
is one arm lighter or heavier than the
other this one's like it's
it feels buoyant
like it feels like it's in water
like i don't feel like i'm holding it up
which is super weird
good so that's that's an experience of
dissociation
the two hands feel very different
all right now make a fist with this hand
tight fist
ready open
are you aware of a difference in
sensation and control now in your left
hand and arm compared to a moment before
it doesn't feel buoyant and it feels
like my hand again good
but it's really subtle and did you have
a sense of floating lightness or
buoyancy in your left hand and arm
during the test yes
very much so did you have that sense in
any other part of your body head neck
thighs abdomen chest
no no no i tried to imagine myself
floating so i felt very calm
and relaxed
but that was the only part that felt
like when it was up here like right now
i feel like i'm holding it there right
right but when it was there before i
didn't feel like i was holding it okay
well your score is seven out of ten
you're quite hypnotizable
that was really interesting
but that was a more subtle than i
expected it to be
and b that once i was in that position
it was
then it really felt strange i felt like
i could leave it like that forever yeah
and i would have no sense of effort
right which was unexpected you were able
to do it without effort and that's
exactly what you can feel with hypnosis
that you can learn
to change the way you experience parts
of your body um and i could see how that
would have tremendous implications for
pain
to your point about focus
like at one point
the only thing i was thinking about was
my hand right or my arm right exactly
exactly narrowing your focus
disconnecting the way it felt from the
way the rest of your body felt that's
what you can do in hypnosis and very
quickly
and what would you say your level of
tension overall physical tension is
right now
uh well it's back to normal so now i'm
aware that i'm on camera that i'm being
watched
whereas when we were doing that i
at one point when my hand was up i was
completely focused on that and forgot
that i was in front of camera i felt way
more relaxed exactly exactly so you can
see that you can reduce that level of
tension very rapidly and then it may
come back but you can do it again you've
learned that you can do that again and
so that's one of the advantages is you
have a an in vivo experience of how
quickly and profoundly you can change
the way parts of your body feel or your
whole body feels what's interesting
though when you talk about this in the
book i wanted it
and this is weird and a little
uncomfortable i wanted it to come from
you and not for me
like i was so aware of like don't move
it if it feels like you're moving it you
know what i mean right like that sort of
ouija board thing where it's like i'm
not gonna move it so if this thing moves
it's because somebody else is moving
this thing
um right and so that was i was almost
too aware of that so i wanted it to be
external i didn't want it to be
something
that i was faking
right but it's
it's a learning experience and one that
you can learn to to benefit from and yes
it helps to have guidance into it to see
what the phenomenon is to see how
capable you are of experiencing it but
once you've learned that
you can increasingly do it again yeah
that's so weird like i can now now that
i'm thinking about it i've got that
tingling sensation in my arm again right
it's starting to feel light that's
really trippy
that's really interesting good good dr
spiegel thank you so much for coming on
the show where can people connect with
you thank you they can connect with us
on reverend you can go to the app store
and download the reverie r-e-v-e-r-i app
um and we have a website www.reverie.com
where you can also sign up for the
android version we're developing that
and it should be out in a few months so
people who have android phones but if
you have ios phones now you can download
the app and try it out try it free for a
week see what it's like and
we hope that it will help a lot of
people control pain help manage their
sleeping better control stress
eat better
learn to stop smoking
and find their focus the way the way you
talked about and that's what we want to
help people do and use it to help better
manage these problems i can say from a
sleep perspective i downloaded it last
night and tried the sleep thing and i
was falling asleep so fast i was like
okay well i have to stop i'm not done
researching it so yeah but certainly
certainly effective for falling asleep
i'm really glad that's great yeah for
sure
guys uh this is something that intrigues
me i think that hypnosis is another tool
in your tool kit i highly encourage you
to try the app definitely read the book
it's all amazing he's also got a lot of
other incredible interviews check them
out i think this is something that could
be transformational for a lot of people
speaking of things that could be
transformational if you haven't already
be sure to subscribe and until next time
my friends be legendary take care peace
then what you realize is your capacity
to tap into dopamine as a motivator not
just seeking dopamine rewards that is
infinite and i i can say with with great
certainty that this is
how you were able to build a big company
and sell it how you've been able to
build a successful podcast and sell it
how you constantly seeking because
seeking is the