How hypnosis may be more real, and powerful, than you think — Chasing Life

[0:02] Hey there, welcome to Chasing Life. You know, most people think of hypnosis as stage tricks [0:07] and swinging watches, maybe even people clucking like chickens. And you know what? I thought that [0:12] too. But I got to tell you, my views have changed on this. In medicine, clinical hypnosis is [0:19] something very different than what you might think. New research is showing they can actually [0:23] show how the brain processes pain, can reduce stress and anxiety, help break bad habits, [0:29] and even enhance performance. Some Olympians are now using self-hypnosis to sharpen their focus and [0:35] improve their results. Now, this part may surprise you, but roughly two-thirds of adults are actually [0:42] hypnotizable. And the percentage for children is even higher than that. I've seen the impact of [0:48] this up close. I wrote an entire book about pain, and I was so struck by the evidence for hypnosis [0:54] that I devoted a whole section to how it can help people reframe and reduce their pain experience. [1:01] Now, to be clear, it doesn't magically erase pain, but it can significantly change the way your brain [1:07] interprets those pain signals and help you feel more in control. And that's the key. Now, part of [1:12] the reason I wanted to talk about this today is that despite decades of research, I think hypnosis [1:18] remains underutilized and misunderstood. So what exactly is hypnosis? What exactly is happening in [1:26] your brain during hypnosis? Who can benefit? And can you safely try some of this yourself? [1:32] Today on Chasing Life, I'm going to talk to Dr. David Spiegel. He's Associate Chair of Psychiatry [1:37] and Behavioral Sciences at Stanford University School of Medicine, and he's one of the world's leading [1:42] researchers on clinical hypnosis. He's going to explain the science behind hypnosis, [1:47] who it works for, and why this particular way of focusing your attention might be a powerful tool [1:53] you can use in your own life. I'm Dr. Sanjay Gupta, CNN's Chief Medical Correspondent, [2:00] and this is Chasing Life. I'm curious, the first time for you, I think you were in medical school. [2:11] Yes. [2:12] This is what sort of launched you into this career of hypnosis. Tell me what happened. [2:16] Yeah, I took a hypnosis course, and I was on my pediatric rotation at Children's Hospital, [2:22] and the nurse says, Spiegel, your next patient's in room 133. She's in status asthmaticus. [2:27] And I'm hearing the wheezing down the hall as I'm walking into the room. I walk in. [2:31] Bad asthma attack. [2:32] Bad asthma attack. 15-year-old girl in bed, leaning forward, knuckles white, [2:38] struggling for breath. Her mother's standing there crying. They had tried subcutaneous [2:42] epitimes, too. It didn't work. They were next going to give her general anesthesia and start her on [2:48] steroids. And I didn't know what to do, but I had taken my hypnosis course. So I said, well, [2:54] do you want to learn a breathing exercise? And she nods. She could barely talk. And so I got her [2:59] hypnotized. And then I started, broke into a sweat because we hadn't gotten asthma in the course yet. [3:05] So I came up with something very clever. I said, each breath you take will be a little deeper and [3:09] a little easier. And within five minutes, she's lying back in bed, and she isn't wheezing anymore. [3:15] Her mother stopped crying. The nurse ran out of the room. My intern came into the room looking for [3:21] me, and I thought he was going to pat me on the back. He said, I need to inform you that the nurse [3:25] has informed the nursing supervisor that you violated Massachusetts law by hypnotizing a minor [3:31] without parental consent. Now, two things about that. Massachusetts has a lot of weird laws, [3:38] but that is not one of them. And her mother was standing right next to me when I did it. So he said, [3:42] you have to stop doing this. And I said, oh, really? Why? He said, well, it could be dangerous. [3:50] Oh, really? [3:50] And I thought that anything that could help a patient that much that fast and violate a [3:55] non-existent Massachusetts law had to be worth looking into. And I've been doing it ever since. [4:02] And the thing is, it was like right in front of my eyes. There's no other explanation. You could see [4:06] it happening. Yeah. I mean, I can't imagine that someone who's having an asthmatic attack who can't [4:13] breathe to have that degree of relief so quickly through hypnosis. That's got to be very, very [4:18] gratifying. Let's start with some basics here. What is hypnosis? How do you define it? [4:25] Hypnosis is a state of highly focused attention, Sanjay. Have you ever gotten so caught up in a good [4:31] movie that you forget you're watching a movie and you enter the imagined world? That's what hypnosis is. [4:36] It's believed in imagination. You don't judge it. You don't evaluate it. You just experience it. [4:41] Right now, for example, you're sitting in a chair. You have sensations in parts of your body touching [4:47] the chair. But I'm hoping that you weren't even aware of that until I mentioned it to you. Am I [4:52] right about that? Yeah, you're right. If I was wrong, we could just stop the interview. Now you'd be [4:56] already bored. So we naturally do it. We dissociate. That's the second part. So there's absorption in the [5:03] focus of attention. To do that, you dissociate. You put outside of conscious awareness things that [5:08] would ordinarily be in consciousness to allow yourself to fully immerse yourself in the focus [5:14] of your attention. And the third thing is that you tend to disconnect from your usual way of thinking [5:21] about things. And we've seen this in the functional neuroimaging that we do, where three things happen [5:29] in the brain when you go into a hypnotic state. The first is you reduce activity in the salience [5:37] network. So you're just turning off the alarm and allow yourself to experience things. You increase [5:43] functional connectivity between the prefrontal cortex, particularly on the left, and the insula, [5:50] you know, the little island of tissue in the frontal lobe that has to do with mind-body connection. [5:55] So you intensify your ability to control and perceive your body. And the third is inverse [6:01] functional connectivity between the dorsolateral prefrontal cortex and the posterior cingulate, [6:07] part of the default mode network. That's, you know, the part of your brain when you're not [6:11] thinking or doing anything in particular, you're just kind of ruminating. And it tends to keep you [6:17] on track sometimes, but it also can inhibit you. And so you're disconnecting from the part of your [6:24] brain that says, you should be doing this, things ought to go like that, and allowing yourself to [6:29] try out being different. [6:31] You just drew a distinction, I think, between hypnosis and meditation. [6:35] Yes, yes, right. [6:36] Talk about that a little bit. These are two different things. [6:39] They are. I mean, they're not unrelated. And there's neuroimaging evidence, for example, [6:45] that in meditators over time, reduce activity in the posterior cingulate cortex and part of the [6:52] default mode network, which is where in hypnosis, you can also inhibit activity. But meditation is [6:59] about being and hypnosis is about doing. So in meditation, you're taught to have open presence, [7:06] to just don't try to change anything, just allow feelings, thoughts and feelings flow through you [7:12] like a storm passing by. It's a way of being, which I admire. I think it's a wonderful tradition, [7:18] but it's not a problem-solving tradition. By definition, it isn't. With hypnosis, you're [7:23] altering your state of focused attention, turning off the part of your brain that triggers this [7:29] reactivity to something that is troubling you. You're able to better control what's happening in [7:36] your body. Can anyone be hypnotized? No. Most children are very hypnotizable. You know, you call [7:43] them in for dinner, they don't hear you. But as we go through what are called formal operations in [7:49] adolescence, where we start to value analysis over experience, which is part of maturation, some people [7:58] lose some of that ability. And basically, in the adult population, about 20% are extraordinarily [8:04] hypnotizable. They lose themselves in movies. They get so involved in a work project that they [8:11] forget to go to dinner. There are all kinds of things. They just immerse themselves completely. [8:16] About 60% are moderately hypnotizable. So they'll engage in intense experiences like that, and then [8:22] they'll step back and wonder about it. And there's a group at the lower 20% who just aren't hypnotizable, [8:30] and they value thinking over feeling. But by the time you're 20, 21, the hypnotizability you have, [8:38] and it can be low, medium, or high, is very stable. [8:42] There's a thing called the Spiegel test, obviously named after you. And I think one of the questions [8:46] for a lot of people who are listening or watching is, can I be hypnotized? And about two-thirds of adults [8:52] can be hypnotized, some more than others, as you mentioned. [8:55] Is it overall an attribute to be hypnotizable? Is that saying something good about your brain? [9:02] Yes, I would say it is. It's a cognitive and affective flexibility. You can immerse yourself [9:09] in things, get into them, enjoy them, but then step back. And so it's a skill that people can use, [9:17] but it can make trouble for you. If you become totally convinced that one more, you know, [9:24] a bit of pain in my chest means I'm having a heart attack every time it happens. [9:29] You can lose yourself in that. You can believe it. You can sometimes get taken in easily by people. [9:35] One thing I noticed about very hypnotizable people is that they're empaths. They quickly tune into the [9:41] way other people are feeling and try to please them. Whereas the low hypnotizables, nah, you know, [9:47] they judge everything. So it defines a set of natural abilities to get mobilized that can be [9:54] good things or sometimes problematic. Are some people just more genetically more hypnotizable than [10:00] others? Yes. There is a genetic component to hypnotizability. In the dopamine metabolic pathway, [10:09] there is a heterozygous and a homozygous component to the dopamine processing. If you're heterozygous, [10:20] that is ideal for hypnotizability. So people, you maintain a sort of steady, relatively high level [10:27] of dopamine, and they tend to be more hypnotizable than those who are homozygous in either direction. [10:34] There's also an experiential component, and it can either be a good one or a bad one. Children who [10:41] have parents who engage them in imaginative involvements, who read them stories every night [10:46] at bedtime, who tended to encourage children to use their imagination, that tend to be more [10:51] hypnotizable as adults. But sadly, there's a bad one, and that is that children who have been mistreated [10:56] or abused tend also to be very hypnotizable because they can't let go of that ability. They use it as a [11:03] defense. And I've had patients who said that when my father would beat me or abuse me, I would just [11:09] go to a mountain meadow full of wildflowers. And, you know, he's got my body, but he hasn't got me. [11:14] So for some, unfortunately, children, it's a defense mechanism as well. [11:20] Yeah. I gotta let that sit for a second. That, I mean, a defense mechanism essentially was what [11:27] that sort of hypnotic state was for them. [11:30] Yeah, absolutely. And people will tell you this, you know, in a car accident, you know, [11:35] time goes very slowly. You know, it took a couple seconds and it felt like half an hour. [11:40] Soldiers in combat will do things under terrible duress that they may not even remember doing. [11:49] They're in this kind of altered state too, intensely focused, everything else outside of awareness. [11:53] And that's a hypnotic-like state as well. [11:56] Can you hypnotize yourself? [12:01] Yes, I've done it. Absolutely. And all hypnosis, Sanjay, is really self-hypnosis. [12:07] What I do is teach people how to use an ability to the extent that they have it. [12:12] And so you're conscious, you're aware of what's going on, but you're more narrowly focused. So [12:17] in a hypnotic state, you're solving a problem, but you're putting aside other things that in [12:22] ordinary consciousness you might be thinking about. [12:25] I think I remember reading in one of your articles that you hypnotize yourself around [12:29] shoulder pain as well. [12:30] Yes, yes, that's right. Yeah, I had a recurrent dislocating shoulder. I eventually had a bank [12:36] heart repair. [12:37] But when you did this for yourself, can you just talk us through, what did you do? [12:43] I have a very simple hypnotic induction. I look up, top of your head, while looking up slowly, [12:50] close your eyes, take a deep breath, let the breath out slowly through your mouth. Let your [12:58] eyes relax, but keep them closed. Let your body float. And then I let one hand or the other float [13:04] up in the air like a balloon. And that's a signal to myself that I'm ready to concentrate. [13:09] And you can notice a kind of dissociation between your right hand floating up, your left hand [13:13] comfortably sitting down. You're already experiencing a non-clinical ability that you have [13:20] to change the way your body feels. And that means also I could imagine that I had a cooling pad on [13:27] my right shoulder and let the cool tingling numbness penetrate deeper and deeper and filter [13:34] the hurt out of the pain. And I might imagine being somewhere that I felt good in a mountain lake or [13:41] in a hot tub. And then I would come out very quickly by counting backwards from three to one. On [13:47] three, get ready. Two, with your eyelids closed, roll up your eyes. One, let your eyes open. Hand [13:51] float back down, make a fist open. And that's the end of the exercise. It's... [13:57] That's the induction. [13:58] That's it. That's it. [14:00] So what you just talked us through, you were talking about for yourself, but that would be the [14:05] same if somebody were to come to your office? [14:07] Absolutely. It's no big deal. You don't have to count upstairs and downstairs. I differ with many of [14:12] my colleagues about the concept of deepening. You know, there are a lot of people feel you've got [14:17] a talk for 10 or 15 minutes. If you've got the ability, you can go there in a flash. It's just [14:22] a matter of having the structure for doing it. What I do is I measure everybody's hypnotized ability. [14:28] So the first five to six minutes of my intervention clinically is to give a structured test of your [14:34] hypnotized ability, instruct people that their hand, if they pull it down, it'll flow right back [14:39] up to the upright position. How much reinforcement do you have to give to get that? Does the right hand [14:44] feel as if it's not as much a part of the body as the left hand? Then when you give a cutoff signal, [14:50] touch the elbow, does the usual sensation and control return? Did they respond to that cutoff? [14:56] Did they have a sense of floating lightness or buoyancy in their hand and then elsewhere in the [15:01] body? And so after that five minutes, I have a very clear idea of how hypnotizable people are and [15:07] how to work with them based on their degree of hypnotizability. [15:10] After the break, we have much more with Dr. Spiegel. Stay with us. [15:22] 7,000 patients you say you have helped over your career. Is there a common type of patient? What [15:29] are they most likely seeing you for? [15:31] Commonly for problems like stress and anxiety, because they can very quickly learn to soothe [15:37] and disconnect that sort of snowball effect of the reaction to the problem from what initiated it [15:43] for pain. And so I resonated with your wonderful book, because it's very useful for pain control. [15:52] We published a study in The Lancet in 2000, randomized clinical trial, patients having [15:59] things threaded through their arteries, and we randomized them into three conditions. [16:04] Standard care, which meant press a button, get opioids into your bloodstream, [16:08] that plus a friendly nurse providing emotional support, or that plus hypnosis. And the average [16:14] pain ratings in the standard care group were 7 out of 10, in the nursing support group were 4 out of [16:20] 10, and in the hypnosis group, 1 out of 10. [16:23] Wow. [16:24] And they were using half as much of the opioid injection. Now, Sanjay, if we published that, [16:30] and it was a drug that produced that, every hospital in the country would be using that drug now, [16:36] because it worked extremely well, it cost virtually nothing, and there are no side effects. [16:42] Right. [16:42] But there's also no big industry pushing it. And so, unfortunately, the evidence there is, [16:49] it just isn't taken seriously, because it can't be that quick and easy and safe, but it is. [16:54] You know, we talk about pain, we talk about asthma, even your shoulder surgery. What about optimizing [17:01] performance? [17:02] Ah, yes. [17:03] We talk about Olympic athletes, for example, I think. [17:05] You bet. Well, this wonderful figure skater, Elisa, from Oakland, she does visualization. To [17:12] me, that's all self-hypnosis. She said, I would just, before I did the routine many times, I would [17:18] just close my eyes and picture myself making every move I wanted to make, and she would do it. [17:24] Rory McIlroy, who won the Masters, he was frustrated for like seven years, because at one point, [17:32] on one hole, I think, the ball wound up in a tree somewhere. [17:35] Yeah, I remember that. [17:37] I remember that. [17:37] He was humiliated. And he kept doing it every year, and the same thing happened on that hole. [17:43] Learned association. His brain thought, you know, here, it's going to happen again. And the more you [17:47] say, oh my God, I hope it doesn't, of course, the more it's likely to happen. [17:51] And he decided to get professional help from a hypnotist, and he won the Masters. There's a book [18:00] called Zen and the Art of Archery. An Irish sociologist figured out that the main difference [18:06] between Zen archers and most archers is they say, if you're focusing on the target, you're making a [18:13] mistake. Focus on your relationship with the bow and arrow. And if your relationship is right, [18:18] the arrow will go where it should go. And that's the thing with many professional athletes. They're [18:23] so focused on the outcome and what it'll mean that they're actually distracting themselves from what [18:28] matters, which is how they're relating to their body and getting it to do what they want it to do. [18:35] I think that really makes sense to me. Instead of thinking about the target for that archer, [18:39] think about your relationship with the bow and arrow. And we're talking about archery specifically, [18:44] but I feel like that applies to maybe many things in our life, you know? [18:48] You're absolutely right. Focus on the process and not the outcome. [18:53] You know, hypnotism is seen as a stage show or swinging watches and, you know, clucking chickens [18:59] and things like that. That's what a lot of people think of when they think of hypnosis. So not only [19:05] does it not get the attention it deserves, it gets marginalized and even maligned sometimes. That's [19:10] going to be very frustrating for you. [19:11] If it weren't for self-hypnosis, I'd be frustrated all the time. It is. Yes, it's terribly frustrating [19:19] because it's a joke or it's dangerous or it doesn't do anything. None of which is true. But I'll tell you [19:25] one thing. I try to use the negatives about hypnosis to our advantage to tell people. If you've seen the [19:33] football coach dancing like a ballerina in front of an audience of 500 drunken people, there is an [19:39] important lesson in that. And that is, he's willing to try out being different. And he's not worried [19:45] about what they're going to say to him in the locker room on Monday morning. That ability to put [19:50] aside your usual expectations of who you are and what you are is actually can be very adaptive. [19:56] And the same is true with problems like stress and pain and smoking. We help people stop smoking. [20:02] You can do things you didn't think you could do. And that is a real advantage. And so even if you've [20:08] seen one of those stage shows, there's a lesson there. If you want to do something, if you want to [20:13] change, if you want to be different, try this. It'll help you do it. [20:17] One of the things that sort of surprised me a little bit is that you shouldn't let people can [20:20] alter how they see color under hypnosis. This is really important because in some ways you're [20:27] changing your reflection of reality. That's exactly right. That's well put. And that's true. [20:33] Basically, we had people look at color versus black and white and what happened in the occipital [20:40] cortex, which is where we process vision, including color. And then in another condition, [20:45] we hypnotized them. I had them imagined that they were looking at color when it was really [20:50] black and white. And we had increased activity in the color processing regions of the brain. [20:55] That's fascinating. [20:56] So, you know, believing is seeing, you know, but seeing is believing. That's the remarkable [21:02] thing. But in a way, Sanjay, it's just like what you've written about with pain. You can change your [21:08] experience. One of the common things I do for pain control is I just say, what do you naturally do [21:14] to relieve the pain? Do you take a warm bath? Do you take a cold shower? Do you use ice? And I have [21:20] them go into a state of self-hypnosis and imagine that that's what they're doing. You're in the warm [21:25] bath, filter the hurt out of the pain. And what you're doing is just like in that color experiment, [21:31] you're getting your brain to process as though it were having that kind of perceptual experience. [21:37] And why shouldn't it? Why should it be able to do that? I remember what that was like. It's just [21:41] like when you think back about a beautiful scene you saw on a vacation, you know, you see it, you [21:47] feel the cool breeze. That intense absorption in what you're thinking about will change what you [21:53] are perceiving. [21:54] I think this isn't so inspiring, right? That the fact that we have so much dominion over our brains, [22:01] like I think for a lot of people, they see it as a passive receptacle of things that are happening [22:06] to us. But the idea that we can, in one extreme, change our perception of reality. But at the other [22:12] hand, and I encourage people to look this up, but the data on using your brain to deal with certain [22:18] pain conditions, the certain ones that I saw that had good data behind it, inflammatory bowel syndrome, [22:24] fibromyalgia, migraine headaches, things that people deal with on a regular basis, and frankly, [22:29] hijack their lives and hijack their identities, the fact that you have control over it, and it [22:34] doesn't mean it's just all in your head, it means you have control over it probably in ways that you [22:39] have not fully considered. [22:41] Well, thank you, Sanjay. You put it beautifully. And the worst, you know, people ask me, what's the [22:46] worst misconception about hypnosis? And it's that it's a loss of control. It's an increase in control. [22:52] Just the way you said it, you're learning to take more control of your brain and use it to your [22:58] advantage. And so it's a way of enhancing your ability to control how you feel and what you do. [23:05] People surprise themselves. That's one of my favorite times in my work, Sanjay, [23:09] is I see people are surprised that they can do this. They can feel less pain. They can stop smoking. [23:15] They can reduce their anxiety. They can interrupt their asthma attacks. I just love watching people [23:21] surprise themselves at how much control they have. [23:24] I think this is a podcast about hypnosis, but I think in more ways, it's a podcast about trying to [23:31] figure out our relationships with our bodies and our brains. If you figure that out, I mean, [23:37] that's like a, it's a cheat code. I think there's so many ways for life. [23:42] It is. It is. When I'm just counseling people about their lives, there are things we control and things [23:48] we don't control. And ironically, the thing we control the least is actually the thing we control [23:53] the most. And that's our body if we do it right. And if you're fighting against losing control, [23:58] you're missing the point. You want to just build a better relationship with your body and hypnosis [24:03] can help you do that. [24:05] Just in closing, what is the one practical lesson you think people should take away from what we know [24:11] about hypnosis research? [24:12] I think that hypnosis and techniques like it should be treated like any other biomedical phenomenon. [24:21] You know, focus on the evidence, not the presumption of what it could or couldn't be. [24:26] It's the oldest Western conception of psychotherapy. It's been around for 250 years. [24:31] And we know how it works. We know that it works. So give yourself the benefit of the doubt. Give your [24:37] body the benefit of the doubt. And learn to use this. Try it out. See what it feels like. [24:42] And you'll enjoy it. You can use your imagination to your benefit. And that's what I want to see [24:49] happen. [24:51] What a pleasure, David. [24:52] Thank you. Thank you. Likewise. And I admire your work and the way you communicate medicine. [24:56] It makes me proud as a doctor. So thank you for that. [24:59] Well, that means a lot, sir. And I've learned a lot today. So really appreciate that. [25:03] You're most welcome. [25:04] That was Dr. David Spiegel of Stanford University School of Medicine, [25:11] an expert on clinical hypnosis. Thanks so much for listening. [25:16] And before I go, wanted to let you know that I have a new documentary coming out this Sunday. [25:22] It's called Weed 8, Women and Weed. As you may know, we've been reporting on cannabis, [25:28] on medical marijuana for nearly 15 years now. This time, we are focused on women who are now the [25:35] fastest growing users of cannabis in the country. Why is that? What does it mean? We traveled the [25:41] country to investigate. You can watch it on CNN, 8 p.m. Eastern, Sunday. And it will be available [25:48] to stream the next day on the CNN app.