Dr. David Spiegel: Using Hypnosis to Enhance Health & Performance
Huberman hosts Dr. David Spiegel, a renowned expert in hypnosis and stress physiology, to discuss its clinical applications. They explore trauma, pain, and anxiety treatment using hypnosis, hypnotizability, self-hypnosis techniques, and cognitive flexibility. Key findings and resources for guided self-hypnosis are shared, emphasizing the importance of working with trained professionals.
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Full Notes
Dr. David Spiegel on Hypnosis
- Hypnosis: a state of highly focused attention
- Similar to being absorbed in a movie or sports game
- Involves a narrowing of context and losing of the self
- Can include body experiences as part of the event
Clinical Hypnosis vs. Stage Hypnosis
- Clinical hypnosis: used for treatment of various ailments of mind and body
- Involves changing brain state to make adjustments in brain and body
- Can improve symptoms of stress, chronic anxiety, chronic pain, and other illnesses
- Stage hypnosis: hypnotist gets a person to do things they would not otherwise do
- Different from clinical hypnosis
Hypnotizability
- Not everyone can be hypnotized as readily as others
- Dr. Spiegel developed a simple test to determine hypnotizability
- High, medium, or low degree of hypnotizability
Reverie App
- Developed by Dr. Spiegel based on clinical studies and research
- Currently only available for Apple, soon for Android
- Seven-day free trial available
- Designed with clinical treatments in mind
Breath Work
- Collaboration between Dr. Spiegel and Dr. Huberman’s research lab at Stanford
- Developing specific breath work protocols for anxiety, mood, and sleep improvement
Hypnosis
- Developing specific breath work protocols for anxiety, mood, and sleep improvement
Getting into Hypnosis
- Hypnosis is often associated with stage hypnosis and entertainment
- Clinical hypnosis is different from stage hypnosis
- Stage hypnosis can be harmful and make fools out of people
Hypnosis in Clinical Settings
- Enhances control over mind and body
- Provides cognitive flexibility and ability to shift perspectives
- Can be a great therapeutic tool if used correctly
Brain Activity during Hypnosis
- Studied using functional MRI scans
- Three main characteristics during entry into hypnotic state:
- Turning down activity in the dorsal anterior cingulate cortex (DACC)
- DACC is part of the salience network and acts as a conflict detector
- Increased connectivity between the dorsolateral prefrontal cortex (DLPFC) and the insula
- DLPFC is involved in executive control, while the insula is involved in body awareness
- Decreased connectivity between the DLPFC and the default mode network (DMN)
- DMN is involved in self-referential thinking and mind-wandering
Exiting Hypnosis
- Failure to exit the hypnotic state can lead to distress and confusion
- Brain activity changes as people exit hypnosis, but more research is needed to understand the specific processes involved
Hypnosis and Mental State Change - Mental state change has therapeutic potential
- Example: Ketamine treating depression
- Changing mental state can help regulate and change responses
- Hypnosis can help with unsystematic desensitization
- Changing mental states to face problems and see them from a different point of view
- Can help with phobias, trauma, and stress
- State-dependent memory
- When in a certain mental state, you enhance your ability to remember things about it
- Hypnosis can help people remember and deal with memories better because they’re more in the mental state
Hypnosis in Treating Phobias and Trauma
- Hypnosis can help people manage their anxiety and have a wider array of experiences
- Can create a network of associations that isn’t so negative and may even be positive
- Can help restructure understanding of trauma
- Confront the trauma and engage in self-protection strategies
- Can accomplish things more quickly and effectively than traditional psychotherapy
- Adding hypnosis to PTSD treatment can improve outcomes
Dissociation and Hypnosis
- Going into the state one is trying to deal with, but then dissociating from that state is key
- Can help people drop into feeling states and deal with emotions around their experiences
- Hypnosis can help access state-dependent memories and deal with them more effectively
Dissociation and Trauma Treatment - Dissociation during traumatic episodes is an adaptive strategy
- Creates issues and problems
- Ketamine, which creates a dissociative state, can be useful for trauma treatment
- Carl Dyseroth’s research on ketamine and dissociative states
- Rhythmic discharge in the retrosplenial region triggered by ketamine
- Rats showed dissociative-like behavior
- Human subject reported being in a dissociative state
- Hypnosis can help enhance control over mind and body
- Useful for treating trauma-related disorders
Hypnosis for Pain Relief and Anxiety
- Hypnosis can provide quick relief
- Long-lasting changes possible with practice
- Clinical hypnosis vs. self-hypnosis
- Start with a licensed professional for assessment and guidance
- Learn self-hypnosis for continued practice and control
- Dr. Spiegel’s study on hypnosis for pain relief during medical procedures
- Hypnosis group reduced pain by 80% and used half the amount of opioids
- Fewer complications and shorter procedure time
- Long-term effects of hypnosis
- Study on women with metastatic breast cancer
- Hypnosis group had half the pain after a year on low amounts of medication
- Hypnosis becomes a skill that people can acquire and use for themselves
Reverie App
- App developed to teach people self-hypnosis
- Helps with pain, stress, focus, insomnia, and other issues
- Provides interactive support for learning and practicing hypnosis
- Users can see quick results and know if hypnosis is likely to help them
Hypnosis and Mental Health
- Hypnosis can be helpful for stress reduction, phobias, and pain management
- Hypnotizability varies among individuals
- 1/3 of adults are not hypnotizable
- 15% are extremely hypnotizable
- Hypnotizability is more stable than IQ over a 25-year interval
- Hypnosis may not be as effective for those with OCD or ADHD, as they may be less hypnotizable
- Hypnotizability can be measured using the Hypnotic Induction Profile
- Helps guide treatment options for patients
Eye Roll Test
- Developed by Dr. Spiegel’s father
- Used to assess hypnotizability
- Involves looking up at the ceiling and closing eyes while looking up
- Highly hypnotizable individuals may show only the whites of their eyes (sclera) when performing the eye roll
- Can help determine the best treatment approach for patients based on their hypnotizability
Hypnosis for Obsessive Thoughts and Superstitions
- Hypnosis may be helpful for some individuals with obsessive thoughts or superstitions
- However, those with OCD may be less hypnotizable and less likely to benefit from hypnosis
- Response prevention can be an effective technique for breaking superstitions
- Involves forcing oneself to not engage in the superstitious behavior for a period of time
- Helps establish a new context in the brain where the desired outcome is achieved without the extraneous behavior
Spiegel Eye Roll Test and Hypnotizability
- Spiegel Eye Roll Test: measures hypnotizability
- Involves looking up at the ceiling, tilting head back, and closing eyes while maintaining upward gaze
- If white part (sclera) is visible, person is highly hypnotizable
- If colored part (iris) is visible, person is less hypnotizable
- Eyes and levels of consciousness
- Closing eyes when sleeping, rapid eye movement when dreaming
- Most drugs affecting consciousness can affect eyes and eye movements
- Hypnotizability
- About two-thirds of people can be hypnotized
- 15% of people are highly hypnotizable
- Repeated use of hypnosis may slightly increase hypnotizability, but not significantly
EMDR (Eye Movement Desensitization Reprocessing)
- EMDR: therapy for trauma-related problems
- Involves lateralized eye movements
- Some claim it coordinates the two sides of the brain or mimics rapid eye movements during sleep
- Criticisms and limitations
- Lateral eye movements may not add significant benefits to therapy
- EMDR may be another form of exposure-based therapy for trauma
- One session may not be enough for lasting results
- More focus on processing the trauma itself may be beneficial
Dream States and Hallucinations
- Alan Hobson: sleep researcher, studied brain activity during sleep
- Dreams can have inconsistent stories and images, but consistent affect (emotion)
- Lateral eye movement may suppress amygdala activity, regulating affect in dreams
EMDR and Hypnosis
- EMDR may incorporate elements of hypnosis
- Lateralized eye movements may suppress amygdala, inducing a calm state
- Exposure therapy through discussion about the issue
Facing Trauma and Phobias
- Getting close to the trauma or phobia is crucial for adjusting the response to it
- Voluntary self-exposure is important for effective treatment
- Stress inoculation: exposure to stress can help build resilience and ability to manage stress
Mind-Body Connection
- Mind and body signals can be seen as tools to help understand the world and what’s important
- Pain can be categorized and processed differently based on its meaning
- Emotional pain can also be modified by how the brain interprets it
- Blending receptive and active responses can help in managing mind-body connections
Hypnosis and Grief - Grief is a natural, necessary stage of life
- Grief rituals help make an incomprehensible loss comprehensible
- Expressing negative emotion can help people be less anxious and depressed over time
- Hypnosis can help individuals face loss, live with the emotion, and reflect on what they gained from the lost person
Hypnosis and Children
- Children can be hypnotized, but may need more structure for self-hypnosis
- Hypnosis can be effective for children in medical settings (e.g., pediatricians, dentists)
- Hypnosis can help children with fear and pain during medical procedures
Hypnosis in Groups and Couples
- Hypnosis can be done in groups, such as support groups for women with advanced breast cancer
- Coordinated hypnosis for couples has not been widely explored, but group hypnosis has been successful
Hypnosis and Drug Therapies
- Hypnosis can have a sedative effect at the chemical level, with a correlation between hypnotizability and GABA activity in the anterior cingulate cortex
- Benzodiazepines can improve hypnotic response for very anxious individuals, but may inhibit hypnotic activity for those who are not very anxious
- Mild stimulants might enhance hypnotic responsiveness, but too much can scatter attention and reduce control
- Hypnosis is generally more of a replacement than a supplement for drug therapies
Role of Respiration in Hypnosis - Breathing is a bridge between conscious and unconscious states
- Breathing patterns can increase or decrease sympathetic arousal
- Sighing (more time spent exhaling than inhaling) may induce parasympathetic activity
- Hypnosis induction often involves taking a deep breath and slowly exhaling
- Breathing is at the edge of conscious and unconscious control, allowing modulation of internal states
Key Elements of Hypnosis
- Breathing
- Vision
- Bodily states
- Directed mental focus
- Can involve physical relaxation or intense activity (e.g., athletic or musical performance)
Resources for Hypnosis
- Reverie app for self-hypnosis: reverie.com
- Society for Clinical and Experimental Hypnosis: sceh.us
- American Society for Clinical Hypnosis: asch.net
- Look for licensed and trained professionals in psychiatry, psychology, medicine, or dentistry with training and interest in using hypnosis
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