THIS IS IMAGINE HYPNOSIS

TIME MAGAZINE

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UPDATED: SEPTEMBER 4, 2018 

(edited version)

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Look into my eyes. The phrase calls to mind images of a psychotherapist swinging a pocket watch. Or maybe you picture Catherine Keener in the film Get Out, tapping her teacup and sending an unwilling man into a state of hypnotic limbo.

“There are many myths about hypnosis, mostly coming from media presentations,” like fictional films and novels, says Irving Kirsch, a lecturer and director of the Program in Placebo Studies at Harvard Medical School. But setting aside pop culture clichés, Kirsch says hypnosis is a well-studied and legitimate form of adjunct treatment for conditions ranging from obesity and pain after surgery to anxiety and stress.

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In terms of weight loss, some of Kirsch’s research has found that, compared to people undergoing cognitive behavioral therapy (CBT)—one of the most evidence-backed non-drug treatments for weight loss, depression and many other conditions—those who undergo cognitive behavior therapy coupled with hypnosis tend to lose significantly more weight. After four to six months, those undergoing CBT+hypnosis dropped more than 20 pounds, while those who just did CBT lost about half that amount. The hypnosis group also maintained that weight loss during an 18-month follow-up period, while the CBT-only group tended to regain some weight.

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Apart from aiding weight loss, there is “substantial research evidence” that hypnosis can effectively reduce physical pain, says Len Milling, a clinical psychologist and professor of psychology at the University of Hartford.

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One of Milling’s review articles found that hypnosis could help reduce kids’ post-surgical pain or pain related to other medical procedures. Another of his review articles found that when it comes to labor and delivery-related pain, hypnosis can in some cases significantly add to the benefits of standard medical care—including epidurals and drugs.

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“It is very helpful for smoking cessation,” adds Dr. David Spiegel, a hypnosis expert and professor of psychiatry and behavioral sciences at Stanford University School of Medicine. “Half the people I see once stop [smoking], half of them won’t touch a cigarette for two years.” A 2007 randomized trial of 286 smokers found that 20% of people who received hypnosis managed to quit, compared to 14% of those receiving standard behavioral counseling. The smoking cessation benefits were even more pronounced among smokers with a history of depression—hinting at an additional potential benefit of hypnosis.

Hypnosis can also be “very helpful” in treating stress, anxiety and PTSD, Spiegel says. Research has found hypnosis can even alter a person’s immune function in ways that offset stress and reduce susceptibility to viral infections.

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But what exactly does hypnosis entail, and how does it provide these benefits? That’s where things get a little murky. “If you asked 10 hypnosis experts how hypnosis works, you would probably get 10 different explanations,” Milling says.

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Almost everyone in the field agrees that the practice of hypnosis involves two stages, which are usually referred to as “induction” and “suggestion.”

“During the induction, the subject is typically told to relax, focus his or her attention, and that he or she is going into hypnosis,” Milling says.

This stage could last anywhere from a few seconds to 10 minutes or longer, and the goal of induction is to quiet the mind and focus its attention on the therapist or counselor’s voice and guidance.

The “suggestion” phase involves talking the hypnotized person through hypothetical events and scenarios intended to help him or her address or counteract unhelpful behaviors and emotions. Patients are invited to experience imaginary events as if they were real, Milling says. The type of suggestions used depend on the patient and his or her unique challenges.

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In some ways, hypnosis can be compared to guided meditation or mindfulness; the idea is to set aside normal judgments and sensory reactions, and to enter a deeper state of concentration and receptiveness. Both Milling and Spiegel compare hypnosis to losing oneself in a book or movie—those times when the outside world fades away and a person’s mind is completely absorbed in what she’s reading or watching. Research has also referred to hypnosis as the temporary “obliteration” of the ego.

“While most people fear losing control in hypnosis, it is in fact a means of enhancing mind-body control,” Spiegel says. Instead of allowing pain, anxiety or other unhelpful states to run the show, hypnosis helps people to exert more control over their thoughts and perceptions.

How does hypnosis do this? Spiegel’s research has shown it can act on multiple brain regions, including some linked to pain perception and regulation. Hypnosis has also been found to quiet parts of the brain involved in sensory processing and emotional response.

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However, there’s a lot of controversy over how hypnosis works, Milling says. “Originally, Freud theorized that hypnosis weakens the barrier between the conscious and subconscious,” he says, adding that this theory has largely been abandoned. While some attribute the power of hypnosis to the placebo effect, another theory is that “hypnosis causes people to enter an altered state of consciousness, which makes them very responsive to hypnotic suggestions,” he says. While talk about “altered states of consciousness” sounds a little spooky, there’s no loss of consciousness or amnesia.

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Not everyone benefits equally from hypnosis. Milling says that about 20% of people show a “large” response to it, while the same percentage of people don’t respond much at all. The remaining 50% to 60% of people land somewhere in between. “Children tend to be more hypnotizable,” Spiegel says.

But even people who score low on measures of hypnotic suggestibility can still benefit from it, Kirsch adds. He also says it’s important to view hypnosis as a supplement to other forms of therapy—something to be tried only in conjunction with CBT, psychotherapy or other types of treatment.

Milling reiterates this point. He compares practitioners who are trained only in hypnosis to carpenters who only know how to use one tool. “To be an effective carpenter, it takes more than knowing how to use a saw,” he says.

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Finally, don’t expect hypnosis to work after a single session. Some experts say one shot can be effective. But Milling argues that “in general, a single treatment session involving hypnosis is unlikely to be beneficial.”

STANFORD MEDICINE NEWS CENTER

Study identifies brain areas during hypnotic trances

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By scanning the brains of subjects while they were hypnotized, researchers at the School of Medicine were able to see the neural changes associated with hypnosis.

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Stanford researchers found changes in three areas of the brain that occur when people are hypnotized.

Your eyelids are getting heavy, your arms are going limp and you feel like you’re floating through space. The power of hypnosis to alter your mind and body like this is all thanks to changes in a few specific areas of the brain, researchers at the Stanford University School of Medicine have discovered.

The scientists scanned the brains of 57 people during guided hypnosis sessions similar to those that might be used clinically to treat anxiety, pain or trauma. Distinct sections of the brain have altered activity and connectivity while someone is hypnotized, they report in a study published online July 28 in Cerebral Cortex.  

“Now that we know which brain regions are involved, we may be able to use this knowledge to alter someone’s capacity to be hypnotized or the effectiveness of hypnosis for problems like pain control,” said the study’s senior author, David Spiegel, MD, professor and associate chair of psychiatry and behavioral sciences.

A serious science

For some people, hypnosis is associated with loss of control or stage tricks. But doctors like Spiegel know it to be a serious science, revealing the brain’s ability to heal medical and psychiatric conditions.

David Spiegel

“Hypnosis is the oldest Western form of psychotherapy, but it’s been tarred with the brush of dangling watches and purple capes,” said Spiegel, who holds the Jack, Samuel and Lulu Willson Professorship in Medicine. “In fact, it’s a very powerful means of changing the way we use our minds to control perception and our bodies.”

Despite a growing appreciation of the clinical potential of hypnosis, though, little is known about how it works at a physiological level. While researchers have previously scanned the brains of people undergoing hypnosis, those studies have been designed to pinpoint the effects of hypnosis on pain, vision and other forms of perception, and not the state of hypnosis itself.

“There had not been any studies in which the goal was to simply ask what’s going on in the brain when you’re hypnotized,” said Spiegel.

Finding the most susceptible

To study hypnosis itself, researchers first had to find people who could or couldn’t be hypnotized. Only about 10 percent of the population is generally categorized as “highly hypnotizable,” while others are less able to enter the trancelike state of hypnosis. Spiegel and his colleagues screened 545 healthy participants and found 36 people who consistently scored high on tests of hypnotizability, as well as 21 control subjects who scored on the extreme low end of the scales.

Then, they observed the brains of those 57 participants using functional magnetic resonance imaging, which measures brain activity by detecting changes in blood flow. Each person was scanned under four different conditions — while resting, while recalling a memory and during two different hypnosis sessions.

“It was important to have the people who aren’t able to be hypnotized as controls,” said Spiegel. “Otherwise, you might see things happening in the brains of those being hypnotized but you wouldn’t be sure whether it was associated with hypnosis or not.”

Brain activity and connectivity

Spiegel and his colleagues discovered three hallmarks of the brain under hypnosis. Each change was seen only in the highly hypnotizable group and only while they were undergoing hypnosis.

First, they saw a decrease in activity in an area called the dorsal anterior cingulate, part of the brain’s salience network. “In hypnosis, you’re so absorbed that you’re not worrying about anything else,” Spiegel explained.

It’s a very powerful means of changing the way we use our minds to control perception and our bodies.

Secondly, they saw an increase in connections between two other areas of the brain — the dorsolateral prefrontal cortex and the insula. He described this as a brain-body connection that helps the brain process and control what’s going on in the body.

Finally, Spiegel’s team also observed reduced connections between the dorsolateral prefrontal cortex and the default mode network, which includes the medial prefrontal and the posterior cingulate cortex. This decrease in functional connectivity likely represents a disconnect between someone’s actions and their awareness of their actions, Spiegel said. “When you’re really engaged in something, you don’t really think about doing it — you just do it,” he said. During hypnosis, this kind of disassociation between action and reflection allows the person to engage in activities either suggested by a clinician or self-suggested without devoting mental resources to being self-conscious about the activity.   

Treating pain and anxiety without pills

In patients who can be easily hypnotized, hypnosis sessions have been shown to be effective in lessening chronic pain, the pain of childbirth and other medical procedures; treating smoking addiction and post-traumatic stress disorder; and easing anxiety or phobias. The new findings about how hypnosis affects the brain might pave the way toward developing treatments for the rest of the population — those who aren’t naturally as susceptible to hypnosis.

“We’re certainly interested in the idea that you can change people’s ability to be hypnotized by stimulating specific areas of the brain,” said Spiegel.

A treatment that combines brain stimulation with hypnosis could improve the known analgesic effects of hypnosis and potentially replace addictive and side-effect-laden painkillers and anti-anxiety drugs, he said. More research, however, is needed before such a therapy could be implemented.

The study’s lead author is Heidi Jiang, a former research assistant at Stanford who is currently a graduate student in neuroscience at Northwestern University.

Other Stanford co-authors are clinical assistant professor of psychiatry and behavioral sciences Matthew White, MD; and associate professor of neurology Michael Greicius, MD, MPH. 

The study was funded by the National Center for Complementary and Integrative Health (grant RCIAT0005733), the National Institute of Biomedical Imaging and Bioengineering (grant P41EB015891), the Randolph H. Chase, M.D. Fund II, the Jay and Rose Phillips Family Foundation and the Nissan Research Center.

Stanford’s Department of Psychiatry and Behavioral Sciences and Department of Neurology and Neurological Sciences also supported the work.

• Sarah C.P. Williams

  Sarah C.P. Williams is a freelance science writer.

Media Contacts

• Tracie White

  Tel 650-723-7628

  tracie.white@stanford.edu

• Margarita Gallardo

  Tel 650-723-7897

  mjgallardo@stanford.edu

Stanford Medicine integrates research, medical education and health care at its three institutions - Stanford University School of Medicine, Stanford Health Care (formerly Stanford Hospital & Clinics), and Lucile Packard Children's Hospital Stanford. For more information, please visit the Office of Communication & Public Affairs site at http://mednews.stanford.edu.

SCIENCE DAILY

Hypnosis extends restorative slow-wave sleep, research shows

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June 2, 2014

Source:

University of Zurich

Summary:

Sleeping well is a crucial factor contributing to our physical and mental restoration. Slow-Wave sleep (SWS) in particular has a positive impact for instance on memory and the functioning of the immune system. During periods of SWS, growth hormones are secreted, cell repair is promoted and the defense system is stimulated. If you feel sick or have had a hard working day, you often simply want to get some good, deep sleep, a wish that you may not be able to influence through your own will.  

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Sleeping well is a crucial factor contributing to our physical and mental restoration. SWS in particular has a positive impact for instance on memory and the functioning of the immune system. During periods of SWS, growth hormones are secreted, cell repair is promoted and the defense system is stimulated. If you feel sick or have had a hard working day, you often simply want to get some good, deep sleep, a wish that you may not be able to influence through your own will.

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Sleep researchers from the Universities of Zurich and Fribourg now prove the opposite. In a study that has now been published in the scientific journal "Sleep," they have demonstrated that hypnosis has a positive impact on the quality of sleep, to a surprising extent. "It opens up new, promising opportunities for improving the quality of sleep without drugs," says biopsychologist Björn Rasch who heads the study at the Psychological Institute of the University of Zurich in conjunction with the "Sleep and Learning" project.

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Brain waves ­- an indicator of sleep quality

Hypnosis is a method that can influence processes which are very difficult to control voluntarily. Patients with sleep disturbances can indeed be successfully treated with hypnotherapy. However, up to now it hadn't been proven that this can lead to an objectively measurable change in sleep. To objectively measure sleep, electrical brain activity is recorded using an electroencephalogram (EEG). The characteristic feature of slow-wave sleep, which is deemed to have high restorative capacity, is a very even and slow oscillation in electrical brain activity.

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70 healthy young women took part in the UZH study. They came to the sleep laboratory for a 90-minute midday nap. Before falling asleep they listened to a special 13-minute slow-wave sleep hypnosis tape over loudspeakers, developed by hypnotherapist Professor Angelika Schlarb, a sleep specialist, or to a neutral spoken text. At the beginning of the experiment the subjects were divided into highly suggestible and low suggestible groups using a standard procedure (Harvard Group Scale of Hypnotic Susceptibility). Around half of the population is moderately suggestible. With this method women achieve on average higher values for hypnotic susceptibility than men. Nevertheless, the researchers expect the same positive effects on sleep for highly suggestible men.

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Slow-wave sleep increased by 80 percent

In their study, sleep researchers Maren Cordi and Björn Rasch were able to prove that highly suggestible women experienced 80 percent more slow-wave sleep after listening to the hypnosis tape compared with sleep after listening to the neutral text. In parallel, time spent awake was reduced by around one-third. In contrast to highly suggestible women, low suggestible female participants did not benefit as much from hypnosis. With additional control experiments the psychologists confirmed that the beneficial impact of hypnosis on slow-wave sleep could be attributed to the hypnotic suggestion to "sleep deeper" and could not be reduced to mere expectancy effects.

According to psychologist Maren Cordi "the results may be of major importance for patients with sleep problems and for older adults. In contrast to many sleep-inducing drugs, hypnosis has no adverse side effects." Basically, everyone who responds to hypnosis could benefit from improved sleep through hypnosis.

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HOW DOES HYPNOSIS REALLY IMPACT THE BRAIN?

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https://bigthink.com/neuropsych/how-hypnosis-works-stanford-university/