February 21, 2022 • 1hr 48min

Dr. David Spiegel: Using Hypnosis to Enhance Mental & Physical Health & Performance

Huberman Lab

In this episode, Dr. Andrew Huberman interviews Dr. David Spiegel, Associate Chair of Psychiatry & Behavioral Sciences and Director of the Center on Stress and Health at Stanford University School of Medicine. Dr. Spiegel is a world expert on clinical hypnosis with over 40 years of research and clinical experience. The discussion covers the neurobiology of hypnosis, its clinical applications for issues like stress, pain, and trauma, how hypnotizability is assessed, and the development of self-hypnosis tools. Dr. Spiegel provides fascinating insights into how hypnosis works in the brain and its powerful therapeutic potential.

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Key Takeaways

Hypnosis is a state of highly focused attention, like looking through the telephoto lens of a camera - you see details vividly but devoid of context
Clinical hypnosis is very different from stage hypnosis. Stage hypnosis makes fools out of people, while clinical hypnosis enhances control over mind and body
Brain imaging studies show three key changes during hypnosis:
- Decreased activity in the dorsal anterior cingulate cortex (conflict detector)
- Increased connectivity between prefrontal cortex and insula (mind-body control)
- Inverse connectivity between prefrontal cortex and posterior cingulate (self-reflection)
Hypnosis can be very effective for stress reduction, pain management, sleep, phobias, and trauma
About 2/3 of adults are hypnotizable to some degree, with 15% being highly hypnotizable. Hypnotizability is quite stable over time
The Spiegel Eye Roll Test is a quick way to assess hypnotizability by observing eye movements
Confronting and reprocessing trauma is key to healing, rather than avoiding triggers. Hypnosis can help approach trauma safely
Self-hypnosis apps like Reverie can teach people to use hypnosis on their own for issues like stress, pain, sleep, etc.
Breathing patterns play an important role in hypnosis and shifting between sympathetic/parasympathetic states

Introduction

In this episode, Dr. Andrew Huberman interviews Dr. David Spiegel, Associate Chair of Psychiatry & Behavioral Sciences and Director of the Center on Stress and Health at Stanford University School of Medicine. Dr. Spiegel is a world expert on clinical hypnosis with over 40 years of research and clinical experience.

The discussion covers the neurobiology of hypnosis, its clinical applications for issues like stress, pain, and trauma, how hypnotizability is assessed, and the development of self-hypnosis tools. Dr. Spiegel provides fascinating insights into how hypnosis works in the brain and its powerful therapeutic potential.

Topics Discussed

What is Hypnosis? (8:28)

Dr. Spiegel defines hypnosis as "a state of highly focused attention...like looking through the telephoto lens of a camera. In consciousness, what you see, you see with great detail, but devoid of context." He contrasts this with stage hypnosis, which makes fools out of people, while clinical hypnosis enhances control over mind and body.

Hypnosis is similar to being absorbed in a movie and forgetting you're watching it
It involves suspending critical judgment and just having an experience
Self-hypnosis enhances control over mind and body, rather than losing control

Neurobiology of Hypnosis (20:18)

Dr. Spiegel describes brain imaging studies that have revealed three key changes during hypnosis:

Decreased activity in the dorsal anterior cingulate cortex (DACC)
- Part of the salience network that detects conflicts/threats
- Reduced activity makes you less likely to be distracted
Increased connectivity between prefrontal cortex and insula
- Enhances mind-body control
- Allows control over typically involuntary bodily functions
Inverse connectivity between prefrontal cortex and posterior cingulate
- Reduces self-reflection
- Enhances cognitive flexibility and willingness to try new things

Clinical Applications of Hypnosis (28:22)

Dr. Spiegel discusses several areas where hypnosis has shown clinical benefits:

Stress reduction
- Helps dissociate physical reactions from psychological stress
- Teaches visualizing the stressor while keeping the body relaxed
Sleep improvement
- Very effective for helping people fall and stay asleep
- Teaches visualizing worries on a "screen" while body stays relaxed
Pain management
- Can dramatically reduce pain and anxiety during medical procedures
- Allows reframing the meaning of pain signals
Phobias and trauma
- Allows safe exposure and reprocessing of traumatic memories
- Helps restructure understanding of traumatic events

Hypnotizability and the Spiegel Eye Roll Test (1:01:43)

Dr. Spiegel explains that about 2/3 of adults are hypnotizable to some degree, with 15% being highly hypnotizable. Hypnotizability is quite stable over time - more stable than IQ over a 25 year period.

The Spiegel Eye Roll Test is a quick way to assess hypnotizability:

Look up at the ceiling, then close your eyes while still looking up
Ability to keep eyes rolled up while closing lids correlates with hypnotizability
Involves contradictory signals to eye movement nerves
May relate to ability to turn inward and focus attention

Confronting Trauma and Stress (1:21:43)

Dr. Spiegel emphasizes the importance of confronting and reprocessing trauma rather than avoiding triggers:

Avoidance reinforces fear and prevents new positive associations
Hypnosis allows safe exposure to traumatic memories
Helps restructure understanding of the trauma
Building stress resilience requires facing stressors, not avoiding them

He states: "You can't learn to ride a bicycle without taking the risk of falling off it...we need to build our ability to recognize and manage stress. And you can't do that without doing it."

Mind-Body Connection (1:27:56)

Dr. Spiegel discusses the complex relationship between mind and body in hypnosis:

Sometimes hypnosis unifies mind-body connection, other times it uncouples them
Goal is to have more control over mind-body interactions, not absolute control
Important to process bodily signals but also manage/reframe them
Blend receptive awareness with active responses to situations

Grief and Hypnosis (1:31:35)

On using hypnosis to process grief, Dr. Spiegel recommends:

Facing the loss and sitting with the painful emotions
Also visualizing what the person left you with/bequeathed to you
Reframing grief as reflecting how much the person gave you
Balancing processing pain with finding meaning

Hypnosis in Children and Groups (1:35:45)

Dr. Spiegel notes that children can be very responsive to hypnosis:

May need more structure than adults for self-hypnosis
Very effective for managing pain/anxiety during medical procedures
Can be done in groups, which may enhance the experience

Breathing Patterns and Hypnosis (1:42:39)

Dr. Spiegel discusses the important role of breathing in hypnosis:

Breathing bridges conscious and unconscious control
Certain patterns like cyclic sighing may induce parasympathetic activity
He incorporates deep breaths and slow exhales in hypnotic inductions
Breathing offers a way to modulate internal states consciously

Conclusion

This wide-ranging discussion with Dr. Spiegel provides fascinating insights into the neurobiology and clinical applications of hypnosis. Key takeaways include:

Hypnosis is a powerful tool for enhancing control over mind and body
It can be highly effective for issues like stress, pain, sleep, and trauma
Brain imaging is revealing how hypnosis works neurologically
Most adults can benefit from hypnosis to some degree
Self-hypnosis apps are making the technique more accessible
Confronting difficulties (safely) is key to building resilience

Dr. Spiegel's decades of research and clinical work demonstrate the significant therapeutic potential of hypnosis when applied properly. As our understanding of its neural mechanisms grows, hypnosis is likely to become an increasingly valuable tool for enhancing mental and physical wellbeing.