The New Psychology Of Hypnosis - Dr David Spiegel

Dispelling Common Myths About Hypnosis

Dr. Spiegel begins by addressing the prevalent misunderstandings that hypnosis is either inherently dangerous or useless. The greatest fear, he observes, is the misconception that hypnosis entails losing control. Far from this, hypnosis actually teaches individuals to enhance control over their minds and bodies. Through the example of a stage hypnosis act where a football coach dances like a ballerina, Dr. Spiegel highlights how hypnosis enables people to temporarily suspend their habitual self-conceptions and experiment with alternative modes of being without shame or inhibition. He emphasizes that hypnosis facilitates exploration of new behavioral patterns rather than submitting one's will to an external force.

The Brain in Hypnosis: Mechanisms and Networks

Moving from anecdote to neuroscience, Dr. Spiegel describes three parallel changes observed in the brains of highly hypnotizable individuals using functional MRI studies. First, activity diminishes significantly in the dorsal anterior cingulate cortex—the brain's salience network—effectively turning down the "alarm system" that normally hijacks attention when triggered by external stimuli. This reduction allows for a deep absorption in the hypnotic experience, simultaneously reducing stress and anxiety. Second, there is increased functional connectivity between the dorsolateral prefrontal cortex, responsible for planning and executive function, and the insula, a region critical for mind-body integration and interoception. This enhanced connectivity improves control over bodily sensations, enabling better regulation of physiological states. Third, an inverse functional connectivity develops between the prefrontal cortex and the posterior cingulate cortex, part of the default mode network associated with self-referential thought and internal narratives about the self. By dampening activity here, hypnosis suppresses critical self-judgments and internalized expectations, liberating the individual from habitual identity constraints. Together, these changes yield improved concentration, diminished anxiety, and increased self-regulation.

The Structure and Experience of Hypnosis

In practical terms, Dr. Spiegel explains that hypnosis need not involve elaborate rituals or inductions. For those naturally hypnotizable, a brief suggestion—such as imagining a hand rising like a balloon—can suffice to enter the state. Hypnosis, he points out, is essentially a form of self-hypnosis, a harnessing of talents humans already exercise unconsciously throughout life, such as immersive engagement in a book or movie. The hypnotic state involves letting go of critical judgment and entering the experience fully, akin to "getting lost" in a narrative or activity. He draws an evocative analogy to an Etch A Sketch, describing hypnosis as a momentary clearing of the complex overlay of self-narratives and emotional reactions, enabling one to "try out being different" and create new mental and behavioral patterns rapidly.

Evolutionary Foundations of Hypnotizability

Exploring the origins of hypnotizability, Dr. Spiegel situates it in evolutionary terms. On one hand, the capacity to deeply engage with experiences such as music, drumming, or collective dances likely fostered social cohesion—crucial in the survival of human infants who depend on social groups. On the other hand, the ability to modulate fear and pain responses—freezing in place, dissociating from pain—offers a survival advantage in escaping predation despite humans' relatively weak physiques compared to many predators. Thus, hypnotizability both supports intense social bonding and facilitates stress and pain regulation, providing adaptive benefits across human development.

A vivid safari anecdote underscores how humans naturally shift bodily states—intensifying attention, regulating arousal, and heightening sensory perception—in response to danger, akin to a natural hypnotic state tuned to survival needs. This example illustrates how flexible brain states enable humans to meet environmental demands and self-regulate physiological responses.

Hypnosis Compared to Meditation, Sleep, and Flow

Discussing analogs to hypnosis, Dr. Spiegel notes that hypnosis is not sleep, nor is it merely meditation, although it shares some characteristics with both. Unlike meditation's open, non-judgmental awareness, hypnosis entails focused engagement with an active goal or experience. It is perhaps closest to a flow state, where individuals are deeply absorbed and performing optimally, enjoying the process itself rather than fixating on outcomes. He offers the example of a Stanford swim team that improved competitive performance by learning self-hypnosis techniques to focus internally on body mechanics rather than external distractions, thus enhancing flow and reducing performance anxiety.

Individual Differences in Hypnotizability

Hypnotizability is a remarkably stable trait established by early adulthood and generally remains consistent over decades. This trait ranges from low to high, with some individuals effectively non-hypnotizable despite repeated attempts. Typical hypnotizability assessments involve simple inductions such as hand levitation suggestions, measuring participants' sense of involuntariness, dissociation, and response to suggested commands. Hypnotizability correlates loosely with personality characteristics; highly organized, rational individuals tend to be less hypnotizable, while imaginative or creative people often rank higher.

Genetic influences have also been identified, particularly involving the COMT gene that modulates dopamine metabolism. Variations in dopamine clearance rates in the prefrontal cortex influence an individual's hypnotic responsiveness, mediating cognitive flexibility and anxiety reactivity.

Therapeutic Applications and Evidence

Dr. Spiegel shares compelling clinical anecdotes illustrating hypnosis's utility. He recounts successful treatment of chronic pain through hypnotically induced analgesia, emotional trauma reframing in survivors of abuse and PTSD, and remarkably effective smoking cessation interventions. Notably, hypnosis can cut opioid use in surgical patients and lead to dramatic improvements in pain and anxiety with minimal sedation.

He discusses the digital evolution of hypnosis delivery, such as the "Revery" app, which achieves significant reductions in pain, stress, and insomnia through guided self-hypnosis and breathwork exercises. These outcomes demonstrate that hypnosis can be effective even remotely and in brief sessions, reinforcing its accessibility and low risk. Importantly, hypnosis's benefits are cumulative and can be repeatedly invoked "on demand," without diminishing returns or risk of addiction common in pharmacotherapy.

Integrating Breathwork and Other Modalities

Hypnosis synergizes with other mind-body approaches, particularly breathwork techniques such as cyclic sighing and box breathing that engage the parasympathetic nervous system to promote relaxation. Controlled breathing complements hypnosis by facilitating rapid shifts into calm, focused states, underscoring the importance of combined interventions for stress modulation and emotional regulation.

Hypnosis, Agency, and Societal Barriers

Contrary to fears of lost agency, hypnosis enhances self-awareness and control. Dr. Spiegel cautions that social susceptibility, rather than hypnosis itself, poses the greater risk of undue influence. He contextualizes hypnosis within broader societal challenges of misinformation, trauma exposure, and pervasive negative messaging, which impair mental health and resilience.

The conversation touches on why hypnosis remains underutilized in mainstream medicine despite extensive evidence. Economic and cultural factors, pharmaceutical industry influences, and the preference for procedural interventions over conversational therapies contribute to its marginalization. Hypnosis challenges dominant medical narratives by emphasizing non-pharmacological brain-based healing, necessitating a shift in clinicians' and patients' perceptions.

Hypnosis and the Human Narrative

The discussion repeatedly returns to the pivotal role of narrative in emotional suffering and healing. Hypnosis alters the stories people tell themselves about pain, trauma, and identity—allowing them to dissociate from maladaptive beliefs, embrace compassion for themselves, and reframe their experiences. Through guided imagery and dissociative techniques, individuals can shift deeply ingrained self-judgments, often with profound and lasting psychological transformation that transcends conscious recall.

Ultimately, Dr. Spiegel portrays hypnosis as a scalable, practical, and gentle approach to enhancing mental and physical wellbeing across a variety of contexts—whether managing pain, mitigating anxiety, improving performance, or confronting existential challenges such as terminal illness. It empowers individuals to access latent self-regulatory capacities, enabling better mind-body integration and emotional resilience.

By invoking states that calm the body's alarm system, increase brain connectivity, and suspend the default mode network's constraining narratives, hypnosis offers a unique doorway into more adaptive ways of being. As awareness and scientific understanding grow, hypnosis stands poised to reclaim its place as a vital and respected component of modern psychological medicine.