Practical Hypnosis, Meditation vs. Hypnosis, Pain Management Without Drugs, and More — David Spiegel

Preview (00:00:00)

• The speaker asks the audience to notice sensations in their back, particularly in an area that is usually painful, and guides them to feel relaxed.
• The speaker asks the audience to rate their discomfort level on a scale of 0 to 10.

How Herbert Spiegel was exposed to hypnosis. (00:00:33)

• David Spiegel's father, Herbert Spiegel, was exposed to hypnosis during World War II while he was a battalion surgeon in the Army.
• Herbert Spiegel's handlist, a Viennese refugee named Gustaf F. Schenberg, offered to teach Army doctors how to use hypnosis.
• Herbert Spiegel used hypnosis to help soldiers deal with combat stress reactions and pain.
• One soldier who developed a conversion hysterical paralysis was able to walk again after Herbert Spiegel helped him realize that his friend was already gone and there was likely nothing he could have done to save him.

Using hypnosis to cure non-epileptic seizures. (00:03:56)

• Milton Erickson treated a woman with non-epileptic seizures using hypnosis.
• He had her go back in hypnosis to the last time she had a seizure and experience the symptoms again.
• He taught her how to make the symptoms milder and milder until she was cured of her seizures.
• He communicated nonverbally that he would not put her through the same misery repeatedly but would show her how to manage it better.
• He taught her that if she could make the seizures happen, she could make them happen differently and change the way they happened.
• Over time, she deconditioned the intensity of the seizures through repeated practice.

What is a forensic psychiatrist? (00:05:40)

• A forensic psychiatrist works for an attorney, not the patient.
• They assess patients to prepare reports, such as evaluating emotional damage in a case involving a forest fire.
• They serve as subject matter experts in legal cases, determining the validity of claims.
• Forensic psychiatrists may testify in court and enjoy the simplicity of knowing who their friend and enemy is in the courtroom, unlike in academia.
• Hypnosis is a state of focused attention and heightened suggestibility.
• It is not sleep, unconsciousness, or a loss of control.
• Hypnosis can be used for various purposes, including pain management, stress reduction, and habit change.
• Hypnosis is not a magic wand and requires active participation from the individual.
• It is important to find a qualified and experienced hypnotherapist to ensure a safe and effective experience.

How hypnosis works. (00:08:33)

• Hypnosis is a heightened focus of attention, like looking through a telephoto lens.
• It involves narrowing the focus of attention and dissociating from other things in the environment.
• Hypnosis has three main components:
  • Highly focused attention or absorption.
  • Dissociation: putting outside conscious awareness things that are in Consciousness.
  • Suggestibility: being more cognitively flexible and able to let go of old premises and hook into new ones.

Hypnosis and the flow state. (00:11:51)

• Hypnosis is a state of highly focused attention where people tend to let go of their ordinary premises and can try out being different.
• Hypnosis is like a flow state, an autotelic experience that is self-rewarding and feels good to do.
• Athletes can use hypnosis to get into a flow state and focus on the process rather than the outcome.
• Hypnosis can help athletes improve their performance by allowing them to connect with their bodies and coordinate their muscles.
• Hypnosis is a natural state that people can enter on their own.
• Hypnosis can be used to help people with various issues such as pain management, anxiety, and stress.
• Hypnosis can also be used to improve athletic performance and creativity.
• Hypnosis is a safe and effective way to help people improve their lives.

How hypnosis differs from meditation. (00:15:09)

• Hypnosis and meditation are different practices.
• In mindfulness meditation, individuals engage in open presence, non-judgmentally observing thoughts and feelings without getting lost in them.
• Hypnosis, on the other hand, involves a natural shift in attention, leading to a flow-like experience.
• Hypnosis is more intense, briefer, and focused on achieving specific purposes such as pain management, stress control, sleep improvement, smoking cessation, and healthier eating habits.

Determining one’s susceptibility to hypnosis. (00:16:53)

• Hypnotizability is a stable trait that can be measured and divided into three groups: highly hypnotizable, moderately hypnotizable, and not very hypnotizable.
• Highly hypnotizable individuals have increased functional connectivity between certain brain regions, allowing them to become absorbed in activities without distractions.
• A genetic component influences hypnotizability, with a specific polymorphism of the dopamine-metabolizing gene playing a role.
• The hypnotic induction profile is a six-minute test that provides valuable information for therapists and clients regarding hypnotizability.
• Not being hypnotizable is not a client's fault, as most are paying for help and are not resisting the process.
• Hypnosis offers a neutral experience where individuals can explore and learn from it.

I take the eye-roll test. (00:21:51)

• The eye-roll test is a moderately reliable indicator of hypnotizability.
• People who can keep their eyes up as they close them tend to be more hypnotizable.
• Eye movements are related to level of consciousness, autonomic arousal, and the reticular activating system.
• The ability to shift gears, inhibit peripheral awareness, and intensify focus is associated with hypnotizability.
• Hypnosis is a state of focused attention and heightened suggestibility.
• It can be used for pain management, stress reduction, and habit change.
• Hypnosis is not sleep, and it is not mind control.
• Meditation is a practice of quieting the mind and focusing on the present moment.
• Hypnosis is a state of focused attention and heightened suggestibility.
• Both meditation and hypnosis can be used for relaxation and stress reduction.
• Hypnosis can also be used for pain management and habit change.
• Hypnosis can be used to reduce pain without the use of drugs.
• It works by blocking pain signals from reaching the brain.
• Hypnosis can also help people to relax and cope with pain.
• David Spiegel is a professor of psychiatry and behavioral sciences at Stanford University.
• He is a leading expert on hypnosis and its use in medicine.
• Dr. Spiegel has written several books and articles on hypnosis.
• He is also the founder of the Stanford Hypnosis Clinic.

Thoughts on EMDR. (00:24:12)

• EMDR (Eye Movement Desensitization and Reprocessing) is a technique used to help people with trauma, particularly by the VA.
• While eye movements in EMDR don't significantly contribute to its effectiveness, controlled exposure to traumatic memories, cognitive restructuring, and helping individuals gain new perspectives are beneficial components.
• Unlike exposure therapy, flashbacks don't cure PTSD because they lack control and can feel like reliving the trauma.
• Cognitive restructuring helps individuals understand and view their traumatic experiences differently, reducing feelings of guilt and helplessness.
• Hypnosis can help restructure perspectives about traumatic events, leading to a change in perspective and a reduction in negative emotions.

Therapeutic psychedelics and ego dissolution. (00:30:20)

• MDMA-assisted therapy for PTSD and psilocybin for treatment-resistant depression show promise.
• Psychedelics like psilocybin induce ego dissolution and non-judgmental awareness, similar to the subjective experiences of people who benefit from other therapeutic modalities.
• Psychedelics are contraindicated for many people due to their risk profile, but their potential impact is significant.
• MDMA works well for PTSD because it promotes human connection and helps reprocess traumatic experiences by disconnecting them from the sense of shame.
• Depression and post-traumatic stress disorder harm people by tarnishing their self-perception, but psychedelics can help disconnect the experience from negative self-conclusions.
• Psychedelic therapy carries risks, including adverse events.
• MDMA and psilocybin have shown promise in treating PTSD and breast cancer-related anxiety, respectively.
• Psychedelic experiences involve ego dissolution and non-judgmental awareness, allowing individuals to view their experiences from different perspectives.
• MDMA's effectiveness in PTSD treatment is attributed to its ability to foster human connection and reprocess traumatic memories while reducing feelings of shame.
• Depression and PTSD negatively impact self-perception, but psychedelics can help separate the experience from negative self-conclusions, leading to therapeutic benefits.

Potential adverse effects of hypnosis? (00:35:16)

• Hypnosis has a low risk profile compared to drugs like opioids.
• There have been less than 10 potential problems reported out of 3-4 million downloads of a hypnosis app.
• Most potential problems are easily reversible periods of anxiety or stress.
• Hypnosis can be turned on and off quickly, minimizing the risk of adverse effects.

Accelerated TMS improves response to hypnosis. (00:36:55)

• Accelerated TMS (transcranial magnetic stimulation) can improve hypnotizability in people who are less highly hypnotizable.
• A single session of accelerated TMS to the left dorsal lateral prefrontal cortex can transiently increase hypnotizability.
• This finding suggests that accelerated TMS may be a useful tool for enhancing the effectiveness of hypnosis for treating pain and other conditions.

Hypnosis as a tool for stress and pain relief. (00:38:49)

• Hypnosis is effective in managing stress and pain.
• 80% of people experience a significant reduction in stress levels within 10 minutes of hypnosis.
• Hypnosis helps people focus and intensify their attention, allowing them to plan and execute their goals effectively.
• Hypnosis has been used for pain management since ancient times.
• A British surgeon named Esdale reported 80% surgical anesthesia with hypnosis in pre-ether anesthesia era.
• Hypnosis can reduce pain by altering brain activity in areas such as the C meta sensory cortex and the dorsal anterior singulate.
• Different hypnotic techniques, such as imagining a physical remedy or teaching compassion for one's body, can be used to achieve pain reduction.
• Hypnotic analgesia has been proven effective in randomized clinical trials and can reduce the need for medication.
• Hypnosis is an underutilized resource with great potential for stress and pain management.

David treats my back pain with hypnosis. (00:43:36)

• Hypnosis can be used as a drug-free method for pain management by reinterpreting pain signals and inducing a state of dissociation similar to meditation.
• A simple self-hypnosis technique involving hand movements and visualization can alleviate pain, especially when combined with physical remedies like warm baths and foam rolling.
• Dissociative experiences, such as those induced by ketamine, involve a lightness and conscious awareness of the body without the usual level of identification with it, allowing for more effective pain management.
• Detaching from pain by experiencing it differently, rather than enduring it, can be an effective way to manage pain.
• Simple actions like touching and moving a body part can have surprising effects on sensation and pain perception.
• Self-hypnosis can be used for pain management.
• The Rivy pain control app provides guided self-hypnosis exercises.
• The app uses interactive branching responses to simulate a one-on-one session.
• Meditation and hypnosis are both altered states of consciousness.
• Meditation is about focusing on the present moment, while hypnosis is about accessing the subconscious mind.
• Hypnosis can be used to change thoughts, feelings, and behaviors.
• Hypnosis can be used for pain management, stress reduction, and habit change.

Understanding the science of pain relief. (00:53:14)

• Hypnosis can rapidly alter brain activity and modulate pain perception.
• Highly hypnotizable individuals have increased GABA binding in the anterior cingulate, enabling them to suppress anxiety responses.
• There might be a link between hypnotizability and the effectiveness of psychedelic-assisted treatments, but more research is needed.
• Psychedelic studies have demonstrated long-lasting improvements in PTSD and traumatic brain injuries, challenging conventional models of receptor occupancy and serotonin uptake.
• Hypnosis involves resetting and rebooting the brain, interacting with the default mode network activity to induce lasting changes in expectations and symptom perception.
• Hypnotic instruction could be a valuable addition to psychedelic treatments, complementing psychotherapeutic support.
• Further research is necessary to fully understand the mechanisms and applications of hypnosis in conjunction with psychedelic therapies.
• Pain perception is influenced by how the brain interprets signals, not just the intensity of the signal.
• The brain distinguishes between discomfort and pain through interpretation.
• Hypnosis enhances the connection between the dorsal prefrontal cortex and the insula, intensifying the brain's ability to interpret bodily sensations.
• Athletes interpret sensations that others would perceive as pain as necessary training, demonstrating the role of interpretation in pain perception.
• Hypnosis helps regulate and control the interpretation of pain, distinguishing between actual pain and non-painful sensations.
• Framing issues in hypnosis is beneficial rather than detrimental.
• Hypnosis can help individuals overcome challenges and achieve their goals by reframing their perceptions and interpretations.
• Hypnosis allows individuals to access their inner resources and strengths to cope with difficulties.
• Hypnosis can enhance self-confidence and self-efficacy, enabling individuals to overcome obstacles and achieve personal growth.

For us, not against us. (01:02:12)

• The best way to change behavior is through intermittent positive reinforcement.
• Hypnosis can be used to help people stop smoking by focusing on the positive aspects of quitting and the importance of respecting and protecting one's body.
• Even people who are not hypnotizable can benefit from hypnosis by focusing on the positive aspects of a resolution and feeling good about committing to it.
• Hypnosis is a state of focused attention and heightened suggestibility.
• Hypnosis can be used for therapeutic purposes, such as pain management, smoking cessation, and anxiety reduction.
• Hypnosis is not mind control and cannot make people do things against their will.
• Meditation is a practice of quieting the mind and focusing on the present moment.
• Hypnosis is a state of focused attention and heightened suggestibility.
• Both meditation and hypnosis can be used for relaxation and stress reduction.
• Hypnosis can be more effective than meditation for specific therapeutic purposes, such as pain management and smoking cessation.
• Hypnosis can be used to manage pain without the use of drugs.
• Hypnosis works by altering the perception of pain and by reducing the body's response to pain.
• Hypnosis can be used to manage both acute and chronic pain.
• Hypnosis is a safe and effective alternative to pain medication.

Hypnosis vs. other addiction interventions. (01:04:57)

• Hypnosis is comparable to other addiction interventions like varenicline, bupropion, or nicotine patches in terms of effectiveness.
• About 20% of people who undergo hypnosis for addiction completely stop the addictive behavior, while the rest reduce it by about 50%.
• More hypnotizable people are more likely to benefit from hypnosis for addiction.
• The anticipation of pleasure from addictive substances is a key factor in addiction, and hypnosis can intervene by providing a sense of well-being without the need for the substance.
• Focusing on the positive aspects of life and what individuals are capable of achieving is a crucial part of the therapeutic strategy in hypnosis for addiction.

A mesmerizing tale of hypnotic history. (01:07:33)

• The oldest documented evidence of hypnosis or something resembling it dates back thousands of years in Bali, where trans healers enter a trance-like state while chanting and singing, captivating their patients.
• In the late 18th century, Franz Anton Mesmer, a Viennese physician, introduced the concept of "animal magnetism," believing that hypnosis involved altering a patient's magnetic field.
• Mesmer's popularity in Paris surpassed that of leading French physicians, who relied on bloodletting and leeches as primary treatments.
• Mesmer's approach involved cheerful and well-lit offices, fostering a positive atmosphere for patients, in contrast to the grim and pessimistic environments of traditional French physicians' offices.
• King Louis XVI convened a panel to investigate Mesmer's methods, including Benjamin Franklin, Antoine Lavoisier (the chemist who discovered oxygen), and Dr. Guillotin (the inventor of the guillotine).
• The panel concluded that hypnosis was merely "heated imagination," dismissing Mesmer's theories and setting back the development and recognition of hypnosis as a valuable therapeutic tool.

Most surprising patient outcomes. (01:12:14)

• Hypnosis can have rapid positive effects on patients, as seen in cases such as a 15-year-old girl's severe asthma being alleviated and an army cook's psychotic symptoms being stabilized after a traumatic experience.
• The effectiveness of hypnosis can be observed quickly and facilitates rapid positive changes in the brain and body connection.
• Hypnosis can be used as a therapeutic tool to help individuals process and manage difficult emotions and experiences, such as the grief of losing a young boy during the Vietnam War.
• Hypnosis can also be used to manage chronic pain, anxiety, and other psychological issues.
• Self-hypnosis techniques can be taught to individuals to enable them to manage their own symptoms and improve their well-being.

Finding connection to treat the agitated. (01:21:28)

• Highly hypnotizable people can have intense experiences while staying connected and contained.
• They can modulate and control their emotions while focusing on a narrow container of being intense.
• They are aware that they are reliving an event and it is not actually happening.
• The therapist needs to maintain control and ensure that the intensity is related to meaningful work.
• The therapist and the patient develop a deep connection where they can feel each other and understand each other's needs.
• There might be a correspondence between trait hypnotizability and good candidacy for psychedelic-assisted therapies.
• Highly hypnotizable people can switch quickly between different emotional states while maintaining a sense of observer awareness.

Who is Reveri designed for? (01:25:31)

• Reveri is designed for anyone curious about dealing with their problems.
• It's a tool that can help people explore and change their mental states.
• It's particularly useful for people with pain, stress, insomnia, phobias, and habit problems.
• Hypnosis is a state of focused attention and heightened suggestibility.
• It can be used to help people relax, relieve pain, and change their habits.
• Self-hypnosis is a technique that allows people to induce hypnosis in themselves.
• Meditation is a practice that involves quieting the mind and focusing on the present moment.
• Hypnosis is a state of focused attention and heightened suggestibility.
• Both meditation and hypnosis can be used to help people relax and relieve stress, but they work in different ways.
• Hypnosis can be used to help people manage pain without drugs.
• It works by blocking pain signals from reaching the brain and by releasing endorphins, the body's natural painkillers.
• Hypnosis can be used to help people with acute pain, such as burns or injuries, as well as chronic pain, such as arthritis or back pain.
• David Spiegel is a professor of psychiatry and behavioral sciences at Stanford University.
• He is the director of the Center for Integrative Medicine at Stanford University.
• He is a leading expert in the field of hypnosis and has written several books on the subject.

Hypnosis as a first rather than last resort. (01:28:16)

• Hypnosis can be an effective tool for pain management and should be considered before resorting to more invasive interventions.
• Hypnosis is a skill that can be learned and utilized by individuals to manage their own pain.
• Hypnosis is often underutilized due to lack of awareness and promotion compared to pharmaceutical options.
• Hypnosis is inexpensive, effective, and has a favorable risk profile, making it a suitable first-line approach for pain management.
• A pregnant woman with severe lower back pain experienced significant pain relief through hypnosis, highlighting the potential benefits for individuals who may not be able to use certain medications.

Further resources and final thoughts. (01:31:24)

• Hypnosis is a state of focused attention and heightened suggestibility that can be used for pain management without drugs.
• Meditation is a practice that helps individuals develop awareness and calm the mind.
• Both hypnosis and meditation can be used to treat various conditions such as anxiety, depression, and phobias.
• Hypnosis can also be used to improve performance in areas such as sports and public speaking.