Dhru Purohit Show - The Mind Blowing Science of Hypnotherapy and its Ability to Heal Chronic Pain, Reduce Stress and Improve Sleep Quality with Dr. David Spiegel

Episode Date: January 5, 2023

This episode is brought to you by Cozy Earth and ButcherBox Today on The Dhru Purohit Podcast, Dhru sits down with Dr. David Spiegel, a psychiatrist with more than 40 years of clinical and research experience with hypnosis and psychotherapy. Dhru and Dr. Spiegel discuss the many misconceptions about hypnotherapy and how it can be used as a tool to gain control over the mind and body to help people overcome trauma, heal from disease, and rewire the neurocircuitry of their brains to align with their goals and ambitions.  Dr. Spiegel is a professor and the Associate Chair of Psychiatry and Behavioral Sciences at Stanford University School of Medicine. In addition, he directs the Center on Stress and Health at Stanford, where he is also the Medical Director of its Center for Integrative Medicine. Dr. Spiegel has been a pioneer in integrating the principles of psychiatry with hypnosis and applying them to cancer therapies, chronic stress, pain control, trauma, and sleep disorders.  In this episode, Dhru and Dr. Spiegel dive into: -The categories of life that hypnosis can help improve (2:22) -A summary of what hypnosis is and what it isn’t (10:32) -What’s happening in the brain when it undergoes a state of hypnosis (24:27) -The history of hypnosis and how it plays into our evolution (35:10) -Common examples of how we tap into the power of hypnosis (39:59) -What makes some people more hypnotizable than others (49:00) -How Dr. Spiegel has used hypnosis to benefit his own life (1:00:45) -The difference between hypnosis and meditation (1:04:21) -Some of the limitations of hypnosis (1:24:42) -Using hypnotherapy to help you pursue a goal or dream (1:34:08) -Other areas where people have benefited from hypnotherapy (1:37:24) Also mentioned in this episode: -Dr. Spiegel’s app, Reveri -Society for Clinical and Experimental Hypnosis  -American Society of Clinical Hypnosis -Division 30: Society of Psychological Hypnosis -Psychology Today’s Find a Hypnotherapist database For more on Dr. David Spiegel’s app, Reveri, check it out on Instagram @reveri and Facebook @tryreveri or head on over to reveri.com.  Cozy Earth are the most comfortable, temperature-regulating, and nontoxic bed sheets on the market. Right now, get 40% off your Cozy Earth sheets. Just head over to https://www.cozyearth.com and use code DHRU. ButcherBox has a variety of different boxes, and you can choose your box and frequency. For a limited time, you can sign up today and get two pounds of ground beef free for a whole year PLUS $20 off by going to https://www.butcherbox.com/dhru Hosted on Acast. See acast.com/privacy for more information. Learn more about your ad choices. Visit megaphone.fm/adchoices

Hypnosis, which is a state of just highly focused attention with a reduction in peripheral awareness is a powerful way to change the way your brain processes pain. What if I told you there was a tool in your mind so powerful that simply unlocking it would allow you to access immediate relief from stress, insomnia, and even help you manage chronic pain. Welcome to the Drew Prod podcast. Each week, we explore the inner workings of the brain and the body with one of the brightest minds in wellness, medicine, and mindset. This week's guest is Dr. David Spiegel, a psychiatrist,

researcher, and world-renowned expert on all things self-hypnosis. And on today's podcast, Dr. Spiegel is here to share his 40 years of clinical and research experience on the topic of self-hypnosis and how it can be a powerful tool in our healing toolbox. Here are just a few list of categories that Dr. Spiegel has shown with his team, that self-hypnosis can be extremely supportive of. Could sleep in insomnia? Anyone dealing with that? Stress and anxiety.

How do you get immediate relief in the moment when you're dealing with stress and anxiety? Improving focus and performance. Eating healthier and keeping your focus on the healthy habits. Smoking cessation. There's a lot of people that are addicted to cigarettes and breaking cigarette addiction is one of the hardest things to do. Hypnosis can be supportive in that tool. And lastly, this is a topic that is huge right now, pain management. Dr. Spiegel has done some incredible research in this category.

Now, a little bit more about Dr. David Spiegel. He's the Associate Chair of Psychiatry and Behavioral Sciences, director of the Center on Stress and Health, and medical director of the Center for Integrative Medicine at Stanford University School of Medicine. He's also the co-founder of the app, reverie. That's reverie.com, which was designed to make self-hypnosis more accessible to individuals

around the globe. If you're curious about the topic of self-hypnosis, but don't know where to start, this podcast episode is absolutely for you. Stay tuned. Dr. David Spiegel, thank you for being on the podcast. I'm excited to talk about this fascinating topic of hypnosis. So to start us off and our audience off, can you give us a couple categories? that you've seen through your work and your research where hypnosis can be a powerful tool in

our toolbox to make a significant improvement in that category. Sure, I'm happy to, happy to be here. One of them for sure is pain. Pain, you know, the way I think of it is that the strain in pain lies mainly in the brain. And hypnosis is a way of using the brain to alter it. You know, people assume that pain is this kind of, um, a way of, um, unavoidable sensation if you've injured some part of your body. And it's certainly related to it. But right now, you're having sensations in your back resting against the chair. Hopefully you were not aware of those until I mentioned it to you.

If you were, we can stop the interview now. Our brain makes decisions all the time about how to interpret signals from the body and how much attention to pay to them. And hypnosis, which is a state of just highly focused attention with a reduction in peripheral awareness is a powerful way to change the way your brain processes pain. So we're finding that people using the Reverie app get about a 30% reduction in pain within 15 minutes of just learning to do the self-hypnosis. Fascinating. So pain is one of them. You have a couple others that you want to highlight at the beginning of the conversation. Our hope here is to give people a little bit of a

teaser that if they've heard a little bit about hypnosis, they think they kind of know about it. Of course, we're going to unpack it in this conversation, but part of is that we're going to give you a little bit of a preview of what is possible when you can tap into the power of hypnosis. Absolutely. And one of the nice things about hypnosis and what the app can do is you'll know right away. You know, you don't have to practice it for three weeks to get an impression of whether it's going to help you or not. You'll know within 15 minutes, whether it's likely to help you. So sleep is another one. A lot of people have trouble falling asleep or staying asleep. The old idea of hypnosis, whether you are feeling very sleepy, that's not what hypnosis is.

it's actually a kind of waking up. It's an alerting. But what you can learn to do is separate your physical arousal from your mental arousal. And what bothers a lot of people trying to get to sleep or get back to sleep is that they feel so tense that they're gearing up for physical activity instead of gearing down for sleep, relaxing, self-soothing. And what you can do is dissociate, separate your mental experience, projecting your thoughts and feelings onto an imaginary screen while you imagine your.

your body floating in a bath, a lake, a hot tub, or floating in space, and it allows you to go to sleep. Now, you'll notice that before I told you how quickly people can respond to a reduction in pain, we have trouble getting the follow-up scores from the people who use it because they're falling asleep and they don't want to arouse themselves and tell us my sleepiness has gone from a three to a tent. So, but it's very effective. People love just having the sense of allowing themselves to drift.

off to sleep. We had one user who complained because she had some trouble just with the app, you know, the technical parts of the app. And she said, I do want to explain to you that the reason I'm so upset about that is that this is the first time in 15 years I've gotten a good night's sleep and I want it to work. So it can be very helpful for sleep. And stress related to sleep but during the day is another thing where hypnosis and what we teach on the app can be very helpful. The principle is similar, that how do we experience stress? A lot of the ways in which we do is not what's happening outside, you know, the boss being mean to you or what we read in the newspaper every day or whatever it is.

It's the way your body reacts to it. So you notice that as you read this or you talk about some stressful event, your muscles get tense, you start to sweat, you may sense your heart beating a little faster, and then you think, oh, God, this is really bad, and you feel worse. It's like a snowball rolling downhill, then your body reacts. So what you can use hypnosis for is to interrupt that interaction between the thought about the stress, the perception of the stressor and the way your body's reacting to it. So that's the first step in beginning to control.

Before you even think about what to do about the stressor, you think about how to help your body deal with it. And the reason our bodies react this way is that we're pathetic physical creatures. You know, we don't run very fast. We don't smell that well. We see pretty well. We don't hear all that well. and we were the victims of predators as humans evolved. And so you had better get ready to fight or flee if you're under stress.

Today's stressors, thank God, are mostly psychological rather than physical. So we're kind of wired and programmed in evolution to respond in a way that may have been good 10,000 years ago, but is less helpful now. And you can use hypnosis to reprogram yourself to control the physical reaction first, and then you can and better deal psychologically with what the stressor is doing to you. So much incredible stuff that you've just shared there in this opening. And we want to pull on some of those threads and go into them a little bit deeper. You bet. And one of the areas that I really want to get a chance to dive into is the first topic you talked about, which is pain.

But to set that conversation up and to talk about how people can both use your app and also potentially work with the clinician that's out there who can practice hypnotherapy with you, Right. Let's give a little bit more of a background. So hypnosis, you know, you've shared in a previous interview that self-hypnosis is a way of gaining control of the mind and the body, right? So self-hypnosis is a way of gaining control of the mind and the body. So if that is what hypnosis is, tell us what hypnosis isn't, especially with all these

preconceived ideas that people have about what they thought they've heard about hypnosis. Well, you know, people who practice hypnosis have one rule is you always try and tell people what is true rather than what is not true. It's like try telling someone don't think about purple elephants. But you're right that a lot of people have in their mind this image, not only the dangling watch, but this Fangali-like person controlling somebody else's mind. They fear they're losing control. Somebody will take over control. We think of what the response to hypnosis is not as suggestibility, but as kind of. cognitive flexibility. People in hypnosis can see things from another point of view. The people who

tend to be more hypnotizable are people who get so caught up in a good movie. I don't know if you do, Drew, that you kind of forget you're watching a movie and you enter the imagined world. It comes to seem real to you. And I know you've talked about doing visualization a lot. And they're very much related. It's been called believed in imagination. So when you allow yourself to engage so much with some other kind of input, you're more open to learning about it. You're more open to being able to kind of reprogram your own neural circuits to respond in this new way. So with pain, for example, you can teach people to filter the hurt out of the pain. You say, well, you have a sensation in this ankle that you sprained.

But imagine that you're putting your ankle in warm or cool water. And the pain sensation is more like a tingling. You let the tingling filter the hurt out of the pain. So you can teach your brain to transform the sensations. You have the content you need to know. Don't walk on that ankle for a little while, but you can experience it in a different way and literally transform the pain. And it's not just anecdotal experiences that you have and user feedback from your app. You've actually done some studies on this area.

Can you talk about one of the most premonent studies that you did when it came to hypnosis and pain? Yes. We with my colleague, an interventional radiologist, O'Bura Lang and some other colleagues, we published a paper in The Lancet, which is a leading British medical journal, randomized clinical trial, 241 subjects, all undergoing invasive radiological procedures. So that means a cut down into the femal artery, threading catheters through it, little cameras that could visualize renal artery stenosis or deliver chemotherapy to the liver, for example. It's not comfortable.

We don't use general anesthesia for it, but the procedures take about two and a half hours. And you're lying there. You're worried about what's going on inside your body. And we randomized them to one or three conditions. They all had a button they could push that would release opioids into their bloodstream. So they could have opioid analgesia. The second one had that plus a friendly nurse being comforting. And the third randomized condition was learning self-hypnosis.

Take your body somewhere else. Imagine you're on vacation and spend your time thinking about being the, there, filter the hurt out of the pain. I'll let your body and float as if you're in a bath, a lake, a hot tub, or floating in space. They could also press the button. By the end of an hour and a half, the pain was five out of ten in the standard care group, and it was two out of ten in the hypnosis group. That's incredible. The anxiety levels scared me a little bit because they were five out of ten in the standard care group, three out of ten in the nursing support group, and zero in the hypnosis group.

I was afraid they'd all died or something. They were fine. The procedures got done 17 minutes faster on average in the hypnosis group compared to the other two. They had fewer complications. And here's the best part, true. They were using half as much opioids as the people in the other. So they were more comfortable. It got done quicker, fewer complications.

And they used half the opioid medication. And one thing that people need to understand is that opioids do, reduce pain in the short run. But if you, after a surgical procedure, continue using opioids after three days, your risk of getting addicted to the opioids goes up and up and up. It's a dangerous thing to do. So here they were at far less risk of wanting to use opioids after the procedure was done. And we published this finding in the Lancet. And, you know, we got a lot of people cited the paper and all that. But if that were a drug, you know, and pharma were pushing it. Every hospital in the country would be using that now,

and that is not the case. And, you know, you've even speculated sometimes, like, why isn't that the case? Why don't we talk about that more when it comes to the topic of pain, which is something that there are, I mean, I've looked at the statistics before this interview. I don't have them in front of me here, but the levels of chronic pain are going up and up every single year, and people are looking for different solutions. So why don't you think it gets the attention that it deserves? Well, I don't know. There are a couple of things. Number one, there are big pharma companies pushing drugs and, you know, this horrible story with how the opioids have been pushed as sort of, you know, the upper middle class white form of heroin that is okay to use. We now have, in the last 10 years,

we've had 500,000 opioid overdose deaths. You know, it's more than car accidents, it's more than gunshot victims and God knows there are enough of those. And part of it is that pharma has made a whole lot of money. Purdue and other pharma that produced OxyContin have made a fortune on that. And that's a disgrace, I think. It's not that there isn't a place. I'm a physician. I have prescribed opioids, but with control at the right time for a limited amount of time.

And the dangerous thing about opioids is that there are two parts of the neuron that respond to the opioids. And one receptor, the muropyroid receptor, gives you analgesia. It does reduce pain acutely. The other one suppresses your respiration when you're sleeping. And you can habituate to one and not the other. So there are a lot of people who think, I need more opioids and to control the pain. So I must be able to handle it in other ways. They fall asleep and they don't wake up.

And you see now these young people get fentanyl, which is far more potent than standard opioids, car fentanyl even worse in these drugs, and they just go to sleep and they don't wake up. It's terrifying. It's really an awful thing. So those drugs are dangerous, but companies have made a lot of money doing it. The second reason is, and I know this as a psychiatrist, there's prejudice against psychological approaches and psychological problems. People say it isn't real.

If it gets better, the problem wasn't real in the first place. And that could not be more wrong. My lovely wife, Helen, had our two kids with hypnosis as the only anesthesia. Our son was 10 pounds when he was born. I had no pain at all. No, she handled it extremely well. And that's real pain. You know, she's not making it up.

She's given birth to a child. And in the same way, people have the mistaken idea that if you can control pain with your head, the pain isn't real. that is just plain flat out wrong. And there's a general prejudice about psychiatric problems in general that people are making them up and they just get a grip and they'll be fine. The brain is the major control system of the body and things can go wrong with your brain just like they can with any other part of their body. It's one other organ that has problems.

And we're not born with a user's manual. There are a lot of things our brains can do that it takes a while to figure out. And hypnosis for pain is one of them. What do you know about the history of hypnosis, both in medicine and even in sort of cultures throughout the world? Hypnosis is the oldest Western conception of a psychotherapy. So it's the Western equivalent from a historical point of view of meditation where there's a much longer history in the East.

But it was the first time that a talking interaction was thought to have therapeutic potential. It was sort of discovered by Franz Anton Mesmer or Viennese physician who would induce these kind of dissociative episodes and patients they would suddenly kind of swoon and they'd wake up and feel different from the way they were before. He had this idea that there were magnetic fields in their bodies that went astray. And if he put his magnetic field next to theirs, theirs would get better. I don't know, his wouldn't, why his didn't get worse. But he then had these tubs of iron filings that would induce magnetic fields. And a lot of patients were getting better. And so he left his wife and family in Vienna and moved to Paris, where he competed very successfully against French

physicians. And I've read a lot about what happened in that era. And the comparison of his office, it's like, you know, with your interest in both visualization and your interest in integrative medicine approaches, it was cheerful, it was bright, patients were talking with one another about how well they were doing. French physicians' offices were dark and somber, and you went there to get bad news. Voltaire wrote to his brother, we did everything we could to save father's life. life, we even sent the doctors away.

And so he was competing very effectively against French physicians. They didn't like that. So they got the king to institute a commission to investigate Mesmer. And they concluded that hypnosis was nothing but heated imagination. Now, I think that's a pretty good definition, actually. It's not terrible. But Mesmer was convinced it was the magnetic fields that were doing it. And that was pretty much the end of his career.

And the people on the commission were our own Benjamin Franklin, who was having a good time in Paris back then, the brilliant French chemist Lavoisier, who invented oxygen chemistry, and who also invented the notion of the gross national product just six months before he was beheaded by the French revolutionaries. And another person who was on the committee actually was Dr. Guiletain, the inventor of the guillotine. So he kind of created the mind-body problem. And that was, for a long time, you know, that was the end of hypnosis. But others, there was something, you know, the nice, it's never been mainstream. On the other hand, it just won't go away. And I think it won't because it's so interesting. So there was a Scottish surgeon named Ejdale, who went to India, used hypnosis for surgical anesthesia.

He reported 80% surgical anesthesia just doing hypnosis. They were amputating limbs, you know, with maybe a little bit alcohol and that. And 80% anesthesia. And at Mass General, when they made the first use of ether, 10 years later, a surgeon strode strode to the front of the amphitheater and said, gentlemen, this is no humbug. And to distinguish it from Esdales' report on hypnosis. So Esdale said, where they're reporting 90%, I'm only getting 80%, I give up. And that's happened time and again, where you can do remarkable things with it.

somebody comes along and says, there's a physical thing, you know, incision, ingestion, or injection. That's the real medicine. But what that is is treating the body like a broken car, you know, you just replace the muffler or something. And then it's, the wonderful thing about our bodies is how elegantly they can be controlled by our brains if we learn to do it right. Fascinating, because in a way we're talking about hypnosis has this deep history of being pressure tested. Yes, that's a good way to put it. And it's been used throughout history for people. And every so often that skepticism comes in and kind of washes things away, what was the last wave of skepticism that kind of did some harm to the world of exploring hypnosis?

Anything that you can recall? Well, there has been a debate about trauma, the effects of trauma and memories, including memories induced by hypnosis. And, you know, is hypnosis just a tool to induce force? false memories of trauma. There's been a lot of fuss about that in recent years. And I use hypnosis to help people deal with traumatic events, with post-traumatic stress disorder. It can be helpful. Memories are often imperfect. And you can, if you're really pushing people using hypnosis, get them to report things that may not be true. But you know what? You can do that without hypnosis, you know. And there are experimenters, Elizabeth Loftus and others,

that show that if you show somebody an automobile accident where there's a yield sign on the road and say, did you say, did you see the stop sign when there isn't one? About a third of people will say, yeah, I saw the stop sign. They'll mistake the yield sign. So memory is fallible, but people have blamed hypnosis for inducing false memories. And of course, if somebody's accused of sexually abusing their child, they're going to, you know, be resort at nothing to stop at nothing to try and convince a judge that it wasn't that they did it it was that the child's memory was contaminated now you can contaminate memory that's not you know that's a risk that

a good court needs to evaluate so hypnosis has been blamed as making trouble rather than helping people in trouble and that's not true it's unfortunate what's actually happening inside of the brain when we are in hypnosis? We've studied that. We're really interested in it, and we found some pretty interesting things. We took a bunch of highly hypnotizable people. We tested their hypnotizability

compared to a group of low hypnotizable people. And we put them in the MRI scanner, and we had four conditions. We had just a basic rest there, be there at rest. One was a simple memory task. One was think of a vacation hypnotically. You're going to where you enjoy, feel good on vacation. The third was just an emotion task.

Imagine yourself feeling happy or sad or whatever it was. And we then compared high and low hypnotizable's in those four conditions. So the contrast of interest was the two hypnosis conditions in the highs versus the low hypnotizables. And what we found was pretty interesting. Three things happened. One is that they turn down activity in the anterior cingulate cortex. Now, the cingulate cortex is like a C on its ends sitting at the base of the brain. And the anterior, the front part, the dorsal anterior cingulate, is part of the salience network.

It does pattern matching. And so if suddenly we hear a loud noise that sounds like a shot outside the studio here, our salience network is going to fire and we're going to lose attention on what we're talking about and pay attention over there. That's what it does. In hypnosis, you turn down activity there. In other words, your brain is basically saying, don't worry about anything else. Allow yourself to get fully absorbed in what's going on. And we found in another study with highs and lows that there is more functional connectivity between that region and the dorsalateral prefrontal cortex, part of the executive control network, the one that I'm hopefully using now while I'm talking to you to control and

explain things. When they coordinate and the activity and the salience network goes down, you're really concentrating intently. So that's one major thing that happens. The second thing is you get more functional connectivity. That is when one is working hard, the other one is two, or conversely, if the one is turned off, the other is between the executive control network and the insula. The insula is another region of the salience network that is a mind-body relay. It helps us interocept, to perceive what's going on in the body, but also control what's going on in the body. And when those two regions work together, you have more control of what's going on. We did another experiment years ago with a gastroenterologist.

We put down a nasogastric tube. We had people eat imaginary meals. It would go on for an hour. And one woman after half an hour said, let's stop, I'm full. And we got an 89% increase in gastric acid secretion. They're not eating anything. They're just hypnotically enjoying eating food in their imaginations. We then did the opposite.

We said, you're going to have a relaxing, wonderful time. You can do anything you want except eat or drink. We got a 39% decreasing gastric acid secretion. So they could change it either way with hypnosis. And then we injected them with pentagastrin, which is what the body's hormone that triggers the release of gastrog acid. And we still had a 19% reduction in hypnosis. hypnosis. So that brain-body connection is very strong, and we can do a lot more with our brain

regulating our body than we give ourselves credit for. And the third thing that happens in hypnosis is more functional connectivity, inverse connectivity between the executive control region and the posterior cingulate cortex. That's part of what we call the default mode network. It's a part of the brain where you reflect on who you are and what you're doing and what people think of you, when you're not doing anything else. And that kind of rumination can make people miserable. It can make them feel good. But when you're doing something with your dorsalateral prefrontal cortex and hypnosis, you've turned that off.

So you've dissociated. You're disconnecting what you do from who you think you are. And that can be a way of dissociating, allowing yourself again to focus because you're not saying, you know, somebody like me shouldn't be doing this. So in the stage shows, which unfortunately a lot of people have seen with hypnosis, that's part of why the football coach will dance like a ballerina or something like that. You know, they don't reflect at the time on what it means. And so that's what seems to be going on in the brain when people are hypnotized. So when you take that explanation and you talk about, for instance, some sort of form of chronic pain, I think in the study that you mentioned inside the Lancet, would you describe that as that was more of an acute pain situation?

that people were going through when they were going under this procedure. So let's take something like chronic pain. What's happening in the brain when somebody is continuously receiving signals that there's some sort of pain censoring? And how would something like hypnosis modify that signaling in the way that it was being received in processing? Well, you know, part of it is that there's an interaction between the sensation and and your cognition about it. So you, a lot of people with chronic pain get depressed because

they think, oh, God, another day, I'm just going to be miserable. So the anticipation. The anticipation. One part of it. Right. And so you set up these neural channels, these neural networks, you know, neurons that fire together, wire together that, oh, you know, I'm feeling that ache or I couldn't sleep last night. It woke me up from sleep. I'm going to feel more pain today. And yet, even before that association can get triggered, we did one study. using what are called evoked potentials. That is, you give a series of shocks to the wrist, and you see what the brain's electrical response to those shocks are.

And we took a bunch of highly hypnotizable Stanford students, in one condition, gave them the shocks, the shock on the wrist, and just recorded the electrical response throughout the brain to these shocks. And in another, we said, your hands in circulating ice water, cool, tingling, and numb, filter the hurt out of the pain. And they had half the electrical response to the same shocks. And this was within a tenth of a second after the signal started to emerge. And so what this means is that it's not just reinterpreting it later.

You can actually reduce how much pain you feel, how much discomfort you feel. And there are other investigators at the University of Montreal, Pierre Rainville and his colleagues, that showed using fMRI that when you do that, you can reduce activity in somatosensory quartets especially, the part of the brain, the middle on the sides of the brain, that monitor sensory activity, and you can reduce their response to the same pain signals. But there's another region, our good old anterior cingulate cortex, that if you tell them not that you'll feel less pain, but whether you do or not, it won't bother you so much, you reduce activity in the anterior singular cortex, which is part of the pain response network, the salience network as well. That's telling

you, oh, my God, this is trouble. And part of the problem in dealing with chronic pain is that we tend to think of it as if it were acute pain. So it's very important. If you just broke your ankle, you better pay attention to it. And there are some like football players who don't notice it. They keep playing the game. And then the coach looks at their ankle and says it's swollen. What happened?

So you can acutely reduce it. But the point is that with hypnosis, you can actually alter your. a response to the pain signal itself. You can change and reduce the amount of pain you feel. And so you don't necessarily have to treat all pain as if it were acute pain. You know, a lot of times as you're healing, the body's healed well enough that using the limb, the arm that had been broken, is not going to do it any harm, but you feel anything and you think, oh my God, there's trouble. For breast cancer patients, I've run support groups for women with metastatic breast cancer, Pain can be a problem because you feel a new pain in your chest and you think, oh my God, it's a new metastasis.

So you treat it like that acute pain. It means the cancer spreading. It might, but it might not. And so we teach them, we taught them self-hypnosis and once a week group therapy. And they would just do the hypnosis exercise. And they felt reassured that they could filter the hurt out of the pain and make it feel better. And also uncouple it from the anxiety that they felt about the illness itself. So it's a matter of teaching the brain not to react if you're in acute pain, but not to overreact if you're not.

So is it correct in saying that you are essentially providing a new pipeline of information to the brain? That previously you might be limited in the number of pipelines in what we perceive to be our actual reality. But hypnosis is part of our actual reality too. We're just thinking about another pipeline to come in. So if you're thinking about this pain and the example that you mentioned with the Stanford students who were shocking their wrist with some sort of stimuli, that is one pipeline of information. And then another pipeline of information is imagine your hand in an icy cold bath. And they're imagining it. And that's actually real to the brain.

So it's another pipeline of information that's coming into the brain. That's well put true. That part of the reality of even things like physical pain, even dealing with an injury, is the way your brain processes the injury. It's part of the injury system because the brain is interpreting what it means. And the brain can overinterpret it. It can underinterpret it. It's good when you're acutely injured to pay attention to how hurt you are

and to get the help you need. But at the same time, it can set in motion a process whereby the brain becomes an amplifier, and you can turn down the gain, you can turn down the volume, and that can be a part of recovering from the injury. is you're absolutely right that in a sense, you know, your foot is injured, but your brain may be injured too, and you need to use your brain better to help you put the pain into perspective. You know, you've mentioned before, and you kind of said at the beginning of this interview,

you said, we're born with the brain, but we don't have a user manual for it. Right, right, right, right. And hypnosis is, do you think that, you know, if you had to guess, how do you think, How do you think that human beings stumbled upon the idea of hypnosis? And what role did it play in our evolution? I think an example is, as I mentioned, we're pretty pathetic. We were often preyed upon by other animals. And one thing that predators detect is movement.

And so they're animals that survive because they freeze. So if you have developed an ability in this big brain that we have to not react immediately in a physical way, you actually probably have better odds of evading a predator than if you're going to jump and jerk and move, shake if you're afraid, or move and try to run when you can't. And I do think actually that there is evolutionary advantage to the capacity we have to modulate our reactions even to physical stress and physical pain. So even though I can see this panther that's there in front of me, which I know is looking for me, I am going to use some sort of version of another input, which is in a way stepping into hypnosis to say, it's better that I freeze right now.

Is that what you're saying? That's right. That's right. It's better that I not react. You know, if I've been bitten or fallen and broken something, if I'm still in danger, it's better to control the reaction. I had a woman come to see me. She'd been in the World Trade Center after the attack. and she said, you know, I just told myself, just put one foot ahead of the other and get down the stairs.

And if I just get to the ground floor, I'll be okay. That's what she was telling herself. To me, that's a hypnotic construction to her. I could be screaming and crying and all kinds of things. This is what, this is my survival strategy. And she got to the ground floor and the other building collapsed. And she got blown out the window of the front door of the other tower, the trade center. And she was angry with herself.

She said, why was I fooling myself? I said, you saved your life. You know, if you don't, there are times when you really don't want the big picture and you don't want your body to react to the big picture, you've got to figure out what to do to stay alive, and that's what you did. And so that ability to dissociate to just say, I'm going to focus on this and that's all, at times has real survival value. That's a great clarification because I kind of had an aha moment there for a second because

I was thinking, what is the difference between thinking and hypnosis in the context of us seeing an animal, a panther, whatever, a predator who's looking for us right now, maybe in a setting in the jungle? And we are saying, okay, let me freeze right now so it doesn't come after me. I thought, well, isn't that just thinking? That's just the human brain thinking. But really what I'm hearing from you and correct me if I'm wrong, because I might have this wrong, is that actually hypnosis in a way is part of what we think about as modern thinking. It's the ability to override our lower part of our brain that might say, run, get out of here, fight.

Those are the only options. But no, we're telling ourselves a story to create a different manual for what to do in that situation, even if our inputs are telling us to do something different. Well, that's very interesting. I think you're right. As I mentioned, it's believed in imagination. And at the kinds of times you talk about that Panther is looking at you and you're looking at it, there are a lot of interpretations of what's going on that could distract you.

You could say, oh my God, you know, in 10 minutes I'm going to be his dinner or something like that. Not a great thing to think about at a time like that, but hard to control the mixture of emotion and physiological arousal and thinking strategically. And what hypnosis allows you to do is say, I'm going to limit, It's like looking through the telephoto lens of a camera. I'm going to see this and not worry about the context. I'm going to get my brain to focus on what really matters for me to stay alive right now. And so it's a matter of controlling not just thinking, not just cognition, but also controlling affect, controlling physical arousal.

And so if you're immersed in that story, you have a better chance of controlling it if you're not thinking, well, you know, maybe I should try to run or, you know, turn the other way or something. So you want to intensify your reaction and also be cognitively flexible. Think about things you might never have thought of before, you know, like that woman, one foot in front of the other getting out of here. You mentioned that people don't often think of it this way, but when you get so into a movie where you kind of forget you're watching it for a second and you're so into the characters or the action or something that's happening, that's a version of hypnosis. You are under hypnosis.

what are some other common examples that people may not think about that are ways that hypnosis is part of their life on a regular basis? Well, you know, reading it happens when you're reading. You get so caught up in a novel that you're just, you know, you're picturing. You're picturing the imagined world. You're feeling your heart race, when the character's in threat. That's exactly right, you know. And it's also sometimes, you know, being truly entranced with some. somebody, you know, we use that word entranced, you know, when you're in love. You know,

nobody else matters. You're engaged with your partner, your lover, and you can almost feel what they're feeling and they can feel what you're feeling. You're just in tune with one another. That capacity, get absorbed in another person is something like that. I sometimes have feelings when I'm working with patients where I, you know, I play a little game with myself. I, I know what the next thing they're going to say is. I know the direction of the conversation is going. And that intense attunement with somebody else is a kind of hypnotic state as well. There's a saying that it's a smart hypnotist that knows who is hypnotizing whom. And so sometimes intense engagement is like that. Or, you know, the experience you have on some adventure, you know,

riding a horse for the first time or something, where you're just caught up in that and what it feels like, you're integrating how your body is feeling, what you're doing, the kind of control you need to be engaged in, and your enjoyment of it. And you're just. And you're enjoyment of it. And so those times when you can integrate emotion and experience and physical experience can be hypnotic. Now, you have a fascinating story of how you kind of fell into this world, a little bit of family lineage that's there. But before we go into that, you mentioned your work with patients. You know, not only do you have this app, which we have a link to inside of the show notes that people can download, and it's a much more accessible tool for people to practice

hypnosis all around the world. But you've also have this. you know, one-on-one experience with patients, including also, of course, the clinical trials that you've been involved in. What were maybe one or two, you know, you can start off with one early story with a patient where you really saw firsthand the power that hypnosis can have on a struggle that a patient is going through. Anything that comes to mind? Yeah, yes, Drew, the first time I did it, I was taking a core. I mean, there's a bit of a genetic component. My father was a psychiatrist who used hypnosis in World War II actually to help wounded soldiers and deal with PTSD. So I was introduced to the concept.

But I took a course in medical school and I was in the Children's Hospital in Boston. And this nurse says to me, your next patient, Spiegel, is down the hall. She's got an acute asthma attack. And I walk into the room and there's this pretty 15-year-old girl, Knuckles White, struggling for breath. I could hear the wheezing is down the hall. and her mother's standing there crying and the nurse tells me that they tried epinephrine twice and it didn't work and they were thinking about general anesthesia and starting around steroids and I had just taken this course I didn't know what else to do so I said would you like to learn a breathing exercise and

she nods and I said okay I get her hypnotized and I said each breath you take will be a little deeper and a little easier so I was breaking the frame a little bit that is she's desperate everything they've tried so far hasn't worked. This was her third hospitalization of three months in status asthmaticus. And I'm saying I can do something that will make you feel better. So I'm beginning to change the expectational set, only I had no idea myself whether it was going to do anything. And we hadn't gotten to asthma in the course. And I thought, well, what am I going to say to her now that she's hypnotized? But she was in a state where she's beginning to feel different already just by being hypnotized. So that lays the groundwork for somebody thinking, well, maybe something else good is going to happen here.

And so it's that cognitive flexibility part. And I just said, to her, each breath you take will be a little deeper and a little easier. And within five minutes, she's lying back in bed. You can't hear the wheezes anymore. Her mother stopped crying. The nurse ran out of the room. I was kind of stunned myself. And my intern comes looking for me. And I figure he's going to pat me on the back and say, nice job, people. What the hell did you do? And he said, he's, and he's, he's going to. And he's, says, I want you to know that the nurse has filed a complaint with the nursing supervisor that you violated Massachusetts law by hypnotizing a minor without parental consent. Now, Massachusetts has a lot of weird laws, but that's not one of them. And he said, so you're going to have to stop doing this.

And I said, oh, really, why? He said, well, you know, it might be dangerous. And I said, you're going to put her on steroids and you think my talking to her is dangerous, you know. And he said, well, you've got to stop doing it. I'll tell you what. Take me off the case if you want. You can do that. But as long as she's my patient, I'm not going to tell her anything I know is not true. And so I thought, well, it's been a nice career, Spiegel. Over the weekend, the intern, the chief resident, the attending all meet. And they had a sort of counsel of war about what to do. And they came back on Monday with a radical idea. They said, let's ask the patient. I don't think that had ever happened before. And she said, well, you know, I kind of like this. And so we kept doing it. She did have

one subsequent hospitalization, but went on to study to be a respiratory therapist. And I figured that anything that could, you know, help a patient that much that fast, frustrate the head nurse, violate a non-existent Massachusetts law, had to be worth looking into. And so it was really an aha moment for me where I thought, you know, you can actually do something real for a patient just by the way you structure their experience. A powerful story. Now, a couple questions for you on that story because it was such a pivotal one. And early on in your experience, did you call it hypnosis with the patient? How did the nurse even know to say that you hypnotize somebody? Did you use that term with the patient? Yeah, I did use the term. I said, yeah. Let her know, like, hey, listen, I'm going to teach you this thing and breathing and it's hypnotherapy. Yeah, yeah. I mean, I didn't go into a long explanation. You know, sometimes the second time you say, no, it means yes. You know, the second time you You say, this is all safe and wonderful. People start to wonder where you're telling me.

But, yeah, now that you mention it, Drew, I'm not sure whether I said breathing exercise or hypnosis, but it clearly had the structure of hypnosis. I had her look up and close her eyes and take a deep breath and imagine her body floating. And so I was willing to tell her this was something unusual that's going on. But I think that was helpful. Even if it may have worried her and her mother a little, you know, it was, it was, is a statement to them that something different may happen right now, something unusual may happen right now. And that's not a bad thing. That's a good thing. It's a little bit of a palate cleanse

to sort of, hey, we're going to try something new here. Right. Exactly. Exactly. In your embarking down that process and practicing hypnotherapy with this young woman, one of the things you mentioned earlier was this idea of some individuals are more hypnotizable than others. Talk about that. Who is, who isn't. And in the case of this young woman, did you assess her first to see if this would work? Or did you just kind of say, hey, let's try this at least. We have nothing to lose. Yeah. Well, first of all, hypnotizability is an interesting, stable and measurable trait. About a third of hypnotize of adults are pretty hypnotizable. About a third somewhat and about a third, not very much. Most eight-year-old children are in trances most of the time.

You know, you call them in for dinner. They don't hear you. They're work and play. They're all the same thing for kids. So hypnosis is a more childlike experience of the world where feeling something is as important as thinking what's going on. And as we train people to value logic more than experience as we do in adolescence and in school, some lose that ability.

By the time you're about 21, your hypnotize ability is as stable as your IQ over a 25-year interval. There was a test, retest study done. 25 years later, they retested former Stanford students and found a 0.7 correlation between their college hypnotizability and what they had in midlife. So it's a pretty stable trait. And I routinely test people. It takes about five minutes. And at Revery now, we're actually going to mount an automatic automated hypnosis. hypnotizability test on the app very soon so people can tell for themselves how hypnotizable

they are. But the nice thing about it is even if you're not hypnotizable, sometimes just the way you're approaching the problem can be somewhat helpful. It tends to be more dramatic and immediate with people who are highly hypnotizable, but it's not going to do you any harm if you're not. What do you think makes somebody more hypnotizable and somebody less? Do we know that right now? Well, we know from our fMRI studies that people who are more hypnotizable have naturally more functional connectivity between the executive control network and the salience network. So thinking and feeling it's okay to be thinking about that go together more easily in people who turn out to be more highly hypnotizable. Those two brain regions are used to coordinating with one another. How does that happen? There's kind of a good path. There's a genetic component to it. People,

who have a variant of the gene that metabolizes dopamine, which is a major neurotransmitter, particularly in the frontal parts of the brain, and energizes you, engages you in search for new things. The people who metabolize enough that they don't have too much or too little turn out to be more highly hematizable. The genes involved, methionine and valiase, are equally represented in the catechol-o-methyl transferase gene that metabolizes dopamine. So we find that there is a genetic component, people who have that particular version of that gene. There are also experiential components, and there's a good one and a bad one.

The good one is what we would call imaginative involvement. So parents that like to read their kids' stories at night before they go to sleep, who engage in imaginative play, get the kids to use their imagination, Those kids tend to retain more of their hypnotize ability in adult life. And the bad one is that kids who have been abused, who have been mistreated emotionally or physically, often escape. One, I had a patient who sadly died recently as an adult many years later of natural causes. She told me that when her father and his friends would come and sexually abuse her, she said, I'd just go to a mountain metal full of wildflowers. You know, she would just leave her body behind.

And many rape victims report floating above their bodies feeling sorry for the person who's being assaulted. It's a defense mechanism. It helps you. You know, like I said, you don't want to get the full picture when it's happening. And so those people who have been abused tend to retain more of their hypnotizability later in life because it was so important to them early in life. A self-defense mechanism, as you mentioned. That's right. Separate from the abuse situation, and obviously those are horrible,

that's a horrible scenario for anybody to find themselves in, but separate from those situations that would cause somebody to be more hypnotizable, I'm generally hearing that being more likely to be hypnotized, more hypnotizable is correlated with kind of a lot of positive things that are there. And I guess that I'm bringing that up because I guess in the old way of looking at hypnosis for people who are just thinking about it from what they've seen on stage shows with stage hypnotics, or being portrayed negatively in movies, you would think that if you are going to be more likely to be hypnotized,

that that would be somehow a negative thing. So now we're hearing that that's not the case. No. Because that probably means that you know how to use hypnosis to modulate a whole bunch of different things that you want to have happen or don't want to have happen in the body, including reducing pain if you find yourself in that situation. I had a wonderful professor, Tom Hackett.

who was chair of psychiatry of mass general at Harvard, who taught my course. He's the one who taught me to do it initially. And he said, you know, being hypnotizable is so good in so many ways. He said, I would gladly trade 10 points of my IQ for two points on the hypnotic induction profile. And I said to him, Tom, I think you've gone and done it. But yes, it is. You know, the people who can, you know, throw themselves into things, who enjoy novelty, who embrace novelty, who can be cognitively flexible, you know, see things from other people's point of view.

There are times when it goes too far, and I tell patients, be careful for you, you're the kind of person who will too easily take on some other person's point of view. Now, if, you know, if you think hypnosis is dangerous in that regard, remember that 70% of Republican adults think that Trump won the election. I mean, you know, people can be aberrantly influenced in ways that at least overtly don't involve hypnosis. And I had a patient once who said, you know, I'm a disciple in search of a teacher. You know, she was a very bright college professor, but she kept seeing other people's

point of view as more impressive than her own. And some people do that. So it can be a disadvantage, but they're the people who can tremendously enjoy creative processes, who can enjoy going to theater, who can enjoy, you know, a new adventure on a vacation, who get lost in a sunset, you know, that experience of just being overwhelmed by the beauty of what you're seeing is a hypnotic-like experience too. And the Olympic ski team that was at the Sochi Olympics where that, you know, who Putin insisted the Olympics would be in Russia,

even though there was very little snow, could only practice one run before they had to compete. And the team went up, stood at the top of the run, looked up, closed their eyes, and imagined every move all the way down. And they did extremely well. So, you know, just the way you've talked about visualization and how you prepare yourself for something by thinking your way and feeling your way through the event, that's a hypnotic-like experience. And so it, you know, like any human trait, there can be advantages and disadvantages.

But I agree with my hypnosis professor that a couple more points in hypnotizeability are an advantage. So making that connection clear for myself, you know, you mentioned it pretty quickly, but you were talking about. around the age of eight, you know, kids have this childlike sense of wonder where a lot of what they imagine and what they experience, like, it's just all real for them, right? That's right. So that childlike sense of wonder, that sense of play, being able to step into a story, I've heard you on another interview with a friend of the podcast and acquaintance of the podcast, Andrew Huberman, you said there that peak, our peak ability to be hypnotized is in that age range,

Like six to ten, you were saying. That's right. So is it to connect those two dots together with what you said previously, are you then saying like part of our ability to step into hypnosis is maintaining that childlike sense of wonder? Right? We want to maintain that. Were there any ways with your father's background in this world of hypnosis and I have a few questions on that, which I'd love to get you, was any ways that your father encouraged you as a child to keep that childlike sense of wonder?

whether he did it on purpose or whether it was just a natural part of how he raised you. Well, I think it was more just kind of intellectual curiosity. I mean, the dinner table conversations were interesting, and I remember going to see him film a movie of a patient who had hysterical seizures. You know, she looked like she was having an actual convulsion, but she wasn't. And he could hypnotize her and bring on the seizure. And then he gradually taught her to, control it. You know, you can't tell someone like that to stop it, but you can tell them to start it.

You bring them back to a time when they had a seizure before, and lo and behold, they'll have another one, and you're beginning to teach them that there's a way that they can learn to control it. So I remember being on Terry Gross years ago when I had a book come out, and she was doing a very nice kind of, you know, straightforward interview about hypnosis. And then all of a sudden she gets journalistic on me and she said, your father was well known for hypnosis. Did he ever try to hypnotize you when you were a child? And I said to her, I don't think so. And she said, okay, okay. So, you know, once or twice he tried doing like the test, the hypnotic induction profile, but as far as I'm aware, he wasn't hypnotizing me in other ways. Going back to this idea of people seeing if they are more

hypnotizable. There's kind of like a quick little test that people can do, right? You mentioned the full test that you're building into the app that you guys have built, you and your incredible team, but walk us through something quick that people can do to just get a sense of stuff. This is a guess, this was my father's discovery. And he, actually, that patient I mentioned, who had the seizures, he noticed that when she would go into the seizure state, her eyes would roll way back up in her head. And all he would see was the whites of her eyes. That was And then she'd go into the hypnotic state. And when she'd come out of it, often her eyes were still rolled way up in the back of her head.

And the next Monday, he had a very obsessional patient who asked him a million questions and argued with him and was very difficult. And he asked him to look up at a point on the ceiling, close his eyes. And he couldn't keep his eyes up. He had to bring them all the way down. And he began in examining people to realize that there was a, seem to be a connection between the ability to dissociate lowering the eye with lowering the lid, which is hard to do because you're asking some of the cranial nerves to do contradictory things.

And that people who seem to be more highly hypnotizable actually could keep their eyes up, dissociate lowering the eye from lowering the lid, whereas people who weren't brought their eyes back down. So he developed a measure he called the eye roll test. and you just ask someone to look up while they're closing their eyes. I can ask you now if you want. All right. So look up all the way, past your eyebrows, all the way up, keep your chin down, but look up. That's it.

And as you keep looking up, slowly close your eyes. Look up, close. So, okay. Was that too quick? Well, try it a little slower. I got an idea. Look up, close, close, close, close, close. So you're about a three out of four.

Your eyes, your irises didn't disappear, but they stayed up even as you closed your eyes. It was difficult for me to close my eyes. It is, isn't it? It's hard because you're dissociating lowering the lid from lowering the eye. And eye movements are very much associated with our arousal, with our alertness. The cranial nerve nuclei are surrounded by the reticular activating system and the brainstem that regulates arousal. drugs that influence arousal put you to sleep will affect your eye movements. And so it's not that surprising that the way you handle your eye movements may have something to do with your level of arousal.

So you gave me a three. Three out of four, right. Out of four. Right. So that would mean what? That you are likely to be at least moderately, if not more highly hypnotizable. Okay, great. So that's a score.

That's a score. Yes. That's it. Well, connecting it back to, again, your original point is that in this example, where you had the young woman who had the asthmatic episode, 15 years old, nothing was working for her, everybody was worried, her mom was crying, in that instance where you suggested, or you just let her know that this is about to happen, you're going to take her through a little process of hypnosis, you can pretty much instantaneously, as she saw, you saw whether or not

this thing worked or didn't work. So even if somebody is on the fence and not sure if hypnosis can be a tool for them, they can still give it a shot. Right. Because what do you have to lose? What do you have to lose? That's fantastic. That's exactly right.

Talk a little about how you have used hypnosis in your own life in, you know, separate from your wife using it when she was in the process of labor. Is there anything that you've used hypnosis for as a process for your life in the way that you might work with it with individual patients? Sure. Well, there been a couple. One kind of funny one was. I was trying to learn water skiing.

And, you know, I kept winding up on my face in the water. I just, you know, the boat would start and I'd, you know, fall down. And then I remembered that I had to program my body that the position for water skiing is arm straight, knees bent. So I did a little self-hypnosis and I just told myself, arm straight, knees bent, arm straight, knees bent. And the next time my arms were straight and my knees were bent and I didn't fall over. I was doing the opposite.

I had my arms bent and my knees straight. over I went. So I began to see that it was a simple way of programming my body to work well. Another time... And so can I ask one clarification of that? So in that example, if we had a sort of Venn diagram, what's the overlap and the difference between hypnosis and visualization? Well, I think there's a lot of visualization that is hypnotic-like, that I think you're not just thinking about it, you're experiencing what it would be like to do it. So you're pulling in the sensory and motor circuits. It's not just a concept, you know, what would, what should I mean? You're feeling it. You're feeling it. You're experiencing it. And you're programming the parts of your body that sense

what's going on and the muscles that have to do it to act as though they were doing it. And so you're, it's experiential. It's not just cognitive. And does that mean that also as you're imagining yourself skiing, water skiing, that you're smelling the ocean or you're smelling the water or that you're feeling it sort of, do you go through that? Yeah, I do. And I was trying to feel the surge of the power of the boat, you know, which is a little threatening at first, you know, and either you let go or you fall down or maybe you stay up and you have a good time.

So I'm thinking in that context, I can still maintain control over what the parts of my body are going to do. So visualization could be more thinking related, but hypnosis is not just the thinking part, it's the actual feeling. You're using your senses to feel through that process. That's exactly right. The somatosensory part. And, you know, another time I had a dislocating shoulder repeatedly, which was messing up by vacations and things. So I had a repair done. It was a three-hour surgery. I had general anesthesia. But afterwards, I just did self-adgnosis for pain control. You know, I just, my shoulder is cool, tingling, and numb. I was fine. And I was, it was at the hospital. I

worked at Mass General, so I got to read my chart, even though I wasn't supposed to. And the surgical resident wrote, patient using very little pain medication, we mustn't have cut many nerves. See, and that's that, you know, mechanical view of what it is. You know, and I have a, you know, a scar from here to here, I can assure you they cut nerves. So it was, you know, it was incredibly useful by just restructuring my experience of the discomfort and partly my reassurance that the surgeon did a good job. Nothing was going to go wrong in my shoulder and moving it a little bit was not going to tear the sutures apart. And so I was my way of reassuring myself, but also knowing that I could literally change the amount of pain. And I would sometimes be surprised at how little pain I felt

afterwards, you know, should have had more pain, but I didn't. Just like we described the differences and the similarities of visualization and hypnosis, can you talk about with meditation? We chatted about meditation a little bit earlier. What are some of the differences there that you see between hypnosis and meditation and some of the similarities? Sure. There are, you're right, there are similarities and differences. I have great respect for meditation. It's a tradition that's been around for a very long time. But it's Eastern. And so part of what's different about it from hypnosis is that you don't do it to solve a problem. You do it to be different, you know. So the idea is that you cultivate open presence and in which you don't fight feelings, you just allow them to flow

through you and see what happens. So you decrease your resistance to them. You do a body scan, which is a little more hypnotic like, where you're sensing what sensations are in different parts of your body. And you cultivate compassion with other people, which is a wonderful thing to do. So it's partly trying to kind of create selflessness. Now, I think hypnosis does that in a much more focused and transient way, where when you're focusing on one thing, you're disconnecting from your usual expectation of who you are and what it means and all that. So there's a kind of mini-dissociation rather than the kind of selflessness that comes as a kind of goal of meditation over a long period of time. And with hypnosis, you can do something very quickly. I mean, one of the cool

things about what we do in the Rivery app is you will know whether you're going to feel better within a few minutes, within 15 minutes. Either you have less pain or you don't. Either your stress levels have gone down or they're not. Either you're asleep or you're not. That's not the idea with meditation. The idea with meditation is to just have a consistent experience. Do it like John Kapp at Zen, my friend does 30 minutes twice a day.

Make it a regular practice, which I have great respect for, but the goal is different. And the idea, and Judson Brewer at Brown has done some very interesting neuroimaging studies showing that the main. change in mindfulness, unlike hypnosis, which I described earlier, is reduced activity in the posterior singular cortex. And that's very consistent with the meditation goal of selflessness. You're literally turning down the bar of your brain and experience meditators do this, that reflects on yourself, has this conception of a self that needs. And it's interesting that that's also an effect that happens with people who take psychedelics, that activity is turned down

in that region of the brain as well. So there is therapeutic potential in doing that, but in hypnosis, it's a briefer and more problem-oriented kind of selflessness where you say, I'm different from the person who was just suffering five minutes ago. And I didn't think I could be, but I am. I love that distinction. I've heard you say it before, which is that hypnosis is a very good at problem-specific technique. There could be a lot of reasons why somebody might do visualization.

there could be a lot of reasons why people might tap into the power of meditation. There's a lot of benefits that are there. But this is really if there's a problem. There's a problem. Now we're going to use hypnosis as a tool to bring some sort of relief that's there. That's exactly right. So you eloquently described how that happens in the world of pain. Let's talk about sleep as another big topic of something that people struggle with, but often

not really knowing exactly what tool to use with that. So for people with hypnosis for sleep, is there particular aspects of sleep that are improved with hypnosis? For example, some people have a hard time staying asleep. Sometimes people have a hard time falling asleep. So is hypnosis for one of those in particular or another version of that that I didn't bring out? Well, I would say there are two sort of arousal anxiety related problems with sleep. And one of them is falling asleep. And another one is waking up and getting back to sleep.

And often, you know, there are things, you know, that you arouse yourself if you wake up in the middle of the night and you look at the clock and you think, oh, damn it, it's three in the morning. I won't get back to sleep. It's a bad thing to do. Turn your clocks around. Don't look at them when you wake up. So don't look at the clock. Don't look at the clock. But what you have in common is that you can separate your, what's running through your head at the time.

You can choose what to think about. Rather than thinking about how nasty your boss was to you, think about something you accomplished at work, or think about a friend you were with that you comforted or something. Think about something that would naturally be soothing rather than arousing because sleep, you want to turn off your sympathetic nervous system and turn on the parasympathetic, the self-soothing component of your autonomic nervous system. And that's why an alarm clock wakes you up, is that it triggers this sympathetic nervous system arousal. Your epinephrine starts firing. So you want to turn that off. So picture yourself somewhere you feel safe and comfortable, get your body floating as if you're in a bath, a lake, a hot tub or floating in space.

And then project your thoughts onto a screen. So it's like you're watching a movie, but it's out there. It's not inside your body. So you're separating the physiological from the psychological arousal. Now, I don't have any evidence that you can keep yourself with hypnosis from waking up, with one exception. There are people who have parasomnia, sleepwalking, who will wake up. I think what they're doing is going from a dream state into an awakened, into a hypnotic state without waking up first.

And so they'll be sort of acting as if they were in a dream and they'll start wandering around the room. Some people... I used to have the issue out as a kid. Did you really? Yeah. You must have done some funny things. I used to wake up in the middle of the night.

Well, not awake, but I'd be up and I would be thinking that I'm dreaming, but I'm exploring, you know, we're spending the night at my cousin's house or something. And I'm in like a dream state, but I'm not fully awake. And I like triggered their alarm in their house. You triggered the alarm. Everybody woke up and was like, what happened? And by that time, I'd already gone back to bed. That it does happen.

And there I have used hypnosis with people and I give them a hypnotic suggestion that if you feel pressure on your feet, that will wake you up. So in other words, if you're getting out of bed and you're walking around, that will. That's a signal. That's a signal. And that has sometimes worked, that it's a way of making the connection because I think you were in a hypnotic-like state when you were a kid and you were just still half dreaming, half in hypnosis, wandering around and doing physically something like what was going on in

your dream. And I'm glad you stopped. People can hurt themselves sometimes. It's not always a good thing. I can imagine. So when it comes to sleep, would you use the same general process of hypnosis once somebody finds out, you know, what that is for them to both fall asleep initially and then if you wake up later on in the night and you're having trouble getting back to sleep, could you use the same

version of hypnosis? Yes, exactly. Pretty much the same thing that you just look up. And that's where the reverie app is helpful because if you, you can, some, a lot of people just remember it and do it that way, but your phone's next to your bed, you can turn it on and listen to my blue flu's voice talking you back into being asleep again. So you can do it, you can do it either way. But yes, it's pretty much the same approach.

It's fantastic. Going back a little bit, you know, you mentioned about your dad and I said I was going to ask a few follow-up questions. So just clarifying a little bit for the audience that was listening. We got a little part of the story. What was your father's first introduction into the world of hypnosis? Well, he was in training to be a psychoanalyst. It was back in the 40s. And any psychiatrist who was anybody was interested in psychoanalysis and Freud's theories had just recently crossed the Atlantic. And, And he got off the couch one day. You do a daily analysis as part of your training. And his analyst finally said something to him. He said, Herbert, would you like to learn about hypnosis? And my father said, what did I say wrong? You know, why are you asking me this? And he said, no, there is an Austrian refugee psychiatrist, Gustafana Schaffenberg,

who cannot be in the U.S. Army to fight the Nazis. but he wants to pass on a skill that he acquired as a forensic psychiatrist. And the way he got it was he'd had smallpox as a kid and he had a big scar right in the middle of his forehead. And he noticed that when he was treating, he was a forensic psychiatrist treating some of these prisoners, they would look at his scar and suddenly their heads would sort of turn to the side and they closed their eyes and they were in a trans state. So he got interested in hypnosis and he taught my father and a number of other young

Army doctors how to use hypnosis. And they used it for, you know, pain control when people were wounded in combat. They used it to treat post-traumatic stress disorder. And that's how he started doing it. He gets back after the war. He was wounded himself. He shell fragment broke his leg, and he was recovering from that and getting back into analysis. And he was told by a senior analyst that he better stop using hypnosis because he'll ruin his reputation. And after all, Freud gave it up so who are you to keep doing it? And Freud started his studies in hysteria with using hypnosis. And he actually stopped one day when he said a woman woke out of her hypnotic state when I was tracing her attacks of pain to their traumatic origin. And she threw her arms around my

neck. And Freud wrote, I was modest enough not to attribute this event to my own irresistible personal attractiveness. And I discovered the mysterious element of work beneath hypnosis. And there's a couch and analysis because he used a couch to hypnotize people. And when he was going to have them then keep their eyes open and free associate, he moved his chair around behind the couch because they didn't like people staring him in the eye. And so from an analytic point of view, that was the end of hypnosis. But he had a wonderful supervisor, Frieder from Reichman, who said to him, he told her that. And she said, Herbert, what are you feeling so precious about your reputation? You haven't even got one yet. You're going to teach a course at our Institute in

hypnosis, and I'm going to take it, so you better do it. And so he kept doing it. He kept using it. And he began to discover after about 10 years that he was getting farther with a few sessions of hypnosis than he was with patients who he was analyzing four times a week for years. And so he... And in that example, do you know what he was helping that? with? What were they stuck on? What were the things that were there? Was it trauma that they had experienced? Was it some of the categories that we've talked about? Pain, sleep? It tended to be more anxiety, stress and anxiety sorts of problems. He did saw some people who had been traumatized, but it was more performance anxiety. He actually, he had one famous actor who came to him and said,

Herbert, I lost my butterflies. I used to be more, he actually wanted help being more anxious because he said he wasn't acting as well because he wasn't as nervous about his performance. Interesting. And he began to see more people who just needed help with things like stopping smoking. And so he found that, you know, I can do more for them by getting them to stop smoking than having them reflect on how their parents raised them and what happened early in life and toilet training and all that. So he shifted over more to stress management, some insomnia, and social anxiety kinds of problems.

and then habit problems. And he did one study where he found that after a single session of self-hypnosis, half the people stopped right away, and 23% didn't touch a cigarette in two years. And so he began to see that, you know, and then at the time, we weren't doing much in the way of follow-up studies on any kind of psychotherapy. Now, of course, that's standard, but it wasn't that. So the kinds of problems changed somewhat, but it was still more anxiety, social anxiety sorts of problems that he was dealing with.

Has any of the work with smoking cessation continued when it comes to hypnosis? Yes, and we're doing it now with reverie. And we just found that the first study I did with Ariel Polar that 19% of the people who use the app stop smoking. And, you know, that's about as good as with many of the medicament of verena clean and bupropion and other drugs, it's not so different from that, but all it is is practicing self-hypnosis

and listening to the app. So we're excited about doing that, and it's one of the things that we have on Reverie. And part of the theory that he helped to develop was focusing on what you're for and at what you're against. So we don't tell people, you know, I remember seeing signs on the highway, are you dying for a smoke?

And, you know, people would think, yes, I am. I think I'll have a cigarette. But instead you focus on respecting and protecting your body, on what you're for. For my body smoking is a poison. I need my body to live. I owe my body respect and protection. You know, what would you, you know, would you think of putting tar and nicotine into the lungs of your baby, you know, or of your pet dog or anything else?

No, you never would. So you can feel good from the moment you make that commitment. And that's what helps some people get the momentum to say, I'm not depriving myself of something. I'm doing something important to protect and respect my body. That's really interesting that in hypnosis, you guys have found that being for something is more important than being against something. Right. When typically a lot of the research and the work of often like goal setting is that often

like a negative stimulus initially might be more of a initial stronger motivating factor than a positive. What do you equate that to? Well, I equated to what we talked about earlier about this aliens network, that, you know, it is true that, you know, much social media grabs your attention by running something threatening by you and you better pay attention to that. But if you want something that will make you feel good by sustaining your attention to it, it's focusing on what you're for. It's on respecting and protecting your body, feeling good about it. And it's been known for a long time that showing people of, you know, cancer destroyed lungs just turn. turns people off. They run the other way. They don't want to. They check out. They're used to it. They're going to buy it anyway. Yeah, I know it's terrible, you know, but, you know, and whereas if you give them a way to have immediate positive reinforcement, and that's turning down this salience network, feeling good about something, not feeling bad, not feeling scared, feeling good, it makes you feel

good to continue. It gives you positive reinforcement for engaging in the practice that you want to change to. And that principle, intermittent positive reinforcement, we know from experimental psychology, is the best way to change behavior, you know, tell someone something positive, not something negative, you know. If you were to take the power of hypnotherapy and integrate it into just our entire sort of medical approach, what would be some big picture things that you would do with the magic wand if you were given it? If I were given it, I would, you know, teach people that they have this tremendous power

to collaborate with their doctors in their care, that you can help them, help them, help themselves, that they can focus on how they better manage their body, deal directly with their anxiety about it, but not let the anxiety drive them, manage the anxiety, manage the pain, manage the symptoms, help your body to feel better by sleeping better, by eating better, that you become a partner. And a lot of the interest in integrative medicine has come not so much from medical staff, but from patients who, you know, spend more out of pocket for integrative care than they do out-of-pocket for mainstream medical care.

They make more visits. And I think it's in part because they want to be in a situation where they're contributing to their health care. And rather than disrespecting their ability to control it, I want to respect it and teach people how to promote it, how to do it well. And I think that will help people. I see a lot of people who want to feel more in charge of their own bodies and more in charge of their own care.

And that can mean cooperating with your doctor, but doing it in a way that. that honors your ability to control and regulate how you react to whatever it is that's going on. What have you seen from your work or research or through the feedback that you got into the app in terms of frequency or quote unquote dosage of using something like hypnotherapy when it comes to, for example, pain, a subject that we were dissecting a little earlier? Well, people, you know, the thing about it is it's a tool that's always available. It's in your head. You've learned how to use it. And we did a study with women with metastatic breast cancer.

We had them meet once a week to deal with their fear and anxiety about the disease progressing, to help one another cope better with it, to use their expertise as patients as an advantage, not a disadvantage, and to practice self-hypnosis. And we found over the course of a year in a randomized study that the pain levels of the women who were taught self-hypnosis were half as high as the pain levels in the standard care, and they use the same amount of medication and low, not a whole lot of pain medication. And so the idea here is that you know you've got it if you need it. So people can sometimes do it every day or any time they feel pain.

Sometimes they certainly did it once a week in that study. But the nice thing is that you don't have to practice it every day. I think there's a kind of ramping up period where it's very important at the beginning to do it. I'll tell people every one to two hours, anytime you have pain, don't fight it, admit it, go into the state of self-hypnosis and reestablish your control of the pain. Don't wait till it gets bad. But then after a while, you've got it when you need it. So you do it when the pain starts to build up, and you can do it that way.

So it's something that's a tool if you need it. You've got it in your quiver, and you can use it when you want to. Do you see the same thing when it comes to sleep as well or even the topic of stress, which was your other top two that you listed in three things that hypnosis could be used for? Yeah, it's the same thing. To use it to get to sleep or to stay asleep. after a while, you know you've got it. And so if you have, you know, somebody once said that losing sleep is nothing to lose sleep over.

It is. But it's, it's, you've got, you know, you feel better just knowing that if worse comes to worse, here's what I can do to help myself get back to sleep. Is there a part of you that remembers some of the principles of hypnosis, even if you're not necessarily doing it? Therefore, it becomes more of your natural reaction to a situation. without actively engaging in hypnosis. You're absolutely right.

And there is a study by Ocky-Telligan, the University of Minnesota, who developed what he called an absorption scale. It's a measure of people's tendency to get lost in sunsets or movies and to go into these kind of altered states spontaneously. And that's highly correlated with hypnotizability. So people do, yes, it becomes a kind of way of being for them, a way of life. and they don't always have to formally say, I'm going to put my arm and float up in the air

and let my body float. They just naturally start to do it. And I think many good performers do that. You know, you ask, you know, many good actors, you know, the method in acting is to be the person you're acting, you know, not to think what would that person say, but to become that person. And I think many good actors are highly amitizable.

And you tell them you were great in that. And they say, I don't know, I was just, you know, I don't know what I did, but I was being that person, and that's what came out. And so that kind of experience doesn't necessarily need formal entry and exit to hypnosis, but it is hypnotic-like. What are the limitations of hypnosis, right, within the context of this conversation, right? So not just saying any random limitation, because everything has limitations, but what are some of the limitations that people should be aware of when it comes to hypnosis?

Well, you know, I think anything that has the power to help has the power to hurt, you can, you know, hypnotize yourself and panic yourself. You know, you can focus on all the wrong things. You can focus on what you're afraid of rather than what you can do to cope with it. Are some panic attacks that you will have a version of them hypnotizing themselves for essentially a version of harm? I think that's a very good example. Yeah, you know, people go from feeling the pressure and the their chest and their fear to thinking I'm having a heart attack. I'm having a heart attack. This is going on. WebMD. This is exactly the situation. Right. Right. And now they can almost create that inside of their body. They can create it. That's right. And so you can make things better. You can make them worse. That's a very good example of it. Are there examples where you have genuinely seen hypnosis be used for something not good on someone else? If people have any sort of general fear about working with hypnosis. Self-hypnosis through an app may be one thing, but working with the practitioner, a teacher. Have you actually heard of or seen any examples of hypnosis being used

for some sort of malfeasance? Yes, I have. You know, I've seen situations where, I mean, I was involved in one terrible legal case where a woman was seeing a sort of hypnotherapist with like five things on his card of all the magical things he could do. And the next thing, the next thing, next thing you know, so she, he quickly gets her into a sexual relationship, which is malpractice by any standard. And then, um, suddenly he's driving her new BMW and she's driving his old beat up Toyota. And the next thing you know, she's written a will where she's turning over her business to him. And the next thing you know, he, she got a phone call from him one night. She gets up at midnight, dresses in black, drives in a bicycle without a light, and gets killed by a truck on the, on the

highway. And we won a civil case, you know, about saying that he was programming her to turn everything over to him and then get herself killed. Now, that's a pretty extreme horrible case, but it really happened. And so, yes, you know, God knows there's enough in the newspaper with Me Too and other things that people will take advantage of other people in horrible ways. Even without hypnosis, but it is also true. that there are times when people will suspend critical judgment and allow themselves to be manipulated. And again, there are lots of examples of manipulation without hypnosis, but it can happen with it too. So is there anything that people can do to protect themselves from that, if that's something that

is out there, even if it's in the rare minority? Well, that's a good question. I actually take our hypnotizability test because people who are highly immunizable are more vulnerable to seeing things from other points of view. So if you scored a four out of four, then you might be, how would you navigate if hypnosis is still something that you want to try?

I think it's good to use it, to learn. Doing it is not a bad thing, but what you want to do is learn what it teaches you about yourself and that it's great if you can affiliate with and act upon positive things, but many people with hypnosis will tell me, frankly, you know, I tend to fall for things. You know, my father had a playwright as a patient, pretty well-known playwright, who kept getting hit up by people for all kinds of charities.

And his accountant said to him one day, you know, you're doing pretty well, but you're not doing that well. And you're going to be broke if you keep doing this. And he kept saying, it seems like a good idea at the time kind of thing, you know. And so my father said, here's what you're going to do. You're going to arrange a checking account where any check for more than $100 has to be countersigned by your accountant. And so what he would then do was smile right out of the check. for $500, hand it to the guy and say, and here's my accountant's card, I wish you a lot of luck, you know? So sometimes you have to make arrangements to protect yourself from your own good

intentions. And so being aware of that is a good thing, actually. That's fascinating because my extrapolation of that would be that there are some people that even if they're not trained in hypnosis, they might be good at manipulating people. And so they can take advantage of you, and that could happen in dating. that can happen in, you know, just business and sort of life. And so if you're one of those people, you should maybe find out if you're highly suggestible and make arrangements accordingly.

Yes, I think it is wise to be aware of it. That's right. And God knows we've seen enough experiences of that in which unreality is foisted upon us as reality, you know, in this country. And there are a lot of hypnotizable people, maybe some who aren't, but a lot of people have fallen for nonsense

about election integrity and all that. So yes, I think it is wise to be aware of how influenceable we are. Could you use hypnosis to make you less suggestible of a person? I really like that. That's cool. Well, you know, one sort of example of that is the sleep instruction I was talking about where you say you're going into a hypnotic state. You will be made aware of it by a signal from your feet that you're touching the floor and come out of it. And so I think there are times when you can sort of program yourself, you know, to sort of try and enhance your awareness of the danger signals, you know, that something's going on that just somehow doesn't feel right.

Because in hypnosis, you're kind of more open to your cognitive, emotional, but also physical sensations. And so you can sometimes sensitize people to that sort of physical arousal when you feel like something's wrong, but you don't know quite what it is. pay attention to that and figure out what it's telling you before you go any farther. So yes, there are ways you can use it to help people be more aware of that. And can people partner hypnotherapy with other modalities? Generally speaking, is it, you know, in the topic of chronic pain?

Often people might be working with an integrative practitioner or somebody who gives them some things to help with chronic inflammation or whatever it might be. And is there any challenges with integrating hypnotherapy along with other modalities that people are doing? No, I think it's a very good idea. You know, I think there are principles of cognitive behavioral therapy that could be linked. It's a much more sort of structured, focused, less experiential kind of therapy, but there are principles of it. You know, the sort of recognizing, for example, the difference between something that makes you anxious and the feeling of anxiety. You know, people tend to identify what they're worried about with how anxious they feel about it.

And if you just say, what you know for sure is that you're anxious, what you don't know for sure is whether that is going to make you more anxious or not. So you could program people to kind of, when they start to feel anxious, to, you know, close their eyes, go into a hypnotic state. And I sometimes use an imaginary screen. Picture on that screen, one thing that makes you anxious, but something else that might reassure you. So you have a more balanced view of it. You can process it differently and not let your mind get taken over by the feeling of anxiety

as if it represented truly how dangerous the situation was. I'm asking this because I've never stepped into the bucket of hypnotherapy, but I'm excited to jump into it, try your app out. You know, Revery app, it's in the show notes. People can download it, check it out. Great. But I noticed that sometimes, and this happened for me when I, early on, sort of venture into the world of meditation, which again, is different. We talked about the

differences that are there. But often this narrative that's in people's head that is this really going to do anything? Is this going to work as they're sort of going through that process? Does stepping into hypnosis and using one of these, you know, apps or self-hypnosis tools like what you've built, does it take, even though you say that it's pretty much people will know right away whether it works for them or not. Is there a little bit of that getting rid of the narrative that has to happen before people can fully take advantage of it? Well, you know, I'd say that the biggest obstacle is just the sort of initial reluctance, the belief that it's, you know, it's voodoo or magic or nothing, you know, that people have two extreme fantasies about it,

that either it doesn't do anything and it's ridiculous or it's really dangerous, you know, don't do it. And neither of those is true. And so I worry more about people. people that don't give themselves the opportunity, give it a try. You know, I say, try it, you'll like it. If it doesn't work for you, fine. You'll know it very quickly. And so I think it's the sort of things before you taste the food that are the biggest obstacle. And, you know, try it.

If it tastes good, if it helps you, if you feel better good, if you don't. Fine. But I think the sort of cognitive expectations are the biggest problem. If I'm sleeping okay, I don't have pain at the moment, knocking on wood because I have a lot of areas of my life that I work on, you know, I try to be fit and work out regularly. I prioritize my sleep. I've been doing these things for a while. If I wanted to improve an area of my life, give a little bit of love to something. Can I still use the power of hypnotherapy?

Absolutely. Absolutely. And again, it's, you know, we talked about the focus on what you're for and what you're against. You think to yourself. And I think you've done with visualization. know, that there are studies that show that if people just even think about building muscles that sometimes their muscles get stronger, they may use them differently, they sometimes get stronger, pick a goal that you're having trouble achieving and try to formulate it in a way

that doing it in the immediate practice, not with the outcome coming down the road, will make you feel better. What would make the practice self-reinforcing? How do you patch yourself on the back for doing it? You know, if you're having, you know, oh, I think I'll skip my workout today, you know, and then try and figure a way to make yourself feel good. And picture yourself doing it. Look up, close your eyes.

Now, if I do this now, how is my body going to feel? How am I going to feel about how I've been looking after my body better? So find a way to structure some immediate positive reinforcement that will, in fact, encourage you to do it. Before we wrap up here, Dr. Spiegel, how would your father look at the work that you're doing now? And what are some of the things that, you know, he would think about on your global quest now to make hypnosis so much more accessible? Well, I think he'd be happy about it. We co-authored a textbook together, Trans and Treatment, many years ago, because I was trying to help him put forward.

It was the beginning of my career, middle of his career, and I were trying to get the word out about doing it. So he was certainly engaged in that goal, too. I think he would have been surprised that we could do it on an app. There was a time when people in the hypnosis field thought it would be dangerous to do that. There was a time actually when cars were invented 100 years ago when people thought we shouldn't have windshield wipers because, you know, the old dangling watch thing that watching the wiper would hypnotize the driver, you know, doesn't happen. So I think he would have been surprised at the scale that we've been able to achieve using it, you know. We've enrolled almost 190,000 people experiencing reverie.

And that's a lot more than both of us have seen, although we both saw a lot of people. So I think he would get a kick out of that. He would enjoy spreading the word and doing it in a very different way. But using the concepts that he helped to develop over decades of his own practice, but getting the word out much more broadly. So I think he would have gotten a kick out of that. You know, we start off this podcast by talking about three of the core areas that hypnosis is used to really help people as a powerful tool in the toolbox, especially for people who medication might have already been exhausted or in some cases, there's a balancing act that people have with medication where they're trying to not abuse it or overuse it, especially in the category of pain, which we went into a deep dive on. But also in the category of stress and sleep as well, too. You know, people don't want to be.

super relying on Ambien and other things because of its waning effects in the long term. Are there any other items, for example, I have a family member right now that's suffering with tinnitus, right? Are there any other ones, just a little grab bag for people who didn't hear their choice of suffering that they're going through right now, unfortunately, and our heart goes out to them, are there any others that you want to just quickly mention here that you've seen hypnosis potentially work for? Sure. I've helped people to some extent with tinnitus.

It's a difficult thing because that nasty noises there all the time. But sometimes it's possible for them to imagine that the noise is something less odious, that it's, you know, a rushing waterfall instead of something that just sounds like some crackling in your ear. So it sometimes helps people to just re-experience the noise as something that they find more pleasant and less awful. On a more serious note, I've used it to help people with post-traumatic stress disorder dealing with the intrusive thoughts and the flashbacks that occur with PTSD. I had a lovely woman who, the immigrant to this country, who was a medical professional, but got very depressed. And it turned out that in her country of origin, she had been raped by their landlord at age 12 and the family couldn't do much about it. She said as I grew up, I realized that, you know, my body wasn't my own.

And, you know, it was a very repressive culture. And she found it awful. She got here. And she was told throughout her life that it was her failing, that she was a fallen woman. And that often happens that shame overwhelms people with trauma. And I had, I hypnotized her. And I had her picture herself as that 12-year-old girl. And I said, you're a mother and, you know, a medical professional.

What would you do if you saw yourself as that? 12 year old girl. And she said, well, I give her a hug. And she started a cry. And she recalled, she said, I'm stroking her hair, you know. And she saw herself in a different way, in a very intense way in hypnosis, and came out of it and said, you know, I just never thought of myself that way. And she then said, thank you, Jesus. Now, I don't incorporate Jesus into my, my hypnotic instructions, but she did. And she came back a couple weeks later and she said, my friends want to know what you did to me. She said, I'm a different person. She said, my psychiatrist wants to know what you did to me. But I'm happy, you know, and I think this sudden shift allowed her to free herself

of the belief that many traumatized people, many rape victims, many children who have been abused have, that somehow it's their fault, you know, that if these things happen, it's not because there's a bad person out there, but because I did something wrong. I didn't resist. I didn't this. I didn't that. And we'd rather feel guilty than helpless. And so shifting the frame in this way and having her face, what she feared she would see,

that it really was her fault, allowed her to see herself as an innocent little girl who had been abused and damaged. And sometimes, you know, it doesn't always happen in that sudden and extreme a way, but it can. It can be a way of seeing an old. old consistent reality, a consistent way you viewed yourself and breaking that frame and seeing it differently. Wow. That's the power of hypnosis as another tool in the toolbox to help people heal.

That's right. And their toolbox and in mind. That's a beautiful story. Thank you for sharing that. You're welcome. Dr. Spiegel, how can people get the app and also any databases that are out there that you'd recommend to people if they want to look for working with somebody in person, which again comes with cost, comes with maybe limitations of geography?

which is a big reason why you develop the app and do the work that you do? Sure. Well, it's the Revery app. You can go to www. revery.com and it will explain to you about Revery and also show you how to link to it. You can download the app if you have an iOS Apple-type phone from the App Store or if you have an Android phone, we just now have developed the Android app and that's available from Google Play. And you can try it.

See if you like it. The first week's free. Give it a try and see. Within a week, you'll know if it works for your night. Exactly. You'll try it. See if you feel better or not. So it's fast. You get immediate feedback, and it can be very effective. And it's a nice way also now to give it a try. And I used to, you know, when we built Reverie, I originally wanted it to try and be something like as good as the experience that I try to give my patients. And I've used it with about 7,000 people in my career as a lot of people. But I realized in some ways that we've been using it, it's better because, you know, they see me once or twice or three times or however many times, but then they're kind of on their own to use it.

And with every, I'm in your smartphone, you know, so anytime you need reinforcement on what to do, there I am. So it makes me very tired, but it's a terrific thing to be able to offer people. And is it your voice that they hear? Well, yeah, oh, it's my voice. It's all my voice. That's great. You have a very soothing voice.

Thank you. Well, I'm glad I've worked on it over the years. And so that's, you know, something that I think people, it's fun to try and see, see if it works. We had one wonderful woman who was in our study to stop smoking. And she was a kind of acerbic person and didn't like the initial. It was when we were doing a study. And so we first evaluated them face to face and then gave them the app. And she said, I didn't like it.

But then I went home and I tried it. And I didn't even want to stop smoking it, but it flipped a switch. And she said, I haven't had a cigarette since. I smoked for 25 years. My friends can't believe it. And she said, this is some crazy-ass voodoo shit. And I mean that in a good way. And she's now getting her friends to stop smoking.

It's really cool. She's campaigning. So people can be surprised. It's a lot of fun. I really like that. If you want a professional, I do recommend seeing a licensed and trained professional psychologist, psychiatrist, other kind of physician, dentist, people who use it within the scope of their professional training. There are two good professional hypnosis societies, the Society for

Clinical and Experimental Hypnosis. I think the website is sceh.us and the American Society of Clinical Hypnosis, ASCH.net. But you can look up the names and you can get referred, and they have referral services. The American Psychological Association has Division 30, which is the division of psychological hypnosis, and they can also help you find a licensed psychologist. And psychology today has web-based recommendations of professionals with that specialization as well. So you can go to that on the web. So I think the main rule is someone who's trained in hypnosis, but is licensed and trained in a professional specialty. So that they know how to bring the intersection of those two things together.

That's exactly right. Because it's not just hypnotizing someone. It's A, the training and goodwill and responsibility that comes from professional training, but also knowing how to choose wisely among the many approaches that could be used with hypnosis. Beautiful. Well, we'll link to all that inside the show notes. Dr. David Spiegel, it's been a pleasure to get to know your work and to have you on the podcast.

And I wish you the utmost success with all your work. and to really provide healing to all the people that are suffering so much. It's a really beautiful app you guys have created. I'm excited to dive into it myself. Maybe we'll have you back one day for a round two, and we'll talk about my experiences on it. I'd love to do it, and I admire what you're doing, and the realization you're bringing to people about what we can do as people to help ourselves live better as people and help our bodies do it.

Thank you for that. Thank you.