San Francisco Chronicle
Stephanie M. Lee
Stephanie M. Lee
October 23, 2012
Despite what Halloween lore might have you believe, hypnosis isn't all about swinging watches, magic spells and mind control.
It is the oldest Western conception of psychotherapy and, in mainstream medicine, it has been shown to help patients manage pain, stress and anxiety, and combat traumas and phobia. It is also associated with being used to retrieve "repressed" memories connected to mental disorders.
Now, new scientific research, bolstered by technological advances, is shedding light on the neurological nuances of the brain's response to hypnosis. For instance, a recent study from the Stanford University School of Medicine helps explain why some people easily fall into a trance while others do not.
David Spiegel, the study's senior author, defines hypnosis as a state of highly focused attention, achieved through deep breathing and muscle relaxation. When patients are fully hypnotized, they can, for instance, alter their minds to perceive pain as less painful.
"It's the equivalent in consciousness of a telephoto lens on a camera - great detail, but not a lot of context," said Spiegel, medical director of Stanford's Center for Integrative Medicine.
The ability to slip into this mentality varies among people, according to Spiegel's study. Published this month in Archives of General Psychiatry, it shows that the reason may have to do with the strength of connections between specific brain regions.
Spiegel and his team performed brain imaging scans on 12 adults considered highly hypnotizable and 12 others who were not so hypnotizable. They were divided into the two groups based on a test that assessed their behavioral responses to hypnosis.
The researchers examined activity in different networks in their brains while they were relaxed and not hypnotized. They found that the highly hypnotizable patients showed greater activity between parts of the executive-control network, which is involved in making decisions, and the salience network, which is involved in deciding what is important.
In particular, researchers saw a strong connection activated between the left dorsolateral prefrontal cortex, which is part of the brain's executive-control network, and the dorsal anterior cingulate cortex, which is part of its salience network and plays a role in focusing one's attention.
"For the high hypnotizable, it was a high level of functional connectivity," Siegel said. "If executive control is on, so is the salient network. (They) tended to work together. That's the kind of absorption you see in highly hypnotizable people. When they're in something, they're not thinking, 'Why am I doing this and not that?' "
In contrast, the activity between those regions was very low in the less hypnotizable subjects. Spiegel said his study was the first to show teamwork between the two networks in relation to hypnosis.
The 10 percent
Spiegel estimated that 10 percent of people are highly hypnotizable, one-third are not and the rest fall in between.
It is unclear why some people are more wired for hypnosis than others, but some theories posit that those who are hypnotizable especially enjoyed imaginative activities as children or learned early to focus their thoughts elsewhere in times of physical pain, Spiegel said. Another explanation holds that some people are genetically predisposed to produce certain neurotransmitters in a way that makes them more hypnotizable.
This deeper proof of people's abilities to be hypnotized helps physicians explain to patients that hypnosis "is not just some carnival trick" but a helpful medical tool, said Donald Olson, director of the pediatric epilepsy program at Lucile Packard Children's Hospital at Stanford. He was not involved in Spiegel's study.
In a 2008 study, Olson and Richard Shaw, a child psychiatrist at the hospital, used hypnosis to properly diagnose nine children who appeared to be epileptic.
Despite what Halloween lore might have you believe, hypnosis isn't all about swinging watches, magic spells and mind control.
Despite what Halloween lore might have you believe, hypnosis isn't all about swinging watches, magic spells and mind control.
It is the oldest Western conception of psychotherapy and, in mainstream medicine, it has been shown to help patients manage pain, stress and anxiety, and combat traumas and phobia. It is also associated with being used to retrieve "repressed" memories connected to mental disorders.
Now, new scientific research, bolstered by technological advances, is shedding light on the neurological nuances of the brain's response to hypnosis. For instance, a recent study from the Stanford University School of Medicine helps explain why some people easily fall into a trance while others do not.
David Spiegel, the study's senior author, defines hypnosis as a state of highly focused attention, achieved through deep breathing and muscle relaxation. When patients are fully hypnotized, they can, for instance, alter their minds to perceive pain as less painful.
"It's the equivalent in consciousness of a telephoto lens on a camera - great detail, but not a lot of context," said Spiegel, medical director of Stanford's Center for Integrative Medicine.
The ability to slip into this mentality varies among people, according to Spiegel's study. Published this month in Archives of General Psychiatry, it shows that the reason may have to do with the strength of connections between specific brain regions.
Spiegel and his team performed brain imaging scans on 12 adults considered highly hypnotizable and 12 others who were not so hypnotizable. They were divided into the two groups based on a test that assessed their behavioral responses to hypnosis.
The researchers examined activity in different networks in their brains while they were relaxed and not hypnotized. They found that the highly hypnotizable patients showed greater activity between parts of the executive-control network, which is involved in making decisions, and the salience network, which is involved in deciding what is important.
In particular, researchers saw a strong connection activated between the left dorsolateral prefrontal cortex, which is part of the brain's executive-control network, and the dorsal anterior cingulate cortex, which is part of its salience network and plays a role in focusing one's attention.
"For the high hypnotizable, it was a high level of functional connectivity," Siegel said. "If executive control is on, so is the salient network. (They) tended to work together. That's the kind of absorption you see in highly hypnotizable people. When they're in something, they're not thinking, 'Why am I doing this and not that?' "
In contrast, the activity between those regions was very low in the less hypnotizable subjects. Spiegel said his study was the first to show teamwork between the two networks in relation to hypnosis.
The 10 percent
Spiegel estimated that 10 percent of people are highly hypnotizable, one-third are not and the rest fall in between.
It is unclear why some people are more wired for hypnosis than others, but some theories posit that those who are hypnotizable especially enjoyed imaginative activities as children or learned early to focus their thoughts elsewhere in times of physical pain, Spiegel said. Another explanation holds that some people are genetically predisposed to produce certain neurotransmitters in a way that makes them more hypnotizable.
This deeper proof of people's abilities to be hypnotized helps physicians explain to patients that hypnosis "is not just some carnival trick" but a helpful medical tool, said Donald Olson, director of the pediatric epilepsy program at Lucile Packard Children's Hospital at Stanford. He was not involved in Spiegel's study.
In a 2008 study, Olson and Richard Shaw, a child psychiatrist at the hospital, used hypnosis to properly diagnose nine children who appeared to be epileptic.
The young patients periodically erupted in behavior that included twitching, loss of consciousness, shaking, jerking and falling - all signs of epilepsy. But psychological stresses, such as physical or emotional trauma, manifest in the body in virtually identical episodes in a non-epilepsy-related condition called conversion disorder, Olson said.
Determining epilepsy
The only way to truly know if epilepsy is the cause of those behaviors is to monitor the child's brain activity during such an episode for abnormal electrical impulses, he said.
To figure out who had which condition, the physicians hypnotized the children and, after they connected a panel of electrodes to their scalps, instructed them to envision an unpleasant, stressful situation and recall the feelings or events that usually preceded seizure-like behavior. Eight of the nine children responded with that behavior. To end the test, the children were then instructed to envision their favorite place.
By looking at their brain activity, the researchers found that the eight were actually experiencing non-epileptic episodes. Olson said the method is now in use at the hospital to help diagnose patients.
"Most people can sense these non-epileptic seizures coming on, and many of them can learn a self-hypnosis technique to interrupt it and keep it from coming out in a full-blown manner," Olson said.
Katie Duchscherer, 21, a senior at Stanford, didn't know she was highly hypnotizable until Spiegel mass-hypnotized her class of 150. The psychology major has participated in his studies since then and learned how to slip into that focused state of mind on her own.
Duchscherer likens the feeling to intently reading a book to the point where the rest of the world seems to disappear.
"Hypnosis is actually similar to that, but instead of focusing on the TV you're watching or the book you're reading or the project you're working on, you're focusing on what's going on inside your head and what's going on inside your body," she said.
Self-hypnosis recently proved useful during a doctor's visit, when she had a wart on her foot frozen off with liquid nitrogen.
Was it painful? Sort of - but Duchscherer said she was able to hypnotize herself into believing that she was running barefoot through the snow for fun. When it was over, her mother remarked that she hadn't even winced.
"If you can get into this brain state where you're thinking about it differently, thinking about the pain differently," she said, "it can be a lot less unpleasant."
Stephanie M. Lee is a San Francisco Chronicle staff writer. E-mail: slee@sfchronicle.com Twitter: @stephaniemlee
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