'Hey there. Welcome to Chasing Life. You know, most people think of hypnosis as stage tricks and swinging watches, maybe even people clucking like chickens. And you know what? I thought that too. But I got to tell you, my views have changed on this. In medicine, clinical hypnosis is something very different than what you might think. New research is showing they can actually show how the brain processes pain, can reduce stress and anxiety, help break bad habits, and even enhance performance. Some Olympians are now using self-hypnosis to sharpen their focus and improve their results. Now, this part may surprise you, but roughly two-thirds of adults are actually hypnotizable, and the percentage for children is even higher than that. I've seen the impact of this up close. I wrote an entire book about pain, and I was so struck by the evidence for hypnosis that I devoted a whole section to how it can help people reframe and reduce their pain experience. Now to be clear, it doesn't magically erase pain, but it can significantly change the way your brain interprets those pain signals and help you feel more in control. And that's the key. Now, part of the reason I wanted to talk about this today is that despite decades of research, I think hypnosis remains underutilized and misunderstood. So what exactly is hypnosis? What exactly is happening in your brain during hypnosis who can benefit? And can you safely try some of this yourself? Today on Chasing Life, I'm gonna talk to Dr. David Spiegel. He's Associate Chair of Psychiatry and Behavioral Sciences at Stanford University School of Medicine. And he's one of the world's leading researchers on clinical hypnosis. He's gonna explain the science behind hypnosis, who it works for, and why this particular way of focusing your attention might be a powerful tool you can use in your own life. I'm Dr. Sanjay Gupta, CNN's Chief Medical Correspondent, and this is Chasing Life.

I'm curious, the first time for you, I think you were in medical school.

Yes.

This is what sort of launched you into this career of hypnosis. Tell me what happened.

Yeah, I took a hypnosis course, and I was on my pediatric rotation at Children's Hospital. And the nurse says, Spiegel, your next patient's in room 133, she's in status asthmaticus. And I'm hearing the wheezing down the hall as I'm walking into the room.

Bad asthma attack.

'Bad asthma attack. 15-year-old girl in bed, leaning forward, knuckles wide, struggling for breath. Her mother's standing there crying. They had tried subcutaneous epi times 2, it didn't work. They were next going to give her general anesthesia and start her on steroids and i didn't know what to do but I had taken my hypnosis course so I said well do you want to learn a breathing exercise and she nods she could barely talk. And so I get her hypnotized and then I started broke into a sweat because we hadn't gotten asthma in the course yet so i came up with something very clever I said each breath you take will be a little deeper and a little easier and within five minutes she's lying back in bed and she isn't wheezing anymore. Her mother stopped crying. The nurse ran out of the room. My intern came into the room looking for me and I thought he was gonna pat me on the back. He said, I need to inform you that the nurse has informed the nursing supervisor that you violated Massachusetts law by hypnotizing a minor without parental consent. Now, two things about that. Massachusetts has a lot of weird laws but that is not one of them. And her mother was standing right next to me when I did it. So he said, you have to stop doing this. And I said, oh, really, why? He said, well, it could be dangerous.

Oh really?

'And i thought that anything that could help a patient that much that fast and violate a non-existent Massachusetts law had to be worth looking into and, and i've been doing it ever since and the thing is it was like right in front of my eyes you know there's no other explanation you could see it happening.

Yeah, I mean, I can't imagine that someone who's having an asthmatic attack who can't breathe to have that degree of relief so quickly through hypnosis, that's got to be very, very gratifying. Let's start with some basics here. What is hypnosis? How do you define it?

Hypnosis is a state of highly focused attention, Sanjay. Have you ever gotten so caught up in a good movie that you forget you're watching a movie and you enter the imagined world? That's what hypnosis is. It's believed in imagination. You don't judge it, you don't evaluate it, you just experience it. Right now, for example, you're sitting in a chair, you have sensations in parts of your body touching the chair, but I'm hoping that you weren't even aware of that until I mentioned it to you. Am I right about that?

Yeah, you're right.

'If I was wrong, we could just stop the interview now. You'd be already bored. So we naturally do it. We dissociate. That's the second part. So there's absorption in the focus of attention. To do that, you dissociate, you put outside of conscious awareness things that would ordinarily be in consciousness to allow yourself to fully immerse yourself in the focus of your attention. And the third thing is that you tend to disconnect from your usual way of thinking about things. And we've seen this in the functional neuroimaging that we do, where three things happen in the brain when you go into a hypnotic state. The first is you reduce activity in the salience network. So you're just turning off the alarm and allowing yourself to experience things. You increase functional connectivity between the prefrontal cortex, particularly on the left, and the insula, the little island of tissue in the frontal lobe that is, has to do with mind-body connection. So you intensify your ability to control and perceive your body. And the third is inverse functional connectivity between the dorsolateral prefrontal cortex and the posterior cingulate, part of the default mode network. That's the part of your brain, when you're not thinking or doing anything in particular, you're just kind of ruminating. And it tends to keep you on track sometimes, but it also can inhibit you. And so you're disconnecting from the part of your brain that says, you should be doing this, things ought to go like that, and allowing yourself to try out being different.

You just drew a distinction, I think, between hypnosis and meditation, in the same sentence.

Yes, yes, right.

Talk about that a little bit. These are two different things.

'They are, I mean they're not unrelated and there's neuroimaging evidence for example that in meditators over time reduce activity in the posterior cingulate cortex in part of the default mode network, which is where in hypnosis you can also inhibit activity. But meditation is about being and hypnosis is about doing. So in meditation you're taught to have open presence, to just don't try to change anything, just allow feelings, thoughts and feelings flow through you like a storm passing by. It's a way of being, which I admire. I think it's a wonderful tradition, but it's not a problem-solving tradition. By definition, it isn't. With hypnosis, you're altering your state of focused attention, turning off the part of your brain that triggers this reactivity to something that is troubling you. You're able to better control what's happening in your body.

Can anyone be hypnotized?

No, most children are very hypnotizable. You know, you call them in for dinner. They don't hear you. But as we go through what are called formal operations in adolescence where we start to value analysis over experienc, which is part of maturation some people lose some of that ability. And basically in the adult population about 20% are extraordinarily hypnotizable they lose themselves in movies they get so involved in a work project that they forget to go to dinner. There are all kinds of things. They just immerse themselves completely. About 60% are moderately hypnotizable. So they'll engage in intense experiences like that and then they'll step back and wonder about it. And there's a group at the lower 20% who just aren't hypnotizable and they value thinking over feeling. But by the time you're 20, 21, the hypnotizability you have, and it can be low, medium, or high, is very stable.

There's a thing called the Spiegel test, obviously named after you. I think one of the questions for a lot of people who are listening or watching is, can I be hypnotized? And about two thirds of adults can be hypnotized, some more than others, as you mentioned. Is it overall an attribute to be hypnotizable? Is that saying something good about your brain?

Yes, I would say it is. It's a cognitive and affective flexibility. You can immerse yourself in things, get into them, enjoy them, but then step back. And so it's a skill that people can use, but it can make trouble for you. If you become totally convinced that one more, you know, bit of pain in my chest means I'm having a heart attack every time it happens. You can lose yourself in that, you can believe it. You can sometimes get taken in easily by people. One thing I noticed about very hypnotizable people is that their empaths, they quickly tune into the way other people are feeling and try to please them. Whereas low hypnotizables, nah, you know, they judge everything. So it defines a set of natural abilities to get mobilized that can be good things or sometimes problematic.

Are some people just more genetically more hypnotizable than others?

Yes. There is a genetic component to hypnotizability. In the dopamine metabolic pathway, there is a heterozygous and a homozygous component to the dopamine processing. If you're heterozygous, that is ideal for hypnotizablity. So people, you maintain a sort of steady, relatively high level of dopamine. And um they tend to be more hypnotizable than those who are homozygous in either direction. There's also an experiential component, and it can either be a good one or a bad one. Children who have parents who engage them in imaginative involvements, who read them stories every night at bedtime, who tended to encourage children to use their imagination, that tend to more hypnotizable as adults. But sadly, there's a bad one, and that is the children who have been mistreated or abused tend also to be very hypnotizable because they can't let go of that ability, they use it as a defense. And I've had patients who said that when my father would beat me or abuse me, I would just go to a mountain meadow full of wildflowers and, you know, he's got my body but he hasn't got me. So for some, unfortunately, children, it's a defense mechanism as well.

Yeah, I gotta let that sit for a second, that, I mean, a defense mechanism essentially was what the, that sort of hypnotic state was for them.

'Yeah absolutely, and people will tell you this, you know, in a car accident, you know, time goes very slowly. You know, it took a couple seconds and it felt like half an hour. Soldiers in combat will do things under terrible duress that they may not even remember doing. They're in this kind of altered state too, intensely focused, everything else outside of awareness, and that's a hypnotic-like state as well.

Can you hypnotize yourself?

'Yes, I've done it, absolutely. And all hypnosis, Sanjay, is really self-hypnosis. What I do is teach people how to use an ability to the extent that they haven't, and so you're conscious, you're aware of what's going on, but you're more narrowly focused. So in a hypnotic state, you are solving a problem, but your putting aside other things that in ordinary consciousness you might be thinking about.

I think I remember reading in one of your articles that you hypnotize yourself around shoulder pain as well.

Yes, yes that's right. Yeah, I had a recurrent dislocating shoulder. I eventually had a bank heart repair.

But when you did this for yourself, can you just talk us through, what did you do?

'Uh... I i have a very simple hypnotic induction I look up top your head while looking up slowly close your eyes take a deep breath. Let the breath out slowly through your mouth. Let your eyes relax but keep them closed. Let your body float. And then I let one hand or the other float up in the air like a balloon and that's a signal to myself that I'm ready to concentrate. And you can notice a kind of dissociation between your right hand floating up, your left hand comfortably sitting down. You're already experiencing a non-clinical ability that you have to change the way your body feels. And that means also I could imagine that I had a cooling pad on my right shoulder and let the cool, tingly numbness penetrate deeper and deeper and filter the hurt out of the pain. And I might imagine being somewhere that I felt good, in a mountain lake or in a hot tub. And then I would come out. Very quickly by counting backwards from three to one. On three, get ready. Two, with your eyelids closed, roll up your eyes. One, let your eyes open and float back down. Make a fist open and that's the end of the exercise.

That's the induction.

That's it! That's it.

So what you just talked us through, you were talking about for yourself, but that would be the same if somebody were to come to your office.

'Absolutely. It's no big deal. You don't have to count upstairs and downstairs. I differ with many of my colleagues about the concept of deepening. You know, there are a lot of people feel you've got to talk for 10 or 15 minutes. If you've gotten the ability, you can go there in a flash. It's just a matter of having the structure for doing it. What I do is I measure everybody's hypnotizability. So the first five to six minutes of my intervention clinically is to give a structured test of your hypnotizability. Instruct people that their hand, if they pull it down, it will flow right back up to the upright position. How much reinforcement you have to give to get that. Does the right hand feel as if it's not as much a part of the body as the left hand? Then when you give a cut-off signal, touch the elbow, does the usual sensation and control return? Did they respond to that cut- off? Did they have a sense of floating lightness or buoyancy in their hand and then elsewhere in the body? And so after that five minutes, I have a very clear idea. Of how hypnotizable people are and how to work with them based on their degree of hypnotizability.

After the break, we have much more with Dr. Spiegel. Stay with us.

7,000 patients you say you have helped over your career. Is there a common type of patient? What are they most likely seeing you for?

Commonly for problems like stress and anxiety, because they can very quickly learn to soothe and disconnect that sort of snowball effect of the reaction to the problem from what initiated it. For pain, and so I resonated with your wonderful book because it's very useful for pain control. We published a study in The Lancet in 2000, randomized clinical trial, patients having things threaded through their arteries, and we randomized them into three conditions. Standard care, which meant press a button to get opioids into your bloodstream, that plus a friendly nurse providing emotional support, or that plus hypnosis. And the average pain ratings in the standard care group were seven out of 10, and the nursing support group were four out of ten, and in the hypnosis group, one out of Ten. Wow. And they were using half as much of the opioid injection. Now Sanjay, if we published that and it was a drug that produced that, every hospital in the country would be using that drug because it worked extremely well, it costs virtually nothing, and there are no side effects. But there's also no big industry pushing it. And so unfortunately, the evidence there is, it just isn't taken seriously because it can't be that quick and easy and safe, but it is.

You know, we talk about pain, we talked about asthma, even your shoulder surgery. What about optimizing performance?

Ah, yes.

We'll talk about Olympic athletes, for example, I think.

'You bet. Well, this wonderful figure skater, Elisa, from Oakland, she does visualization. To me, that's all self-hypnosis. She said, I would just, before I did the routine many times, I would close my eyes and picture myself making every move I wanted to make. And she would do it. Rory McIlroy, who won the Masters, he was frustrated for like seven years because at one point, on one hole, I think the ball wound up in a tree somewhere.

Yeah I remember that. I remember that!

And he was humiliated. He was humiliating. And he kept doing it every year and the same thing happened on that hole. Learned association. His brain thought, you know, here it's gonna happen again. And the more you say, oh my God, I hope it doesn't, of course, the more it's likely to happen. He decided to get professional help from a hypnotist and he won the Masters. There's a... There's a book called Zen and the Art of Archery and Irish sociologists figured out that the main difference between Zen archers and most archers is they say if you're focusing on the target you're making a mistake focus on your relationship with the bow and arrow and if your relationship is right the arrow will go where it should go and that's the thing with many professional athletes they're so focused on the outcome and what it'll mean that they're actually distracting themselves from what matters. Which is how they're relating to their body and getting it to do what they want it to.

I think that really makes sense to me instead of thinking about the target for that archer, think about your relationship with the bow and arrow. And we're talking about archery specifically, but I feel like that applies to maybe many things in our life, you know?

Absolutely right focus on the process and not the the outcome.

You know, hypnotism is seen as a stage show or swinging watches and, and, you know, clucking chickens and things like that. That's what a lot of people think of when they think of hypnosis.

Yeah.

So not only does it not get the attention it deserves, it gets marginalized and even maligned sometimes that's going to be very frustrating.

'If it weren't for self-hypnosis, I'd be frustrated all the time. It is, yes, it's terribly frustrating, because it's a joke or it's dangerous, or it doesn't do anything, none of which is true. But I'll tell you one thing, I try to use the negatives about hypnosis to our advantage, to tell people, if you've seen the football coach dancing like a ballerina in front of an audience of 500 drunken people, there is an important lesson in that. And that is, he's willing to try out being different and he's not worried about what they're going to say to him in the locker room on monday morning that ability to put aside your usual expectations of who you are and what you are is actually can be very adaptive and the same is true with problems like stress and pain and smoking we help people stop smoking you can do things you didn't think you could do that is a real advantage and so even if you've seen one of those stage shows, there's a lesson there. If you wanna do something, if you wanna change, if you want to be different, try this, it'll help you do it.

One of the things that sort of surprised me a little bit is that you shouldn't that people can alter how they see color under hypnosis.

Yes!

This is really important because in some ways you're changing your reflection of reality.

That's exactly right, that's well put, and that's true. Basically, we had people look at color versus black and white and what happened in the occipital cortex, which is where we process vision, including color. And then in another condition, we hypnotized them and had them imagine that they were looking at color when it was really black and White. And we had increased activity in the color processing regions of the brain.

That's fascinating.

'So believing is seeing, but seeing is believing. That's the remarkable thing, but in a way, Sanjay, it's just like what you've written about with pain. You can change your experience. One of the common things I do for pain control is I just say, what do you naturally do to relieve the pain? Do you take a warm bath? Do you a cold shower? Do you use ice? And I have them go into a state of self-hypnosis and imagine that that's what they're doing. You're in the warm bath, filter the hurt out of the pain. And what you're doing is just like in that color experiment, you're getting your brain to process as though it were having that kind of perceptual experience. And why shouldn't it? Why shouldn't it be able to do that? I remember what that was like. It's just like when you think back about a beautiful scene you saw on a vacation, you know, you see it, you feel the cool breeze, that intense absorption in what you are thinking about will change what you you are perceiving.

I think this is just so inspiring, right? That the fact that we have so much dominion over our brains. Like I think for a lot of people, they see it as a passive receptacle of things that are happening to us. But the idea that we can, in one extreme, change our perception of reality. But at the other hand, and I encourage people to look this up, but the data on using your brain to deal with certain pain conditions, the certain ones that I saw that had good data behind it, inflammatory bowel syndrome, fibromyalgia, migraine headaches, things that people deal with on a regular basis and frankly, hijack their lives and hijack their identities. The fact that you have control over it, it doesn't mean it's just all in your head. It means you have control over probably in ways that you have not fully considered.

Well, thank you, Sanjay, you put it beautifully. And the worst, you know, people ask me, what's the worst misconception about hypnosis? And it's that it's a loss of control. It's an increase in control. Just the way you said it, you're learning to take more control of your brain and use it to your advantage. And so it's way of enhancing your ability to control how you feel and what you do. People surprise themselves. That's one of my favorite times in my work, Sanjay. Is I see people are surprised that they can do this. They can feel less pain. They can stop smoking. They can reduce their anxiety. They can interrupt their asthma attacks. I just love watching people surprise themselves at how much control they have.

I think this is a podcast about hypnosis, but I think in more ways it's a podcast about trying to figure out our relationships with our bodies and our brains. If you figure that out, I mean, that's like a, it's cheap code. I think there's so many ways for life.

It is, it is. When I'm just counseling people about their lives, there are things we control and things we don't control. And ironically, the thing we control the least is actually the thing that we control most, and that's our body, if we do it right. And if you're fighting against losing control, you're missing the point. You wanna just build a better relationship with your body and hypnosis can help you do that.

Just in closing, what is the one practical lesson you think people should take away from what we know about hypnosis research?

I think that hypnosis and techniques like it should be treated like any other biomedical phenomenon. You know, focus on the evidence, not the presumption of what it could or couldn't be. It's the oldest Western conception of psychotherapy. It's been around for 250 years. And we know how it works. We know that it works, so give yourself the benefit of the doubt. Give your body the benefit to the doubt and learn to use this. Try it out. See what it feels like. And you'll enjoy it. You can use your imagination to your benefit and that's what I want to see happen.

What a pleasure, David.

Thank you, likewise, and I admire your work and the way you communicate medicine makes me proud as a doctor, so thank you for that.

Well, that means a lot, sir, and I've learned a lot today, so really appreciate that.

You're most welcome.

That was Dr. David Spiegel of Stanford University School of Medicine, an expert on clinical hypnosis. Thanks so much for listening.  And before I go, wanted to let you know that I have a new documentary coming out this Sunday. It's called "Weed 8:  Women in Weed". As you may know, we've been reporting on  cannabis on medical marijuana for nearly 15 years now. This time we are focused on women who are now the fastest growing users of cannabis in the country.  Why is that?  What does it mean? We traveled the country to investigate. You can watch it on CNN 8:00 PM ET Sunday.  And it will be available to stream the next day on the CNN app.