Stanford Medicine
3-10-2012
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Not getting sleepy? Research explains why hypnosis doesn’t work for all

Not everyone is able to be hypnotized, and new research from the Stanford University School of Medicine shows how the brains of such people differ from those who can easily be.

The study, published in the October issue of Archives of General Psychiatry, uses data from functional and structural magnetic resonance imaging to identify how the areas of the brain associated with executive control and attention tend to have less activity in people who cannot be put into a hypnotic trance.

“There’s never been a brain signature of being hypnotized, and we’re on the verge of identifying one,” said David Spiegel, MD, the paper’s senior author and a professor of psychiatry and behavioral sciences. Such an advance would enable scientists to understand better the mechanisms underlying hypnosis and how it can be used more widely and effectively in clinical settings, added Spiegel, who also directs the Stanford Center for Integrative Medicine.

Spiegel estimates that one-quarter of the patients he sees cannot be hypnotized, though a person’s hypnotizability is not linked with any specific personality trait. “There’s got to be something going on in the brain,” he said.

Hypnosis is described as a trance-like state during which a person has a heightened focus and concentration. It has been shown to help with brain control over sensation and behavior, and has been used clinically to help patients manage pain, control stress and anxiety and combat phobias.

Hypnosis works by modulating activity in brain regions associated with focused attention, and this study offers compelling new details regarding neural capacity for hypnosis.

“Our results provide novel evidence that altered functional connectivity in [the dorsolateral prefrontal cortex] and [the dorsal anterior cingulate cortex] may underlie hypnotizability,” the researchers wrote in their paper.

For the study, Spiegel and his Stanford colleagues performed functional and structural MRI scans of the brains of 12 adults with high hypnotizability and 12 adults with low hypnotizability.

The researchers looked at the activity of three different networks in the brain: the default-mode network, used when one’s brain is idle; the executive-control network, which is involved in making decisions; and the salience network, which is involved in deciding something is more important than something else.

The findings, Spiegel said, were clear: Both groups had an active default-mode network, but highly hypnotizable participants showed greater co-activation between components of the executive-control network and the salience network. More specifically, in the brains of the highly hypnotizable group the left dorsolateral prefrontal cortex, an executive-control region of the brain, appeared to be activated in tandem with the dorsal anterior cingulate cortex, which is part of the salience network and plays a role in focusing of attention. By contrast, there was little functional connectivity between these two areas of the brain in those with low hypnotizability.

Spiegel said he was pleased that he and his team found something so clear. “The brain is complicated, people are complicated, and it was surprising we were able to get such a clear signature,” he explained.

Spiegel also said the work confirms that hypnotizability is less about personality variables and more about cognitive style. “Here we’re seeing a neural trait,” he said.

The authors’ next step is to further explore how these functional networks change during hypnosis. Spiegel and his team have recruited high- and low-hypnotizable patients for another study during which fMRI assessment will be done during hypnotic states. Funding for that work is being provided by the National Center for Complementary and Alternative Medicine.

Funding for this study came from the Nissan Research Center, the Randolph H. Chase, MD Fund II, the Jay and Rose Phillips Family Foundation and the National Institutes of Health.

The study’s first-author is Fumiko Hoeft, MD, PhD, who was formerly an instructor at Stanford’s Center for Interdisciplinary Brain Sciences Research and is now an associate professor of psychiatry at UCSF. Other co-authors are John Gabrieli, PhD, a professor at MIT (then a professor of psychology at Stanford); Susan Whitfield-Gabrieli, a research scientist at MIT (then a science and engineering associate at Stanford); Brian Haas, PhD, an assistant professor at the University of Georgia (then a postdoctoral scholar in the Center for Interdisciplinary Brain Sciences Research at Stanford); Roland Bammer, PhD, associate professor of radiology; and Vinod Menon, PhD, professor of psychiatry and behavioral sciences.

The Guardian
22-7-2012
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Vaughan Bell: hypnosis is no laughing matter

Long derided as a tool of quacks and comedians, the science of suggestibility is enjoying a revival as a clinical tool

Hypnosis is the eccentric uncle of cognitive science. It was once part of the mainstream – studied by scientists and clinicians alike in its 1960s heyday – but it slowly fell into disrepute as it was picked up and popularised by tacky stage hypnotists and quack practitioners in the following decades.

In recent years, hypnosis has seen something of a rebirth, and neuroscience studies using the technique are now regularly published in some of the most respected scientific journals. Curiously, though, it hasn’t shaken off the stigma entirely. While writing this article I contacted several researchers who have published neuroscience studies using hypnosis, and not one replied. The reticence is understandable. Like the study of consciousness 20 years ago, hypnosis is still considered by some to be a “career-limiting move”. Consequently, scientists make sure they stick to the most conservative and orthodox form of research – academic journals, occasional conference presentations, and definitely nothing that hints of hype, or indeed, public exposure.

The lack of wider discussion is a pity, as hypnosis – or rather suggestibility – is a remarkable aspect of human psychology. The ability to be hypnotised seems to be a distinct trait that is distributed among the population, like height or shoe size, in a “bell curve” or normal distribution: a minority of people cannot engage with any suggestions, a minority can engage with almost all, and most people can achieve a few.

The key word here is “engage”, as, contrary to popular belief, hypnosis cannot be used to make people do something against their will, even though the effects seem to happen involuntarily. If this seems paradoxical, a good analogy is watching a movie: you don’t decide to react emotionally to the on-screen story, but you can choose to turn away or disengage at any time. In other words, the effects of the film, just like hypnosis, require your active participation.

The most difficult suggestions to achieve are those which affect the fundamentals of the mind, such as memory and perception, meaning that while highly hypnotisable people can experience temporary hallucinations and amnesia after suitable suggestions, low-hypnotisable people may only be able to experience temporary changes in their volition or movements – such as an arm feeling heavier than usual, perhaps.

It seems, however, that there is very little that can be done to make you more or less hypnotisable – the hypnotisability trait is the primary factor in how successfully you can experience the effects. We know that there is a genetic component to this trait and that several studies have indicated that highly hypnotisable people show structural and functional differences in the brain when compared to low-hypnotisables, but the question of why we have a varying ability to have our reality changed by suggestions remains a mystery.

Due to their ability to have their mental processes temporarily altered in ways previously not thought possible, highly hypnotisable people have become key in scientific studies. Amir Raz and colleagues at McGill University in Montreal reported that it was possible to “switch off” automatic word reading and abolish the Stroop effect – a psychological phenomenon that demonstrates a conflict between meanings, such as where we are much slower to identify the ink colour of a word when the word itself describes a different hue. Furthermore, when this experiment was run in a brain scanner, participants showed much lower activation in both the anterior cingulate cortex, an area known to be particularly involved in resolving conflict between competing demands, and the visual cortex, which is crucial for recognising words. Although this may seem like a technicality, to the scientific world it was a strikingly persuasive demonstration that hypnosis could apparently disassemble an automatic and well-established psychological effect in a manner consistent with the brain processes that support it.

Neuroimaging has also proved key in answering the question of whether hypnotised people are pretending to experience the effects. When people are asked to fake hypnosis, to the point where observers cannot tell the difference between them and the genuinely hypnotised people, the two groups are clearly distinguishable by their brain activity.

Taking the science one step further, researchers from the Macquarie Centre for Cognitive Science in Sydney have published a series of studies in which they have used hypnosis to temporarily simulate genuine conditions where patients may hold false beliefs or lose awareness of a problem after brain injury. One such condition, called somatoparaphrenia, can occur after right-sided brain injury and can result in the patient denying ownership of a limb. Literally, the patient believes that their arm is not theirs, has been replaced, or belongs to someone else – something which both challenges our intuitive ideas about how we perceive our body and can pose a practical problem for post-injury rehabilitation. In highly hypnotisable volunteers, the Macquarie team momentarily instilled a similar feeling of limb alienation to examine whether healthy people could rationalise such a counterintuitive idea, finding that participants remained consistent in their explanations even when challenged with visual evidence.

A special issue of the respected journal Cortex will shortly be dedicated to the neuropsychology of hypnosis, additionally pointing to the growing momentum of the scientific revival. The wider public, however, still base their knowledge on the watches and weight-loss stereotype, meaning it is likely to be a while before neuroscientists feel comfortable about breaking their self-imposed silence.

NPR
30-06-2011
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Report Details How One Principal Hypnotized Students For Years

A school district in Florida just released a 130 page report that details how one high school principal hypnotized between 70 and 75 students since 2006.

The school district began investigating Dr. George Kenney, the former principal at North Port High School in Sarasota, after he admitted that he had hypnotized Wesley McKinley, 16, a day before he killed himself in April.

According to ABC News, investigators say Kenney now admits that he had hypnotized two other students who died within a month of McKinley.

ABC News reports:

[Kenney] had denied using the technique on Brittany Palumbo, 16, who killed herself May 4, or Marcus Freeman, 16, a star quarterback on the high school team, who died in a car crash March 15.

“Dr. Kenney admitted that he lied … and he admitted that he did have sessions with both of the other deceased students,” according to the report by Steele Investigations Agency, released this week.

In his interview with the investigators, Kenney, a popular principal at the school since 2001, said he felt terrible about “putting his school and his students through something that they didn’t need or deserve to have to endure on top of all the tragedy they already have experienced” and started to cry, the report says.

Tampa Bay’s Fox 13 reports that Kenney’s hypnosis sessions were well known and widespread. Kenney would hypnotize students to help with their test scores and athletic performance. Fox 13 reports that Kenney always sought parental consent. In 2009, the report says his supervisor told him he could only perform hypnosis in a psychology class, but Kenney continued doing it because he said he was never told to stop.

Fox 13 says no one is linking the hypnosis with the deaths of the students, but The Sarasota Herald-Tribune reports that the school district put Kenney on leave in May pending an investigation into whether he broke the law when he hypnotized students.

The Herald Tribune reports that “therapeutic” hypnosis is against the law the in Florida, unless it is monitored or conducted by a medical professional. But it’s unlikely that Kenney will face prosecution, because the law is vague and “rarely used” since it was enacted in 1961.

The Herald Tribune reports:

Bradenton lawyer Mark Lipinski said the statute lacks the crucial definition of “therapeutic,” leaving investigators with only its broad dictionary definition.

“The law is obscure, vague and unenforceable,” he said. “I honestly just don’t see a crime and any case would be a stretch, in my opinion.”

BBC
06-06-2011
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NHS should offer hypnosis as standard says new report

Hypnosis should become a standard technique on the NHS to treat a range of conditions according to a new report.

The hypnosis and psychosomatic medicine section of the Royal Society of Medicine says the technique can be used to relieve pain and treat stress related conditions such as irritable bowel syndrome.

Graham Satchell reports.

American Psychological Association
01-2011
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Hypnosis continues to show promise in reducing pain and soothing anxiety, although the research is still inconclusive about its success in smoking cessation.

The first task for many psychologists who use hypnosis is telling patients what hypnosis is and what it isn’t.

“If you watch hypnosis on TV, the subject always ends up clucking like a chicken, being naked or assassinating a president,” says Eric Willmarth, PhD, founder of Michigan Behavioral Consultants and past president of APA Div. 30 (Society of Psychological Hypnosis).

Even though stage hypnotists and TV shows have damaged the public image of hypnosis, a growing body of scientific research supports its benefits in treating a wide range of conditions, including pain, depression, anxiety and phobias.

“Hypnosis works and the empirical support is unequivocal in that regard. It really does help people,” says Michael Yapko, PhD, a psychologist and fellow of the American Society of Clinical Hypnosis. “But hypnosis isn’t a therapy in and of itself. Most people wouldn’t regard it that way.”

Hypnosis can create a highly relaxed state of inner concentration and focused attention for patients, and the technique can be tailored to different treatment methods, such as cognitive-behavioral therapy. Patients also can become more empowered by learning to hypnotize themselves at home to reduce chronic pain, improve sleep, or alleviate some symptoms of depression or anxiety.

Hypnosis has been used for centuries for pain control, including during the Civil War when Army surgeons hypnotized injured soldiers before amputations. Recent studies have confirmed its effectiveness as a tool to reduce pain. Among the leading researchers in the field is Guy H. Montgomery, PhD, a psychologist who has conducted extensive research on hypnosis and pain management at Mount Sinai School of Medicine, where he is director of the Integrative Behavioral Medicine Program.

In one study, Montgomery and colleagues tested the effectiveness of a 15-minute pre-surgery hypnosis session versus an empathic listening session in a clinical trial with 200 breast cancer patients. In a 2007 article in the Journal of the National Cancer Institute (Vol. 99, No. 17), the team reported that patients who received hypnosis reported less post-surgical pain, nausea, fatigue and discomfort. The study also found that the hospital saved $772 per patient in the hypnosis group, mainly due to reduced surgical time. Patients who were hypnotized required less of the analgesic lidocaine and the sedative propofol during surgery.

“Hypnosis helps patients to reduce their distress and have positive expectations about the outcomes of surgery,” Montgomery says. “I don’t think there is any magic or mind control.”

In a 2009 article in Health Psychology (Vol. 28, No. 3), Montgomery and colleagues reported on another study, which found that a combination of hypnosis and cognitive-behavioral therapy could reduce fatigue for breast cancer patients undergoing radiation therapy.

Research has also shown the benefits of hypnosis for burn victims. In a 2007 report in Rehabilitation Psychology (Vol. 52, No. 3), Shelley Wiechman Askay, PhD, David R. Patterson, PhD, and colleagues at the University of Washington Medical School found that hypnosis before wound debridement significantly reduced pain reported by patients on one pain rating questionnaire.

No cure-all
People vary widely in their ability to respond to hypnotic suggestions, a trait which can be measured by standardized scales. But it isn’t well understood what causes the varying levels of “hypnotizability” or their significance.

Yapko says few clinicians use hypnotizability scales because responses to a structured test don’t predict how a patient will respond to hypnosis in treatment. He served as guest editor for a recent special issue of the International Journal of Clinical and Experimental Hypnosis (Vol. 58, No. 2) that examined research on hypnosis and depression. In an editorial, Yapko urged more research and a rejection of outdated views that hypnosis can precipitate suicide or psychosis in depressed patients. Other articles examined how hypnosis can be integrated with cognitive-behavioral therapy or used with depressed patients and their families.

Willmarth says he doesn’t always use hypnotizibility scales with his patients, but will try a hypnosis session and measure the patient’s response to see if it is effective. “You have to be a little bit willing to fail in order to do it often enough to succeed,” he says.

Hypnosis may not succeed in all cases and can actually be detrimental in some instances, especially in the realm of retrieving memories.

Joseph P. Green, PhD, a psychology professor at Ohio State University at Lima, has researched how hypnotic suggestions can produce distorted or false memories. He also found that people may believe hypnotically induced memories are more reliable, mirroring a mistaken cultural belief that hypnosis acts like a truth serum. Hypnosis is “on thin ice” when used to recover memories, as is the case with most other memory retrieval techniques, Green says.

Hypnosis got a bad name in the 1990s when some therapists convinced patients they had been molested or abused as children because of hypnotically induced memories, which often had no evidence to support them. As a result, many innocent people were wrongly accused of abuse in hundreds of court cases, Yapko says.

“People didn’t really understand the suggestibility of memory,” he says. “That whole issue has pretty much fallen by the wayside now” because of advances in research.

In a 2007 decision, the Supreme Court of Canada established a precedent that post-hypnosis evidence is inadmissible in court because of its unreliability. In R. v. Trochym, the court overturned a murder conviction after a witness changed her timeline of events following a hypnosis session that was requested by detectives. The jury wasn’t told that the witness had been hypnotized or that she had changed her recollection.

“In sum, while it is not generally accepted that hypnosis always produces unreliable memories, neither is it clear when hypnosis results in pseudo-memories or how a witness, scientist or trier of fact might distinguish between fabricated and accurate memories,” the decision stated.

Up in smoke
Smokers also should be wary of the plethora of hypnosis programs and tapes peddled online with guarantees of instant success. “Despite the widespread use, the science warranting that popularity is suspect,” Green says.

Green began studying hypnosis and smoking cessation more than 25 years ago after seeing overblown claims from itinerant hypnotists who held weekend sessions in hotels before moving on to the next town. In a January article in the American Journal of Clinical Hypnosis (Vol. 52, No. 3), Green and Binghamton University psychology professor Steven Jay Lynn, PhD, wrote about the body of research on hypnosis and smoking cessation and found mixed results.

In a literature review published in 2000 (International Journal of Clinical and Experimental Hypnosis, Vol. 48, No. 2), Green and Lynn analyzed 59 studies on hypnosis and smoking cessation. While hypnosis was more successful than no treatment, it was generally equivalent to other smoking-cessation methods. However, many studies had combined hypnosis with cognitive-behavioral therapy or other treatment methods, so it was impossible to determine the effectiveness of hypnosis alone. Green says hypnosis may help smokers quit, but more research needs to be done. In a 2008 report published by the Cochrane Library, Neil C. Abbot, operations director for ME Research UK, and colleagues examined nine randomized trials and also found insufficient evidence to recommend hypnosis as a specific treatment for smoking cessation.

Learning the ropes
While more research is being conducted on the benefits of hypnosis, graduate schools are lagging behind in incorporating hypnosis training into psychology programs, say Yapko, Willmarth and Montgomery. “The universities have really dropped the ball by thinking hypnosis is a sideshow rather than being relevant to effective psychotherapy,” Yapko says.

Some graduate schools may not be convinced of the effectiveness of hypnosis or the research supporting its use, but other schools have developed clinical hypnosis classes, including Saybrook University’s Graduate College of Mind-Body Medicine in San Francisco, where Willmarth teaches a hypnosis course. At Washington State University, psychology professor Arreed Barabasz, PhD, directs the hypnosis laboratory and teaches graduate-level hypnosis courses and research seminars. He also is editor-in-chief of the International Journal of Clinical and Experimental Hypnosis.

Since many psychologists have never taken a hypnosis class as part of their education, they often seek training later in their careers. It can be bewildering to find a class, though, since a search for “hypnosis training” generates more than 600,000 hits on Google.

“You can go anyplace on the weekend and get a hypnosis certification,” Willmarth says. “You have thousands of lay hypnosis schools that are willing to train anyone who will pay the tuition.”

To make sure psychologists don’t end up with charlatan teachers, Willmarth recommends courses approved by the American Society of Clinical Hypnosis. ASCH also offers a certification in clinical hypnosis for licensed health-care professionals with at least a master’s degree. Certification requires at least 40 hours of ASCH-approved workshop training, 20 hours of individualized training and two years of independent practice using clinical hypnosis.

Willmarth says interest in clinical hypnosis is growing and more psychologists are learning how hypnosis can help their patients.

“It goes in waves,” he says. “Right now, we’re on an upswing.”

Cochrane Library
06-10-2010
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Hypnotherapy for smoking cessation

Background
Hypnotherapy is widely promoted as a method for aiding smoking cessation. It is proposed to act on underlying impulses to weaken the desire to smoke or strengthen the will to stop.

Objectives
To evaluate the efficacy of hypnotherapy for smoking cessation.

Search methods
We searched the Cochrane Tobacco Addiction Group Specialized Register and the databases MEDLINE, EMBASE, AMED, SCI, SSCI using the terms smoking cessation and hypnotherapy or hypnosis. Date of most recent searches July 2010. There were no language restrictions.

Selection criteria
We considered randomized controlled trials of hypnotherapy which reported smoking cessation rates at least six months after the beginning of treatment.

Data collection and analysis
Three authors independently extracted data on participant characteristics, the type and duration of the hypnotherapy, the nature of the control group, smoking status, method of randomization, and completeness of follow up. They also independently assessed the quality of the included studies.

The main outcome measure was abstinence from smoking after at least six months follow up. We used the most rigorous definition of abstinence in each trial, and biochemically validated rates where available. Those lost to follow up were considered to be smoking. We summarised effects as risk ratios (RR). Where possible, we performed meta‐analysis using a fixed‐effect model. We also noted any adverse events reported.

Main results
Eleven studies compared hypnotherapy with 18 different control interventions. There was significant heterogeneity between the results of the individual studies, with conflicting results for the effectiveness of hypnotherapy compared to no treatment, or to advice, or psychological treatment. We did not attempt to calculate pooled risk ratios for the overall effect of hypnotherapy. There was no evidence of a greater effect of hypnotherapy when compared to rapid smoking or psychological treatment. Direct comparisons of hypnotherapy with cessation treatments considered to be effective had confidence intervals that were too wide to infer equivalence.

Authors’ conclusions
We have not shown that hypnotherapy has a greater effect on six‐month quit rates than other interventions or no treatment. There is not enough evidence to show whether hypnotherapy could be as effective as counselling treatment. The effects of hypnotherapy on smoking cessation claimed by uncontrolled studies were not confirmed by analysis of randomized controlled trials.

The Guardian
30-09-2010
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Hypnosis reaches the parts brain scans and neurosurgery cannot

No longer a mere vaudeville routine, hypnosis is being used in labs to cast light on the innermost workings of the brain

Vaughan Bell blogs at Mind Hacks

Whenever AR sees a face, her thoughts are bathed in colour and each identity triggers its own rich hue that shines across her mind’s eye. This experience is a type of synaesthesia which, for about one in every 100 people, automatically blends the senses. Some people taste words, others see sounds, but AR experiences colour with every face she sees. But on this occasion, perhaps for the first time in her life, a face is just a face. No colours, no rich hues, no internal lights.

If the experience is novel for AR, it is equally new to science because no one had suspected that synaesthesia could be reversed. Despite the originality of the discovery, the technique responsible for the switch is neither the hi-tech of brain stimulation nor the cutting-edge of neurosurgery, but the long-standing practice of hypnosis.

The surprising reversal of AR’s synaesthesia was reported in a recent study by psychologist Devine Terhune and his colleagues at Lund University in Sweden. The researchers showed photos of colour-tinted faces to AR and asked her to identify the onscreen hue while electrical activity was measured from her brain using scalp electrodes.

When the colour of the onscreen face clashed with the colour that appeared in her mind’s eye, she reacted slowly, as if trying to read traffic lights through tinted glasses. Meanwhile, the electrical measurements showed her brain struggling to resolve the conflict.

But after hypnotic reversal, she glided through the colour naming, reacting as quickly as people without synaesthesia, and showing none of the tell-tale neurological signs of trying to resolve competing mental demands. Hypnosis had not only altered her experience but had modified the workings of specific brain pathways in ways that we cannot usually manage through conscious will alone.

In a growing number of labs around the world, hypnosis is being used as an experimental tool to allow researchers to temporarily unpick our normally integrated psychological responses to better understand the mind and brain.

Synaesthesia is an automatic psychological association that occurs only in a very few people, but we are blessed (and, indeed, cursed) with minds that mostly operate on autopilot. Take words, for example. As you read the words in this text, you are not consciously identifying each letter, joining them together in your head, and matching the collection to a memory of what it means, it just seems to happen automatically when you see each one.

In an analogy to AR’s colour-clash face task, if I ask you to name the colour that the word green is highlighted in, I hope you would say red. It turns out that you are slightly slower at naming the highlight colour when it clashes with the word (like in red, green and blue) than when the colours and the words match (as in red, green and blue) because we can’t decide not to read the words when we see them – it happens automatically – and this interferes with trying to name the ink colour.

This interference is known as the Stroop effect and, along with the normal brain responses that accompany it, have also been reversed with hypnosis by “switching off” automatic word reading.

If you’re not familiar with hypnosis, I suspect you might be entertaining visions of a Victorian gentleman in a three-piece suit swinging a pocket watch in a brain scanner, but there is no magic to the procedure – it simply requires that someone concentrates on your voice. Even the relaxation part has been found to be optional after an innovative study managed to hypnotise people while on exercise bikes.

Perhaps the most important thing to know about hypnosis is that not everyone is hypnotisable to the same extent: countless research studies have shown that we each differ in our susceptibility. Most people can experience their arm feeling light or heavy at someone else’s suggestion, a few less can feel as if movement is being prevented on command, and only a minority – about 10% of the population – experience changes in the workings of perception, memory and thought.

For those who are “low hypnotisable”, being hypnotised is often like listening to one of those slightly dull relaxation tapes that go on for too long, but for high hypnotisables, known as “virtuosos” in the scientific literature, the effects are compelling.

We don’t know why we have this tendency, but we do know it is partly genetic, that it’s influenced by specific genes, and has been linked to differences in the structure of the brain.

The trait seems to be normally distributed throughout the population and no reliable methods have been found to alter how hypnotisable we are. Most likely, some people have it, while others do not. This trait is usually described as “suggestibility” but it is nothing to do with gullibility or being easily led. People susceptible to hypnosis are not more naive, trusting or credulous than anyone else, but they do have the capacity to allow seemingly involuntary changes to their mind and body.

The key phrase here is that they “have the capacity to allow” because hypnosis cannot be used to force someone against their will. It’s a bit like watching an emotional movie. If you want, you can turn away, ignore what’s going on, or play sudoku in your head, but if you engage with the story you don’t consciously decide to feel joy or sadness as the story progresses, you just react. Hypnosis works in a similar way – some people just seem to have the capacity to get more “caught up in the story”.

When a suggestion is successful, the experience of it seeming to “happen on its own” is key and this is exactly what neuroscientists have been working with – by suggesting temporary changes to the mind that we wouldn’t necessarily be able to trigger on our own. In the case of the two experiments that managed to temporarily “switch off” the Stroop effect in highly hypnotisable people, the suggestion was that the words appeared as “meaningless symbols”. This avoided a clash between the colour and the word because the text suddenly appeared to be gibberish.

These studies have been useful because they have found that the brain’s system for resolving conflicting demands, part of our system for managing attention, seemed to go offline. Hypnotic virtuosos apparently have the capacity to put this system on standby when they need to, something that low hypnotisables lack. Neuroscientists Amir Raz and Jason Buhle suggest hypnosis is really when we allow suggestions to take over from our normally self-directed control of attention that deals with mental self-management, allowing science an exciting tool to “get under the hood” of the conscious mind.

As well as allowing us to better explore the nuts and bolts of the mind and brain, hypnosis is also being used to simulate experiences that normally cause people problems, such as hallucinations or loss of control over the body. Because the effects of suggestions are only temporary, hypnosis can be used to trigger these experiences without distress and for only a few minutes at a time. “Virtuosos” are now highly sought after for brain scanning experiments where researchers look at patterns of brain activity when, for example, they are asked to hear illusory music or feel as if they can’t move their hand.

Several research groups have shown that hypnosis seems to emulate these experiences very closely and that the effects on the brain are different from when participants are asked to fake or imagine the same thing – both important comparisons because we can’t tell just from what someone says that they are genuinely experiencing the effects (as parents of school-shy youngsters with mysteriously timed stomach aches could attest).

Our own research group is using hypnosis to simulate changes in control of the body, in part to examine whether similar brain processes are involved both in hypnosis and a condition called conversion disorder – where what seem to be neurological symptoms appear, like paralysis or blindness, despite there being no damage to the nervous system that could explain them.

So far, there seems to be similarity between the disorder and the effects of hypnosis in that the frontal lobe attention systems seem to be taking other brain areas offline. What we’re not sure of, is why this is only temporary in hypnosis but long-term in conversion disorder.

But perhaps even more mysterious is why we have the capacity to be hypnotised at all. As a species, about 10% of the population can have their reality profoundly altered simply by tuning in to suggestions made by someone else – something that is deeply weird when you think about it.

Virtuoso hypnotisability has never been reliably linked to any problems or difficulties and it has been suggested that, on the contrary, it actually reflects a more efficient control of the brain’s attention systems. It could be a side-effect of other benefits, but we still don’t have any good theories. If you have any suggestions, do let me know.

Los Angeles Daily News
05-08-2009
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HEALING – After a childhood of trauma, local woman finds solace in hypnotherapy

Sasha Carrion will tell you from firsthand experience: It takes a lot of strength to overcome a lifetime of trauma.

But nearly 30 years after her mother disappeared – murdered, she believes, by her own father – the 32-year-old former Torrance resident has figured out a way to put the past behind her.

She did it through hypnosis.

“My whole life was absolutely centered on getting justice for my mother’s murder,” said Carrion, who was so moved by her emotional transformation that she became a hypnotherapist. “It had consumed me.”

Hypnosis, a process by which a person enters a state of deep relaxation and heightened suggestibility, helped Carrion heal by allowing her to let go of her past.

It wasn’t an easy past to relinquish.

Carrion’s life has been a series of struggles – tragic events that began 27 years ago when she awoke one day to find her mother, Rosa Maria Marquez, missing from their Bell Gardens home.

She was 5, and her parents were separated and in the process of getting a divorce.

“I remember calling out to my mom and she didn’t say anything,” said Carrion, now a stunning woman with deep brown eyes and coffee-color hair. “The next thing I remember is the cops were there.”

Carrion’s father, Raphael Marquez, whom Carrion described as abusive and volatile, was questioned about the disappearance but never arrested.

“The police were asking me questions,” said Carrion, who chose to take her mother’s maiden name. “My dad showed up and he quickly pushed me to the side and said, `Don’t tell them that I ever hit your mom or you.’ ”

Her father fled to Mexico shortly afterward, leaving Carrion and her 3-year-old sister in the care of their widowed grandmother.

Because her mother’s body was never found, police never categorized her disappearance as a murder. Consequently, Carrion wrestled with the possibility that perhaps her mother had left them.

“I knew it was either A, my father had killed my mother, or B, she had abandoned us,” Carrion said. “You can’t win with that. Either way you lose.”

Finding family
When Carrion was 19 and ready to face her past, her paternal uncle agreed to take her to her father.

They flew to Mexico, where had remarried and had two more children.

Shortly after their reunion, Carrion asked her father: “Did you kill my mother?”

He said no.

“He told me that she had left him for another man,” Carrion said. “I was so desperate for a family that I believed him.”

For almost a decade, she maintained a relationship with her father and his new family. She sent gifts. She visited often. Then one day, her uncle came to her with a confession.

“He told me, `I’m afraid if I die I’m going to have to face your mother on the other side,’ ” she said. “Then he tells me how my father killed my mother.”

Carrion suspected her uncle’s words were true.

“I called my father to confront him about this. He didn’t admit it; he just told me to (expletive) off.”

Carrion tried to get legal action taken against her father – she even got her story featured on the Web site of “America’s Most Wanted.”

But there was no evidence. No body. Nothing she could do. In 2007, her father died from a rare form of lymphoma and cirrhosis of the liver.

Carrion said she didn’t mourn.

“The moment he died, it was as if I was free,” she said. “I had that weight taken off my shoulders. It was to the point where it had completely taken over my life.”

Alleviating the pain
By that time, years of distress had taken its toll. Not yet 30, Carrion was suffering from a host of ailments including migraines, hair loss, stomach pains and backaches.

Doctors couldn’t help her, she said. Antidepressants didn’t work either.

It wasn’t until, on a whim, she decided to try hypnotherapy that she began to feel better.

“I was finally able to let go,” she said. “I felt better almost immediately.”

Carrion said becoming a hypnotherapist herself (at the time she had been working in the fashion industry) was a natural step.

Within months, she was certified by the International Hypnosis Federation and the Omni Hypnosis Training Center, the first accredited school of hypnosis.

She had found her calling.

“When I did my first class of hypnosis, it was huge,” said Carrion, who practices out of her home in Marina del Rey and an office in Redondo Beach. “They asked for volunteers, and every chance I could get I would put my hand up.”

How hypnosis works
For most people, hypnosis conjures images of swinging pendulums and sleeplike trances.

In reality, it is more aptly described as a state of focused attention and heightened suggestibility, during which the patient is completely aware of what he is doing and saying.

“There is a fear that with hypnosis you can make the client do whatever you want them to do, but it doesn’t work that way,” said Torrance psychiatrist Isabel Puri. “The person who is in control is the patient. At any point, if you want to stop the hypnotic state you can.”

Puri, who has a certificate in hypnotherapy, said hypnosis can be an effective treatment, particularly for mild depression and anxiety disorders.

“Typically, the milder disorders are more likely to respond to hypnotherapy,” she said. “That is because all hypnosis is actually self-hypnosis. Once you learn the techniques, you need to practice by yourself.”

Hypnotherapy is often used to help people stop smoking, lose weight and overcome phobias. It also has proven helpful, as in Carrion’s case, in overcoming trauma.

To break the trauma cycle, a hypnotherapist must replace negative thoughts with positive, reassuring thoughts and feelings.

“Sometimes it’s like being freed from a curse,” Carrion said.

That’s how it felt for “Joan.”

An Orange County attorney who preferred her real name not be used, Joan, 27, had been suffering from anxiety and panic attacks for several years before going to see Carrion.

“It was to the point where I literally could not eat in a restaurant, not even a Subway or McDonald’s,” she said. “Basic things like going grocery shopping and running errands was a struggle.”

Joan had heard about Carrion through a friend who had gone to see her. She said she was skeptical at first, but decided to give it a try.

It worked. After only two sessions, Joan said, she started feeling better. Carrion also taught her self-hypnosis, which she used at home.

“Right away, I noticed that I wasn’t as agitated,” Joan said. “Instead of going to the bad place where everything is a crisis, it’s more like, `Things are going to be OK. Things are fine. I’m in an appropriate amount of control.’ ”

The Guardian
07-06-2009
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Hypnotise your patient, surgeons told

Technique seen as alternative to general anaesthetic for certain operations

Doctors should be taught to hypnotise patients not to feel pain instead of using general anaesthetics during some operations, the Royal Society of Medicine will be told today.

In what he has described as a “clarion call to the British medical profession”, Professor David Spiegel, of the Department of Psychiatry and Behavioural Sciences at Stanford University in the US, will also call on the National Institute for Health and Clinical Excellence (Nice) to add hypnotherapy to its list of approved therapeutic techniques for the treatment of conditions ranging from allergies and high blood pressure to the pain associated with bone marrow transplantation, cancer treatment and anaesthesia for liver biopsy. Nice has already approved the technique for the treatment of irritable bowel syndrome.

“It is time for hypnosis to work its way into the mainstream of British medicine,” Spiegel will say at the joint conference of the Royal Society of Medicine, the British Society of Clinical and Academic Hypnosis and the British Society of Medical and Dental Hypnosis.

“There is solid science behind what sounds like mysticism and we need to get that message across to the bodies that influence this area. Hypnosis has no negative side-effects. It makes operations quicker, as the patient is able to talk to the surgeon as the operation proceeds, and it is cheaper than conventional pain relief. Since it does not interfere with the workings of the body, the patient recovers faster, too.

“It is also extremely powerful as a means of pain relief. Hypnosis has been accepted and rejected because people are nervous of it. They think it’s either too powerful or not powerful enough, but, although the public are sceptical, the hardest part of the procedure is getting other doctors to accept it.”

Professor Marie-Elisabeth Faymonville, head of the Pain Clinic at Liege University Hospital in Belgium, who has operated on more than 6,000 patients using hypnosis combined with a light local anaesthetic, said: “The local anaesthetic is used only to deaden the surface of the skin while a scalpel slices through it. It has no effect inside the body.

“The patient is conscious throughout the operation and this helps the doctor and patient work together. The patient may have to move during an operation and it’s simple to get them to do so if they remain conscious. We’ve even done a hysterectomy using the procedure.”

The theory behind medical hypnosis is that the body’s brain and nervous system can’t always distinguish an imagined situation from a real occurrence. This means the brain can act on any image or verbal suggestion as if it were reality. Hypnosis puts patients into a state of deep relaxation that is very susceptible to imagery. The more vivid this imagery, the greater the effect on the body.

Dr Martin Wall, president of the Section Hypnosis and Psychosomatic Medicine at the Royal Society of Medicine, said hypnosis fundamentally alters a subject’s state of mind. Hypnosis is not, he said, simply a matter of suggestibility and relaxation.

Nice said it would welcome submissions for hypnotherapy to be considered as an approved therapeutic technique on the NHS if it could be cost-effective, and consistent delivery could be guaranteed.

But Professor Steve Field, who chairs the Royal College of General Practitioners, said he was sceptical as to whether hypnotherapy could meet these standards.

“It is a useful tool used by some GPs and patients for relaxation, but I don’t think it is something that we should support being rolled out to all medical students and all doctors,” he said.

“We can’t call on the NHS to support it without there being a firm medical and economic basis, and I’m not convinced those have been proved to exist.”

The Guardian
06-07-2008
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Cognitive hypnotherapy

Cognitive hypnotherapy provides overworked minds with the toolkit they need to fix their own stresses and strains. It is based on modern psychology and neuroscience and, don’t worry, there’s not a pendulum in sight …
Sun 6 Jul 2008 01.25 BST
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What is it?

Chances are, when you think of hypnotherapy, you either imagine a swinging pocket watch or a hapless audience member being made to cluck like a chicken on stage in the name of entertainment. Neither of these preconceptions is true. Cognitive hypnotherapy combines cognitive behavioural therapy and hypnosis with theories based on modern neuroscience.

We all go into natural hypnotic trances every day without even knowing it. It’s comparable to being so absorbed in a book or film that the hours seem to fly by, or being in a meeting where your mind has wandered. It is this natural state of mind that is used in cognitive hypnotherapy. You never lose control and are certainly never put under the control of anyone else. Practitioner Katie Abbott explains: “There are no over-the-top, annoying motivational speeches or long, arduous hours of difficult analysis. Cognitive hypnotherapy is just an extremely effective way of making positive change.”

Is there any evidence?

Controlled trials have shown that hypnosis can reduce anxiety (particularly before medical procedures), although there is still some doubt that the hypnotic state actually exists. In the past five years, however, scientific research has become more credible, thanks to the latest brain imaging technology; brain scans now prove that hypnotised subjects are more susceptible to hypnotic suggestion. In one study, volunteers were given hypnotic suggestions to “see in colour”. Scans showed that areas of the brain associated with colour perception were activated, even though the pictures they were looking at were black and white.

Where does it come from?

In the 18th century, Austrian doctor Franz Anton Mesmer used magnets to practise a form of hypnotism (hence “mesmerising”). His patients claimed they felt no pain while being treated under his trance. Mesmer was later dismissed as a charlatan, but his methods have since been investigated and developed into the form of hypnotherapy we know today.

In 2001, Trevor Silvester set up the Quest Institute (questinstitute.co.uk) and introduced the idea of combining hypnosis with cognitive behavioural therapy, tools from positive psychology, cognitive theory and neuro-linguistic programming.

Who can do it?

“We all see the world in different ways, so hypnotherapy works to readjust your particular frame of reference,” Abbott says. “There’s no one way to treat stress or to encourage relaxation, it all depends on the way you see things – your model of the world. As part of a session, the client is supplied with a toolkit for the mind. This enables them to use different tools to fix different mental states.”

So the theory is that everyone has the capacity to adopt new mental tools, and anyone can be hypnotised. The only prerequisite is to be open to the process.

What results can I expect?

Usually, cognitive hypnotherapy needs two or three sessions in which the foundations for change are effectively put in place, although you are likely to feel relaxed after just one session.

According to Katie Abbott: “Most people report a change after their first meeting. It’s a change of mindset, the move towards a goal. Hypnotherapy can teach you how to control your body’s responses and reactions, and anchor you in calm when you become worried.”

Contra-indications

The hypnotic state is not dangerous, but people with severe depression, psychosis or epilepsy should consult their doctor before seeing a hypnotherapist.

How was it for you?

Kate Abbott (worrier)

I never thought hypnotherapy would be the thing to calm me down, but that’s what Katie Abbott has done for me, Kate Abbott. As I approached the treatment room, I panicked. What if I actually do lose my (self-diagnosed as endearing) neuroses? Or, scarier still: what if my namesake steals my identity?

But as soon as I was ushered into Katie’s Harley Street haven, I realised she wasn’t going to brainwash me like the horror movie reel running through my mind. The session started with a simple chat. We discussed our goal of relaxation versus my reality as a worrier. What followed was an hour of gentle conversation that induced a state of complete calm.

Throughout the session, I was unsure if I was “hypnotised” or just had a case of the cathartics, but I submitted entirely, visualising my past, present and future from a different perspective (“It’s OK not to be perfect”, I tell my 11-year-old self).

The result of this enlightening delve into my personal timeline is the self-hypnosis that I now practise at home. Katie asked me to concentrate on the present moment and to call to mind three things I could hear, three things I could see and three things I think about regularly, and comment on them. As I told Katie about he-who-shall-not-be-named, any angst I’ve ever experienced about relationships, past or imminent, eased off.

I didn’t care when I stumbled out on to Oxford Street moments after my session (I have been known to cry in the face of teeming crowds), and I didn’t experience so much as a sweaty palm onboard a plane the next day. I was in control, calm and confident.