Hypnosis
People think hypnosis is about giving up control. But it’s actually giving control back to the patients.
—PSYCHIATRIST DAVID SPIEGEL1
When John was born, his mother could see that there was something wrong with his skin. As he grew up, his whole body, apart from his face, neck, and chest, became covered by a thick, inelastic, black substance that bore no resemblance to normal skin. This black substance was as hard as teeth or fingernails, and John was troubled by painful cracking of the skin. He was a horrible sight, and at school John was treated like an outcast. Doctors told John’s parents that he was suffering from ichthyosiform erythrodermia, a harrowing condition known as “fish skin disease.” Unfortunately, no cure was known and John’s chances of leading a normal life appeared negligible.
In May 1950, at age fifteen, John could barely move without causing painful fissures in his “black armour plating.” He was admitted to the Queen Victoria Hospital in East Grinstead in Sussex, England, a hospital with an international reputation for its plastic surgery department. The famous plastic surgeon Sir Archibald McIndoe and his team would try to help.
McIndoe and his colleagues began with the palms of John’s hands, which were now enveloped in “a rigid horny casing” that had cracked and become infected. The surgeons scraped the black substance off both his horny palms and transplanted some skin from his chest. But the operation was soon shown to have failed: a few weeks later the grafted skin had thickened and turned black. When a second attempt also proved unsuccessful, McIndoe and his associates concluded that they could not do anything more for John.
But anaesthesiologist Albert Mason had an innovative idea: he proposed to try hypnosis on John. Mason had previously cured warts through hypnosis and was firmly convinced that hypnotic suggestions could significantly improve the boy’s condition.
Mason began by talking John into a hypnotic trance state. Then he repeatedly told the boy, “Your left arm will clear.” Strikingly, five days later, “the horny layer softened, became friable, and fell off. The skin underneath became pink and soft within a few days. . . . At the end of ten days the arm was completely clear from the shoulder to the wrist.”2 Mason continued his treatment, beginning with the right arm and moving on to the trunk and the legs. The improvement was startling: it ranged from 50 percent on the legs and feet to 95 percent on the right arm.
Justifiably proud, Albert Mason took John along to show him to Archibald McIndoe. Flabbergasted, McIndoe told Mason that the outcome of his hypnotic treatment made no sense medically—John’s skin had no oil-forming glands that would allow its outer layers to peel off and refurbish themselves. Yet McIndoe was deeply impressed and proposed to Mason to present John at the next Royal Society of Medicine (RSM) conference. Mason agreed. The doctors who attended John’s presentation at the RSM were similarly baffled. Some said that John’s case challenged the traditional medical concepts about the relation between mind and body.
This story has a happy ending. One year after the end of the treatment, John had become a normal, happy young man and had found a job as an electrician’s assistant.3 A few years later, the case was re-presented to the RSM. Mason reported, “Not only has there been no relapse, his skin has continued to improve. . . . without further treatment of any sort, hypnotic of otherwise.” 4
John’s recovery is vivid and heartening. It illustrates particularly well how strong the mind can sometimes be and to what extent hypnosis can allow us to tap into the power within. But what is hypnosis? And how does it work?
More than half a century after John’s early miraculous recovery, there is still no consensus regarding the hypnosis or how it works. We can say that hypnosis is a trance state (that is, an altered state of consciousness) that is accompanied by changes in perception, memory, emotions, and action—changes that might seem familiar. Indeed, spontaneous mild trance states constitute a normal activity of the mind. These states occur routinely—for example, when we are daydreaming, reading an interesting book, or watching a captivating movie.
Most experts agree that hypnosis is a cooperative social interaction in which one person, the subject, becomes highly focused and receptive to verbal suggestions given by another person, the hypnotist. In the induced hypnotic state, however, the mind is guided by the hypnotist, who makes specific suggestions to help the subject change a medical condition, a perception, or a behavior. To guide the subject into a hypnotic state, the hypnotist generally asks the subject to close her eyes, breathe in a certain way (designed to calm and regulate the breath), and visualize a relaxing scene (for example, “Picture yourself walking along a long, smooth, white beach . . . hear the waves breaking on the shore . . .”). In this way the subject becomes relaxed and open to the hypnotist’s suggestions.
But hypnosis does not necessarily have to involve another person. Hypnotic suggestions can also be self-administered: a hypnotic state that is self-created is called autohypnosis (or self-hypnosis). Many experts believe that if you accept the suggestions made by a hypnotist, you are actually hypnotizing yourself. In other words, all hypnosis would be essentially self-hypnosis, even when it is assisted by a hypnotist.
Because hypnosis is a continuum rather than an all-or-nothing phenomenon, most people can be hypnotized to some degree.
Many people, however, insist that they can’t be hypnotized. A number of reasons exist for this attitude, including the belief that hypnosis requires the subject to be weak minded, naïve, or unintelligent. But this belief is mistaken. Indeed, research shows that the best candidates for hypnosis are intelligent and focused. Researchers have found that a propensity to become absorbed in fantasy or imagery—such as in books or movies—and an aptitude for blocking out the surrounding world are the best predictors of the capacity to be hypnotized.5
Some people also believe, erroneously, that a person under hypnosis can be forced to do things against her or his will. This attitude has not been helped by nightclub acts in which stage hypnotists seem to compel audience volunteers to do embarrassing things—cluck like a chicken, cry like a baby, or act foolishly in some other way. In fact, during the hypnotic state, hypnotized subjects do not lose complete control over their behavior and do not do anything that they would not be inclined to do otherwise.
The modern era of hypnosis began with the Scottish surgeon James Braid in the early nineteenth century. Using eye-fixation techniques, Braid was able to induce trance states. He also discovered the importance of using suggestions and is credited with introducing the term hypnotism—the act of inducing hypnosis.6
In the mid-nineteenth century, anesthetics were not yet available, and terrible pain was associated with every surgical procedure. The English surgeon John Elliotson—a professor of medicine at University College, London, and his protégé, Scottish surgeon James Esdaile, a medical officer for the British East India Company—proposed that hypnosis could be used as a therapeutic tool to reduce surgical pain. To test the validity of their proposal, Elliotson and Esdaile performed hundreds of surgical interventions with the hypnotic trance as the sole anesthetic agent.
Some of the surgeries Esdaile carried out in Bengal between 1845 and 1851 included amputations of breasts, penises, limbs, and scrotal tumors (caused by filariasis, an infectious tropical disease transmitted by mosquitoes). Here is how Esdaile describes a scrotal tumor case involving Gooroochuan Shah, a forty-year-old shopkeeper:
He has got a “monster tumor,” which prevents him from moving; its great weight, and his having used it for a writing-desk for many years, has pressed it into its present shape. His pulse is weak, and his feet oedematous, which will make it very hazardous to attempt its removal; but with such an appendage, life is literally a [burden]. He became insensible on the fourth day of mesmerizing [hypnosis], and was drawn with the mattress to the end of the bed (my usual mode of proceeding): two men then held up the tumor in a sheet, pulling it forward at the same time, and in the presence of Mr. Bennett, I removed it by a circular incision, expedition being his only safety. The rush of venous blood was great, but fortunately soon arrested; and after tying the last vessel, the mattress was again pulled back upon the bed with him upon it, and at this moment he awoke. The loss of blood had been so great that he immediately fell into a fainting state, and it took a good while to remove him. On recovering he said that he awoke while the mattress was being pulled back, and that nothing had disturbed him. The tumor weighed 80 pounds, and is probably the largest ever removed from the human body. I think it’s extremely likely that if the circulation had been hurried by pain and struggling, or if the shock to the system had been increased by bodily or mental anguish, the man would have bled to death, or never have rallied from the effects of the operation. But the sudden loss of blood was all he had to contend against; and, though in so weak a condition, he has surmounted this, and gone on very well.7
Remarkably, these surgeries performed under hypnosis were conducted without pain and with very low morbidity rates: in fact, the death rate was reduced to only about 5 percent at a time when surgical mortality was about 40 percent. Esdaile attributed this positive outcome to the successful relief of pain with hypnosis.8
Not long after the pioneering work of Elliotson and Esdaile, chemical anesthetics such as ether and chloroform became popular and displaced the use of hypnosis for anesthesia in surgery. Still, many observers had taken notice of the potential usefulness of hypnosis.
In the early part of the twentieth century, hypnosis became an object of scientific investigation, and American researchers interested in this emerging field became more influential than their European counterparts. Research on hypnosis exploded in the 1960s. Today scientific research into hypnosis is still growing, and hypnosis is becoming widely used in various areas of clinical psychology and medicine. It is now available to patients at some of the best medical centers in the United States, including Mount Sinai Medical Center and Beth Israel Medical Center in New York City, the Cleveland Clinic in Ohio, and Stanford Hospital on the campus of Stanford University in Palo Alto, California.9
Contemporary research shows that what goes on in our minds can greatly influence our unpleasant sensations of pain. In fact, the psychological aspect of pain—how much pain we expect to feel—seems to be as important as the physiological processes that give rise to it. No wonder, then, that hypnosis can be used to induce pain relief.
Hypnotically induced analgesia—pain relief—represents one of the most dramatic, clinical applications of hypnosis. Although chemical anesthetics largely replaced the use of hypnosis for anesthesia in surgery during the second part of the nineteenth century, hypnosis is making a something of a comeback in this area. An increasing number of people today prefer to undergo surgery consciously, under hypnosis, to avoid the wooziness and other unpleasant aftereffects associated with general anesthesia.
The case of Pippa Plaisted illustrates this trend. A few years ago, this forty-six-year-old woman underwent a breast cancer operation at Lister Hospital, London, without anesthesia or painkilling drugs, using only hypnosis to relieve pain. It seemed a daring thing to do, but Plaisted had good reason: she had previously had several operations, and after each one of them, the anesthetic drugs had left her feeling dizzy and nauseous for several months.
Just before Plaisted’s surgery began, hypnotherapist Charles Montigue stood at the operating table and put her into a hypnotic trance, resting his thumb on Plaisted’s forehead to monitor her hypnotic state. During surgery she had her eyes closed and she could hear the surgeon telling her, at each phase of the operation, what was coming next. Astoundingly, she reports that she did not feel any sensation at all during the operation. “The surgeon was cutting and sewing inside me, but I could not feel any sensation at all,” Plaisted recalls. “After the operation, I felt tired, but there was no nausea or wooziness. I had a clear head and felt totally normal.”10
Some surgical patients choose to combine hypnosis with a local anesthetic to avoid the debilitating knockout effect of general anesthesia. Marianne Marquis is one of these patients. In 2011 she was hypnotized ten minutes before surgery to remove her thyroid, a small gland located at the bottom of the neck that produces hormones involved in the control of the body’s metabolism. The operation was performed at Cliniques Universitaires St. Luc in Brussels, Belgium. Marquis, fifty-three, was put into a hypnotic trance by her anaesthesiologist, Dr. Fabienne Roelants. While the surgeons were slicing her neck open, Marquis said later, she was “imagining squishing my toes in the sand and feeling water come up over them.” She did not feel any pain during the surgery.
Marianne Marquis’s case is not unique. Combining hypnosis with local anesthetics is becoming an increasingly popular option in Western Europe. This approach is used at Roelants’s hospital for one-third of the surgeries carried out to remove thyroids and one-quarter of the breast cancer surgeries. Fabienne Roelants and her colleagues are planning to expand this approach to knee arthroscopies and plastic surgeries. A few plastic and facial surgeons in Germany also currently use hypnosis for pain control.
Doctors who support this approach have several reasons. Clearly, it cuts down on the need for anesthetic drugs. Proponents also argue that the recovery time of patients is faster, and their need for painkillers afterward is diminished. Other doctors, however, warn that hypnosis is not usable in surgical interventions implicating the heart or other internal organs because the pain would be unendurable. And for the surgeon, there’s no possibility of error. George Lewith, a professor of health research at Southampton University, England, says bluntly, “If hypnosis doesn’t work and you’ve got somebody’s abdomen or chest open, then you’re in big trouble.”11 Another limitation is the fact that while many people can by hypnotized to some degree, not everyone can be brought into a deep hypnotic state.12 Nonetheless, research shows that about half of the population can obtain significant pain relief—a one-third reduction in felt pain—from hypnosis.13
This is welcome news for people suffering from serious burns, for whom pain is a major problem. Pain impairs wound healing and contributes to posttraumatic stress disorder; and severe pain can even lead to the development and maintenance of suicidal thoughts in burn patients after they are released from the hospital. Powerful analgesic drugs, such as morphine, are generally given to severely burned patients to help them cope with acute pain. But the doses required for controlling this extreme pain are often very large, augmenting the risk of negative side effects. Given this, some researchers have sought to evaluate whether hypnosis can benefit burn patients and diminish analgesic drug consumption.
In one study, patients with major burns admitted to the intensive care unit of the University Hospital in Lausanne, Switzerland, were asked if they would like to try hypnosis in addition to conventional treatment (including analgesic medications). Patients in the hypnosis treatment group reported lower pain scores and less anxiety than control patients, who received only the standard treatment. Patients in the hypnosis group also required fewer pain-relieving drugs afterward and displayed better wound healing than those in the control group.14
Pain is the most common symptom of bone cancer, in which cancerous tumors destroy normal bone tissue. In a carefully designed investigation, patients with advanced bone cancer were randomized to receive either weekly sessions of supportive attention or a hypnosis intervention. Patients assigned to the hypnosis intervention were given a minimum of four weekly sessions in which a hypnotic induction—including suggestions and instructions—was completed. They were also provided with an audiocassette tape recording of a hypnotic induction and were instructed in home practice of self-hypnosis. The patients in the intervention group showed an overall reduction in pain for all hypnosis sessions combined compared to those who received only supportive attention. Moreover, the effectiveness of self-hypnosis home practice was reported as 6.5 on a 0-to-10 scale.15
Hypnosis has also been shown to be efficacious with migraines, a common and very painful type of headache that is often debilitating. In one study, patients who had suffered with migraines for a minimum of one year were randomly assigned to receive either medication treatment or hypnotherapy. The hypnosis treatment consisted of six sessions at intervals of about two weeks. Hypnotic suggestions included experiencing less tension and less anxiety, and patients were also instructed to imagine the arteries in the head as becoming smaller and more comfortable. They were then asked to practice self-hypnosis on a daily basis.
Results showed that that the number of migraines per month was significantly lower in the hypnosis group. In the second six months of treatment, the hypnosis group averaged only 0.5 migraines per month compared with nearly three per month in the medication group. At one-year follow-up, ten hypnosis patients had experienced complete remission of migraines during the previous three months—that is, they had experienced no migraines at all—compared with only three patients in the medication treatment group.16
Chronic pain—pain for any reason that lasts for more than six months—is a common reason for seeking medical care. Unrelieved chronic pain can lead to substantial suffering, emotional distress, and physical limitations. Frustratingly, it often persists despite treatment with analgesics and physical modalities. Nearly 20 percent of American adults claim they suffer from chronic pain.
The findings of several studies indicate that hypnosis produces significant decreases in pain associated with various chronic pain problems, including fibromyalgia, arthritis, low-back problems, and temporomandibular disorder (TMJ)—a condition resulting from an inflammation of the temporomandibular joint, which connects the jawbone to the skull. These studies have generally found that hypnosis is more effective than nonhypnotic interventions such as attention, physical therapy, and education. Thanks to these findings, interest in hypnosis for pain management is now getting stronger.
The pain associated with labor and delivery is described by many—if not most—women as the most extreme pain they have ever experienced. Although pharmacologic methods such as analgesic drugs and epidurals have been shown to be effective, these methods can be risky for both mother and child, and after a certain point in labor cannot be administered at all. It’s not surprising, then, that many expectant mothers have reservations about drug-induced pain relief.17
Over the past twenty years, a number of studies have been conducted to evaluate the effectiveness of hypnosis in reducing labor pains. In one of these studies, pregnant women were divided into two groups. Half of the women were randomly assigned to receive hypnotic suggestions for relaxation and analgesia; the other half received breathing and relaxation exercises. The hypnosis treatment was audiotaped for the patients to listen to daily prior to delivery; women in the control group listened to a commercial pre-birth relaxation tape. The women who received hypnosis had shorter labor, used less pain medication, and had higher rates of spontaneous deliveries than did women in the control group. Women receiving hypnosis also reported less labor pain.18
Another investigation sought to assess whether hypnosis could diminish birth complications. Overall, 520 pregnant women who were still in either their first or second trimester were recruited. These women were randomly assigned to either a hypnosis treatment or a supportive psychotherapy. The hypnosis intervention emphasized suggestions for decreased anxiety and fear, increased feelings of relaxation, and confidence in the ability to cope with the pain of labor. The supportive psychotherapy intervention was based on discussions of issues related to pregnancy. Women in the hypnosis treatment group experienced less complicated deliveries and Cesarean sections than those in the supportive psychotherapy group. In addition, the women who received the hypnotic suggestions used analgesics and epidural anesthesia less frequently than those in the other group.19
Recently, the birth outcomes of women undergoing hypnotic preparation for labor and delivery pain were assessed in the obstetrics and gynecological service of the Women’s and Children’s Hospital in Adelaide, Australia. Seventy-seven women—some who were having their first baby (primigravid), and some who had given birth more than once (parous)—received up to four forty- to sixty-minute hypnosis training sessions after thirty-five weeks of pregnancy. During the first session, these women were taught how to use hypnosis. In subsequent sessions, they received suggestions for relaxation and analgesia. The participants in the hypnosis treatment group were compared with a control group of 3,249 women, matched for parity (that is, the number of live-born children and stillbirths a woman has delivered at more than twenty weeks of gestation) and gestational age. Women in the control group received standard medical care. Results revealed that primigravid women in the hypnosis treatment group used epidural anesthesia significantly less frequently and had a decreased need for drugs during labor compared with women in the control group.20
Taken together, these studies suggest that hypnotic preparation can be more effective than standard medical care in diminishing pain and analgesic use during labor and delivery—good news for women seeking to give birth naturally, without drugs and with as little pain as possible.
Surgery is often a frightening prospect of unknown outcomes that are out of the patient’s control. So it’s not surprising that anxiety is a real problem for people anticipating surgery. More than half of presurgical patients fear the effects of anesthesia or the possibility that they will not wake up after surgery. Hypnosis has been used for decades to lessen the anxiety associated with surgery.
A recent study examined the effect of hypnosis on preoperative anxiety.21 People undergoing outpatient surgical procedures were randomized into three groups: a hypnosis group, an attention-control group, and a “standard of care” control group. Participants in the hypnosis group were told during the suggestion phase that they would continue to feel relaxed and calm before the surgery. In the attention group, participants received attentive listening and support, without any specific hypnotic suggestions. Researchers assessed the participants’ anxiety levels before and after intervention, and on entering the operating room. Participants in the hypnosis group reported a marked decrease of 56 percent in their anxiety levels on entrance to the operating room. By contrast, the attention group reported an increase of 10 percent in anxiety, and the control group reported an increase of 47 percent in their anxiety.
Breast cancer is the most common cancer among women today, and the second leading cause of cancer deaths in women (after lung cancer). Screening mammography allows early detection of this type of cancer, and ameliorates chances of successful treatment and survival. In the United States, more than 60 percent of women aged forty or older undergo mammography each year. Five to 10 percent of mammograms produce inconclusive or abnormal results that require follow-up biopsies in which doctors use a large hollow-core needle to get small breast tissue samples. This procedure is usually done under local anesthetic, which limits the use of intravenous drugs to decrease anxiety and pain.
Recently, a group of researchers compared the effect of self-hypnosis, structured empathic attention, or standard care on the anxiety levels experienced by 236 women undergoing breast biopsy with a large core needle. The women receiving only standard care reported a significant increase in anxiety, while the anxiety level did not change in the empathy group. Anxiety decreased significantly in the self-hypnosis group.22
There is also considerable evidence that hypnosis reduces anxiety associated with various dental procedures and oral surgery, such as multiple dental extractions or the excision of cancer cells on the cheek.
Hypnosis has also been shown to have a positive effect on healing a variety of conditions. These range from external conditions, such as skin problems and burns, to internal conditions such as asthma.
John’s dramatic experience with fish skin disease, described at the beginning of this chapter, is just one example of a broad array of skin conditions that can be substantially improved using hypnosis. Two common conditions, psoriasis and urticaria, seem especially susceptible to suggestion.
Stress and emotions are known to play a major role in the onset, exacerbation, and prolongation of psoriasis, an inflammatory skin disease characterized by the formation of reddish spots and patches, especially on the scalp, trunk, elbows, and knees. Cases of extensive severe psoriasis that had resisted twenty years of conventional treatment and that have demonstrated marked improvement (for example, 75 percent resolution) or full resolution when treated with hypnotherapy have been reported. Moreover, a double-blind controlled trial using hypnosis as complementary therapy in psoriasis has shown significant improvement in highly hypnotizable individuals.23
Urticaria (also called hives) is a skin eruption characterized by temporary wheals of changing shapes and sizes. This eruption is caused by an allergic reaction, which is due to a hypersensitivity of the immune system. Allergic reactions—which occur in response to usually harmless environmental substances called allergens (such as pollen and house dust)—are associated with disproportionate activation of certain white blood cells, such as mast cells and basophils. In a study of hypnosis on fifteen patients with chronic urticaria of nearly eight years’ average duration, six patients had resolved and another eight improved within fourteen months. Other investigations have demonstrated that hypnotized volunteers can significantly decrease the immediate wheal-and-flare reaction to an injected allergen in a skin test. In a particularly interesting study, participants under hypnosis who were asked to increase their reaction to one allergen while decreasing it to the other showed a significant difference in reactions between the two allergens.24
Hypnosis has also been utilized with success to foster healing of severe burns. For instance, one study has shown faster surgical incision wounds healing in a group of participants having received hypnotic suggestions compared to control participants.25 In another investigation, hypnotic suggestions helped severely burned patients to heal quickly and without scarring. One of these patients was a man whose right leg had briefly been immersed up to the knee in melting aluminum.26
The impact of hypnosis on asthma, which can cause severe breathing problems, has also been evaluated on several occasions. In one clinical trial involving patients with this respiratory disease, those who were assigned randomly to the hypnosis group had lower wheezing scores and less use of bronchodilators (devices used by many asthmatics to administer medication that eases breathing) than patients in the control group. The participants who responded best were more easily hypnotized, more compliant with practicing self-hypnosis techniques, and experienced a deeper level of trance.27
Structural changes in the body without surgery, using only hypnosis, arguably constitute the most spectacular manifestation of the power of hypnosis. In the 1970s, a few studies were performed on women who wanted to increase the size of their breasts. These women were put into a hypnotic trance and instructed to visualize themselves as they wanted to look. Amazingly, nearly all of the women succeeded in increasing their breast size: across the studies, the average increase in the circumference of their breasts ranged between 1.44 and 2.11 inches. In one of the studies, 46 percent of the participants found it necessary to buy larger brassieres at the end of the twelve-week hypnosis intervention. Further, it was found that participants who had better visual imagery skills had the greatest success.28
Hypnotic suggestions may also be able to influence the repair of bone fracture. Research psychologist and hypnosis expert Carol Ginandes and radiologist Daniel Rosenthal, both affiliated with Harvard Medical School, have tackled this intriguing question. They recruited twelve people with broken ankles who did not need surgery, and who had been given the standard orthopedic treatment—including serial radiographs and clinical assessments—at Massachusetts General Hospital. Participants were then randomized to either a treatment group or a control group. The treatment group received a hypnotic intervention (individual sessions) once a week for twelve weeks. This intervention was designed to accelerate fracture healing. The casts were applied by the same doctor, and the same radiologists took regular X-rays to monitor how well the participants healed. In addition, the radiologist who examined the X-rays did not know which participants underwent hypnosis.
X-rays revealed an important difference in fracture-edge healing at six weeks following injury, and orthopedic evaluations showed trends toward greater healing for hypnosis participants through week nine, including improved ankle mobility and better functional ability to descend stairs. Ginandes and Rosenthal concluded that hypnosis may be capable of enhancing fracture healing.29
Changes in the body resulting from hypnotic suggestions are sometimes unpredictable. Deirdre Barrett, another psychologist and hypnotherapist on the faculty of Harvard Medical School, has reported the case of a man who underwent hypnotherapy to quit smoking. During one hypnosis session, Barrett gave the man the suggestion to imagine himself as the person he would like to be. Rather than imagining himself as a nonsmoker, the man—a homosexual—imagined himself as a pregnant woman. For a long time, apparently, he had wished that he could bear a child. After the suggestion by Barrett, the man continued on a regular basis to visualize himself as a pregnant woman. When he arrived at the hospital three months later, he was not pregnant—but he had an expanded abdomen and one of his breasts was enlarged. Furthermore, his nipples were secreting and he was suffering from morning nausea.30
A few skeptics have attempted to discredit hypnosis by arguing that it is nothing more than an amplified form of social compliance: that is, hypnotic subjects adopt a role to cooperate with the wishes of the hypnotist. One way to test the validity of this view is to investigate whether measurable changes can be detected in the brain of hypnotized people. In 2000 Stephen Kosslyn, a professor of psychology at Harvard University, and his colleagues examined this titillating question. Specifically, they sought to determine whether hypnosis can influence the brain mechanisms underlying color perception.31
The researchers pretested 125 individuals. Eight highly hypnotizable people were recruited for the study (this category includes about 8 percent of the general population—about half of the people can be hypnotized to a medium extent). Each participant was hypnotized as he or she lay in a positron emission tomography (PET) scanner at Massachusetts General Hospital. During hypnosis, a computer screen overhead presented patterns of red, blue, yellow, green, and gray rectangles. The PET scanner recorded the participants’ brain activity while they were instructed either to “color” the gray rectangles with their minds or to see gray rectangles when they were in fact looking at brightly colored rectangles. Participants were also scanned when they were not hypnotized as a baseline.
The results showed that when participants were hypnotized, color areas of both the left and right hemispheres were activated when they were asked to perceive color, and decreased when they were told to see gray—regardless of which rectangles they were being shown. That is, when the participants believed they were looking at color, the parts of their brains involved in color vision showed increased blood flow; and when they believed they were looking at gray, these brain areas showed decreased blood flow.
The results of this PET study cannot be explained by saying that hypnotic subjects are just telling hypnosis researchers what they want to hear. Indeed, these results demonstrate that hypnotized volunteers can change the way the brain processes information.32
In recent years, other brain imaging studies have been performed to learn how hypnosis works. One of these studies was carried out by a team of researchers at the University of Iowa. The study was led by anaesthesiologist Sebastian Schulz-Stübner. The researchers used fMRI to evaluate whether hypnosis changes brain activity in a way that might explain how it reduces pain perception.33
Twelve healthy participants had a heating device put on their skin to determine the temperature that each of them felt to be painful (8 out of 10 on a 0–10 subjective pain scale). Next, the participants were divided into two groups. One group was hypnotized and placed in the fMRI machine, where their brain activity was recorded while the painful heat was applied. Then the hypnotic state was terminated and another scan was carried out without hypnosis while the same painful thermal stimulation was again applied to their skin. The participants in the second group underwent their first scan without hypnosis. These scans were followed by second scans performed under a hypnotic state.
Under hypnosis, all of the participants experienced a significant pain reduction (less than 3 on the 0–10 self-reported pain scale) in response to the painful heat. Moreover, different patterns of brain activity were seen compared to when the patients were not hypnotized and received the painful stimulation. Specifically, brain activity was reduced in areas of the pain network.
The pain network, as its name suggests, is involved in the perception of pain. It operates like a relay system. An input pain signal from a peripheral nerve goes to the spinal cord, where the information is processed and transmitted to the brainstem. From there the signal is passed on to the midbrain region and finally arrives in the brain area implicated in the conscious perception of painful stimulation. Schulz-Stübner and his colleagues speculated that decreased activity in regions of the pain network may prevent pain signals from reaching the parts of the brain associated with pain perception.
Hypnosis can also be useful for investigating so-called conversion disorder, or what used to be termed hysteria. This enigmatic condition involves people who experience symptoms affecting sensory or motor function, such as blindness, numbness, and paralysis, with no identifiable neurologic explanation. Toward the end of the nineteenth century, Sigmund Freud proposed that conversion disorder symptoms are the result of emotional conflicts, which are “converted” into neurological ailments.
Neuroscientist Martin Pyka and fellow researchers at the University of Marburg, Germany, have used hypnosis to explore what may be going on in the brain in conversion hand paralysis.34 Nineteen highly suggestible participants were recruited in this fMRI study. Participants underwent two sessions of fMRI, one under the hypnotic suggestion of a left-hand paralysis and the other session while in a normal state.
Researchers began hypnotic induction with suggestions such as “The left hand feels weak, heavy.” These suggestions were followed by direct instructions like “The left hand is paralyzed, you cannot move the hand anymore.”
The left-hand paralysis induced by hypnosis was not associated with activation of brain areas involved in the inhibition of movement but with increased coupling between regions implicated in the representation of the self and those that monitor one’s own movements. These results indicate that the hypnotic suggestions did not lead to the actual suppression of the participants’ hand control. Rather, it seems that the participants no longer thought they had the power to move their left hands.35
Hypnosis can be a powerful tool for harnessing the power of our minds and affecting the way our brains and bodies function. Research shows that suggestions received in a hypnotic state of trance can markedly reduce pain perception and improve various skin conditions, allergies, and asthma. Hypnotic suggestions can also alter the activity of the brain and even lead to spectacular body changes.
As researcher Emily Williams Kelly points out, these bodily effects are much more specific than the general physiological processes associated with simple relaxation.36 The mechanisms by which specific hypnotic suggestions can trigger specific physical effects and contribute to the healing of the body still remain elusive.
It seems clear that the phenomena apparently produced by suggestions from the hypnotist largely depend on the subject’s own mental activity. We are not, in fact, being controlled by hypnotic suggestion; rather, hypnosis can help us let down the normal barriers that prevent us from using the abilities that lay dormant within us. In the hypnotic state, subjects seem to be able to access deeper levels of the mind. These deeper levels allow a connection with a larger intelligence hidden within us, which has a much greater capacity than the normal waking mind to influence what is going on in the body.37
In this chapter we have seen that suggestions and images received in a trance state can substantially affect our own body’s functioning. But can mind influence the bodily functions of other people at a distance? Can it receive information that is beyond the reach of our ordinary senses?