The Science of Self-Hypnosis | Dr. David Spiegel

How it can help with stress, anxiety, and panic. Dr. David Spiegel https://med.stanford.edu/profiles/david-spiegel is Willson Professor and Associate Chair of Psychiatry at Stanford School of Medicine. Standing on a lifetime of research and clinical experience (nearly 50 years), he is a world renowned expert on hypnosis and has treated more than 7,000 patients with it. He founded the Reveri https://www.reveri.com/ app to make his methodology accessible to all. In this episode we talk about: What hypnosis actually is — and how it does or doesn't differ from the mainstream conceptions (ie stage hypnotists) The types of people who are — and aren't — hypnotizable. And why. We go over the steps of self-hypnosis, so you can do it at home We talk about the differences between hypnosis and a flow state The difference between hypnosis and meditation What happens in the brain during the hypnosis And what hypnosis is helpful for, including stress, anxiety, and panic (sidenote: Dan agreed to do the interview because he really wanted to see if hypnosis could help him with his ongoing claustrophobia on airplanes and elevators. You'll get to hear him try…) Try Dr. David Spiegel's Reveri https://www.reveri.com/ app: 20% off yearly or lifetime with code 10PERCENT Join Dan's online community here http://www.danharris.com/ Follow Dan on social: Instagram https://bit.ly/3tGigG5, TikTok https://bit.ly/3FOA84J Subscribe to our YouTube Channel https://bit.ly/3FybRzD Get ready for another Meditation Party at Omega Institute! This in-person workshop brings together Dan with his friends and meditation teachers, Sebene Selassie, Jeff Warren, and for the first time, Ofosu Jones-Quartey. The event runs October 24th-26th. Sign up and learn more at eomega.org/workshops/meditation-party-2025 http://eomega.org/workshops/meditation-party-2025. To advertise on the show, contact [email protected] or visit https://advertising.libsyn.com/10HappierwithDanHarris SPONSORS: Function Health Learn more and join using our link. Visit www.functionhealth.com/HAPPIER http://www.functionhealth.com/HAPPIER to own your health. Monarch Money Get control of your overall finances with Monarch Money. Use the code "happier" at monarchmoney.com http://monarchmoney.com/ in your browser for 50% off your first year.

Speaker names marked ? are inferred from speaking time and the show’s known hosts — they are not voice-verified.

• 0:04Dan Harris?

  This is the 10% Happier Podcast. I'm Dan Harris.

• 0:18Dan Harris?

  Hey, hey, how we doing, everybody? Today, we're going to talk about yet another thing that I initially dismissed as nonsense, only to be proven wrong. This is a recurring theme in my life. The subject in question today is hypnosis, more specifically, self-hypnosis. I'm talking to Dr. David Spiegel, who's from Stanford Medical School, where my parents went, and he's one of the leading researchers and practitioners of hypnosis. So, we're going to talk about what hypnosis actually is and how it does and doesn't differ from the mainstream conceptions, you know, the stage hypnotists that we often see. I remember seeing one when I was in college who came and had people make fools of themselves

• 1:00Dan Harris?

  on stage, which is probably the point of origination for my skepticism about hypnosis. We're also going to talk about the types of people who are and are not hypnotizable, and why. We go over the steps for self-hypnosis, so you can do it at home. We talk about the differences between hypnosis and flow states, the difference between hypnosis and meditation, what happens in the brain during hypnosis, and what hypnosis is helpful for, including stress, anxiety, and panic. As a side note, I actually agreed to do this interview because I really wanted to see if self-hypnosis could help me with my ongoing claustrophobia on airplanes and elevators, and you'll get to hear Dr. Spiegel try it out on me. Speaking of stress and anxiety, we've got a brand-new meditation today from our Teacher

• 1:44Dan Harris?

  of the Month, the wonderful Kyra Jewell-Lingo. It's all about stress and anxiety, which I suspect many of you will relate to. She has this great little phrase she uses. It's a kind of a question you can ask your anxiety. "What are you trying to protect me from?" Highly recommend it. Go check it out on danharris.com. On the topic of guided meditations, I can now finally share a few things with you. First, back in June, we started offering companion guided meditations for all of our full-length Monday, Wednesday episodes. We started posting them over on danharris.com. I'm happy to say we're going to keep doing that going forward. Second thing to say is that, starting in September, our Teacher of the Month, that's how we're doing this, we're hiring teachers of the month to create the guided

• 2:27Dan Harris?

  meditations. Starting in September, our live guided meditation and Q and A sessions that we do on video, we're going to now do these every week. So every Tuesday afternoon for the foreseeable future, I don't want to say forever because nothing's forever, but every Tuesday now, in the afternoon, we're going to be doing a live guided meditation. Sometimes I will do it, sometimes it will be our Teacher of the Month, and sometimes it'll be both of us. The idea here is that meditation can feel like a lonely pursuit, so we want to create an HOV or carpool lane so that we can all derive the scientifically proven benefits of doing stuff as a group. So on September 2nd, we'll do our first weekly guided meditation. It will be with our September Teacher of the Month, fan favorite

• 3:12Dan Harris?

  and personal favorite, Vinnie Ferraro. Last thing to say, and then I'll shut up and we'll hear from Dr. David Spiegel. Last thing, in October, I'll be up again at the Omega Institute for another IRL installment of Meditation Party. This is an in-person retreat with my friends, Seven A Salassi, Jeff Warren, and this time, Ofosu Jones-Cortez is going to join us. It'll be happening on October 24th through October 26th, and you can get your tickets at eomega.org. I put a link in the show notes. Hope to see you there. Okay, we're going to take a quick break. After that, Dr. David Spiegel.

• 3:48Speaker 01

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• 4:15Speaker 02

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• 4:51Dan Harris?

  Dr. David Spiegel, welcome to the show.

• 4:53Speaker 03

  Thank you, Dan. I'm delighted to be here.

• 4:55Dan Harris?

  I'm delighted to have you here. Let me start with a very obvious question, which is, what is hypnosis?

• 5:01Speaker 03

  Hypnosis has been called believed in imagination. It's a state of highly focused attention, like looking through the telephoto lens of a camera. What you see, you see with great detail, but you're less aware of the context that it's in. It's a naturally occurring state. Most children are in hypnotic states most of the time. Eight-year-olds, you call them in for dinner, they don't hear you. But as we grow up, some of us lose some of that ability. But it is a state, it's been called something like a flow state, where you're just immersing yourself in what's happening and not judging it, not evaluating it, experiencing it. And that provides some extra capacity for intense concentration and for mind-body control as well.

• 5:44Dan Harris?

  Okay. I have a million questions just to clarify that. But before I get into my clarifying questions, what you just described does not sound like the hypnosis that I watched on stage when I was in college and they brought a hypnotist in and he made people do weird things on stage.

• 6:04Speaker 03

  I'm not thrilled about stage hypnosis, but it often does tap into a similar phenomenon. It's a little deceptive in that the stage hypnotists try to make it look like anybody could be hypnotized and lie between two chairs while you sit on them. And Where the football coach would dance like a ballerina, they actually filter through the audience to get the like 10 or 15% of people who are extremely hypnotizable. And that's when they do their show. But there is a lesson in stage hypnosis that I hope people will remember. And that is, the reason the football coach will dance like a ballerina is that he is suddenly willing to try out being different and see what it feels like. So he kind of forgets his usual restrictions or anxieties about looking silly and doing

• 6:49Speaker 03

  something that a football coach would never do. And that's a real opportunity because as a psychotherapist and psychiatrist, I like having people to work with who are willing to try out being different and they can often surprise themselves at what they can do. And that's one of the great strengths of hypnosis portrayed in a way that I find unfortunate.

• 7:09Dan Harris?

  Okay, so there's a kernel of truth in stage hypnosis, but also a lot of caricature.

• 7:17Speaker 03

  Right, well put.

• 7:18Dan Harris?

  So let me go back to the way you described it. You described it as something akin to, if not entirely synonymous with a flow state.

• 7:28Speaker 03

  Yeah, it's similar. You know, Chick sent me a high call the flow state, an autotelic experience, one that is intrinsically rewarding. You want to do it just because it feels good to do it. And you lose your distractions, your concerns, your misconceptions, and you just let yourself go with the experience. And hypnosis is very similar to that.

• 7:49Dan Harris?

  A flow state, it's a bit elusive, but my understanding is you can create the conditions to the best of your ability to get yourself into flow. Is that similar to a hypnotic state in that there's some agency involved? Because I think of hypnosis as something someone does to you, not something you do for yourself.

• 8:11Speaker 03

  Yeah, I'm glad you asked that question. And all hypnosis is really self-hypnosis. I can't hypnotize someone who isn't hypnotizable. I can teach people who are hypnotizable, which is a majority of people, how to use that state, but they're allowing me to do that. So the misconception that hypnosis is a loss of control is really, the real story is it's an opportunity to enhance control over body and mind. Hypnosis is a state of learning how to better control your perception, your motor control of your body, what you think about, how you focus on things, and what you think of yourself.

• 8:49Dan Harris?

  And you're saying this is a place that we can take ourselves, although not everybody is hypnotizable.

• 8:58Speaker 03

  Right.

• 8:58Dan Harris?

  What would make somebody hypnotizable or not?

• 9:02Speaker 03

  Well, there are genetic components, there are experiential components, Dan. So, as I said, most eight-year-olds are in hypnotic states. Most of the time, you call your kid in for dinner, he doesn't hear you, he's playing, work and play are all the same thing for kids. As we go through adolescence, we develop what are called formal operations in psychology, where you tend to value reason and logic more and experience less. By the time you're in your early twenties, your hypnotizability is about as much as it's going to be throughout your adult life. It's as stable as IQ at that point. And part of it is genetics. We've discovered that there are genes, one gene in particular, the COMT gene, that is involved in metabolizing dopamine in the brain. And the people with a certain polymorphism of

• 9:46Speaker 03

  that gene turn out to be more hypnotizable than those who have a different polymorphism. It has to do with the speed of metabolizing dopamine, so that you keep the right amount in your brain, and you can focus in that way, and the parts of the brain, like the attention and salience network in the brain, that allows you to shift into this state. The other part of it is developmental, and there is good way and a bad path. The good path is if you've had imaginative involvements with your parents, they read you a story when you go to sleep every night, you tend to retain more of that hypnotizability because you're used to the idea of shifting into this state of believed in imagination. The bad part is mistreatment abuse. And I've had patients who would go to a mountain meadow

• 10:30Speaker 03

  full of wildflowers when they were being assaulted. So, it's a state that either you like to go to because you enjoy it, or because you need it. But those people tend to be more hypnotizable as adults as well.

• 10:43Dan Harris?

  Interesting. And for you, as a, somebody who treats people...

• 10:49Dan Harris?

  What is hypnosis good for? What can it help?

• 10:54Speaker 03

  It can help people with anxiety, with stress, with pain control. It's a powerful analgesic without drugs. It can help people control habits like smoking, stop smoking, or to eat better. It can help you go to sleep. It can help you manage stress. And the nice thing about it is it's free. It can occur within minutes. And we found with our users over every our self hypnosis app that four out of five of them find relief from their level of stress or their level of pain in about 10 minutes. So it's quick.

• 11:30Dan Harris?

  Wow.

• 11:30Speaker 03

  And you can tell right away whether it's likely to help you or not.

• 11:34Dan Harris?

  And the evidence for the use cases and benefits that you just described is robust?

• 11:41Speaker 03

  Absolutely. We published, for example, Dan, a randomized clinical trial in the Lancet, a leading British medical journal. Three-arm study, patients undergoing surgery through their arteries. So you usually don't use general anesthesia for it. Takes about two and a half hours. It's anxiety provoking. It can be painful. And we randomized them into one of three conditions. One, push a button and you get opioids in your bloodstream through an IV. Two, that plus a friendly nurse providing emotional support. And three, someone teaching them to do self hypnosis, to manage the stress and the pain. And by the end of an hour and a half, the average pain level for the standard care group was five out of 10. For the nursing support group, it was three out of 10.

• 12:25Speaker 03

  For the hypnosis group, it was one out of 10. And they were using half the level of opioids. They had fewer procedural complications and they got done 17 minutes faster. So, you know, it reduced stress on the treatment team as well. They were functioning more efficiently. The anxiety levels were even more different. Five out of 10 with standard care, three out of 10 with the nurse and zero in the hypnosis group after an hour and a half. I thought they died or something. They were fine. They were just completely relaxed. So significant reduction in pain and anxiety, randomized clinical trial, and fewer procedural complications, too. Fewer cardiac arrhythmias and things like that, changes in blood pressure. So it's safer, quicker, and faster.

• 13:09Dan Harris?

  And does a study like that avoid questions around causation versus correlation?

• 13:15Speaker 03

  Yes, it does, because it's a randomized clinical trial. So they didn't choose, it wasn't certain. People chose to do one thing and certain chose to do another. They were randomly assigned. They were all subject to the same intervention conditions, but they had three different methods of providing help. They all got something. So, yes, this was not self-selection or anything other than what you would do with a medication if you were doing a randomized trial.

• 13:41Dan Harris?

  What about a placebo effect?

• 13:43Speaker 03

  You know, they all could have a placebo effect. They all expected that the doctors were going to try and make them comfortable and that this procedure was in their best interest to do it. There are other studies that show that placebo helps to a certain level. There was a study where people were randomized to keep their hand in circulating ice water. And the longer you keep it in, the more uncomfortable it is. And so you could just measure how long they were able to keep their hands in the water. For high and low hypnotizable people, for both of them, the placebo effect allowed them to keep it in for a certain amount of time that was comparable. But for the hypnosis group, they were able to hold their hand much longer. So placebo is kind of one level that everybody can experience to a certain extent

• 14:26Speaker 03

  if you expect some kind of positive outcome. But hypnotic analgesia is more powerful than placebo analgesia.

• 14:34Dan Harris?

  So can you explain, and you may have said this already, but I just want to make sure that I get it. What is the mechanism here? We get into this state that is akin to a flow state, a believed-in imagination state, intense focused, sort of a telescopic focus where distractions are minimized. And how does that help reduce anxiety, pain, insomnia, desire for unhealthy things? What's the mechanism?

• 15:02Speaker 03

  Well, I knew you were going to ask me this. So five years ago, I did a bunch of studies using functional magnetic resonance imaging, which allows us to see exactly where in the brain activity is changing. And we took a group of highly hypnotizable people and a group of low hypnotizable people, put them in the scanner and hypnotized them. Three changes happened in their brains. One is that activity was reduced in what we call the salience network. It's the anterior cingulate cortex. It's like a C on its ends in the middle of the base of your brain. And the front part is like the alarm system in your brain. So if I make a loud noise and you look up like that, your salience network is saying, whoops, there was something potentially threatening. I better pay attention to it.

• 15:45Speaker 03

  In hypnosis, and the extent to which these people felt hypnotized during the time they were in the scanner, activity in this interior dorsal part of the anterior cingulate cortex was reduced. So hypnosis was associated with reduced vigilance, reduced concern about what else is going on in the world so that you can just turn inward. That's the first thing. The second thing is higher, what we call functional connectivity. So when one region is active, the other is active between the executive control network, the left dorsolateral prefrontal cortex, and the insula. Insula is Latin for island. It's a little island of tissue in the middle of the frontal cortex. And it's a mind-body pathway.

• 16:28Speaker 03

  It's ways in which the brain gives signals to the body to do or not do certain things. It's also a focus of interoception, how the brain understands, perceives what's going on in the body. And there's more connectivity between those two regions. So it's a state in which the brain is better at understanding what's happening in the body and controlling what the body is doing. That's one way that hypnosis can be so effective in controlling pain and controlling anxiety. The third part is when there's more activity in the prefrontal cortex, there's less activity in the back of the brain, the posterior cingulate cortex, which is what we call the default mode network. That's where you think about who you are, what you are. When you're not doing anything in particular, you're just reflecting on who you are,

• 17:12Speaker 03

  what your parents thought you should be, how well you've succeeded, those kinds of things. That's when the default mode network is working, or I call it the my fault mode network, when you think about what's wrong with you. And if you can inhibit activity in that part of the brain, you can try out being different. You know, the football coach doesn't think, hey, wait a minute, I'm not supposed to do this. You just see what it's like. So those are the three things that happen in the brain when people are in a hypnotic state.

• 17:40Dan Harris?

  Okay, so that's what happens in the brain, but I'm curious about the mechanism by which change becomes possible. I guess what I had assumed, and you'll correct me if, and this is almost certain if I am wrong, that you get into a hypnosis, you are then susceptible to the power of suggestion, and somebody can tell you, like for in my case, "Dan, you're totally safe on an airplane, stop freaking out," and then when I'm not hypnotized anymore, I've, that software has been upgraded.

• 18:13Speaker 03

  Well, I'll be glad to show you how one can do it, but it's not sort of what they're telling you, it's how they're helping you to approach the problem and regulate what's going on. And when somebody tells me to stop freaking out, that's when I start to get nervous, you know, it's, it's like, we people who do hypnosis love to say that the worst thing you can tell someone is don't think about purple elephants, you know, that's what you do. So it's a matter of how you approach your problem, and hypnosis is you're going into a state where you have expanded your ability to alter your perception, to regulate how your body is reacting. We did an experiment once where we got people first thing in the morning into the lab,

• 18:55Speaker 03

  hypnotized them to eat imaginary meals, they hadn't actually eaten anything. We put a nasogastric tube down their nose into their stomach, and we measured how much gastric acid they secreted. We had them think for an hour, take a gastronomic tour of the Bay Area, and after a half an hour, one woman said, "Let's stop, I'm full," eating imaginary food. They had an 89% increase in the amount of gastric acid secreted, just through hypnotic suggestion that they were eating something. So then we had them do the opposite, go to a desert island, you know, enjoy the sun and the sand and the beach, but you can't eat or drink anything. 39% decrease in gastric acid secretion. And then we injected them with pentagastrin, which stimulates maximal output from the stomach of gastric acid.

• 19:40Speaker 03

  They still had a 19% decrease in gastric acid secretion in the hypnosis condition. So hypnosis is a, an extraordinary way of controlling what's going on in parts of your body you didn't think you could control at all. And so we can control pain, gastric acid secretion, stress, a lot of things you can learn to do with hypnosis.

• 20:00Dan Harris?

  So far from being as a stage hypnotist. Would have you believe, far from being a loss of agency, it is actually a massive increase in agency where you're putting your mind and brain into a state where you can have more control over the connection between psychology and physiology.

• 20:20Speaker 03

  Absolutely. Beautifully put. That's exactly right. It's an increase, not a decrease. And, you know, if you ask people like combat veterans who get the Congressional Medal of Honor for doing some extraordinary feat of valor, and half the time they'll say, "I barely remember what I did. I have no idea how I did it." Because in times of stress, we go into states like that spontaneously. Hypnosis is not some artificial thing. It's a part of the way we're wired. And it helps us deal with extreme situations, pay attention to what you need and want to, and put aside everything else.

• 20:55Dan Harris?

  Coming up, Dr. David Spiegel runs a test to see if I'm hypnotizable. We go deeper on exploring my ongoing panic disorder. We compare hypnosis to other therapies that are available, and we go over the steps for self-hypnosis so that you can do this for yourself.

• 21:15Speaker 04

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• 21:47Dan Harris?

  Well, so for the last 15, 20 minutes, I've been forcing you to talk about chocolate. Let's taste the chocolate. I'm a little worried that I won't be hypnotizable, and this will be a huge letdown, but let's try it.

• 21:58Speaker 03

  Well, I've been there before. Okay, so I'm gonna give you a brief standard test of your hypnotizability, Dan. So get as comfortable as you can.

• 22:07Speaker 03

  And now I want you to look up to the top of your head, all the way up high as you can. But keep your eyes open at first. Look up, that's it. And while looking up, slowly close your eyes.

• 22:19Speaker 03

  Close while looking up, close. Okay, now take a deep breath.

• 22:25Speaker 03

  Let the breath out slowly, let your eyes relax, but keep them closed and let your body float.

• 22:32Speaker 03

  Just imagine you're floating somewhere safe and comfortable, like a bath, a lake, a hot tub, or floating in space. And while you feel your body floating in space, I'm going to ask you to concentrate on your left hand and arm.

• 22:46Speaker 03

  In a moment, I'm going to ask you to take your right hand and stroke the back of your left hand, starting at the tip of your middle finger. And go ahead and do that now. Stroke along the back of your left hand. Let your right hand float over and touch the back of your left hand.

• 23:05Speaker 03

  That's good. And as you do that, stroke along the back of your left hand toward your left wrist, and then all the way up to your left elbow.

• 23:15Speaker 03

  You'll feel a sense of tingling and numbness, good, and lightness. And now let your left hand float up in the air like a balloon.

• 23:24Speaker 03

  That's good. And let it rest in a comfortable upright position. You can bend your elbow if you want. That's good.

• 23:33Speaker 03

  And I'm going to give you this instruction. Your left hand will remain light and in this upright position, even after I give you the signal for your eyes to open. Later, when I ask you to take your right hand and pull your left hand back down and let go, your left hand will float right back up to the upright position. You'll find something pleasant and amusing about this sensation. After that, when I ask you to touch your left elbow with your right hand, your usual sensation and control will return. Each time you go into this state of concentration, you'll find it easier and easier to do, and you can use it to help you concentrate on what's important to you.

• 24:16Speaker 03

  Right now, we'll come out of this state of concentration together by counting backwards from three to one. On three, you'll get ready. On two, with your eyelids closed, roll up your eyes. And one, let your eyes open. Ready, three, two, one. Good. Now, you can let your eyes come back down, leave them open, but look straight ahead. And describe what physical sensations you are of now in your left-handed arm.

• 24:42Dan Harris?

  What physical sensations do I have in my left hand and arm?

• 24:45Speaker 03

  That's correct.

• 24:47Dan Harris?

  Light and tingly in the hand, some mild distress around the elbow from the discomfort of holding my arm up like this.

• 24:57Speaker 03

  All right, well, you can let it rest closer to your body if you wish, but keep your left hand up. Good. Does your left hand feel as if it's not as much a part of your body as your right hand?

• 25:08Dan Harris?

  Maybe.

• 25:10Speaker 03

  Well, does it feel as connected to the wrist as your right hand feels connected to the wrist?

• 25:16Dan Harris?

  I think so.

• 25:18Speaker 03

  Okay. All right, now, please take your right hand. Pull your left hand back down to your leg or the arm of the chair. And then let go.

• 25:31Speaker 03

  Now, turn your head, look at your left hand and watch what's going to happen. And as you look at your left hand, just imagine it to be a big boy with a balloon.

• 25:41Speaker 03

  Can you describe what it's feeling like?

• 25:45Dan Harris?

  I do feel some upward momentum.

• 25:48Speaker 03

  All right, so as you imagine it to be a balloon, permit it to act out as if it were a balloon, be big about it.

• 25:55Speaker 03

  That's good, all the way up.

• 25:58Speaker 03

  Now, by way of comparison, please raise your right hand.

• 26:03Speaker 03

  Put your right arm down.

• 26:06Speaker 03

  Are you aware of a relative difference in sensation in your left hand going up compared to your right?

• 26:12Dan Harris?

  Yes, the left hand does feel more sort of effervescent, light, floaty.

• 26:19Speaker 03

  Good, than the right, so over which hand would you say you have more control right now?

• 26:24Dan Harris?

  Maybe the right? Yeah, but I still, I don't feel like

• 26:31Dan Harris?

  if somebody walked in the room and demanded I use my left hand, I would be unable to meet those demands.

• 26:37Speaker 03

  Okay, but there is a relative difference in your sense of control. All right. So notice how you're able to change your sensation and control in one hand and arm compared to the other. Now, please take your right hand and touch your left elbow. And then let go.

• 26:54Dan Harris?

  Touch and let go?

• 26:55Speaker 03

  Mm-hmm. Okay.

• 26:59Speaker 03

  Are you aware of a difference in sensation and control now in your left hand and arm compared to a moment before?

• 27:06Dan Harris?

  Not massively.

• 27:08Speaker 03

  Well, does the left hand still feel a bit lighter than the right? Or is the control equal now in the two hands?

• 27:14Dan Harris?

  Yeah, I guess it's not as light as it was previously.

• 27:17Speaker 03

  Yeah, so, okay. Did I do or say anything that would indicate there'd be a change in sensation or control in your left hand and arm?

• 27:25Dan Harris?

  Well, I think you told me that when I touched my my left elbow with my right arm, that you said something would happen at that point.

• 27:34Speaker 03

  Something, you don't remember quite what it was.

• 27:36Dan Harris?

  I can't exactly remember, something like the state of hypnosis would be over or something to that effect?

• 27:41Speaker 03

  Yeah, that's close to it. Did I do or say anything that would indicate that? So it was the touching of the elbow?

• 27:50Dan Harris?

  Yes.

• 27:51Speaker 03

  Did you have a sense of floating lightness or buoyancy in your left hand and arm during the test?

• 27:56Dan Harris?

  Yes.

• 27:57Speaker 03

  Did you have that sense in any other part of your body? Head, neck, thighs, abdomen, chest, all over, or just in your left hand and arm?

• 28:03Dan Harris?

  Just in the left hand.

• 28:04Speaker 03

  Okay, all right. That's the end of the test. You can put your left hand down now if you like. Your score is 6.5 out of 10. You're moderately hypnotizable. Could you describe a little bit more about how sensation and control changed in your left hand during the experience?

• 28:21Dan Harris?

  Well, with the caveat that

• 28:26Dan Harris?

  the doubt that was percolating in my mind was that I want this to work.

• 28:30Speaker 03

  Sure.

• 28:30Dan Harris?

  So I just want to say that. But I will say the most striking moment for me was when you said, because I had a moment of like, there's nothing happening here.

• 28:39Speaker 03

  Right.

• 28:39Dan Harris?

  Because I thought the hand was supposed to naturally rise up and that wasn't happening. And you said, well, just look at your left hand and imagine it as a balloon.

• 28:49Speaker 03

  Yeah.

• 28:50Dan Harris?

  And as I did that, and this is where the doubt creeps in just a little bit, because I thought, I wondered, oh, maybe it would be cool if I felt that way. And so maybe that's why I'm feeling this way. But I did start to feel a mildly irresistible upward momentum in the hand at that moment. Whether I willed that or not, it was there.

• 29:12Speaker 03

  It was there. Good. I like that phrase of mildly irresistible upward momentum. I hope we can continue that mildly irresistible upward momentum. Because what you're seeing is that changing the way you think and experience your body through self-hypnosis, which is what you were doing, you can change how your body feels. And your brain has much more flexibility in modulating how you feel and how your body acts than we give ourselves credit for. You've mostly experienced that, from what I understand, in an unpleasant way. That is, you get anxious about something and things start to change in your body that are unpleasant. And then you notice that. Am I right about that?

• 29:56Speaker 03

  Or, and then you feel worse?

• 29:58Dan Harris?

  Yeah, panic disorder, or I don't know exactly what the right diagnosis is, either claustrophobia or panic disorder, or some combination of the two. And it's been a tough couple of years where planes have been very hard for me.

• 30:14Speaker 03

  That's what I understand. Well, let's see. I think you can use your ability, your hypnotic ability, to help with that. Because think of it this way, you were able to very quickly change the way your left arm felt. Your brain can play tricks on you in lots of ways. So a phobia, claustrophobia, is a fear of a bad thing happening, which people often then avoid, which only deprives them of experience of dealing with what they're scared of without bad things happening. So it reinforces, the avoidance actually reinforces the phobia. Panic is the psychophysiological reaction to a bad situation. And there, you're breathing more rapidly and shallowly, and your heart rate goes up and your muscles tense. But the interesting thing is the snowball effect. So, and I'm sure you've been through

• 30:59Speaker 03

  this many times, where you start to think, oh, oh, this is getting bad. And then you notice something in your body. You know, your heart rate goes up a little bit, your muscles tense, you start to sweat. And then you think, oh, my God, it's gonna be this again. I can't stand it. And I understand, if I may say, that you've gotten off of airplanes. You've just decided, I can't deal with it.

• 31:18Dan Harris?

  Yes.

• 31:18Speaker 03

  So, but it is a snowball effect. So you get anxious, your body reacts, you notice your body reacting, you get more anxious, and on it goes. But you can learn ways to control that. If your brain can play a bad trick on you by making you feel as though things are more threatening and unpleasant than they are, you can teach your brain to play a good trick on you, which is, you know, things really aren't that bad. And the way I have people do this is to start not with the stressor they're worried about, but with the one thing they can control, which is their body and how it's reacting to the stressor. And once you do that, you're starting to interrupt that snowball effect and teaching

• 32:00Speaker 03

  your brain how to better manage your physiological reaction to the stress, but also your mental reaction to it. So if you'd like, we can try doing an exercise like that. And if flying in planes is a primary problem, why don't we start with dealing with that? Yes, I would love to do that, and I appreciate your willingness. Good. Happy to do it. We psychiatrists always appreciate it when people want to hear us better. That's a good thing. All right, so get as comfortable as you can. How would you rate your general level of stress right now?

• 32:32Dan Harris?

  Pretty low, three.

• 32:34Speaker 03

  Three? Okay. All right, so get as comfortable as you can. On one, please do one thing. Look up, all the way up high as you can. Open your eyes first again, and look up and slowly close your eyes while you're looking up. Close, good. Now take a deep breath. Breath out slowly through your mouth. Let your eyes relax, but keep them closed and let your body float. Just imagine your body floating somewhere safe and comfortable, like a bath, a lake, a hot tub, or floating in space. Just imagine your body floating safe and comfortable, and then let one hand or the

• 33:16Speaker 03

  other float up in the air like a balloon, and that'll be your signal again that you're ready to concentrate. Each breath, deeper and easier. Good. Now, your right hand floating in this upright position is your signal that you are ready to concentrate. I want you to imagine you're floating somewhere you really enjoy, a bath, a lake, a hot tub, or imagine floating in space. And again, inhale through your nose, and then slow exhale through your mouth. Now, with your eyes closed, remaining in the state of concentration, please describe how your body is feeling right now.

• 33:58Dan Harris?

  Light, tingly. The only source of mild tension is an itch on my face.

• 34:07Speaker 03

  Okay, you're allowed to scratch if you'd like.

• 34:12Dan Harris?

  Continue to breathe deeply.

• 34:14Speaker 03

  Breathe deeply, inhale through your nose, and then slow exhale through your mouth.

• 34:22Speaker 03

  That's good.

• 34:25Speaker 03

  So just imagine that you're floating, safe and comfortable, and notice how quickly and easily you can use your store of memories and your imagination to help yourself and your body feel better.

• 34:39Speaker 03

  Nice inhale through your nose and then slow exhale through your mouth.

• 34:45Speaker 03

  How's your body feeling now?

• 34:48Dan Harris?

  Great.

• 34:49Speaker 03

  Good. Alright, so now we're going to work together on how you prepare yourself for flying and what you do when you're in an airplane. And there are three critical points I want you to remember.

• 35:02Speaker 03

  The first is when you get on the plane, buckle your seatbelt, go into this state of self-hypnosis, and feel yourself floating with the plane.

• 35:13Speaker 03

  There's no point physically fighting with the plane, getting tense, struggling with it.

• 35:20Speaker 03

  Think of the takeoff

• 35:23Speaker 03

  the way you would feel as a kid on a roller coaster.

• 35:27Speaker 03

  Just enjoy the movement. So float with the plane, just feel yourself. Imagine right now you're in the plane, it's moving down the runway faster and faster,

• 35:39Speaker 03

  and then taking off into the air, and just feel your body floating with the plane.

• 35:48Speaker 03

  Again, with your eyes closed and remaining in this state of concentration, please describe how your body's feeling right now.

• 35:56Dan Harris?

  Body continues to feel good. Deep breathing always feels nice.

• 36:01Speaker 03

  Good. And you can imagine your body floating with the plane. Plane's moving, you're just floating with it. Is that right?

• 36:09Dan Harris?

  Yes, I will say, just for mild clarification, usually by the time we're taking off, that's not when the fear hits. It's usually as I sit there buckle my

• 36:20Speaker 03

  Good.

• 36:21Dan Harris?

  seatbelt and I'm awaiting them closing the door and the fear that I will feel locked in.

• 36:27Speaker 03

  Right. Okay. So that's, that's part two.

• 36:33Speaker 03

  So just get nice and comfortable in the seat. And the second part of the exercise is to think of the airplane as an extension of your body. If you want to get from one place to the next, the easiest thing to do is walk.

• 36:49Speaker 03

  If you want to get there a little faster, you might hop on a bicycle

• 36:54Speaker 03

  and cycle over to your friend's house.

• 36:58Speaker 03

  Now, in that sense, the bicycle is an extension of your body, allowing you to get from one place to another faster. If it's farther away, or you want to get there faster, you might get in a car and drive. The car is an extension of your body. And now I want you to think of the airplane as an extension of your body. It helps you to get from one place to another.

• 37:21Speaker 03

  So your brain is deciding that the most efficient way to get from one place to another is to have an airplane as an extension of your body.

• 37:30Speaker 03

  So rather than being trapped in a can, you're using the airplane to extend your body and get from one place to another faster. And think of the pilot as an extension of your brain. You chose the airline you flew on because they have well-trained pilots.

• 37:50Speaker 03

  And the pilot is an extension of your brain, helping you to safely and rapidly get from one place to another.

• 37:57Speaker 03

  So you're in fact, in the driver's seat. You're deciding what to use as an extension of your body and how to use it. Through the plane and the pilot. So you're floating with a plane. And you're thinking of the plane as an extension of your body and your brain. How does that feel?

• 38:20Dan Harris?

  It's a nice reframing. It's not a prison. It's. An example of my agency of choosing. To get somewhere.

• 38:30Speaker 03

  Exactly.

• 38:31Dan Harris?

  And outsourcing aspects of my prefrontal cortex to the pilot who's going to operate the controls.

• 38:37Speaker 03

  Beautifully put. You got it. That's exactly right. And now here's the third part of the exercise, Dan. And that is the difference between a possibility and a probability. It's always possible the plane will crash. Although per mile. Driving in a car is a lot more dangerous than flying in an airplane. It's possible. But it isn't probable. It's always possible. I'm sitting here in California that the great earthquake will happen right now. And my house will fall down on top of me, but it isn't probable. So keep in mind. The vividness with which you could picture a bad outcome.

• 39:19Speaker 03

  Is totally unrelated to the probability that a bad outcome will happen. So there's a big difference between a possibility and a probability.

• 39:28Dan Harris?

  Oddly enough, I'm not actually worried about the plane crashing. I'm worried about my brain and body going into mutiny mode. As soon as they lock the door and I'll lose my mind and go insane in front of everybody.

• 39:41Speaker 03

  Yeah.

• 39:41Dan Harris?

  But the same logic applies. The probability. Is low.

• 39:46Speaker 03

  The probability is low. That's right. So you can worry about it, but you've already exerted. Your control over your body and your brain. By getting your body more comfortable, imagining floating with a plane. Reconceptualizing the plane as an extension of your body and the pilot is an extension of your brain. And what pilots tell me in terms of possibility and probability is that at least when something goes wrong on a plane, the pilot has seven or eight minutes to figure it out and fix it, which is not the situation in a car. It's a couple of seconds, one way or the other. So even that possibility is even less probable in an airplane. So once

• 40:28Speaker 03

  again, notice how you've been able to keep your body comfortable, just imagining being in an airplane and getting ready to take off. And how you can reconceptualize what the plane is, who the pilot is, and how you're using them to do what you want to do. And how to think about the difference between a possibility and a probability. How are you feeling now?

• 40:53Dan Harris?

  Feel pretty good, mate.

• 40:54Speaker 03

  Good.

• 40:55Dan Harris?

  A little bit uncomfortable holding my arm up, but other than that.

• 40:58Speaker 03

  Good. So can I ask you this, Dan? If you had just spent the last 10 minutes or so just thinking about being in a plane and taking off, how would you be feeling?

• 41:10Dan Harris?

  Normally.

• 41:11Speaker 03

  Yeah, normally.

• 41:12Dan Harris?

  I can get myself to, not quite to panic, but to reasonably five, six, seven level of anxiety swarm of bees in the chest type of feeling. And I don't feel any of that right now.

• 41:26Speaker 03

  That's terrific. So how would you rate your level of anxiety right now on the zero to 10 scale?

• 41:34Dan Harris?

  If I imagine myself sitting on a plane with the door about to close?

• 41:38Speaker 03

  Yeah.

• 41:39Dan Harris?

  Two or three.

• 41:40Speaker 03

  Right. And is that how you're feeling now? You feeling two or three or more or less?

• 41:46Dan Harris?

  That's when I make the imaginative leap. But the way I'm actually feeling right now is if I'm not conjuring the image is, you know, zero to one.

• 41:57Speaker 03

  That's wonderful. So notice how much agency you have.

• 42:02Speaker 03

  Over how you react to the same potentially stressful situation. And how you did it by going into the state of self hypnosis and starting with your body, the thing you do control and helping your body feel comfortable. And then reconceptualizing what's happening and what's about to happen. By using your brain differently. Focusing on the realities of the situation. And putting them into perspective while your body feels safe and comfortable. And that's the way in which you can use self hypnosis to control your agency. And manage the anxiety you have felt about flying.

• 42:42Speaker 03

  So what I suggest that you do is anytime you're worried about flying, don't fight it, admit it. Go into the state of self hypnosis, get your body floating and comfortable. And go through these three points, float with a plane is an extension of your body and the pilot is an extension of your brain. And the difference between a possibility and a probability. And do this as often as you need to do it when you sit down in an airplane, the next time you get into one. And then when you're ready, you'll come out of the state of self hypnosis by counting backwards from three to one. At three, you'll get ready, two, with your eyelids closed, roll up your eyes. One, let your eyes open, your hand float back down, make a fist open, and that's the end of the exercise. How are you feeling?

• 43:26Dan Harris?

  I feel pretty good. Yeah.

• 43:28Speaker 03

  Terrific.

• 43:30Dan Harris?

  Not anxious.

• 43:31Speaker 03

  There you go.

• 43:33Dan Harris?

  It's interesting, well, I have a million questions, but one question that's of local interest to me, and I don't know how interesting it will be to the audience is. I have been doing quite a bit of work with different types of therapists of late to really try to tackle my claustrophobia on planes. In part because I'm really tired of taking medication to fly and dealing with the hangover. In part because my family finds me very annoying. Either when I'm on the medication, which is Klonopin, which is a, you know, can make you a little goofy. And they also find me annoying when I have taken an insufficient amount of Klonopin and have to get off the flight. Which has happened a few times recently.

• 44:17Dan Harris?

  So I'm quite motivated and I'm noticing a real difference between the hypnotic approach or the hypnosis approach, which is to get your body into a relaxed state. And once you're in that relaxed, focused, flow-like state, to cognitively reframe the situation so that you recognize you're not in any danger.

• 44:41Speaker 03

  Right.

• 44:42Dan Harris?

  As compared to exposure therapy, which I've done some where you're gently, consistently, persistently, systematically exposed to that which scares you. And the idea is to actually provoke some degree of panic and teach the brain that the panic is survivable. And so these seem quite different. One, I could imagine a CBT or an exposure therapist saying, "You, David Spiegel, are helping me avoid that which I shouldn't be avoiding."

• 45:18Speaker 03

  Yeah. Well, they might say that, but I would say they're avoiding the remarkable ability you have within yourself to do it a hell of a lot faster and easier. And you're not avoiding it. I experience you now as somebody who will be able to get on an airplane and fly because you know how to manage your psychophysiological reaction to the stress. It's a kind of a psychological shortcut to doing the same thing, accomplishing your goal, but a lot faster and a lot easier.

• 45:47Dan Harris?

  So a couple of practical questions. And again, these are oriented in a selfish way. And then I'm going to ask you some broader questions. But practically speaking, is this something I should be practicing consistently in preparation for my next flight?

• 46:01Speaker 03

  Yes, I think at first it would be a good idea because of the history you have of having trouble with it. I would try several times a day to sit down or lie down, go through this little exercise. And anytime you start to get anxious again, say, "Okay, I am. I'm going to go into this state and reestablish my ability to control my reaction to the idea of flying." And there you're facing what you're anxious about, but you're experiencing mastery, not submission to or struggle with the psychophysiological anxiety. You're mastering it.

• 46:33Dan Harris?

  Right.

• 46:33Speaker 03

  Because the cool thing about hypnosis is you can really change how your brain manages your body. You can make a difference. And that's what you're learning to do. So you come out of it now, I think, feeling good. You feel a little proud. I did this. I feel better, not worse, when I'm thinking about it. So rather than chipping away at it and saying, oh, I'm still anxious, but a little less, you're saying, I can face this and manage it differently. And that makes you feel good.

• 46:58Dan Harris?

  So just to restate it for the purposes of clarity, for myself and for the audience, the exercise you're describing of self-hypnosis

• 47:08Speaker 03

  Right.

• 47:08Dan Harris?

  is as follows, if memory serves. To aim your eyes as high up as you can as toward the top of your head, to then close your eyelids while the eyeballs are in that position.

• 47:21Speaker 03

  That's correct.

• 47:22Dan Harris?

  Then to start breathing deeply in through the nose, out through the mouth.

• 47:28Speaker 03

  Right.

• 47:29Dan Harris?

  Relax the eyes once you've started the deep breathing.

• 47:33Speaker 03

  Right.

• 47:33Dan Harris?

  And so you're in this state with your eyes closed, you're breathing deeply, which can reset the nervous system. And in this state, you then bring to mind a situation that, in my case, a phobia might arise and reframe it cognitively, in my case, through the plane of thinking first of myself floating. I skipped a step. While I'm deep breathing, I'm imagining myself floating.

• 48:03Speaker 03

  Floating, right.

• 48:04Dan Harris?

  I pictured myself in a jacuzzi. I have a lot of somatic memories of

• 48:08Speaker 03

  Good.

• 48:08Dan Harris?

  floating in a jacuzzi as a little boy.

• 48:10Speaker 03

  Yeah.

• 48:10Dan Harris?

  And so then I'm on the plane, I'm imagining that the plane and I are floating together, and that the plane is an extension of my body.

• 48:19Speaker 03

  Right.

• 48:19Dan Harris?

  And the pilot, an extension of my brain.

• 48:23Dan Harris?

  And so that's the exercise I wanted to do.

• 48:25Speaker 03

  Right. And then the difference between a possibility and a probability is the last.

• 48:29Dan Harris?

  Right.

• 48:30Speaker 03

  But notice how your brain is tuning into this. So like, I never mentioned a jacuzzi to you. You summoned up a memory in which you connect your brain state with a comfortable body state. That's great. That's your brain is saying, okay, I catch on to this. Here's what I want to do. Instead of thinking about how scared I am about being buried alive in a tin cannon at 30,000 feet, I'm thinking about a time when my body felt really comfortable. And your brain can just as easily get into that positive mental state as it can a negative one. And you can control it. And that's what you're doing.

• 49:05Dan Harris?

  The one thing, as I recapitulated the basic steps of the exercise, the one thing I left out was the lifting of the arm.

• 49:12Speaker 03

  Oh, yeah.

• 49:13Dan Harris?

  How important is that?

• 49:15Speaker 03

  Well, it's not necessary, but what I think that the arm taught both of us is that your brain has this ability to change the way a part of your body feels. So before we started this, you might say, come on, every time I think about getting in an airplane, I get tense and this happens. And I'm showing you in a neutral way that you can change the way your body feels. You can make your left arm feel different from your right arm. One feels lighter than the other. And so you're showing yourself that when you go into this state of self hypnosis, you're enhancing your ability to control how your body feels. And you don't have to automatically go on a downhill spiral where you get more anxious and your body gets more tense. You can go in the other direction. And that's what you're seeing there is what do you know? This hand feels different from that one.

• 50:00Dan Harris?

  Okay, so that makes sense. And it doesn't seem like a non-negotiable part of the self hypnosis process.

• 50:08Speaker 03

  No, you can do it without it, but it's a, I think it's a useful entry into your understanding and deepening of your ability to do this, to just have a neutral test case. I'm not trying to loosen my gut. I'm just trying to see. How my arm feels, this one compared to that one? Yes, so it's not necessary, but it's a good start.

• 50:28Dan Harris?

  And just to say for people who want to try this at home,

• 50:30Speaker 03

  Yes.

• 50:31Dan Harris?

  we've described the practice and so people can just go do it. But you also have an app.

• 50:35Speaker 03

  Yes.

• 50:35Dan Harris?

  R E V E R I, Reverie, which gives guided instructions for doing this.

• 50:42Speaker 03

  Right, and this is in one of the exercises and wherever we have exercises for stress and insomnia and pain. But we also have this flying phobia program in the app. And so you get to hear my mellifluous voice giving you the same instructions on Reverie that I've just given you. You can download it from reveri.com, from the App Store and from Google Play. And the first week is free. You can try it out and see what it feels like. I hope it will help lots of people. It's accessible, it's easy to use, and I hope people will, more people will get on planes. It's about 10% of Americans are afraid to fly. They just don't fly.

• 51:20Dan Harris?

  Yes.

• 51:21Speaker 03

  And so it's a lot of people who could potentially be helped.

• 51:26Dan Harris?

  Coming up, Dr. Spiegel talks about the connection between hypnosis and meditation, the importance of the eyes in hypnosis and other therapies, how you can rely on deep breathing, even if nothing else lands. And just out of curiosity, we talk about how stage hypnotists can figure out who in the audience is most hypnotizable.

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• 52:51Dan Harris?

  This is a show that concerns itself quite frequently with mindfulness meditation.

• 52:56Speaker 03

  Yes.

• 52:56Dan Harris?

  What is the connection between the hypnotic state and a meditative state in your mind?

• 53:03Speaker 03

  Well, they're similar, but they're not the same. Meditation involves open presence, you know, just not trying to control your thoughts and experiences, but just letting yourself feel, let things flow through you like wind blowing by. It's different in that it is not designed to help you change something or change who you are, but just experience things differently. It involves developing compassion. It involves a body scan too, seeing how your body is feeling. But hypnosis is more directed at solving a problem, whereas meditation is more directed at being different. And it's a powerful, interesting technique. But from an American point of view, it's not as efficient.

• 53:47Speaker 03

  I had a woman who called me, she had migraine headaches. And she said, "Doc, I've been doing meditation twice a day for 10 years, and I still have my migraines. Can you help me?" So I had her in hypnosis, imagine she had a cap of ice on her head, cool, tingly, numbness. People with migraines often feel their heads are hot. They have vasodilatation around the head. She called me a week later and she said, "My migraines are gone. Thank you, and thank you for freeing me to use my intentionality." Because with meditation, you're not supposed to be intentional. You're supposed to be experiential. And with hypnosis, it's fine to be intentional. So we found that in people who've done research on meditation in the brain show reduced activity back in that same region,

• 54:32Speaker 03

  the posterior cingulate cortex, the default mode network. So experienced meditators tend to reduce that. They think less about who they are and what they are. And that's part of the idea of meditation too, is to kind of let go of your clinging to a certain identity of who you are. So they're overlapping, they're similar, but hypnosis is much more problem focused.

• 54:53Dan Harris?

  Let me give you my take on what you just said, because I think there's a lot to it. Meditation, and I've come out of a Buddhist context, so even within Buddhist meditation, there's a pretty wide variety. There are practices that actually are quite, to use the word you used before, intentional, like for example, loving kindness practice, where you're envisioning a variety of beings and then sending them phrases like, "May you be happy, may you be safe." And there's a lot of busyness in the mind, there's a lot of business you are conducting in the mind, and it produces concentration. It is classically referred to as a concentration technique, because it focuses the mind. It

• 55:38Dan Harris?

  gives the mind a lot to do and gets quite focused. And that, to me, feels at least like a cousin to what you were having me do, which is simultaneously deep breathing, conjuring a felt sense of floating, and then cognitively reframing the thing that I'm worried about. Meanwhile, there's another form of meditation that is much more commonly taught, which is mindfulness meditation, where it really is about feeling whatever you're feeling, noticing physical sensations, thoughts, emotions, and not getting attached to them, letting them go. So, having done for 16 years both loving kindness and mindfulness,

• 56:22Dan Harris?

  I actually found them both useful in the process of self-Hypnosis. First, because I have enough practice now doing a bunch of things in the mind at the same time in an intentional way. And second, because there were intrusive thoughts, "Is this bullshit? Am I fucking this up?" You know, like, "Is this a boring podcast?" Whatever. Those thoughts were coming through, but I was actually, I was able to handle them in a reasonably supple manner by just noticing, "Oh, that's a thought. I'm gonna let it go and go back to what the doctor's asking me to do." So that's a long response to your answer. Does any of that land for you?

• 57:00Speaker 03

  Yeah, absolutely. And I do think, in both cases, There's a kind of focus on the one hand in mindfulness, less than in other meditative practices, but you are directing your thoughts in some ways, but also letting go of traditional distractions and things that might keep you stuck in the same rut that you're in. I think it is no accident that different cultures around the world have different practices of altering your state of mind, but I think what they have in common is this capacity to be different mentally, to experience yourself as a different kind of person than you thought you were, and to try things you might never have tried before and feel different when you do it.

• 57:44Speaker 03

  And I think hypnosis is about 250 years old. It's a short Western tradition compared to meditation in the East, but they're both mental practices that help you expand your array of abilities to use this machine in your head. So they have things in common, but there are differences too.

• 58:05Dan Harris?

  What is the importance of the eyes? You had me look up toward the top of my head. The caricature version of hypnosis is watch this, you know, keep your eyes on this, watch swinging, pendulating back and forth. Why are the eyes so important in this process?

• 58:24Speaker 03

  Well, the eyes are, you know, we're visual creatures primarily. The whole back of our brain is devoted to processing visual signals. It's the main way we protect ourselves. We see things. There are animals that can hear better and smell better than us. We see extremely well to perceive threat. And when you're ready to go to sleep, to shut down consciousness to a large extent, you close your eyes. What you're doing with the upward gaze is you're saying, I'm going to close my eyes, but I'm not going to just stop concentrating and thinking. I'm going to turn inward. And there is actually an old Zen practice called looking at the third eye, where you do exactly the same thing. You look up and close your eyes. And drugs that affect levels of consciousness, like the meds you used to take for flying,

• 59:06Speaker 03

  affect eye movement. Opioids give you pinpoint pupils and stimulants give you large, expanded pupils. The eyes are in the middle of the motor nuclei of the eyes, third, fourth, and sixth cranial nerves, are in the middle of the reticular activating system in the brainstem, which adjusts level of arousal. So eye movement and arousal are very much connected in our brains. And so controlling your eye movements in a certain way, that means I'm closing my eyes, but I'm not going to sleep, I'm doing something different, is a helpful way into an altered state of consciousness. And that's part of the meditation tradition, as well as the hypnotic tradition.

• 59:45Dan Harris?

  It got me thinking, because one of the other therapy, I've been trying a bunch of stuff recently. And one of the other therapies I've been trying is called brain spotting, which is evolution of something called EMDR, eye movement desensitization.

• 59:58Speaker 03

  Reprogram, yeah, yeah.

• 59:59Dan Harris?

  Yes. So both EMDR and brain spotting involve using your eyes to look in a certain place and then enter into a, well, I can only speak to brain spotting. You look in a spot that is somewhat triggering, and then you let your mind rest and relax. And you let the subconscious mind go to work to find the root memory that is causing your phobia. I don't need you to comment on whatever you think about brain spotting, although you can if you want. I'm only bringing it up to say that a lot of these therapies implicate the eyes.

• 1:00:37Speaker 03

  Yeah, they do.

• 1:00:39Dan Harris?

  And that seems interesting to me.

• 1:00:40Speaker 03

  Yes, they do. And I think that's right. And the eyes have a lot to do with our level of arousal and how we manage it. I would say in general, the funny thing about a lot of people with phobias, some have had horrible experiences that are tied to their phobias, but a lot of people haven't. They just develop the phobia because it becomes a kind of... Feedback loop. You get a little anxious, something bad happened, you get more anxious. You notice your body. It's that snowball effect. And sometimes people are phobic with no historical event. And I treat a lot of people with trauma, so I'm attuned to that. But there are a lot of people haven't had any original trauma. They just have, over time, had this kind of layering on of psychological and physiological distress

• 1:01:23Speaker 03

  that winds up being a phobia or a panic state. It doesn't have to be that way. And the idea of EMDR was that, you know, if you cross the midline and you focus things on the left and the right, that will have some magical effect. It doesn't. So I think it's more having an experience in which you can, from the bottom up, control how your body's reacting and then how your brain is reacting to a stressful situation. So it sounds like you're pretty skeptical about EMDR. I am. Yeah. You know, a lot of people have used it. It does help people deal with traumatic events, there's no question. But I think it's not the moving back. Now, you know, they've given up on the eye movements. It's now tapping one side of the body or the other.

• 1:02:05Speaker 03

  I just think that's the wrong mechanism. I don't think that's what's going on. So can it help people? Yes, but not for the reasons I think they think. One other thing I would mention, while we have a few minutes, is that, you know, if people get into a panic state, even if they are not up to using hypnosis, just that breath work, the cyclic sighing that we did, can be very helpful to people in a panic state. You know, they tell people, take a deep breath. That's actually something that arouses you. Because when you inhale, you drop pressure in the chest, you reduce blood flow to the heart a little bit, and your sympathetic nervous system takes off and says, oh, we need more blood to the heart. Whereas a slow exhale increases pressure in the chest, increases blood flow to the heart,

• 1:02:49Speaker 03

  and the parasympathetic, the anti-arousal part of the autonomic nervous system takes over. And so you may have just felt like in your legs a little bit, did you? When you, when you exhale slowly through your mouth, did you feel a little bit of more physical relaxation when you did that?

• 1:03:05Dan Harris?

  Yes, just for the listener, cyclic sighing is the term of art that Dr. Spiegel is using for deep breathing. And I do, almost every time I sit to meditate, I do a minute or two, sometimes more of straw breathing, which is a deep in-breath through the nose and then a much longer, three or four times longer out-breath through a pursed lips as if you're blowing through a straw. It is very much, physically feels very good.

• 1:03:35Speaker 03

  Yes, exactly. I'm glad to hear that. That's right. And you're helping inhibit your sympathetic nervous system and stimulate the parasympathetic system. And we found that when people do this regularly, just five minutes a day, their average respiratory rate per hour goes down by one breath a minute. And we all tend to breathe too fast and too shallowly. So when people start to have a panic attack, just that straw breathing or cyclic sighing that you talk about can sometimes be very helpful.

• 1:04:04Dan Harris?

  Interesting. One last question, I hope it's the last, it might not be, but I do have my eyes on the clock because I know you have to leave soon. But another question about hypnosis itself, is your experience that this can be, for some people, a one and done? You get them into a deep hypnotic state and get them to reframe, you know, their desire for a cigarette or whatever it is, and then it's over? Or is your experience, is it more common that this is a thing people need to practice? And like for me, for example, I'll need to do this every time I get on a plane indefinitely?

• 1:04:37Speaker 03

  Well, you might. It can be either one. If you've got it solved and you don't need to think about it anymore, fine. But the nice thing is you've learned a skill that you can use anytime you need it. And if you're just thinking about the flight next week and you're getting a little anxious, you can do it. And you can queue up reverie and have me give you instructions. And it's interactive. So you give an answer, I'll give you a different type of instruction each time you do it. But it can be one and done. We found that one out of four people that use the app just once stop smoking. You know, it's not everybody, but it's as good as the or better than the the medications that are used for antihistamine and bupropion and Nicorette. So people can sometimes just get it and move on. And that's what's cool. You're really resetting the clock.

• 1:05:21Speaker 03

  You're changing the way you think about yourself and what you can do. And once you've done it, you're pulling yourself out of that cycle of frustration and disappointment and anxiety and body tension and so on. You can just disrupt that and handle it differently. So, yeah, some people can just do it. Other people need to refresh themselves, but that's fine. It's easy.

• 1:05:41Dan Harris?

  This is really the last question, I think.

• 1:05:43Speaker 03

  Okay.

• 1:05:44Dan Harris?

  You said something

• 1:05:45Speaker 03

  Yeah.

• 1:05:46Dan Harris?

  a million years ago, that at the beginning of this conversation, that just caught my attention. You were talking about stage hypnotists.

• 1:05:53Speaker 03

  Yeah.

• 1:05:54Dan Harris?

  You said that they often figure out who's hypnotizable before they do their thing.

• 1:05:58Speaker 03

  Right.

• 1:05:59Dan Harris?

  How can you quickly test if somebody's super hypnotizable?

• 1:06:02Speaker 03

  If you want to know for yourself, they often don't do this, but you know, you ask somebody, do you ever get so caught up in a good movie that you forget you're watching a movie and enter the imagined world? People who do that tend to be more hypnotizable. But what the stage hypnotists do is they'll be up there doing an initial spiel about what hypnosis is and what it isn't. And they'll be swaying back and forth. And they're looking for people in the audience who are swaying with them. And then they'll invite them to come up and they'll try a few hypnotic tricks. And if they respond, they keep them. If not, they say, thank you very much, and they'll get somebody else. So they go through the audience to find the most hypnotizable people before they stretch them between two chairs and sit on them and stuff like that. So, yes, that's the trick.

• 1:06:44Dan Harris?

  Got it. How did you come to the number 6.5 for me on the hypnotic scale?

• 1:06:51Speaker 03

  You had some, when I asked, is the left hand not as connected to the wrist as the right? Does it feel not as much a part of your body? You weren't so sure about that. You said, maybe it's a little less connected. So that was one out of two points. The challenge where I had you put the hand down and bring it back up, you did, it floated up, but I had to give you several verbal reinforcements. So you lost a point and a half out of two for that. You did have a sense of control differential, that you felt less control over the left hand than the right. That was two points. You responded to the signal touching your elbow and you got the control back. You said, oh, yeah, it feels like the way it was. That was two points. And you had a sense of floating lightness or buoyancy in your left hand and arm, but not anywhere else in your body.

• 1:07:34Speaker 03

  So you lost three and a half points out of 10. That's how it works and it's a reliable measure. It's as reliable as IQ over a 25 year interval. It's very stable.

• 1:07:45Dan Harris?

  But it is self-report. That was kind of one of the things I was starting to doubt is like, I want this to work. So how much am I, do you see where I'm going and does that even matter?

• 1:07:59Speaker 03

  Dan, I've used this with about 7,000 people in my career and there are a lot of people who pay good money to see me and they want help and they just can't respond. So my experience is that people are not afraid to disappoint me. If they're not feeling, I mean, there may be some, but it's not in their interest either because I can help you, even if you're not extremely hypnotizable. It's a different way I approach it. So it's helping teaching me, what's the best channel to get to you? And people who are very hypnotizable, it's easier to just say, you'll do this, you'll feel different seeing you. For less hypnotizable people, you've got to explain it and have them do it their way and try it in a different, a couple of different ways. And so it's more of a negotiation, but you can help people too.

• 1:08:42Speaker 03

  And just at our Reverie team meeting this morning, there was somebody who said, I'm not hypnotizable at all, but I've used it to help myself get to sleep and deal with anxiety and thank you. So it's a combination of the way we approach the problem. Focus on what you're for and not what you're against and going into this altered state and the combination seems to work pretty well.

• 1:09:05Dan Harris?

  Dr. David Spiegel, I want to thank you for your time, for your willingness to

• 1:09:10Dan Harris?

  treat this difficult patient. I want to remind everybody that Dr. Spiegel's written a book called Trance and Treatment, Trance and Treatment, that I will put a link to in the show notes. He's also the founder of the Reverie app. That's R E V E R I. I'll put a link to that in the show notes as well. Doctor, thank you again.

• 1:09:30Speaker 03

  It's been a pleasure. Thank you for articulating it and being so open to have the experience and show so many people how it can work. And you'll get my bill in the morning.

• 1:09:39Dan Harris?

  Awesome. I look forward to it.

• 1:09:41Speaker 03

  Take care.

• 1:09:46Dan Harris?

  Thanks again to Dr. David Spiegel. Don't forget, there's a companion guided meditation that goes with this episode. It's all about how to deal with stress and anxiety, which is one of the use cases for self-hypnosis. It comes from our Teacher of the Month, Kyra Duolingo. It's available for paying subscribers over on danharris.com. Also, starting on September 2nd, we're going to be doing live guided meditation sessions on video, weekly, every Tuesday afternoon. This month, it's Kyra Duolingo. Next month, in September, it's Vinnie Ferraro, who, as I often say, is a fan favorite and a personal favorite. He and I will be doing a live guided meditation sesh on video on September 2nd, Tuesday afternoon.

• 1:10:28Dan Harris?

  And like I say, if you sign up at danharris.com, you can come to all of these weekly. It really is designed to help you start, or boot up, or boost your meditation practice. And finally, don't forget to sign up for the live meditation party we're doing the weekend of October 24th at the Omega Institute, north of NYC in Reinbeck, New York. You can get a link in the show notes. Finally, I want to thank everybody who worked so hard to make this show. Our producers are Tara Anderson, Caroline Keenan, and Eleanor Vasili. Our recording and engineering is handled by the great folks over at Pod People. Lauren Smith is our production manager. Marissa Schneiderman is our senior producer. DJ Cashmere is our executive producer. And Nick Thorburn of the band Islands wrote our theme.