Dr. David Spiegel On Mind-Body 'Tranceformation' Through Hypnosis

This is a conversation about the science, neurobiology and use cases for clinical hypnosis with the world’s leading researcher and clinician in the field, Dr. David Spiegel. Dr. Spiegel is the associate chair of psychiatry and behavioral sciences at Stanford University School of Medicine, the director of the Stanford Center on Stress and Health, and has published over 480 journal articles, 170 book chapters, and a whopping 13 books on the subject of hypnosis and related topics. Hypnosis is unfortunately a loaded term, one I admittedly met with skepticism. But as you’ll soon discover, clinical hypnosis, as opposed to ‘stage’ hypnosis, is a genuine and efficacious therapeutic protocol that induces a unique brain state—one that can be leveraged to improve everything from sleep states to high performance. It can be a powerful tool against addiction. And hypnosis has proven efficacious in the alleviation of trauma-related symptoms such as anxiety, chronic pain, and more. In this episode, Dr. Spiegel explains hypnosis, distinguishes the ‘stage’ variety from the clinical definition, and dispels the many myths associated with the field. We discuss the many aforementioned efficacious use cases for hypnosis, and a process Dr. Spiegel calls 'tranceformation'. Finally, we cover helpful tools for self-hypnosis, a simple test to gauge your own receptivity to hypnosis, and many other topics. Watch: YouTube. Read: Show notes. For a special discount on the Reveri mobile app (iOs & Android), visit reveri.com/richroll where you will be entitled to purchase a yearly or lifetime membership at a reduced price. I receive no benefit or remuneration from this offer. Please enjoy what I think you will find to be a truly fascinating, potentially life-altering conversation. Peace + Plants, Rich Learn more about your ad choices. Visit podcastchoices.com/adchoices

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

• 0:00Rich Roll?

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• 1:05Speaker 01

  The brain can really control what's going on in the body, even in rather extreme circumstances. The major evolutionary advantage we have as humans is this big brain on the top of our bodies. It's connected to every organ in the body, but it doesn't come with a user's manual. And so, we don't take full advantage of what it can do. And we underestimate. We tend to think that the real treatments in medicine are ingestion, injection, or incision. You know, that the body is like a broken car. You just replace the part, and everything will be fine. And otherwise, you're not really doing anything. You're just talking to the person. People worry, hypnosis means losing control. It doesn't. It means enhancing control of your brain and of your experience. So, part of what gives truth to what they're experiencing

• 1:48Speaker 01

  is they're feeling in control when they're doing it. And they're saying, you know, "I know what I could control. I have to face what I couldn't control." Frankly, that's the only way we humans are gonna survive. We have to face our own vulnerabilities. Having the strength and ability to face it strengthens you, it doesn't weaken you.

• 2:20Rich Roll?

  Today, we're going to talk about hypnosis, the science and neurobiology of what today's guest calls "transformation," "trans" with a "CE," and the many efficacious use cases for it. We're going to do it with perhaps the world's leading researcher and clinician in the field of hypnosis, Dr. David Spiegel. Dr. Spiegel is the Associate Chair of Psychiatry and Behavioral Sciences at Stanford University School of Medicine. He is also the Director of the Stanford Center on Stress and Health. He's published over 480 journal articles, 170 book chapters on hypnosis, and 13 books.

• 3:02Rich Roll?

  Like I said, an absolute world expert. This one is truly fascinating. It's mind-bending and mind-expanding, and it's coming right up. But first...

• 3:19Rich Roll?

  Okay, hypnosis. So, let's face it, it's a loaded term. It's a term we unfortunately associate with parlor tricks. But as you will shortly discover, scientific hypnosis, termed "clinical hypnosis" as opposed to "stage hypnosis," is very much a real thing. And an efficacious therapeutic protocol that induces a unique brain state that can be leveraged to improve, quite quickly, I might add, everything from sleep states to high performance. It can be a powerful tool against addiction and a very effective means to ameliorate symptoms related to trauma, anxiety, chronic pain, and more.

• 4:06Rich Roll?

  Today, we get into the science and neurobiology of hypnosis, meaning what exactly transpires in the brain during a hypnotic state, as well as the many use cases for hypnosis. We talk about the differences between hypnosis, mindfulness, visualization, and so-called flow states, why some people are more hypnotizable than others. We talk about the critical role that breath plays in hypnosis, how hypnosis can be used to induce an optimal state of high performance, and the mind-body connection incident to hypnosis. Finally, Dr. Spiegel imparts helpful tools for self-hypnosis, including a simple test to gauge your own receptivity to hypnosis,

• 4:51Rich Roll?

  as well as reference to the Reverie mobile app, which is a tool developed by Dr. Spiegel and his lab at Stanford, which you can find in the iOS App Store. The app has a nominal cost, but Dr. Spiegel and his team were kind enough to offer all of you a special discount on the Reverie service. To take advantage of that discount, go to reveri.com/richroll for 30% off a yearly or lifetime membership. And the Reverie app is now available on Android and iOS devices. That's reverie, R-E-V-E-R-I dot com slash richroll for 30% off. You can also find the offer in the show notes

• 5:35Rich Roll?

  on the episode page at richroll.com. I should add that I receive no benefit from this offer. It's simply a gift to you for listening, and perhaps a nudge to check it out. And with that, please enjoy what I think you will find to be a truly fascinating conversation with Dr. David Spiegel.

• 5:56Rich Roll?

  Well, David, it's a delight to meet you. I appreciate our mutual friend, Dr. Andrew Huberman, introducing us. I'm really excited to talk to you today. Before we get into anything, though, I think it's important to point out one specific thing for clarity purposes, which is that you are not the psychiatrist, David Spiegel, who testified for Amber Heard in the Johnny Depp trial, correct?

• 6:22Speaker 01

  Correct, Your Honor.

• 6:24Rich Roll?

  I'm, I'm, I can't help but ask, were, were you confused with him? Did you end up, you know, on the receiving end of some nasty threats and such?

• 6:35Speaker 01

  I, so far, not nasty threats. I did my, my star rating went down temporarily at Stanford because some people pretended that they had seen me clinically and gave me a terrible rating. I was having dinner with, we invited some friends over and this, one of my friends, a very bright woman who says what she thinks, she said, "Now, David, you told me that psychiatrists cannot make, render opinions about people they have not examined. And yet, today, you testified in court about him and about his, you know, how he must have done it because he played a pirate somewhere, you know." And I said, "I did not." And I, so then she showed me the video and it was the first that I knew of it.

• 7:20Speaker 01

  I didn't know this guy existed, David R. Spiegel. I don't have a middle name, so I'm not David R. And then there've been a couple of things, you know, in the social media space about how, apparently, her lawyer got advice to hire me and looked up David Spiegel and found this guy who was in Eastern Virginia Medical School. And she thought, "Oh, well, he's nearby, won't cost much, you know, I'll just get him to do it, that's great."

• 7:49Rich Roll?

  Wow, the plot thickens. So you were actually meant to be the person?

• 7:52Speaker 01

  I don't know that for sure. I was never called, I was never contacted. But apparently, several people had got information that the lawyer who made, who mentioned the name, called her up afterwards and said, "I told you David Spiegel from Stanford." And she said, "Oh, shit, you know, this is bad news."

• 8:10Rich Roll?

  Wow, well, you dodged a bullet. Not that you would have agreed to do that in the first place, but, yeah, it was a very interesting kind of social phenomenon, the manner in which, you know, social media bifurcated over that case and armies of people lined up to defend and attack.

• 8:28Speaker 01

  Yeah.

• 8:29Rich Roll?

  Yeah, and you happen to be kind of collateral damage to some extent.

• 8:34Speaker 01

  Well, you know, I got two kinds of emails. One kind said, "I couldn't possibly be you. I know you, I know what your work is like, I know your research." It could, that could not, you could not have been the David Spiegel, and so, thanks.

• 8:46Rich Roll?

  Well, a simple, sorry to interject, but a simple cursory Google search, you could see the guy, there's video of him, you know, it's easily discernible.

• 8:54Speaker 01

  And I got a couple of other emails saying, "Good for you, you said exactly what should have been said. Congratulations." I thought, okay.

• 9:03Rich Roll?

  Well, that's like, you know, a psychological experiment unto itself.

• 9:07Speaker 01

  It is, it is. You know, the, I mean, we're learning a lot about how people can affiliate with false beliefs of various kinds, so.

• 9:15Rich Roll?

  Yeah, well, there's a, there's a meta-conversation to be had around that, for sure.

• 9:19Speaker 01

  You bet.

• 9:19Rich Roll?

  Perhaps for another day, because today, we're going to focus on hypnosis, the myths, the truths, the science. And so, I think it's important, just out of the gate, to define what it is we mean when we say hypnosis, the difference between stage hypnosis, clinical hypnosis, and perhaps provide kind of a cursory glance at your research and clinical work.

• 9:43Speaker 01

  Sure, I'd be happy to do that.

• 9:47Speaker 01

  If you've ever gotten so caught up in a good movie that you forget you're watching the movie, you enter the imagined world, you're part of the film, not the audience, that's a hypnotic-like state. It's a state of highly focused attention with reduced peripheral awareness. So, in order to really engage fully, you have to decide you're not going to be worried about what you have to do later in the day, you're not going to pay attention to anything else, you're going to narrow your focus. And that has a couple of consequences. It lets you think very clearly, very well. It also gives you a kind of cognitive flexibility that used to be called suggestibility, you know, and people worry about that, you know, can you make me think I'm a chicken and do all kinds of foolish things?

• 10:28Speaker 01

  And it, that, but that also means you're willing to approach an old situation from a new point of view, to see it differently. If you intensely focus, if you suspend judgment, you can learn. And so, it's also a very good situation to be in if you're engaging in a good kind of psychotherapy, for example. You won't immediately dismiss some new idea because it's new or different. The third thing, so there's this intense absorption, there's this cognitive flexibility, and the third thing is dissociation. So you let go of what this means for who you think you are, and you just kind of do it. You can detach yourself. Now, people spontaneously dissociate in situations of stress or trauma, for example.

• 11:12Speaker 01

  This can't be happening to me. And, you know, many rape victims experience the rape as if they're floating above their bodies, feeling sorry for what's happening to the person below. And that can be protective. It can keep you from having to engage in the worst aspects of a traumatic situation when it's happening. But you can induce that with hypnosis. Now, we normally dissociate to a certain extent. Right now, you're having sensations in your bottom touch in the chair across from me, but hopefully you were not even aware of that until I mentioned it to you. If you were, we can stop the interview now, and you know. So we do that as a way of allocating our attentional resources where we want and not where we don't want. And in hypnosis, you intensify those three things, and that allows you to concentrate

• 11:57Speaker 01

  intently, to have profound effects on mind and body, and to alter your approach to problems. So that's what hypnosis is. It's a naturally occurring experience. It doesn't just happen when I dangle a watch. We don't, you know, digital watches don't dangle very well anyway, so we don't do that. But it's a, it's a, an unusual state that many people can get into, and people who are hypnotizable get into naturally. So people who are more hypnotizable get lost in sunsets, you know, they get absorbed in movies, they miss dinner because they're so busy working on something. That capacity to deeply allocate your attentional resources is something that happens in hypnosis.

• 12:39Rich Roll?

  Yeah. I definitely want to put a pin and drill down on this notion of hypnotizability, but prior to that.

• 12:46Speaker 01

  Sure.

• 12:47Rich Roll?

  As we're kind of defining what we, what we mean when we talk about hypnosis, what you just described as clinical hypnosis.

• 12:54Speaker 01

  Right.

• 12:55Rich Roll?

  We're mostly familiar with this idea of, of stage hypnosis, the parlor trick version of it, that, you know, is the, is the ire of your existence, I'm sure. But how are these two things different? And, you know, sort of talk a little bit about, maybe that's a, a larger discussion about the history of this modality.

• 13:18Speaker 01

  Sure. Well, it might be, that might be a good way to frame it, Rich, because hypnosis is the oldest Western conception of a psychotherapy. It's the first time that a talking interaction was thought to have therapeutic potential. And it started 250 years ago with Franz Anton Mesmer in Austria. He thought that, he would provoke what looked like seizures. He would take people next to the, what they called paquets, full of metal filings with a slight magnetic field, and they would start to shake and some would faint. And he would use it to treat a whole variety of what we would then, we would call psychiatric and medical problems. He became very popular in Vienna, so of course he left his wife and family there and moved

• 14:02Speaker 01

  to Paris, where he started competing with the French physicians of the day. And, you know, Voltaire wrote to his brother when his father was dying, "We did everything we could to save father's life, we even sent the doctors away." And the main treatment in France at the time was bloodletting. So if you stayed away from a French doctor by going to Mesmer, you would do better. And he became very popular in Paris. But his theory about why it happened was criticized correctly, that the hypnotist doesn't project a magnetic field on someone.

• 14:34Rich Roll?

  Wasn't it also about moving fluids into balance?

• 14:37Speaker 01

  Yes, that's right. So rearranging the balance of magnetically charged fluids in the body. And the hypnotist's magnetism could, he called it animal magnetism at the time. So, the theory, the phenomenon was interesting, the theory was wrong. He was examined at King Louis' behest by a French panel of experts that included our own Benjamin Franklin, who was having a lot of fun in Paris at the time.

• 15:03Rich Roll?

  Right.

• 15:03Speaker 01

  The brilliant French chemist Le Boisier, who discovered, you know, defined oxygen chemistry and also invented the concept of the gross national product shortly before he was beheaded in the French Revolution.

• 15:16Rich Roll?

  Hence the term mesmerized.

• 15:17Speaker 01

  Mesmerized, that's it.

• 15:19Rich Roll?

  To be mesmerized.

• 15:20Speaker 01

  And the other person on the panel was a guy well-known for his work on separating the mind from the body, Guillotin, Dr. Guillotin, who invented the guillotine, was also on this panel.

• 15:32Rich Roll?

  Wow.

• 15:33Speaker 01

  He created the mind-body problem, in a sense. And so that was a damaging blow to hypnosis for many, many decades.

• 15:42Rich Roll?

  And was that a scenario in which Mesmer would go to kind of fancy dinner parties and do it in, you know, kind of highfalutin groups of high-society people?

• 15:52Speaker 01

  No, Mesmer was not a stage hypnotist. He was a dedicated healer. And one of the things that was noted about his offices were that they were cheerful and bright, and there would be other patients teaching new patients about what they'd learned. Unlike French physicians, who had these dark, grim, bare offices, that you kind of felt like you were going to get sicker there. And in Mesmer, he created this positive expectation. He was not a stage hypnotist, but it led, his work led to stage hypnosis. And these guys, one trick that most people don't realize that they do, you know, they make it seem that they could do this to anybody, and they can get the football coach dancing like a ballerina, or somebody quacking like a duck, or lying stiff between two chairs.

• 16:36Speaker 01

  They always screen a large number of people. And they bring them up, they try out a few things, most of them go back and sit down. Or they'll say to somebody in the audience, when they give a suggestion to the audience, "If you noticed your neighbor reacting a lot, let me know." And so what they do is they go through the large number of people to get to the 10% or 15% who are very hypnotizable. And that's when the real show begins. So the first half of it is just screening for hypnotizability and getting those people up there, and then you can do the more extreme things. But, as you mentioned, I don't like it. It makes fools out of people. It sometimes can be damaging or upsetting.

• 17:17Speaker 01

  My late father, who was a pioneer in hypnosis, starting in the middle of the last century, had a woman, a neurologist, called him up and said, "Herbert, you are going to see this patient this morning," because she was found wandering in the streets of Manhattan at 2:15 in the morning, and she's in some kind of weird mental state, and I don't know what it is, but see her and fix her, you know. And it turned out that the trick in the stage hypnosis show was that she was holding an imaginary bird cage. And there was a little birdie in it and she was reacting just that way and it all was going great. And then he said, now imagine that we're opening the door and the bird will fly away. And she stood there and she started to shake. I mean, it sounds pretty innocent, right? And she said, the bird won't fly away, the bird won't fly away.

• 18:02Speaker 01

  And she got more and more anxious and panicked and it was clearly spoiling the show. So he just got her off the stage. And she's wandering around, you know, midtown Manhattan at two o'clock in the morning. And it turned out that this apparently innocent suggestion to her was a reminder of who she was. She was the trophy wife of a very wealthy man and she felt like a bird in a gilded cage. And so when she decided, and people learn things about themselves when they engage in hypnotic experiences like this. She sort of visualized that and it was an important thing for her to know, but not under those circumstances.

• 18:37Rich Roll?

  And the practitioner didn't exit her out of the hypnotic state, so she was in a persistent state of hypnosis, wandering around.

• 18:45Speaker 01

  Right. Coupled with the upset, it's sort of crystallizing what she kind of knew about herself but hadn't really faced. So, you know, my father was able to bring her out of the hypnotic state and discuss whether what it meant and how to get help for it. Now, I don't, I don't, you know, I don't want to present that as saying, this is what happens every time somebody else uses hypnosis. It's not dangerous. Hypnosis is just a state of highly focused attention. So things can go wrong in that state, but they can go wrong in a lot of other states too. But it's one reason that I'm not wild about stage hypnosis, because these guys have no clinical responsibility at all if something happens. So I just, I think it does give hypnosis a bad, I mean, people are intrigued by it, that's good, but it gives it a bad name, as it should.

• 19:30Rich Roll?

  It does have that veneer of, of being some kind of snake oil, carnival barker type of situation. Your work is really about disabusing people of that notion and, you know, not for nothing, I mean, your dad really was the pioneer of this field. And I was looking into him a little bit. I know that he treated Sybil and he was kind of the toast of the town and would dine at Elaine's, like, he seems like he was quite the guy.

• 19:57Speaker 01

  Yeah. He was. He said, he didn't go to Broadway Theater because what happens in his office is more interesting. You know?

• 20:05Speaker 01

  But most of the theater people came to Elaine's afterwards anyways. So we saw him there.

• 20:10Rich Roll?

  Yeah, but interestingly, it seems like it's not a case in which you grew up, you know, thinking you were gonna pursue this craft as well, this science as well, initially at least.

• 20:21Speaker 01

  It was interesting. I'll tell you a story. When I published a book some years ago, Living Beyond Limits, that talked about treating cancer patients and some about hypnosis. Teri Gross was interviewing me on Fresh Air and she said, you know, I happen to know that your father is a well-known hypnotist. Did he ever try to hypnotize you when you were a child? You know, suddenly she got journalistic on me. And I said to her, Teri, I don't think so. She said, okay, okay, we're done with it.

• 20:53Rich Roll?

  Well, you kind of dodged the question, though.

• 20:56Speaker 01

  Of...

• 20:57Rich Roll?

  Whether or not your dad was hypnotizing you.

• 20:59Speaker 01

  Oh, no, he wasn't. He was. And, you know, there are a couple of things, at least not that I remember.

• 21:05Rich Roll?

  Right.

• 21:06Speaker 01

  But, no, but I was very interested in the dinner table conversations. I mean, it was kind of fun to listen to this. And every once in a while, when he'd be filmed making a movie of a patient, he had a patient who had what we now called non-epileptic epilepsy, where you don't actually have a seizure focus in the brain, but you act like you're having a seizure. And she was just having these events at any time, anywhere. Her husband's desk at the factory near their home was moved to be near the door so he could run home and help her. So they filmed my father hypnotizing her and inducing one of these seizures. And, you know, the story is, maybe you can't stop it, but you can start it.

• 21:46Speaker 01

  And that's the way of teaching you control over this mind-body relationship. So he had her do that. And I'm watching her, you know, like a fish flopping on the sofa there. I'm thinking, this is, this is pretty interesting. So I was, I was attracted to it, although of course I tried everything else first. But my parents, my mother is also a psychiatrist and psychoanalyst. And my parents told me that I was free to be any kind of psychiatrist I wanted to be.

• 22:15Speaker 01

  So I took him up on it.

• 22:16Rich Roll?

  Right.

• 22:17Speaker 01

  And here I am.

• 22:17Rich Roll?

  Right. And yeah, here you are. I mean, you, you sort of ventured west. You started with a focus on philosophy.

• 22:24Speaker 01

  That's right.

• 22:24Rich Roll?

  You ended up going to medical school. You ventured to San Francisco, thinking it'll be a short-term thing. And you've been at Stanford for quite some time at this point.

• 22:32Speaker 01

  That's right. I just couldn't, couldn't go back. I loved it. I loved it out here.

• 22:37Rich Roll?

  Right. So, so talk a little bit about, you mentioned the mind-body connection. And I think that's a really important point in broadening our understanding of this world of hypnosis.

• 22:47Speaker 01

  Well, you know, you mentioned snake oil earlier. And one of the things that really troubles me, saddens me about the way hypnosis has been understood and treated is, you know, there have been a lot of problems with medications too. You know, we have 60,000 opioid overdose deaths in the United States last year. Medications have their problems too. And I'm a physician. I use medications. I'm not against that. But, you know, we, the major evolutionary advantage we have as humans is this big brain on the top of our bodies. It's connected to every organ in the body. And, but it doesn't come with a user's manual. And so we don't take full advantage of what it can do. And we underestimate, we tend to think that the real treatments in medicine are ingestion,

• 23:32Speaker 01

  injection, or incision. You know, the, the body is like a broken car. You just replace the part and everything will be fine. And otherwise, you're not really doing anything. You're just talking to the person. And I'll tell you, Rich, the day that I really, that turned me around about this, I was a third-year medical student at Harvard. I was in pediatric rotation. The nurse says to me, "Spiegel, your next patient is in room 342," and I'm following the sound of the wheezing down the hall. And there's this 15-year-old girl, redhead, bolt upright, knuckles white, struggling for breath. You could hear the wheezing. Her mother's standing there crying. They had tried to use subcutaneous epinephrine twice. It didn't work. They were thinking about general anesthesia and starting her on steroids. And I didn't know what else to do.

• 24:17Speaker 01

  So I said, "You want to learn a breathing exercise?" And she nods. And I had take, started a hypnosis course. And so I got her hypnotized. And then I realized we hadn't gotten asthma in the course yet. So I came up with a very clever idea. I said, "Each breath you take will be a little deeper and a little easier." And within five minutes, she's lying back in bed, her knuckles aren't white, her mother's not crying, and she's breathing almost normally. And the nurse ran out of the room. My intern comes to find me and I figure he's gonna pat me on the back and say, "Good job, Spiegel, what'd you do?" You know. He said, "The nurse filed a complaint with the nursing supervisor that you violated Massachusetts law by hypnotizing a minor without parental consent." And you know, Massachusetts has a lot of weird laws, but that's not on the list.

• 25:00Speaker 01

  And her mother was standing next to me when I did it. So he says to me, "You're gonna have to stop doing it." And so, I mean, this, just observing that, I think, you know, "There is something here, there's something to this. The brain can really control what's going on in the body, even in rather extreme circumstances." So, they told me that it was dangerous. And I said, "You're gonna put her on steroids and put her under general anesthesia and my talking to her is dangerous?" You know. And he said, "Well, you may not be able to follow her." And I said, "Well, I'll, you know, I'm in Boston. I'll follow her as long as it's necessary." And he said, "You gotta stop doing it." I said, "I'll tell you what. As long as she's my patient, I'm not gonna tell her anything I know is not true. So if you wanna take me off the case, go ahead, but otherwise, I'm not."

• 25:42Speaker 01

  So, there was a council of war among the, my intern, the resident, the chief resident, and the attending that weekend. And they came back on Monday with a radical idea, never been tried before. They said, "Let's ask the patient." And she said, "I like this," you know. And, and that, just that observation, that just something I said to her, that using this simple, straightforward, undangerous technique could produce such a radical change in such a short time, really hooked me. I mean, I, you know, I'd learned a lot, a fair amount about hypnosis, growing up, but nothing like this, where you see it happen. And, and that, I think, is one of the tremendous advantages right now, is that you will know very quickly whether it's gonna help you or not.

• 26:26Speaker 01

  Doesn't help everybody, but it helps a lot of people. And you can feel it right away, which is unusual among psychotherapies, even among medications. It often takes a while to, to feel the effects.

• 26:37Rich Roll?

  It's interesting that, that breath is such a core, critical kind of conduit to achieving these states.

• 26:46Rich Roll?

  So talk a little bit about the impact of breath. I mean, breath is interesting. You're talking about voluntary and involuntary actions. The distinction between the conscious mind and the unconscious mind. Breath is sort of unique in that we breathe no matter what we do. Our body will take care of that, but we can kind of override that and control that as well. I don't know how many other physiological, biomechanical things that fall into that category.

• 27:15Speaker 01

  That's exactly right. It's a very astute observation. And I'm researching that now with my colleague and friend Andrew Huberman. We've got some funding to study breath work and compare it to other forms of mind-body control. And you're exactly right that the interesting thing, I mean, the centers for breath control are right at the tip of the spinal cord, so between the brain and the spinal cord. So they're also right at the edge of conscious versus unconscious control. So as you said, we can consciously control our breathing, but we usually don't. And it seems to me to be a pathway into this mind-body connection, just because it's at that tipping point between conscious and unconscious.

• 27:57Speaker 01

  And because also, the way we breathe affects our autonomic nervous system. So if you think like your heart for a minute, when you inhale, you inhale by reducing pressure, expanding the diaphragm down, expanding the rib cage, and so you pull in because you create a bit of a vacuum air into your lungs. That also reduces blood flow to the heart, because it's coming up through the vena cava into the heart, and it slows it down a bit. So the sinoatrial node says, wait a minute, there's less blood coming. We better speed up heart rate and blood pressure. So you get a bit of a pump of your sympathetic nervous system.

• 28:38Speaker 01

  And then, when you exhale, you increase pressure, you increase return to the heart. And so the parasympathetic, the self-soothing system that opposes the sympathetic nervous system kicks in and slows down your heart rate and your blood pressure. We do this all the time. It's called respiratory sinus arrhythmia. And it is actually a very good measure of health, the capacity to self-soothe. Can you turn on that parasympathetic system when you need it? And if you breathe in certain ways, one is called cyclic sighing, where if you do this, you inhale partway, hold it.

• 29:13Speaker 01

  Fill your lungs and then slowly exhale. What you're doing is privileging your parasympathetic over your sympathetic nervous system. And it's a nice, natural relaxation experience. And Andrew and I have found that it actually improves mood and makes people feel more rested when they do it. So, we think there are ways of controlling your breathing that can enhance your capacity to self-soothe.

• 29:39Rich Roll?

  And what is it about breath that helps induce this hypnotic state?

• 29:44Speaker 01

  Well, it's not necessary, but typically, when I do a hypnotic induction, I combine looking up and closing your eyes with taking a deep breath and slowly exhaling. And I think in part, it's triggering this self-soothing parasympathetic response. Because one of the things, you can get all aroused in hypnosis, but typically, the arousal, even if it's mental arousal, doesn't necessarily bring with it physical arousal. And that's how hypnosis is a very good stress reduction technique. Because you can be facing something that makes you anxious, but you can still be having a physical experience of being comfortable. You can dissociate your mental from your physiological arousal.

• 30:24Speaker 01

  And so, the breath is a way of helping to speed the transition into a state where whatever it is you're focusing on or concentrating on, your body can feel relaxed and comfortable. And that begins to teach you how to control stress.

• 30:39Rich Roll?

  And what do we know and perhaps have yet to learn about what's going on neurochemically in the brain when you induce a hypnotic state? Like, what aspects of the brain are being turned on, turned off, etc.?

• 30:53Speaker 01

  We've been studying that for the past decade. And we've discovered some things that really begin to make a lot of sense. And one of them, and I'll talk first about neural function in the brain and then neurochemistry. One of the things that happens when somebody goes into a hypnotic state is that they turn down activity in the dorsal anterior cingulate, the salience network. The way to think about the cingulate gyrus is it's a bundle of nerves that looks like a C on its end here. And it goes under the cerebral cortex and over the limbic system. And this part here in the front, the dorsal anterior cingulate cortex, is part of the salience network. It's part of the brain that is a context detector, and it tells you, should I pay attention or not?

• 31:39Speaker 01

  And so if a loud noise suddenly happens, you startle and you go turn your attention to where it is. Social media is very good at using this, you know, they they'll float something by you that sounds a little scary or threatening and you suddenly, you know, detach from what you were paying attention to. That's the salience network. In hypnosis, you turn down activity in that brain region. And in fact, in another study, we looked at the prevalence of neurotransmitter activity in those regions, and you see more GABA activity in the anterior cingulate of people who are very hypnotizable. So they have more ability to inhibit, it's an inhibitory neurotransmitter, it's one that is activated by anti-anxiety drugs.

• 32:22Speaker 01

  And there's greater ability there because of the higher prevalence of this inhibitory neurotransmitter to inhibit the salience activity. So it's one thing that helps you concentrate intently, you're less likely to worry about what else you might be thinking of or thinking about. The second thing that happens is higher what we call functional connectivity. That's if one region is active, the other region is active, that region is inactive, the other region tends to be inactive. Between the dorsolateral prefrontal cortex on the left, which is part of the executive control network, it's the part of my brain I'm hopefully using now as I'm describing this to you, and the insula, that's another part of the salience network that's a major mind-body pathway.

• 33:05Speaker 01

  So it helps your brain control what's happening in your body, control gastrointestinal function, control autonomic activity. And so you have a greater ability in hypnosis to control what's happening in your body, like that 15-year-old girl with her asthma attack. The third thing that happens is you have inverse functional connectivity. So when one region's active, the other is inactive, between the executive control network and the posterior part of the cingulate cortex. That's what we have called the default mode network, and it's a part of the brain that's active when you're thinking about yourself, when you're reflecting on who you are and what it means. It's a part of the brains that where activity goes down in experienced meditators.

• 33:48Speaker 01

  And of course, part of meditation is to sort of detach from your self-ness, you know, to just experience things and not judge them or see what they mean for you. And that's a mechanism of dissociation in hypnosis. So we found that a lot of things that we know from the phenomenology of hypnosis are actually happening in specific regions of the brain that should control that kind of activity.

• 34:11Rich Roll?

  And is this the result of fMRI testing? That you've been able to discern all of this?

• 34:16Speaker 01

  Yeah, we've screened hundreds and hundreds of, thankfully, cooperative Stanford students and picked out the ones who on formal testing are very high and very low in hypnotizability. We get, put them in the scanner, the highs and the lows. We give them hypnotic instructions and we see what happens in the brains only of the high hypnotizables and only when they're in the hypnotic conditions. And that's what enabled us to observe what's going on in the brain.

• 34:42Rich Roll?

  And on that subject of hypnotizability, let's talk a little bit more about that. I mean, first, how do you determine whether somebody has a high receptivity to it? And secondarily to that, like, is that a preset that people come into the world with? Is it malleable? Is it something that can be shifted with technique?

• 35:04Speaker 01

  We're doing some research now that adds to another body of research over the last decade or so, showing that there does seem to be a genetic component to hypnotizability, that particularly people with a certain polymorphism of the production of dopamine, a neurotransmitter that's prominent in the prefrontal cortex and throughout the brain. If they produce just enough, so this is an enzyme, catecholomethyltransferase, it's an enzyme that metabolizes dopamine. And if you, if you're at a point where you don't metabolize it too quickly or too slowly, Those people seem to be more highly hypnotizable. And related people, people with in general genetic commonalities, tend to be more similarly

• 35:49Speaker 01

  hypnotizable than people who are unrelated. And so there is some evidence that it may have to do with this genetic variation in neurotransmitter metabolism. But there's also evidence, Josephine Hilgar published a book called Personality Hypnosis, where she looked at the early life histories of former Stanford students, of Stanford students, and found that higher hypnotizability was associated with one positive and one negative thing. Imaginative involvements, children who had been raised to have imaginative involvements, their parents read stories to them every night, they played games in their imagination, turn out to be more highly hypnotizable. But sadly, also, children who have been physically and sexually abused are more highly hypnotizable.

• 36:34Speaker 01

  And it may be that it's a kind of protective defense mechanism if you're going through terrible experiences.

• 36:41Rich Roll?

  Right, because they developed the ability to disassociate when their brain was still malleable.

• 36:46Speaker 01

  That's exactly right. I had one patient who said, "I'd just go to a mountain meadow full of wildflowers when my father and his friends were abusing me." You know, that's the way she dealt with it. And so there's a developmental part of it, but the other part of the story is that most children are highly hypnotizable.

• 37:03Rich Roll?

  Right, that's what I was thinking, because they're less calcified in their neuropathways.

• 37:08Speaker 01

  That's, that's part of it. And because they're, for children, you know, knowledge and emotion and experience are all kind of one thing. You know, it's why work is play for kids. You know, it's a shame that we make them into little adults, because they love doing whatever it is they're doing. They just get fully engaged hypnotically, in a way, in whatever they're doing. And you call your eight-year-old in for dinner, and she doesn't hear you, she's out doing whatever she does. In adolescence, when we develop what the psychologist Piaget used to call formal operations, where you kind of privilege logic over experience. Many people lose to some degree that hypnotizability. And by the time you're 20, 21, the level you have is what you're going to have 25 years later.

• 37:51Speaker 01

  And they did a study at Stanford in which they blindly retested students and 25 years after they'd taken their Psych 1 class, and found that there was a 0.7 correlation between their original hypnotizability and the one they had at age 45 or 46.

• 38:08Rich Roll?

  Is that Zimbardo?

• 38:10Speaker 01

  Yeah.

• 38:10Rich Roll?

  That did that?

• 38:10Speaker 01

  Yeah.

• 38:11Rich Roll?

  I took Psych 1 from him.

• 38:12Speaker 01

  Did you really?

• 38:13Rich Roll?

  I was not part of that cohort.

• 38:15Speaker 01

  You weren't part of that cohort? Did he read the hypnotizability?

• 38:17Rich Roll?

  I mean, it was, you know, 30 years ago. I don't remember.

• 38:20Speaker 01

  Yes, that's right. You were there in the 80s. You were at Stanford. Well, you know, so what it suggests is that once you get into early adulthood, it's a very stable trait. It just doesn't change very much. And so some people who retain it, I think, have brains that have grown into a relationship, particularly between, and we've done some neuroimaging on this too, the dorsolateral prefrontal cortex and the anterior cingulate. And people, the students we studied who were more highly hypnotizable, had more functional connectivity between the executive control and the salience networks than the low hypnotizables. So when they thought about something, they tended to coordinate that with a part of the brain

• 39:05Speaker 01

  that says, is this worth thinking about or not? Whereas, and it's interesting, if you see really low hypnotizable people as adults, and I see a lot of them, they come to me, they want to be hypnotized, and they're not hypnotizable. They're very critical, and they evaluate things carefully, and they argue, and they raise questions, which is all good, but it's a kind of non-hypnotic way of responding.

• 39:26Rich Roll?

  Right. It's sort of an external evidence of non-hypnotizability through character traits, right? Just being kind of skeptical and defensive, perhaps, a little bit.

• 39:40Speaker 01

  That's exactly right.

• 39:41Rich Roll?

  But you've developed this test, the Spiegel test, right? To kind of easily, in a facile way, determine hypnotizability. Will you indulge me in taking me through this?

• 39:52Speaker 01

  Sure, I'd be glad to. Well, the first part, my father observed, he used to have people look up at the ceiling, get a light on the ceiling, and close their eyes. And actually, he noticed that the woman I mentioned earlier, who was extremely hypnotizable and having these seizures, these pseudo seizures, that when she looked up, he noticed that all he could see was the sclera, the whites of her eyes. He couldn't see her iris or her pupil at all. And his next patient, the following Monday, was a very rigid, obsessional lawyer, who just fought him every bit of the way. He had him look up, and the guy had to bring his eyes back down. And he was not at all hypnotizable. So my father started measuring it. And there seemed to be a modest but real correlation

• 40:38Speaker 01

  between this measurement, that he called the eye roll, and the rest of the test, which only takes about five minutes, but measures hypnotic experience and behavior. So I do the whole test with every patient that I see to determine how hypnotizable they are. So I can see for a start, if you want, see what your eye roll is.

• 40:57Rich Roll?

  Do I have to take my glasses off, or I can leave them on?

• 40:58Speaker 01

  Oh, you can leave them on. So look up all the way up past your eyebrows. Keep looking up and slowly close your eyes, close. So you would be open, you would be about a two out of four. I can see about half iris and half sclera. But there's a bit of a convergence that usually adds a point. Your left eye tends to converge to the middle when you're doing that.

• 41:21Rich Roll?

  Yeah, I have a weak left eye.

• 41:23Speaker 01

  Yeah, I could see that. But so you'd be a two or three. So you'd be in the sort of middle to high, but not extremely high range, would be my guess, just from that. Now, there's the rest of the test. I can do it if you want to see formally how hypnotizable you are.

• 41:38Rich Roll?

  Right, interesting. What is it about the optic nerve? I mean, obviously, the optic nerve is part of the brain. But that test, on a surface level, feels very, you know, kind of correlative, but not necessarily causative.

• 41:54Speaker 01

  Right.

• 41:54Rich Roll?

  Right, so what is that relationship between? Sight seems to be very important.

• 41:59Speaker 01

  Well, sight is important. And I think, you know, part of why I ask people to look up and close their eyes is I want them to be alert and awake, but turning inward. We're used to going to sleep when we close our eyes. So the idea that you can be reflective and intensely concentrating, but your eyes are closed, means that you're cutting off your scanning awareness. You know, we're pretty pathetic creatures in the animal world.

• 42:25Speaker 01

  And one way that we keep ourselves alive is by scanning the visual environment to see if there are any threats. And with hypnosis, you're kind of trusting the outside world to leave you alone and turning inward. So part of it is that, just closing your eye, looking up, closing your eyes. And there's an old Zen practice called looking at the third eye, where it's part of meditation and you look up and close your eyes. But there are other things about the neurophysiology of eye movement. The third, fourth, and sixth cranial nerve nuclei that control eye movement and control the lowering of the eyelid and that are involved in the exercise that I did with you just now are also surrounded by the reticular activating system, which is a part of the brain stem

• 43:08Speaker 01

  and the lower part of the brain that modulates arousal. And drugs that affect level of arousal also affect eye movement. So if you take barbiturates, you get nystagmus, your eyes move back and forth like this. They control the size of the pupils, so stimulates, enhance the size of the pupil, opioids constrict the pupil. And so there's a lot about arousal that is very closely linked to eye movement. And that, I think, is one reason that these two may be connected.

• 43:46Rich Roll?

  With respect to the other senses, though, and thinking about hypnosis in terms of absorption and suggestibility, I can't help but think about sense memory and how powerful things like smell or hearing a song that you haven't heard for a very long time that can evoke a very specific vivid memory. Like, how do those other senses play into this kind of modality?

• 44:10Speaker 01

  Well, what they show is that they can't, what we're doing with this eye movement test is just seeing what it tells us about your ability to manipulate these other things. But we have plenty of evidence that hypnosis can be used to alter perception, somatosensory perception, visual perception, auditory perception. And we did one study where we showed a group of highly hypnotizable people a color grid, like a Mondrian painting, and had them in hypnosis drain the color out of the color grid. And after a while, they said, "Yeah, it looks black, white, and gray to me." And then we showed them some black, white, and gray grids and said, "Make them colorful." And they did that.

• 44:55Speaker 01

  And they could convincingly to themselves see it differently. And what we found using PET was that there was, when they were draining the color, they turned down activity in the lingual infuser form gyrite in the occipital cortex that process color vision. And when they were adding color to the black and white grid, they increased activity in those same regions. So they could change it in both directions. And I call that my believing a seeing experiment. You know, that with hypnosis, you can get highly hypnotizable people to literally change their perception of color.

• 45:26Rich Roll?

  Right.

• 45:26Speaker 01

  And it's not just the reporting, it looks different. They see it differently.

• 45:30Rich Roll?

  Yeah.

• 45:30Speaker 01

  And we've seen the same thing using EEG on pain perception and others. At the University of Montreal, there's a very good research group here, Rainville, that has taught people to use hypnosis to reduce pain. So you administer some shocks and you say your hand is in ice water in hypnosis, and they turn down activity in the somatosensory cortex where you process ultimately sensation. And if you use different words in hypnosis, you say, well, the pain's there, but it won't bother you, which is sort of what people on opioids feel. You turn down activity in the anterior cingulate cortex and you still get analgesia. So you can use hypnosis to change not just how the brain reacts to things, but how the

• 46:14Speaker 01

  brain processes things. You experience them differently.

• 46:17Rich Roll?

  It's utterly fascinating. And of course, the dark side of my personality can't help but think about the Manchurian Candidate, you know, example of how this could be, you know, weaponized for nefarious means.

• 46:31Speaker 01

  You know, I, you know, the sort of what you're taught in, you know, grade one hypnosis training is, oh no, people would never do anything that they otherwise wouldn't do. I would like to think that, but look, you know, we live in a country where a substantial minority of the population actually thinks that Trump won the presidential election, you know. So.

• 46:52Speaker 01

  It is entirely possible for us human beings to succumb to social influence and believe things that are just flat out not true.

• 46:59Rich Roll?

  Mm-hmm.

• 47:00Speaker 01

  That's a little scary. It goes beyond hypnosis, but if, you know, it does suggest that...

• 47:05Rich Roll?

  It's a mass hypnosis of sorts.

• 47:07Speaker 01

  Yeah, I think, I think so. I think it was. I pay attention to something else. It's like a giant, you know, big stage, stage hypnosis, you know? And you look at what happens in those rallies and what people will go for, you know, when somebody tells them this is the right thing to do and this is what must happen and all this. It's a little scary, but it's not hypnosis' fault. You know? Leave my specialty out of this. But I, I do think, um, so is there a Manchurian candidate thing possible? Sure. Do, um, I don't think it happens very often, and I do think people are capable of resisting, even in a hypnotic circumstance, um, doing something that they feel deeply is wrong. Uh, but on the other hand, we all get, you know, we've all had that it seemed like a

• 47:51Speaker 01

  good idea at the time experience, you know? And you wonder, what the hell was I thinking when I did that? And so I think anything that has the power to help has the power to hurt.

• 48:01Rich Roll?

  In a clinical hypnosis setting, is there a sense of how long you can create a persistent hypnotic state? Does it wear off with time? Or can somebody kind of remain in that state indefinitely?

• 48:14Speaker 01

  Well, I know a few people who may have, but I, um, let me put it this way. I have to, I can answer that question in two ways. Typically, in, in the sort of formal sense, if I hypnotize somebody in my office, they were very hypnotizable, they're in a trance, and I get called away and forget to come back or something. Usually, the worst thing will happen is they'll fall, eventually fall asleep, and when they wake up, they'll be out of the state. Some people can begin to wonder what's going on and bring themselves out. But the other side of that coin is, look, what I do to put someone into a hypnotic state if they're hypnotizable is pretty straightforward, very fast, easy to do.

• 48:56Speaker 01

  And so that means that people who have that ability go into the states like that all the time anyway, and they come out of them. So there's a great psychologist at University of Minnesota called Aki Teligen who developed an absorption scale. It's a measure of how often you get caught up in sunsets or movies, you forget to come home for dinner, you just get totally engaged and absorbed. And those people, when they're tested formally, are more hypnotizable than those who don't have these high absorption scores. So what it suggests is, you know what, it's happening all the time anyway. People who are hypnotizable are going into hypnotic-like states, getting absorbed and engaged, and then coming out of them again.

• 49:34Rich Roll?

  We associate hypnosis with pinwheels and, you know, watches swaying back and forth and all the like. I feel like hypnosis needs, clinical hypnosis needs, a bit of a rebranding to bring it into the 21st century. Like, if you called it something else, like the neuroabsorption protocol or something like that, I feel like it would have a traction that it kind of is in need of.

• 50:00Speaker 01

  You know, you're really good at this, Rich, and if you have some good advice, I'm looking for it.

• 50:04Rich Roll?

  Hire a marketing agency. Like, beating the dead horse of this term, hypnosis.

• 50:12Speaker 01

  Well, here's the thing, though. I mean, I'm, the term I'm playing around with in my head is transformation, but with a C, not with an S.

• 50:19Rich Roll?

  I like that.

• 50:20Speaker 01

  It's a way of making, transforming yourself, making changes in a hurry and using the state. And on the other hand, there's a sort of impish part of me that is saying, you know, maybe we ought to just say, folks, hypnosis dangerously effective, you know, that if people are a little, you know, a little bit scared of it, they might actually pay more attention to it. So, and I've tried using other terms, but, you know, when I do it, everybody says, come on, Steve, you're talking about hypnosis, give me a break, you know? So I hear what you're saying, and I think we have a problem, but I don't know whether we make the problem better by trying to call it something else or by... Acknowledging what it is, but expanding upon what it is.

• 51:02Rich Roll?

  Yeah, interesting. Transformation. I like that.

• 51:05Speaker 01

  You like it?

• 51:05Rich Roll?

  Well, let's talk about use cases. You mentioned pain management, opioid addiction. There are, you know, I think most people associate hypnosis, or at least the efficacy of it, with smoking cessation. You know, we're in Los Angeles. There's lots of kind of quote unquote like celebrity hypnotists. People pay an unbelievable amount of money to go see these people to quit smoking. I don't know whether those people fall into the category of being legitimate clinical hypnotists, but there are, you know, there's a wide spectrum of use cases here. So let's talk about that for a few minutes.

• 51:40Speaker 01

  Sure, I'd be glad to. Well, certainly, I can save some of these wealthy people in LA a lot of money by saying, you know, we do this on REVERIE, our hypnosis app. And there, we did choose a different name, by the way. We didn't call it a hypnosis app, but it's, you know, R E V E R I. And we have interactive digital hypnosis there where we treat pain, we treat stress, we help people focus their attention more, we help them control trouble sleeping, insomnia, trouble eating, and smoking control. We help people stop smoking. We get one out of five people, just using the app, stop smoking. Now, it's not everybody, but that's

• 52:17Rich Roll?

  Twenty percent, that's pretty good.

• 52:18Speaker 01

  It compares favorably with a lot of other things. I had one, we're doing a number of studies on this now, and I had one woman came in, we do a careful evaluation in the study, and she sort of at first didn't like it when we taught it to her, but she went home, and she did the exercise, and she said, cigarette, phew, who wants that? And she said, I haven't smoked a cigarette since. And she said, this is some crazy ass voodoo shit, and I mean that in a good way.

• 52:47Rich Roll?

  That's amazing.

• 52:48Speaker 01

  And she said her friends are amazed that she stopped, and she's helping her friends stop. So it can be a place where you turn a corner, where you can just, because you concentrate intently, you're cognitively flexible, you're dissociating from your usual pattern of associations that lead you to have another cigarette, that you can focus on respecting and protecting your body, rather than fighting smoking. One of the strategies that hypnotists are pretty good at is saying to patients, "The worst thing I could do is tell you, don't think about purple elephants."

• 53:19Rich Roll?

  Right.

• 53:20Speaker 01

  "What are you thinking about?" So if you tell yourself, "Don't smoke," what do you want to do? You want to smoke. But if I tell you to think about your body as if it were a trusting, innocent child that had to take into it anything you put into it, even if it were damaged by it, that's a whole different way of thinking about it. And you can feel good about yourself right away. You're not depriving yourself. You're protecting and respecting your body. And that's something you can be for. And that's something you've written about and talked about a lot. That you, you know, came to a turning point about how you were treating your body and how your body was treating you. And everything changed when you did that.

• 53:54Rich Roll?

  Yeah, the solution's a little bit different, though. But I think what's interesting about addiction, and perhaps this is related to pain management, is there is a physiological thing occurring in your body that's creating discomfort, right? Whether it's the chemical craving for the substance or the, you know, neural impulse that's creating the pain that somehow is being overridden by this hypnotic practice.

• 54:21Speaker 01

  Well, you know, part of it is that for pain, for example, our brains are used to treating all pain as if it were acute pain. You know, if you've just broken your ankle, you better know about it and do something about it. But after a while, you know, even as it's healed and moving it doesn't necessarily do any damage, your brain tends to react in the same way. It learns that something really bad happened to your ankle and you better do something about it. And so it's partly learning, teaching your brain how to reinterpret the peripheral input so that it's not, you know, it becomes like, you know, the loudest kid in the classroom. You know, you just pay more attention to him even though you don't want to. I saw a lovely woman yesterday I hadn't met before

• 55:05Speaker 01

  who had a terrible car accident like 30 years ago, has had 10 surgeries on her legs as a result, has back pain, and is just frustrated beyond words and is on a bunch of, you know, oxycodone and other opioid treatments. They're telling her, "Get off them because you're going to get addicted," which happens. And she herself was a clinical hypnotist. And she said, "I help a lot of other people, but I can't seem to help myself." And I, she was moderately hypnotizable. When we started, her pain was six out of 10, which she said, I can sort of tolerate, but if it gets to seven or eight, I can't. And she has a bath, her insurance company gave her a walk-in bath, because she has to get around with a walker now.

• 55:49Speaker 01

  And I said, you're in your bath, you're warm, tingling, numb, feel your body floating. And, and I said, there's one other thing I want you to think about. I'm suspecting that you're pretty angry at your body. And she said, you bet I am. And I said, well, you know, she had actually two new grandchildren. And I said, if your little granddaughter were in pain and were crying, what would you do? Would you get angry at her? She said, hell, no. I'd, you know, hug her and comfort her and soothe her until she felt better. And I said, good, that's what you're gonna do for your body. And so I want you to imagine comforting your body the way you comfort your great-granddaughter. And within a few minutes, like 10 minutes, the pain was down to two. And she said, I can live with that.

• 56:31Rich Roll?

  Wow.

• 56:32Speaker 01

  And, and, you know, she was sort of surprised, but she wasn't. I mean, she does hypnosis for a living, but she couldn't do it for herself.

• 56:39Rich Roll?

  Right, right, right.

• 56:40Speaker 01

  And, but part of it is also the strategy. It's not just, you know, can you change it, but how do you approach the problem? And again, I want it to be what you're for, not what you're against. So she was, she was able to do it and, and felt, you know, much better than she had a few minutes earlier.

• 56:55Rich Roll?

  And it seems like a big piece in that strategy is this idea of self-love and self-respect.

• 57:01Speaker 01

  That's right.

• 57:02Rich Roll?

  Yeah.

• 57:02Speaker 01

  That's right. You know, I, I had a cancer patient who said, you know, I used to treat my body like it was my dog, you know, sit here, go over there, do this, do that, you know? And when I got cancer, I realized it wasn't listening to me anymore. And one, you know, you, you feel frustrated, anxious, but you know, we'd rather mostly be mad than sad. We'd rather, you know, be angry at something that should be better or different than realistically assess what's going on. And part of what we don't fully live as if we understood is that we are in full charge of our bodies. And they'll do things, the body can make you feel bad, but you can make the body feel bad. And if you can learn to treat it with respect, the way you would any other creature that

• 57:47Speaker 01

  depended upon you, you'll live better within your body and your body will help you live better too.

• 57:53Rich Roll?

  And does that strategy hold true for other use cases? Like you mentioned the asthma story or, you know, sleep disorders. What about, you know, obsessive thoughts, OCD, trauma?

• 58:07Speaker 01

  With trauma for sure. That's in part because people are in dissociative states when they're traumatized. And when you get things like post-traumatic stress disorder, and this is not a sort of one-shot cure situation, but one that I use in treatment, is you get people to think about their traumatic experience from a different point of view. We know that most of the treatments for PTSD involve what's called exposure-based therapy or cognitive restructuring about the trauma or some combination of the two, but you have to re-approach the trauma. And given that flashbacks are a symptom of PTSD, I've often wondered, why doesn't it cure itself? You know, okay, you're getting the exposure, why aren't you feeling better? Because you're not in control. You're feeling re-attacked by the memory or the flashback, the way you were when the

• 58:52Speaker 01

  trauma happened. And so what you need to do is approach it in a way that helps you take control of what you can control and give up the fantasy of control where you can't. Most people would rather feel guilty than helpless. They'd rather blame themselves with the fantasy that somehow I could have prevented it from happening, it might not have happened again. And if you can get them to face it, but see it from a different point of view, while they control their physical reaction, they don't feel reassaulted by the memory because they're bringing it on. So I had a woman come to see me to use hypnosis because she'd been, it was an attempted rape. She was getting dark. She was coming home from the store. This guy jumped her and wanted to drag her up into her apartment. And she couldn't really see his face.

• 59:37Speaker 01

  And she was hoping the hypnosis would help revivify her image of the face. And occasionally that can happen. But she said, I still can't see much. But she said, you know what I do see? And I said, your body is safe and comfortable. You know, you may be remembering this, but your body is protected. You're not going to be harmed now. And she said, you know what? He didn't just want to rape me. He wanted to kill me if he got me up to my apartment. And he, she fought with him so hard. He gave her a basil, her skull fracture. She actually had a seizure and was taken to the hospital afterwards. And I said, all right, now your body is safe. I want you to picture on the other side of the screen, what you did to protect yourself. Everybody who's in a situation like that comes up with some strategy. Maybe freeze, don't say anything, don't antagonize them.

• 1:00:21Speaker 01

  It may be fighting, but they do something. But they often don't appreciate what they did. And she said, you know what? He's surprised that I'm fighting so hard. He didn't think I would. So she came away from that experience with a completely different view of what had happened. That not that she got herself hurt and shouldn't have, but that she probably saved her own life.

• 1:00:40Rich Roll?

  Right.

• 1:00:41Speaker 01

  And that's the kind of thing you can do with hypnosis. You can hold those two thoughts in your mind, look at what happened and see it from a new point of view.

• 1:00:48Rich Roll?

  But the key piece being here is volition, right? If you're going to revisit trauma PTSD, you know, without your volition, you're being visited by these traumatic events that are kind of enhancing the traumatic experience versus getting into a state where you can welcome some aspect of that experience in a, in a safe environment so that you can work through it.

• 1:01:13Speaker 01

  Yes. That's well put, and that's, but you know, people worry hypnosis means losing control. It doesn't. It means enhancing control of your brain and of your experience. So, part of what gives truth to what they're experiencing is they're feeling in control when they're doing it. And they're saying, you know, I know what I could control, I have to face what I couldn't control. And part of what is so damaging about trauma, why people have post-traumatic stress disorder, why one out of four combat veterans comes back with PTSD, is that you feel, trauma is the experience of being made into an object, a thing. The victim of nature's indifference, somebody else's rage. And so that means

• 1:01:55Speaker 01

  you're stuck in one view of who you are. And the minute you think about it, you feel like you are once again an object with no control. And with hypnosis and in psychotherapy, you're parsing that experience to say, yes, there were aspects you did not control, but there were aspects you did, and here's what you did.

• 1:02:12Rich Roll?

  Right. I know you talked about this with Andrew, but I think it brings up an interesting discussion in a broader context around how we think about our own exposure to things that perhaps could traumatize us. You know, we're in a culture of trigger warnings and safe spaces and things like that. I just saw, it wasn't a Spiegel eye roll, but it was a bit of an eye roll. You know, and as a psychiatrist, understanding that we have to kind of anure ourselves to exposure on some level as a means of strengthening our resilience, our emotional resilience to things that might disturb us.

• 1:02:49Speaker 01

  I completely agree with you, and I just think this whole trigger warning thing is misguided. That is, you have to, you know, life is full of tragedy and misery, you know, as we know all too well, if you just, you know, gaze at a newspaper, listen to the news every once in a while, people are suffering, you know, lethal assaults on their countries, all kinds of horrible things are happening. A million Americans died of COVID in the last couple of years. I mean, there are terrible things happening, and you can't just have, live in this happy fantasy that things aren't happening. It's a matter of how you face it. And if you think about the fact that what we've just discussed, that the main treatment for PTSD, so these are people who have been traumatized, who are

• 1:03:31Speaker 01

  very symptomatic, is not to have them avoid it and run away from it and get a trigger warning, don't think about this. It's to have them face it in a controlled, supportive, thoughtful way. And frankly, that's the only way we humans are gonna survive. We have to face our own vulnerabilities. And you know, the term "trigger warning" is an unfortunate one because, you know, triggers are causing a lot of the trauma that we're facing now. By the time an American child has grown up, they've seen 20,000 people killed, mostly with guns, on television. And yet, they're desensitized to it because almost all of those situations are ones in which you don't care about the person who's killed. You know, "the cops got the bad guy" kind of thing.

• 1:04:11Speaker 01

  So we desensitize people to real tragic, horrifying trauma. And you know, there's a big debate now about should we show these poor children who have been killed, show what's left of their bodies after one of these exploding bullets hits them? And I think we're sanitizing it too much. You know, it's painful to see it, but we damn well oughta know what's happening to people. And the fact that there are 400 million firearms in this country and 330 million people, and that it's a leading cause of death among young people now is gun deaths. We've gotta face that. We gotta do something about it.

• 1:04:48Rich Roll?

  Yeah, perhaps it's a different form of PSYOP or mass hypnosis, the extent to which we've been, you know, kind of inoculated against the horrors of that type of activity.

• 1:05:00Speaker 01

  You're exactly right. We're sanitizing it, and we shouldn't. You know, at least face it, see what you're doing.

• 1:05:06Rich Roll?

  Let's talk about amnesia. I think there's an interesting discussion to be had around memory and hypnosis. People that, you know, perhaps they've gone through some sort of traumatic experience, they can't remember it, and hypnosis being a vehicle for recapturing lost memory.

• 1:05:23Speaker 01

  Yes. It's, um, that's the dissociative part of hypnosis, where you can sort of disconnect your memory of a certain experience, particularly and often because it arouses very strong emotion that you have trouble, understandably. Dealing with, and so one form of emotion regulation is to just keep the content out of consciousness so that you don't get so upset when you when you remember it. And, you know, to some extent, we all have dissociation or loss of memory of things. You know, you you may have had the experience of going back, you go back to Stanford and you look around the buildings you were in and you may start remembering things that you hadn't thought of. Sure. You know, why do we do that? Why do we go back for reunions, you know, to to see people, but also to stir up memories we had?

• 1:06:07Speaker 01

  So that isn't formal dissociative amnesia, but it is the case that the sort of lack of cues that would link you to a given memory may make the memory harder to recover. On the other hand, there are situations where people literally lose recollection for hours or days. People who were in the World Trade Center attack, many of them couldn't recall events that happened, and it was probably a good thing because at the time, they also narrowed the focus of attention. I treated one woman who was getting out of the the second tower that fell, and she's telling herself, I just want to put one foot in front of the other, and if I get to the ground floor, I'll be OK. And when she did, the other building collapsed, and she was blown through a window, but managed to survive.

• 1:06:52Speaker 01

  Wow. And she was angry at herself. She said, I lied to myself. I wasn't really safe. Well, of course, she wasn't really safe, but the best thing she could do, her survival technique, was to just focus on what she could do, and that's one step in front of the other, going down the stairs. And so we do that. So the experience was encoded in this in this way. There's been research, for example, about people who are the victims of shootings or armed robberies. And the cops asked them, what did the guy, they give a brilliant description of the gun. You know, it was a black revolver, and it was, you know, eight inches long, whatever it was. And they said, what the guy looked like? They say, I don't know. Because they're in a hypnotic-like state. They're so focused on what's likely to kill them that that's all they're paying attention

• 1:07:37Speaker 01

  to. So some of the amnesia is you really didn't acquire much information at that point.

• 1:07:42Rich Roll?

  Right, it just didn't imprint at the get-go.

• 1:07:44Speaker 01

  But in other cases, there was, you may remember down, not far from here, Chaochilla, California, there was a school bus kidnapping. These guys overtook a school bus, buried the whole bus with the kids in it in some trench somewhere.

• 1:07:58Rich Roll?

  Oh yeah, I remember that.

• 1:07:59Speaker 01

  Took two days. And they, so they found, they managed to dig their way out, and fortunately, the kids were okay physically. The bus driver couldn't remember much about the guys, the car that overtook the bus. He was hypnotized, and they asked him to look at the front of the car that was overtaking the bus and say what he could remember about the license plate. And only under hypnosis, he recalled all of the correct numbers and letters of the license plate in the wrong order.

• 1:08:28Rich Roll?

  Wow.

• 1:08:29Speaker 01

  But that was enough. And that led the police to find and arrest the guys, and they're rotting in jail somewhere for having done it. So there are times when, you know, the intensity of the experience will tend to compartmentalize your memories, make it harder to access them, but not impossible. And hypnosis, particularly done in a way that reassures people about their current comfort and safety, can sometimes help with that.

• 1:08:52Rich Roll?

  Yeah, there's some debate, it seems, as to the efficacy of using hypnosis in a court context, right? You can see, you can foresee many situations in which this would be powerful for either the prosecution or the defense to induce a witness into a hypnotic state to remember these things, or to have them testify as to what occurred during a hypnotic state and introduce that in court. Is that a state-by-state thing, or what is the court system?

• 1:09:19Speaker 01

  Yeah, in most states now, California has a decision called People versus Shirley, where it was a situation, it was the worst possible use of hypnosis. This was some guy brought a woman home, they were starting to flirt with one another, he goes out and gets some, and they had, they had sex with one another. He goes out to get some more beer. When he comes back, she decides that she's been raped. I mean, it was not a good, you know, story for a rape conviction. The night before she was to go on the stand, the assistant district attorney hypnotized her, and her story got better. That's a textbook case of how not to use it, using it to just suggest to people things, not to help them recover things.

• 1:10:00Rich Roll?

  And so that's a precedent to prevent this from being...

• 1:10:03Speaker 01

  That's a precedent, people versus Shirley. So California now, the law is that if a witness or victim's been hypnotized, they may not testify. Now, I frankly think that's too draconian, because, you know, if somebody threatens to kill your family if you testify, that will influence what you say, but those people can testify. If somebody's a known liar, has lied 15 times, like certain prominent politicians we know, they can testify. But someone's been, you know, somebody's dangled a watch in front of them, they can't. I've testified in a couple of appeals cases in Texas, in which witnesses of accessories to murder or of, you know, somebody outside a house just before somebody was murdered, you know, she was across the street looking in, were hypnotized.

• 1:10:46Speaker 01

  And what I've found in cases like that is, they don't change their story very much, and they don't change their conviction all that much, and the facts tend to support them. And I said, "Look, you know, it could have contaminated the witness, but I don't think it did." And in most of those cases, we've sustained the conviction. So, it's a difficult area, but, and where it's problematic, Rich, is that sometimes police get lazy. They say, "Well, we don't need to do the dirty work of, you know, getting, you know, concrete evidence, we'll just get somebody hypnotized and that'll take care of it." And that's not good.

• 1:11:20Rich Roll?

  Right, and I suppose the fear would also be that if you had a witness who is highly hypnotizable, and you had a clinical hypnotist with an agenda trying to drive a certain result, that that person could push that witness in a certain direction to derive a result?

• 1:11:37Speaker 01

  That's absolutely right. And the California legislature passed a law that said there were circumstances under which... A hypnotized victim or witness may testify, and that's if it's done by an independent licensed professional, so it's not a member of the police or the district attorney's office. If you video record everything that's happened, including knowing what the hypnotist knew before they conducted the interrogation, that those people may testify if it's done properly.

• 1:12:06Rich Roll?

  Interesting. I want to talk about perhaps my favorite use case, which is high-performance states. I know that you worked at some point with the Stanford women's swimming team, so I want to hear a little bit about that and have a discussion around kind of enhancing our ability to perform under duress.

• 1:12:24Speaker 01

  Yes, sure. And I know you're good at that stuff, so you can tell me what your perspective on it is. Richard Quick, who is the coach of the Stanford women's swimming team, which is a very good team.

• 1:12:36Rich Roll?

  Yeah, and he's one of the all-time greats, Richard. He's passed away.

• 1:12:40Speaker 01

  Yeah. He called me up and he said, "Look, I got a problem. My swimmers are swimming better in practice than they are in meets. Their times are better." And that tells me that there's some kind of competitive anxiety that's interfering with their performance. So what I did was I got together with them and I had them go into a state of hypnosis and imagine swimming your best race, you know, just doing, and you're a swimmer, so you know what that's like. But the interesting thing about swimming, unlike other sports, is it's not a contact sport. In a sense, it doesn't really matter what the person in the next lane is doing. What matters is what you're doing. And they got distracted by it. They were not, so they got out of touch with their body, they got out of touch with how

• 1:13:25Speaker 01

  they could, in fact, enact their best strategy to perform at their best. And from what I heard, they were doing better, that it helped them refocus On their relationship with their body and their swimming plan, not on whatever the girl in the next lane was doing.

• 1:13:41Rich Roll?

  So, did you do that, like you performed hypnosis in a group setting for them?

• 1:13:47Speaker 01

  Yeah, I did.

• 1:13:48Rich Roll?

  How many times did you do that?

• 1:13:49Speaker 01

  I don't remember. I think two or three, not a whole lot, but I taught them to do it for themselves.

• 1:13:54Rich Roll?

  Right, so, yeah, and we're gonna get into self-hypnosis in a bit, but just to kind of stay on this for a little bit. I'm interested in the difference between doing this through the modality of hypnosis versus what we would consider to be visualization. Like, I kind of learned a version of this in high school as a swimmer. Like, you lay down, you know, and for 10 or 15 minutes, you just visualize every piece of the race going, you know, in the minutest detail, slowing down time so that you can anticipate everything. So, how is that different qualitatively from inducing a hypnotic state to do the same thing, essentially?

• 1:14:33Speaker 01

  To be honest with you, I don't think it's all that different. I think if you're hypnotizable, that kind of relaxed visualization is a kind of hypnotic experience. Because what you're doing is, first of all, dissociating your imagery about a very vigorous physical activity from your current physical state. So, you're dissociating the content from the physical experience of it. And you're picturing, and I like the sort of time distortion and other things you did to kind of allow yourself to micromanage what you would be doing. And so, to be honest with you, I don't think there's a whole lot of difference between that kind of relaxed imagery that you were doing and hypnosis if you're hypnotizable.

• 1:15:16Rich Roll?

  And what is the relationship between what you just described and what would be considered like a quote-unquote "flow state"? Like, talk about marketing. You know, I don't know, who came up with the term "flow state"?

• 1:15:30Speaker 01

  Chick sent me high.

• 1:15:32Rich Roll?

  Yeah, that's genius, because people love that.

• 1:15:35Speaker 01

  Right.

• 1:15:36Rich Roll?

  It's not a new idea, but it's been kind of encapsulated in a notion that's very modern and appealing.

• 1:15:41Speaker 01

  Yeah, he did. And, you know, I read the book. I've heard him talk. I like what he says. There are a couple of things that are a little different. He calls the flow state autotelic, that is, you... You just being in it is enough to make you feel good. So it's not just what you do with it, but just being there. And there's a sense in which that's a component of mindfulness, too, that you just, you know, get to a point where you allow yourself to experience things non-judgmentally. And you just feel good because you're doing it, not because you're doing anything in particular with it. And he, he, he talks about absorption so that you're totally engaged in what you're doing. You're not worried about consequences or outcomes. You're just in the experience, which shares something with meditation, too.

• 1:16:25Speaker 01

  And, but it is true that in hypnosis, particularly if you're moderately to highly hypnotizable, you do have this sense of just going along with things and enjoying the ride. You know, you're just letting it happen, but you're in control of what's happening. I mean, that's where people worry about loss of control, but you're really enjoying it and controlling it. We tend to use hypnosis more to sort of problem solve. And flow isn't meant to be about, you know, getting engaged in work or pleasurable activities.

• 1:16:53Rich Roll?

  It's experiential.

• 1:16:54Speaker 01

  Experiential. So they're, they're related, but they're not exactly the same thing.

• 1:17:07Rich Roll?

  In my experience as an endurance athlete, when I was, you know, really training hard for some of these crazy long races, there would be days where I would literally be out all day. Like I'd be on my bike for eight or nine hours. And the fitter that I got, my relationship with time would change. Like I would build up to a place where that type of activity didn't seem to be that daunting and didn't seem like it took all day. Like there was this relationship with time that was very different. And I don't know whether it's because of the manner in which breath works in an elevated kind of aerobic heart rate zone of activity.

• 1:17:49Rich Roll?

  But my experience was that of a hypnotic state, like you could call it a flow state. But to me, it did feel more hypnotic because of that time piece there. And I'm interested as to whether you've thought a little bit about or whether you've done any work around like endurance activity or physical activity in general, and the extent to which that alters your brain state and whether or not that could be considered hypnotic.

• 1:18:17Speaker 01

  Oh, I absolutely think it could be considered hypnotic. But I'm interested in your language. You're very accomplished at these extreme athletic performances. But you're still, I hear you sort of describing it as though it were, I finally got my body to the point where it let me do this, where it let me be able to compress time and see it in another way. And I would, I'm a psychiatrist.

• 1:18:41Rich Roll?

  This is the clinical psychiatrists coming out.

• 1:18:43Speaker 01

  Coming out.

• 1:18:43Rich Roll?

  No, I love it. This is great.

• 1:18:44Speaker 01

  It's free. No, no charge.

• 1:18:45Rich Roll?

  Please continue.

• 1:18:47Speaker 01

  That your brain got to the point where it allowed your body to do what it was doing.

• 1:18:53Rich Roll?

  Interesting, yes.

• 1:18:53Speaker 01

  And you were focusing more on, you got to the point, and this is where your body let you do it, but you got to the point where even though your body was performing at very high and unusual levels, you were able to experience the sort of accomplishment and pleasure of your body in this new kind of motion, rather than your body got to the point where you could enjoy it.

• 1:19:15Rich Roll?

  Right. The relationship with the discomfort changed and that, that, that state changed in the brain. Not in the body.

• 1:19:22Speaker 01

  Yes, that's what I would, but what do you think about that? I'd be interested in your.

• 1:19:27Rich Roll?

  I mean, I think that's, that's super interesting. Of course, there's the physical capacity to do the work.

• 1:19:32Speaker 01

  Sure.

• 1:19:32Rich Roll?

  But it's your relationship with that work. Are you dreading it? Are you enjoying it? Are you in a, in a kind of relaxed state while you're doing it? That's all signaling that's occurring, you know, between the two ears, right?

• 1:19:46Speaker 01

  Right, exactly. And, you know, part of it, I mean, I'm not saying your body had nothing to do with it. It had plenty to do with it. And your body was, by that time, well enough trained that you, it could allow you to think about what was happening in a different way and not just feeling in pain and I can't do this and I'm out of breath, you know. So you got to a point where you could begin to develop the way your brain managed this transformed body. And but it was partly your brain was, you know, our brains grow and reconfigure every night when we when we go to sleep, we, you know, cut off certain synapses and add others. And so our brains change too. And so I'm guessing that your your body was in training, but so was your brain.

• 1:20:28Rich Roll?

  Yeah, well, I would I would characterize it as being a heightened state of absorption, being very absorbed in the activity, but perhaps not necessarily disassociated. So I mean, maybe this is semantics and it gets into a a conversation around the differences between hypnosis, flow state, and and also something I want to talk about, which is mindfulness.

• 1:20:50Speaker 01

  Mm hmm. Okay.

• 1:20:51Rich Roll?

  Being present with the state that you're in.

• 1:20:53Speaker 01

  Sure.

• 1:20:54Rich Roll?

  And that's that's different. I've heard you characterize the differences being that mindfulness is a practice, whereas hypnosis is a tool to solve a problem. So talk a little bit about that.

• 1:21:06Speaker 01

  Yes, I think it is. And I think partly you got to a point where it was very difficult, but it wasn't a struggle, you know, you weren't worried that your body was going to let you down or you're going to get hurt. But you also could kind of, you know, be the conductor of the symphony, not, you know, and you knew that the players were able to play their pieces properly. So it was, I it it allowed you to have a certain level of comfort and then impose that level of comfort on your body. So it became coordinated, not a struggle. You know, you knew your, the parts of your body could do what they had to do. And you're like, and I I've talked to concert pianists who said, when I'm, if if I actually start

• 1:21:48Speaker 01

  thinking while I'm playing about what which finger is going to do what, I'm screwed.

• 1:21:52Rich Roll?

  Of course, right.

• 1:21:53Speaker 01

  He says, I'm thinking about the tone and the pacing and a lot of, and the, you know, the emotion going along with it. That's what I'm thinking about. So you've got to have a well-oiled machine that lets you do that. You have to be experienced with it. But you also have to, in your brain, be in that role of managing it at that level.

• 1:22:11Rich Roll?

  Right.

• 1:22:12Speaker 01

  It's not a little struggle. It's not, you know, the first time you're out training. It's kind of coordinating the symphony in your body. Mindfulness, I think, is meant to be There's less focus on control and more on sort of lack of control. You know, just the way you experience emotion is you don't fight it. And I think this is a good idea. You just let the emotions flow like a storm blowing by and see what happens. Because very often, we create more trouble by fighting negative feelings than by just having them. Saying, oh, yeah, now how do I put that in perspective? And so I do think that mindfulness is meant to be more of a way of being. You do the sort of body scan where you check out different parts of your body and how they're feeling.

• 1:22:54Speaker 01

  And cultivating compassion, which is an important part of mindfulness, that you try to think about situations or people who may irritate you or make you angry or something and develop compassion for them. And that's a very important practice, too, that in in hypnosis, that's not, you know, a major feature. Although your openness to accepting new input from the hypnotist is a kind of compassion for them. You're saying, I know this isn't me and I'm going to trust that he or she is doing something that will help me, not hurt me.

• 1:23:24Rich Roll?

  Yeah, it does. It does feel like there is some shared DNA there. And and and there is a sense that mindfulness can be used as a tool to solve a problem. I mean, I had Judd Brewer in here. I know that you know him.

• 1:23:36Speaker 01

  I do.

• 1:23:37Rich Roll?

  And he's got a whole thing about mindfulness in the context of habit formation, smoking cessation. He's got his own app for that. And it seems like it could be applied towards the same ends that hypnosis can be, but you're getting there through different routes.

• 1:23:52Speaker 01

  Well, yes, I think that's true. Judd Brewer's study is the one I talked about mindfulness, turning down activity in the posterior cingulate cortex. That's his work. It's very good work. I think, you know, mindfulness is eastern and hypnosis is western. That is, you know, it's not meant to be there to do to to accomplish something, to solve a problem. That's kind of an unmindful thing to do. It's meant to just be an experience that will help you. And, you know, in Buddhist thinking, detached from this sort of transitory connection to a persona that we have from time to time, that's the way the Buddhists think about it. Whereas hypnosis is very much, this is you, this is your life, this is what you got, this is your body. Figure out how to use it as well as you can. And it's more, you know, problem oriented.

• 1:24:36Speaker 01

  You're right. It's do it for a purpose, which is a typical Western way to approach things.

• 1:24:41Rich Roll?

  Right.

• 1:24:42Speaker 01

  The eastern people would say, that's your problem.

• 1:24:44Rich Roll?

  Yeah.

• 1:24:45Speaker 01

  You've got to let go of that.

• 1:24:46Rich Roll?

  Yeah, it's really a philosophical distinction.

• 1:24:49Speaker 01

  Yes, it is.

• 1:24:50Rich Roll?

  In many ways.

• 1:24:50Speaker 01

  And but it means a respect for different traditions and and, you know, I'm very impressed and glad that mindfulness has has achieved so much attention and popularity in this country.

• 1:25:02Rich Roll?

  We associate hypnosis with, you know, the idea that you need a guide and certainly a guide is important, but we do have the capacity to induce this state ourselves. So let's talk about self hypnosis and maybe we can do that in the context of Reverie, your app and and how we should be thinking about how we can incorporate this into our own lives.

• 1:25:22Speaker 01

  Thanks. Well, that's what I hope to do, you know. I began to realize, Rich, and I think that, you know, there are things, I think unfortunately the pandemic has forced us into this, you know, we have to, we we used to think that doing good psychotherapy is all about person to person, you know, looking at one another across the room and having feelings and correcting distortions. And I do that. I think it's important. But I I think there are elements of various psychotherapies that are much more disseminable than we than we think. And that's what we're, that's the challenge now. And I thought, you know, I've used hypnosis with about 7,000 people in my career. That's a lot of people. But I've learned things that I'm convinced can help a lot more people than that.

• 1:26:02Speaker 01

  And I want sort of my legacy to be to spread the wealth, to help people get what they can, even if they're not sitting in the office with me. And so we designed Reverie to be interactive so that it's not simply listen to a recording and do something, but rather I suggest you do something. I ask, you know, are you, is your left hand feeling lighter than your right or not? They give an answer, we analyze it with AI, and then they get a different suggestion based on what they just told us.

• 1:26:32Rich Roll?

  Oh, that's interesting.

• 1:26:32Speaker 01

  So it is, it it changes. Each person's experience is different, depending on how they responded to us. And so I tried to make it as much like what happens in my office as I could, but also share the strategies, you know, focus on what you're for and on what you're against, recognize your ability to transform perception and make your body comfortable. And so the the apps are each about 12 to 15 minutes long. Interactive, we ask you to rate before and after how your level of stress is or your level of pain is. We're getting a 35% reduction in stress in the first 15 minutes after people do this.

• 1:27:08Rich Roll?

  Wow.

• 1:27:09Speaker 01

  And we're getting a 25% reduction in pain. We get one out of five people stop smoking. So people, and people can tell right away. I mean, what I really am happy about is they'll know, is this helping me or not? If it is good, keep doing it. If it's not, maybe try some more. But if you don't want to, that's fine, too. So, and we have some hypnotic minutes, too. We have some things where people just take a minute or two to reinforce what they've learned before, and a minute isn't too long to do that. And we're finding that like 40% of people with the hypnotic minutes feel better just after a minute of re-engaging in that state, you know? And we, we find, you mentioned earlier that, you know, people, if they just have a memory or a smell, or a sound of something, an old song or something, it changes their mental state and they kind of get back in that mode.

• 1:27:53Speaker 01

  And that's what we're finding with Reverie, too, that people can just dip back into the experience and get a lot of the benefit from it very quickly. So I hope it will help spread the wealth, help people learn from it, try it out, see what it feels like, and, and hopefully feel better.

• 1:28:10Rich Roll?

  Yeah. The, that's fascinating and, and quite a service, so I commend you for that.

• 1:28:16Speaker 01

  Thank you.

• 1:28:17Rich Roll?

  And, you know, and you describing that, I can't help but think about the induction phase. We talked a bit, a bit about like breath work and how that can help induce the state, but I also assume that the choice of words is very important. And there's a lot of science and, and your experience that's gone into, we say this at this point, and now we say this. So talk a little bit about like how you make those choices and how that, you know, what that's doing to our brains and our bodies to kind of create the, the preferred receptivity.

• 1:28:49Speaker 01

  Sure. Well, I try to make the language simple, clear. I want people to feel when they're going into the hypnotic state, feel what they're doing when they're in it, and feel what it means to come out of it. So I want to be clear about that. I want to use language that focuses more on what people are for than what they're against, that tends to stir engagement rather than rejection or a sense of failure. I want people to have an experience that allows them to get the best of whatever their ability is and see how they, how they respond to it. So I, I try to be... Positive, clear, simple and straightforward about the way I tell people what to do.

• 1:29:31Speaker 01

  And I think in the hypnosis, there has been a lot of sort of mystification of what you have to say and how long it has to take. You know, I used to be taught early on, you have to take 20, 25 minutes to get people counting upstairs and downstairs and all kinds of stuff. And I myself wouldn't want to devote that much time to that, you know, and it's not necessary. So the other thing is, I try to make it fairly rapid and efficient, you know. You do it here. If you've got the ability, do it, see what it feels like, and then come out of it. And be clear with yourself when you're doing it and when you've stopped.

• 1:30:05Rich Roll?

  Right. And if you're somebody who has a low receptivity to hypnosis, can you get a refund? Like, if you're just somebody who can't be hypnotized and you're like, this is not working for me.

• 1:30:15Speaker 01

  Listen, this costs so little to begin with it. And by the way, the app can be downloaded from the App Store, R E V E R I. And we're building, it's an iOS app now. We're building an Android app. And you can send to our website, www.reveri.com, a request that you be notified when the Android app is up and running. It isn't yet. So we try to use it in a way that makes it accessible to people, but also, we accept and they accept, if it's helping them good. If it's not, do something else. That's fine. And the one other thing I'd mention is, the book I wrote with my father was called Trance and Treatment: Clinical Uses of Hypnosis. And the idea is that they're related, but they're separate

• 1:31:00Speaker 01

  things. So what you do, people, because when people are in a trance, they concentrate intently, they reduce their critical judgment. You want to be sure that the therapeutic strategy you're using is pretty good. You don't want to suggest to them something in that receptive, attentive state, that maybe is a bad idea to begin with. And so I would say that even for some people who aren't hypnotizable at all, they can benefit from the strategy, from the way we're approaching the problem. And so there are some people who aren't hypnotizable, but if you just sit there and listen to me for a few minutes, you may take on a new point of view about how to deal with an old problem. So rather than fighting food, you eat with respect for your body.

• 1:31:43Speaker 01

  You focus on feeding your body the way you would feed your baby, or your dog or cat. You know, put in it what's good for it, and that makes you feel good about it. You can eat like a gourmet. You can eat less, but enjoy eating more. That seems paradoxical, but it really isn't. You know, most of the time when we eat, we're watching television, or playing with our phone or something. I had a friend who started the Reverie app. He said he felt terrible when he looked at a picture of a party, and somebody was wearing the same shirt he was, only he had this huge belly. And he said, "I realized it was me," you know. So he started, he'd used the app, he started eating with respect. He lost forty pounds. He's now walking to work from Palo Alto to Mountain View and back.

• 1:32:28Speaker 01

  He doesn't ride in a car anymore. And he's kept the weight off, and he's going around proselytizing about it now. And he wasn't that hypnotizable, but the approach was something that appealed to him cognitively. And he's using it cognitively, and changing a whole bunch of aspects of his behavior.

• 1:32:45Rich Roll?

  Yeah, reverie, reverence, self-reverence.

• 1:32:49Speaker 01

  I like that.

• 1:32:50Rich Roll?

  You know, I can't help but think about the similarities between that notion of self-care, self-love, and loving-kindness meditation, right? Like, you're practicing a form of meditation that is sort of thinking about, or wishing for, or practicing loving-kindness towards others, but also towards yourself, right? With reverence.

• 1:33:14Speaker 01

  I love that connection with reverence. I hadn't thought of it, but I'll, believe me, I'll.

• 1:33:18Rich Roll?

  Oh, really? So where does the name come from then? I just assumed that it.

• 1:33:22Speaker 01

  Well, it's more reverie like a dream.

• 1:33:23Rich Roll?

  Oh, reverie, I got you. Yes, reverie.

• 1:33:25Speaker 01

  Or with a "me" at the end. That was it.

• 1:33:27Rich Roll?

  Well, here you have the double entendre.

• 1:33:29Speaker 01

  Yeah, I like it. But, you know, I think the difference is that in mindfulness, you learn to be compassionate for yourself through contemplating compassion for others.

• 1:33:44Speaker 01

  And the technique we use in hypnosis is having compassion for yourself and for your own body and thinking of your body the way you would think of some other trusting, innocent creature that depends upon you. And so it is more, you know, if you think about it, eastern cultures are more sociocentric. They, you know, they are their social environment, you know, they're, they don't separate themselves in the same way that we do. Here, we're splendid individuals, you know, and freedom is everything. God forbid you should wear a mask, you know. And, and that's not, I mean, people were wearing masks in Japan, you know, 10 years before there was COVID. So I do think they reflect cultural differences, that, that in, in eastern cultures, having,

• 1:34:29Speaker 01

  A, they don't value individuality, individuality in the same way we do, but B, it is more natural to cultivate compassion for your community, for people around you. Here, it's more natural to cultivate compassion for yourself, for individuals. And so you learn to be more compassionate to yourself and to your body with hypnosis. But I, so it's, the, the notion of compassion is very important, but it's sort of implemented in a different way that is, I think culturally appropriate.

• 1:35:00Rich Roll?

  Yeah, yeah, that, that cultural distinction. I mean, the idea that, you know, we would never treat, we would never treat other people the way that we treat ourselves.

• 1:35:08Speaker 01

  Right.

• 1:35:09Rich Roll?

  Is, you know, there's something kind of inherently American about that, I think.

• 1:35:13Speaker 01

  I'm afraid I have to confess.

• 1:35:16Rich Roll?

  Yes. That's true. I want to talk a little bit about your lab. I mean, in addition to being a clinician, you're also a researcher. You referenced some of the work that you're doing with Huberman Lab around breath. What are, what are some of the other studies that you're involved in right now? And, and also like what are, what are some of the studies that you wish to see performed that would give us a lot more clarity and kind of, you know, help with mass adoption of this modality?

• 1:35:42Speaker 01

  Well, there are a couple of things. We are doing some studies on the effects of the Reverie app because we need to provide an evidence base. Sure you're getting all these data sets now. Works, that's right. I mean, we have one study of 15,900 people showing a reduction of, you know, 35% in stress in the first 15 minutes. That's, you know, and we're doing more of that. We need to do studies with control conditions, which are always hard to come up with, but we'll, we'll find a way. So I want to do more studies on what the actual effect of using Reverie is compared with other things like meditation. We're comparing meditation and breath work with Andrew and finding some very interesting things. That breath work in very short pieces of breath work, like five minutes a day

• 1:36:27Speaker 01

  for a month, are having pretty big effects on people's anxiety and stress and sleep as well. So that's one thing we're doing. I'm collaborating with a wonderful young colleague at Stanford, Nolan Williams, who's doing transcranial magnetic stimulation. And so we're actually, he loved the idea of taking on the challenge. Can we change a fixed neural trait like hypnotizability? And so we're using TMS. He was just on the Today Show the other day showing how he's using it for depression and suicidal thinking, actually very effective. And what's TMS? I'm sorry, transcranial magnetic stimulation. Got it. So, you know, hypnosis was animal magnetism 250 years ago. This is real magnetism, applied

• 1:37:10Speaker 01

  locally to the brain. And if, you know, you know that electric current, when it flows through a wire or a nerve, generates a magnetic field around it that circumvent, circles the wire in the perpendicular direction. Conversely, a magnetic field induces changes in the electrical current in the neuron. And so you can activate or inhibit a brain region very precisely using these transcranial magnetic stimulators. And he's been very effective in treating depression. I've seen patients say, I feel like my old self after two years. Not that I feel better, I feel like my old self. That's super interesting. And, and we're stimulating the dorsolateral prefrontal cortex.

• 1:37:51Speaker 01

  And we've got some preliminary evidence that we can enhance hypnotizability, at least transiently.

• 1:37:56Rich Roll?

  Wow.

• 1:37:56Speaker 01

  So it's the first time we've been able to change a neural trait. And the idea is, we've been studying it with fibromyalgia, we've got support from the National Center for Complementary and Integrative Health. And we're hoping that it could be an augmentation to a hypnotic treatment for fibromyalgia and other kinds of treatment-resistant pain. So we're exploring that, both to understand better the brain mechanism, but also as a potential new treatment for that.

• 1:38:25Rich Roll?

  Wow, that's amazing. And I like the kind of connective tissue dating all the way back to Mezmer, right? Like, Mezmer almost had it right. He just, you know, he was a little bit off on part of it with the fluid thing, but like, here we are.

• 1:38:38Speaker 01

  That's right. A little ahead of his time, but not in a way that always helped.

• 1:38:42Rich Roll?

  In addition to Reverie, if somebody is inspired or intrigued by everything that you've shared today, and thank you for that, how does one go about finding a, you know, an appropriate clinical hypnotist, so they're not, you know, falling under the prey of some stage hypnotist if they want to explore this?

• 1:39:02Speaker 01

  Right. Well, stay out of theaters, but the, I would say the important thing is to find somebody who is trained and licensed in a clinical discipline. So clinical psychologist, physician, dentist, social worker with marriage and family counseling credentials. Find someone whose primary thing is that they're a trained clinician and who also was trained in hypnosis. There are, there's two good professional societies, three good professional societies. The Society for Clinical and Experimental Hypnosis, you can look up S C E H dot U S. The American Society for Clinical Hypnosis, A S C H dot N E T, I think. And there's a Division 31 of the Amering Psychological Association.

• 1:39:47Speaker 01

  They're all licensed and trained psychologists who use hypnosis. So your primary search should be for a good licensed and trained professional, and then someone who knows something about hypnosis. And there are now websites that can help you identify those people. Psychology Today has one and others who can help you find someone who has... And you'll see what kind of professional training they have.

• 1:40:11Rich Roll?

  Yeah, that's great. We'll put those links up in the show notes, of course. And before I let you go, I was remiss in not asking you about the work that you've done with breast cancer patients. I mean, cancer is really, you know, that was, that was, you know, really has been, I don't know if it still is, but initially was a big part of your focus, right?

• 1:40:28Speaker 01

  Yes, that's right.

• 1:40:29Rich Roll?

  So, you know, I wanted to give you the opportunity to talk a little bit about that because I think that's, that's really powerful.

• 1:40:35Speaker 01

  Well, thank you. When I, when I came to Stanford, I was recruited in part by Irv Yalom, who is, you know, the leading figure in group psychotherapy and who was working on a book on existential psychotherapy. And he said to me, you know, the existential philosophers have read, written that you don't really live authentically until you face the possibility of non-being. And if that's true, then perhaps a period of facing your death could be a period of growth. So, you know, that maybe we've been approaching this from the wrong way. Just make them less anxious and depressed, but help them grow. And he said, would you like to co-lead a group with me? So this is like my first year as an assistant professor and the world's authority in group therapy says, would you co-lead a group? You think for a second and you say, yes. So I did.

• 1:41:20Speaker 01

  And I loved this group, you know, these women were dealing with very difficult things, but they weren't getting demoralized, you know, they were getting re-moralized. They would grieve when somebody from the group died. And we were warned by some oncologists that, you know, you demoralize them because, you know, the two-year survival was 50%. They're going to see other people die, as though cancer patients, you know, don't understand that they could die from their cancer. It's the first thing everybody thinks. Half of all people diagnosed with cancer live to die of something else. More women with breast cancer die of heart disease than breast cancer. So, you know, it's, it's not a great thing, but, you know, people can deal with it. And I was so impressed. At how women faced their own mortality, but differently by seeing it in someone else.

• 1:42:05Speaker 01

  You know, you can see things in somebody else that you're going through, but you can't see for yourself. We had one woman who came in and said, you know, I think it's time for me to sort of hasten my exit. You know, she was talking about assisted suicide because my husband's a banker, but he's not a teller. He doesn't talk, and I think he's had it with me. It's just too much. Now, his husband wasn't in the room, and one of the rules Irv says is, you know, here and now, in the room. So I said, I wonder if she's asking us a question. Are we tired of her? Are we wishing she weren't here? And she just got, you know, covered with praise. She was always beautifully dressed, even though she was clearly very sick. She was getting closer to death.

• 1:42:44Speaker 01

  Matched accessories make up everything, and they admired how well she looked after herself and her body, even though she was that sick. So they made it clear to her. They wanted her to live as long as possible, and she did not shorten her life. She died about four months later. And in her will, it was written that they sent a bus to take us all from the building where the group met to her memorial service. Wow. And another woman in the group said, you know, being in this group is like looking into the Grand Canyon when you're afraid of heights. You know, if you fell down, it'd be a disaster, but you feel better about yourself because you're able to look. I can't say I feel serene, but I can look at it.

• 1:43:23Speaker 01

  And it was very touching to hear her say that and to recognize that that's what was going on. That they were feeling like experts in living and experts in dealing with the disease. They felt better about themselves because they could help other people. You know, we do that in medicine all the time. When I was training at Boston City Hospital and learning to do lumbar punctures and things, what we used to joke with one another is it's see one, screw one, do one, teach one. You know, that that's the progression. You feel better about yourself because you've learned something that you can use to help someone else. And that's what they were learning, and that's what they were doing. So. We found at the end of a year in this randomized trial that the women in our weekly support groups that ended with self-hypnosis, by the way, we taught them to grieve losses,

• 1:44:07Speaker 01

  to picture the loss of someone who died and at the same time picture on the other side of the screen one thing she left with you that's still within you. And they were half as anxious and depressed by the end of the year as the control group. They had half the pain the control group from doing the self-hypnosis exercises on very low amounts of medication. And the big surprise was that I got the idea because people were talking about wishing away your cancer, and we weren't wishing it away at all. We were saying, "You've got it. Deal with it." That they lived 18 months longer on average than the control. And we have replicated, we tried to replicate that study at a time when the hormonal treatments got to be a lot better than they were originally. We found that women with non-hormonally responsive cancer

• 1:44:52Speaker 01

  lived longer in the treatment group, but overall, we did not replicate that. But we've seen, we've done a meta-analysis recently of all the studies on psychotherapy and survival and find a significant survival advantage for cancer patients randomized to various kinds of supportive psychotherapy. And there's one published in the New England Journal recently with dying patients, patients entering palliative care with lung cancer who lived four months longer if they got this palliative care support facing their death than if they didn't. So, you know, and we know married cancer patients overall live four months longer than unmarried cancer patients.

• 1:45:31Rich Roll?

  Yeah. What's interesting about that for me, and it goes back to what we were talking about earlier about trauma and volition, like the kind of welcoming into the experience, a level of acceptance. And this idea that, you know, we think that if we deny it or we pretend it doesn't exist or we ignore it, that that will reduce our anxiety, but in truth, it's quite the opposite, right? Like, in kind of embracing the harsh reality of the circumstances ends up reducing the anxiety because you learn to be in a place of cohabitation with it, I guess, right?

• 1:46:10Speaker 01

  You can face it. The devil you know is better than the devil you don't know. You know, at least you can see aspects of it and put it into perspective. There have been some interesting recent studies of people dying of cancer taking psilocybin in a couple with psychotherapy. And it kind of surprises me, to tell you the truth. You know, I wouldn't want to have a bad trip when I was, you know, facing imminent mortality. And the majority of them, and they get careful psychotherapy as well during this report. I could just see it from a different point of view. And it helped me feel that my capacity to live, to experience things, was so precious. And I still have it. And I'm going to lose it, but I still have it. And they found it reassuring.

• 1:46:51Speaker 01

  So I think you're absolutely right, that having the strength and ability to face it, strengthens you, it doesn't weaken you.

• 1:46:58Rich Roll?

  Is there a sense of enhanced receptivity to hypnosis when somebody has undergone some kind of psychedelic experience? And we, I don't want to do a whole podcast on psychedelics. We're rounding this out now, and that's a whole other discussion. But I know there's a lot of emerging science here and some interesting things that are happening.

• 1:47:18Speaker 01

  There is, and there's more interest. And we're building a program at Stanford to do it. And there are a number of other excellent places that have programs and that are taking it seriously. I think there is one message, though, that is pretty strong. And that is that changing mental states can, in and of itself, be therapeutic. You see things from a different point of view, you know? You make the mistake of reading your email at 11 o'clock at night, and you get some nasty email, and you think, oh, God, what am I going to do? And the next morning, after a night of sleep, you say, oh, that, like, him again, you know, I'll deal with that. Just being able to see the same problem from a different mental perspective, in and of itself, helps enhance your coping ability.

• 1:47:57Rich Roll?

  Which is what hypnosis is, and which is what a psychedelic experience induces.

• 1:48:02Speaker 01

  Bingo. And sleep, too, you know? Absolutely, same thing. So, I mean, we can't live without sleep. So we, our brains are constructed to experience different states of consciousness, and there's a reason for it. It helps us. It helps us deal with stress. It doesn't, it's not a problem, it's a potential solution.

• 1:48:19Rich Roll?

  Yeah. Well, it'll be interesting to see, to kind of pay attention to the research that's up. It's interesting that Stanford's doing that now. I mean, I know Johns Hopkins is associated with that.

• 1:48:28Speaker 01

  That's right.

• 1:48:29Rich Roll?

  You know, this is now becoming more mainstream.

• 1:48:32Speaker 01

  It is.

• 1:48:32Rich Roll?

  Yeah.

• 1:48:33Speaker 01

  Well, I hope hypnosis will, too.

• 1:48:35Rich Roll?

  Yeah, so on that note, as we kind of end this thing, you know, leave us with some parting thoughts about hypnosis, self-hypnosis, for the person who's listening or watching, who's interested in this. What would be a good way for them to begin or wrap their heads around how this might benefit their lives?

• 1:48:51Speaker 01

  Well, you know, Consider the kind of problem you have and whether it's something you're hitching to do something about. Think about situations in your life already where a change in state of consciousness has had some beneficial effect. So you may have some experience already that you could see an old problem from a new point of view. And then find a way to give it a try. You know, it's one of these things where there really aren't any side effects, the way there are with meds. And we're just taking a little bit of time to try out transforming your experience of a problem might make a difference. And Reverie is one. There are other, there are many good professionals who can help you with it.

• 1:49:32Speaker 01

  There are things to read as well about hypnosis. There's our book, Trans and Treatment, but there are others too. And I think you sort of put yourself in an experimental, it's a low-cost, rapid, experimental experience that could make a big difference.

• 1:49:47Rich Roll?

  Well, I appreciate you coming here to talk to me. A lot of respect for the work that you're doing. I think it's super important and it's been a privilege to hear about this world and learn about your world. So, thank you.

• 1:50:01Speaker 01

  Thank you very much. Well, you've set an example for personal transformation that a lot of people have followed, and I really appreciate that.

• 1:50:07Rich Roll?

  Yeah, through my own version of self-hypnosis on some level, I suppose. But anyway, I'd love to talk to you more and learn more about this. So perhaps part two at some point when it works out for you. So, thank you.

• 1:50:19Speaker 01

  Thank you.

• 1:50:20Rich Roll?

  All right. Peace.

• 1:50:25Rich Roll?

  That's it for today. Thank you for listening. I truly hope you enjoyed the conversation. To learn more about today's guests, including links and resources related to everything discussed today, visit the episode page at richroll.com, where you can find the entire podcast archive, as well as podcast merch, my books, Finding Ultra, Voicing Change, and The Plant Power Way, as well as the Plant Power Meal Planner at meals.richroll.com.

• 1:50:55Rich Roll?

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• 1:51:38Rich Roll?

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