#731: Dr. David Spiegel, Stanford U. — Practical Hypnosis, Meditation vs. Hypnosis, Pain Management Without Drugs, The Neurobiology of Trance, and More

Dr. David Spiegel is Willson Professor and Associate Chair of Psychiatry & Behavioral Sciences, Director of the Center on Stress and Health, and Medical Director of the Center for Integrative Medicine at Stanford University School of Medicine, where he has been a member of the academic faculty since 1975. He is the founder of Reveri https://www.reveri.com/, the world's first interactive self-hypnosis app. Timestamps for this episode are available below. Links to everything discussed: https://tim.blog/2024/04/10/dr-david-spiegel-hypnosis/ Sponsors: Momentous https://livemomentous.com/tim high-quality supplements: https://livemomentous.com/tim (code TIM for 20% off) Helix Sleep https://helixsleep.com/tim premium mattresses: https://helixsleep.com/tim (20% off all mattress orders and two free pillows) AG1 https://drinkag1.com/tim all-in-one nutritional supplement: https://drinkag1.com/tim (1-year supply of Vitamin D (and 5 free AG1 travel packs) with your first subscription purchase.) Timestamps: [00:00] Start [07:00] How Herbert Spiegel was exposed to hypnosis. [10:14] Using hypnosis to cure non-epileptic seizures. [11:53] What is a forensic psychiatrist? [14:43] How hypnosis works. [17:54] Hypnosis and the flow state. [21:03] How hypnosis differs from meditation. [22:38] Determining one’s susceptibility to hypnosis. [27:21] I take the eye-roll test. [29:33] Thoughts on EMDR. [36:29] Therapeutic psychedelics and ego dissolution. [41:05] Potential adverse effects of hypnosis? [42:34] Accelerated TMS improves response to hypnosis. [44:25] Hypnosis as a tool for stress and pain relief. [48:56] David treats my back pain with hypnosis. [57:09] Replicating this effect with self-hypnosis. [57:57] Understanding the science of pain relief. [1:03:18] Filtering the hurt from the pain. [1:06:37] For us, not against us. [1:09:12] Hypnosis vs. other addiction interventions. [1:11:41] A mesmerizing tale of hypnotic history. [1:16:10] Most surprising patient outcomes. [1:24:53] Finding connection to treat the agitated. [1:28:40] Who is Reveri designed for? [1:31:15] Hypnosis as a first rather than last resort. [1:35:02] Further resources and final thoughts. * For show notes and past guests on The Tim Ferriss Show https://tim.blog/podcast, please visit tim.blog/podcast https://tim.blog/podcast/?utm_source=podcast&utm_medium=podcast&utm_campaign=podcast-description. For deals from sponsors of The Tim Ferriss Show https://tim.blog/podcast, please visit tim.blog/podcast-sponsors https://tim.blog/podcast-sponsors Sign up for Tim’s email newsletter (5-Bullet Friday) at tim.blog/friday https://go.tim.blog/5-bullet-friday-1/. For transcripts of episodes, go to tim.blog/transcripts https://tim.blog/transcripts. Discover Tim’s books: tim.blog/books https://tim.blog/books. 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• 0:00Tim Ferriss?

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• 0:42Tim Ferriss?

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• 1:27Tim Ferriss?

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• 2:09Tim Ferriss?

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• 2:27Tim Ferriss?

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• 3:09Tim Ferriss?

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• 3:50Tim Ferriss?

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• 4:35Tim Ferriss?

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• 4:50Speaker 01

  At this altitude, I can run flat out for a half mile before my hands start shaking. Can I answer your personal question?

• 4:56Speaker 02

  Now would be an appropriate time.

• 5:00Speaker 01

  I'm a cybernetic organism, living tissue over metal endoskeleton.

• 5:13Tim Ferriss?

  Hello, boys and girls, ladies and germs. This is Tim Ferriss. Welcome to another episode of The Tim Ferriss Show. I'm very excited about this episode. It is incredibly practical, very, very tactical, and we answer some questions I have had for a very, very long time. What is hypnosis? Is it credible? If it is, how do you apply it? What is the latest and greatest science? For what indications is it best applied? How can you use it? How can I use it? And to separate fact from fiction, I went to one of the world's foremost experts. His name is Dr. David Spiegel. Dr. David Spiegel is Willson Professor and Associate Chair of Psychiatry and Behavioral Sciences, Director of the Center on Stress and Health, and Medical Director of the Center for Integrative Medicine at Stanford University School of

• 5:57Tim Ferriss?

  Medicine, where he's been a member of the academic faculty since 1975. Dr. Spiegel has more than 40 years of clinical and research experience, has published 13 books, 404 scientific journal articles, and his work has been supported by the National Institute of Mental Health, the National Cancer Institute, and more. He is also the founder of Reverie, spelled R-E-V-E-R-I, the world's first interactive self-hypnosis app. He has some amazing stories, some incredible case studies, and actually hypnotizes me in the middle of this conversation. And we do a little demo, which was a first for me. The website for Reverie is reveri.com,

• 6:37Tim Ferriss?

  R-E-V-E-R-I dot com. You can find it on Instagram, instagram dot com slash reverie, and we will add more links to everything we discuss in the show notes, as always, at tim.blog/podcast. With all that said, please enjoy a very wide-ranging conversation with the one and only Dr. David Spiegel.

• 7:00Tim Ferriss?

  David, so nice to have you here. Thank you for making the time.

• 7:02Speaker 03

  Thank you so much for having me, Tim.

• 7:04Tim Ferriss?

  And I want to say upfront that you're a man of many talents. In addition to hypnosis and the other things that people will get from your bio, you are an expert in wordplay. You came up with ostentatious, as in Austin City, before we started recording, and I had to write it down. I was like, if there's not a retail shop with that name, there must be. So I'm gonna will that into existence and just put it out there. Somebody, feel free to grab it.

• 7:26Speaker 03

  Okay.

• 7:26Tim Ferriss?

  And we'll start with a question, which is not how you were exposed to hypnosis, but how your father was exposed to hypnosis. Would you mind winding back the clock?

• 7:37Speaker 03

  I'd be glad to. It's a good psychoanalytic thing to do. I'm the child of not one, but two psychiatrists and psychoanalysts. Both of my parents were, and they told me that I was free to be any kind of psychiatrist I wanted to be. So here I am. My father was finishing his analytic training just at the beginning of World War II, and so he enlisted in the army. He was a battalion surgeon. And as he was getting off the couch, his analyst actually said something to him. He said, Herb, would you like to get a course in hypnosis? And my father was thinking, what was wrong with my free associations? You know, is he trying to fix me some other way or something? And his analyst said, no, there's a Viennese

• 8:20Speaker 03

  refugee, Gustav von Aschaffenberg, who was a forensic psychiatrist in Austria. He had a smallpox scar right smack in the middle of his forehead. And he noticed that as he's interviewing these prisoners, suddenly their heads would sort of nod, they'd close their eyes and go into some kind of altered state. So he got interested in hypnosis and was using it to help his prisoners. And so he offered to teach army docs how to use it. So my father took this course from Dr. von Aschaffenberg, and he used it to help soldiers deal with combat stress reactions, to deal with pain. The dinner table conversations were really interesting. He told me a story of one guy who developed a hysterical conversion

• 9:04Speaker 03

  paralysis. He couldn't use his legs. The guy said, they just don't work. I don't know what happened. So my father asked him about the context, and he said, well, we were ordered to retreat. And I saw my best friend lying on the ground and I had to make a choice. Do I try and save him or do I follow orders? So I followed orders. I feel terrible and you know, maybe I could have saved him. And so my father in hypnosis said, I want you to look at your friend right now. And I want you to notice something. His boots are facing down and that means he's already gone. And the guy said, thank you, doctor. And he got up and walked.

• 9:42Tim Ferriss?

  Wow.

• 9:43Speaker 03

  That he was telling himself physiologically, I should not have moved. I should not have left him. And when my father helped relieve him of the guilt and you know, most people who have been traumatized would rather feel guilty than helpless. They'd rather find a way to blame themselves as though they could replay the movie and it would come out differently. And he was helping him face the fact that his buddy was gone and there was likely nothing he could do to, to stop it. So I'd hear those kinds of conversations at the dinner table and they were pretty interesting. I got invited once to watch him treat a woman who had non-epileptic seizures.

• 10:18Tim Ferriss?

  So she's your father?

• 10:20Speaker 03

  My father. So he's making a teaching movie and he invited me to come and watch. And he had her go back in hypnosis to the last time she had a seizure and her head starts to twist and shake and she's starting to have these convulsive movements. And you know, he said to me, it's a lot easier to get people to start these symptoms than to stop them. You know, they've already tried to stop them. It didn't work. So the way you teach them how to control it is you teach them how to bring it on. And then he had her practice making them milder and milder and milder. And he cured her of her hysterical seizure.

• 10:54Tim Ferriss?

  How does she make them milder? If you're triggering these events, how do you ratchet down the intensity of say the convulsions? How does your father? Coach someone through doing that?

• 11:08Speaker 03

  It was kind of an inference. He's basically non-verbally communicating that I'm not just gonna put you through the same misery over and over again, I'm gonna try and show you how to manage it better. And so he taught her that if you can make it happen, you can make it happen differently. You can change the way it happens. And you're not gonna get all the hysterical reactions around it. Her husband had his workbench at his factory put near the door. So when she had another seizure, he could rush out the door and go to her apartment and help her. That's how much panic it elicited. So he taught her that you can have this for whatever reason, but it doesn't have to be as bad. And over time, the more she did it, the more she kind of deconditioned the intensity of the seizures.

• 11:53Tim Ferriss?

  So we're gonna get to definitions pretty quickly, just in terms of what hypnosis is, what it is not. But first, a few follow-up questions. Forensic psychiatrist. I've seen these words separately, but what is a forensic psychiatrist?

• 12:07Speaker 03

  Well, I do that in my copious spare time. It's basically, in those situations, you work for an attorney, not for the patient. So you're, you may assess the patient, try and decide what's wrong with them, but it's for the purposes of preparing a report. For example, some kind of emotional damage that was someone. I was evaluating a woman who, terrible situation, one of the recent forest fires, where she's on the phone with her mother as the mother's home was burning down in one of these fires. And it turned out that the community had not been adequately warned how bad this was gonna be. And even worse, her boyfriend didn't wanna be bothered to go pick up her mother. So it was a very complicated emotional situation.

• 12:49Speaker 03

  So I was evaluating what the emotional consequences were for her of losing her mom.

• 12:55Tim Ferriss?

  You're being brought in as a subject matter expert to determine the meritorious nature or longer of...

• 13:03Tim Ferriss?

  This particular case, okay.

• 13:04Speaker 03

  One of my favorite moments doing that, I kinda have, you know, I like testifying in court because, and I was being grilled by some attorney one day and I'm thinking this, I'm enjoying this, and then I thought, you're crazy, Spiegel, what are you, and he's going after you. And I said, you know what, compared to academic life, this is simple. Your friend is the guy at that table and your enemy is the guy at that table. And in academia, you never know where it's coming from. So, this lawyer is going after, it was a case at the, the United Parcel Service where a gunman, you know, employee gun, gun off, came in with a bunch of guns in his pack, got through a metal detector, the guard was looking at his phone and not paying any attention.

• 13:42Tim Ferriss?

  Oh wow.

• 13:43Speaker 03

  And he started shooting nine minutes later. And I just said, this is a horrible breach of protocol. If he's gonna be checking people, he ought to do something about it. And even if he didn't wanna confront the guy directly, he could've called the police. The police got there in three minutes when they were called, it took the guy nine minutes to get ready to start shooting. It was a terrible thing. The lawyer, the defense lawyer, did not like what I was saying. And he said, well, Dr. Spiegel, you're not a security expert, are you? And I said, no, sir, I'm more of an insecurity expert. And I could hear the judge and the jury laughing and that cost them a lot of money.

• 14:18Tim Ferriss?

  That cost them a lot.

• 14:19Speaker 03

  It cost them plenty. So, I, I enjoy doing that on the side.

• 14:22Tim Ferriss?

  Was it, I think it was Kissinger who said, I left academia because I couldn't stand the politics or something like that?

• 14:28Speaker 03

  Yeah, no, he said, the reason academics fight so bitterly is that the stakes are so low.

• 14:33Tim Ferriss?

  Right, right, there we go, thank you, okay. And the other question I had was, you mentioned this gent, I can't remember the, there was a Vaughn in there, I can't remember the full name.

• 14:42Speaker 03

  Vaughn Ashaffenberg.

• 14:43Tim Ferriss?

  Vaughn Ashaffenberg, who had the smallpox scar in the middle of his forehead, and I think it was he who, when he spoke with his patients, noticed they were nodding off or transitioning into this altered state. Why were they entering that altered state? Was he doing it deliberately? Or was there some manner in which he was conducting these sessions that he ended up just correlating with that and he figured out it was causal? What was actually happening?

• 15:07Speaker 03

  It was more the latter. It was more at first. I mean, later on, he was doing formal inductions. But what hypnosis is, Tim, is just a heightened focus of attention. It's like looking through a telephoto lens with a camera. You get fully absorbed in the center of your awareness and things that ordinarily you'd be conscious of, noises on the outside, other things you dissociate, you put outside of conscious awareness. So it's a kind of self-altering, highly focused attention. And it was happening at first by chance, just because instead of looking at him, looking at his eyes and listening to his words, they just tended to focus on the spot in his forehead. And many hypnotic inductions involve some kind of visual focus to narrow the focus of attention.

• 15:49Speaker 03

  When Andrew Huberman, my friend and colleague, was on your program, he was talking about that. The narrowing of attention, just as the lens of the eye changes and limits the amount of information, you get this kind of heightened focus on the center of attention. So it changes your state of consciousness as well.

• 16:05Tim Ferriss?

  How would you, for people who are listening, and for me, I'm listening.

• 16:09Speaker 03

  Glad to hear that.

• 16:10Tim Ferriss?

  Differentiate hypnosis from, say, meditation, concentration practice meditation, and also from what people might consider, say, a flow state? And maybe they're the same, but when people have this focus to the exclusion of much else in these, say, sports contexts or other types of contexts. If you could just delineate those three, that would be very helpful.

• 16:34Speaker 03

  Sure. So hypnosis has three main components. I've already mentioned two. Highly focused attention or absorption, dissociation, putting outside conscious awareness, things that are in consciousness. Right now, for example, hopefully you're so interested in what I'm saying that you're not aware of the sensations of your feet touching the floor right now. If you were, we could just stop now. But the more intensely focused you are, the more things you've got to put outside of awareness to keep from distracting you. The third component, and in some ways the most interesting in hypnosis, is what used to be called suggestibility. You know, you'll do anything I say if I tell you to do it, which is not exactly true. But the truth in it is that you are more cognitively flexible. We've done some research, Afik Fairman, my postdoc and I did a study looking at the

• 17:19Speaker 03

  continuous performance task in people who are high and low hypnotizable. The task has subtle changes in the way you solve the problems you're solving, but they don't tell you what it is. So people who are more cognitively flexible will figure out quicker that the rules have changed and how you do it. And that highly hypnotizable people are very good at that. They're good at letting go of the old premise and hooking into the new one. So that's a kind of cognitive flexibility that is very valuable. And I think a key aspect of why hypnosis is so helpful in treatment and helps people just manage problems better.

• 17:54Tim Ferriss?

  So a question there, just in terms of the reason that it helps people in a clinical context with various issues. Is it because the, in a sense, the arrows of causality point both ways in the sense that someone with this higher cognitive flexibility are better at letting go of, say, one premise and then taking on another, but at the same time you can use hypnosis to make someone, put someone into a state where they are more cognitively flexible and can kind of overwrite the previous premise?

• 18:25Speaker 03

  Yes, you're right. And it's because, you know, all hypnosis is frankly self-hypnosis. That is, you don't need to watch somebody dangle a watch or have a, develop a small puck scar on their forehead. People can shift into this state of highly focused attention. And when they do, and one of the coolest things about the state is you tend to let go of your ordinary premises, not just about what's going on at that moment, but who you are, what kind of a person you are. And that's what scares people, you know? It's the stage show thing of the football coach dancing like a ballerina. But there's a message there. Not that hypnosis is good to make people look silly. It's that people can try out being different and see what it feels like. They can let go. Of their usual premises. And that's where hypnosis is something like a flow state.

• 19:09Speaker 03

  Chik Seng-Mei-Hai, I knew him.

• 19:11Tim Ferriss?

  No kidding.

• 19:12Speaker 03

  And, and his point, you know, he calls flow an autotelic experience. It's one that is self-rewarding. It feels good just to do it. And hypnosis is like that. When you get really absorbed in experience, like you ever get so caught up in a good movie that you forget you're watching a movie?

• 19:27Tim Ferriss?

  Sure, or drawing especially.

• 19:29Speaker 03

  Drawing?

• 19:29Tim Ferriss?

  Yeah, time just kind of vanishes when I'm in that state.

• 19:33Speaker 03

  Exactly. That's a self-hypnotic state, and I'm sure you're good at that. And one of the ways in which I help athletes, for example, I was asked to consult with the Stanford Women's Swimming Team. They're a terrific team. A lot of the women went up in the Olympics. But the coach noticed that they were doing better in practice than they were in meets. Their time was better. And thinking, what the hell's going on here? Well, swimming is not a contact sport. And so the only person you're really competing with is yourself. And what the women were doing was distracting themselves by paying attention to the women in the lane on either side, instead of being in touch with their own bodies, getting into a flow state by saying, how do I move through the water? How do I connect with my muscles? How do I coordinate them?

• 20:17Speaker 03

  We were being distracted from that. And so I got them in hypnosis to get into more of a flow state, to focus not on the outcome, but the process. And that's a key thing for athletes in, you know, in golf and basketball. You know, Tiger trained with hypnosis. He had a caddy who was helping him with hypnosis. I've helped golfers do that. You know, there are a number of major basketball players who do it as well. And it's a way of not worrying about whether you're going to hit the basket or not, but what you need to do in your body to make the connection, to do what you want to do. And so hypnosis is like a flow state. It's something that you just get in it to enjoy the feeling of doing it and how you relate to your body.

• 21:00Speaker 03

  And by the way, good things can happen when you do it.

• 21:03Tim Ferriss?

  If you were using, let's just say, a concentration practice in meditation, whether that be something like transcendental meditation with a mantra, or thinking of a candle flame, or fill in the blank. Would that qualify as a subset of self-hypnosis? Or are there differences that you'd want to highlight?

• 21:21Speaker 03

  They're different, Tim, because in mindfulness, you're engaged in a somewhat different practice. It's open presence. You're not judging, you're not evaluating, you're just letting feelings and thoughts flow through you. And people learn to do it with great discipline over time. But it doesn't come naturally. You don't lose yourself in it the way you lose yourself in a movie. Now, eventually, some people do. But as you know, from having considerable experience with it, it takes training and it's a struggle. Whereas the funny thing about hypnosis is, boy, if people are hypnotizable, they're in it just like that, even if they've never formally done it before. If you're hypnotizable, you just do it. So it's a kind of natural shift in attention, narrowing the focus,

• 22:06Speaker 03

  that leads you along and gets you engaged in a flow-like experience. Whereas with meditation, you have open presence, you do a body scan, you cultivate compassion, they're all important things. But it's about being rather than doing. Whereas hypnosis is more doing than being. In hypnosis, you do it for a purpose. You do it to control pain, to manage stress, to get to sleep, to stop smoking, to eat more sensibly. So it's more intense, it's briefer, and it does emphasize the development of absorption and flow.

• 22:39Tim Ferriss?

  If someone is highly hypnotizable, how do you determine hypnotizability? And I have the eye roll test in my notes, which I've never done.

• 22:47Speaker 03

  Yeah.

• 22:48Tim Ferriss?

  So I was curious if that is just one of a portfolio of techniques that you use? Or if that is a dominant test? How do you determine if someone, to what degree someone is?

• 22:58Speaker 03

  Hypnotizable. Well, hypnotizable is a very stable trait. Most eight-year-olds are in trance most of the time. As you know, if you call your eight-year-old in for dinner, he doesn't hear you. You know, he's doing his thing. Work and play are all the same thing for kids. I don't know why we try to train them to be little adults, because they have so much fun. But as we go through adolescence, Piaget talked about developing formal operations in adolescence, where you begin to privilege reason over experience.

• 23:24Speaker 03

  Some of us lose some of that hypnotizability. You don't get as easily absorbed in things. You have to think them through logically first. By the time you're about twenty one, your hypnotizability becomes as stable a trait as IQ. And there was a study done at Stanford. They did a twenty five year blind follow up to former Psych One students who'd been had their hypnotizability measured. And the test retest correlation was point seven. Now, that's that's better than IQ. I mean, that's really something. And in general, what happens is they get divided into one of three groups. The people we call the poets, highly hypnotizable. They still get totally absorbed in movies and caught up in things. That's about twenty percent, about sixty percent.

• 24:03Speaker 03

  We call them the diplomats. They'll have the experience and then they'll think about it, negotiate it, and then go back and try it a little more and go back and forth. And there's twenty percent we call the researchers who just aren't very hypnotizable. The researchers. Yeah. But they can benefit from techniques employing hypnosis because you learn to focus on what you're for, not what you're against. You don't fight a problem. You find a way to master it by joining it and focusing on a positive resolution, a self reinforcing resolution of it. So hypnotizability, we know what's going on in the brain. We've taken high and low hypnotizables, put them in the functional MRI scanner. And there's an interesting thing that happens only in the highly hypnotizable people, and that is

• 24:44Speaker 03

  functional connectivity. That is when one region is active, the other region is active between the left dorsolateral prefrontal cortex, which is part of the executive control network, the one I'm hopefully using now, talking to you. And the dorsal anterior cingulate. Now, the cingulate cortex is like the C on its ends in the middle of the brain. And the dorsal front part is part of our salience network, the alarm system. It's the thing that if you hear a loud noise, you know, it distracts you. So the salience network is coordinated in highly hypnotizable people with the executive control network, and that makes sense. If they're working together, it's easier to lose yourself in an activity and not worry about whether you should be doing something else. We've actually found also, there's a genetic component to that.

• 25:28Speaker 03

  There's a particular polymorphism of the gene that metabolizes dopamine, catechol, omethyltransferase.

• 25:34Speaker 03

  If you happen to have the methionine, valine version of it, you have moderate metabolic rate, which keeps pretty high and stable levels of dopamine in the brain. And those people are more hypnotizable than those who are homozygous for either methionine or valine. I had a brilliant young graduate student, Dana Courtois, who actually developed a point of care genetic test for hypnotizability. So you can take a drop of blood and in a couple of minutes, we can tell how hypnotizable you're likely to be. But we also have a test called the hypnotic induction profile that my late father and I developed that gives you like a six minute hypnotic experience. Have your hand float up in the air. If you pull it down, will it float right back up? Do you experience a loss of control in that hand?

• 26:18Speaker 03

  Do you respond to the signal ending that experience? Do you have a sense of floating lightness or buoyancy? So you get a score from zero to 10. And that is likewise a very stable trait. It's something I have used with every one of the 7,000 people I've used hypnosis with in my career. And it helps me have a sort of common experience that is not initially connected to treatment, but just we both can see how much they can respond. And A, it gives me useful information. B, it gives them useful information. And C, we're not blaming the victim here. If somebody is not hypnotizable, it's not because they're resisting, because most people aren't. They're paying good money to see me and get help. And it's not because I'm not good at what I'm doing because I've learned something about it.

• 27:03Speaker 03

  Although my first psychanalytic supervisor said, yes, you didn't go into a trance despite having had 200 shock treatments because you're a lousy hypnotist. And I said, I don't think so. But it's nice because it makes it a neutral experience. It's one in which you try out and see what it's like and they learn from it and I learn from it.

• 27:21Tim Ferriss?

  Where does the eye roll test stand in terms of a reliable indicator?

• 27:25Speaker 03

  Well, the eye roll test is like a good initial guess. It's moderately correlated with formerly measured hypnotizability. And my father discovered this. He was using eye fixation on a light on the ceiling of his office. And he noticed that the woman I mentioned, who, you know, had the hysterical pseudo seizures, he noticed that when he asked her to look up at that light and then close her eyes, all he saw was the whites of her eyes. They stayed up. After he made that movie that day, the following Monday, he had one of the most obsessional men he'd ever seen, and he had the guy look up and he could not keep his eyes up as he was closing the eyelids. They came down and all he saw was his iris as they closed their eyes. So he began measuring that. And it turned out you can score people

• 28:07Speaker 03

  from zero to four on how much they're able to dissociate lowering the eyelid with lowering the eye. And that is an initial interesting indication of hypnotizability. So if you want a quick five second test-

• 28:18Tim Ferriss?

  Let's do it.

• 28:18Speaker 03

  Here it is.

• 28:19Tim Ferriss?

  Love five second test.

• 28:20Speaker 03

  All right. So look up past your eyebrows, all the way up, eye way, way up. And as you keep looking up slowly, close your eyes, look up, close, oh yeah, oh yeah, yeah. You're a three to four. You're on the upper end because you keep your eyes way up and I can barely see your iris as you start to close your eyes.

• 28:35Tim Ferriss?

  Great. Well, another option on the menu then.

• 28:39Speaker 03

  Yeah, you bet.

• 28:40Tim Ferriss?

  And do you have any hypothesis for why those are correlated?

• 28:43Speaker 03

  Eye movements are very much related to level of consciousness. The obvious thing is you close your eyes when you go to sleep. Drugs that affect the eye and eye movements are related to autonomic arousal. Your pupils get big when you're, you know, your sympathetic nervous system is going on small when you're on opioids, for example. And the third, fourth, and sixth cranial nerve nuclei are surrounded in the brain stem by the reticular activating system, which is part of our arousal network. And so, things that affect eye movements tend to affect arousal as well. And so, we think it's an ability to shift gears, inhibit peripheral awareness, and intensify your focus. And that this is just, it's no accident that

• 29:27Speaker 03

  it's the same parts of the brain that regulate arousal and eye movement that are associated with this eye roll.

• 29:32Tim Ferriss?

  And this is a side alley question. We're going to come back to the mainstream in a second, but I'm very curious, do you have an opinion of EMDR?

• 29:42Speaker 03

  I do.

• 29:43Tim Ferriss?

  And if you could just explain for folks what that is?

• 29:46Speaker 03

  I'm from New York. I'm not devoid of opinions.

• 29:48Tim Ferriss?

  Fellow New Yorker here.

• 29:51Speaker 03

  All right.

• 29:52Tim Ferriss?

  Here we go.

• 29:52Speaker 03

  There we go.

• 29:53Tim Ferriss?

  Strap in, folks.

• 29:56Speaker 03

  EMDR is eye movement desensitization and reprocessing. Francine Shapiro developed this and it's a widely used technique. The VA uses it a lot to help people with trauma and hypnotic like techniques are very helpful with trauma and I'll be glad to talk about that. But her idea was that somehow you facilitated communication between the hemispheres if you had people move their eyes back and forth while they were discussing a traumatic experience. Now, the certainly good idea in this is that we now know more and more that re-exposure under controlled conditions to traumatic memories is in itself therapeutic. So exposure therapy and cognitive restructuring are two very prominent ways of helping people

• 30:39Speaker 03

  deal with trauma and EMDR has components of that. But, and you know, if you think about it, is it anything like hypnosis? Well, what was the oldest way of inducing hypnosis? Remember the dangling watches? You know, what are your eyes doing when you know you're moving back and forth? So I think there's a lot that's hypnotic in EMDR. But to tell you the truth, every study that has de-convoluted eye movements from everything else that goes on in EMDR has shown that the eye movements don't have much to do with it. And toward the end of her career, Francine Shapiro stopped. She then did tapping rather than eye movements and other things. But it's not at all clear to me that the actual eye movements have anything much to do with the outcome. So it's another therapeutic technique, but I have to say that my overall impression

• 31:24Speaker 03

  is that what's good about it isn't new and what's new about it isn't good.

• 31:27Tim Ferriss?

  So what are the ingredients in EMDR aside from discussing the traumatic event? Are there other characteristics or elements that contribute to outcomes when they are good? I don't know if this has been studied in any structured way.

• 31:41Speaker 03

  Yes, it has been used, I mean, the VA has used it extensively in helping combat vets with post-traumatic stress disorder. And the fact that you summon up A traumatic event and then you picture it, become aware of the emotions that come along with it can be a component of effective psychotherapy. I think the two things that matter the most and what I do when I use hypnosis in treating PTSD is number one, the control with which you summon it. I've always wondered if exposure therapy works so well, why don't flashbacks cure PTSD? And flashbacks are symptoms of PTSD. You're reliving the event as though we're happening again. And the difference, I think, is that there's no control. You feel re-attacked by the memory the way you did the trauma.

• 32:25Speaker 03

  And so I think with EMDR, like other psychotherapies, like exposure therapies, cognitive reframing therapies, you, in a controlled situation, bring up a traumatic memory. So it's not hitting you again from out of nowhere. You're saying, I'm going to spend some time thinking about this now. So you're doing it in an element of control that was completely absent when the trauma happened. That was just done to you. This is something you're doing to yourself in a controlled way with the prospect of a direct benefit. The second thing is cognitive restructuring is helping you to see an old problem from a new point of view, to understand it differently. So, you know, I was treating a California road worker who was in a construction zone

• 33:10Speaker 03

  when some idiot went the wrong way and hit him with a car. He was taking a rest on his break. It was two days before his wedding. He had bad ankle fracture. He had just pushed himself out of the way as the car was coming and he was miserable, you know, and his fiance was miserable and he just thought, how, why didn't I see this coming? And time and again, if I had a nickel for every traumatized person, either sexual assault or physical assault, that blame themselves for events they didn't control, you know.

• 33:36Tim Ferriss?

  That's a guilt versus helplessness.

• 33:38Speaker 03

  Guilt versus helplessness. That's exactly right. And I had him relive it in hypnosis. I said, let's go through this. And he said, I'm sitting on the thing having my lunch and suddenly I realized that he's not going the way all the other cars were going. He's coming at me. And I just pushed myself away from a barrier next to me and fell forward and that's when he hit my leg. And I said, I want you to look at this. What would have happened if you hadn't done that? He said, "Well, he would have hit me dead on." And I said, "So you saved your life." "So it's tragic, it's a terrible thing that happened, but it could have been so much worse." "So think about this, not just from what went wrong, but from what went right." "What you did to help yourself." And he felt entirely different about the trauma after that. He was still unhappy about his leg being injured.

• 34:23Speaker 03

  But it's a way of restructuring your point of view about the problem. And that's where techniques, including hypnosis for trauma, can help people really change their perspective. The other thing that happens in hypnosis is the more you concentrate, use your prefrontal cortex, the less activity in the default mode network. Now, that's the part of the brain, the posterior cingulate, that's involved with self-reflection and self-understanding. And when you're not doing much, but thinking about yourself and who you are, you've got a lot of activity going on in default mode. And if you can, in hypnosis, turn that down, you can try out being different. Instead of seeing this as just a total failure and disaster that messed up your wedding and all kinds of things,

• 35:06Speaker 03

  you can see it as evidence that you had the wherewithal in a matter of a split second to do something that saved your life. So it changes your view of yourself and who you are. And that's one of the terrific things about hypnosis, is it allows you to try out being different, see what it feels like.

• 35:25Tim Ferriss?

  Just a quick thanks to one of our sponsors, and we'll be right back to the show. This episode is brought to you by AG1, the daily foundational nutritional supplement that supports whole-body health. I do get asked a lot, what I would take if I could only take one supplement? And the true answer is invariably AG1. It simply covers a ton of bases. I usually drink it in the mornings and frequently take their travel packs with me on the road. So what is AG1? AG1 is a science-driven formulation of vitamins, probiotics, and whole-food sourced nutrients. In a single scoop, AG1 gives you support for the brain, gut, and immune system. So take ownership of your health and try AG1 today. You will get a free one-year supply of vitamin D and five free AG1 travel packs with your first subscription purchase.

• 36:10Tim Ferriss?

  So learn more, check it out. Go to drinkag1.com/tim. That's drink A-G-one, the number one. Drinkag1.com/tim. Last time, drinkag1.com/tim. Check it out.

• 36:29Tim Ferriss?

  Feel free to fact check this, but I've had a lot of involvement with, say, MDMA-assisted psychotherapy for PTSD and all the way through phase three trials and so on. And I've also, through my foundation, funded a lot of basic science and some clinical work related to different psychedelic assisted therapies for, say, treatment-resistant depression or major depressive disorder in the case of psilocybin. And the default mode network and this type of, not quite deactivation, but sort of down regulation, I'm not sure what the proper technical term would be, is something that Robin Carhart-Harris talks a lot about, predominantly out of Imperial College London and then later at UCSF.

• 37:07Speaker 03

  Right.

• 37:08Tim Ferriss?

  And it's striking because the subjective reports in a lot of these experiences, whether it be in the MDMA-assisted psychotherapy, although I don't really consider MDMA a psychedelic for various reasons, but let's just use psilocybin or even LSD, the ability to take a impartial observer status on yourself and to assume new perspectives, the description that, you know, I'm paraphrasing here, but that you just shared, is very similar to the subjective reports of people who get, who have good therapeutic outcomes with these other modalities. So it's exciting to me to hear you describe it in that way because psychedelics are contraindicated for so many people. There are quite a few people who should not take psychedelics in any form. I do want to talk about some of the applications, but in terms of risk profile, usually the

• 37:53Tim Ferriss?

  kind of magnitude of potential impact is correlated to some type of risk profile. Are there adverse events?

• 38:00Speaker 03

  There are, but before I get to that, let me just backtrack a little bit on MDMA and psilocybin for PTSD, because a lot of the things that the psychedelics have in common, although some are more hallucinogenic than others like psilocybin, is what's been called ego dissolution, and that you seem to just suppress activity in the default mode network. And so it becomes a kind of non-judgmental awareness, where you see it happens. But you're sort of disconnected from it. So breast cancer patients dying of breast cancer have done very well with psilocybin trips. Now, I've for years worked with women who are dying of breast cancer. I know what it's like. And what struck me as similar and interesting is one of my group therapy patients said that

• 38:45Speaker 03

  looking at death in the group is like looking into the Grand Canyon when you're afraid of heights. You know, if you fell down, it would be a disaster, but you feel better about yourself because you're able to look at it. I can't say I feel serene, but I can look at it. So it's this odd kind of detachment where you can see it. And what they think about their death now is, I still don't like the idea of dying, but what I can see now is what a miracle it is that I ever got to live at all. And so they see the same thing from two different perspectives. So this ability to sort of disconnect your selfhood. And in hypnosis, it's a rapid suspension of your usual selfhood. In psychedelic work, it's more this ego dissolution, it kind of dissolves.

• 39:24Speaker 03

  So it's a quicker reversible form of something similar, which is playing with who you are and what you are. And that has tremendous therapeutic possibilities. Now, I think one reason MDMA works so well with PTSD is because it's the sort of human connection drug, you know, in these raves and everything. People suddenly feel connected with people they never even know or feel very different about their loved ones and how they connect with them. People who have been traumatized, who have PTSD, feel deep shame. And it's not because they've done anything wrong, but just to be treated like an object, like a thing, is humiliating.

• 40:03Speaker 03

  And so to be able to relive it in a state where you're feeling different about who you are is a way of reprocessing and disconnecting from the sense of shame. Just saying, yes, it happened, I don't like it, but it's not the bottom line about me. And that's where... Depression with post-traumatic stress disorder are so harmful to people because it tarnishes their feeling about who they are as people. And if you can understand the experience, but disconnected in some ways from this default mode conclusion about what sort of a person you are, that can be powerfully therapeutic.

• 40:41Tim Ferriss?

  Absolutely. The commonalities are really worth highlighting here because certain treatments are not accessible to some folks, which is also part of the reason why I'm so interested in the work that is being pioneered in part by our mutual friend Nolan Williams.

• 40:58Speaker 03

  Yes.

• 40:59Tim Ferriss?

  That's the effort.

• 41:00Speaker 03

  Nolan's terrific.

• 41:01Tim Ferriss?

  And we'll probably come back to Nolan and Accelerate TMS in a second.

• 41:05Speaker 03

  Sure.

• 41:06Tim Ferriss?

  But what are the risks, if any?

• 41:07Speaker 03

  There are very few. I'll tell you, when we started Reverie about three years ago, I was kind of worried because, you know, 30 years ago, I would not have dared to put an interactive digital hypnosis app out there on the web and just see what happened to people. I worried that people would have all kinds of app reactions and dissociative reactions and terrible things could happen. But I thought, what the hell? I want people to have access to this and be able to try it. And we've had like three quarters of a million downloads and the number of potential problems we've had is less than 10, and none of them are serious. You know, some of them are ecstatic positive experiences, kind of like, you know, psychedelic ones. Most of them are, you know, periods of anxiety or stress that are easily reversible.

• 41:51Speaker 03

  And so the good thing about hypnosis is you can turn it on real fast, you can turn it off real fast. So the worst thing that happens most of the time is sometimes it doesn't work, so what? So you do something else.

• 42:02Tim Ferriss?

  Right.

• 42:03Speaker 03

  So compared to the side effects of drugs, like let's take opioids, for example, where last year, 88,000 Americans died of opioid overdoses and almost all of them were not suicides, they were just inadvertent overdoses of opioids. Hypnosis has not yet succeeded in killing anyone. It's just not dangerous.

• 42:22Tim Ferriss?

  And the reason you're using that as an example is because of? The intersection with pain management?

• 42:29Speaker 03

  You bet.

• 42:29Tim Ferriss?

  Okay, so we'll also

• 42:31Speaker 03

  We'll come back to that. Got it. Marker noted.

• 42:34Tim Ferriss?

  So adverse risk profile, pretty low. Adverse event profile, pretty manageable. I want to come back to Nolan for a second because I'm wondering if someone is in the researcher 20%. So a low responder. Is there, because I do believe that Nolan mentioned this to me, the possibility of using something like accelerated TMS, which is transcranial magnetic stimulation. This is a type of brain stimulation to improve trait hypnotizability. I don't know what the trait as a modifier means, but is it possible that one could use a tool like accelerated TMS to improve their response to hypnosis?

• 43:13Speaker 03

  The answer is absolutely yes. And Nolan and I and Afik Fireman and a number of other members of Nolan's team just published a paper in Nature Mental Health in which we took hypnotized people who were less than highly hypnotizable and we administered to them either accelerated TMS to the left dorsolateral prefrontal cortex with the idea of regulating activity in the dorsolateral cingulate using real versus sham TMS. So we could tell whether they actually got the TMS or not. They couldn't tell. The paddle made the same noise, but they didn't know. And we were able to transiently significantly increase hypnotizability in the ones who got the real TMS and not in the ones who got the sham.

• 43:53Tim Ferriss?

  What was the dosing on that? Was it one day? Was it five sessions?

• 43:56Speaker 03

  Yeah, no, it was one day. It was just one session and then we

• 44:00Tim Ferriss?

  Single session?

• 44:01Speaker 03

  Single session. Oh, yeah. It was not repeated like the treatment of depression or suicidal ideation.

• 44:06Tim Ferriss?

  Single session?

• 44:07Speaker 03

  Yep.

• 44:08Tim Ferriss?

  Okay. Well, that seems like

• 44:09Speaker 03

  So we're hoping, that's right. I can see your face lighting up. I feel the same way that we may be able for people. We were studying people with fibromyalgia, people with chronic pain to enhance their hypnotizability and then use it to treat pain, which it is very effective for.

• 44:25Tim Ferriss?

  Okay, I'm gonna get to pain quickly, folks, I promise. The segue is different tools. Show their best results in different contexts. And so you might have something like PRP, platelet-rich plasma for certain types of injury repair, surgical recovery. Better for some types of surgeries and joints than others. You might have, fill in the blank, MDMA system, psychotherapy, for instance. Better for certain indications like complex PTSD than others, for instance. Other things might be better suited to, say, alcohol use disorder. What is hypnosis best for? Where have you seen the most outstanding results compared to other options?

• 45:02Speaker 03

  We've seen excellent results in helping people to manage stress. We're finding with Reverie that about 80% of people within 10 minutes feel a significant reduction in their stress levels. It helps people focus, intensify their focus of attention, plan what they want to do, and then do it. It's a skill that they can learn to use very quickly. It's very effective with pain. It's one of the oldest uses of hypnosis with pain. In fact, there was a British surgeon named Esdale who went to India and was using hypnosis. This was pre-ether anesthesia. Now, they would just get people drunk, have them bite on a block of wood, hold them down, and cut on them.

• 45:41Tim Ferriss?

  Frontier medicine.

• 45:42Speaker 03

  Frontier medicine, right. And he went to India and he reported 80% surgical anesthesia with hypnosis. And when 10 years later at Mass General...

• 45:52Tim Ferriss?

  You just don't want to be in the 20%.

• 45:53Speaker 03

  No, you don't, but it's better than...

• 45:55Tim Ferriss?

  It's better than zero.

• 45:56Speaker 03

  Better than what was happening before.

• 45:57Tim Ferriss?

  Better than bourbon in a wallet.

• 45:58Speaker 03

  Right, exactly. And when ether was first introduced at Mass General 10 years later, the surgeons strode to the front of the amphitheater to say, "Gentlemen, this is no humbug to distinguish ether from hypnosis." Well, they were getting 90% anesthesia. And so Esdale withdrew his paper. He said, "Well, they're doing 10% better."

• 46:18Tim Ferriss?

  You're saying ether is getting 90 and hypnosis is getting 80?

• 46:21Speaker 03

  Yeah.

• 46:21Tim Ferriss?

  I gotta say, he withdrew his paper.

• 46:23Speaker 03

  He withdrew his paper. And, you know, it's taken us like a century and a half to figure out that the brain actually has something to do with pain processing.

• 46:31Tim Ferriss?

  Yeah.

• 46:31Speaker 03

  And there are studies now showing which part of the brain, just changing the words you use in hypnosis, which part of the brain is involved in the analgesis. So you significantly reduce pain. In the somatosensory cortex, if you say the hand that's receiving the shocks is cool, tingling, and numb, filtered, hurt out of the pain, you get the same reduction in pain response if you say, "Well, the pain is there, but it won't bother you so much," sort of like opioids, then you return down activity in the dorsal anterior cingulate. So you can see different parts of the brain involved in pain processing and in hypnotic analgesia.

• 47:04Tim Ferriss?

  Depending on the language you're using.

• 47:05Speaker 03

  Depending on the language. So if you think that what doctors say to patients... Right, it is spellcasting, that's right. But no pointy hats or anything.

• 47:13Tim Ferriss?

  Yeah. Those come at the more advanced levels. It's got a payer association to do is to get the hats.

• 47:20Speaker 03

  Right.

• 47:21Tim Ferriss?

  So how does that affect the treatment? If you're looking at, say, the example that you just gave where different wording is affecting different neuroanatomical structures and activity, does that then determine your neurotargeting, for lack of a better term? And you're like, "Okay, we saw A instead of B light up. We really want to go after A based on what we know."

• 47:46Speaker 03

  It may be for certain kinds of pain or certain kinds of problems, you want to emphasize one or the other. But frankly, we have four different sets of instructions that involve either just going somewhere else, leaving your body here and going to a desert island and enjoying things, or imagining a physical remedy that actually reduces pain, a warm bath, or an ice bath, or something like that, or move the pain around, see what it feels like to do that. And one other technique that's very helpful is teach people to have compassion for their bodies. This is like mindfulness in some ways. But you know, if your body were a three-year-old child who'd been hurt, would you get frustrated and angry with it? Hell, no. What would you do? Everybody says, "I'd give him a hug, and I'd stroke him, and I'd try and make him feel better." So there are different language techniques

• 48:31Speaker 03

  we can use to get the same effect, which is to significantly reduce pain. We have randomized clinical trials that prove that hypnotic analgesia works at much lower levels of medication, too. And so it's an underutilized resource. Hypnosis is like an underappreciated company that hasn't been managed well and has a lot more positive resources. And that's what it's like. We just don't take advantage of it.

• 48:56Tim Ferriss?

  So let's use me as a hypothetical intrepid user of self-hypnosis. So I have some low back pain. We were chatting about this before we started recording. Is there a particular approach that you might recommend one, or in this case, I start with in a case like this?

• 49:13Speaker 03

  Sure. We can try it if you want.

• 49:16Tim Ferriss?

  Oh, yeah, I'm game.

• 49:17Speaker 03

  You're game?

• 49:18Tim Ferriss?

  I'm absolutely game.

• 49:19Speaker 03

  All right. How would you rate your pain right now on a zero to 10 scale?

• 49:22Tim Ferriss?

  I'd say it's a two out of 10. It's more of a bothersome stiffness.

• 49:26Speaker 03

  Yeah. And is there a physical remedy that helps you with it? A warm bath?

• 49:31Tim Ferriss?

  There are foam rolling, say the like piriformis and glutes and so on does help. Using psoas release tends to help. Just laying on my stomach, honestly, with my hands under my pelvis to take all the activity out of the spinal erectors helps. Those are a few things, like laying down on my stomach and breathing into the back to relax the spinal erectors, I would say is one thing that seems to help.

• 49:56Speaker 03

  Well, that seems like a vivid image. And temperature things don't make much difference, say?

• 50:01Tim Ferriss?

  Temperature, if I do say a cold bath and then a hot bath, just contrast therapy like that, that seems to help. So that feeling of cold tissue vasodilating when I get into the hot bath, that type of like prickly sensation of being sort of perfused with blood, that's something I associate, I would say, with feeling better.

• 50:22Speaker 03

  Feeling better. So part of what you're doing is reinterpreting the signals you're getting in a different way. So let's try it if you want to see. So get as comfortable as you can. On one, please do one thing. Look up all the way up high as you can. Two, do two things. Slowly, close your eyes and take a deep breath. And three, do three things. Let the breath out. Let your eyes relax, but keep them closed and let your body float. Imagine you're floating somewhere safe and comfortable, like a bath, a lake, a hot tub, or floating in space.

• 50:58Speaker 03

  And then take your right hand and stroke the back of your left hand, starting with the tip of your left middle finger. Or you can put it on the table, that might be better. Now stroke the back of your left middle finger, down along the back of your left hand, past your wrist to your elbow. And as you do that, develop a sense of tingling and numbness and lightness. And let your left hand float up in the air like a balloon. Feel the tingling, that's good, and let it float up. You bend your elbow and you can rest your arm lightly on the table.

• 51:38Speaker 03

  And please describe what physical sensations you're aware of now in your left hand and arm.

• 51:44Tim Ferriss?

  Feel my heartbeat in my palm.

• 51:46Speaker 03

  Mm-hmm, okay.

• 51:48Tim Ferriss?

  A little bit of, I can feel the hair on the back of my arm touching the sleeve that I rolled up.

• 51:56Speaker 03

  And I'm gonna give you this instruction. If you pull your hand back down to the table with your right hand and then let go, it will float right back up to the upright position to see what happens. That's good, so you're putting it down, now let go. I see you smiling, what's happening?

• 52:13Tim Ferriss?

  There's, I mean, it feels like it's floating, number one. I'm also kinda second guessing myself, 'cause I wonder if I'm doing this to conform to the exercise, if that makes sense. But it feels like it's floating.

• 52:27Speaker 03

  Okay.

• 52:28Tim Ferriss?

  Yeah.

• 52:28Speaker 03

  And as you do that, let your left hand remain upright. Later, when I ask you to touch your left elbow with your right hand and let go, your usual sensation and control will return. But right now,

• 52:40Tim Ferriss?

  Can you say that last part again?

• 52:41Speaker 03

  When I ask you to touch your left elbow with your right hand and then let go, your usual sensation and control will return.

• 52:49Tim Ferriss?

  Okay.

• 52:50Speaker 03

  Right now, I want you to notice sensations in your back. What does your back feel like right now?

• 52:57Tim Ferriss?

  The part that's usually painful?

• 52:59Speaker 03

  Yeah.

• 53:00Tim Ferriss?

  It feels relaxed right now.

• 53:02Speaker 03

  Good.

• 53:02Tim Ferriss?

  More relaxed, yeah.

• 53:03Speaker 03

  Good. And how would you rate the discomfort level right now on that two to ten scale?

• 53:08Tim Ferriss?

  0.5, one out of 10.

• 53:10Speaker 03

  One out of 10, 0.5 to 1. Okay, good. So already, notice how you've been able to change sensation, not just in a neutral part of your body, your left hand and arm, but in a part that has been problematic. Now I want you to imagine now, If you're lying on your belly, maybe with a roll under you, and feel a pleasant tingling numbness in your lower back, as if it were cooler or warmer, or you were changing it from warmer to cooler, feel a pleasant tingling numbness and let it filter the hurt out of the pain. Each breath deeper and easier.

• 53:52Speaker 03

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

• 53:59Tim Ferriss?

  It does feel cooler.

• 54:02Speaker 03

  Good.

• 54:04Tim Ferriss?

  Feels a little dissociated.

• 54:10Speaker 03

  Uh huh.

• 54:11Tim Ferriss?

  Makes sense, like.

• 54:13Speaker 03

  Can you describe that a little more?

• 54:15Tim Ferriss?

  Feel like it's very similar to tequila or.

• 54:18Speaker 03

  There you go.

• 54:19Tim Ferriss?

  Or a low dose of ketamine, which I don't recommend, but I mean, as a dissociative anesthetic.

• 54:24Speaker 03

  Mm hmm.

• 54:25Tim Ferriss?

  I've always struggled to put words to the dissociative experience. There's a lightness and there's a conscious awareness of the body without being as identified with the body.

• 54:37Speaker 03

  Exactly. So you can observe it, but it feels different. And would it be fair to say that it's not as annoying as it usually is?

• 54:47Tim Ferriss?

  It's not as annoying.

• 54:49Speaker 03

  Good. So notice how you're able to filter a lot of the discomfort and displeasure out of the usual pain situation by detaching from it, by experiencing it differently. It's not a sentence you have to endure. It's a sensation your body is giving you that you can interpret in different ways.

• 55:12Tim Ferriss?

  Now, for people who might wonder if this is compartmentalizing in a way that is long-term harmful, I'm not saying that's what it is, but is this just taking a different vantage point? How would you encourage them to think about this?

• 55:25Speaker 03

  Yes, I would say it's reinterpreting the sensations and signals that you're getting from that part of your body. And you're uncoupling them from the usual sense of annoyance and limitation that tends to actually make it worse.

• 55:39Tim Ferriss?

  Oh, 100% makes it worse.

• 55:41Speaker 03

  Yeah. And instead you're saying, okay, it's there. I don't like it, but it's not bad. And that capacity to reframe, to reprocess the signal is a powerful way of better managing pain, filtering the hurt out of the pain. Now, please take your right hand and touch your left elbow and then let go. And see what happens to your left hand and arm.

• 56:05Tim Ferriss?

  Yeah, just more. Movement is more forthcoming.

• 56:09Speaker 03

  Uh huh. Good.

• 56:10Tim Ferriss?

  That's surprising, isn't it? Yeah, I was noticing how like my fingers got kind of got frozen in this position. I thought that was interesting. Not making too much out of it, but I was saying.

• 56:23Speaker 03

  Hmm. All right, you can let it float back down now.

• 56:28Speaker 03

  And how's your left hand and arm feeling now?

• 56:32Tim Ferriss?

  Normal.

• 56:32Speaker 03

  Normal, good. So you were able to change sensation in both directions? And how's your, how's your lower back feeling now?

• 56:40Tim Ferriss?

  Feels really good, actually. Yeah, so.

• 56:43Speaker 03

  Terrific.

• 56:43Tim Ferriss?

  That's remarkable.

• 56:45Speaker 03

  I'm very glad. That's great.

• 56:47Tim Ferriss?

  So thank you for that.

• 56:48Speaker 03

  You're welcome. Where do you get my bill?

• 56:53Tim Ferriss?

  You have my email.

• 56:56Speaker 03

  I'm really, I'm really glad.

• 56:57Tim Ferriss?

  Fresh books, $6,000.

• 57:02Tim Ferriss?

  What happened to the first one's always free? Oh, wait, no, that's drug dealing. Not hypnosis.

• 57:07Speaker 03

  Yeah, exactly.

• 57:09Tim Ferriss?

  And if someone's inducing that from a self-hypnosis perspective, well, let's just talk about it could be in the context of Reverie, it could be in a different context. What are the steps that they take or how do they self-induce? For something like that, let's just say, if I want to do that five minutes a day.

• 57:25Speaker 03

  If I wanted to do it five minutes a day, you could remember what I told you, or you could queue up the pain control app on Reverie and you get to hear my mellifluous voice teaching you an exercise.

• 57:38Tim Ferriss?

  This dulcet tone.

• 57:39Speaker 03

  Dulcet tone, there you are, to teach you how to do this and you could follow along. And it's interactive. So I'll ask you, is your hand floating? If it is, I'll tell you one thing. If not, it's something else. So it's a branch chain kind of response that I tried to make as much like being across the table or in my office as I could.

• 57:57Tim Ferriss?

  And not to beat the dead horse of neurobiology, but just to reinforce my understanding from a neurobiological or neuroanatomical perspective, what is happening?

• 58:08Speaker 03

  So what's happening is, and we've got EEG studies, we've got fMRI studies, we've got PET studies showing that what's happening, if you think about it, that pain is always a combination of peripheral input through the lateral spinothalamic tract, through the thalamus, through the periaqueductal gray and up to the somatosensory cortex with input from the salience network. So if you just broke your arm, the salience network's going, "God, you're in trouble. You better do something." But the problem is, because we're fairly pathetic physical creatures, we have to take very good care of our fragile bodies. And so we have a brain that is designed to help you recognize when you're hurt and get help and manage the pain.

• 58:51Speaker 03

  But for example, freeze, not necessarily move so a predator could detect you more easily. So pain is a combination of those peripheral signals coming in and what your brain decides is wrong and what to do about it. And so very often, chronic pain is really not anything you need to do anything about, but your brain often treats it as if it were acute pain. "Here I am," and so it derails you and it annoys you and it keeps you from doing what you want to do. And the more annoying it is, the more attention you pay to it. It's like the noisy kid in the classroom, you know? And so you can learn to modulate that. So we showed in one experiment with Stanford students, we gave them electric shocks, we measured somatosensory evoked responses.

• 59:31Speaker 03

  So you can see waveforms coming out up to a second after the shocks are administered. And in the hypnosis condition, we were able to stop the P100, the first response, cold. There was no response of the brain when they were in hypnosis in the first tenth of a second. And the P200 and P300 were half as big as ordinarily. So within a fraction of a second, the brain is processing the signals differently. And as I mentioned, there are studies that show you can turn that activity in the anterior cingulate, you can turn that activity in somatosensory cortex. So the brain is saying, this is not as bad as I initially thought it was, and I don't have to pay as much attention

• 1:00:12Speaker 03

  to it. It doesn't have to hurt me as much. Because very often, we amplify pain rather than diminish it by being so annoyed that it's happening. And another thing that we know is going on in the brain is, the anterior cingulate is rich in GABA receptors, gamma immunoglobular acid, they're inhibitory neurotransmitter. Highly hypnotizable people have more binding of GABA in the anterior cingulate than low hypnotizable people. So they can use it to be their own little drug dispensaries, to inhibit the anxiety reaction in the dorsal anterior cingulate cortex. So there are many understandable neurophysiological ways by which the brain can literally take the strain out of pain.

• 1:00:55Tim Ferriss?

  Also wondering, I mean, you'd have to test this, of course, but if hypnotizability as assessed by various means, whether it's the eye roll test, or a drop of blood and looking at the genetic profile, if there might be some correlation to high response, baseline response, low response for psychedelic assisted treatments as well. Because as it stands currently, there's a lot of shooting in the dark. I'm not aware of any assessment that determines if someone is likely to be a high responder to psychedelic.

• 1:01:28Speaker 03

  Psychedelic.

• 1:01:29Tim Ferriss?

  But as we're talking about it, there seem to be a lot of parallels.

• 1:01:34Speaker 03

  Oh, I think there are.

• 1:01:35Tim Ferriss?

  It wouldn't be that hard to test. I mean, somebody has to fund it, of course, but science takes money. But, I mean, there are lots of assessments for, let's just say, determining the strength of a mystical experience and how that's correlated to therapeutic outcomes.

• 1:01:47Speaker 03

  Right.

• 1:01:48Tim Ferriss?

  Highly correlated, it turns out, at least with psilocybin, and so on and so forth. They're all the standard assessments that you might have for depression and ham D and so on, or GAD or whatever, all of these various things. But in terms of determining, in the process of patient recruitment, who might be a high responder, that's a huge deficit in the system right now.

• 1:02:06Speaker 03

  I agree with you. I think it'd be a terrific thing to do. And maybe in Nolan's next study, he just published a paper on Ibergain with astounding results. I mean,

• 1:02:16Tim Ferriss?

  Astonishing.

• 1:02:17Speaker 03

  Not just improving PTSD, which I kind of expected, but

• 1:02:20Tim Ferriss?

  TBI.

• 1:02:21Speaker 03

  TBI, traumatic brain injuries, and it stays down, goes down and it stays down.

• 1:02:25Tim Ferriss?

  Yeah, it's very durable.

• 1:02:26Speaker 03

  And that's one of the things about a lot of these psychedelic studies is that it breaks the whole, the whole model of keep occupying that receptor and, you know, blocking serotonin uptake and all this stuff. And it's just once or twice and the brain is like reset, it's rebooted.

• 1:02:42Tim Ferriss?

  Yeah.

• 1:02:43Speaker 03

  And that's where I think this interaction with the default mode network activity is very interesting because I think people reset their expectations of who they are, what they are, and what their symptoms mean in a way that lasts. And there's now a lot of interest. Of course, there's often psychotherapeutic assistance with the psychedelic treatments, which is important, but some of that could be hypnotic instruction too. And I don't think much of that has been done. But it would be very interesting to do. I agree with you.

• 1:03:10Tim Ferriss?

  It'll be super interesting. Yeah, there's a broad canvas still remaining for all sorts of research.

• 1:03:17Speaker 03

  I'm glad to hear that.

• 1:03:18Tim Ferriss?

  So let me ask about a few things. First, you used wording that was along the lines of, I heard you mention at least twice, filtering the hurt from the pain. Am I getting this right?

• 1:03:29Speaker 03

  Right.

• 1:03:30Tim Ferriss?

  Could you elaborate on that? And then the second piece is much earlier, you were referring to the, say, I don't want to call them below hypnotizable, people who fall into this category, nickname of the researcher, who could still use it. And I thought I heard you say something like framing issues as for us, not against us, something like that.

• 1:03:52Speaker 03

  Right, right.

• 1:03:53Tim Ferriss?

  So could you first talk about filtering the hurt from the pain and then this for us versus against us?

• 1:04:00Speaker 03

  Well, the filter that hurt from the pain is, you know, it sounds kind of paradoxical. What are you talking about? Pain hurts, you know? But the degree which it hurts has to do with more than just a signal traveling through the lateral spinal thalamic tract. It has to do with how you interpret that signal. We have all kinds of somatic signals, some of which could be on the verge of discomfort, some of which aren't, and our brain's job is to interpret them and decide what to do about them.

• 1:04:25Tim Ferriss?

  Yep.

• 1:04:26Speaker 03

  And so you can have a signal that doesn't necessarily automatically convey that something is wrong with the body. It may be just an intense ceiling, you know, it's like the difference between, you know, an enthusiastic hug and a squeeze that hurts. And there's a line in there somewhere where that you cross and it's pretty obvious, but there's also an area of interpretation.

• 1:04:47Tim Ferriss?

  Or the ostentatious long hug. There are a lot of guys here who do long hugs. They say, "I'm a hugger" when you try to shake hands.

• 1:04:53Speaker 03

  Yeah.

• 1:04:54Tim Ferriss?

  It's like 20-second hug. There's a point where it gets uncomfortable.

• 1:04:56Speaker 03

  It gets uncomfortable. That's right. And it's usually after the first second or two.

• 1:05:00Tim Ferriss?

  [laughing]

• 1:05:01Speaker 03

  That's right. And so the brain is doing its interpretive job of making meaning out of the sensory experience. One of the other things that we know happens in the brain with hypnosis is higher functional connectivity between the dorsolateral prefrontal cortex and the insula. The insula is this little island, it means island in Latin, in the mid-front part of the brain, that is a mind-body conduit. So it's a place where the brain controls what's happening in the body. How much gastric acid you secrete, your autonomic arousal, for example. And also it receives information, interoception, from the body. How's the body reacting to things? And hypnosis intensifies this connection and intensifies coordinated activity between the executive control network and the insula. And so it's

• 1:05:45Speaker 03

  a way in which the brain can intensify its reading and understanding and interpretation of what's happening in the body. And so, you know, athletes who are pushing their bodies to do things that most of the rest of us would say, "Ouch, you know, I can't do this", are interpreting that as, "I'm pushing my body as hard and as far as I can to get what I want." And so they will interpret things that everyday people would interpret as putting yourself through pain as training, doing what you need to do. And, you know, that runner's high is in part composed of signals that many of us would just consider painful. And so that's part of what the brain does, and that's part of what hypnosis helps us to

• 1:06:26Speaker 03

  regulate and control how much of it is pain and how much it is not. And so the interpretation of pain, the meaning of it, has a lot to do with how much it hurts. And what about the for us versus against us? People who are experienced with hypnosis, that is, people who know that people actually listen and respond to what you say, will say the dumbest thing you can say to somebody is, "Don't think about purple elephants." What are you gonna think about? And the best way to change behavior is intermittent positive reinforcement. So you want the process of change to be what Chick sent me a high called autotelic. You want to feel good about doing it. So an example where we do that in hypnosis, and where even non-hypnotizable people can

• 1:07:09Speaker 03

  respond is, when I try to teach someone how to stop smoking, which was the first experiment we did with Reverie, I don't say, you know, "Ugh, cigarettes will taste terrible." My professor at medical school did that. He, you know, "Your cigarettes will taste like horse shit." And the guy lit up the cigarette and said, "Oh, thank you, doctor." And he got a frantic call two hours later. He said, "Doc, my house smells terrible." My house smells like horse shit. Right. And Hackett said, "Well, are you smoking?" He said, "No, but I forgot to tell you that my wife is a smoker." So he had to hypnotize him and say, "Only your cigarette." You know, it doesn't work. You focus on what you're for. Respect and protect your body. For my body, smoking is a poison. I need my body to live. I owe my body respect and protection.

• 1:07:53Speaker 03

  You would never put tar and nicotine filled smoke in your baby's lungs. Your body is as dependent on you as your baby was. So treat your body with the same respect you'd give a child. And so you're focusing not on whether you have an urge to smoke or not, whether you feel better on nicotine or not, but whether you are going to commit to respect and protect your body. And that way, you can feel good from the moment you make the commitment to do it. I'm being a good parent to my own body. So even people who aren't hypnotizable can get that concept. And say, I'm not going to worry about my urge. I have lots of urges I don't act on. I don't have to act on this one just because I have it. So I had one alcoholic who I was trying to use that to help him stop his drinking.

• 1:08:38Speaker 03

  He said, Oh, you mean sort of like the body is the temple of the soul? And I said, Yes, you got it. That's it. And he stopped drinking. So it's a matter of finding a way to formulate the resolution of a problem. So that you start feeling good from the moment you commit to doing it. Before you know that you're going to stop smoking. And we're getting one out of five people stop just like that. And they surprise themselves. That's one of the things I love about working with hypnosis. Is people are surprised at what they can do. Because they're trying out being different and seeing what it feels like.

• 1:09:12Tim Ferriss?

  What do you think is happening with the addiction specifically? Whether it's nicotine, alcohol, or other? Why does this work where other things fail? And I should ask, actually, just so you can set the table for this. How does hypnosis compare? And I'm sure it depends on the practitioner and so on. Which kind of gets into a whole separate question I wanted to ask about just schools of hypnosis. I don't know how standardized things are like CBT, for instance. But not that that's hypnosis. I'm just saying they've tried to standardize so they can track things. How does hypnosis compare to other types of interventions for addiction?

• 1:09:47Speaker 03

  Well, the results we get with hypnosis is about one in four, one out of five people just flat out stop. And the rest cut down by about 50% in how much they're smoking. That's roughly comparable to the use of Verenaclean or Bupropion or Nicorette patches. It's not very different. Depends on the population. But it's about as good. Is it the same people? I don't know for sure because they're done in different contexts. But it's not bad. And I have people who are surprised by how easy. They said like a lever was pulled. And I just don't worry about it anymore. I just don't think about it. Now, does it have with everyone? No. But every time, we feel good any time we get anybody to stop.

• 1:10:27Speaker 03

  The most reversible cause of cancer in the world is cigarette smoking. So anybody you get, that's a good thing. And even people who are, it is correlated with hypnotizability. So more hypnotizable people are more likely to stop. Using this approach, but there are some non-hypnotizable people who do too, because they get the concept even if they don't get the feeling that comes along with it. And the other thing that keeps in mind in addiction medicine is that the odd thing is that it's not actually the high from the drug that hooks people. It's the chase is better than the catch. So you get more mesolimbic dopamine secreted when you're going through a scenario of scoring a drug than when you're actually taking the drug.

• 1:11:12Speaker 03

  So it's the anticipation of pleasure that really gets to people. And from my point of view, using hypnosis, that's fertile ground for intervention. Where you just say, I can make you feel good without chasing after the drug. I can make you feel good the way you felt when you hugged your six-month-old child, because you're doing the same thing with your body now. And that's a good thing. So helping people to focus on what they're for is a crucial part of the therapeutic strategy and makes it work.

• 1:11:41Tim Ferriss?

  What is the oldest, that you're aware of, documentation of hypnosis or something resembling hypnosis?

• 1:11:48Speaker 03

  You know, I was in Bali watching trance healers. And the difference in Bali, and this has gone on for thousands of years, they go into a trance and their patients watch them. So they kind of go into this altered state and start chanting and singing. And the idea is if you watch it, it's kind of hypnotic and you'll kind of go along with them. But from a Western point of view, it started in the late 18th century with Franz Anton Mesmer, who was a Viennese physician.

• 1:12:13Tim Ferriss?

  Hence mesmerized.

• 1:12:14Speaker 03

  Mesmerized, that's right.

• 1:12:17Speaker 03

  And he called it animal magnetism. And he thought it actually had to do with changing the magnetic field in a patient's body. And he had them look at tubs filled with iron filings and he had a magda. In fact, the magic wand in magic shows comes originally from a magnetic rod that was used to hypnotize people. Yeah, that's right. From animal magnetism to transcranial magnetic stimulation. That's right. And he was very popular. He left his wife and family in Vienna. He moved to Paris. He was out competing the leading French physicians of the day. Voltaire wrote to his brother, "We did everything we could to save father's life. We even sent the doctors away." And if you think about the major treatment at the time in France, it was bloodletting.

• 1:13:01Speaker 03

  France was the world's leading exporter of leeches. And unless you happen to have congestive heart failure. France was the world's leading exporter of leeches? Leeches, because that's how they did it. And they still, in some like hand-damaged things, they use leeches to suck blood out of certain regions in the hand and all that. But at the time, that was the major treatment. And he was so popular. And the cool thing, if you read about what his office was like, it was cheerful. It was brightly lit. Patients would hang around all day boasting about what they'd done with animal magnetism. And the typical French physician's office was truly grim. It was dark, no decorations on the walls, patients were getting bad news from doctors. I once had the opportunity to visit Anna Freud when I was a medical student in London.

• 1:13:45Speaker 03

  And she asked me if I was going to become an analyst. And I tried to be diplomatic and say, "Well, I'm not sure." She said, "So you're not going to be an analyst?" She wasn't messing around, you know. "Why?" And I said, "Well, I don't like the passivity. I don't like not offering something, trying to help fix things with people." And she said, "You need to understand something. When my father was training as a doctor, it was considered a waste of time for a doctor to listen to a patient. Patients were there to listen to doctors." And I was humbled by that. I thought, you know, it was a very, it was a very good point. And she said, "It's hard to be analyzed because analysis is a liberation from your parents, and that's difficult if your parents are analysts." And she knew better than anyone because her father was her analyst, actually.

• 1:14:30Speaker 03

  Oh, boy. But so doctors. Lots to unpack there. Yeah, there was a lot in the doctor-patient relationship in that time that was pretty grim. And so the fact that Mezner was talking to patients and listening to them made him very popular. So they got King Louis to convene a panel to investigate Mezner. The panel was very interesting. Our own Benjamin Franklin was on it. He was having a lot of fun.

• 1:14:53Tim Ferriss?

  Why was Mesmer being investigated?

• 1:14:55Speaker 03

  Because he was competing so successfully with French doctors.

• 1:14:58Tim Ferriss?

  So the French doctor lobby?

• 1:15:00Speaker 03

  The French doctor lobby.

• 1:15:02Tim Ferriss?

  Pulled out the stops.

• 1:15:03Speaker 03

  They said that his theory was all wrong, that he wasn't really changing magnetic fields, which is correct. It's true. They concluded, and another member of the panel was Lavoisier, the brilliant French chemist who developed oxygen chemistry and who, six months before he was beheaded in the French Revolution, discovered the idea of the gross national product. He was a genius. And one of the third other panel members was a doctor named Dr. Guillotin, the inventor of the Guillotine. He kind of created the mind-body problem.

• 1:15:37Tim Ferriss?

  What a panel.

• 1:15:38Speaker 03

  Yeah, what a panel.

• 1:15:39Tim Ferriss?

  It's like the setup for a joke.

• 1:15:41Speaker 03

  Yeah, it is, but it wasn't, unfortunately. They concluded that hypnosis was nothing but heated imagination. And you know what? I've heard worse definitions than hypnosis. But that was it for Mesmer.

• 1:15:52Tim Ferriss?

  Yeah.

• 1:15:52Speaker 03

  And so, you know, it set in motion a pattern of why hypnosis is just an underdeveloped resource, is that people think it's either dangerous or it's ridiculous. And it's neither. It's a valuable, effective treatment that we have underutilized for decades, for centuries.

• 1:16:10Tim Ferriss?

  What is, if you had to pick one or two, anything that comes to mind, some of the more surprising patient outcomes or changes that you've seen? Because there are cases where I'm sure you could have predicted the outcomes. I have a 50% chance this person has a 30% reduction in A, B, and C symptoms. But were there any that really stand out to you as surprising?

• 1:16:31Speaker 03

  The first one was the one that got me to decide that, yes, this happens to me under my father's interest, but I'm not going to let that deter me from something I'm interested in. And it was the first patient I reused hypnosis with. It was on my pediatrics rotation at Children's Hospital in Boston. The nurse says, "Spiegel, your patient is in room 342. She's in status asthmaticus. She's been hospitalized every month for three months, and she's back again. And she hasn't responded to Dephenephrine twice, and we're going to maybe give her general anesthesia and put her on steroids." So I walk in the room. Following the sound of the wheezes down the hall, pretty 15-year-old girl bolt upright in bed, struggling for breath, knuckles white, mother standing there crying, I didn't know

• 1:17:15Speaker 03

  what to do, but I had taken a hypnosis course. So I said, "Well, would you like to learn a breathing exercise?" And she nods. So I get her hypnotized, and then I break into a sweat, and I think, "Wait a minute, we haven't gotten the asthma in the course." So I said something very subtle and clever. I said, "Each breath you take will be a little deeper and a little easier." And within five minutes, she's lying back in bed, she's not wheezing anymore, her mother stopped crying, nurse runs out of the room. And if you think about the dynamic of that, I mean, it was stunning to me, I couldn't believe it. But each time she tried to breathe and had trouble, she got more and more anxious, because she thinks, "I'm gonna not be able to breathe, it's very frightening." So you have her anxiety

• 1:17:56Speaker 03

  building like a snowball, rolling downhill on top of the physical sensations. So in comes my intern, I thought he's gonna pat me on the back and say, "Good for you," you know. He said, "The nurse has filed a complaint with the nursing supervisor that you violated Massachusetts law by hypnotizing a minor without parental consent." Kid you not. And Massachusetts has a lot of dumb laws, but that is not on the list. And furthermore, her mother was standing next to me when I did it. He said, "Well, you're gonna have to stop doing this." And I said, "Oh, really? Why?" He said, "Because it could be dangerous." And I said, "You're gonna give her general anesthesia and put her on steroids? And my talking to her is dangerous? I don't think so." So I said, "Tell you what, as long as she's my patient, I'm not telling her something I know isn't true. So take me off the case

• 1:18:39Speaker 03

  if you want." So he storms out of the room, he finds the chief resident and the attending, and they have a council of war. And they came back with a radical solution. They said, "Let's ask the patient." You know, I don't think they'd ever thought of that. Breakthrough. Yeah, breakthrough. And she said, "Oh, I like this, I wanna keep doing this." And she was hospitalized one month after that, a month later, and went on to study to be a respiratory therapist. And I thought that anything that could help a patient that much, that fast... Frustrate the head nurse violated nonexistent Massachusetts law had to be worth looking into. And I've been doing it ever since. But you know, the nice thing is you can see it in front of your eyes. You see whether it's going to help, you know, just like you with your pain, you know, it's the same thing.

• 1:19:22Speaker 03

  If it's going to happen, your brain is wired to every part of the body to make it happen quickly. And it doesn't always happen, but it often does. I'd say the next major patient that really struck me when I first got to Stanford, I was assigned to the Palo Alto VA Medical Center. And there was an Army cook who had been mustered out of the Army because after 19 years of good service, something happened during the Tet Offensive and he just grabbed an ambulance and some guns and ran out in the jungle and started shooting at what he thought were Viet Cong. And he seemed psychotic, they couldn't contain him, he was agitated. He was emotionally uncontrolled, he wasn't responding to meds.

• 1:20:04Speaker 03

  And he wound up being discharged from the Army and spending 11 months in a state mental hospital in California. And a social worker there interviewed him and said, he's not a drug user, he's, you know, he doesn't seem psychotic to me, there's something wrong, but I think it's post-traumatic. So I saw him at the VA and he told me that something happened during the Tet Offensive and it had something to do with a Vietnamese child that he had informally adopted. He was like the youngest of 13 children, he identified with young kids. This kid had been badly burned, was on a crutch. Nobody seemed to claim him and so he just kind of took over and they became buddies.

• 1:20:44Speaker 03

  And during the Tet Offensive, I find out in hypnosis, he comes upon the boy's body and he realized he's been killed. And in reliving this in hypnosis, and he was very hypnotizable, he says, oh my God, they hit Che wing. Oh my God, they ain't got to kill kids, they ain't got to kill kids. So he's screaming and crying and then he's going into setting up defenses on a water tower because he thinks we're going to be overrun by Viet Cong and he's going through all of that. And I move him then, the remarkable thing was he was very intensely involved in all this, but very malleable. So I'd say, okay, we're gonna change times now. And we're gonna go to the time when you collected his body and buried him.

• 1:21:26Speaker 03

  And so he does that, and he says ashes to ashes and dust to dust, I guess that's it. And then he starts banging on the arm of his chair and he says, if I'd only taken you over to G Wingman, you wouldn't be there. It's all my fault. And I said, tell me something, would this boy blame you for what happened? And he starts to smile. He says, no, no. He said, you're number one cook. You're my number one cook, number one cook. He knew he was gonna die, that he was crippled, he looked like he had arthritis. And so I said, okay, we're gonna go to his funeral now. And no, we're gonna go to a different time. We're gonna go to a time before the funeral, when you had a party for him, a happy memory. Because, you know, often with grief, the reason it hurts so much

• 1:22:11Speaker 03

  is that you loved and cared about each other so much. So there's something positive behind the grief. Right. And so he says, oh, you look so happy. The Donut Dolly's brought a cake. My sister sent an electric train for a present for you. You've never seen an electric train before, have you? You know, Vietnam, then you got no railroads. And it turned out later that the train was actually from Spiegel Brothers department store in Chicago. And he said, he's so happy, you're my number one cook. So I said, okay, we're gonna put as much of this as you don't wanna think about now, behind a filter, to be there if you need it. But you're gonna remember two things about this.

• 1:22:54Speaker 03

  You're gonna remember burying him, and you're gonna remember that birthday party. And so he's, you know, he's sweating, his tears going down his cheeks. And I brought him out of the hypnosis. And he looked a little sort of dazed, he looked a little confused. And I said, what do you remember? And he said, Doc, I remember a grave and a cake.

• 1:23:16Speaker 03

  That was it, grave and a case. So it was a way of helping him acknowledge his grief, begin to go through a process of grieving, but see it from two points of view. That he had this time with this kid. He made the boy happy, the boy made him happy, and that can't be taken away, even though he died. And he was in the hospital for a while longer. He practiced it every day, sitting in the ward. He was doing his self-hypnosis. And he was discharged. He was upset he couldn't get back in the army. He wanted to, but he'd been discharged. His brother, who was a police officer in Chicago, was killed in the line of duty, and he decompensated again. But we processed.

• 1:23:54Tim Ferriss?

  What does decompensated mean?

• 1:23:55Speaker 03

  He just got symptoms all over again. He started to look like he was hearing voices, although he wasn't, but discontrol of emotion. And so I had him grieve his brother's death in the same way. And he got discharged. He was spending his time training teenagers how to do long-distance cycling. And he was out of the hospital and doing fine. So, you know, I thought that anything that can help people in these rather extreme situations come to a new point of view in a hurry about that was worth pursuing, and I've been doing it ever since. And we've had people in wherever, a guy who was in his home for three years. He had the social phobia, you know, where he just couldn't stand to leave his house. He was there for three years,

• 1:24:40Speaker 03

  and we taught him to use self-hypnosis to deal with his anxiety. And he's out in the world again. He's living a normal life. So it is surprising how much it can help people in a hurry.

• 1:24:52Tim Ferriss?

  What a remarkable story. I want to ask you to just describe wherever you're for folks in a minute. But first, I want to ask, in that circumstance where you have this veteran who some think psychotic, who is getting really animated, heated, sweating, to maintain your composure and direct that environment, that person in that state, what does it take to get to that point where you're comfortable doing that?

• 1:25:22Speaker 03

  That's a very astute question because the intensity of it is remarkable. We actually have a grainy old video of it. But I sometimes get surprised myself. I was actually holding on to his arm the whole time. I didn't even realize it at the time, but I was like trying to connect with him. So that whatever else was going on, he knew I was there with him. And I guess two things. And one was it's a characteristic of highly hypnotizable people that they can be having intense experiences and yet be connected and contained. That is, they're absorbed in it, but they're not just out of control. They're not just wild, you know? They're expressing their emotion, but they're also able to modulate and control it and

• 1:26:05Speaker 03

  focus on this sort of narrow container of being intense in reliving what happened, but also somehow aware that it is a reliving of the event. It isn't actually happening. And so I figured you gotta have the reins of the horse when you're riding fast. But it was clear to me that he was listening to me. And what struck me the most and what reassured me frankly was that he could change times very easily. He could change mood. So literally transition from screaming, "I should have taken you over the hooch, man. It's all my fault," to ashes to ashes and dust to dust was a few seconds, you know? But he was following me. And you know, if I saw that he wasn't, I'd spend more time on the control issue.

• 1:26:49Speaker 03

  But it's also because the intensity he had to do with something we were meaningfully working on. That is, I wasn't doing it just to have him show off how emotional he could be. I was doing it to help him queue up into perspective, the thing that was upsetting him so much, and help him to process it in a way that made him feel better about it. So I knew I was doing something that I thought could help him. And I'll tell you that in some of these intense kinds of hypnotic therapies, I'm a little dissociated too, you know? There's this thing, it's a smart hypnotist that knows who is hypnotizing whom. But I'm kind of listening to my own mind saying... What's the next step? What do we need to do here? And I'm thinking about it for a second and saying, is this really the right thing? Well, let's try it out and see.

• 1:27:33Speaker 03

  And so I'm also testing his response. And if I see that we're not getting anywhere, then I'll change course. And it takes some time in training to just sort of know the direction you want to go in and why you're doing this. And is it really going to help him? Or is it just putting on a show? And it was clear to me that's what he needed to do. And you get this sort of deep connection with somebody that they can feel you and you can feel them, you know, that he knows what I'm trying to do and I know what he's needs to do.

• 1:28:01Tim Ferriss?

  I think there might be something to the correspondence of trade hypnotizability and good candidacy for psychedelic assisted therapies. I really do, because that way you just described also, I think, would be mirrored in many patient reports who exhibit strong durable outcomes. They're able to switch from one thing to the next very quickly. From one maybe very positive emotional valence to one very negative emotional valence and then back and forth while still maintaining some semblance of observer awareness, if that makes sense. So very, very curious. Who is Reverie designed for?

• 1:28:44Speaker 03

  Reverie is designed for anybody who's curious about dealing with their problems. If you just want to learn something about your ability to explore and change your mental states, it's useful. It's a tool. It's more like an antibiotic than a vitamin. It's if you've got a problem, you can try and see if it'll help. So people with pain, stress, insomnia, that's our most popular use. People getting to sleep or getting back to sleep. I used to worry that Reverie wasn't quite as good as being in my office with me. And then I thought, if you wake up at three in the morning and need to get back to sleep, you probably don't want me in your bedroom helping you do it.

• 1:29:18Tim Ferriss?

  You probably don't want to be in.

• 1:29:19Speaker 03

  I don't either.

• 1:29:19Tim Ferriss?

  Someone in the bedroom at three in the morning.

• 1:29:21Speaker 03

  That's exactly right. It's very useful for dealing with phobias like airplane phobias, claustrophobia. Had a lovely woman who had obsessive compulsive disorder all her life and claustrophobia. Was diagnosed recently with cancer and had to have a scan in an enclosed tube. And just was freaked out about doing it. And I had her picture doing two things that made her feel better. One is just floating somewhere she felt comfortable. And she said, I remember floating in the Dead Sea. And I thought for a cancer patient, it might not be the ideal image, but the intense salinity of the Dead Sea makes you float like a cork.

• 1:30:02Speaker 03

  And so she liked it. So I said, okay, we'll do that. And she had a very loving sister in New York who would come out to visit her. And I said, and I want you to imagine that your sister is standing next to that scanner, giving you a hug and reassuring you. And she came out of it and she started to cry and she said, for the first time, I think I can do this. You know, I can actually do this. I mean, she was afraid to go in an elevator by herself. It was too scary. She'd wait in the hospital. I know multiple people who have this issue with elevators, airplanes. And with airplanes, I have people, imagine they're floating with the plane, the way you take a roller coaster ride. Don't fight the plane, float with it. And see, the plane is an extension of your body like a bicycle. If you want to get somewhere faster, you're using the plane as an extension of your body.

• 1:30:45Speaker 03

  The pilot is an extension of your mind. You chose an airline that has good pilots and he's or she is an extension of your mind. So concepts like that can help people do self hypnosis and get from point A to point B. So that's good. And then for habit problems like smoking or drinking or eating badly. You know, you can learn to eat like a gourmet. You can enjoy eating more while you eat healthier food by using the self hypnosis to do that. What have you used, if anything, self hypnosis for on yourself? I had recurrent dislocation of my shoulder and I realized I needed surgery done. It's a three hour operation. It's a big deal. Had my left shoulder reconstructed.

• 1:31:30Speaker 03

  It's a lot of fun, isn't it? Yeah. So I used general anesthesia for the surgery itself, but afterwards. I just did self-hypnosis for the pain control, you know, and it was a Mass General and I wasn't supposed to read my record, but I worked there, so. The nurse kind of looks at me like, and the resident wrote in my record, "Patient using very little pain medication, we mustn't have cut any nerves." Now, you know, I've got a scar from here to here, I can tell you they cut nerves, but it's this misunderstanding that, you know, the body is just like a broken car, you just gotta, you know, incision, ingestion, or injection, you know, you gotta do something to the body, rather than teach the person to use the control system that we're all

• 1:32:12Speaker 03

  born with, this three-pound object at the top of our shoulders, that is connected to every part of the body and helps to control it. And why on earth shouldn't we be able to use that better? You know, it doesn't come with a user's manual, you know, so you gotta figure out how to do it, but it makes a huge difference. And so, you know, hypnosis is not a commodity, it's a skill to be shared. And that's one reason, actually, it's underutilized, is, you know, I don't have a bunch of ex-cheerleaders going to doctors' offices telling them, "Use hypnosis," but drug companies do. And, you know, I'm a doctor, I prescribe meds, but there are many times when doing something like this is much better and safer and more effective.

• 1:32:54Tim Ferriss?

  Could also be the, given the very favorable risk profile, something that you at least attempt before moving on to more severe interventions.

• 1:33:05Speaker 03

  That's exactly right. You know, why not try this first? I had a young woman, seven months pregnant, very bad lower back disease, and of course, as the baby grew, you know, it got worse, they put in a nerve stimulator, it didn't help, and they couldn't give her opioids because she was, you know, had it pregnant. And so, I have her imagine she's floating in a nice warm bath, filtered the hurt out of the pain. Her pain went from seven to three in a couple of minutes, but she looked angry, and I said, "What's the matter?" She said, why in the hell are you the last doctor I got sent to instead of the first? And that's exactly right, Tim. I don't get it. You know, it's inexpensive, it's effective. Why not try that first? And then if that doesn't work, do something else.

• 1:33:50Speaker 03

  It's really a shame. It's a disservice to people who can help themselves. It's excessively expensive to do use medications or procedures when some people may not need it. Some do, but a lot don't. And so I would like to see Reverie used as a kind of placeholder while people are getting evaluated and getting appointments with people who can help them deal with whatever their pain or other problem is.

• 1:34:13Tim Ferriss?

  It can take forever to find a good specialist, meaning outside of hypnosis. I have a friend who's dealing with a very unpredictable onset of what he describes as overwhelm that seemed to begin after he had a pretty bad neck injury. He was constantly in this flexed position while he was working at his laptop. And then he went to play tennis one day, went into a serve, bent his head back and had some type of structural event that then precipitated this onset of what he would call sort of overwhelm, where he goes into fight or flight and really can't focus or work. And it's taken many, many, many, many months to find specialists to work with just to begin the trial and error.

• 1:34:58Tim Ferriss?

  So in the meantime, I could see something like this being incredibly valuable. Aside from Reverie, and people can find Reverie at reveri.com, great name by the way. R E V E R I dot com. And on all the socials, we'll link to that in the show notes as well, but reveri.com. And I would imagine that can be found in the App Store as well, but R E V E R I.

• 1:35:19Speaker 03

  R E V E R I.

• 1:35:20Tim Ferriss?

  In addition to that, are there any resources? Because I'm sure there's the good, the bad and the ugly when it comes to hypnosis resources, whether those are books, documentaries or otherwise. Are there any particular resources for those who would like to try to educate themselves more? Explore this more?

• 1:35:36Speaker 03

  You know, there are a number of good professional hypnosis societies that have members who are professionally trained and use hypnosis. The Society for Clinical Experimental Hypnosis, S C E H dot U S. The American Society of Clinical Hypnosis, A S C H dot N E T. There's an international society of hypnosis for your listeners who are elsewhere. There are good textbooks on hypnosis. We've written one of them called Transent Treatment. My late father and I read.

• 1:36:02Tim Ferriss?

  Transent Treatment.

• 1:36:03Speaker 03

  That's available. There are other good apps. There's OneLeaf, which is a French app that the French government has invested in that has excellent recordings to help people use hypnosis. There's one called Nerva out of Australia that helps people with irritable bowel syndrome, and hypnosis can be very effective for that as well. So there are more and more of those apps coming as well that seem to help people manage with hypnosis. So it's growing, the list is growing.

• 1:36:33Tim Ferriss?

  So we'll link all those. And transent treatment, I must ask, since you mentioned Bali, and I've seen various types of...

• 1:36:41Speaker 03

  Yeah.

• 1:36:42Tim Ferriss?

  I think what we would consider trance, whether that's Sufi's spinning, or various types of repetitive singing, droning. Do you have any particular longstanding type of trance that you find most interesting or appealing?

• 1:36:59Speaker 03

  There's a sociologist's book called Boiling Energy about the use of drumming, actually, as a kind of trance-inducing experience in Africa. And there's no question that people use that kind of rhythmic activity as a way of socially connecting and soothing themselves, you know? And there's something about being in that rhythm of rate that is usually roughly the rate of heartbeat, you know, about one a second, that helps people. And it's why people like to dance and sing and things like that. I think we coordinated social activity that gets the body involved that can be very soothing, actually. And so I think a lot of our healing rituals involve repetitive movement that people find soothing.

• 1:37:43Tim Ferriss?

  David, thank you for what a... What a fantastic, wide-ranging conversation this became. And is there anything else you'd like to mention? Of course, people can find Reverie at reveri.com. R-A-V-E-R-I dot com. Is there anything else you'd like to

• 1:37:57Speaker 03

  Thank you.

• 1:37:58Tim Ferriss?

  mention or point people to?

• 1:38:00Speaker 03

  It's from the App Store and Google Play as well has it if people have Android phones. I would say, I think we've talked about the major uses of it. I would love it if people give it a try, see it as a first recourse, not a last recourse. And I'd love to see it integrated better with people's overall health and wellness care. I think it's been sort of the Rodney Dangerfield of psychotherapies.

• 1:38:27Tim Ferriss?

  Can't get no respect.

• 1:38:28Speaker 03

  Yeah. He said, "They asked me to leave a bar so they could start happy hour."

• 1:38:35Speaker 03

  After having done this my entire career, this is a legacy project for me. You know, a time will come when I'm not available to keep doing this for people. It warms my heart that while we've been talking, I've helped more people than I used to in months of person-to-person clinical activity. And I want people to have it as a resource for helping themselves feel better and function better. And I think it can. So, thank you for helping me do that, because that's the same kind of thing you're doing with your show, and I'm honored to be a part of it.

• 1:39:06Tim Ferriss?

  My pleasure entirely. What fun. This is the best job on earth, as far as I'm concerned. And to everybody listening, we will have links to all things discussed in the show notes, as per usual, at tim.blog/podcast. Spiegel, S-P-I-E-G-E-L. You can just search it there and it'll pop right up. And until next time, as always, just be a little kinder than is necessary to others and to yourself. Thank you for tuning in.

• 1:39:33Tim Ferriss?

  Hey, guys. This is Tim again. Just one more thing before you take off, and that is Five Bullet Friday. Would you enjoy getting a short email from me every Friday that provides a little fun before the weekend? Between one and a half and two million people subscribe to my free newsletter, my super short newsletter called Five Bullet Friday. Easy to sign up, easy to cancel. It is basically a half-page. That I send out every Friday to share the coolest things I've found or discovered, or have started exploring over that week. It's kind of like my diary of cool things. It often includes articles I'm reading, books I'm reading, albums perhaps, gadgets, gizmos, all sorts of tech tricks and so on that get sent to me by my friends, including a lot of podcast guests.

• 1:40:15Tim Ferriss?

  And these strange esoteric things end up in my field, and then I test them, and then I share them with you. So if that sounds fun, again, it's very short, a little tiny bite of goodness before you head off for the weekend, something to think about. If you'd like to try it out, just go to tim.blog/friday, type that into your browser, tim.blog/friday, drop in your email, and you'll get the very next one. Thanks for listening. This episode is brought to you by Helix Sleep. Helix Sleep is a premium mattress brand that provides tailored mattresses based on your sleep preferences. Their lineup includes 14 unique mattresses, including a collection of luxury models, a mattress for big and tall sleepers, that's not me, and even a mattress made specifically for kids.

• 1:40:59Tim Ferriss?

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• 1:41:41Tim Ferriss?

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• 1:42:24Tim Ferriss?

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• 1:43:07Tim Ferriss?

  Momentus offers high-quality supplements and products across a broad spectrum of categories, including sports performance, sleep, cognitive health, hormone support, and more. I've been testing their products for months now, and I have a few that I use constantly. One of the things I love about Momentous is that they offer many single ingredient and third-party tested formulations. I'll come back to the latter part of that a little bit later. Personally, I've been using Momentous Mag 3 and 8, L-theanine, and apigenin, all of which have helped me to improve the onset quality and duration of my sleep. Now, the Momentous Sleep Pack conveniently delivers single servings of all three of these ingredients. I've also been using Momentous Creatine, which doesn't just help for physical performance,

• 1:43:51Tim Ferriss?

  but also for cognitive performance. In fact, I've been taking it daily, typically before podcast recording, as there are various studies and reviews and meta-analyses pointing to improvements in short-term memory and performance under stress. So those are some of the products that I've been using very consistently, and to give you an idea, I'm packing right now for an international trip. I tend to be very minimalist, and I'm taking these with me. Now back to the bigger picture. Olympians, Tour de France winners, Tour de France winners. The US military and more than 175 college and professional sports teams rely on Momentous and their products. Momentus also partners with some of the best minds in human performance to bring world-class

• 1:44:32Tim Ferriss?

  products to market, including a few you will recognize from this podcast, like Dr. Andrew Huberman and Dr. Kelly Starrett. They also work with Dr. Stacy Sims, who assists Momentous in developing products specifically for women. Their products contain high-quality ingredients that are third-party tested, which in this case means informed sport and/or NSF certified, so you can trust that what is on the label is in the bottle and nothing else. And trust me, as someone who knows the sports nutrition and supplement world very well, that is a differentiator that you want in anything that you consume in this entire sector. So, good news. For my non-US listeners, more good news, not to worry. Momentus ships internationally, so you have the same access that I do. So, check it out.

• 1:45:14Tim Ferriss?

  Visit livemomentous.com/tim and use code TIM at checkout for 20% off. That's livemomentus, L-I-V-E-M-O-M-E-N-T-O-U-S dot com slash TIM and code TIM for 20% off.