The unique effects of hypnosis on the brain suggest that it can be a powerful way to relieve pain, and might even be an alternative to opioids, one expert believes.
The power of hypnosis to alter your mind and body is thanks to changes in a few specific areas of the brain, according to a new study from the Stanford University School of Medicine.
‘Hypnosis causes altered activity in a few specific areas of the brain. A treatment that combines brain stimulation with hypnosis could improve the known analgesic effects of hypnosis and help replace painkillers and anti-anxiety drugs.’
Researchers used functional magnetic imaging to scan the brains of participants during guided hypnosis sessions similar to those that might be used clinically to treat anxiety, pain, or trauma They discovered three distinct sections of the brain are influenced in subjects that are hypnotizable. They found distinct neural areas experience altered activity and connectivity while someone is hypnotized.
"Hypnosis is the oldest Western form of psychotherapy, but it's been tarred with the brush of dangling watches and purple capes," said the study's senior author, David Spiegel, M.D., professor and associate chair of psychiatry and behavioral sciences at the Stanford University School of Medicine "In fact, it's a very powerful means of changing the way we use our minds to control perception and our bodies."
Despite a growing appreciation of the clinical potential of hypnosis, though, little is known about how it works at a physiological level. While researchers have previously scanned the brains of people undergoing hypnosis, those studies have been designed to pinpoint the effects of hypnosis on pain, vision and other forms of perception, and not the state of hypnosis itself.
When Dr. David Spiegel emerged from a three-hour shoulder surgery in 1972, he didn't use any pain meds to recover. Instead, he hypnotized himself. It worked, to the surprise of everyone but Dr. Spiegel, who has studied hypnosis, a state of highly focused attention and intense concentration, for 45 years. Patient using very little pain medication, he remembers reading from his chart when he snuck a peek. We mustn't have cut many nerves.
Being hypnotized feels like what happens when you become so absorbed in a movie that you forget you're watching one at all, like you have entered an imagined world, Spiegel says. This trance-like state, in which you're more open and suggestible than usual, can be an effective tool to control pain, ease anxiety, quit smoking and deal with stress, trauma and even hot flashes, research shows. How it does that is what Spiegel, and his colleagues wanted to find out in their new study published in the journal Cerebral Cortex
Spiegel and his colleagues screened 545 healthy participants and found 36 people who consistently scored high on tests of hypnotizability, as well as 21 who scored on the extreme low end of the scales, who served as controls. The ability to be hypnotized is a highly stable trait that can be tested by a hypnosis practitioner in a five-minute mini-hypnosis session. Not everyone can be hypnotized, but two thirds of adults can, and people who are easily hypnotized tend to be more trusting of others and more intuitive. Only about 10% of the population is generally categorized as highly hypnotizable, while others are less able to enter the trance-like state of hypnosis.
They used functional magnetic resonance imaging, which measures brain activity by detecting changes in blood flow. The scans were done during several different conditions- at rest, while recalling a memory and during two bouts of hypnotism.
"It was important to have the people who aren't able to be hypnotized as controls," said Spiegel. "Otherwise, you might see things happening in the brains of those being hypnotized but you wouldn't be sure whether it was associated with hypnosis or not."
Three interesting things happened in the brain, but only in the highly hypnotizable group, while they were being hypnotized. The researchers saw a drop in activity in the dorsal anterior cingulate, part of the salience network of the brain. It is a context decoder a part that alerts you to what you should attend to and what you can ignore. This part of the brain, which fires up when there's something to worry about, actually simmers down during hypnosis.
The second change was an increase in conections between the dorsolateral prefronta cortexl, the part of the brain where you plan things and carry out routines and the insula, a part of the brain that helps regulate body functions, like increasing blood pressure and heart rate. Spiegel describes this as a brain-body connection that helps the brain process and control what's going on in the body.
Finally, the research team also observed reduced connections between the dorsolateral prefrontal cortex and the default mode network, which includes the medial prefrontal and the posterior cingulate cortex.
"One thing you see in hypnosis is that people tend to do things but not reflect on their doing it," Spiegel says. "That's why sometimes people will do embarrassing or silly things in staged hypnosis shows they're not thinking about themselves doing it, they're just doing it."
During hypnosis, this kind of disassociation between action and reflection allows the person to engage in activities either suggested by a clinician or self-suggested without devoting mental resources to being self-conscious about the activity.
In patients who can be easily hypnotized, hypnosis sessions have been shown to be effective in lessening chronic pain, the pain of childbirth and other medical procedures, treating smoking addiction and post-traumatic stress disorder and easing anxiety or phobias.
The new findings about how hypnosis affects the brain might pave the way toward developing treatments for the rest of the population, those who aren't naturally as susceptible to hypnosis. "We're certainly interested in the idea that you can change people's ability to be hypnotized by stimulating specific areas of the brain," said Spiegel.
A treatment that combines brain stimulation with hypnosis could improve the known analgesic effects of hypnosis and potentially replace addictive and side-effect-laden painkillers and anti-anxiety drugs, he said.
More needs to be learned about hypnosis in order to harness its potential effects and for that, researchers need to take it seriously, Spiegel says. "If opiates affect certain regions of the brain like the dorsal anterior cingulate and some other brain regions, there's no reason why we can't use a different approach to produce similar effects in the brain that are real effects that reduce pain and anxiety and help people stop smoking," he says.