Using Hypnosis to Enhance Health & Performance | Dr. David Spiegel

KEYPOINTS

• 01

  Hypnosis is highly focused attention, not sleep or loss of control

  Spiegel likens it to looking through a telephoto lens: rich detail with little surrounding context. Getting so absorbed in a film that you're part of the movie rather than evaluating it is a hypnotic-like state. Rather than giving up control, self-hypnosis is a way to gain more of it over your mind and body.

• 02

  Three brain changes mark entry into hypnosis

  In Spiegel's fMRI work comparing highly and non-hypnotizable people, activity drops in the dorsal anterior cingulate cortex (part of the salience network, a 'conflict detector'), so you're less easily pulled out. Connectivity rises between the left dorsolateral prefrontal cortex (executive control) and the insula, a mind-body control hub. And the DLPFC becomes inversely coupled with the posterior cingulate (default mode network), which underlies the dissociation of doing something without reflecting on what it means for you.

• 03

  Hypnotizability is a stable trait you can measure

  About a third of adults are not hypnotizable, about two-thirds are, and roughly 15% are highly hypnotizable. Spiegel scores it 0–10 with the Hypnotic Induction Profile. Practice may raise it slightly: in one training study, initial scores explained about three times as much of the final score as training did. Spiegel says it's better to use the capacity you have than to try to boost it.

• 04

  The eye-roll sign roughly predicts hypnotizability

  Developed by Spiegel's father, Herbert Spiegel: look up toward the ceiling, then slowly close your eyelids while keeping your eyes up. If mostly the white of the eye shows as the lids close, you're likely moderately to highly hypnotizable; if the iris drops into view, likely less so. Closing your eyes while staying alert is an unusual state that signals the brain to turn inward.

• 05

  Hypnosis can separate the body's stress reaction from the stressor

  Stress snowballs: you notice your heart racing or sweating, interpret it as bad, and feel worse. Spiegel teaches people to imagine their body floating somewhere safe (a bath, a lake, space) while picturing the problem on an imaginary screen. The rule is to keep the body comfortable whatever appears on the screen. You can't control the stressor yet, but controlling your physical reaction restores a sense of agency and room to plan one step.

• 06

  Hypnosis is a problem-focused tool with specific best uses

  Spiegel highlights stress, sleep, pain, phobias, smoking cessation and habits. For ADHD and OCD it depends on hypnotizability: very obsessional, over-controlling people tend to evaluate rather than experience, and often score low. Spiegel guesses that many people with ADHD would not be very hypnotizable, but says he hasn't studied it.

• 07

  Repeated practice may strengthen these networks

  Citing Carla Shatz's 'neurons that fire together wire together' (Huberman notes it is often misattributed to Donald Hebb), both suggest regular self-hypnosis trains the circuits. You can practice during the day for stress, then use the skill when a stressor or a middle-of-the-night waking comes up.

• 08

  Stage hypnosis gives the practice a bad name and can cause harm

  Stage performers pre-screen audiences for the most hypnotizable people. Spiegel's father treated a woman who wandered New York dissociated after a stage hypnotist had her play with an imaginary bird. The image had tapped her feeling of being 'a bird in a gilded cage'. The same suspension of critical judgment that makes hypnosis therapeutic can be misused.

• 09

  Breathing and eye position are key ingredients

  Spiegel now emphasizes a deep breath followed by a slow exhale during induction, informed by joint work with Huberman suggesting exhale-emphasized breathing such as cyclic sighing promotes parasympathetic calm. Hypnotic-like states also occur at peak performance: pianists who 'float above the piano' and athletes in flow aren't thinking step by step.