Defining hypnosis has always been difficult: we can see the effects, such as behavioural changes or reduced pain, but exactly how they come about is less clear. In fact, one study suggested that:
‘Hypnosis has
always been an enigma, and it can be said that the more it is subjected to the
light of modern empirical scrutiny, the more it eludes definition.’ [1]
In this article, I’m going to see how far recent advances in neuroscience might help us to resolve that enigma and shed some light on the nature of hypnosis.
Does hypnosis exist?
There have always
been disagreements about what hypnosis is and what it can do. Historically, the
arguments tended to be around whether hypnosis was primarily a physical state
(Mesmer’s Animal Magnetism, Charcot’s emphasis on pathology) or a psychological
one (Braid’s neurophysiological theory, Liebeault and Bernheim’s psychotherapy).
But there have also been discussions about whether it exists at all. That
particular argument works like this [2].
- The ‘non-state’ (or
socio-cognitive) theories say that hypnosis essentially doesn’t exist except as
a social construct. In this theory, people taking part in hypnosis are actively
involved with what is going on, and their responses to suggestions made by the
hypnotist are explained by contextual and psychological factors such as
compliance, conformity, obedience, social roles, expectation, etc. Inductions
and other rituals connected with hypnotising people simply enhance those other
effects. (Sarbin, 1950; Spanos, 1986; Kirsch, 1985, 1991, 1994)
- The ‘state’ (or intrapersonal) theories work on the basis that hypnosis exists as an identifiable and specific altered state of consciousness. Responses to suggestions made by the hypnotist are a result of being in this altered state of consciousness and/or an associated change in suggestibility, brain function, or reality distortions. Of course, the other factors mentioned above also play a part (we can’t avoid them) but they do not explain all the results. (Hilgard, 1974, 1986; Woody & Bowers, 1994; Gruzelier, 1998).
With new technology, such as functional neuroimaging, researchers can see precisely how hypnosis changes the brain’s activity. This means that neuroscience can hopefully give us a greater understanding of hypnosis and how it works to help our clients.
What happens when we’re hypnotised?
A study carried out
at Stanford University (Jiang et al. 2017 [3]) used functional imaging to record
brain activity in four different conditions, which were applied in different
and random order, using subjects who scored both very high and very low for
hypnotisability:
- Being asked in
hypnosis to imagine a time when they felt happy,
- Being asked in
hypnosis to remember or imagine a holiday,
- Being in a resting
but un-hypnotised state,
- Being asked to
recall a memory in an un-hypnotised state.
- Focused Attention: Activity
was reduced in the Dorsal Anterior Cingulate Cortex, which is a warning system
that tells you when something needs your attention. When it slows down, your
focus is narrowed, and it helps you to tune out distractions.
- Emotional Control: The
connections between the Dorsolateral Prefrontal Cortex and the Insula increase.
The DLPFC controls what we think of as the ‘executive functions’ that help with
planning and decision-making. The Insula monitors your bodily awareness and
emotional responses. When the two work more closely together, you have more control
of your physical and emotional reactions.
- Reduced Self-Awareness:
The connections between the Dorsolateral Prefrontal Cortex and the Default Mode
Network in the brain are reduced. The DMN includes the Posterior Cingulate Cortex, which
is associated with self-awareness and as above, the DLPFC is associated with
executive functions. When the self-awareness and decision-making parts of the
brain are less connected, you feel less self-conscious and less aware of normal,
everyday thoughts. You are immersed in what is happening ‘in the moment’.
Other studies, such
as Egner et al. (2005)[4] and Rainville & Price (2003)[5] have supported the idea
that hypnosis alters brain regions involved in attention control, sensory
experiences and inhibition.
That goes a long
way towards explaining the effects we see both on the stage and in the therapy
room. If hypnotised individuals are less inhibited by what they think they ‘should’
do, think or feel, interpret sensory experiences differently, are more in
control of usually automatic responses, and are more focused on the interaction
between themselves and the hypnotist, they are much more likely to go along
with the suggestions they’re given, whether that is to cluck like a chicken or
feel less anxiety or pain.
Cognitive changes in hypnosis
You will almost
certainly have come across the Stroop Effect, even if you don’t know the name. It’s
when people have trouble processing conflicting bits of information.
Try this. Name the colour of this word out loud - BLUE. Did you find that tricky? Because it’s printed in red, there is a conflict between the instructions you've been given and the automatic response of reading the word - even if you said 'red' it probably took you longer than you'd usually need to read such a simple word.
In hypnosis, however, people can bypass this conflict, suggesting a change in automatic thought processes. When hypnotised subjects are given a suggestion to see letters as meaningless symbols, the processing conflict doesn’t happen and they can say the colour of BLUE as easily as BLUE. (Oakley & Halligan, 2011 [6]). This works with other automatic attentional processes as well.
Other researchers (Raz and Campbell, 2011 [7]) have referred to this as ‘hypnotic dyslexia’ and it’s possible that comparing scans of neurotypical and dyslexic people in and out of hypnosis who are processing this kind of task will help us understand more about that condition.
Does research help us define hypnosis?
I believe it gets
us further forward but doesn’t (yet) provide a fully satisfactory definition.
Most studies are
more focused on what hypnotherapy does rather than what it is, so there are
still questions to ask about its fundamental nature.
Does research answer the state/non-state question?
The research strongly suggests that, under hypnosis, predictable brain changes take place which implies a distinct state. But, again, most researchers look at the brain’s reactions to suggestions during hypnosis rather than on the hypnotic state itself. [8]
To clarify whether these changes are due to hypnosis or simply the power of suggestion, we need more studies comparing the brain’s response to suggestions both in and out of a hypnotic state.
The future of hypnosis in neuroscience
Kihlstrom (2013)[9] says that ‘Future developments in this area … will require more than machine time, computational power, and a tame hypnotist.’
I’ve already mentioned the possibility of gaining more understanding of dyslexia by using hypnotic suggestions, and other conditions might benefit in the same way. For example, Kihlstrom (ibid.) suggests that, by comparing scans of brains before, during and after a hypnotically induced amnesia experience, we may learn a lot about how memory works.
While some elements of hypnosis remain difficult to pin down, exploring it through neuroscience is offering fresh insights. And it works both ways. In exploring hypnosis, we might also come to a better understanding of brain functions like memory, attention, and even conditions like dyslexia.
So, as we learn about hypnosis
from neuroscience we can also reach a better understanding of neuroscience from
hypnosis.
References:
[1] Pratt et al, (1988) A clinical hypnosis primer, New York: John Wiley and Sons.
[2] Hypnosisandsuggestion.org. (2012). Theories of Hypnosis | Hypnosis and Suggestion. [online] Available at: https://hypnosisandsuggestion.org/theories-of-hypnosis.html.
[3] Cerebral Cortex, Volume 27, Issue 8, August 2017, Pages 4083–4093, https://doi.org/10.1093/cercor/bhw220
[4] Egner, Tobias, Jamieson, Graham, Gruzelier, John, Hypnosis decouples cognitive control from conflict monitoring processes of the frontal lobe, NeuroImage, Volume 27, Issue 4, 2005, Pages 969-978, ISSN 1053-8119, https://doi.org/10.1016/j.neuroimage.2005.05.002.
[5] Rainville, P., & Price, D. D. (2003). Hypnosis Phenomenology and the Neurobiology of Consciousness. International Journal of Clinical and Experimental Hypnosis, 51(2), 105–129. https://doi.org/10.1076/iceh.51.2.105.14613
[8] Halligan, P. W., & Oakley, D. A. (2014). Hypnosis and beyond: Exploring the broader domain of suggestion. Psychology of Consciousness: Theory, Research, and Practice, 1(2), 105–122. https://doi.org/10.1037/cns0000019
[9] Kihlstrom JF. Neuro-hypnotism: prospects for hypnosis and neuroscience. Cortex. 2013 Feb;49(2):365-74. doi: 10.1016/j.cortex.2012.05.016. Epub 2012 Jun 5. PMID: 22748566; PMCID: PMC3528837.
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Author: Debbie Waller is an experienced hypnotherapist and hypnotherapy trainer. She is the author of Anxiety to Calm: a Practical Guide to a Laid-Back Life, The Hypnotherapist's Companion, Their Worlds, Your Words, and The Metaphor Toolbox, all available from Amazon or direct from the author. Find out more about Debbie's services on
Yorkshire Hypnotherapy Training - multi-accredited hypnotherapy practitioner training, taster days and foundation levels.
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