#985 - Dr David Spiegel - Hypnosis, Brain Hacking, & Mental Mastery

26:41So, you know, I have seen some of the great hypnotists and hypnotic professionals work for a long time with someone who is just not hypnotizable and it doesn't matter. They just cannot respond. And so the way I start every session of about 7 ,000 people I've used hypnosis within my career with a five minute evaluation of their hypnotizability. And that guides me in how to work with them. So if they're extremely high, we just do it. You know, I had a woman who was born with a soft -adjeele fistula to her trachea. And so it meant, you know, food would get it to her lungs, and she was painful. She's had multiple surgeries, and she's had pain in her throat throughout her life.

27:25And she's about 39, and she just had it. And I got her hypnotized. As she was 10 on the scale, 10 out of 10. extraordinarily hypnotizable, hands floating up in the air. And I had her imagine that she had swallowed some ice water and had soothed her throat. And she opened her eyes and she started to cry and she said, you're a magician. She said, I have never been to a doctor where the pain just plain went away. And this was not medication. It wasn't surgery. It was just teaching her brain how to respond to those signals differently. So with highs you can do that dramatic stuff. With mid -range people you negotiate more.

28:07You teach them how to try it out, evaluate how it went, see if there are ways that they can find a better image that might work better for them. So it's a negotiation process. With lows it's much more cognitive. It's just, you know what? Your brain is reacting to this history of discomfort that you've had and it may be making it worse instead of better. So if instead of fighting the pain, you take it as a message, you got the message. And what else can you do that will distract you? For the lows, it's sounding suspiciously close to acceptance and commitment therapy. There's a bit of that in it.

28:45But for highs, ACT is just a diversion. You know, they can do it in minutes and feel it. Wow. What does the assessment look like for that? How How do you walk? How do you walk in? It's a standard hypnotic induction. I have people look up close, their eyes take a deep breath, let their hand go up in the air and I give them the instruction. Your hand will remain light and in this upright position. Even after you open your eyes, if I pull your hand back down it will float right back up to the upright position. You'll find something pleasant. I'm using about this. Later when I touch your elbow your usual sensation and control will return.

29:25And I see how well then they respond to that. And we rate them on the sense of dissociation. Does the left hand feel as if it's not as much a part of their body as the right? On their response to a challenge where you pull the hand down and see if it floats up, on a sense of involuntaryness, crucial questions. Is your left, do you feel more control over one hand than the other? And if they're hypnotizable, they tend to feel more control and then on a hypnotized hand. then response to the cutoff signal when I touch the elbow. And so it's two points for each of these. And then two points for whether they had a sense of floating lightness or buoyancy in their hand alone or in their body as well.

30:04And so you get a ten point score and it's a very stable, reliable measure. What I'm interested in is what are the sort of people who tends to be, ten sexes, fours and zeroes or ones. Can you see when somebody walks in or if you were given a profile of somebody beforehand, high -powered chief operations officer, very logistical and rational? Is it less likely that that person's going to be high in hypnotizability compared with the artsy creative person who comes in with dyed hair and tattoo, you know what I mean? Like, you're right. And there's some truths to that. I mean, you can miss sometimes.

30:44But, But yes, in general, people who were organized, who want to have things just the way they need to be, tend to be less hypnotizable. I had a guy recently who had bad lower back problems and pain in his knees, but a very sort of rational, he went to a million doctors and nothing seemed to work. And they took X -rays and they didn't see anything definitive, but there may be things wrong. and routinely I ask what, well, what's your hand in this? Are you right or left handed? Tough question. And he said, well, I'm right handed, but I always want my left hand to be equally active. So I always use my left hand the same way just after I use my right hand.

31:27So like a real simple question, you know, what hand in this do you have? And he had to analyze that too. Yeah, yeah. And he was a zero, like flat out zero. And I said that to him, you know, he came to me for hypnosis. And I said, you know, I think your problem is that you make everything a problem. You worry about everything, including whether you're right or left handed. And I think your doctors have been telling you, there's nothing that wrong with your bones and your joints, and you keep worrying about it. And he looks sort of relieved. I thought he'd get mad at me. He said, you know, Doc, all the doctors I've seen, you're the first one who's told me that, and I think you're right.

32:06And so I said, the problem is the signal is weak, but your elaboration in the signal is high. So just think about other things than that. So you've had to go top down, not bottom up with him because he's a zero? That's right. It's much closer to act, all the CBT or something than hypnosis. But it's also, you know, focus on what you're for, not what you're against. Don't fight it. You know, we say with hypnosis, the worst thing you can tell someone is don't think about purple elephants. You know, what are you going to think about? So instead you find a strategy that's appealing that they can affiliate with and feel good about from the moment they do it.

32:42For mid -range people it's more triad and let's discuss it. You know, it's kind of they have the yeah, you know, I do feel somewhat better. You know, I had a pianist, a guy who was a, you know, a professional pianist, but to make a living, you know, the saying about the difference between a musician and a pizza, a pizza can feed an average family of four. He had a day job in construction and he'd gotten himself injured and had a lot of pain. It got to where he couldn't manage the pedals on the piano well and it was really awful for him. But he was frustrated. He was mid -range in hypnotized ability.

33:24Frustrated that he kept getting distracted from his favorite thing, which was to play. So I had him hypnotized and I said your body is floating Cool and comfortable and I want you to play air piano for me So he's there hypnotized he's playing You know, I can actually enjoy this you know this is good. I wrote this song I really like this and he reduced his pain from five to like two to three and So it was a sort of negotiation with him trying out different things and doing it and with the highs It's like that lady with the throat and Trekkie a problem She just did it. She's a she cool tingling and numb.

34:02It's gone. She did it. Digging into this sort of profile thing a little bit more. First off, have you ever done any behavioral genetics studies on the heritability? Yes. Okay. And we found there's one gene that's very interesting. It's catacole -o -methyl transferase. It's a gene that is in the metabolism of dopamine in the brain. Dopamine is to feel good, neurotransmitter. Okay. It is involved in hypnotized ability. Okay. Can you give me the gene? What's the gene name? C -O -M -T, C -A -T -E. I already know that I have this. Oh, methyl transfer. So it's what are you looking for? It's the metabolism of C -O -M -T.

34:43Yeah. Okay. If you have, there's one polymorphism where you have either two methanines, two valines or a methanine and a valine. And the methionine -availing version has moderate metabolic rate of COMT. So it keeps the kind of moderate level. Can I just give you mine? Yes, what's yours? Your COMT gene variant is the Val 158MAT RS4680AA genotype, also written as MATMAT. MATMAT, but you said it was ValMAT before. Let me see.

35:20So you're met me. If you're met me, you're likely to be less sympathizable. High dopamine and epiphylocorectus, lowlycylone TNT and same activity. Yeah. So that would make you less sympathizable. Interesting. The valmet, the the the the heterozygous polymorphism is more likely to be very, but it doesn't mean you're not, but it means. So you want high fast dopamine clearance? Well, no, you want moderate dopamine. If you clear it too quickly, you're low. Oh, you want Valmet, you want GA. You want Valmet, yes. Right, okay, interesting. So yeah, I've got slowed dopamine clearance. It's fantastic for getting me addicted to things.

36:01Yeah. Yeah, higher baseline dopamine potential in hands cognitive performance when working on memory task runs stresses low, you know, so making them mentally rigid or over focused under pressure. which I imagine is, it sounds highly movable and able to stress an anxiety, especially social performance -based stress. Prefrontal cortex can become impaired into high stress. Interesting. That's fascinating. Okay, sounds like your African journey just a bit. Exactly. That's why I haven't been back to see that elephant again. I've been remembering it. And so that was the first thing. Second thing, what are you mentioned by early adult hood?

36:41You kind of locked in to your area of this. What are the lifestyle predictors? We've got at least CMT variant, I want to be an intermediate dopamine clearer. What are the lifestyle factors that would predict if you're doing twin studies? Why does not you come into making hypnotizability different? Different. And that makes it, it does in two opposite ways. The good news is what's called imaginative involvements. So if you know when you're putting your kids to sleep, you have them tell them a story and they affiliate with the story I used to tell my kids that they were in a raff floating down a river and they go floating down the river.

37:26If you have a lot of those experiences, is you tend to be more hypnotizable. And the other, unfortunately, is a negative one. And that is, people who have been abused tend to use dissociative abilities to distance themselves. You got my body, but you haven't got me. Oh, so that trauma response is that way of surviving the situation, but predisposes them to a much more gentle version of that being re -injuiced. Well, yeah, they hang on to it. They just, you know, they just go somewhere else, you know. That's it. Before we continue, if you haven't been feeling a sharp or energized as you'd like, getting your blood work done is the best place to start, which is why I partnered with function because they run lab tests twice a year that monitor over 100 biomarkers.

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38:46Just go to the link in the description below. I head to functionhealth .com slash modern wisdom. That's functionhealth .com slash modern wisdom. is openness to being hypnotized in adult herda skill that you can train then like mindfulness. 97 is how stable it is. That means point three if you got control of that. Not really. We have done one recent study in which we use trans cranial magnetic stimulation. You know, it's a magnetic stimulation that's being used very successfully to treat depression and suicidal ideation and obsessive compulsive disorder now, very effective. We used it to suppress activity in the dorsal anterior singulate.

39:28We located the connecting pathways and we found that transiently we could increase hypnotizability with TMS and the idea would be that perhaps for some people with pain who aren't that hypnotizable, we could combine TMS with hypnosis and enhance the response. Sounds like a new study. So you may not have just published it. You may not have the answer to the question, which is pretty obvious from that, which is you're talking about a state change there. How embedded would a hypnosis -induced trait change be if the state change of the person is only acute and not chronic? Do you hold onto the gains of hypnosis if you were briefly hypnotizable but then revert back to being less hypnotizable?

40:15Well, we don't know. That's a very good question. I'd like to find out. But there is a possibility because what we find is with people, even those who are very eventizable, is, first of all, even those who are not so appetizing, with wherever we've done it with thousands of people not teaching them to reduce their pain levels, their stress levels, to get to sleep, we find that four out of five people get significant reduction in pain, 15, 20 % reduction in pain and stress in 10 minutes. And even the low hypnotizable gets some relief because of the idea that they can do it and the way we approach the problem, focusing on what you're for, what can you control and what can't you control.

40:58And so you can get benefit even if you're not that hypnotizable. Use the approach and see if it helps. And the nice thing about hypnosis is the worst thing it happens is it doesn't work. work. You know, 118 ,000 Americans died of opioid overdoses last year in the United States. Hypnosis is the oldest conception of psychotherapy. It's been around for 250 years. We haven't succeeded in killing anybody yet.

41:23So, you know, try it. The worst thing that happens is it doesn't work. Is it more effective in person? You know what? I would like to think that because I've made my living and I love seeing people and caring for them. But I have to tell you that it's so far it looks like the pain and stress reduction rates are about the same. We have one study that really tested that. We published a paper like 30 years ago in person use of hypnosis to help people stop smoking. We have them imagine you don't say oh I don't like saying I had a a teacher in Tom Hackett was the chair of psychiatry at Miss General and he taught me my first hypnosis course and he said I was teaching people that their cigarettes would taste like horseshit, you know, and so the guy would light it up that's terrible thanks Two hours later he got a frantic call from the guy and said my house smells terrible and Dr.

42:20Hackett said, well, are you smoking? He said no, I forgot to tell you that my wife smokes So he had to hit the wife and you're or she didn't want to so he said you know your cigarettes but not her it doesn't work it's not a good strategy. So what we do is we tell people in hypnosis to think about three things for my body smoking is a poison. I need my body to live I owe my body respect and protection. So you focus on what you're for I tell them would you ever take your baby and put tar and laden heated smoke in their lungs. Hell no, well your body is as dependent on you as your baby. You know, you don't have to take a fan self.

43:01Anything you put into it, even if it's damaged by it. So you focus on what you're for and that way you don't feel you're depriving yourself of something. You can feel good from the moment you did it. The best way to change human behavior is intermittent positive reinforcement. So you say you can feel good about this. So we We built an app, so we got one out of four people to stop. Half stopped right away, one out of two stopped right away, half of them had not touched a cigarette any year. How many sessions? From one session, single session, self -regulatory. And that's as good as you'll get with verenoclin or buproprian, the medications that are used to get people to self -sort.

43:42or okay. And so, it's good to be appropriate on to get this. It's a well -butedron. Yeah, it's an anti -depressant that also seems to work. That's interesting. An SNRI interjects for smoking cessation. Yes. I didn't know that. I know that I have a few friends that we both are aware of who are using microdose low dose while butrin as a neutropic, daily neutropic, like way below the therapeutic threshold that you would be using in order to step in. We'll see how long that goes for. I'll have to check in with them and see if they're still doing it. But yeah. So we tested, we then, hypnosis app company, wherever we got started at a Stanford Brain Mind Summit about five years ago, when Ariel Polar, who's a graduated Stanford Business School MIT, and helped to start Strava, you know, the exercise app, came up to me and he said, I gave a talk on Hypnosis.

44:48He said, hey, you want to try making an app and see if that might work? So I said, sure, let's do it. And we, Alex at the time, was making a real easy to program things because they wanted to recruit more customers for Alexa. So we built a smoking app. But same principle for my body smoking is a poison. I need my body to live on my body respecting protection. And you know what? We got the same results. It's very frustrating. I didn't have to be there in person. Oh, you're out of a job. Well, hopefully I'm in a new one. Where my Malifla voice is saying for my body smoking is a poison. I need my body to live on my body respecting protection.

45:26And we got one out of four stop smoking with the app. And actually the rest of the people cut their average cigarette consumption by about half, which for a single session intervention remote is not bad. And that's on the Revery app now. And my favorite bit of feedback came from a social worker in San Francisco who said, you know, I didn't even want to stop smoking. I got in your study. I tried it the first time. I didn't like it. I've been smoking for 25 years. All my friends smoke. I didn't want to stop. And that night I tried it one more time at home. I lit up a cigarette, I looked at it and said, who needs that?

46:05I haven't smoked a cigarette since. She said, my friends can't believe it. And I'm helping them to stop smoking. And then she said, this is some kind of crazy as voodoo shit. And I mean that in a good way. Mm -hmm. So, yes, it's a fascinating work as well. Fascinating. That's a really interesting case study. Somebody who didn't even want it. Didn't even want it. Somebody who didn't even want it. I suppose you know, started this off. There is some concern that people have over a loss of control in some ways. Now this is a loss of control because your team are responsible and they're telling people to move their body in a direction that is objectively better for them, regardless of whether or not subjectively they actually want to change.

46:49But you can see with that a potential vector for something that maybe I don't want to do this. Well, I've been convinced of doing it through hypnosis and perhaps that's, you could have a real nefarious evil person who wanted everybody to smoke. You know, the smoking companies released their own version, obviously, wouldn't be allowed. But, you know, I mean, you have, I don't want to smoke more. And yet I've been convinced to do it. I wonder, I wonder, maybe deep down, she did want to stop smoking. Maybe that was her. I don't know. Yeah, I think she may have. But, But look, Chris, we're social creatures, right?

47:25We're susceptible of social influence. And all you have to do is read the newspapers or listen to the news to see how people can tune in to really crazy ideas and think they're true. All these conspiracies, the child abuse under the garage of the Pete Sethlase. There's all kinds of crap that people believe. And so, you know, he's sown to me, I think it's the fact that we are social creatures and we accept information and don't always judge it very carefully. My favorite study on that was Boston Marathon bombing. So there's a study done around the level of post -traumatic stress that people felt.

48:11individuals who had watched more than 90 minutes of news coverage about the Boston Marathon bombing showed high levels of post -traumatic stress than people who were actually there at the event and lived through it. You know, we've published on that actually because I think you'll study. We studied the response to the 9 -11 World Trade Center bombing and we evaluated people within a month after it happened and then six months later. One of the things we found is that people who watched more than three hours of television today about it were significantly more distressed. They had, it did, you know, and there comes a point where you know all you can know about it and it didn't help.

48:56Also people who lived in social networks that encouraged suppression of emotion, don't talk about it. So, the combination of being overexposed to the stimulus and not having an outlet, not having an outlet where people were more distressed at the time and did worse off six months later as well. So that's absolutely true. And I did a study of, we compared two groups of people, one were reporters who looked at the, who witnessed the execution of Robert Altan Harris, serial killer in California. and they had very high levels of PTSD, even though they were in no personal danger themselves. They were there because they wanted to be there to cover it as a news story.

49:40And we compared that with the levels of PTSD and people who were in a law office at 101 California Street where a disgruntled client came in and shot a bunch of people there. And the levels of PTSD symptoms were about the same in the two groups. So the emotional experience just witnessing it is bad enough. And we identify with people who we see being hurt and victimized and it's deeply upsetting. So you know, and it troubles me, frankly, the average kid by the time they're 20 has watched like 18 ,000 murders on television, you know, you do or in movies. They is TV series. Yeah. Intent. Yeah, I had a really phenomenally fascinating conversation earlier on this week.

50:31I learned that a study was done where they put microphones around the necks of kindergarteners. They did it for a full week. And then they did sentiment analysis on what the microphones picked up. What were these young kids being told? 85 % of the language that was being told to them was negative. Don't do that. You can't go there. Get down from that. You're too late. Stop talking. Get to the, you need to sit down in class. No, you're going to be late for dinner. Parents, teachers, coaches, 85 % of the language that was delivered. And the argument being some parents have a concern around their kids getting out over their skis a little bit too much.

51:16We don't want to give them an ego, want them to make sure that their feet are on the ground. It kind of feels a little bit like making every child British. Don't get too big for your boots. And you think you was the parent, parents, if every single word that you said to your kid was positive, unless you're with them more than 50 % of the time, they're still going to be on the scales going to be balanced in weight of negative language, from what they're from parents from coaches from, you know, everybody else. It's just siblings. It's a very bad way to raise children. It's just asking for trouble.

51:54Because you're a number one, you're belittling them, you're making them feel bad about themselves. And number two, you're telling them not what to do, what not to do, which only focuses their attention more on that, and less on what it is they might do. Our son was a lot of fun. And I would hypnotize him to go to sleep at night. I mentioned that floating down a river. And one night, apparently it didn't work. He came out looking for me and said, Dad, I need a professional. This is not working. Sorry. But he also, we were talking about the dinner party about television and what a bad influencer was on children and all that.

52:33We said, oh, yes, we don't let them watch from the side of the land. And Dan comes padding in and his PJ, his 40 PJs and says, is, Dad, I'll be right back after these messages. You know, so he was letting us know that he was going to do it, whether he told him not to or not. Wow. So, but I think you're absolutely right and it's very disturbing. And that, you know, I mean, now and you know, what's out there, you know, in Instagram and other things, it's really disturbing what you could see on that. It's tough. I've been using 8 -sleep for years and I genuinely can't imagine life without it. Having a mattress that actively cools and heats each side of the bed is a total game changer, and the newest model, the Pod 5, takes things to the next level.

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53:56And if you're still on the fence, there are 30 day sleep trials, so you can buy it and sleep on it for 29 nights, and if like it, they'll just give you your money back, plus they ship internationally. Right now, you can get up to $350 off the pod five by going to the link in the description below. I had to hate sleep .com slash modern wisdom using the code modern wisdom. A checkout that's e i g h t sleep .com slash modern wisdom and modern wisdom. A checkout. Yeah, I mean, I know I had Dr. Paul Turk, you familiar with him? No. Evolutionary pediatrician. So it looks at Pediatrics both clinically and developmentally from an evolutionary lens, ancestral lens.

54:37So a lot of hunter gatherer analysis, he's the guy that found, he was the, I think his team is the one that looked at the he not just coating on rice puffs being able to reverse anaphylaxis in toddlers. So you sort of, I do a controlled exposure over time. I think you can do the same thing with lactose as well to be able to get kids to. And if you do it by age five, then there are H3 or something that they're okay for the rest of time. But this increase in helicopter parenting, snow club parenting, or there might be a little bit of anaphylax, or there was, and then you avoid exposing the child to that, which makes them more susceptible to it in future.

55:20Other bits of insights, it's maybe not directly from him, but it's kind of similar. A house that has a dog in it, the kids are 50 % less likely to have asthma. The same thing goes for houses that these dishwashers are supposed to hand washing. If you're in a house with the dishwasher, you have higher rates of asthma, higher rates of ... Yeah, you know. Yeah, we want this tiny, yeah, exactly at the dog. The dog's coming in. It's just enough. It's just enough of a dog's like that. Same thing goes with this peanut dusting. Anyway. He also found a one in six American adults have flattening of the occipital lobe from how much time they spent laid down as a child.

56:00So you literally have the imprint of your baby bed on the back of your head when you're a 50 year old man or whatever. And again, he's seeing when he looks at hunter -gatherers, you're permanently in different positions. A child that's on the floor is a meal without wheels. It's not even a meal on wheels. It's a male that can crawl a tiny little bit. It's dead. It's gone.

56:28Parents, I understand. I'm getting into parenting territory now. It's very passionate. Parents are worried about what is called co -sleeping or something where the kids in the bed with them. That's a concern. Maybe there's some mechanical reasons why you should be concerned about that, but for all of human history, the baby used you as a bed. Forget the baby being in the bed, you were the bed. It was on you for eight hours or whatever. And that's just what, because it's what's it gonna be on the floor of the cave, like out in the near the, you know, so, looking at the levels of exposure, what it is that kids are exposed to, don't do that, don't go there, you shouldn't do this.

57:09Plus, we roll on top of it. Social media, extreme amounts of news. I have a couple of, you know, another example what you're saying. I'm thinking about how children were born throughout human evolutionary history. You know, no nerve blocks, no anesthesia. Women did it differently. They often did it standing actually because she would let gravity help pull the pavita and they would push and they were fine. My lovely wife, Helen, had both of our children without anesthesia. She did self -hypnosis a stole time. And she wanted to be in control. And I've talked with other women who said, I wanted to control the process.

57:51I wanted to get the baby I wanted needed to go and open myself up and do it. And, you know, there are some advantages, but more and more this evidence of some cognitive brain problems with general anesthesia in general.

58:10And even You know, one does it on the doctor. I mean, too. But we overdo it. And the idea that people can't learn to handle pain, that pain is this sort of unexpected intrusion on my life. I don't want it rather than it's a part of life and a part of managing your body. And you can learn to manage your pain better if you can train your brain to be in a different state than the one it is when you're in pain. What does it say that interventions that do not change the mechanics of somebody's lower back can change their interpretation of the discomfort? What does that say about the way that pain discomfort, the story we tell it, or even emotional pain?

59:05What does that say about the way that that works within the human system. The strain and pain lies mainly in the brain. If you'll forgive a British analogy, think about it. The brain is this control center in the skull. It gets in and interprets information from the body from the world around it and makes sense of it and decides what to pay attention to and what to ignore. Right now, hopefully you're so fascinated by what I'm saying, the guile that the sensations in your bottom touch in the chair we're sitting in, It's not in part of your consciousness, right? Now, as that have knows this well, maybe.

59:41But it's part of the way the brain works. It decides what's worth paying attention to and what isn't. And that has survival value, it has comfort value. And we can train our brain to be different about it. So I had a group of Stanford students. We connected them to a little device that would send electric shocks and measured their of vocal response, if their brain's response sends some out of sensor of vocal response to these shocks. And in the normal condition, they had a pretty substantial P100, P200, P300, EEG response to the series of shocks. We hypnotized them, given exactly the same shocks, but said your arm is in circulating ice water.

1:00:22Cool tingling in them. The P100 disappeared. So within a tenth of a second after the shocks were delivered, the brain is acting like, I don't know these P numbers. P numbers. So, the evoked response looks like just a waveform. And there are standard parts. So the first, the early response is a little peak of activation in the brain. The P200 is usually about twice as big and the P300 about three times as big, a third of a second after. And it's still way the brain receives sensory information and responds to it. But what happened was this first response within a tenth of a second just disappeared.

1:01:04The brain acted like the same signals weren't there. And the P300 is usually a reaction to whether something is either pleasant and interesting or unpleasant or necessary to do something. So the more you have to act on it, the bigger the P200 is. That was half as big. So basically, same signals, the brain was making less of them in the hypnotic analgesic condition. So the brain has to process huge amounts of information and decide what's worth paying attention to and what is the salient coming back on. Is it salient or not? And so the brain can substantially control responses like paint. We did a randomized controlled trial of people having surgery through their femoral artery, threading catheters up, doing chemo -embolization of tumors in the liver, trying to expand arterial constrictions near the kidney and all that.

1:02:01It's not pleasant. It takes about two and a half hours. You don't use general anesthesia. And we randomized subjects into three conditions. Standard care, which meant press a button, you'll get opioids in your bloodstream. That plus a friendly nurse, or that plus learned training and self -hypnosis. And at the end, and this is like 120 subjects, at the end of an hour and a half, the average pain levels for the standard care group were 5 out of 10, 3 out of 10 with a nurse and 1 out of 10 in the hypnosis condition. And we looked at how anxious they were, 5 out of 10 in standard care, 3 out of 10 with a nurse and 0 in the hypnosis.

1:02:39I thought they'd died or something. They were all fine. They used less of the opioids as well. Exactly half as much. Half as much opioids. So they had fewer procedural complications. Yeah, less constipation, right. Exactly. And they got done 17 minutes faster. Because the fact that they had a comfortable patient made the surgical team more efficient, shifting around, they're not having to mediate, they're not having to cajole, or make the feel okay. So hypnosis is an absolutely effective analgesic, even in extreme circumstances. And you'll see people in combat or something who are very badly injured.

1:03:18but they're busy trying to help a buddy and somebody has to say, hey, wait a minute, you know, looks like you've been shot as well. Yeah, exactly. So that's what the brain does. It decides what's important and what isn't. And hypnosis is a powerful way of taking full advantage of that ability. And so that's why we built Revery. We're seeing people getting immediate reductions in pain response. Just with that. Blessing people go if they want to get hold of Revery. just you can download it www .revery .com from the web or from the App Store or Google Play. That's a EVI. No, E at the end. Rev a rye.

1:03:59Rev a rye. EV or I. Okay. And try it. You know, you get the first weeks free. You can see if it helps with your pain or your stress levels. What we do with stress is we say we're going to start from the bottom up. you mentioned this before, rather than saying, figure out how to handle the problem and you'll feel better, we say start out feeling better. Imagine your body's floating in a bath, a lake, a hot tub of floating in space, control your body's reaction, and then picture on an imaginary screen, the problem on one side, and what one thing you can do about it on the other. So you start out doing something by reducing your somatic overreaction to the stressor, and then you can think more clearly about what to do about it.

1:04:44And we get 20 % reduction in stress levels in 10 minutes just teaching people to do that. What's the gold standard intervention? A lot of this is very impressive because it's single session. Right? I'm like a one session, this was smoking session, one session and 20 % production. By design, that is either 75 % or 80 % of people who you don't get that within a single session, right? It's one in full. One in full. No, no, no, no, that's not what the data are. The data are, it is 80 % get some kind of positive response. Oh, okay. The rest either get no change or if you get worse. Right. But they get the actual reduction, the percent reduction in their total stress level.

1:05:37Understood. Is like 15 or 20. Understood. Understood. That wasn't the response right. No, for most of them, four out of five, get better. Understood. Let's say that you wanted to get it from a 20 % reduction to 30 or 40. What's the gold standard when it comes to this kind of to using reverie or to doing self hypnosis for maximum effect? Well, what we're seeing with reverie is that the baseline levels don't change over time, but each time they do it, they get the same level of improvement. So it means you've got it when you need it. You know, it's sort of like taking the pill, you know, to accept you don't get addicted, or habituated, to like you do the benzodiazepines.

1:06:17You just do it when you want to do it. So the nice thing is you've got the ability. I think the best example is a randomized study we did with women with metastatic breast cancer. We would meet with them once a week. We'd talk about their fear of pain and anxiety, help them deal with that. And at the end of the session, we teach them to do self hypnosis. And what we found over the course of the year was that the women in the randomized to the treatment group had half the pain the control group did on the same and very low amounts of medication. And so what they would tell us was it's not that I never had pain.

1:06:50It's that I always knew that if I had it or it bothered me or it got worse, I could do the self -ignosizing control. So instead of thinking, oh, I pain in my chest is enumetastasis, I'm going to die in a month. And they would say, oh, yeah, I know what this is. I can deal with it. And they would be able to control the pain. What have you or what are you excited about stacking hypnosis with in terms of multiple modalities? Is it a one -stop shop that this is all it sounds like that's kind of a psych therapy, a little bit of a psychotherapy with a hypnosis finisher. But is there something where you think, ah, this is an area of the modality that we've said a bunch of stuff today that sounds kind of psychedelic adjacent, turning off of the default mode network, increasing levels of connectivity in areas that wouldn't typically be, etc., increased inter -reception?

1:07:47Are there any areas that you think, ah, this would be a really interesting combination or stack to have hypnosis be built into? Well, one other thing you're right and the reduction in devolmode network activity happens with psychedelics that happens with meditation too, actually. So there is that common ground there. One thing we've been looking at is breath work is how to help people control their breathing in ways that can help them relax. And that combines very nicely with self -ignosis. And actually we have several breath work exercises, a cyclic sighing and box breathing in the every up now because part of what you can do to help your body relax quickly is not just you know shift into this highly focused but relaxed state but also breathe differently.

1:08:36So you know if you do, you know a cyclic sign is an interesting practice where you do sure you just do and you can try it if you want it's really simple. You just do an abdominal inhale start with your belly through your nose about halfway. Now fill your lungs completely and then slowly exhale through your mouth.

1:09:04Good and try one more time and exhale through your nose quickly. Fill your lungs now. Slow exhale through your mouth.

1:09:20How's your body feeling? Pretty regulated, pretty nice. Pretty flouting. Very quick, pretty right. And what you're doing, we think, is, you know, the standard thing when somebody's actually say, take a deep breath, that's actually not a good idea. Because when you, how do you take a deep breath, you reduce pressure in the chest. You suck air into your lungs, but you also reduce blood return to the heart. You know, veins don't have muscles in the wall. Arteries do. and so that tends to slow the return of blood just a bit, but that sends a signal through the Sinowatrial node to the heart to increase heart rate to keep blood pressure up and keep blood flowing.

1:10:00Whereas when you exhale, you're increasing pressure in the chest, you're increasing Venus return to the heart and that triggers parasympathetic activity, the rest and digest system. So it's a very rapid way to invoke this self -suiting and combining that with hypnosis we think can be very helpful and we've found that people who do cyclic sighing like five minutes a day for a month wind up being happier and less anxious and breathing one breath a minute more slowly and we tend to overbreed and we breathe too rapidly. And so it's a very quick way of helping your body feel better and relax and it combines very nicely with hypnosis.

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1:11:51Slash. Modern wisdom. That's drinklmnt .com. Slash. Modern wisdom. I've done a good bit of breath work. There's some great classes here in Austin that I do that use that to what they would call a two -part breath. Yeah, slow exhale. Yeah.

1:12:13Also, James Nester's been on a rough breath. Brian McKenzie's been on guys from the state app. Who's the lady that did that buyer resonance HIV training. Dang. Anyway, Dr. Lady, a lot of stuff around that. One of the things that I've always been a little bit uncertain about is how much a state change coming from breath work expands out into a trait change that impacts the way that you breathe throughout the day. Is this simply me giving myself a 10 minutes salve from my sympathetic nervous system being tuned up. Or is this the sort of thing that after 30 days does result in lower breath rate across the night or whatever it might be?

1:12:58Well, we have a paper in solar reports medicine that shows that it seems to have less thing effects. That mood is better, anxiety is reduced, positive effects is higher, and you're breathing less rapidly. Presumably the mechanism, but that is just regulation of the nervous system. Yeah. You're just, you know, you take neurons that fire together, wire together, you keep doing it and it tends to change your pattern over time. Have you looked into buyer resonance breathing? No, I mean, it's an interesting one. So you're trying to create the, you find a breath rate of, I think you start off, you do an assessment, 7, 6 .5, 6, 5 .5 down to 3 .5 breaths per minute and it tends to be around about 60 % out versus 30 % in terms of the ratio.

1:13:48That expands our contract. Mine is 4 .5. So my resident, and what you end up doing if you were a little wearable, and that's built to detect HRV. And you can watch it on the screen, and you've got this screen, you're doing it session in 10 minutes or whatever. And you see these huge peaks and valleys. So for me, if I'm doing it during the day, I'll get swings from 80 down to 71, up to 79, back down to 69, up to 78, back down to 69, and you get these. You know, if you saw someone with this on a EKG, you'd think they're having like some A -fib catastrophe, but it's the biggest swings that you can get.

1:14:31And that is, especially given that I'm breathing it 4 .5 breaths a minute, there's no, like, It's not, I shouldn't get that sort of floaty lightheaded, depersonalization, nitrous oxide type scenario. But as I've got better at it, and you have, they've gamified it, obviously. So there's a little zone that you're supposed to stay in and stuff. And as I've got better at it, the felt sense of that is really, really fascinating. So the resonance feedback, I get the sense that that will be a modality that people are going to think about more. It's less accessible because you don't know. I mean, you could do it and just say that one felt right for me.

1:15:12You know, you don't necessarily need to have all the wearables and the fancy stuff. I'm interested in what the most, some of your favorite standout, extreme responses have been, you've mentioned about people being able to go through surgical procedures that would typically be very uncomfortable with minimal levels of sedation or minimal levels of painkillers. I remember reading in Johann Hari's book about this guy who had maybe 1800s a famous wand that was attached to some electrical system and he could wave it over people and get rid of all of their pain. And there was another study that was done where they recreated it even though they didn't have access to the technology.

1:15:54And they slowly removed each of the different components. They unplugged it. They got rid of the box. They got rid of the metal. They got rid of the wire. And then they got rid of the actual stick that it was attached to. And I imagine that what we're seeing with some of those modalities is that you're allowing people to tap into it. But some of those stories were people that had this chronic pain. They've been catatonic for years, etc. I'm interested what across a pretty broad career, some of your standout cases of almost unbelievable responses to hypnosis were. Well, you know, I've had people who have dealt with just horrible, horrifying, dramatic experiences, sexual abuse and childhood, or assault, injury.

1:16:39One technique that I used, that I borrowed in a way from mindfulness, which is compassion, is the issue of having compassion for your own body. I've had a woman who was sexually abused by a landlord when she She was 12 years old and was chronically depressed and miserable.

1:17:06She came to see me. She'd been on anti -depressants for 15 years. She had an okay career, but as a teenager, she said, men could say anything they wanted to me on the streets. I was ashamed. It was just terrible. and I had her in hypnosis picture herself as that 12 -year -old just after she had been assaulted. And I said, I want you to just answer one question for me. And I want you to imagine that you're her mother. So I get people to sort of develop a, use their knowledge and compassion as parents with themselves. And I said, I want you to answer one question for me. Is this her fault? And she started to cry harder and she said, no, I'm stroking her hair.

1:17:58I'm stroking her hair. And she came out of it and she left. She was moved by it. And I've had a lot of patients who just, when you have them use, they will develop parental skills on themselves. You know? And she said, my doctor wants me to answer. ask you what you did because I'm not depressed anymore and my friends don't recognize me. You know? So, and I've had other people who have, it's the shame, you know, that we'd rather feel guilty than helpless. And I found that Moses can help people recognize. You know, another one was a woman who was, you know, groped in a bus. Her mother was a few seats away.

1:18:41It was a very crowded bus and she didn't say anything. but it changed her. She just felt humiliated. She was blaming herself. Why didn't I scream? Why didn't I do what I only do that? I said, you were not in control of the situation. Look at yourself now and picture what it meant to go through that.

1:19:03This capacity and hypnosis to help people change their point of view is something that's powerful. I have a video of a Vietnam vet who was hospitalized for a year in a state mental hospital. It just, he went crazy and over in Vietnam. He went running through the jungle, shooting at what he thought would be at Cung. And I found out that what had happened was he had informally adopted a Vietnamese child. And he just took care of the kid. the kid had been burned and was badly injured and he just kind of took over and was his father. He was the youngest of like 13 kids in his family. He liked being in this role of caring for somebody else.

1:19:48And he comes back in the after the, there was a major assault in Vietnam. And he found the boy dead lying dead on the street. And he just went, he went nuts, he just couldn't and he got out of the army after 15 years in the army. He was discharged dishonorably and was getting psychiatric care. I had him picture that in hypnosis, go back and relive what had happened.

1:20:25I then had him go to the burial. He's saying ashes to ashes and dust to dust. And he said, if I had only been there with you man, you wouldn't be there now. It's all my fault. And I said to him, what would I tell him say to you if he were here? And he'd say, you're my number one cook, my number one sergey. And he just, so I said, I want you to picture two things about this. I want you to picture your putting him in the ground. And I want you to picture one time you were really happy and he remembered a birthday party that he threw for him is he had got a cake and his sister sent a toy train to the kid and you know And I said I want you to remember that every time you grieve his loss I want you to remember the good times you have together He said you number one Sarge number one cook and so he comes out of the hypnosis And I said, do you remember anything?

1:21:27And he said, oh, yeah, I remember a grave and a cake. And that was it. All the other stuff he didn't even consciously remember. And he got off meds. He got out of the hospital. And he was training kids to do long distance cycling. So there are times when you can use hypnosis to change people's perspective in a hurry. to just try out being different, seeing the same situation from a different point of view, and hopefully a more honest, full, compassionate, compassionate situation, including compassion for yourself. What does it say again about the way that the human mind, the human system works, that somebody can go through that, probably very emotionally activated during that hypnosis session, the keystone memory in this man's life.

1:22:26Come out and be able to recall two things and then have a big lifestyle change. You know, we have this sense, I think, almost a kind of solipsism thing about I know me and I know what drives me and if it's matter all that much. It just seems, you know, fascinating that you can have state change, leading to trade change, even though after the state change, you can't recall most of the stuff that happened. And then this guy is transformed. I'm just interested in what that says about. Yeah. Yeah. He remembered enough of it. So I would say, you know, if you think about what we're doing, you know, it's sort of like updating an operating system, you know, you're the rules by which you regulate yourself change because you give up and a lot of people who are traumatized to this.

1:23:26You give up the fantasy that you control everything that happened, especially at moments when you had zero control. You had no control. He was in the middle of a horrifying war, half a million Vietnamese were killed, 54 ,000 Americans were killed. So you're going to keep this poor, interchild alive in the middle of a combat zone, sooner or later something is likely to go wrong. You tried as well as you could and you should recognize that and you gave him periods of happiness, he gave you periods of happiness, but you were not in control of what happened. And it was that sense of his ability to accept the fact that this had happened, but it was a loss but not a total loss because they had time with each other.

1:24:11So it changes your perspective on it. It changes your perspective on who you are, what you can do and what you can't do. And I find that even if they don't remember all the details, they remember some of it, but it gives them a sense of relief. They accept something very sad, but it makes them feel different about themselves. It seems like resistance or some version of resistance as a word is typically a big contributing factor to some of the challenges that people are facing that you're overcoming with hypnosis. I should have been different. I shouldn't feel this pain. This is because there is something that is wrong.

1:24:54It's not so much to do with the thing. It's to do with the story that we're telling ourselves about the thing. the story that we're telling us out that we should be able to be in control and that we should be able to overcome. So this friction that we have between what's happening, and the story, and the shame, and the blame, and the resistance, it feels like... Which is in some ways, it's very liberating. Yes, it is. I think you're right. It's a matter of accepting the inevitable, You know, and seeing the role you played in it, but seeing it objectively is if you were watching yourself. And that's where the dissociation can be helpful, not pathological, which is also, I think, what MDMA psychotherapy is useful for doing, for creating that degree of distance, although maybe a little different of a delivery mechanism than the hypnosis.

1:25:49Yeah, yeah, it is and there's less control. I mean the nice thing for me as a psychiatrist and psychotherapist is that what people experience with hypnosis and why we can put it out there in reverie and have, you know, we've had more than a million downloads and virtually no problems with it is that people learn something about themselves and they don't lose control. You know, if you lose MDMA to a million people, you might have some different views. I think that could be a study, the use of psilocybin with dying cancer patients, I've worked for decades with dying cancer patients. One of the interesting things about that perspective is this oddly odd awareness but disconnection at the same time.

1:26:36People who are scared to death in a psilocybin trip can look at it and they could see, you know what, that will be the end of me. You know, I can accept that, but I can also see that it's a miracle that I ever got to exist in the first place. You know, and so they kind of face it, but they come out different. One of them said it's like looking into the Grand Canyon when you're afraid of heights. You know, it would be a disaster if you fell, but you feel better about yourself because you're able to look. I feel serene, but I can work out it. Well, think about how much I've suddenly learned this through acceptance and commitment therapy.

1:27:19I was struggling to sleep this year. I've had a been kicked in the nuts so many times, that two -dimensional over the last 12 to 18 months. One of the side effects of that is my nervous system basically got turned upside down. So cord dissolved was low in the morning and at its highest at night. DHA also declined throughout the day and Melatonin release was basically not so tied but white, the classic tied but white like burnout type thing. And living in a house with mold, turn of like autoimmune, just complex illness stuff. The same thing that a lot of people that are sad brain fog and tied a lot end up dealing with.

1:28:00And I did some CBTI and some act I as well for trying to deal with that. And so much, when it actually comes down to it, so much of it is in the story that we tell ourselves about, I don't have control. One of the lines that I said to my sleep coach was, I don't feel like I own the pillow. I feel like the pillow owns me. And it's kind of the same with this, the end of life owns me. I don't own the end of my life thing. that this thing is going to come and it's interesting to say it's like looking into the Grand Canyon when your scared of heights even though you're still terrified, the story you tell yourself about doing it.

1:28:42And I think that that's one of the key differences total bro signs here, between act and CBT being that with acceptance and commitment therapy, you're not reframing. I think one of the issues that the act guys have with the CBT guys is that there is a pushing away of thoughts, there is a dealing with the thoughts as opposed to sort of allowing it to move and brew you a little bit more. And that's the kind of saring into the abyss or the Grand Canyon thing. And then, okay, well, what does this cyclically mean? Oh, that means that I'm brave enough to be able to face the thing. Oh, well, maybe that means I'm brave enough to be able to overcome.

1:29:19Oh, well, maybe I can actually take a little bit of action with this, perhaps I do have a bit more agency than I might have thought. And again, we get into this sort of recursive story that we tell ourselves, the subconscious and stuff like that. Well, people fear hypnosis as a loss of agency, but it's an enhancement of agency. You can face things, see them differently, and please try reverie to go to sleep. We find a lot, you know, we get feedback on pre and post pain and anxiety. The most use of reverie is for insomnia, but we had very little data from it. You know, we've got thousands of people using it, but when we asked them why we didn't give us the follow -up, they said, they fell asleep.

1:29:57We fell asleep. Exactly. I can take that. How about a test? What we do to go to sleep is just focus on not turning off the thoughts in your head, but getting your body comfortable, floating safe and comfortable, imagining you're in a bath, a lake, a hot tub. And then project the thoughts as if you're watching a movie. So it's not inside your body, it's not stirring up all down a droneurgic arousal. It's just a scene that you're watching. You don't have to or want to do anything about it. You just picture it and let it flow through you. Why do you think hypnosis has sort of been sidelined in mainstream medicine, despite decades of evidence?

1:30:36Well, I don't know. It frustrates the hell out of me. I think some people are afraid of it. They don't understand it. They either think it's terribly dangerous or it doesn't do anything, both of which are wrong. And I'll tell you another reason, big pharma, you know, anything that's effective, they don't like it. I don't have a team of X cheerleaders going around telling doctors that hypnosis is great. You know, pharma spends more money on advertising than they do on drug development. And it's a product. And I, I think there's big money in doing that. And I prescribe drugs. Their drugs can be very helpful, but not always.

1:31:20There are many of them are over -utilized. And I think it's because also, you know, you have a real appreciation of the brain and what it does and how it works. But for most, many people, many doctors, the real interventions are in search, in injection or incision, you know, or ingestion. It's not talking to people. Is that a real treatment? Is that really doing anything, you know, and the answer is yes, it does. It is. But people, it takes a bit of a leap of the imagination to get that, but breaks the car model. It does. It does. And there's a lot of economic forces pushing the current model.

1:32:04And so I think we, you know, we don't get nowhere where the Rodney Danger Field of treatments. We don't get no respect, you know. He asked me to leave a bar so they could start happy hour. It's one of those things where people have trouble believing that just talking to someone, just them listening to an app can actually make a real change in their life. We've got thousands of people, tens of thousands of people, hundreds of thousands who have had that experience now. So it's a leap of the imagination, but there can be a powerful thing. Dr. David Spiegel, ladies and gentlemen, David, you're fantastic.

1:32:46I feel even if we haven't done the hypnosis today, I'm certainly feeling much more regulated. You have a, I wonder how much your demeanor and your sort of speaking cadence and your nature has been influenced by doing thousands of sessions of hypnosis and how much you just brought into it and that was like being a very tall basketball player, you were already sort of built for this spot but it really does feel like you're in a sort of genius zone with what you're doing. Thank you very much. Thank you for contributing to making the world a better place. Well thank you and thank you for doing that for informing people about these kinds of things.

1:33:18Try my best, it's a lot of good. Thank you Chris.