Choose a focal point in front of you.
Take a deep breath in. And out.
Allow yourself to be completely relaxed, completely immersed in this experience.
Now I’m going to count down from three to deepen this state of complete relaxation and concentration. Imagine each number will take you deeper down a stairway, deeper into this incredible state of relaxation.
Think about hypnosis for a while.
I guess there is a good chance that you are picturing swinging pendulums or shady magic shows right now. But could there be more to it than hocus-pocus?
Hypnosis has an unscientific reputation and this caused a fascinating therapeutical tool to be underexplored by scientists for a long time. However, slowly, the mystery around hypnosis is replaced and de-romanticized with neuroscientific underpinnings. The hypnotic state touches upon fundamental questions about identity, consciousness and agency regarding our thoughts and actions. Whether you are right now fascinated by the myths around hypnosis or think of it as nothing but quackery, I will try to bring some light into the fuzzy picture that has been painted by the media.
Let’s start by debunking the common myths about hypnosis. First of all, you are not asleep during hypnosis. Even though the term derived from “Hypnos”, the Greek god of sleep, hypnosis is rather a state of focused attention (J. H. Gruzelier, 2006; Raz et al., 2002; Spiegel & Spiegel, 2004). Next to that, every hypnosis is ultimately a self-hypnosis, so you can’t be hypnotized against your will. Also, hypnosis can’t bring back memories, for example of a committed crime (hypnosis is still used to convict criminals in the US – more on this later). Unfortunately, hypnosis can’t turn you into that incredible artist or athlete you want to become. And lastly, post-hypnotic amnesia is rare: Most people actually remember exactly what they experienced during hypnosis (Landry & Raz, 2016; Raz, 2011).
So, after telling you what hypnosis is not, I’m uncovering here what it actually is.
Hypnosis is defined as “a social interaction in which one person, designated the subject, responds to suggestions offered by another person, designated the hypnotist, for imaginative experiences involving alterations in conscious perception and memory, and the voluntary control of action” (Kihlstrom, 2013, p. 1). Let’s look a bit closer.
The individual hypnotizability determines how easily someone reaches the hypnotic state (Laurence et al., 2008). This trait can be measured with hypnotizability-scales under standardized hypnosis-conditions. It is estimated to form a bell-shaped curve in the population, with few “highly-responsive” and few “almost-resistant” individuals (Kihlstrom, 2013). Traits that are consistently related to hypnotizability are high ratings of creativity, absorption, attention and imagery. In a sample of college students, hypnotizability ratings were stable for around 25 years (Kihlstrom, 2013). From a genetic standpoint, certain factors, as for example the oxytocin receptor’s genotype, are suspected to influence an individual’s hypnotizability (Bryant et al., 2013; Lichtenberg et al., 2004). On the level of brain connectivity, high ratings of hypnotizabilty have been associated with characteristics such as an altered functional connectivity in the dorsolateral prefrontal cortex and dorsal anterior cingulate cortex (Hoeft et al., 2012). A comprehensive construct of the hypnotizability trait is, however, only starting to emerge. And the actual hypnotic response is under far more influences than just this “disposition”, this susceptibility to suggestion (Jensen et al., 2015).
There are multiple models that try to generalize the hypnotic brain-effects but none of them seems sufficient by itself. One of the reasons is that the hypnotic response is very specific: Brain activity measures are probably more dependent on the type of suggestions than on a general hypnosis pattern. While suggestions to “let go” seem to decrease frontal “control” activity for example, suggestions for analgesia (to shut out pain) seem to increase frontal activity (Jensen et al., 2015). Even for the same suggestion, different levels of hypnotizability can manifest in different activation areas and levels (J. Gruzelier, 1998; Jensen et al., 2015). And there are even more specific contributions to the hypnosis pattern to consider. On the one hand, there are the biological factors, such as the described individual differences in functional and structural brain connectivity or for example hemisphere asymmetry, that have been shown to correlate to hypnotic responding. But next to that, social factors, such as hypnotic context, and finally psychological factors, such as expectations and attitude towards hypnosis, are not to be underestimated. The direction of correlation with hypnosis outcome and whether we look at causality or correlation is still only vaguely defined for most of these factors (Jensen et al., 2015). In sum, some crucial factors that underlie and influence hypnosis have been identified, but the individual parts have yet to be assembled to a conclusive theory.
Whatever theory may be defined for hypnosis in the future, the hypnotic state is already used in psychological practice.
The increased focus, the decreased peripheral disturbance and especially the heightened receptiveness for social cues can be exploited. Hypnosis is already in use as a pain killer, by proposed mechanisms such as “channeling” cerebral blood flow into the orbitofrontal cortex and increasing blood flow in the somatosensory cortex (Crawford et al., 1993). Next to that, hypnosis is in use to “catalyze” psychotherapy for anxiety or depression, by allowing to access and counteract the negative self-suggestions with positive therapeutic suggestions (Green et al., 2014; Yapko, 2013). Despite all this promising potential, the field is still lacking scientific research.
Shockingly and regardless of the uncertainty surrounding it, hypnosis has also been used for a long time to “bring back memories” of witnesses to convict subjects in certain states in the US. Currently, there is an ongoing case of a prisoner in Texas on death watch that was convicted of murder when a witness suddenly “remembered” his face in the court room around a year after she had been hypnotized (and back then actually “remembered” a different person) (Ramchandani, 2019). Actually, hypnosis does not simply bring back memories by allowing access to a “film recording” of events. This is illustrated by another case, in which the hypnotized person remembered eating pizza in a restaurant that didn’t serve pizza at all and there are similar cases of memory constructs that were obviously planted by pure imagination (Ramchandani, 2019). Slowly, some US states have realized the faulty of hypnotic memory refreshment, but a lot of innocent subjects might still be wrongly convicted to date due to an ancient picture of hypnotic practice (Ramchandani, 2019).
I think we can agree that the potential to access one’s mind in a new state of control positions hypnosis as a powerful tool for cognitive research and psychotherapy, outside of magic shows. However, there is still much work to do, which requires ripping apart the outdated picture we might have had about hypnosis (and maybe even about our volition, agency or consciousness). But it’s about time for a hypnosis-rebranding!
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Featured image from Flickr by John Vance (all creative commons).