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America is changing and so is the world.
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I'm Tristan Redman in London and this is The Global Story.
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Hello.
Ever since Franz Anton Mesmer induced trance-like states in his Parisian subjects in the late 18th century, dressed in long purple robes, hypnosis has been associated with performance, power and the occult.
But despite some debate within the medical establishment about the scientific validity of hypnosis, it continues to be used today as a successful treatment for physical and psychological conditions.
Hypnosis has also been a rich source of inspiration for playwrights and filmmakers and novelists, including Charles Dickens, Bram Stoker and Arthur Conan Doyle.
Women to discuss hypnosis are Devin Tahun, reader in Experimental Psychology at King's College London, Quentin Dealy, consultant neuropsychiatrist and senior lecturer at King's College London, and Catherine Wynne, reader in Victorian and early 20th century literature and visual cultures at the University of Hull.
Catherine, how did hypnosis first emerge in the 18th century?
Well, the name that becomes synonymous with hypnosis in the 18th century is the iconic figure of Franz Mesmer.
Now, Mesmer was born in what is Germany today, but of course he was a subject of the Austria-Hungarian Empire.
He spent some time dabbling in various disciplines, including theology, before he landed on medicine and graduated in medicine from the University of Vienna.
His belief was that there was a magnetic fluid which both surrounded and ran through the body.
And he believed that illness ensued when the fluid was blocked by an obstacle.
So he used magnets to magnetise the poles of the body to release any blockages and hence bring about cure.
He was disregarded largely in Vienna.
And he came to Paris in 1778.
And that's where he became famous.
He emerged into the world of Marie Antoinette.
He married well.
And he set up a practice outside of Paris where he treated aristocrats and he also treated the poor as well.
So he was quite democratic in his approach.
Mesmer, however, unfortunately, got a bad reputation.
He was really ostracised by the medical community.
Well, Mesmer created problems for himself.
His style of therapeutic practice really involved him dressing up like a wizard and having his patients sitting around a large tub or a series of baths.
He could treat 200 patients at a time with magnetised water in which there were irons, and they would touch these irons.
A lot of his patients fell into crises or convulsions which precipitated cure.
And there was a commission set up to investigate Mesmer's claims.
The chair of that commission was an American, Benjamin Franklin.
And he was over as a US envoy.
He was 78 at the time, Franklin.
And Mesmer's claims were largely debunked rather unfairly.
Of course, there is no fluid surrounding the body.
Well, I think what Mesmer discovered was actually hypnosis, but he didn't realise that he had discovered what we later term hypnosis.
He didn't understand that actually what he was doing had nothing to do with fluids, but it had to do with suggestion and it had to do with the mind.
But it was too early for Mesmer to really understand that.
And we don't really understand that, or start to come to understand that, until the early 19th century.
Who came to understand that then?
I suppose that the next figure who becomes really significant in that regard is James Braid.
James Braid was a Scottish-born doctor who worked in Manchester.
And he wrote a pivotal book, published it in 1843.
And the year before that he coined the term, although we think it maybe existed before Braid.
He coined the term hypnotism.
And he called it actually neuro-hypnotism.
Why was it pivotal?
Because this is where the origins really of what we understand today as hypnosis started, come from that early tradition.
Because there are no fluids, there are no magnets.
It's all about suggestibility.
It's about the work of the imagination.
It's about the mind.
And that's where the basis of it happens in the 1840s with Braid's work.
And Braid's work actually lists a number of words.
Hypnotism, hypnotic, to de-hypnotise, the hypnotiser.
So he's got a list of these words that come into our common parlance today from Braid in 1843.
Thank you very much.
Devin, could you define hypnosis for everybody?
What produces a set of hypnosis, do you think, and what exactly is that state?
Is it possible?
Sure.
There unfortunately continues to be debate and some controversy regarding the best definition of hypnosis.
Why?
There's different camps that have emerged, and those two camps largely diverge in terms of thinking about hypnosis as either a state or as a procedure.
So the state view harkens back to the era of Braid and others and likens hypnosis to some type of trance-like state of consciousness that one enters in the context of hypnosis.
When I give you a hypnotic induction, a set of suggestions, I help you enter this quote-unquote deep state of hypnosis.
And this trance-like view continues to be popular amongst a number of researchers and clinicians.
The alternative view moves away from that position, is arguably slightly more neutral and just conceptualizes hypnosis more as just a set of procedures.
So procedures involving hypnotic induction.
The purpose of the induction is typically to enhance your responsiveness to verbal suggestions and then a set of suggestions.
And some individuals may enter quote-unquote altered states of consciousness or trance-like states in response to that procedure.
But you don't have to think about hypnosis itself as a state per se, but instead as a procedure.
What do you think happens when somebody is hypnotized?
How do you know this is it?
Hypnosis has taken its effect.
So again, we don't have any single specific marker that someone has been hypnotized or is in a hypnotic state.
We can administer a procedure to an individual, and individuals will respond to suggestions to varying degrees.
But individuals will use different types of strategies to respond to those suggestions and they'll vary in terms of the types of suggestions to which they respond.
So we don't have any clear-cut markers.
There is some evidence for some, You know, preliminary evidence for neurophysiological correlates of how people respond to a hypnotic induction, but there's no significant or clear-cut biomarker of response to hypnosis.
Quinton, how has the relationship between religion, spirituality and science featured in the story of hypnosis?
Well, we can start with the concept of suggestion, where we understand suggestion here as a communicable belief that can modify experience.
So if we start with the case of Mesmer, Mesmer of course interpreted his own practices in terms of his theory of animal magnetism.
But many of the elements were indebted to folk healing practices and religion, and particularly practices of possession and exorcism.
Where did you get those from?
I think from general cultural immersion, familiarity with healing practices, just being part of that cultural milieu at the end of the 18th century.
His practice itself included many ritualised elements, as you've alluded to.
So therefore, his dress, the mesmeric passes of his hands, the use of the glass harmonica What were the passes supposed to do?
The passes of the hands were meant to... His hands were waved across the head of the person...
They were meant to concentrate and channel the magnetic virtue, which is a magnetic fluid permeating the universe.
I mean.
The ideas themselves date back to medieval science figures such as Parasaltus, the idea that large-scale processes in the universe are linked to the individual body.
He had been given support by the notion of gravity.
He was interested in the concept of gravity, but appropriated it in his own terms with this notion of magnetic fluid that he could channel.
But the actual effect of his magnetic practices, the crisis, the convulsions, the hysterical laughter, the falling to the ground which was itself curative and cathartic again, was modelled implicitly upon possession and exorcism.
And so, at the same time that Mesmer was practicing, there was a famous case of an Austrian exorcist, a priest called Josef Johannes Gassner, Father Gassner, who was working in the Black Forest in the mid-1770s, attracting great notoriety as an exorcist.
Now looking at his practice, there were elements of it which would subsequently be interpreted as a suggestion from the secular framework of hypnosis.
That is to say, he would ask a nun suspected of possession whether she agreed with anything.
He should say.
And she agreed.
And then he would call forth the possessing demon.
And then she would have a convulsive collapse.
And then the demon will be expelled.
So he interpreted it in supernatural terms.
Mesmer interpreted it in terms of animal magnetism and he confided to an associate that he thought that Gassner was using magnetism to affect his cures.
But from a later perspective, as the process of suggestion became increasingly understood in secular and psychological terms.
Actually, both Mesmer's practice and that of Gassner would be attributed to psychological processes.
I'm going to bring up Dracula in this context as well because Stoker, he actually had a science degree from Trinity College Dublin.
He references Jean-Martin Charcot in Dracula.
But there are things that are operating within 19th century culture that are very interesting in that regard.
So the idea that there is an occultist phenomenon, the vampire, for instance, can induce this state.
And of course, that's very much seen to be associated with the occult and the demonic world.
So you get that running through the culture as well.
And it's often associated, of course also, apart from the fact that Dracula is a Transylvanian count it's often associated with non-Western cultures as well.
This fear that enters into Victorian discourse about, particularly into the literary discourse around other non-Western cultures who have the powers to hypnotise.
But these are very much associated with the occult rather than the scientific.
And you see, that played out in Dracula in a very, very interesting way, whereas you've got the Count.
The Count Dracula is a vampire vampire.
And he can throw you into a trance.
So it's a cultist and monarch.
It follows that particular trajectory.
But actually an understanding of hypnosis also comes into that novel as well, because there is a hypnotist figure.
He's a kind of an evolving psychiatrist, really, called Van Helsing.
And he puts one of the characters into hypnotic trance.
And when she's in this hypnotic trance, because she shared blood with Dracula, which I won't go into any detail, he's able to read her mind, but she's also able to read his mind when she's in a trance state.
So I think you've got two things going on in that novel.
Which isn't always seen when we look at Dracula, particularly the stage versions of Dracula, is that you've got this sort of occult phenomenon which is very much part of the discourse of the 19th century which is fed into Dracula his taking of blood, because he puts his victims into a trance-like state before he takes it.
But also there is much more of an evolving understanding of hypnotism as a practice, as a science, which we see also in the two psychiatrist figures in Dracula as well.
That's Van Helsing and Dr. Seward.
Quentin.
What is the relationship though between can you say straightforwardly for the listener, including myself The relation between religion and science?
How would you say they fitted together?
Were they antagonistic?
Did they borrow from each other?
Were they like each other?
I think in reality the actual relationships are extremely complex.
You can certainly discern a trajectory within hypnosis research within the context of the Enlightenment and 19th century positivism, where there was a very strong attempt to distinguish the secular understanding of hypnosis as a psychological process, whilst repudiating any association with the paranormal or supernatural.
And that is the tradition which dominates hypnosis research today within universities, for example.
However, at the same time, the eminent figures in the 19th century, including William James, for example, and the whole tradition of the Society of Psychical Research, with the advent of spiritualism in the middle of the 19th century, where there was an intense interest in hypnosis as a potential vehicle for giving otherworldly knowledge.
And so we have actually quite distinguished figures within the history of psychology who themselves, either with a sceptical interest or a believing interest, were very interested in this interface between hypnosis and magnetism and the otherworldly.
Who's practising hypnosis historically at this time and how did it change in the 19th century?
After Mesmer, we have the important figure of the Marquis de Pissegur, who is a French aristocrat trained by Mesmer, who pursued his practice in his ancestral estate of Byzancy.
And it was there that he would use magnetism to heal village folk and people who worked on his estate, one of whom was Victor Grasse, who was a young agricultural labourer.
And the importance of this is that when de Pissegur went to magnetise him on one occasion when he had a fever, instead of responding with the dramatic mesmeric crisis, he appeared to be asleep.
But during this episode of apparent sleepfulness, he could respond verbally to the commands of the magnetiser.
So this quiescent trance in which he, whilst seemingly asleep, and then thereafter was amnesic for the episode, became the prototype of the hypnotic trance.
De Pisegur called it the perfect crisis or artificial somnambulism.
So, whilst it is true that there are many elements of folk healing still associated with De Pisegur's practice, it's also true that there is a significant shift in the direction of a more psychological understanding of suggestion and hypnosis.
Indeed Pierre Jeannet, the eminent French psychologist and psychiatrist and philosopher At the end of the 19th century, beginning of the 20th century.
He argued that, in fact, all of the elements that were subsequently labelled by Braid and others as hypnosis had in fact been established by the magnetisers.
Thank you very much.
Devin, are some people more susceptible to hypnosis than others and how do you find out?
So people vary considerably in their responsiveness to hypnosis.
This has been mapped out as far back as the end of the 19th century.
It was realized during that time period that people varied considerably in what was then known as their hypnotizability.
Basically hypnotic suggestibility typically conforms to a bell-shaped curve or a normal distribution.
So you typically have around 10 to 15 of the population who are very highly responsive to hypnosis or display a high level of hypnotic suggestibility.
How do you count for it just being such a small percentage?
Yeah, I mean, that's an excellent question.
In terms of why that might be the case, we don't have a deep understanding of that.
There's some evidence that it's heritable.
You could think about whether this is a trait that basically has adaptive value in certain contexts or not.
It also seems to be kind of a double-edged sword.
So being a highly suggestible individual can endow an individual with certain abilities in certain contexts that might be valuable in terms of reducing your pain or responding to some type of treatment.
But there is evidence that highly suggestible individuals may be at greater risk for various types of illnesses or psychiatric disorders.
And so you can see how it's not always an adaptive trait.
And that might end up being why you don't have a very large proportion of highly suggestible individuals in the general population.
On the other hand, you have about another 10 to 15 of the population on the other end who tend to be only very, very minimally responsive to hypnotic suggestions.
Now, what's important to emphasize, though, is that group in the middle, right?
So you have about 60 to 80 of the population who display a moderate level of responsiveness to hypnotic suggestions.
So, in other words basically, most people are actually at least minimally or moderately responsive to hypnosis.
Your responsiveness does not seem to be related to gender, for example, in any way, at least in contemporary research.
It's also, there's a kind of a common widespread myth that basically, you know, people that are more responsive to hypnosis might be less intelligent, they might be naive, they might be more gullible.
There's no compelling evidence for that whatsoever.
So we shouldn't be thinking of people who are highly responsive to hypnosis as kind of weak-willed or less intelligent or anything like that.
So it's important to kind of really dispel those types of ideas.
America is changing, and so is the world.
But what's happening in America isn't just a cause of global upheaval.
It's also a symptom of disruption that's happening everywhere.
I'm Asma Khalid in Washington, D.C.
I'm Tristan Redman in London, and this is The Global Story.
Every weekday, we'll bring you a story from this intersection, where the world and America meet.
Listen on BBC.com or wherever you get your podcasts.
Moving it into the cultural context of the 19th century.
It was believed that women were more hypnotisable.
So a lot of the subjects that you see were women.
But also it's very much connected into race theory as well.
And that certain races or certain ethnicities they believed were more susceptible to hypnotism.
Can you give us some examples?
So the Celt, for instance, you know you've got the rational British subject, the English subject and you've got the kind of the Celt who is fiery and passionate.
So those who have passionate or fiery natures were often seen to be susceptible.
So you see that coming through in the literature because it's got no medical or psychological basis at all.
But it's very much tied into thinking about race in the 19th century as well and gender issues.
So you've got somebody like Arthur Conan Doyle who said in 1889 that a travelling mesmerist called Milo de Mera tried to mesmerise him and he said he could not induce any trance in me.
I was too robust or didn't work with me.
But in his fiction he does use characters who are either Celtic or Spanish, and they become suggestible as well.
Can I just stay with you for a moment Catherine, because that takes us to literary figures became involved in this.
Dickens, Conan Doyle, as you mentioned, Oscar Wilde, Giorgio Moriarty.
Is there one sentence or one paragraph which can tell us why they were attracted to hypnotism?
I think hypnotism and the whole culture of the trance and the whole culture of mesmerism and beyond in the 19th century is really actually pivotal to the culture and to an understanding of 19th century culture.
And so that invades all aspects of the culture, and it invades all aspects of both the sort of gallisserie culture certainly, but also the stage culture as well, the performance culture, also the religious cultures, as has been discussed earlier in terms of spiritualism.
But if we bring it back to Dickens, Dickens is a really interesting case.
You've got people who are medics, who are scientists, but also it's sort of something that could be practised, and was very believed to be practised, by ordinary people.
Anyone could hypnotise.
That was the idea, particularly in the late 1820s.
So we bring it back to the figure of somebody called John Elliottson.
Now, John Elliottson was a professor of practical medicine at University College London.
So he's very eminent.
He had a very established position in the medical orthodoxy at that point in the late 1830s.
But he started to work with and practice on these young English working class women called the O'Keys.
And he discovered that these uneducated women, when in the trance state, could actually diagnose patients' illnesses.
One of the O'Keys, Jane, reached states that were really moving into the otherworldly sphere.
And he became friendly with Dickens, so Dickens was invited to some of these demonstrations in Eliot's house.
And it influenced Dickens to a great degree, and he saw himself as a mesmerist.
And mesmerism pervades all of Dickens' fiction, particularly if we think about the psychological dominance that we see in something like Oliver Twist and in The Treatment of Nancy.
But we also see it in Dickens' last novel in 1870, unfinished novel, The Mystery of Edwin Drood, where you have a mesmerist figure, John Jasper.
But the critical cultural moment with Dickens is 1844, when he goes to Genoa and he becomes very friendly with this Swiss woman called Madame Delarue, Augusta Delarue.
And she really is what we would define in the later centuries as hysteric.
And he puts her into trance states and cures her.
His wife, Catherine, wasn't particularly happy about this.
Dickens abandons it.
But she becomes quite obsessed with Dickens in the later years post this treatment as well.
So, Dickens is pivotal.
And then we move on into the late century.
I suppose the most important book in the late century is Georges du Maurier's Trilby, where Hungarian and he's Jewish and that's important as well.
It's often regarded in terms of there's an anti-Semitism running through that novel, which has to be acknowledged.
So he's a Hungarian musician and he puts this young artist model, who cannot sing a note, into a trance state.
And when she's in the trance state, she becomes a concert performer.
She's a beautiful singer.
But of course, when he dies, she loses all ability to sing and dies.
And that's where we get the term Svengali.
Svengali is the novel, but also Svengali, that idea of a manipulative individual who has this power over individuals has come into the language from that 1894 extraordinarily popular novel by Georges du Maurier.
Quentin, can we take that along the line a bit?
This connection between hypnosis and performance, stagecraft and showmanship.
They bundled together quite quickly, didn't they?
Yes.
So again, I think the stage hypnotism, mesmerism on stage is actually very important in the history of hypnosis and its cultural reception, but actually also its scientific propagation.
So Braid was introduced to hypnosis by seeing the performance for magnetiser, La Fontaine.
Similarly, Josef Breuer had seen the work of a stage magnetiser in Vienna, which inspired his interest in hypnotism.
Freud himself... was introduced to hypnosis by stage performance.
So, on the one hand, you had respected figures within the medical and scientific world who were at pains to distinguish themselves from the more theatrical showmanship associated with it.
But at the same time it was a very important vehicle of transmission and demonstration of the power of of the techniques.
The famous French neurologist who's a pivotal figure in the history of this time, Jean-Martin Charcot, who was at the Salpêtrier Hospital in the latter part of the 19th century.
Whilst.
On the one hand, he was a respected figure who was very well known for his method to identify neurological deficits.
At the same time, he had inherited many hysterical patients.
He learnt of the technique of hypnosis from an anaesthetist called Yuzhan Azam and basically would have ward rounds in an amphitheatre in which he would use suggestion to produce and remove hysterical symptoms in his patients.
And there was a particular figure who became very well known, who was a kind of virtuoso or model patient, called Blanche Whitman.
And many people attending.
It wasn't just medical students, but it was also cultural luminaries aristocracy politicians, literary figures who would attend these displays.
And actually they were met with considerable disdain and disquiet this theatrical component by some attending.
So medics would write with disdain of what the subjects were compelled to do in trance, very like stage hypnotism, somewhat humiliating.
And also actually in the United States in the 19th century, the intersection between the theatrical and the spiritual application of hypnosis became very important.
With revivalism in the United States and the period immediately preceding the rise of spiritualism.
And then with spiritualism itself, there was a phenomenon of the travelling magnetiser with a clairvoyant, and they would do large stage performances producing enormous interest.
In 1843, in Boston alone, there were said to be 200 magnetisers.
So this is an important cultural phenomenon.
Devin, can I turn to you?
What would you say was the relationship between hypnosis and control?
And what are the moral implications of hypnosis?
There is this kind of longstanding notion that you can use hypnosis to get somebody to perform actions that they normally wouldn't do in front of you.
There are, of course, always going to be isolated anecdotal cases where hypnosis appears to have been used to facilitate a bank robbery, for example, that was caught on video.
However, all of the research has actually investigated this has consistently found that you cannot use hypnosis to do anything that someone would not normally do in front of you.
So there is no compelling evidence based on research that I could get you to perform some type of immoral act.
It makes good fiction, doesn't it, really?
In the fictional world, it's fascinating.
By the late 19th century.
There's a lot, even in the Times, of criminal cases that are recorded.
As I committed this, I was under a trance state.
And of course, in the fictional world you can take something like hypnosis and you can actually do anything with it.
And that's what the writers do at the end of the 19th century.
So I think culturally it becomes more fearful as a practice and what it can do to the individual.
Rather skipped over Sigmund Freud.
How did it attract his interest and how did it match up with psychoanalysis?
Well, we touched on Freud earlier on in terms of how he becomes attracted to it, or it's broadly in the culture, in the obviously he's attracted.
He comes, of course, from Vienna as well, much like Mesmer.
I don't think he'd like that claim to be made, though, but it's...
That's the starting point of Freud as well.
And he becomes, as part of the culture, he becomes introduced to this.
And a pivotal and a catalyzing figure for Freud is Jean-Martin Charcot, who is operating at the Salpêtrier in Paris, as we've already established, working with hysteric subjects there.
He spends six months with Charcot and that's the starting point of for Freud, taking that back into his own therapeutic practice.
By 1889, Freud is saying everyone is hypnotisable.
But Charcot and Freud are entirely different types of individuals.
Charcot is the showman.
He's the public performer.
And that's one of the reasons why the science of hypnotism becomes, I think, in some ways debased, because it is so much tied up with showmanship in the 19th century.
But Freud then brings it back into private practice.
Quentin, can you tell us, as you say, the relationship between hypnosis and the placebo effect?
There are relationships between hypnosis and the placebo effect.
The evidence is somewhat mixed, actually.
Some studies don't show a strong association between responsiveness to placebo and hypnotic responsiveness.
Others show more of an effect, but if there is an association, it's modest.
But what it draws attention to is the idea that, within a placebo situation, that a placebo is administered in a general context in which people would generally expect an effect to occur, like the administration of a tablet, for example, or a medical procedure.
Whereas in the use of suggestion in hypnosis, you are explicitly introducing an imaginative content effect which the person is having to engage with.
And deep down.
With the important exception of religious and cultural practices, it doesn't align with fundamental ideas about reality.
So it's an imagined scenario that people label as such.
How is the mind working under the process of hypnosis?
The most salient kind of thing that hypnosis really provides an example of is how our beliefs, our expectations, our predictions about the world can fundamentally alter our perception and experience.
This is an idea that for many years was considered peculiar and strange but is now becoming part of kind of mainstream psychology, psychiatry and neuroscience, where it's now increasingly recognized that our perceptual states are often heavily influenced by our predictions about the world.
And hypnosis and hypnotic suggestion and verbal suggestions more broadly represent a kind of very clear-cut, striking example of how those predictions can change our perception.
Is there any way of describing how the mind is working when it's under hypnosis, how it is changing?
It must be changing in some way.
Yeah, so let's take an example.
So if we give suggestions for increased pain and measure brain activity at the same time, so we have subjects, participants who are describing increased pain.
And the brain areas that become active are the pain matrix.
They're the areas of cortex which become active during the actual experience of pain.
And this is different from if you ask people to imagine pain.
So the question is how are suggestions enlisting changes in activity in brain systems which underpin certain types of experience?
And one way of approaching this is to think about cognitive processing as embedded in the brain, in a hierarchy of processing whereby consciousness arises at a very late stage and our experience of the world is already highly edited.
We have a highly edited subjective version of the world.
And so if you can introduce... In terms of everything?
In terms of everything.
The notion there is that our experience of the world is essentially, it can be thought of as a type of hallucination which is guided by external reality.
So, in other words, similar to Kantian philosophy, our experience of the world is a construct which presupposes certain basic assumptions about the nature of the world that we inhabit.
It's a construct.
We've got a grid, and how we experience the world is extensively based on prior learning and prediction.
So all of that brain development that occurs for many, many years.
One of the things that it's doing, it's enabling us to interpret a complex world, which actually requires a lot of prior knowledge to be in place to interpret it.
So what you're doing in the case of suggestion in hypnosis is that you're introducing ideas images expectations, which influence early stages of processing, that we don't have conscious access to.
And suggested effects in hypnosis are piggybacking or exploiting that fundamental capacity of the brain.
And so that is why it's possible for us to influence brain activity without conscious access to those changes.
But we experience the effects of that.
So, in other words, if I make a suggestion that you experience pain in the absence of pain stimuli, or if I make a suggestion that you have a vision of a person and there's no person there, what the suggestion is doing it's enlisting our association courtesies to generate the type of experience that's congruent with the content of the suggestion, in the absence of the normal type of sensory input that would generate that experience.
Devin, what's the view of hypnosis among the medical and scientific community now?
The view amongst those communities at the moment is probably quite diverse.
So you will have certain communities that might have perhaps an overly credulous view of hypnosis and think it's something that could be used perhaps almost as much like a panacea.
Others will be very skeptical, and probably because they've primarily been exposed to hypnosis through cultural context media, stage hypnosis films and so on, and so might end up having a more skeptical view.
And then, of course, you'll probably have a majority who would have a more empirically grounded view of hypnosis, where they understand that hypnosis might not work with everyone, it might not work with every condition, but it can be broadly efficacious for a number of conditions.
Can you tell us, Devin, how has hypnosis been used recently as a medical treatment?
Perhaps the best evidence for hypnosis really comes in terms of the reduction of pain.
So that's where we have the most compelling, consistent evidence from numerous meta-analyses.
In other contexts, hypnosis can be valuable, but it doesn't necessarily stand out as much.
So one example is in the context of smoking cessation.
So hypnosis can be valuable for smoking cessation, but it doesn't really stand out so much compared with other types of more conventional treatments.
One of the important things to say about the medical or therapeutic application of hypnosis is that it should follow principles of informed consent.
So it's very important to actually discuss with the patient what it is that you're proposing to do and for them to understand it very well and agree with what you're proposing to do.
And also all healthcare professionals have a duty of candor, which means that they need to be completely open and honest with patients about the procedures that they're employing.
And then in practice, one of the things that has to be borne in mind when we're talking about the therapeutic application is that hypnosis can be many things.
So to talk about the efficacy of hypnosis therapeutically is a bit like talking about the efficacy of psychotherapy in general.
Catherine, are you three carrying on in your colleagues, carrying on with what was discovered and developed in the Victorian era, or has there been a sea change?
I think the high point of hypnotism entering into the culture is the 19th century in terms of literature and stage culture.
I think it would be useful to go back to think a little bit about the more conventional stage of the 19th century before I go on to the sort of neo-Victorian context.
And I want to draw attention to Henry Irving, who's the great Victorian actor, the first actor to be knighted, and he really dominated the late Victorian stage at the Lyceum Theatre in London.
And he's pivotal as well from this perspective because in 1871 he performs in a play called The Bells.
It's a dramatisation of a French play adapted from the French.
Aesthetically it's a bad play, but it's actually about an innkeeper who has 20 years before murdered a man.
And he visits Paris and he sees a stage performance by a mesmerist and he believes that his crime can come to the fore if he's put into a mesmeric trance.
And this fundamentally destroys him in the play.
And Irving was regarded as a mesmeric performer as well.
The fact is the plays were poor, but actually his performance on stage was mesmerising and magnetic.
So I think that leads us into thinking really about our return to the Victorians in 21st century culture.
And we have this movement, which has been in existence for the last 20 years or so, which is called the Neo-Victorian, where we go back to Victorian texts or Victorian ideas and we think them through again.
We interrogate them.
So as part of that, of course, we go back to mesmerism, as to hypnotism as a very fundamental part of that culture, not only as a part of the mesmeric in terms of the sort of medical culture of that or the scientific culture of that, but also in the sort of the religious culture of which emerges really in what we haven't talked about is mediumship in the 19th century as well.
We have the birth of spiritualism in 1848 in America, which we've just touched on.
And that's where these young women called the Fox Sisters propounded that they heard they could communicate with the dead.
So it becomes a scientific religion, as it were, which was very, very popular in the 19th century, because if you could communicate with the dead through raps, as what they did in their home in Hydesville, New York, you could actually prove that there was an existence beyond life, but also the sort of the mediumship and the séance culture.
So all of that comes back in the neo-Victorian novel and on what we would say their interest again in Victoriana and Victorian culture.
And he is very Victorian in the way he presents himself as well.
And you see it also in the BBC Sherlock series, where actually Derren Brown comes in as Derren Brown and hypnotises Watson.
So it's very much part of the culture and our rethinking of the Victorians today is.
I think mesmerism hypnotism, is very much part of the rethinking of our relationship with the Victorians today.
Devin, what do we still not understand about hypnosis?
Is there something there that you haven't been able to touch on in your work, as well as in this conversation?
There's many things that we still don't understand.
One that I'll just briefly touch upon is we don't have a deep, comprehensive understanding of language in the context of suggestions, both in hypnosis and more broadly.
And this has huge implications when we think about the application and the use of suggestions in both the context of hypnosis, but also in the context of placebo effects, when a doctor is interacting with their patient.
So we don't have a deep, comprehensive understanding of the linguistic terms and the types of words and phrases that could be used to kind of make a suggestion more powerful, more influential, have a more powerful impact on someone's perceptual state.
So I think that's a really important area that we'll see a lot more research on in the coming years.
I think actually doctors and other healthcare practitioners have got a lot to learn about how they can improve talking to patients and relatives, to simultaneously be honest and open, whilst also using language which encourages healing and hope.
And actually I think there's been a trend within recent years towards the notion of informed consent.
To scare people, perhaps sometimes unnecessarily, by talking in great detail about potential side effects of medication, for example, rare side effects for surgical intervention, which is used in anxiety and in some cases no doubt actually contributes to psychological morbidity and symptoms.
So I think there's a very larger, broader project for healthcare about language.
Just very.
One quick example that we haven't gotten to touch upon is, just to follow on from what Quinn's saying or describing, is the nocebo effect.
So how simple descriptions and verbal suggestions can exacerbate or induce symptoms.
And one of the most striking examples of this is when you're going to a doctor or a nurse and having a blood draw.
So they used to just say something like, oh, just a little prick.
And that actually increases pain, that increases anxiety in that context.
And it's better to actually divert their attention away or say oh, why don't you look over there for a moment?
And then do the blood draw.
And that's been consistently shown to kind of reduce anxiety, reduce pain.
So again, just illustrates how our language is incredibly important in a wide range of contexts.
In terms of our understanding of hypnosis.
In actual fact, I think hypnosis as a topic, by virtue of its link to the concept of suggestion, actually raises the broader question of how, in psychology cognitive neuroscience, we understand belief.
Because, if suggestion is a type of communicable belief that can modify experience, there are many different types of suggestibility.
And suggestibility, as it's manifest in hypnosis, is one type that's important to understand because of its cultural importance, because of its medical applications.
But the topic of belief.
A larger understanding of the topic of belief is central to understanding politics and religion and human behavior.
So I think for psychology, broadly conceived as a discipline, to focus on the understanding of belief in the broadest terms and the different subtypes of it is absolutely fundamental.
One of the books that I think is extraordinary is the 1930 Thomas Mann's Mario the Magician, which is about a stage mesmerist, but it can't be called such because the Pope banned the practice of mesmerism in Italy.
And that was why it was underground in Dickens' time.
But it's a novel which arises in the time of Mussolini.
And it's talking about the power of the sort of the political leader.
And I'm just wondering if my colleagues here could comment on that, because you touched on the idea Quintin, of the idea of the political as well.
Clearly, one of the issues here is about the nature of political charisma.
It's actually why some politicians have an ability to mobilise or evoke extremely strong feelings of loyalty in people and to be extremely persuasive.
Now that typically has not fallen within the realm of hypnosis, at least as it's understood, although the charisma or authority of the hypnotist or of the mesmerist is clearly a component of what it is, which allows them to excise psychological influence.
But this itself actually has been a very long-running debate within the history of mesmerism and hypnosis.
So the Marquis de Pisegur strongly emphasised the role of the magnetiser in producing effects in the patient, but actually the Abbe de Faria strongly emphasised the suggestibility, the individual psychological properties of the patient as determining how people responded.
What we see in the 19th century, compared to now, is as we've heard about.
We have people in highly authoritative social positions, like doctors, using suggestion.
But actually the social authority they enlisted was the general social authority invested in them at that time.
We live in a different time, which is somewhat less deferential to authority figures.
And yet it is still possible to deploy suggestion and hypnosis for therapeutic purposes with very marked effects.
So I think it's important, when we're talking about suggestion and hypnosis per se, to try and split it into different components and recognize that suggestion can operate independently of very unequal power relationships.
Thank you very much.
Thanks to Catherine Wynne, Devin Tahun and Quentin Dealy.
Next week, we're back in Vienna to explore the art movement known as the Vienna Secession.
Thank you for listening.
And the In Our Time podcast gets some extra time now, with a few minutes of bonus material from Melvin and his guests.
Devin, what do you not get time to talk about that you'd like to talk about?
So this experience of involuntariness is often referred to as the classic suggestion effect.
But although this is closely tied with hypnosis, it's important to emphasize this is very much a broader feature of how people respond to verbal suggestions more broadly.
So you actually see a similar effect when people respond to placebos, right?
That experiential change, that experience of involuntariness is a core experiential feature of how people respond to verbal suggestions, both in hypnosis and in other contexts.
Through the literary lens.
I think perhaps one of the things you can see in that is is the literary use of hypnosis as metaphor for the involuntary.
So the placing somebody in a trance in order to extract an essence from them, it's not dissimilar to De Morio's novel Trilby about Svengali?
So that's obviously a sort of dominant trope that manifests itself in different ways, although perhaps worth mentioning.
Again mentioning that that is somewhat divergent from contemporary understandings of what suggestion and hypnosis can do.
Are you in a period of change, with a view to what mesmerism and hypnosis can do and where it's going?
I think one change that we might be expecting to see soon is potentially a greater recognition of the value of suggestion more broadly.
And so incorporating suggestion to a broader set of techniques and therapies in both clinical and experimental context, perhaps without hypnosis, but perhaps just harnessing the power and the value of verbal suggestions more broadly, outside of the context of hypnosis, perhaps without all the baggage of hypnosis.
Well, thank you all very much.
I think you've delighted us for long enough.
Would you like a cup of tea or coffee?
Yeah, I'll have a cup of tea, yes, thank you.
Devin?
Nothing for me, thank you.
Devin?
In Our Time with Melvin Bragg was produced by Eliane Glazer and it is a BBC Studios audio production for Radio 4.
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