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A big part of managing stress better is to separate out, to the extent that you can, the somatic reaction to the stress from the psychological experience of the stress.
And so I start from the bottom up.
I say...
Imagine you're floating in a bath, a lake, a hot tub, or floating in space.
Get your body comfortable.
Notice that you can dissociate your somatic reaction from your psychological state.
And once you've done that, then picture one aspect of the stressor while your body is floating and comfortable.
Visualize what you could do, one thing you could do, to deal with that stress.
So you begin then to be able to not have this snowball effect, but instead parse it, get your body comfortable as the first, not the last thing you do, and then see if you can't figure out a better way of dealing with something.
So your boss is yelling at you.
Imagine him being half as big, like a little kid in a big chair, and see if what he said makes you as upset.
Think about what he said and not just who he is.
And think about what you might say to him.
Well, thanks for the advice, bud, or whatever you want to say.
So you teach people means of controlling this mind-body interaction in such a way that the stress doesn't automatically overwhelm you.
I'm hesitant to ask you to do a parlor trick and hypnotize Jonathan.
Your hand will remain light and in this upright position until I ask you to touch your right elbow with your left hand, and then your usual sensation and control will return.
It's Mayim Bialik's breakdown.
She's going to break it down for you.
Because you know she knows a thing or two.
So now she's going to break down.
It's a breakdown.
She's going to break it down.
Hi, I'm Mayim Bialik.
And I'm Jonathan Cohen.
And welcome to our breakdown.
This is the place where we break things down so you don't have to.
We're on a double remote recording today, a little bit different.
Different but exciting, because today we're going to believe in the power of suggestive imagination.
Today we're going to speak to one of the most respected pioneers in the field of Our understanding of hypnosis.
Dr David Spiegel is the Wilson Professor and Associate Chair of Psychiatry and Behavioral Sciences at Stanford University School of Medicine.
He's also the director for both the Center on Stress and Health and the Center for Integrative Medicine there.
He has an app called Reverie.
That is a self-hypnosis app where he uses the hundreds and hundreds of articles that he's written about this, the decades of research that he has done as a psychiatrist and as a person who uses hypnosis for everything from treating cancer patients to those with chronic pain.
And Dr Spiegel gets real personal, both about the things that plague me and Jonathan and the things that he sees in his practice.
And kind of a highlight of this entire podcast, Jonathan gets hypnotized.
And I don't mean by me and my charm.
Jonathan gets hypnotized not by me, but by Dr. David Spiegel.
Mime tries to get me to quack like a duck, but it is not that type of hypnosis.
Little bit of a disclaimer.
Dr. Spiegel literally hypnotizes Jonathan on this podcast.
So please do not attempt to follow along while driving, while operating heavy machinery or while doing anything that requires you to have a conscious presence and your eyes open.
It was a fascinating experience to get to go into a hypnotic state.
I was really concerned.
Could I do it on camera and what it would be like?
But it was wild.
And you got to stick around to the end of the ep for that one.
But he is so insightful, talks about really practical uses of hypnosis, explains what it is.
Jonathan, in addition to him hypnotizing you, we also had a very surprising breath session that Dr Spiegel facilitated, which was surprisingly effective.
It is short.
It was his answer to what do you do in an acute moment of stress?
How do you reset and bring back your baseline so that you are not acting out of reaction, that you can calm down and actually see things for what is?
It's a very powerful tool and an explanation of acceptance and the power of acceptance in your life.
And also, you're probably wondering which one of us can do a slower exhale.
It's me.
It's me.
All right.
That being said, let's welcome Dr. David Spiegel to the breakdown.
Break it down.
Thank you Mayim.
I'm delighted to be here.
Hi, Jonathan.
Hello.
One of the things that we aim to do here with our podcast is to kind of democratize mental health and access to information about mental wellness.
So maybe you could start off by sort of introducing us to how you got into the field that you're in and what made you sort of decide to use your platform to spread the information you do the way that you do.
Uh, sure.
My, I'd be glad to do that.
And these days democratizing anything is a good thing.
We need a lot more of that.
Um, and I'm we.
We started reverie to give people access not just information, but to actually the experience of learning to use hypnosis.
Um, which is something of a genetic illness in my family.
Uh, both of my parents were psychiatrists and psychoanalysts and, uh, Think about that.
And they told me I was free to become any kind of psychiatrist I wanted to be.
So here I am.
Right.
And my father was in his training analysis at the beginning of World War Two.
And he, a Viennese refugee who wanted to serve but couldn't because he was a foreigner, was a forensic psychiatrist and he had a smallpox scar on the middle of his forehead.
And he noticed that prisoners he was interviewing would suddenly sort of their heads would drop and they'd go into some altered state.
And he started studying hypnosis.
So Dr Schaffenberg taught my father and a number of other young army psychiatrists how to use hypnosis.
And my father was using it in combat in North Africa to help people with pain and combat stress reactions.
But when he came back, he went back to his analytic training and was going to give it up, because Freud gave it up.
So who was he to continue doing it?
But he had a wonderful supervisor named Frieda Fromm-Reichmann who said Herb, what are you so anxious about your reputation for?
You're going to give a course at the Institute on hypnosis and I know you're going to do it because I'm going to take it.
And so she kept him going and he began to learn over time that he was getting more interesting and stronger results from a few sessions of hypnosis than he was from years of three or four days on the couch doing analysis.
So he shifted his practice more and more to hypnosis.
So the dinner table conversations were pretty interesting.
And when I got to medical school, I took a hypnosis course.
And my first patient ever was a 15-year-old girl in status asthmaticus.
I was on rotation at Children's Hospital in Boston.
And I followed the sound of the wheezing down the hall and walk in.
And there's this 15-year-old girl, knuckles white, struggling for breath.
Her mother's standing there crying.
And she had twice been unresponsive to subcutaneous epinephrine.
They were thinking about general anesthesia and steroids.
And I wasn't going to do that.
So I said, would you like to learn a hypnosis, like a breathing exercise?
And she nods.
So I get her hypnotized.
And then I realized, oh, we haven't gotten asthma in the course yet.
What do I say?
So I came up with something very clever.
I said, each breath you take will be a little deeper and a little easier.
And within five minutes, she's lying back in bed.
She isn't wheezing anymore.
Her mother stopped crying.
The nurse ran out of the room.
My intern comes looking for me.
And I figure he's going to pat me on the back and say, good job, Spiegel.
And instead he said the nurse has filed a complaint with the nursing supervisor that you violated Massachusetts law by hypnotizing a minor without parental consent.
Now, Massachusetts has a lot of crazy laws, but that is not on the list.
And her mother was standing next to me when I did it.
So he said, you're going to have to stop doing this.
And I said, why?
He said, it's dangerous.
And that's the thing with hypnosis.
For 250 years, it's the oldest Western conception of psychotherapy.
And people either think it's dangerous or useless or both.
And it is, in fact, neither.
So I said to him, tell you what, you can take me off the case if you want.
But as long as she's my patient, I'm not going to tell her something I know is not true.
Now, this girl had had three hospitalizations in three months.
She did have one subsequent one. but went on to study to be a respiratory therapist.
And I figured that anything that could help someone that fast and that risk-free and violate Massachusetts law, even though it didn't exist, and frustrate the head nurse had to be worth looking into.
And so she was the first of some 7,000 people that I've used hypnosis with in my career.
And the fact that you can watch it in front of your eyes, that people could learn to control their body that well, that fast, was something that fascinated me.
And that's what we want to spread around.
I mean, I just want to know what it was like growing up with two psychiatrists for parents.
Well occasionally, when I'd break a dish loading the dishwasher, I'd be told my unconscious was showing you know.
That's exactly what I imagined it would be like.
Most of the time they were sort of ordinary parents with the usual quirks, but every once in a while.
I'm just curious, what was your mother's story?
Because obviously that was a time when not a lot of women were in the medical field, and particularly in psychiatry.
You're right, Maya.
My mother was the third woman to graduate from the Medical College of Virginia.
And she was physically removed from the lecture on birth control.
I kid you not, they said, this is not a decent thing for a woman to hear.
And she said, if I'm going to be a doctor, I need to know what doctors know.
And the professor had the male students escort her out of the room.
That's what life was like back then.
I mean the irony that it's literally something that only happens to a woman's body is also.
I mean, the irony is deep.
That was kind of lost on them.
And she worked initially for a labor union in New York.
And she, you know, the book Sisterhood is Powerful.
It was a famous sort of anthem-like book for women in the 70s and 80s.
My mom had a chapter in it on images of women.
Wow.
And she wrote a book called Sweet Suffering, about how people have to live with suffering, particularly women.
So she was an early feminist and a well-known psychiatrist and psychoanalyst as well.
Did your parents ever hypnotize you as a kid?
I don't think so.
My father tested my hypnotizability once, but other than that, no.
Not that I know of.
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Jonathan and I have spoken quite a bit here and there about hypnosis.
I'm that person who gave birth twice with no drugs using a self-hypnosis method.
And I like to point out to people, I don't believe I'm a superhuman.
I don't believe that there's anything about me that is statistically different honestly, from any woman who has ever given birth.
But it was specifically the tools of, you know, self-hypnosis.
And it's not just like, oh, I'm going to try and see what happens.
Like there's a pretty, you know, detailed protocol that you undertake to learn these techniques.
And, you know, I had a three day labor and I had an under three hour labor.
So I had both experiences and both without medication and using those principles.
So we've talked about that a bit.
You know, I've, I've been in therapy since I was born, is what it feels like.
And I actually recently started doing some deeper trauma work.
And my therapist has used more of kind of what they call trance therapy, which is, you know, I think, kind of an extension of this sort of universe.
But I wonder if you can talk about what is hypnosis?
Because I think for most of us, we learned about it from cartoons from the 1930s.
And that's literally all I ever thought about hypnosis when I heard the word.
I thought of like the cartoons with the eyes, like, you know, doing the swirly do.
But I'd like you to maybe frame it both historically and also just sort of sociologically.
What is hypnosis when you talk about it?
Hypnosis is a state of highly focused attention.
It's like that experience you may have when you're going to a movie or reading a good novel and you get so caught up in the story in the movie that you enter the movie.
You're not in the audience.
You're part of the movie.
It's been called believed in imaginations.
So you can conceive of it as something like looking through the telephoto lens in a camera.
What you see, you see with great detail, but you're less aware of the context.
So the second component is the dissociation of things at the periphery.
So you put outside of conscious awareness things that would ordinarily be in consciousness, so you can focus more intently.
Right now, for example, you're having sensations in your body touching the chair you're sitting in.
Hopefully, that's not what you were focusing on at the moment.
If it was, we can just stop now.
So we naturally do this all the time.
We focus in on some things and focus out on others.
Dissociation is very important.
It's something that you used when you were giving birth, that you were paying attention to some feelings and thoughts and putting the other obvious ones, the contractions and things like that, into context or out of conscious awareness.
The third part, and in some ways it's the most intriguing, is what used to be called suggestibility and what scares everybody.
Oh my God, I can make you do anything.
The reason is we think of it now as cognitive flexibility that you turn down activity in a part of the brain that is involved in self-reflection.
Who am I?
What am I?
What do people think of me?
That sort of gets running when you're not doing anything much else.
You start meditating on yourself.
And the fact that you can reduce activity in that part of the brain suggests that you're free to try out being different before you decide you're going to change.
So you were a very different person when you were giving birth to your two children, and you're not like that all the time.
But the fact that you're not like that all the time didn't interfere with your being able to do it.
And that is one of the cool advantages of the hypnosis and the hypnotic state that you can try things out, even if it seems incongruous or impossible, and see if you can do it.
And if you can, good.
If you can't, okay, you don't.
So it's the combination of highly focused attention, dissociation and this cognitive flexibility to give up the ordinary and try something new and different.
And the idea is not that hypnosis sort of is this isolated activity, as if you're like going swimming.
You know like I'm being hypnotized.
You couch it in the context.
It's not its own kind of therapy.
It is part of therapy, correct?
That's beautifully put.
That's exactly right.
And so...
There's a lot of research by a terrific psychologist at the University of Minnesota named Aki Tellegen on absorption.
So it turns out that the people who tend to get more naturally absorbed in sunsets or in movies or something else are more highly hypnotizable.
Those dreamy people, people who are dreaming.
The dreamy people.
Right, right.
And if you're like that, if you have the ability, you'll use it all the time.
There's no law that says you only do it when some guy who looks Viennese is dangling a watch in front of your face.
That's just not what it's about.
How do you reconcile this, which is totally understandable, with the images people have seen of, You know, people getting on stage and being sort of walked around and then forgetting what has happened to them?
Like, where's the bridge here?
With difficulty.
But here's the story.
First of all, I don't like stage hypnosis.
I don't like using this thing which can be so helpful to people. to make fools of them.
I just think it ain't funny as far as I'm concerned.
However, there's a trick that the stage hypnotists do that most people don't even realize.
And that is the first half of the show is filtering through the audience.
So they get people to come up, they try stuff out.
It works for a few and not for most.
So they're screening to get the most highly hypnotizable people.
About 15% of the general adult population is very hypnotizable.
So in an audience of 150 people, you'll have 10 of them or 15 of them.
And they are the people that he keeps up on the stage and does the other stuff with.
And what they're demonstrating is the capacity to focus on some premise like you're a chicken or you're a ballerina put out of awareness, the The audience reaction, or what you're going to, what it's going to be like for you at parties the next month or two after you do it, and and suspend your usual view of who you are.
So that's why the football coach will dance like a ballerina.
So are they mobilizing hypnotic phenomena?
Yes.
Are they doing it well and for the right reason?
No.
And are those people.
So I think what a lot of people who don't understand this see in these stage hypnosis, and I will tie this back into, I think, the use for good.
But can you clarify, like those people really don't remember.
They're not in it, like there's not a conscious part of them.
Like what's happening on their side?
Well, what's out of sight is not out of mind.
So when you dissociate things, you're not immediately sort of, you don't have access.
The door is closed, but the info is there in the safe.
And so it is possible that it can.
So, for example, people who have suffered serious trauma in their lives may not may always think of it.
And there will be times when they maybe can't even consciously remember it, but does it have an effect on them?
Absolutely.
So So it's a kind of partitioning of memory.
So it's like you haven't found the path to get to it, but it doesn't mean it isn't there and it doesn't mean it's not having influence.
You know, the brain's gonna make very good use of the cells in it and there's gonna be a lot of redundancies.
So what I understand from how I've heard you talk about this and how you sort of just framed it, is that the same mechanisms that the brain will use to dissociate when something is overwhelming and create protection, because that is a sort of survival mechanism, those very same mechanisms can be utilized and harnessed in ways to dissociate from information we don't need in any given moment in order to have access that way,
Is that correct?
Yes, absolutely.
And that's what you did.
I'm sure there are aspects of your delivery of your two children that you may still not be consciously aware of that you were focusing on something else that made you feel more comfortable, that helped modulate the physical sensations.
Is that right?
Yes.
Well, okay.
So yeah, maybe we can, I mean, I'll talk about birth all day long if you let me.
So maybe we can.
I'd like to use that as an example because one of the things you know I have heard like people use hypnosis to stop smoking and you know you hear like oh, that really works.
Yes.
But I think it's really interesting when I hear you talk about that.
Hypnosis can be used, let's say, for chronic pain, right?
So I have this experience for me from giving birth.
I have this experience not of chronic pain, but of acute pain discomfort,
We don't like to use the word pain.
A lot of it is in sort of the framing.
Like we don't call them contractions.
We call them surges.
You know, it's like, we don't call it pain.
We call it intensity.
So what happened was and I'll use my second labor, just because it was a, you know, under three hours.
It was a very discreet period of time during which something was happening in my body that is miraculous in that you have a human life inside of you.
And then at the end of this, it's not on inside, it's on the outside, right?
And so the body has, to you know, has to release that baby, which means that your body, which has been holding it in, needs to open up.
And that's a very intense process.
And so what I learned was that there's a tremendous amount of framing and perception, which is the preparation for using hypnosis in labor.
So it's not just like you do a meditation and hope that the baby comes out and you don't feel anything.
But the notion is that you're suspending a conscious experience of what otherwise would be interpreted as extreme discomfort right,
So that makes more sense to me than when I think about hypnosis for like chronic pain.
So what happens when you use this as a methodology for people who have, in many cases, what might be also deemed mind-body syndrome, kind of pain?
Well, first of all, there's a kind of sensation, but also a motor function alteration that happens.
So typically when people use hypnosis in giving birth, Part of it is that just contracting is actually.
That's part of what you're doing.
But the other thing is you're relaxing, you're opening your body.
So to release the baby out into the world?
If all you do is contract, you're making it harder, not easier.
You don't want to do that.
So you're getting in a mindset where you're helping your body to do what it can do in the most comfortable way possible, which is contract in places and relax and expand in others.
So that's part of it.
Part of it is literally transforming what you feel.
So we have this sort of bottom-up idea that pain is just one thing.
Well, we tend to treat all pain as if it were acute pain.
And because we're pretty pathetic physical creatures, there were a lot of times when we would get hurt and we had to deal with it.
And if you just broke your ankle or your arm, you better do something about it.
But A lot of pain is not like that.
Your body has sustained an injury, you can use it, do what you can, but the brain needs to decide how to process it.
And we've shown using EEG, using magnetic resonance imaging, that the brain can literally change pain.
It can not just suffer a little more happily, but actually change what you're feeling.
That's the title of my memoir, Suffer a Little More Happily.
I'll write a four-word for it.
So we took Stanford students, who are highly hypnotizable.
We gave them a series of shocks on the wrist and we measured their evoked response, the EEG.
There are three components of the waveform that are particularly important one at a tenth of a second after the shocks, one at three-tenths and one at five-tenths of a second.
The P100, 300 and 500.
And I then hypnotized him and said, your hand is in ice water.
It's cool, tingling, and filtered the hurt out of the pain.
The P100 disappeared.
Same shocks.
The first response.
So it wasn't that the brain was saying, oh, ouch, this hurts.
I'm going to change my mind about it.
It was literally presenting the input as a different signal that just was not as bad.
The P300 and the P200 and 300 were half as big as they were in the non-hypnosis condition.
So the brain is very good at modulating perception and deciding what to pay attention to.
So, just like once again, hopefully you don't feel your bottom touching the chair you can modulate pain signals so that it really is a different signal.
It doesn't hurt as much.
When we were practicing.
You know there's practice sessions over several months for, you know, for natural labor.
And one of the things is you put yourself into you know the state and there's you know kind of a procedure.
And then you're supposed to have your partner dig their hand, their nails, into your leg, which is typically a very you You know.
The place you need to get to is the place that I was shocked that I could get to.
I mean, you have nail marks in your leg and there's absolutely no perception.
Like, there's no perception.
In some cases you can feel pressure because there's all these different kinds of receptors in the body and they don't all handle pain.
They handle pressure, vibration, you know, things like that.
Um, but you know, we were also told to practice with your hand in ice water.
And if you can hold your hand in ice water for two minutes and which you know, Jonathan's a fan of the cold plunge.
So he likes to mimic labor, you know, on the daily, if he can.
I would like to talk a little bit about hypnotizability and um, you know not to out Valerie, our producer, but Valerie was certain that I am not hypnotizable.
And, you know, the reason is, you know, I am.
I'm a very logical thinker.
I think too much.
I'm a person that likes to read more than listen.
I know that they say that people who listen more than read, which is the definition of Jonathan tend to be more hypnotizable.
But I also want to note something before we get into a discussion of who's hypnotizable.
The way that people describe the kind of person who's not hypnotizable is also the way sometimes people describe like I bet they're not good in bed.
And the reason I'm bringing that up is that there's all these assumptions about people who do have, you know, a logical side.
And I just want to say advocate for those of us that are logical people and tend to maybe not fit that like oh, I'm hypnotizable or I'm a good partner.
The notion is that in the right setting, with the right information, you can be coaxed into learning, to put yourself into a different state.
And I think like the same kind of people who might say like I can't meditate, I can't do yoga, I can't sit still.
I used to be that person.
And I think that that's an important thing to realize.
And I'd like you to maybe address that in terms of hypnotizability.
It's not just like, if you're a logical person, give it up.
This is never going to work for you.
What that means is that your brain is used to operating in a certain way that it doesn't need to operate in.
And it could be that exactly the tools that get you into a place to be able to be hypnotizable are also the other tools that you need to not oh, I don't know have high anxiety.
Well, I would say that what hypnotizability is in part about is sort of experiential intensity.
And you can be logical intensely too.
And I think it's more a capacity to sort of fully engage with the subject and maybe judge it and evaluate it later, versus some other people who, just you know, the minute they approach anything they have to think about it.
I, I, I can give you two examples of two women that I treated at about the same time.
And they both had what's called trichotillomania.
That's pathological hair pulling.
I don't have that problem, but, um, it's, I had it for a little while.
Welcome to the club, Jonathan.
So um, The first one was a very attractive woman who had a hairdresser who said your hair is so beautiful that I will do it for free, if you, let me take a picture and put it up in the window of the hair salon.
And that went on for a while until he started coming on to her.
And she was getting uncomfortable but didn't know how to just set limits with him.
So she got more anxious about it and she started pulling out her hair to the point that she no longer looked good for the photos.
So that was her way of extracting it, rather than saying you bastard, keep your hands off my leg, kind of thing, was.
You know um, and she also loved taking care of animals, stray animals.
If she saw a wounded animal by the side of the road, she would stop and nurse it.
You know, and i said, in hypnosis, i i taught her, and she was quite hypnotizable um, would you, would you pull, start pulling hair out of a stray dog that was lying by the road?
No well, why not give your body the same respect you'd give a dog, you know?
And so she and i said, i said, if you feel the urge to do that, stroke it, don't pull it, you know.
And so she was fine, she was.
And i said, and by the way, stay away from that hairdresser, you know.
And so she did that.
She was fine, Wait.
So can I interrupt and ask a question?
Because I know you're giving two examples.
The question people are going to ask is, why did she have to be hypnotized for you to tell her that?
I could have just told her that.
But the nice thing about hypnosis is you tend to more easily suspend the judgmental process for a while and just say why are you telling me that?
For
Why are you talking about stray dogs?
You know, just try it.
And that's the cool thing is, before you've decided you want to be different, you can see what it feels like to be different and then make the decisions.
So hypnosis is more intense and focused and you just give it a go, and she did, and she got over it just like that.
So the other woman was a an a, an accountant um, who was?
She said i'm pulling my hair to get at my naughty nerves.
She was very anxious and she argued with me about hypnotizability, so much that i couldn't test her until the second session.
And And I tested her and she was very low in hypnotizability.
I used the same concept, which is, this is your problem.
It isn't your body.
So why are you disfiguring your body?
Because you have your naughty nerves inside.
And so she comes back with a graph of the percent of pre-treatment hair pulling to show me that she initially got worse.
But eventually, after a month...
She finally stopped, you know, pulling out her hair.
So they got there, but they did it in a very different way.
And so hypnosis is a facilitator.
If you're hypnotizable, you can just get into it, try it out and be different.
For the other.
For the second woman, it was more the strategy worked eventually that she could see that.
And that's how, by the way, how we get people to stop smoking.
We teach them that not, you know, oh, get rid of the urge.
I'd say the urge isn't the issue.
We have all kinds of lots of urges that we don't act on.
But would you put tar and nicotine smoke into the lungs of your baby?
Hell no.
That's what you tell people?
Yes, I do.
I say 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, not what you're against.
Whether you have an urge to smoke is irrelevant.
We have all lots of urges we don't act on.
So focus on respecting and protecting your body.
And I'll tell you one story.
There was a woman who came to us when we were first testing the Reverie app.
And she said, I've been smoking for 25 years.
I don't even want to stop smoking.
But she said, I'll sign up for your study.
And the first time she tried that, that for my body smokes and poison, she didn't like it.
The second time that evening, she tried it.
She lit up a cigarette.
She looked at it and she said, who needs this?
She has not had a cigarette since.
Her friends can't believe it.
She's getting her friends to stop smoking now.
And she said to me, Spiegel, This is some kind of crazy ass voodoo shit.
And I mean that in a good way.
So, you know, the cool thing is people are surprised that they can change that fast.
That's one of the great things about hypnosis.
Let's expand this for a second, because there's this notion of see what it's like to be different using our imagination.
Because there have been people in that woman's life who is the smoker, who have told her Smoking isn't good for you.
Like she's probably heard that same message, but there's some sort of priming that happens, that allows things to sink in for people.
This is what I'm making up, and I want to share this back with you for your perspective.
And you know this connects to other things that we talk about in this podcast and other episodes in spirituality and expansions of consciousness, where you can't really absorb something and make a life change until you're ready to hear it.
And it sounds like the hypnosis process is getting people to a point where they can receive information that they would otherwise either reject or be defensive towards.
So there's some sort of expanding or quieting that's happening.
And then this notion that we're using the same skills that we make up that can cause anxiety, our imaginative process of all the horrible things that are gonna happen.
But we're able to then take those, slow down enough.
And I really do want to talk about this trying on of experience, because I think it's such a powerful exercise and ability that we have to use our creativity.
And we've had other people talk about how we're building the neural pathways of success or growth.
But before we get there, let's talk a little bit about this notion of hearing the message in the right state in the right time, and that we can actually create the right time to hear messages, I think is exceptionally powerful.
Thank you, Jonathan.
Well, there are two pieces to it, and one is exactly right.
The cool thing is you don't have to wait until you come to enlightenment or until you have the bliss experience.
I had one patient the other day who said he'd been depressed most of his life And six years ago he went to Burning Man and he hasn't been depressed since.
And I said, how much stuff did you take?
And he said, no, it was just Burning Man.
It was cool.
So I'm saying yes, there are moments when you get to that point in your life where you want to do it.
The nice thing about hypnosis is that you can make that moment happen.
You can just say I'm going to put myself in a frame of mind where I'll suspend my usual judgment about things and just I'll surprise myself.
And that's one of the things I love watching in patients who are hypnotized.
Just when you tell them, their hand will float up in the air and they look at their hand and say what the hell is going on here.
You know, it wants to go back up.
So you have a little experiment in what your capacity for change really is.
And it's greater than you thought.
The second piece of it, though, is the strategy you use.
One of the things that people use hypnosis say all the time is the worst thing you can tell someone is don't think about purple elephants, okay.
What's going to happen?
And a lot of times you have people fighting urges and don't do this and don't do that.
Nobody likes that.
So we find a way to formulate what you're going to do in this state of consciousness in a way that it's an affirmation that you can feel good about it from the moment you do it.
It's sort of like growth mindset where you say, You focus on the effort, not the outcome.
And you'd say I'm going to take a position of respecting and protecting my body the way I respect and protect my baby or my dog.
And I'll feel good about myself doing that from the minute I commit to doing that.
And so it's the combination of those two things being able to create your moment of surprise whenever you want to, and focusing on dealing with the problem in a way that makes you feel better.
Just to reiterate is the idea of capacity for change.
I think a lot of people have things they want to do.
They imagine their life differently, but they don't really spend much time in that imagination because they come up with all the reasons that it can't happen.
And so being able to open and quiet that side of you, to be able to really feel what change is like, and focusing on what you want versus all the reasons it can't happen.
Super powerful.
Well, thank you.
But it's a little different than that in that it's not.
You're just putting aside all the reasons why you can't do it.
You're right.
That's the problem.
But you're just saying that and that's the narrowing of focus.
That's where that state really helps you.
Because, yeah, all those thoughts are there.
You've had them a million times.
And it's not that you've argued yourself out of them or said there's something wrong with them.
You're saying, I'm just not going to pay attention to that.
I'm just going to focus on what it would be like if I do this differently.
I just love that because so much of people's capacity for change is limited.
So just to quiet it, not to say that doesn't exist.
We're not telling you that the rational mind can't come back.
But unless we give the opportunity to say, something can be different, to see it in a different way, to feel it in a different way.
Yeah.
Well, it's like trumping the argument, forgive the term.
But it's like saying you know, it's not that you don't have all those other thoughts or fears or concerns about whether you can do it or not.
Instead of arguing yourself through them, just see if you can do it.
And if you can do it, you've done it.
So those arguments become irrelevant because you actually changed your pain.
You changed your anxiety.
You got to sleep.
You stop smoking.
So you just show yourself you can do it.
And our realities are based so much on the prior because that's all we know.
Right.
So it just feels so magical to, you know, the simplicity of what you're describing.
It's like, well, let's just see what's possible.
But actually the reason I'm coming back to this is because people will listen and they're focused on podcasts.
They're driving, they're doing other things.
And I just want to reiterate how powerful it is to just spend a little bit of time outside of our natural perspective, because our natural perspective can be so limited and our capacity for change thwarted by how limited it is.
Absolutely.
That's well put.
But conversely, You can surprise yourself at your capacity for change if you just say, let's just suspend this for a while.
We do this as humans all the time.
You have a drink in the evening.
We want to change our mental state.
And there's value to it.
Or get out in nature and just think about different things than the stuff you do every day at work.
Changing your mental environment as well as your physical environment, is something that we use as something to help us live better.
But hypnosis is a much more intense way of doing that, where you can do it in a hurry and actually under control.
See, that's the other thing.
People think they're losing control with hypnosis.
Couldn't be farther from the truth.
You're gaining control.
You're using your brain better.
You know, we have this three pound organ on the top of our body that's connected to every other part of the body.
It's this fabulous control system, but it doesn't come with a user's manual.
You know.
The fact that you've got one doesn't mean you know everything there is to be known about how to use it.
And this brain can do things that surprise us.
It can help you set aside these kinds of concerns that impede your ability to change and try something different.
So smoking is one of the examples, as I said, that a lot of people hear about in relation to hypnosis.
And smoking is... It's...
You know when I think of it as an addiction, you know I'm thinking of it from a neuroscience perspective.
You know, what does it mean to say that's an addiction?
You know, there's a craving component.
There's a, you know, there's a reward circuit.
It's a very complicated thing, addiction.
And with smoking in particular, there's a huge social component, which isn't the only way that people smoke, but there's a huge social component.
There's a huge oral component.
You know, there's all these different things. can hypnosis work for other addictions?
And I'm sort of thinking of everything from, like you know, caffeine is also an addiction that you know.
Jonathan recently underwent a fascinating experiment and you know used to function almost exclusively on caffeine.
And you know there's a weaning process that goes on, but I'm thinking of I'm thinking of alcoholism.
I'm thinking of other addictions, which I already know that the answer is it's not that simple.
But I guess I wonder if you can explain where smoking you know kind of can meet a hypnosis.
You know where there's a juncture for smoking and hypnosis that may not exist in the same way for other addictions.
Well, part of it is that the risk-benefit ratio of smoking sucks, right?
You know I mean what you get from inhaling nicotine, which is a natural neurotransmitter we have in our bodies, versus the damage you're doing to your lungs and your heart when you put that stuff inside you.
It's just terrible.
And the other thing is nobody's ever died in nicotine withdrawal.
So there's a spectrum of addictive substances.
You can die in alcohol withdrawal if you're an alcoholic.
You can die in opioid overuse.
You don't die with nicotine.
So one cool thing about smoking is if you stop, you'll be better from the moment you stop.
No problem.
The second thing about addiction altogether is, yes, there's mesolimbic dopamine.
You get a high.
But the funny thing about it is that for opioid addicts, for example, if you study what's going on in the mesolimbic system and the elevation of dopamine which makes you feel good, you get it more from the chase than the catch.
People just thinking about how they're going to score the next shot.
Dope is is more stimulating to them than actually taking the drug.
So people have this fantasy that, oh my god, you know what could i do without it and i that they're hooked.
And and it's you know, i when i, when people say hypnosis is dangerous And we last year lost 70000 people to opioid overdoses in the United States, 300000 in the last 10 years.
That's dangerous.
So people are in much more risk in continuing with these things than stopping them even drugs, where there can be situations where withdrawal could be dangerous or life-threatening.
Tobacco isn't one of them.
But even so, you're so much safer to find a way to modulate it.
And the main thing there is, okay, you've got an urge.
We all have urges that we don't act on.
And so the fact that you have an urge, if you keep fighting the urge, the urge will win.
It'll beat you.
There used to be signs on the highways saying, are you dying for a smoke?
And people would think, oh yeah, actually I am.
I think I'll light up.
It was clever, but If instead, you focus on what the real story is, which is you put this stuff in your body and it's paying a price for it.
And they say, well, I could stop any time.
You say, well, you could, but your body may be done in by the time you get around to that.
So focus on respecting and protecting your body.
It can help people with alcoholism.
I had one guy who you know, when I was talking about what the alcohol was doing to his body and he said, oh yeah, you mean sort of like The body is the temple of the soul.
And I said, you got it.
That's it.
So don't mess up the temple.
Clean it up.
So a follow-up question, and that's very helpful and gives, I think, a really good framework.
You know, when you think about, let's say, alcohol addiction, you think about drug addiction.
You know, when you think about gambling addiction and sex addiction, right?
And, you know, people who are compulsive overeaters, right?
There's this whole kind of universe of other addictions that they make 12-step groups for and such.
But what is taught in all of those 12 step groups is that we all have, you know, what's called a God shaped hole, and everyone has one.
And, depending on your genetics and your environment, you will fill it with whatever you can, whatever you know feels most readily available or helpful.
And for some people that's alcohol and for some people it's sex and, you know, and so on.
And Since you are also a psychiatrist, I'm curious about sort of the place where the other aspects of your training have to play into the patient population you deal with, because I would imagine that there are people who you see, who are, for example, clinically depressed and and for whom you might make other recommendations, and you might make pharmaceutical recommendations, or you might make other recommendations.
And then I would also imagine that you know you might see a vast number of people, you know who come in with trauma and, as many doctors, including you know, Gabor Mate, came on our podcast and talked about you know, everyone has experienced either a big T trauma or a little T trauma.
So we're all sort of, you know Compensating overcompensating, having all of these ways that we're trying to not feel the things that are painful.
So I'm curious if, when it comes to that in your practice, are there some people for whom hypnosis is not necessarily what you go to first, or maybe not what you go to second.
Sure.
I am a psychiatrist.
I'm a physician.
I prescribe meds.
I use a lot of antidepressants.
Not many anti-anxiety drugs, because they're habit forming and create problems, but antidepressants absolutely.
And there are some people who are sufficiently depressed that they can't concentrate very well, and you've got to help them get them to the point where they can.
But the cool thing about hypnosis is A it's basically risk-free and B you try it and if it works, great.
And if it doesn't, do something else.
And so it's easy to do.
I had a woman came to me who was very depressed.
She grew up in a country that is famous for mistreating women.
She said, as a teenage girl, I realized my body wasn't my own.
Men could say anything to me on the street.
And she finally got out of there.
She became a health care professional but was depressed, retired early and was in treatment and was on antidepressants.
And she told me that she had been raped by their landlord when she was 12 years old and that basically, she hadn't been the same since.
She was very hypnotized.
I had her go back.
I said, I want you to be the mother to your own 12-year-old self.
I want you to imagine you're looking at yourself as a 12-year-old girl.
She starts to cry.
I said, answer one question for me.
Was this her fault?
Did she deserve this?
She said, I'm stroking her hair.
I'm stroking her hair.
And she sort of finally got it that she had been blaming herself.
Well, as many trauma victims do, they'd rather feel guilty than helpless.
Somehow I could have been different and not happen and recognize that she was exploited and damaged by this bastard.
And she called me a week later and said Dr Spiegel, my psychiatrist wants to know what you did to me, because I'm not depressed anymore.
And she said, my friends don't recognize me.
And six months later I got an email from her saying I thank God for the doctor who referred me to you.
And I'm still not depressed.
I'm feeling fine.
So that doesn't always happen by any means, but it can happen.
And so you try it.
And if it helps, good.
And if it doesn't, I do something else.
I'm not a hypnotist.
I'm a psychiatrist.
And so it's a tool that I use.
If I've got it and it works, I use it.
And if it doesn't, I do something else.
Maybe that's why magicians use hypnosis as a stage trick, because there's an aspect to what you just described that makes you a sort of magician.
I mean, but that's its own kind of miracle work.
I mean, I think that's unbelievable.
Thanks.
Well, it feels good when it happens.
And it's an opportunity.
You're sort of getting people in a way at their best in terms of their opportunities for change.
And you're seeing how they can use it.
And you try and couple that state with a strategy that gives them a way out.
It's not forget about it.
It's not maybe it was your fault.
Let's figure out what you did wrong.
So it was a strategy that made sense for her and helped her put into a totally different perspective what she'd been living with.
Does hypnosis work for nail biting?
Yes, it does.
You teach people to, if you have to put your nails in your mouth, lick them instead of bite them.
And again, you wouldn't do it to your baby.
Well, actually, mothers do actually.
They're afraid to use nail clipper.
You bite them off.
That's right.
When the babies are little, if you're afraid, you'll chop off a finger, which I once almost did.
Lick them?
Yeah, you do something that's affectionate rather than damaging.
But I would, I mean, this is also why that would be an impediment for me.
I would never want people to see me licking my fingers, but I don't mind.
I guess people seeing me bite my fingers, but maybe that's equally absurd.
Well, you can make a secret of it.
Just lick it instead of, pretend you're biting it and lick it.
All right, we're going to book a session for my Dr. Spiegel.
On finger licking, that'll be good.
On finger licking and cuticle ripping.
The main idea and the main idea of Reverie is to give people the opportunity to do this.
There are not that many people trained to do hypnosis in the U.S. and the world.
The hypnosis societies, I was president of one of them, are very small.
And so it's hard to find it.
And when I started my career I thought if I just do enough science about this, build it and they will come.
Well, you know what?
That hasn't happened.
And I've decided that I've learned stuff from doing this and I want people to have it for themselves.
So the idea is, talking to you, what we're doing with Reverie is to go direct to consumers.
And if you look at integrative health and people's movement to that, it's mostly come from patients themselves.
They pay more out of pocket for integrative care than they do out of pocket for mainstream medical care.
They make more visits to integrative care than mainstream medical care.
So people have the feeling that they want to do something where they make the decisions about their care and they're doing what they want to do.
And we want hypnosis to be one of those things that they can do, like mindfulness, like yoga, like other things they do that can genuinely help them feel better and be better.
And that's something that we know they can do.
And so the idea is to, you want to try it.
And I want to see it as a supplement to other treatments people are doing.
But saying rather than find someone who does hypnosis, who's well-trained and licensed, which is a good thing to do You can try this for yourself today and see what it's like.
I used to worry that it wouldn't be as good as being in the office with me.
And then I thought, if you've got insomnia and you wake up in the middle of the night, you probably don't want me in your bedroom hypnotizing you again to get back to sleep.
And but you've got me on your smartphone.
So try it.
And so the idea is this is something it's a natural state.
It's helpful and you can learn to use it for yourself.
Give it a try.
I'm curious where it plays into your personal life.
Did you marry a psychiatrist?
No, no.
I married a stem cell biologist.
My wife, Helen Blau, is also a professor at Stanford.
And she, by the way, also gave birth to our two children with hypnosis as the only anesthesia.
Was it your voice in her head?
It was my voice.
And I had no pain at all.
You know, I was fine.
That's a real group effort to give birth to children when it's your voice.
Our son was 10 pounds when he was born, first child.
And she said in the middle of it, she said, you know, I teach pharmacology at Stanford.
You know, there are drugs for this.
And I said, you're floating in Lake Tahoe, cool tingling.
And she did fine.
So she's understandable.
When my daughter was little, she's a lawyer now working for Governor Newsom.
But when she was a little girl, somebody asked her what her parents did.
And she said, my daddy is the kind of doctor that helps people.
And my mommy is the kind of doctor that doesn't help people.
Yeah.
So, so, uh, it's, uh, and I mean, it runs in the family.
Our son's an architect.
He designed this house that you're looking at behind us here.
And he was asked to speak at the American Psychiatric Association about what it was like to be the child of a psychiatrist.
And he said, well, you know, my, my dad had two psychiatrists for parents.
I have a little more leeway because my mom's a stem cell biologist.
He said, but you know, you feel different in this room.
Um, than you do at home because spaces give you feelings.
He said, I'm an architect.
I want to be a doctor of spaces.
And I thought, that's really cool.
I'd never heard him say that before.
So you know, they find ways of incorporating what they learn in a different manner, but there was more leeway in our family.
One of the, I think, most enduring things about the research you do which, as you said, may not be where most people learn about you.
They may learn about you from the Reverie app.
But you've kind of expanded your exploration of the role and significance and impact of hypnosis into just about every field that there is, that is, exploring wellness.
And you know what I mean is you know, your research covers really everything that's impacted by stress.
You know whether that's cancer or trauma.
I wonder if you can connect for us and connect for our listeners, how this kind of therapeutic tool can have an impact on things like cancer or things like PTSD treatment.
Sure.
Thanks, Maya.
I've spent decades running support groups for women with metastatic breast cancer and hypnosis is a part of that, but it there's no question that the way we live with and face serious illness can either help us along that path or make things worse.
And if you become terrified and you fight it uh, then every time you get a pain in your chest you think, Oh my God, it's a pneumatastasis.
I'm going to die sooner.
And it becomes nothing but a struggle.
Now, cancer is a struggle, but when people face it directly, they they learn to put it in perspective.
You know that?
Uh, I had one woman who was in one of these groups who said you know, they control their pain by saying I can control the pain with hypnosis.
And the fact that I have a pain in my chest doesn't mean it's a new metastasis and I'm going to die tomorrow.
So they can put their anxiety into perspective.
And one woman said that, even talking about death and dying in the group.
And people died in the group, you know, and they grieved losses.
And we used hypnosis to help them do that.
But they would say I realized that Talking about death is like looking into the Grand Canyon when you're afraid of heights.
You know, if you fell down, it would be a disaster.
But you feel better about yourself because you're able to look at it.
I can't say I feel serene, but I can look at it.
And that's like what people who take psilocybin, who are dying with cancer, say.
You know, I finally face non-being, you know, just the terror of not existing.
But I also saw the miracle that I do exist.
You know and learn to appreciate the fact that I have had time to love and live and do things.
And that's remarkable.
And so it's a way of saying that there are many ways for us to face very difficult things and live with them better and handle them better.
And the brain's capacity, the neuroplasticity to you know, neurons that fire together, wire together.
Um, that if you learn to face the same stimulus in a different point of view, if you make relationships with people.
And we found actually that much to our surprise initially, that women randomized to these kinds of support groups actually lived longer, by like 18 months.
You know nothing trivial.
Married cancer patients live on average four months longer than unmarried cancer patients.
That's a weird statistic, Dr. Spiegel.
I'm going to be honest because like, what are you going to do if you happen to not be married and you get cancer?
Get married in a hurry.
Stop it, both of you.
No, but it's true.
So the interesting thing is that it works better for men than women.
Having a relationship with a woman does your health a lot more good than having a relationship with a man.
You seem to understand that.
That's why women who don't marry or lose their husbands God forbid early tend to live a very long happy life.
But it's one of those things where fix it.
And part of what can be a problem for people with serious illness if they don't have social support.
It'd be good to find it.
Lean on your friends, ask them for help.
People always say, oh, what can I do for you?
Think of a couple of things they can do for you and don't feel guilty about it.
It makes them feel better too.
So I encourage people, even when they're very ill, to build networks if they don't have them.
Is this statement true or false?
People who are less hypnotizable are actually the people who need to learn to be more hypnotizable.
Well, I would say not entirely because it is very hard to change your hypnotizability as an adult.
There was a 25-year test retest study done at Stanford.
And the average stability of hypnotizability was 06, which is as good as IQ over a 25-year interval.
It just doesn't change very much.
So I would say the better path is to use whatever degree of hypnotizability you have and use it well.
So it was like those two women with trichotillomania.
With one, it was easy, do it, feel it, you got it.
The other one, it was harder, but she got there.
She did it her way.
And so what we try to do is identify hypnotizability, and we have a hypnotizability test on the app.
So within six minutes, you can find out how hypnotizable you are.
And there are three groups.
There's the poet, like you, very hypnotizable.
There's the diplomat.
You try it, then you negotiate, then you try it.
And then there are the researchers who have to think it through mostly.
That's okay.
You just adapt your intervention to their style and make the best use of whatever degree of hypnotizability you have.
I'm the diplomat.
Did you come up as a diplomat?
Yeah, I did.
Wait, wait, wait.
Hold on one second.
Wait, we got to back this up a little bit.
Because Jonathan is the kind of person who can like find himself on a hike and you will lose him.
And three hours later, he doesn't even realize that he's been hiking.
I think of you Jonathan, as very, you're very rational, but you're also you're very dreamy and you are a writer and a poet.
How do you reconcile that with your diplomat status?
Okay, hold on.
We're going to circle back to this because, Dr Spiegel, I was wondering can you basically know someone's hypnotizability just by hanging out with them for a little bit and hearing them speak, or do you get surprised?
I can get an idea, but I do the test.
I mean, every one of those 7,000 people, I start out measuring their hypnotizability.
And so I form my hypotheses, but the only way to know for sure is to test it and see if it works.
So what is your hypothesis about Mayim?
Just shot in the dark.
Yeah, I would say you're a diplomat, probably toward the high side, but more mid-range hypnotizability.
You do it, you experience it, and then you pull back and think about it and argue with it a little.
So when she describes me hiking, the thing about Mayim that a lot of people don't see is that she is so engrossed in the moment.
Like if you ever watch her watch UCLA men's finals basketball, There could be a bomb going on around her.
And she's just like on the wave of every pass and every moment of the game.
And she's cheering and screaming and slapping the table.
And like, it's amazing to watch.
And yet in the other time, she'll pull back and be very analytical.
So she kind of goes in and out of that wave.
But I also I love fantasy.
I love fantasy.
I love like I love Dungeons and Dragons and I love, you know, The Hobbit.
And like I've watched, you know, Lord of the Rings like eight dozen times.
And I love that kind.
I love to get immersed, you know, in in that kind of world.
I don't know.
When Mayim was starting the journeys to do more exploratory hypnotic sessions, she would describe sort of being really in it and then pulling back and analyzing it and then sort of diving in and pulling back.
And actually what I think is inspirational is that I saw her become more and more willing to be immersed in it and the analytical side quiet and be more engaged in the journey and then feeling like oh, is this imagination?
Am I making this up?
Where's the reality in what I'm imagining?
And that side of her would quiet and allow her to be more immersed.
And so I think people can... not necessarily change, obviously, their hypnotizability, but their ability to be immersed in the creative process to experience hypnotic states without pulling back as much.
Sure.
I think they can change the way they use it and make better use of it.
And some of this having perspective that you've got that ability.
But it also sounds to me like you, of the two of you you more easily shift to be have the analytical and the experiential kind of together.
And for you, you're in it or you step back from it and then you analyze it.
It's a little different.
Yeah, I think some of the interest I have in you know that sort of like Jungian, like depth psychology stuff of like your imagination is your consciousness,
And like a little bit, I struggle with that because I have a lot of fear.
And it's actually the same thing as a performer that makes me very anxious about improvisation.
And so that's kind of what my therapist has been working with me in, in that you know if there really is no kind of wrong answer.
You know allowing that.
You know allowing that is part of the process.
You know, there's a lot about the future of health and, you know, looking at pretty what we've lost.
And I'm just wondering what you've learned from your window about overall stress as it relates to quality of life.
And I mean, like that's overly simplistic, right?
But we're seeing more and more of the mind body connection, that there is no separation and that our interpretations of experience are, you know, really driving biological function.
And I wonder if you could speak a little bit.
You know you've written so much, you've researched so much and would love to hear your perspective.
Sure.
Well, you know, we know that.
You know the brain controls uh stress hormones.
To release the stress hormones.
We found that, um, you know, cortisol mobilizes glucose in the blood to prepare us to fight or flee.
And that in cancer patients, dysregulation of cortisol can actually have an effect on the rate of disease progression.
So helping people to manage stress better will certainly help them live better and might help them, in some cases, live longer.
The real issue, I think, in thinking about stress is the interaction between brain and body.
Is it to your benefit or is it creating the problem itself?
So, you know, you get worried about something and then your body reacts to that naturally.
So your muscles tense, you start to sweat, your heart rate goes up, your blood pressure goes up.
You notice that interoception.
And then you think, oh my God, this must be really bad, you know, and you feel worse.
And then your body thinks, okay, he's feeling worse.
And it's like a snowball rolling downhill.
So A big part of managing stress better is to separate out, to the extent that you can, the somatic reaction to the stress from the psychological experience of the stress.
And so I start from the bottom up.
I say, imagine you're floating in a bath, a lake, a hot tub or floating in space.
Get your body comfortable and notice that you can dissociate your somatic reaction from your psychological state.
And once you've done that, then picture one aspect of the stressor while your body is floating and comfortable, and then visualize what you could do one thing you could do to deal with that stressor.
And so you begin, then to be able to not have this snowball effect, but instead parse it, get your body comfortable as the first, not the last thing you do, and then see if you can't figure out a better way of dealing with something.
So your boss is yelling at you.
Imagine him being half as big, like a little kid in a big chair, and see if what he said makes you as upset.
Think about what he said and not just who he is.
And think about what you might say to him.
Well, thanks for the advice, bud, or whatever you want to say.
So you teach people means of controlling this mind-body interaction in such a way that the stress doesn't automatically overwhelm you.
The simplicity of what you just said.
I think people could take a lifetime to unpack, because we're so primed to have our somatic reaction be the psychological reaction.
Right, right.
My boss is yelling at me. and I immediately go into the narrative that I have about the boss.
I'm gonna lose the job, or I'm gonna get demoted, or I'm not gonna get the promotion.
And then that leads to well, I'm gonna have housing problems, my marriage is gonna end or my girlfriend won't want me.
And where am I gonna sleep?
I'm a failure.
And those are so quick and so interlinked that we don't even realize that we're happening.
And all of a sudden we're just feel panic.
And we don't even know all of the thoughts that have caused the panic.
That's exactly right.
That's well put.
And the fact that there is a state where you can suspend your usual beliefs about yourself just the kind of things you're talking about means it's an opportunity to see the same stressor from another point of view.
I had a patient who was worried about her future in this company where she's been doing well, but it's a high pressure place.
And she carefully constructed a memo to send to somebody from another company.
The guy who got it kind of resented it and felt she was criticizing him and contacted her boss.
And she was very anxious.
Am I going to lose it?
And I said in all of this, the one thing I don't hear from you is what's wrong with that guy?
That, instead of appreciating your feedback and it just like hadn't even dawned on her that maybe the other part of the equation was this guy was kind of strange.
And in fact, her boss was not that critical of her.
He said it didn't work out well, but you know.
So just allowing yourself to see the same problem from a new point of view and not start with your usual assumption that I must have screwed up again.
And this is just more proof of it and that cycle that you talked about.
And you can do it.
You can try it out in hypnosis.
You can just see what it feels like if you think about other aspects of it without getting so caught up in your own script of it must be due to some deficiency in me.
What do you recommend for people who are in that emergency state?
You know, like I'm trying to make this super practical.
All of a sudden I feel my, call it anxiety, but whatever the term is, rising.
And I feel I'm on that path.
And like, how do I, number one, identify?
And then two.
Do I start thinking that I'm in a floating bath of calm just to re-regulate and see it from a different perspective?
What's like my first step when I'm in that sort of emergency cycle?
Well, you could do it.
But one thing we could even try now, we've got a couple of breathwork exercises on the app as well.
And one is called cyclic sighing.
And I've been surprised at how well and how quickly this works.
So you're getting tense.
So you want to make your body comfortable, as comfortable as you can.
Now, inhale through your nose with your belly.
So diaphragmatic breathing, about halfway.
Hold it.
Now expand your lungs all the way with your chest.
Expand your chest.
And then slowly exhale through your mouth.
Inhale again through your nose with your belly.
Stop.
Now fill your lungs completely.
Expand your chest.
And slowly exhale through your mouth.
How are you feeling?
I like that.
Total reset.
That's great.
Great.
Let's start the interview all over.
I'm in a totally different place.
No, you did really well.
You did fine.
But so, you know, notice how quickly your brain can help your body.
And, you know, we normally, the standard thing is take a deep breath.
Well, you know, it's actually not the inhale that really relaxes you.
It's that nice, slow exhale.
It's the exhale.
And you just, you know, we sigh for a reason.
It conveys acceptance, you know.
And that's what your body's doing.
You're triggering energy. soothing, rest and digest kinds of feelings, parasympathetic activity.
Say that again.
Sighing conveys acceptance.
Acceptance.
Sighing indicates acceptance.
Yes.
That is so powerful.
Let's talk a little bit about just the notion of acceptance, because in the cycle of thought that we go down we are not accepting the thing as it is.
We're panicking about it and then going down a narrative trail, then releasing the stress hormones and then getting ready to flee and attack or whatever we need to do.
And you know, MIME talks a lot about 12 steps and the 12 steps they talk about accepting life on life's terms.
And only in moments of acceptance can we be still and quiet in order to find what the next step is.
That's because the vagus nerve has been stimulated and the parasympathetic nervous system is online.
So the science, the bridge of the science between what is either spiritual or.
That's the physiological.
Yeah.
The physiological explanation of acceptance.
Well, you know, part of it is you know, if you're fighting it, you know this can't be um, you're making it harder for you to resolve what is, because you're fighting to make it not be.
You know, and and uh,
I had a woman who was in the World Trade Center when it was attacked.
And she was angry with herself.
And I said, what were you angry about?
She said, I told myself, I said, just put one foot in front of the other and get down the stairs.
And if you get down to the lowest level, you'll be okay.
She did the other building collapse.
She was blown out the window.
And she was angry at herself for having misled herself.
And I said, you accepted what you needed to do and you did it and you saved your life.
And so that's that kind of acceptance where you just focus it into things you can handle and accept.
And what she could accept is how dangerous this was and what she had to do to get out.
And so it's that same sense of you can you can.
Be more creative in dealing with it if you accept what is.
That's exactly right.
And we're not saying that acceptance will make everything great.
But what you do is you're able to understand the choices that are available.
There are certain things that go on in the world for which there's not an endpoint to fear.
There's not an endpoint to a feeling of threat.
And for children, for example, raised in homes that are not safe.
That's the kind of threat that you know, many children grow up with.
But as adults, there are also things that can feel scary for which we can't see an end.
And I wonder where the kind of work that you do and the kind of support that, you How can that help?
Because right now I'm feeling a little bit like nothing's going to help.
Well, I, you know, I share your feeling and it's, it's a tragedy.
And I used to take comfort from the phrase never again.
And I don't anymore, you know, and my grandfather escaped from the Ukraine a century ago.
That's why I'm here.
But he was running from the same kind of thing and it's terrifying.
And and the sort of weird polarizations and bizarre attacks on our democracy doesn't isn't reassuring either.
Um so uh, i agree with you, but i, i guess you know all i can say is what i try to do is help people deal with whatever it is they have to deal with, and not all of it is soluble, there are, you know.
Plato said courage is knowing when to be afraid, and and there are times to be afraid um, I think.
But what I want to do is help people at least manage the fear better and not let it immobilize them.
So it's not all or none, it's more or less.
And if you can at least manage your somatic reaction to stress, put it into perspective enough that you can figure out what to do next, that's a good thing.
Is it going to make you happy all the time?
Hell no.
But can it help you face what we all have to face and deal with it as best we can?
That's what I hope for.
So will it help you get some sleep at night?
Will it help you manage the stress when you're anxious during the day?
That's what Reverie is all about.
It's giving you one more tool to help you manage whatever you got to deal with as well as you can.
I couldn't help but notice as the child of two psychiatrists that you got a BA in philosophy, is it?
Yes, that's right.
When you were an undergrad?
That's right.
Were you.
I mean the work that you do, I think combines the philosophical and the psychiatric, but did you?
Did you originally not plan on becoming a physician?
I was yeah, I well, of course you know I had to consider something other than what both my parents did.
But I also I took philosophy, actually because I took a great introductory psychology course and
And the professor was brilliant.
He was a former Shakespearean actor who was a great lecturer.
But each week, he would teach a different theory of personality and things like that.
And that one seemed great.
And then the next one seemed great.
And I thought, well, wait a minute.
How do you decide what really is great?
And that's what led me to philosophy, to just think a little more deeply about how people are and what they are.
And I thought about being a philosopher, getting a PhD in philosophy.
But then I thought Being a great philosopher would be one of the greatest things to do with your life.
But teaching freshman Plato for 20 years would not.
And I thought that's where I was heading.
So I gave in and went back to what I knew I would always probably do anyway.
But it has been very helpful to me to think about how people relate to themselves, how they relate to people around them, what matters, and understanding what it is to be human.
And it was very helpful to me and still is.
Dr Spiegel, what do you feel hopeful for in the future, both for yourself and the people you're helping, but maybe also larger?
Well, I do.
I do hope uh Jonathan, that that we can use this new technology which, Lord knows, has given us enough trouble in many ways.
Um, to truly be able to disseminate things that were just not available to people before.
That is, you know, we've had 500,000 downloads.
We've got 23,000 people using the app this month.
So right now talking to you, I've helped more people than I did in a year of person-to-person work.
I do feel good about that.
I think we can genuinely offer people the kind of help that I used to do by myself and other people other.
There are many other fine clinicians using hypnosis that can really help people help themselves, feel better, to view it as ability, not as a liability but as an asset.
All hypnosis is really self hypnosis.
It doesn't take away control.
It gives you control over your mind and your body.
And I want to spread that wealth.
I want people to have the opportunity to use it.
And if, if I can, If that happens, if I can really make it available to people, I'll die a happy man.
You know, that's what I want to do.
Wonderful.
I'm hesitant to ask you to do a parlor trick and hypnotize Jonathan, but I didn't know if there's any small exercise before we let you go that you might want to do, just so people can learn a little bit about what it actually looks like.
The reason I think maybe we should use Jonathan as our guinea pig is because I'm an actor.
I think people will automatically assume that everything that I do is performative.
So I didn't know if Jonathan would be up for closing his eyes a little bit.
Okay.
Okay.
What would you like to do, Jonathan?
I want him to quack like a chicken.
Chickens don't quack.
Ducks quack.
I'm sorry.
Quack like a duck.
She wants you to bend nature.
That's right.
I want a hybrid duck and chicken.
So anything in particular stressing you or you want to deal with that as an issue?
I can answer that.
Go ahead.
Em, I mean, there's so much.
Well, Jonathan just moved.
This is my empty house behind me that I'm trying to block, that there's no furniture.
Ah, okay.
We've talked about it in the past about like, what is home base for people and coming back to a level of acceptance.
So, you know, if there's like almost a re-instantiation of that.
All right.
Well, let's try it.
That sounds good.
Let's give that a go.
Okay.
All right.
So maybe take off your eyeglasses if you don't mind.
All right.
Now get as comfortable as you can.
Look up to the top of your head all the way up as you can.
And as you keep looking up, slowly close your eyes.
Close while you look up.
Close, close, close.
Good.
Now take a deep breath.
Let the breath out.
Let your eyes relax, but keep them closed and let your body float.
Let your breath out slowly.
And now I want you to take one hand and stroke the back of the middle finger of the other hand.
And as you do that, you'll feel a sense of tingling and numbness and lightness, and let that hand, the one you're stroking, float up into the air like a balloon.
Tingling, numbness and lightness and let the hand float up.
That's good.
All the way up higher and higher.
That's good.
Now your hand will remain light and in this upright position until I ask you to touch your right elbow with your left hand, and then your usual sensation and control will return.
But right now I'd like you to take your left hand and pull your right hand back down and then let go of it.
And now please describe what you're feeling and what's happening to your right hand.
Overall, I feel calm and in like a slightly altered state.
I feel like my right hand is not sure where it should be.
It feels like a little floaty.
So just let it be floaty.
It's a strange sensation of like feeling, like I want to control it, but also it just kind of wants to float.
That's great.
And there's like this divide between like the thinking part of me.
That's like, where should I think?
And then the other part of me that's just like, well, why does my hand want to be up here?
There you go.
It feels very effortless to keep it up here.
That's great.
That's good.
So just enjoy this. state of altered attention.
Let your right hand float upwards, your body float.
And as you do that, so I want you to picture a contrast between that sense of relaxing and safety and how that was a shift from the way you felt before.
I feel like it was like this um chaos, it's like a visualization of chaos, and it's dark and it's like scary and almost like in a forest at night and things are growling and moving.
And then here is this like very tranquil, peaceful area and this is a safe and just calm space, and there was just this.
Yeah, the only way to describe it was level of unpredictability and scariness and chaos over there.
And can you let that feeling suffuse through you now, that sense of calm?
Yeah, as I do that, I feel like my shoulders relax.
I feel that image sort of slowly get pushed further away from me, the chaos image.
So notice how you're letting your body help you.
Your shoulders relax, your body feels more comfortable, and that reinforces the sense of calm in your mind which, in turn, helps your body feel more comfortable.
So you can shift back into that cycle of mental and physical comfort and relaxation that you've had a taste of before, and you can keep retasting as you wish.
Now take a few moments to reflect on what this means to you in a private sense.
Let your left hand float over and touch your right elbow.
Let go.
Good.
Your right hand's back down now.
And we'll come out of the exercise together, feeling relaxed and refreshed.
On three, get ready.
On two, with your eyelids closed, roll up your eyes.
One, let your eyes open.
Ready?
Three, two, one.
What's so amazing is the sense of presence, that I'm fully here, that I'm available, but also that, at the same time, I have entered what I can only call is an altered state.
It's not meditation.
It's very effortless.
And yet like if I, and I was thinking while I was doing this, I'm like, why isn't my shoulder sore?
I'm like leaving my hand up here.
And even as I have my hand up here now, I'm like oh, it takes power of my thoughts to keep this thing up here.
Whereas before, while I was in the hypnosis.
You could have given birth.
That's great.
That's a great description.
It's such a strange sensation.
What is it about the eyes that why look up?
You know, there have been a lot of, you know, I've seen different practitioners who do.
You're focusing on your third eye is what it's a mudra.
Yeah.
You know, when we talk about EMDR and the movement of the eye, what is it about?
You know the placement of the eye that helps people get into that state.
Well, you know, the third, fourth and sixth cranial nerve nuclei, which control eye movements, are in the middle of the reticular activating system which manages arousal in the lower part of the brain, the brainstem.
And so there is something about changing eye movements that does seem to be related to the way you manage arousal.
But in particular, you know, we normally use our vision.
It's our major purpose.
Perceptual defense, we're primarily visual.
And normally, if you're turning off the defense, you close your eyes, you're going to sleep.
This is a state of remaining alert, but turning inward.
And so it symbolically has the eyes looking up at the third eye, as you mentioned, and just get into a shift in mental state, but you're still alert.
So it's not the only way to go into hypnosis, but it's a quick way to shift gears.
Maintain your alertness, but turn inward.
That's what it's about.
And also I do want to give a shout out to Eastern traditions that for thousands of years have used practices to focus in ways that the West has taken some time to come to, and there's still a lot of biases of that.
But in Kundalini yoga, for example, a lot of the poses that we do, which we hold for long periods of time, involve that kind of eye focus.
And it's like a specific part of it.
So I think that's also something worth noting.
Dr. Spiegel, it's been really such an honor to get to talk to you.
And we appreciate so much the work that you've done and the years and the decades that you've put into something that is now shared with such a wide audience in such an egalitarian way.
So it's really wonderful.
Thank you.
I'm glad to hear that.
Well, I appreciate your helping us to do that, to get the word out.
And that was really, that was incredible to watch.
Jonathan, you did a great job.
Yes, you did.
That was fantastic.
Dr. Spiegel, it really is such a pleasure to speak with you.
We love your work.
And yeah, this is amazing.
I hope our paths cross again.
I hope so too.
Love your podcast.
It's great.
So keep doing what you're doing.
All right.
Take care.
Bye-bye.
I had asthma as a kid.
I wish I had had David Spiegel to tell me to take deeper and deeper breaths.
I like that one of his measures was like, the mother stopped crying.
As soon as the mother stops crying, the child gets better.
There's a very interesting link between maternal stress and children's asthma which nobody really wants to talk about because it makes us all very uncomfortable, because the idea is not that you caused your kid's asthma, but that there are many factors.
And asthma is one of those that they have really identified some very interesting factors connections between, in particular, maternal stress and anxiety and asthma.
We're not shouting out my mom.
Or anyone's mom who have children with asthma.
I have asthma as an adult.
I'll start blaming my mother now.
Jonathan, maybe you can describe a little bit what you experienced.
I am I definitely, it seemed like you got into a hypnotic state pretty quickly.
So I have tried the Reverie app and I didn't have the immediacy that that happened.
And I don't know what was going on.
His voice, no, his voice, it's his voice is magic like that.
Maybe it's the pressure of doing it live with him.
I don't know.
But there was a moment where there was a physiological change in me.
And at the same time, there was a physiological change.
There was my conscious rational mind analyzing the fact that this physiological change was happening and But I was giving myself enough space where I was like I'm not going to intervene.
I'm going to allow it to happen.
But it was a bit of a floaty sensation.
It was kind of like a little bit of a buzz, a little bit of like everything got turned down in a way.
I mean, do you think it's the?
You know not to be a naysayer but, like some people might say, like oh, it's just the power of suggestion.
Great.
But like Seth Godin says, the power of placebo is extremely powerful.
Why not use it?
I mean, there is something to his voice and him speaking directly to you.
I mean, it's very special.
It's kind of like, it feels like we had Houdini here.
He did a trick just for you.
My arm was up the entire time and part of my thoughts were like, shouldn't my arm get tired?
We used to do these basketball drills where we would do like side shuffles and we have to keep our arms above our head.
And, you know, after a while, your shoulders start to burn.
You have delicate shoulders.
Put your arms up.
Put your arms up right now.
Six minutes.
No, I can feel it already.
It's just, no, you can just feel like, oh, my delts are activated.
Like it involves holding your arm up.
Like you didn't feel any of that.
It felt totally effortless.
And at the same time there was like this you know, when I have meditated and gotten into a very deep meditative space and like I have a body buzz and I'm you know, floaty a little bit,
It felt immediately like that, while also having pure cognition where I could speak, and it didn't get pulled out of it.
And when he asked me about the different states, I could immediately conjure and see my most stressed and anxiety-filled state experience.
Do you remember how you described it?
Yeah, it was like the forest and the kid.
You said there was.
I mean, you were just.
You were describing me like you were describing when we interact.
You said that it was like a dark, like chaos in a forest and you said there was growling.
Yeah, it's like animals.
Just what my voice sounds like, jonathan.
I could see it clearly And then also see myself here clearly.
And I could see a divide of the two states.
And when we talked about expanding them, that other state got pushed further away from me and it got almost quieter.
And then there's this instantiation of what safety felt like or feels like.
You know we have you, and I have talked about this notion of home base, that if we don't know where to return, then we can take our deep breaths, we can calm, but we don't have a grounding in a place that we feel comfortable.
And that's where I was curious about this.
Exercise is like number one.
Can it help people find that safety?
And number two, can it help ingrain it and instantiate it and build a foundation?
For me, people talk about this all the time.
They go to a retreat.
Or they go on a meditation binge and they're like I felt so great, but then I lost my way.
Or I came back from the retreat and I couldn't bring that feeling home with me.
Like, how do we build a spot in ourselves that we can always return to?
Well, I think that was one of the most profound things that he said.
That he talked about was this notion of viewing, not just hypnosis or not just you know these kinds of techniques in therapy.
But how about Finding any place in your life where you can practice being a better version of yourself And I don't mean better like you're not good enough?
I mean a more, I mean I'll just, I'll speak for myself a less reactive person, a more grounded person, a less anxious person, a person who is deserving of respect.
Sleep care That's the notion is that, whether it's meditation, whether it's therapy, whether it's using this app to find a place to practice where it's safe because for most of us it is not safe in our normal functioning daily lives, in our environment, in our job, in our homes, even in our own head, it doesn't feel safe.
And the notion is there is a place where you can practice being safe more of the person that you'd like to be.
What really hit me and I love what he said in terms of separating the somatic stress from the psychological stress because when we aren't accepting what is, we are on a loop, that is a self-perpetuating loop of becoming more and more and more stressed.
So when you say it doesn't feel safe, it isn't safe.
It theoretically may not be safe because there may be active threat, But for a lot of us we actually are safe and we feel like there's an active threat.
Or we always have the ability to find some semblance of safety.
And I think that's the thing for people who experience depression, for people who experience anxiety, for people who are dealing with unprocessed trauma.
You don't believe that there is safety and there's no hope of safety.
So I really...
Really appreciated him saying that.
Jonathan, I'm so glad that you encouraged Dr. Spiegel to come and talk to us.
It was really, really, really wonderful.
Thank you for encouraging him to hypnotize me.
Now I have been hypnotized from a pioneer in the field and I hope everyone can feel a to separate the triggers from the response.
That's what we talk about a lot.
From our breakdown to the one we hope you never have, we'll see you next time.
