Huberman LabUsing Hypnosis to Enhance Health & Performance | Dr. David Spiegel
CHAPTERS
- 0:00 – 12:00
Introduction, Guest Background, and Clinical vs. Stage Hypnosis
Huberman introduces Dr. David Spiegel, outlining his dual roles as researcher and clinician and his extensive career studying hypnosis, stress, and mind–body interactions. They distinguish clinically grounded hypnosis from stage acts, and preview topics including hypnotizability, apps like Reveri, and breathwork collaborations.
- •Spiegel is Associate Chair of Psychiatry at Stanford and directs the Stanford Center on Stress and Health.
- •Clinical hypnosis has strong research backing for pain, stress, anxiety, some cancer outcomes and psychiatric conditions.
- •Stage hypnosis focuses on spectacle and can harm public perception; clinical hypnosis is about patient self‑control and therapeutic change.
- •Reveri app is built on Spiegel’s lab data; currently iOS with Android planned.
- •Huberman emphasizes the podcast’s mission of zero‑cost science education and mentions sponsors.
- 12:00 – 23:30
Defining Hypnosis and Everyday Trance States
Spiegel defines hypnosis as intense, narrowed attention with reduced self-evaluation, likening it to being absorbed in a film or sports event. They parse when such absorption is hypnotic versus merely distracting, depending on whether bodily reactions are integrated or fragmenting.
- •Hypnosis: ‘telephoto lens’ attention—vivid detail, less context and self‑reflection.
- •Everyday examples: getting lost in a movie, deeply engaged in a game, or fully absorbed work.
- •Bodily sensations can either deepen hypnotic absorption or break it if they pull attention elsewhere.
- •Self-altering experiences during intense engagement are common and form a continuum with formal hypnosis.
- 23:30 – 55:30
Spiegel’s Path to Hypnosis and Dangers of Stage Hypnosis
Spiegel recounts his family’s deep roots in hypnosis, his father’s WWII work, and a pivotal case treating a teenage girl’s severe asthma using hypnosis in a children’s hospital. He contrasts this with unethical stage hypnosis, sharing a case where a stage suggestion precipitated a serious dissociative crisis.
- •Hypnosis entered the family through Viennese refugee Gustav von Aschaffenburg, who taught young psychiatrists.
- •Spiegel’s father used hypnosis in war for pain and acute trauma reactions, later finding it more effective than daily psychoanalysis for some issues.
- •Medical school conversion moment: hypnotic breathing suggestion rapidly relieved a girl’s status asthmaticus when drugs failed.
- •Institutional resistance (e.g., false claim of violating a law) highlighted cultural fear of hypnosis.
- •Stage hypnotists pre‑screen for hypnotizable volunteers and can inadvertently trigger deep psychological issues (e.g., woman who felt like a ‘bird in a gilded cage’).
- •Core message: hypnosis offers cognitive flexibility and can be healing or harmful depending on how it’s used.
- 55:30 – 1:19:00
Neuroscience of Hypnosis: Brain Networks and Dissociation
Spiegel details fMRI and connectivity findings in highly versus low hypnotizable people. He outlines three neural signatures of hypnosis: reduced dorsal anterior cingulate activity, strengthened DLPFC–insula linkage, and inverse DLPFC–posterior cingulate connectivity, linking these to focus, mind–body control, and decreased self-referential processing.
- •Dorsal anterior cingulate (DACC) activity decreases in hypnosis, reducing conflict monitoring and distraction.
- •Highly hypnotizable people show greater baseline functional connectivity between DACC and left DLPFC, supporting coordinated task execution.
- •Under hypnosis, DLPFC–insula connectivity increases, supporting top‑down modulation of bodily states (e.g., pain, gastric function).
- •Classic gastric acid study: imagining favorite foods plus hypnosis increased secretion ~87%, while neutral imagery reduced it ~40%; even pentagastrin response attenuated in hypnosis.
- •DLPFC–posterior cingulate (default mode) connectivity becomes inversely correlated, reflecting doing without overthinking self-implications—central to dissociation and reduced self-consciousness.
- •These patterns differentiate hypnosis from meditation, which also reduces posterior cingulate activity but with different phenomenology.
- 1:19:00 – 1:41:00
Attention, ADHD Speculation, and Problem-Focused Uses of Hypnosis
Huberman asks about ADHD and distractibility, and Spiegel offers cautious speculation that some with ADHD may benefit from focus training via hypnosis, though many may be less hypnotizable. Spiegel then surveys stress, sleep, and phobia treatments, emphasizing hypnosis as a powerful tool for managing mind–body dynamics.
- •Potential but unproven use of hypnosis for ADHD; many with high distractibility may be less hypnotizable due to over‑ or under‑control of attention.
- •Hypnosis for stress: imagery of body ‘floating’ plus mental ‘screen’ for problems separates bodily arousal from cognitive processing.
- •This decoupling lets people feel physically calmer while still mentally engaging with stressors, restoring perceived control.
- •Sleep: using floating and screen imagery to fall asleep or return to sleep, with many users reporting improvement after years of insomnia.
- •Phobias: hypnosis enables ‘imaginal exposure’ (e.g., dog or flight phobia) in a controlled mental space, building positive or neutral associations without immediate real-world exposure.
- 1:41:00 – 2:10:00
Imaginal Exposure, Trauma Processing, and State-Dependent Memory
Through detailed cases (attempted rape survivor, dog phobia, pseudo‑epileptic seizures), Spiegel shows how hypnosis allows patients to re‑enter traumatic scenes safely, discover new meanings (e.g., survival efforts), and loosen rigid fear associations. He connects this to Gordon Bower’s concept of state‑dependent memory and natural dissociation during trauma.
- •Rape survivor used hypnosis to revisit the attack on a ‘screen’ while body floated safely; she realized assailant intended to kill her and that her resistance likely saved her life.
- •Trauma processing under hypnosis helps people both face worse realities and reclaim agency, reducing persistent helplessness.
- •Dog phobia cases: patients learn they are not passive victims of the dog; they can influence the interaction, leading one woman to later buy a dog and name it ‘Spiegel’.
- •State‑dependent memory: accessing similar mental states (dissociative in trauma; hypnotic in therapy) unlocks stored traumatic details and facilitates reprocessing.
- •Dissociation during trauma (e.g., ‘floating above my body’) is often protective but later blocks integration; hypnosis recreates enough of that state to allow conscious restructuring.
- 2:10:00 – 2:37:00
Dissociation, Ketamine, and the Central Role of Control
The conversation explores why dissociation—though present during trauma—can also be leveraged therapeutically via drugs like ketamine or hypnosis. Spiegel argues that what matters is regaining control over entering and exiting dissociative states, connecting this to research on breathing restriction and the psychological essence of trauma as helplessness.
- •Carl Deisseroth’s work: rhythmic retrosplenial activity under ketamine correlates with dissociative reports and altered pain behavior in animals.
- •Ketamine may help some trauma patients by allowing them to revisit dissociative experiences in a controlled, time‑limited way, making them processable rather than sealed off.
- •Spiegel’s own disaster research (Loma Prieta earthquake, Oakland firestorm) shows dissociation can buffer acute stress but later impede integration.
- •Breath anticipation studies show inability to breathe when expected is particularly distressing—underlining that control, not just sensation, drives fear responses.
- •Hypnosis and self-hypnosis differ from pathological dissociation in that the patient chooses when and how to enter altered states, transforming helplessness into agency.
- 2:37:00 – 3:16:00
Hypnotizability as a Trait and the Spiegel Eye-Roll Test
Spiegel explains hypnotizability as a measurable, largely fixed capacity, peaking in late childhood and stabilizing by the early twenties. He describes the hypnotic induction profile, longitudinal stability data, and the quick bedside ‘eye‑roll’ test that correlates with deeper standardized measures.
- •Peak hypnotizability occurs in latency-age children (~6–11), when play and absorption are natural and constant.
- •As abstract reasoning and DLPFC-led logic mature, many people lose some of this fluidity, while others retain it.
- •Stanford follow-up after 25 years showed hypnotizability correlation of ~0.7, higher stability than IQ (~0.6).
- •Distribution: ~1/3 low, ~2/3 hypnotizable, ~15% highly hypnotizable.
- •Spiegel eye‑roll test: ask subject to look up at the ceiling and then close their eyes; more visible sclera (eyes stay rolled up) suggests higher hypnotizability.
- •Eye movements are tightly linked to levels of consciousness; the test forces contradictory motor commands (upgaze with lid closure), serving as a ‘stress test’ of this circuitry.
- 3:16:00 – 3:43:00
EMDR, Rapid Eye Movements, and What Really Matters in Trauma Therapy
Huberman probes EMDR mechanisms, and Spiegel argues most benefit likely comes from structured exposure and attention manipulation rather than the specific lateral eye movements. He critiques oversimplified physiological claims and emphasizes that, irrespective of mechanism, facing trauma in controllable doses is the therapeutic core.
- •EMDR incorporates elements similar to classic swinging‑watch hypnotic inductions (rhythmic visual tracking) and thus may function partly as hypnosis.
- •Dismantling studies show trauma improvements with or without the eye movements; the bilateral stimulation adds little beyond exposure and cognitive processing.
- •Original claims tying EMDR to REM sleep neurobiology are unsupported; EMDR eye movements are not the same as REM physiology.
- •Spiegel feels EMDR often underemphasizes narrative and meaning‑making compared to hypnosis‑augmented trauma therapy.
- •He acknowledges many patients do feel helped by EMDR, but locates the active ingredient in systematically revisiting and recoding traumatic memories.
- 3:43:00 – 4:08:00
Confronting Triggers, Stress Inoculation, and the Limits of Trigger Warnings
They discuss cultural moves toward trigger warnings and avoidance of upsetting material, and Spiegel argues this can undermine resilience. Drawing on primate stress‑inoculation studies and group therapy data, he contends that structured emotional expression and facing losses make people stronger over time.
- •Pandora’s box metaphor is misleading; accessing painful memories under guidance does not irreversibly ‘unleash furies.’
- •Directives like “don’t think about purple elephants” show that suppression attempts often backfire.
- •Karen Parker’s primate data on stress inoculation: brief, repeated separations plus reunion lead to more adaptive cortisol responses under later stress.
- •College students and others are more robust than current discourse suggests; shielding from all upsetting content can delay skill-building in emotion regulation.
- •Spiegel’s metastatic breast cancer groups: more serious topics but no chronic mood worsening; expressed negative emotion predicts less anxiety and depression longitudinally.
- •Therapeutic goal: balance honest contact with pain while enhancing perceptions of control and meaning.
- 4:08:00 – 4:36:00
Mind–Body Connection, Pain Reframing, and Grief Work
Spiegel elaborates on adaptive mind–body regulation: using bodily signals as information while also learning to modulate them. He explains how hypnosis helps differentiate ‘new threat’ pain from healing pain, and outlines an approach to grief that honors loss while nurturing ongoing internal connection to the deceased.
- •Pain is evolutionarily treated as a novel alarm, but chronic or healing pain can be reframed so it doesn’t constantly trigger emergency responses.
- •In hypnosis, patients learn to categorize pain (warning vs. healing) and adjust their attention and reactivity accordingly.
- •For grief, rituals make loss real; hypnosis can be used to ask, “What has this person left me with? What would they say to me now?”
- •Group exercises for dying patients: feel sadness about deceased group members while also identifying traits and lessons they carry forward.
- •Spiegel argues grief is not about eliminating sadness, but about integrating it with appreciation and a continuing inner relationship.
- 4:36:00 – 5:05:00
Children, Procedures, and Practical Clinical Hypnosis
The discussion turns to pediatric applications and how hypnosis is implemented in routine practice. Spiegel shares data from children undergoing invasive imaging and describes the typical clinical workflow: assess hypnotizability, do a brief session, then teach self-hypnosis, often replacing or reducing medication.
- •Children are often highly hypnotizable but need more structure and adult scaffolding to do self-hypnosis.
- •Example: pediatricians and dentists use ‘happy button’ imagery or distraction to ease shots and dental work.
- •Randomized VCUG study: girls who learned hypnosis (‘leave your body here and go somewhere fun’) had shorter procedures, less struggle, and lower distress.
- •Routine adult use: Spiegel typically sees patients once or a few times, assesses hypnotizability, runs a targeted hypnosis session, and trains self‑hypnosis.
- •Reveri emerged from the desire to scale this—standardized scripts, interactive feedback, 15‑minute sessions plus 1–2‑minute refreshers.
- •He stresses importance of working with licensed clinicians for medical issues, to avoid masking serious pathology (e.g., coronary disease) with symptom control.
- 5:05:00 – 5:30:00
Hypnosis vs. Medication, OCD and Superstition, and Limits of Enhancement
Spiegel compares hypnosis to pharmacological aids, arguing it often displaces rather than requires drugs, and may itself mimic some GABAergic effects. He notes that in rigid conditions like OCD, hypnotizability is often lower; and although hypnotizability can be nudged, it’s not practically worth trying to ‘train up’ low responders.
- •Spectroscopy shows GABA-related activity changes in anterior cingulate of more hypnotizable individuals, similar to benzodiazepine effects but self‑generated.
- •Benzodiazepines can help extremely anxious patients tolerate hypnosis, but in non‑anxious people they may dampen focus and reduce hypnotic responsiveness.
- •Mild stimulants might marginally aid focus for hypnosis but can also fragment attention if overdone; overall, pharmacological augmentation is usually unnecessary.
- •OCD patients tend to be lower in hypnotizability due to high evaluative control; obsessional checking overrides experiential states.
- •Superstitions, in contrast, may be more prevalent in highly hypnotizable people whose imagination easily overrides reality; response prevention and new experiences are key for unwinding them.
- •Hypnotizability training studies show small improvements, but initial trait levels predict outcomes far better than training conditions.
- 5:30:00 – 5:57:00
Breathwork, Vision, and Peak Performance as Hypnotic States
Huberman and Spiegel connect their joint work on breathing patterns to hypnotic induction and autonomic regulation. They also note that many peak performance states in music, sports, and intellectual work are functionally hypnotic: high absorption, low self‑commentary, and fluid execution.
- •Breathing is a prime mind–body bridge: largely automatic but readily subject to voluntary modulation.
- •Slow, extended exhalations (e.g., cyclic sighing) likely enhance parasympathetic tone and create a better platform for hypnosis and emotional work.
- •Spiegel builds more explicit exhalation cues into his inductions based on emerging data.
- •Vision is central: humans are visual animals; gaze direction and field (narrow telephoto vs. panoramic) gate arousal and context processing.
- •Peak performance states in pianists or athletes are essentially hypnotic: they avoid conscious micromanagement of motor acts and focus instead on higher‑order goals (tone, trajectory, game flow).
- •Hypnosis usually involves physical relaxation, but can also overlay intense activity; what matters is the cognitive-emotional configuration, not immobility.
- 5:57:00
Resources, Reveri App, and How to Find Qualified Hypnosis Clinicians
The episode closes with practical guidance on accessing hypnosis tools and qualified professionals. Spiegel clarifies Reveri’s platform status, lists professional societies that maintain referral lists, and both he and Huberman emphasize hypnosis as a research‑backed, underused option for many common problems.
- •Reveri is currently iOS‑only; an Android version is planned but not live at the time of recording.
- •Reveri offers protocols for pain, stress, focus, insomnia, eating behavior, and smoking cessation, based on Spiegel lab studies.
- •For in‑person clinicians, Spiegel recommends the Society for Clinical and Experimental Hypnosis (SCEH) and the American Society of Clinical Hypnosis (ASCH) referral directories.
- •Patients should seek providers licensed in a primary health discipline (medicine, psychology, dentistry) who have formal hypnosis training.
- •Huberman thanks Spiegel for his translational work bridging lab neuroscience, clinical practice, and scalable digital tools.
- •Huberman reiterates podcast support options (sponsors, Patreon, Thorne, social channels) and points viewers to a separate video of Spiegel hypnotizing him.
