To Kosslyn, the hypnosis study shows how the brain distinguishes between imagination and perception. The right side of the brain processes specific examples of things, while the left side processes more general concepts and categories. The left side knows that Spot is a dog, for instance, while the right side knows that the dog is Spot. That’s why the right side of the brain lights up when we imagine a particular color, but the left side is left cold: The details of the daydream may seem real, but they don’t apply to a larger reality.
“The realms of imagination and perception are not entirely distinct,” Spiegel says. “This goes back to philosophers as far as Kant. What we take as reality is our processing of perceptual input.” We make assumptions about what’s real from small cues that are far from the complete picture. If you are expecting to meet a friend at a restaurant and a stranger comes in with the same jacket and hair, you might call out your friend’s name, but as soon as you see his face your mistake will be obvious. “Rather than passively accepting perception, we set up a competition between imagination and perception,” Spiegel says. “Imagination can alter perception—in a sense it always does. But we’re not aware of it.” Under hypnosis, that distinction breaks down.
Kosslyn believes that hypnosis allows the body to tap into hidden reserves. He compares its effect to that of breaking a world record in sports: It changes our sense of the possible. “For years and years and years, no one could run a mile under four minutes,” he says. “It was like the sound barrier—people thought that limbs would start falling off.” Yet only six weeks after the record was finally broken, by British runner Roger Bannister in 1954, it was broken again by another runner. “Nowadays 40-year-olds can do it.” Hypnosis may have the same effect, Kosslyn says. “It shifts what I call the assumed norm. It can play the part that Roger Bannister did in the four-minute mile.”
Spiegel is a clinician first and a scientist second. The whys of hypnosis aren’t as important, he believes, as that doctors recognize its power and start to use it. To that end, he and Lang have put the technique to the test in the operating room, just as he and Kosslyn did in the PET scanner. Seven years ago, Spiegel and Lang took 241 patients slated for vascular or kidney surgery and divided them into three groups. One group received standard care; another received standard care with an “empathic care provider”; and the third received standard care, an empathic care provider, and hypnosis. During the operation, the patients lay with their heads behind an opaque, soundproof barrier, so surgeons couldn’t tell what care they were receiving. Every 15 minutes, the patients were asked to rate their level of anxiety and pain. They were also hooked up to an IV and given as much painkilling medication as they wanted.
The results of the study were published in The Lancet. On average, Spiegel and Lang found, the hypnotized subjects used less medication, experienced less pain, and felt far less anxiety than the other two groups. Patients who weren’t hypnotized felt more pain over time regardless of how much medication they received; those who were hypnotized stayed equally comfortable throughout the surgery. Operations on hypnotized patients averaged 17 minutes shorter than those of other patients, and the cost of a standard radiological procedure fell from $638 to $300.
Lang has since bolstered those findings with two other ongoing studies, involving more than 330 patients. Once again, the hypnotized patients used less medication, recovered faster, and spent less time in the hospital than those with standard care.
Lang doesn’t test her patients to see if they are highly hypnotizable. The more anxious they are about a procedure, she says, the more likely they are to benefit from hypnosis. “A person with a worst-case scenario about what’s going to happen is somebody that has good imagery potential. It takes a very vivid mind to do that.” Studies have shown that phobic people tend to be highly hypnotizable. Lang believes that people slip in and out of trances daily—that everyone has such moments of utter absorption when they can’t hear what others are saying to them. “The ability to tune out is practiced throughout the world. Particularly in married couples,” she says. Learning to control that absorption offers a way to learn to control pain.
The kidney operation Lang performed that day at Harvard was a good example. The 80-year-old patient came out of her trance at one point—“What is this rubbish about the beach?” she said—but the doctors soon put her under again with a simple hypnotic suggestion: “Your eyes won’t close until your inner mind gives you permission.” If hypnosis is ever to work its way into the mainstream, physicians will need to overcome their reluctance to say such things, knowing there is solid science behind what sounds like mysticism. “I think it should be based on data, not on belief,” Spiegel says. “But in the end it doesn’t matter why it works.”
Can You Be Hypnotized?
In the 1960s, Herbert Spiegel developed one of the first tests of hypnotizability, known as the Hypnotic Induction Profile. The test has two parts. First, the subject is told to look upward. On a scale of zero to four, the more the whites of his eyes show, the more easily he can be hypnotized. Studies have yet to confirm this correlation, but many practicing hypnotists rely on it. Next, the subject is told to imagine that his left hand is a balloon floating toward the ceiling. Once again, the hypnotist rates his reaction from zero to four. Subjects rated zero keep their hands firmly planted on the chair. Those rated four feel their hand suddenly grow lighter and lighter until it lifts into the air.
Hypnotists often also give their subjects a personality survey. Here are a few sample questions. The answers in red are those that highly hypnotizable subjects tend to give.
HYPNOTIC INDUCTION PROFILE PERSONALITY QUESTIONNAIRE
This version is from www.webhome.idirect.com/~kehamilt/psyhypno.html.
1. As you concentrate on watching a movie or a play, do you get so absorbed in what is going on that you lose awareness of where you are?
c) Depends on situation
If so, do you ever get so absorbed that when the curtain comes down you are surprised to realize you are sitting in a theater?
c) Depends on situation
2. In general, as you perceive time, where do you focus more of your attention?
d) All three equally
3. The French philosopher Blaise Pascal once said, “The heart has a mind which the brain does not understand.” He said there are two kinds of minds: the heart-mind and the brain-mind. Which of these do you give priority to?
4. How do you relate to another person?
a) Prefer to control the interaction
b) Prefer to let the other person take over as he or she wishes
c) Depends on situation
5. Regarding your tendency to trust other people, where on average would you place yourself on a scale?
a) Above average
b) Below average
6. How do you tend to learn something new?
a) Judge it critically at the time you are learning it
b) Accept it and perhaps judge it critically at a later time
7. Sensing your responsibility for what you do, where do you place yourself on a scale?
a) Above average
c) Below average
8. If you are learning something new and you know in advance that it’s of such a nature that you can learn it clearly, safely, and equally well using either sense below, how would you prefer to learn it?
a) Through touch
b) Through sight
9. When you come up with a new idea, there are two parts to it: One is to dream it up and the other is to figure out how to do it. Of these two parts, which gives you a greater sense of fulfillment?
a) Dreaming it up
b) Figuring out how to do it
10. As you come up with or work out a new idea, which is more necessary?
a) Writing notes
b) Feeling your way through without writing
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