"On one, I want you to do one thing: Look up. On two, do two things: Slowly close your eyes and take a deep breath. On three, do three things: Breathe out, relax your eyes, and let your body float. Imagine you are floating in a bath, a lake, a hot tub, or just floating in space. Each breath is getting deeper and easier..."
The patient is 80 years old. She is lying under the bright lights of an operating room at Harvard’s Beth Israel Deaconess Medical Center, where radiologist Elvira Lang is about to thread a catheter through her arteries. The tiny tube will work its way to one of the woman’s kidneys, where it will block the organ’s blood supply. A surgeon is scheduled to remove the kidney the next day. Embolizing the kidney will help keep the operation simple, safe, and tidy. But the woman is running a fever, and her kidney may be infected. Because she ate earlier in the day, she can’t be given a sedative. What should have been a routine procedure has become an ordeal.
“This is your safe and pleasant place to be,” one of Lang’s associates reads from a laminated card. “You can use it in a sense to play a trick on the doctors. Your body has to be here, but you don’t.”
Lang is one of a growing number of hospital physicians who use hypnosis in addition to anesthesia. Together with David Spiegel, a professor of psychiatry at Stanford University School of Medicine, she has conducted extensive studies of hypnosis in the operating room, often with dramatic results. Hypnosis and interventional radiology interest Lang for the same reason: Both are ways of making a visit to the hospital less horrific. A tiny incision is all that’s required. By threading a stent into an artery, for example, Lang can help her patients avoid far more invasive surgery. “I’m your medical plumber,” she says. By adding hypnosis, she can make an operation shorter, less painful, and less dependent on drugs. The hardest part of the procedure is getting other doctors to accept it.
Over the years, a number of rigorously controlled studies have proved that hypnosis reduces pain, controls blood pressure, and can even make warts go away. But because very few studies have attempted to find out how it works, most scientists are skeptical of its power. Critics suggest hypnosis is no different from the placebo effect. They both use the power of suggestion to get the mind to heal the body; both are no substitute for medicine.
That skepticism has driven Spiegel and other researchers to take a hard look at what happens in the brain during hypnosis. Trance, they’ve found, opens a window onto the nature of the imagination. Through it, we are beginning to glimpse how the mind distinguishes daydreams from reality.
Spiegel is a second-generation hypnotist. His father, Herbert Spiegel, is a psychiatrist who first used hypnosis as a battlefield surgeon in World War II. In 1943 he even used the technique on himself when he was struck by a mortar from a German tank in Mateur, Tunisia. A steel shell fragment protruded from his ankle, but he managed to tune out the pain.
Soon after returning home, Spiegel was hired as a professor of combat psychiatry at the School of Military Psychiatry at Mason General Hospital in Brentwood, New York. There, he treated hundreds of returning veterans with hypnosis, becoming ever more convinced of its effectiveness. At the same time, the first clinical studies of hypnosis began to appear. In 1961 psychiatrist Ralph August published a study of 850 women who gave birth under hypnosis. Only 4 percent—34 women—required painkillers. Other studies found that hypnotized subjects could resist intense pain for a full minute longer than those who weren’t hypnotized, and for 30 seconds longer than those who had been given a placebo painkiller.
By the 1960s, Spiegel was teaching clinical hypnosis at Columbia University, and his son was among his students. David Spiegel went on to attend medical school at Harvard and to specialize in psychiatry and clinical hypnosis as his father had. In 1978 the two Spiegels coauthored the standard textbook in the field: Trance and Treatment: Clinical Uses of Hypnosis.
Now 58, David Spiegel is tall and a bit disheveled, with his father’s oval face and serene features. He speaks in complex but reasoned sentences and listens with the stoic patience of a man who has faced many disbelievers. “Hypnosis has been controversial since the beginning,” he says. “The thing is, it just won’t go away. There’s so much about the phenomenon that’s interesting.” Among researchers in the field, Spiegel says, there are two schools of thought and a growing chasm between them. One school claims that hypnosis fundamentally alters a subject’s state of mind; the other believes that hypnosis is simply a matter of suggestibility and relaxation. Spiegel belongs to the first school, and over the years he has had a running debate with two scientists on the other side: Irving Kirsch, a psychologist at the University of Connecticut at Storrs, and Stephen Kosslyn, a professor of psychology at Harvard.