In this week’s episode of SuperAge, we hear from Dr. David Spiegel, who, after receiving a PhD in medicine from Harvard, went on to become a renowned expert in hypnosis, dissociative disorder, PTSD, and cancer psychology, as well as a Stanford professor. He has also authored several books over the course of his 40-year career, including Living Beyond Limits: New Hope and Help for Facing Life-Threatening Illness. In our conversation, Dr. Spiegel shares his insights on harnessing the power of the mind for healing and wellness. Drawing from experience, Dr. Spiegel discusses the significant impact of hypnosis in managing pain, stress, and anxiety, especially in cancer patients. He illustrates how self-hypnosis can be a vital tool for emotional and physical wellbeing and provides fascinating stories about its effectiveness. This episode offers a unique perspective on research-backed alternative healing methods, emphasizing the untapped potential of the human mind in health and recovery.
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Key Moments
“We started out helping people to stop smoking and we found that one out of five people just stopped smoking using the [Reveri] app right away. So that’s about as good as I get when people are sitting in my office and I’m doing it. And it’s about as good as you get using varenicline or bupropion or nicotine patches as an alternative.”
“They learned to control their pain with self-hypnosis so that a new pain in their chest didn’t automatically mean to them that their disease was progressing. It meant they needed to do something to control the pain. And they did. So they had half the pain. And in our original study that we published in The Lancet, we found that the women randomized to work groups actually live longer than the control patients by an average of a year and a half.”
“We found actually that people with breast cancer who were inefficient sleepers, who had trouble getting to sleep or staying asleep, actually also had shorter survival. But the other way around is that good sleepers live longer. It was having a long period of good 7 hours of consistent sleep at night, predicted with fewer disruptions, predicted longer survival with breast cancer.”
“After a deep inhale, a slow exhale is important. And part of why it is, you know, we’re used to saying, you know, if you’re anxious or tense, take a deep breath. Well, actually, the inhale actually tends to increase sympathetic activity because it reduces venous return or blood to the heart. If you think about it, you’re lowering pressure in the chest.”
Connect with Dr. Spiegel
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Stanford Healthcare Profile
Transcript
00:00:00:06 – 00:00:06:17
David Stewart
Dr. David Spiegel, I am so happy to have you on the program today. We’re really honored. Thank you so much for joining us.
00:00:06:19 – 00:00:09:03
Dr. Spiegel
Thank you, David. I’m delighted to be here with you.
00:00:09:05 – 00:00:25:02
David Stewart
You have so much interesting work. And I just want to start a little bit here, a little bit on your background. You’re an expert on hypnosis and you have an M.D. You’ve been teaching and practicing for a long time. What interested you in hypnosis?
00:00:25:04 – 00:00:49:12
Dr. Spiegel
Well, David, I have to confess that it’s something of a genetic illness in my family because both of my parents were psychiatrists and psychoanalysts. They told me that I was free to be any kind of psychiatrist I wanted to be. And so here I am. My father, when he was about to go off to be a battalion surgeon in North Africa in World War Two, met a Viennese refugee who had learned to do hypnosis.
00:00:49:12 – 00:01:06:21
Dr. Spiegel
He was a forensic psychiatrist who had a smallpox scar in the middle of his forehead. And he noticed that some of these prisoners he was interviewing would suddenly close their eyes and seem to go into some altered state. And so he started to learn about hypnosis. And because he couldn’t serve in the U.S. military, he offered to teach Army doctors how to use it.
00:01:06:23 – 00:01:27:00
Dr. Spiegel
So my father started using hypnosis to help with combat stress reactions, with pain. And he came back and was going to go back. And he did go back into his psychoanalytic training, which was big at the time. But Freud had given up hypnosis and he was sort of told, you know, who are you to carry on with? It went for it didn’t.
00:01:27:02 – 00:01:46:08
Dr. Spiegel
But he had a wonderful supervisor who said, You know what? Don’t feel so precious about what people think. You’re going to teach a course on hypnosis at the Analytic Institute because I’m going to take it. So you better do it. So he did, and he kept using it. And he was the kind of guy who would follow up with patients after a while and see how they were doing.
00:01:46:10 – 00:02:07:03
Dr. Spiegel
And he discovered that often he got further with a few sessions of hypnosis than he did with three or four days a week on the couch. So he started shifting his practice. The dinner table conversations were pretty interesting. I got to watch him make movies of patients responding to hypnosis. So when I got to medical school, I figured I’d better take it.
00:02:07:03 – 00:02:27:07
Dr. Spiegel
Moses Course I did. And my first patient, I was on pediatrics at Children’s Hospital in Boston. The nurse says, SPIEGEL Your next patient is in status as. And I was following the sound of the wheezing down the hall. I didn’t need the room number. And there’s this pretty red head, bolt upright in bed, knuckles white, struggling for breath.
00:02:27:09 – 00:02:47:13
Dr. Spiegel
Her mother’s standing next to me, crying. The nurses in the room, they had tried subcutaneous epinephrine twice. It hadn’t worked. They were going to give her general anesthesia and put her on steroids. And I didn’t know what else to do. So I said, Would you like to learn a breathing exercise? And she nodded. So I got her hypnotized.
00:02:47:15 – 00:03:07:02
Dr. Spiegel
And then I started to sweat because I realized we hadn’t gotten to asthma in the course. So I said something very, very sophisticated. I said, Each breath you take will be a little deeper and a little easier. And within 5 minutes, she’s lying back in bed. She’s not wheezing anymore. Her mother stopped crying. The nurse ran out of the room.
00:03:07:04 – 00:03:25:10
Dr. Spiegel
My intern comes looking for me. I figure he’s going to pat me on the back and say, What the hell did you do? He said the nurse had 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 weird laws, but that one is not on the books.
00:03:25:10 – 00:03:44:22
Dr. Spiegel
And her mother was standing next to me when I did it and he said, you’re going to have to stop doing this. And David, this is a story with hypnosis where you don’t get no respect. You are either silly or dangerous or both. And he said and I said, why do I have to stop? He said, Well, it’s dangerous.
00:03:45:00 – 00:04:04:23
Dr. Spiegel
And I said, You’re going to give her general anesthesia and put her on steroids. And you think my talking to her is dangerous? I don’t think so. So 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 isn’t true. So he stopped off and they had a council of war among the intern, the resident, the chief resident, and the attending.
00:04:05:01 – 00:04:31:08
Dr. Spiegel
And they came back on Monday with a radical idea. They said, Let’s ask the patient. I don’t think they’d ever done that before. And she said, I like this. I want to keep doing this. She had been hospitalized monthly for three months. She had one subsequent hospitalization, but went on to study to be a respiratory therapist. And I thought that anything that could help a patient that much violated non-existing Massachusetts law and frustrate the head nurse had to be worth looking into.
00:04:31:08 – 00:04:44:03
Dr. Spiegel
And because I could watch it happen right in front of me, I could watch the degree to which she could regain control over her body. And 7000 patients later, I’m still doing it.
00:04:44:05 – 00:04:52:13
David Stewart
Okay. So that answers my next question. I was going to ask you, is it effective? How does it work and is it dangerous? We can skip that.
00:04:52:15 – 00:04:56:02
Dr. Spiegel
Yes, Yes. No.
00:04:56:04 – 00:05:02:10
David Stewart
Okay. We’re going get back to hypnosis in a moment. You’ve also done a lot of work with cancer and cancer patients. And.
00:05:02:10 – 00:05:03:01
Dr. Spiegel
Yes, I have.
00:05:03:05 – 00:05:13:23
David Stewart
You know, there’s something about the title of one of your papers about psycho oncology. So this is. Yes, a phrase I’ve never heard. Tell us what? What is that?
00:05:14:00 – 00:05:39:21
Dr. Spiegel
Well, psycho oncology is basically a medical discipline where people study how people react to having cancer, What are the best ways of supporting them through cancer, and what are some of the psycho physiological mechanisms that may have an effect on how people cope with and how they live with it, how they sleep with it, and whether some psychological issues may have an effect not just on quality of life, but potentially on quality of life, too.
00:05:39:22 – 00:05:50:04
Dr. Spiegel
So it’s how do we understand and better help people with cancer, live through it, live through the treatments and live better and maybe even live longer?
00:05:50:06 – 00:05:58:14
David Stewart
Quickly, could you give me some ideas of some of the methods and protocols you’ve done to help people in this way?
00:05:58:16 – 00:06:24:15
Dr. Spiegel
Sure, David. We’ve done randomized clinical trials sponsored by the National Cancer Institute and the National Institute of Mental Health, in which we take women, for example, with metastatic breast cancer. So these are women who’ve been diagnosed but now have had a recurrence of the disease, which is a more serious situation. And we randomize them either to get standard care with some education about cancer or to attend weekly group support.
00:06:24:17 – 00:06:49:07
Dr. Spiegel
And I started this in the seventies at a time when it was considered a bad idea for cancer patients with advanced disease, especially to see one another because they were going to some of them were going to die. Metastatic disease doesn’t always, but often results in death from cancer, although it’s interesting to note that more women diagnosed with breast cancer die of heart disease and breast cancer.
00:06:49:07 – 00:07:17:10
Dr. Spiegel
Right. It’s not all yeah, it’s not always a death sentence by any means, but it is concerning. And so we got these women together. We would meet for an hour and a half once a week. They would talk about their fears. They would learn to better manage their emotion, to not be so suppressive of how anxious and said they were, but to talk about it because they could see in other people that, you know, they found it comforting to be able to share their feelings and concerns.
00:07:17:12 – 00:07:39:09
Dr. Spiegel
And even when the worst happened, when members of the group died, they were able to grieve the losses together. And you know, death is not a novel concept to a cancer patient. It’s not like, oh, I didn’t know that could happen, of course. And one woman said after being in the group for a while that being in the group is like looking into the Grand Canyon when you were afraid of heights, you know, you know, if you fell down, it would be a disaster.
00:07:39:11 – 00:07:59:06
Dr. Spiegel
But you feel better about yourself because you’re able to laugh. I can’t say I feel serene, but I can look at it. And so these women strengthened one another. And we found over the course of a year that they became less anxious and depressed, just being able to face it. They could see in other women in the group things they couldn’t see in themselves.
00:07:59:06 – 00:08:21:13
Dr. Spiegel
You know, they would feel like I’m weak and too frightened and all this. And they would say, she’s dealing with it the way I am, and I don’t see her as weak or too frightened. I see her as coping well. And they felt less alone with it than they did before. So we found that over time in a randomized clinical trial, the women in the support group were less anxious, less depressed, had less pain than the control group.
00:08:21:13 – 00:08:46:12
Dr. Spiegel
They learned to control their pain with self-hypnosis so that a new pain in their chest didn’t automatically mean to them that their disease was progressing. It meant they needed to do something to control the pain. And they did. So they had half the pain. And in our original study that we published in The Lancet, we found that the women randomized to work groups actually live longer than the control patients by an average of a year and a half.
00:08:46:12 – 00:09:21:11
Dr. Spiegel
There was no cure for cancer, but they lived longer. And there have been a number of studies, some support that finding, others don’t. But the overall studies indicate that good emotional support can actually enhance survival with cancer, which is surprising, but not that surprising. There was a study from out of the Dana-Farber Cancer Center published in the journal of the National Cancer No Journal of Clinical Oncology showing that all in all, married cancer patients live four months longer than unmarried cancer patients.
00:09:21:11 – 00:09:42:06
Dr. Spiegel
And this is like a study of 700,000 cancer patients in the US. So and so this is psycho oncology. This is the fact that what’s going on in your head has an effect on your body, and can help you live better if you handle it better. And maybe it will even help you live longer.
00:09:42:08 – 00:09:51:13
David Stewart
Are we willing to make the other side of that saying that increased anxiety increases disease progression and mortality?
00:09:51:15 – 00:10:20:05
Dr. Spiegel
We think it can. So one of the other things we did is some psycho neuro endocrinology. So we looked at stress response systems in cancer patients. And one of our major stress hormones is cortisol. It’s a it’s a glucocorticoid. It mobilizes glucose into the blood. And we normally have a diurnal rhythm of cortisol. It’s highest for me about now, just after you wake up in the morning and goes down throughout the rest of the day and then rises again at night.
00:10:20:07 – 00:10:46:00
Dr. Spiegel
And it’s very useful if you need to fight or flee, you want more glucose in your blood so you can do it. On the other hand, if you keep firing off that system when you don’t need it, you’re expending resources and can do some wear and tear to your body as well. And we found that abnormal patterns of this glucose in glucocorticoid cortisol, if they stay high, the pattern gets sort of flat rather than the peak in valley.
00:10:46:00 – 00:11:00:01
Dr. Spiegel
That’s normal that that actually is a predictor of shorter survival. So the answer is yes, a maladaptive stress response can potentially hasten disease progression, whereas a good one potentially can lengthen.
00:11:00:01 – 00:11:13:00
David Stewart
It is super interesting. Which brings me to some of your other research, the intersection of circadian rhythm and its disruption and its implication for, I believe the research was on breast cancer folks.
00:11:13:02 – 00:11:14:08
Dr. Spiegel
Yes, that’s correct.
00:11:14:10 – 00:11:16:11
David Stewart
What did you find it? Right.
00:11:16:13 – 00:11:40:14
Dr. Spiegel
We found that a disrupted pattern. And part of it I was already referring to the cortisol pattern being disrupted, Abnormal circadian pattern of cortisol predicted shorter survival. And this is years later. It isn’t like, you know, you know, three days before you die. The pattern is different. This is years before. But the other part of circadian rhythm, David, that’s very important is sleep and wakefulness.
00:11:40:16 – 00:12:08:05
Dr. Spiegel
And we found actually that people with breast cancer who were inefficient sleepers, who had trouble getting to sleep or staying asleep, actually also had shorter survival. But the other way around is good sleepers live longer. It was having a long period of good 7 hours of consistent sleep at night, predicted with fewer disruptions, predicted longer survival with breast cancer.
00:12:08:05 – 00:12:36:23
Dr. Spiegel
A colleague of mine, Oksana Polish, took the lead on those studies. And and so it suggests that, you know, just managing your stress response during the day and getting a good night’s sleep is a good part of therapy for cancer. And there is reasons why people may lose some sleep. I was just talking with someone who two years ago was diagnosed with breast cancer and she found herself waking up at night in a cold sweat.
00:12:36:23 – 00:13:04:06
Dr. Spiegel
Very anxious. And she actually started using every are are you a self-hypnosis app? And she said, I’m sleeping. You know, I sleep through the night. Nomads. I just I sleep better. So that’s that’s good for you psychologically. But you know what? It’s good for your body, too. Good sleep as, you know, exercise during the day and good sleep at night are a should be a part of everybody’s health regimen, but especially cancer patients.
00:13:04:06 – 00:13:06:03
Dr. Spiegel
So that’s what we found.
00:13:06:05 – 00:13:13:18
David Stewart
100%. I mean, I tell people, if I don’t care how many supplements you’re taking, if you’re not sleeping, you’re sabotaging everything.
00:13:13:20 – 00:13:19:01
Dr. Spiegel
That’s right. That’s exactly right. It’s good for your brain and good for your body to get a good night’s sleep.
00:13:19:05 – 00:13:35:13
David Stewart
I’m curious about this intersection of heightened anxiety, trauma, disease, and then reduction of anxiety and possibly addressing past trauma through hypnotism or self hypnotism.
00:13:35:15 – 00:14:02:09
Dr. Spiegel
Yes, hypnosis can be quite effective in helping people deal with trauma for a number of reasons. One of them is that when you’re traumatized, you go into a kind of hypnotic like state. You narrow the focus of attention, you dissociate things that otherwise you’d be aware of. And so we’ve learned that many kinds of treatments for post-traumatic stress disorder involve what’s called exposure and cognitive restructuring.
00:14:02:09 – 00:14:20:10
Dr. Spiegel
So the way you deal with it is not run away from the memory of the trauma, but you address it so that you don’t feel attacked by it. Again, you’re saying, I’m choosing to pay attention to this and I’m going to put it into perspective and so you can use hypnosis as a kind of controlled entry, but also exit.
00:14:20:10 – 00:14:40:14
Dr. Spiegel
The nice thing is you focus intently on it, but then you and you do some mental work about it and then you step back from it. So and there have been there’s been a randomized trial of hypnotherapy for people with PTSD out of Israel. And it shows that, in fact, people recover more quickly. And I can give you an example if you want.
00:14:40:14 – 00:15:04:13
Dr. Spiegel
I had a patient who was a lovely woman who grew up in a country that is not famous for being nice to women. And she said, I realized as a teenager that my body wasn’t my own. Men could comment on anything they wanted to. It was terrifying. And I learned then that she had been raped by a landlord when she was 12 years old and the family was afraid to do anything about it.
00:15:04:13 – 00:15:25:14
Dr. Spiegel
They didn’t want to be thrown out of the building and all that. So they finally got out of their country, came here, and she became a health care professional. But she was chronically depressed. She retired, work 15 years before she needed to. And and I and I initially was treating her for pain with hypnosis. And she got rid of the pain.
00:15:25:15 – 00:15:52:04
Dr. Spiegel
It was from six out of 10 to 0 in one session. She was astounded by it. And then we started talking about this, what had happened to her and her depression and her psychiatrist who was treating the Depression had referred to me. And I said, Well, let’s go back in hypnosis and relive what happened to you. And so I said, I want you to pretend you’re your own mother to your 12 year old self.
00:15:52:06 – 00:16:14:22
Dr. Spiegel
And she starts to cry. And I have her picture herself right after she’d been raped. And I said to her, I want you to answer one question for me. Is this her fault? Did she deserve this? Did she do something? And she started to cry harder and she said, I’m stroking her hair. I’m stroking her hair. This is not her fault.
00:16:15:00 – 00:16:37:08
Dr. Spiegel
I’m stroking her hair. And she came out of it and she said, you know, I feel lighter. Somehow I feel different. And about a week later, she called me up and she said, 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 I just talked to her the other day.
00:16:37:08 – 00:17:01:11
Dr. Spiegel
It’s about eight months. And she said, I’ve had one or one bad months, but otherwise I’m a different person. I feel different now. I’m not depressed. And so there are times when you can use stage like hypnosis to intensely focus on and work through feelings. And of course, the problem with most sexual assault victims, particularly when they’re children, is that they blame themselves for events they didn’t control.
00:17:01:13 – 00:17:28:14
Dr. Spiegel
You know, the worst thing about trauma, about sexual assault, about the horrific things we’ve seen happens in Israel is it’s not pain, it’s not fear, it’s helplessness. You’re made into an object. And we hate that your agency is taken away from you. And so many children, especially who don’t understand independent causation figure if the world is fair, if the world is just and this terrible thing happened to me, it must be something wrong with me that made it happen.
00:17:28:16 – 00:17:50:16
Dr. Spiegel
So they blame themselves for things they didn’t control. And so helping people just understand and face that period of helplessness, but see it not as something they deserve. But it’s something that was imposed on them, can be very helpful to them in putting trauma into perspective and hypnosis can be very helpful with that.
00:17:50:18 – 00:18:14:00
David Stewart
Now, this is a powerful story and well, you’ve worked a lot about respiration and mood, which is something we’re going to we’re going to circle back to that in a moment and talk about reverie because there’s a lot there. But sure, talk to us about there’s a phrase that I came across called cyclic, saying, which I guess is a scientific term for something that I commonly do.
00:18:14:00 – 00:18:15:23
David Stewart
But explain to people.
00:18:16:01 – 00:18:16:16
Dr. Spiegel
I’m sure.
00:18:16:22 – 00:18:17:21
David Stewart
What do you guys mean?
00:18:17:21 – 00:18:53:20
Dr. Spiegel
Basically saying the good saying, Well, it means literally saying in cycles and we all see our respiratory system is programed to have a deeper exhalation from time to time, that that deep inhale helps to open up all, all parts of the lungs so that you get air circulating in and out and you don’t have some of these little alveoli, these little bubbles in the lung where the oxygen and carbon dioxide transfer happens sort of remain collapsed so that they don’t allow for air exchange.
00:18:53:22 – 00:19:19:07
Dr. Spiegel
And but after the deep inhale, this slow exhale is important. And part of why it is is, you know, we’re used to saying, you know, if you’re anxious or tense, take a deep breath. Well, actually, it’s the inhale actually tends to increase sympathetic activity because it reduces venous return or blood to the heart. If you think about it, you’re lowering pressure in the chest.
00:19:19:07 – 00:19:41:11
Dr. Spiegel
That’s how you bring in more air. And so your heart senses a little bit less blood coming into it. And so the sympathetic nervous system says, Oh, you better start beating harder and faster. So there’s just a bit of an increase. When you exhale, the opposite happens. You’re forcing blood into the heart. It triggers parasympathetic activity that slows the heart rate.
00:19:41:11 – 00:20:17:02
Dr. Spiegel
So there’s this constant variation going on, but basically exercises that emphasize a long, slow exhale or relaxing because heart rate slows down a bit, the parasympathetic nervous system happens to it goes into action. So if you want to calm yourself down, one very quick way to do it and you can try it now, David, if you want, is you just inhale first using your abdomen so diaphragmatic, inhale through your nose, inhale through your nose, hold your breath, and now fill your lungs completely by expanding your chest.
00:20:17:04 – 00:20:42:09
Dr. Spiegel
And now slowly exhale through your mouth. Hello. Exhale. Try it again. Inhale through your nose, halfway with your belly. Hold Now fill your lungs completely slowly. Exhale through your mouth. How are you feeling now?
00:20:42:11 – 00:21:01:11
David Stewart
I’m familiar with this exercise, and I owe you. Are you? I love it. Yeah. It was actually taught to me by gentleman I had on the show who was a former Blue Angel pilot. Who is Top Gun, huh? And they’re experts at, you know, sympathetic, parasympathetic being able lastly back and forth. And he taught me that. Yeah.
00:21:01:13 – 00:21:33:14
Dr. Spiegel
Good. Well so yeah it’s surprising often how instantly relaxing it is and that’s one of the other exercises we have on the air every now and we we published a study in cell reports last January that if we taught people in a randomized trial to do this particular exercise and some other breathing exercises that also help like box breathing, which is inhale, hold, exhale, hold the Navy SEALs do that before they go out on maneuvers.
00:21:33:16 – 00:21:59:17
Dr. Spiegel
It’s called tactical breathing that we actually found that if people did that just 5 minutes a day for a month, their mood was better. They felt they had more positive emotion. They were less anxious and their average respiratory rate. So we had a whoop strap on them that measures their heart rate and sleep time and respiratory rate actually reduced.
00:21:59:17 – 00:22:17:04
Dr. Spiegel
So their average breathing rate went down, which meant their sympathetic arousal was was going down. So there are things you can do like that with not that much time, but just some regular practice that can help help lower your overall level of tension and stress.
00:22:17:06 – 00:22:36:02
David Stewart
I’m going to ask you, since your doctor, I’m going to ask you a question about myself. I’m 65 now, and what I found is over the last ten years, I’ve developed a little bit of an essential tremor in my hand. But it’s only when I’m either hungry or highly sympathetically activated. I also have this silly thing I do.
00:22:36:02 – 00:22:57:06
David Stewart
I’m a ski racer, and if I do that for a couple of hours and I come down and I’m both highly sympathetically activated and hungry, I can hardly hold a spoon. I’m just sort of shaking and I and I try and bring myself down. I, the neurologist tells me my basal ganglia are not functioning like the way they should.
00:22:57:09 – 00:22:59:22
David Stewart
In thoughts? Yeah. Tell me.
00:23:00:00 – 00:23:05:14
Dr. Spiegel
Yes, sure. Well, where do you get my bill, David? But I. I tear.
00:23:05:15 – 00:23:05:22
David Stewart
It up.
00:23:06:00 – 00:23:47:20
Dr. Spiegel
Yeah, I think. Look, in general there are, you know, sort of rhythmic discharges of all of our neurons all the time. But in general the, the sort of fine motor skills are overridden by the general control systems that, that tell the hand to move and, and stop and that your level of tension which increases sympathetic activation may sort of bring out some underlying rhythm that is not well dampened when you’re really stressed and activated or hungry and seeking nourishment.
00:23:47:20 – 00:24:08:23
Dr. Spiegel
Your blood sugar may be a little bit low. And so it’s a kind of subtle dis control in the system that most of the time you can handle. But when you’ve got strong, sympathetic arousal, like when you’ve been skiing and on a race, it tends to unmask that. And, you know, I would say I don’t think it’s anything to worry about.
00:24:08:23 – 00:24:24:20
Dr. Spiegel
It’s not a hell of a lot of fun, but things you can do to self regulate. And it would be actually an interesting experiment for you to do when this is happening after you’ve come down from skiing. Do the cyclic sign that. Yes. And see if you can slow that down. I’ll bet you can.
00:24:24:20 – 00:24:29:11
David Stewart
I can. I was going to tell you that this works. Oh, good. Is where I was going with. There you.
00:24:29:11 – 00:25:00:04
Dr. Spiegel
Go. Good. That’s what I figured. So it what it’s showing is that you’re unmasking a sort of slightly uncontrolled, sympathetic arousal. And if you can just get the autonomic nervous system back in balance, you can control it. So it’s not a whole lot of fun, but it’s I don’t need anything to worry about. And the fact that you have this you can invoke this secondary parasympathetic control is is is a good thing.
00:25:00:04 – 00:25:16:07
Dr. Spiegel
So, you know, I would view it as something like the temperature gauge on your car. You know, if it goes up, you know, what to do to to bring it back down. But it’s interesting actually that if you have that experience, but the good news is you can control it.
00:25:16:09 – 00:25:31:14
David Stewart
I’m friendly with a lot of high performing athletes and their coaches, and this can be trained really, huh? Yeah. I’ve had Andy Walsh on this show. He’s head of high performance for Red Bull. And that sort of like sympathetic is their world, right? Yes.
00:25:31:17 – 00:25:32:15
Speaker 3
Yes.
00:25:32:17 – 00:25:35:11
Dr. Spiegel
That’s right. Yeah. But they.
00:25:35:13 – 00:25:55:02
David Stewart
Train this. So after something happens, if you watch a really high performing athlete, they’ll do their thing and then they’ll be like 30 seconds where there’s where they’re doing this, where they’re sort of bringing everything down so they can do their thing again, because they can’t you can’t stay at that high level consistently.
00:25:55:02 – 00:26:03:19
Dr. Spiegel
That’s a good point. That’s very interesting. And I’m sure that’s true. And you want the arousal or you want it and not when you don’t.
00:26:03:21 – 00:26:15:07
David Stewart
Like the Navy SEALs, you know. Yes, they they run through the jungle for ten miles, all the stuff, and they’re all jacked up. But now they have to focus. So they have to have to, like, bring themselves down to do that.
00:26:15:07 – 00:26:38:03
Dr. Spiegel
That’s true. Yeah. You want to martial it, so you’ve got it when you need it. We they coach of the Stanford women’s swimming team some years ago. We have a superb women’s swimming team, but he noticed that they were swimming faster in practice than they were in meets and that’s not a good thing. Right? And what we realized was that they were getting distracted by worrying about what the woman in the next lane was doing.
00:26:38:03 – 00:26:59:14
Dr. Spiegel
And swimming is not a contact sport, so it really doesn’t matter what the other person. So I had them do self-hypnosis and just practice swimming their own best race, focusing on their communication with their body. Just the thing you’re talking about and having the feeling within their body that they were using their body as efficiently and as well as possible.
00:26:59:16 – 00:27:12:17
Dr. Spiegel
And their times when they went down, they did it faster and better when they were just focusing on themselves and ignoring what was going on in the neighboring lanes. So that’s another example of that.
00:27:12:21 – 00:27:40:02
David Stewart
We had Dr. Lauren Labarga on the show a couple of weeks ago, and she’s a performance expert, deals with a lot of athletes. But the conversation was about all of life is performance. Talking to my wife, I need to be able to perform properly, you know, going to the grocery store like it’s all you’re not necessarily an Olympian, but being able to perform properly and being able to focus like this and exactly what you’re talking about, which brings me to Reverie.
00:27:40:08 – 00:27:43:21
David Stewart
Great. So let’s talk about reverie. What is this?
00:27:43:23 – 00:28:07:15
Dr. Spiegel
Reverie is a digital interactive hypnosis app. I decided that, you know, I’ve treated a lot of patients, about 7000 in my career, but there are a lot more people who can benefit from managing their pain, stress, anxiety, insomnia, bad habits. And I wanted to make what we’ve learned available. And there are a couple of sort of tricks to it.
00:28:07:15 – 00:28:26:17
Dr. Spiegel
And one is that all hypnosis is really self-hypnosis. So is it possible that people can just do it for themselves when they get the right instructions? And we built Reverie. Ariel Poller, who’s the co-founder of Reverie with me, came up to me after a brain wine summit at Stanford and said, Would you like to try and build an app that would do this?
00:28:26:18 – 00:28:48:21
Dr. Spiegel
And at first I was a little nervous about it. You know what would happen if all these people out there were getting hypnotized? I wasn’t there watching them, you know, And and but I thought, you know, why not? Because you don’t. I don’t really hypnotize people. I teach them how to use their own hypnotic ability. And so why can’t people why shouldn’t people be able to do that?
00:28:48:23 – 00:29:13:03
Dr. Spiegel
But I wanted it to be as much like the experience in my office as I could, and that meant interaction. So, you know, I give some instructions. I see how they’re responding. I ask them, and then I make decisions about what to do next. So I wanted it to be like that. And he said, Well, you know, Amazon’s Alexa is making this, you know, interactive speech platform available then want more people to use it.
00:29:13:05 – 00:29:37:05
Dr. Spiegel
Should we try it? Let me build you one. So we worked on that together. We started out helping people to stop smoking and we found that one out of five people just stopped smoking using the app right away. So that’s about as good as I get when people are sitting in my office and I’m doing it. And it’s about as good as you get using varenicline or bupropion or nicotine patches as an alternative.
00:29:37:06 – 00:30:01:18
Dr. Spiegel
So we began to see, you know, it could work, but the app, it was a little clunky. And so we decided we hired some great engineers, built up a tool company, and we’ve got our own app now that works very smoothly and and helps people get to sleep, get back to sleep, control their pain. You know, I noticed you had a doctor on the show after, has it?
00:30:01:19 – 00:30:02:03
David Stewart
Yes.
00:30:02:03 – 00:30:28:15
Dr. Spiegel
Who talked about pain control and that the pain is in part, you know, the way I like to say it is the strain in pain lies mainly in the brain that people brain is an interpretation of signals that come into the brain. And we found, as many other people have with hypnosis, that you can control pain perception, you can make it worse, you can make it better, mostly better.
00:30:28:17 – 00:30:58:04
Dr. Spiegel
And he talked about how the default mode talks with the salience network. Those are exactly parts of the brain that hypnosis alters. So we found when we hypnotize people that they can turn down activity in the in the salience network, the dorsal anterior cingulate they can disconnect from the default mode network. So when they’re engaged in the hypnotic things, they turn down activity in the default mode and they reinterpret pain signals.
00:30:58:04 – 00:31:22:16
Dr. Spiegel
So we find that about three out of four of the people who use it find within 12 minutes that they’ve been able to reduce their pain. And so we’re viewing this as a way of helping people with stress, with pain, with bad habits and a number of other everyday problems. People that with the reverie can help them do it and it’s safe and effective.
00:31:22:16 – 00:31:51:13
Dr. Spiegel
And, you know, if you consider, David, the effect that, you know, pharma, like Purdue Pharma, have gotten, you know, hundreds of thousands, if not millions of people addicted to opioids, and that last year, 82,000 Americans died of opioid overdoses in the U.S. They’re expecting CDC is expecting 111,000 this year. It’s horrifying. And, you know, people are scared of hypnosis and they say it’s weird or it’s dangerous or something.
00:31:51:15 – 00:32:19:05
Dr. Spiegel
We have not succeeded in killing anybody with hypnosis yet, but millions, hundreds of thousands of people are dying of opioid overdoses. And so that possibility and attract the reality that you can control your pain using self-hypnosis is something everybody ought to try. You know, it won’t work for everybody, but it’ll work for a lot of people. We’re finding with every three out of four people who use it for pain control feel less pain within 12 minutes.
00:32:19:06 – 00:32:45:23
Dr. Spiegel
And, you know, I had a young woman in my office who was seven months pregnant, had bad lower back disease and terrible pain, and she couldn’t use drugs because she was pregnant. But the bigger the baby got, the more pain she had. And I got her hypnotized. She was quite advertised. Well, her pain went from 7 to 3 in a few minutes and she opened her eyes and she looked angry.
00:32:45:23 – 00:33:05:07
Dr. Spiegel
And I said, What are you angry about? And she said, Why are you the last doctor I got sent to instead of the first? And and so this is something that people can try. And if it works, great, and it often will. And if it doesn’t, no harm, no foul, you know, So I encourage people to give Reverie a try.
00:33:05:07 – 00:33:14:06
Dr. Spiegel
You can download it from the App Store if you have an iOS phone and from Google Play, if you have an Android and give it a try and see if it helps.
00:33:14:08 – 00:33:32:18
David Stewart
We’ll put that link in the show notes. And for those that are listening, Reverie is r e. D. E. R. I. I went on reverie and the first thing that happens is you take a test, right? Are you the right personality type? I’m like A-1 personality type for hypnosis.
00:33:32:23 – 00:33:35:17
Dr. Spiegel
The poet.
00:33:35:19 – 00:33:41:01
David Stewart
Although, as I mentioned earlier, I have a degree in mechanical engineering, but not my personality type. So are you.
00:33:41:01 – 00:34:05:12
Dr. Spiegel
The kind of guy that gets so caught up in a good movie that you kind of forget you’re watching a movie and enter the image world? Yes. There you go. There you go. So that’s people using their natural hypnotic ability spontaneously. We call it absorption. And you get caught up in movies in a sunset and whatever else you’re doing that’s a spontaneous help self hypnotic state.
00:34:05:14 – 00:34:26:06
Dr. Spiegel
And so since you do it anyway, since your brain is configured to help you do it rapidly, deeply and efficiently, why not take full advantage of it? Our major evolutionary advantage is this big brain that sits £3 on top of our bodies, but it doesn’t come with the user’s manual. You know, we don’t always know how to make take full advantage of it.
00:34:26:08 – 00:35:03:08
Dr. Spiegel
And this is a way of doing exactly that. Oh, yeah, Yes, I like that. I like that. That’s true. Change your mind. Well, that’s what hypnosis helps you to do. And one of the things it helps you to do also is to change who you are. You know, the turning down activity in the default mode network is. And that’s what having experienced meditators do that over time, they they turn down activity.
00:35:03:10 – 00:35:21:14
Dr. Spiegel
The whole thing about meditation is getting over yourself. You know that not focusing on who you are on yourself and who you are, but just on experience, on being, on letting feelings and experiences flow through you. And in hypnosis, you can do that very rapidly. You can just turn down that, you know, that’s why the football player will dance like a ballerina.
00:35:21:14 – 00:35:42:13
Dr. Spiegel
And one of those stupid shows is that you can let go of who you think you are or what people of you and just be something else. And the cool thing about hypnosis is you can surprise yourself by what you can be and become if you just try it, see what feels like because you’re turning down the part of your brain that’s sitting there saying, Wait a minute, you can’t do that.
00:35:42:15 – 00:36:00:18
Dr. Spiegel
You’ve got to be having bad pain now because the doctor told you this is wrong and that’s wrong. And instead, just what would it be like if I could actually control that pain or for you if I could control that little tremor, you know, and you can do it and and you’re being very hypnotized, but it’ll be easy for you to do that.
00:36:00:18 – 00:36:58:02
Dr. Spiegel
Exactly. That by managing your overall level of arousal. Great. That’s right. Right. That’s right. So give it a try. Give it a try. It’s. It’s worth it, right? Right, right. Thanks. Well, it helps. And we just we get people to focus on what they’re for, respecting and protecting their body rather than fighting an urge which just makes it worse.
00:36:58:04 – 00:37:16:18
Dr. Spiegel
You know, it’s like telling yourself, don’t think about purple elephants, you know? Are you dying for a smoke? Yes, I am. I think I’ll have No, it’s you focus on your position of respect and protection for your body as if it were a baby. And people can one out of five stop. Most of the others at least cut down on the amount of cigarets for smoking.
00:37:16:18 – 00:37:54:11
Dr. Spiegel
So yes, it can be helpful. It’s worth a try. Likewise. Yes, we could. We could be a pleasure. You’re most welcome, David. Thank you for having me. Bye bye. All right, Good luck. Get in your flight there. Good. You’re most welcome. I enjoyed it. Thanks for having me. I hope so. Thank you. Take care. Bye bye.
