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Hypnosis-based treatments have been employed in the management of several mental illnesses, including phobias and other anxiety disorders, physical illnesses such as fibromyalgia, and smoking cessation. Hypnosis can be very effective for some patients, but its scope is limited because people inherently have different levels of suggestion. Approximately 20% of people can be easily hypnotized, while 20% of people are basically not hypnotized.
clinical research in natural mental health reported that transcranial magnetic stimulation (TMS) can temporarily increase susceptibility to hypnosis. Although this proof-of-concept study requires follow-up, the findings are interesting because they show that traits thought to be stable throughout life can be modified.
Although people may be familiar with hypnosis as a stage act, hypnosis’ role in therapy is not to put someone into a trance, says lead study author Wilson Professor and Associate Director of Psychiatry at Stanford University School of Medicine. Author David Spiegel, MD, explains: . Rather, hypnotherapy brings individuals into a state of focused attention and increased cognitive flexibility. Combining these conditions can facilitate behavior change goals.
“Hypnosis has similarities with psychedelics, and psychedelics also hold promise as adjuncts to psychotherapy,” Spiegel said.he said Psychiatric news Both approaches suppress the brain networks that control ruminative thinking (such as daydreaming and mind wandering), suppress many preconceptions, and encourage new identity attempts.
The seeds for this current study were planted several years ago, when Spiegel’s team used brain imaging data to identify potential brain connections associated with the likelihood of becoming hypnotized. They found that people who were easily hypnotized had stronger neural connections between the dorsolateral prefrontal cortex (DLPFC) and the dorsal anterior cingulate cortex (dACC) than those who were less easily hypnotized. It makes sense that the two areas are related to hypnosis. The DLPFC controls decision-making and executive functions, and the dACC processes and filters external stimuli.
“We found that both of these regions were prominent targets for TMS,” said Dr. Spiegel, director of the Stanford Brain Stimulation Institute and a pioneer in high-precision neurostimulation technology. I decided to reach out to my colleague in psychiatry, Nolan Williams, MD. Together, their team set out to see if they could modulate hypnotic responses.
The Stanford University team recruited 80 adults (ages 18 to 69, 94% female) with fibromyalgia. Fibromyalgia is a chronic disease characterized by an increased response to pain, fatigue, and cognitive impairment. All participants were rated as low to moderately hypnotizable according to the Hypnosis Induction Profile (HIP). This test is a simple test in which your therapist gives you a standardized set of suggestions. For example, have individuals roll while closing or raise their hands. It feels light. To qualify, he had to score 8 or less on her HIP scale of 0 to 10 points.
Participants were randomly assigned to receive one session of theta burst stimulation, a rapid form of TBS that can be delivered in approximately 90 seconds, or sham stimulation. Similar to another TMS protocol developed by Williams, known as SAINT, each participant in this study underwent an MRI scan to identify areas within the DLPFC with the strongest connections to the dACC. (SAINT stands for Stanford Accelerated Intelligent Neuromodulation Therapy.) Participants then took the HIP assessment immediately after stimulation and again 1 hour later.
On average, HIP scores for participants who received active TMS increased by approximately 1 point immediately after stimulation, whereas scores for sham participants remained the same. The change in HIP score disappeared after his 1 hour.
Although the effects were modest and temporary, Williams believes they are encouraging given that this was the first attempt to involve just one stimulation session. Regular TMS therapy for depression typically requires numerous sessions spaced out over several days or weeks to achieve reliable effects. He plans to conduct additional tests to see if TMS’s hypnotic effects can last longer or be more powerful.
Williams acknowledged that the mechanistic study only assessed an individual’s hypnotizability index. The researchers did not provide detailed hypnotherapy to see if fibromyalgia patients would respond more robustly after TMS.
Williams and Spiegel hope to launch a clinically focused trial to investigate whether TMS can enhance the effectiveness of hypnotherapy for people trying to quit smoking. Since TMS has been tested as a monotherapy for smoking cessation, it may have a synergistic effect when combined with hypnotherapy.
Spiegel believes that increasing hypnotizability could have a wide range of applications.he said Psychiatric news Some psychological treatments, including cognitive behavioral therapy, could be enhanced if people were more focused and willing to try new ways of thinking, he said.
This research was supported by an Innovation Award grant from the National Center for Complementary and Integrative Medicine. ■
