Video summary
Dr. David Spiegel explains that hypnotizability is a highly stable personality trait established early in life, with most eight-year-olds exhibiting high levels of suggestibility due to their immersion in play and immediate experience. As individuals progress through adolescence into formal operational thinking, they begin to prioritize analysis over direct experience, leading to a stabilization of their hypnotic potential by age 21. This stability is so profound that Stanford psychology professor Philip Zimbardo found a test-retest correlation as high as IQ after retesting former undergraduates twenty-five years later. Consequently, there are indeed "total non-responders" who simply cannot respond to hypnosis regardless of the professional's skill or duration of effort; these individuals possess low hypnotizability scores that remain consistent over time. To determine a patient's potential for response, Dr. Spiegel utilizes a standard five-minute evaluation involving specific instructions and observations. He asks subjects to lift their hand while keeping it light, then attempts to pull it down after they open their eyes, observing if the arm floats back up due to dissociation and buoyancy sensations. Crucially, he assesses involuntariness by asking which hand feels more controlled; highly hypnotizable individuals typically feel less control over the moving (hypnotized) hand compared to the stationary one. This process yields a ten-point score that reliably categorizes patients into low, mid-range, or high groups, guiding Dr. Spiegel's approach for his career-long practice involving thousands of sessions. The therapeutic strategy varies significantly based on this assessment. For those with extremely high scores, such as a woman born with an esophageal fistula who scored a perfect 10 and experienced immediate relief from chronic throat pain without medication or surgery, the process is direct and dramatic. In contrast, mid-range individuals require a negotiation where they test different suggestions to find images that work best for them, similar to how Dr. Spiegel helped a professional pianist reduce his knee pain by imagining playing an "air piano." For low-scoring subjects, hypnosis functions more like Cognitive Behavioral Therapy (CBT) or Acceptance and Commitment Therapy (ACT), focusing on cognitive reframing rather than direct suggestion. Dr. Spiegel illustrates the challenges of working with low scorers through the example of a rational man who was a "zero" because he over-analyzed even simple questions, such as determining his handedness to ensure equal activity in both hands. This individual's high elaboration and weak signal processing meant that fighting pain only exacerbated it; Dr. Spiegel had to shift him from bottom-up sensory experiences to top-down cognitive strategies by pointing out that his worry about bone structure was unfounded despite negative x-rays. The core principle for all levels is to focus on what the patient can do rather than what they are against, avoiding commands like "don't think of purple elephants" which often trigger counter-productive thoughts in low scorers who struggle with inhibition control.
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Talk to me about this profile of anyone
being hypnotizable versus specific
people being more or less likely to
respond. Are there some total
non-responders? Are there some Right.
That's right. There hypnotizability is a
very stable trait. Um
most most eight-year-olds are in
transances most of the time. You know,
you call your kid in for dinner, he
doesn't hear you. He's work and play are
all the same thing. It's a wonderful
thing about being a child. It's a shame
we have to grow up. But as we go through
adolescence, we develop what is called
formal operations. We begin to value
thinking and analysis more than
immediate experience. And that's got
real advantages. You know, you can judge
and evaluate things. But so by the time
people get to 21 or so, they've settled
into a very stable degree of
hypnotizability from low to medium to
high. And uh Phil Zimardo, a late
psychology professor at Stanford, did an
interesting study where he took his
former undergrads in psych 1 who had had
their hypnotizability measured and
blindly went out and retested them 25
years later. The test retest correlation
was.7.
>> Now that's as high as IQ in a 25-y year
interval. It does not change much. So,
you know, I I have seen some of the
great hypnotists and hypnotic
professionals
work for a long time with someone who is
just not hypnotizable. And it doesn't
matter. They just cannot respond. And
so, the way I start every session of
about 7,000 people I've used hypnosis
with in my career with a five-minute
evaluation of their hypnotizability
and that guides me and how to work with
them. So if they're extremely high, we
just do it, you know. Um I had a woman
uh who was born with esophageal fistula
to her trachea. And so it meant, you
know, food would get into her lungs and
she it was painful. She's had multiple
surgeries and she's had pain in her
throat throughout her life. And she was
about 39 and she just had it. And I got
her hypnotized. She was 10 on the scale.
10 out of 10. Extraordinarily
hypnotizable. Hands floating up in the
air. She and I um I had her imagine that
she had swallowed some ice water and had
soothed her her throat
and she opened her eyes and she started
to cry and she said, "You're a
magician." She said, "I have never been
to a doctor where the pain just plain
went away." And this was not medication.
It wasn't surgery. It was just teaching
her brain how to respond to those
signals differently. So with highs, you
can do that dramatic stuff. With
mid-range people, you negotiate more.
You teach them how to try it out,
evaluate how it went, see if there are
ways that they can find a better image
that might work better for them. So,
it's a negotiation process. With Lowe's,
it's it's it's much more cognitive. It's
just, you know what, um, your brain is
reacting to this history of discomfort
that you've had, and it may be making it
worse instead of better. So if instead
of fighting the pain, you take it as a
message. You got the message and what
else can you do that will distract you?
>> Sounding for the lows, it's sounding
suspiciously close to acceptance and
commitment therapy.
>> There's a there's a bit of that in it,
but but for highs, ACT is just a
diversion, you know, they can they can
do it in minutes and feel it.
>> Yeah. Wow. What
What does the assessment look like um
for that? How do you work it how do you
work it out? Uh it's it's a standard
hypnotic induction. I have people look
up, close their eyes, take a deep
breath, let their hand go up in the air,
and I give them this instruction. Your
hand will remain light. And in this
upright position, even after you open
your eyes, if I pull your hand back
down, it will float right back up to the
upright position. You'll find something
pleasant and amusing about this. Later,
when I touch your elbow, your usual
sensation and control will return. And I
see how well then they respond to that.
And we rate them on the sense of
dissociation. Does the left hand feel as
if it's not as much a part of their body
as the right? On their response to a
challenge where you pull the hand down
and see if it floats up.
>> Uh on a sense of involuntariness.
Crucial question. Does your left do you
feel more control over one hand than the
other? And if they're hypnotizable, they
tend to feel more control in the non uh
hypnotized hand. Uh then response to the
cut off signal when I touch the elbow.
And so it's two points for each of
these. and then two points for whether
they had a sense of floating lightness
or buoyancy in their hand alone or in
their body as well. And so you get a
10-point score and it's a it's very
stable, reliable measure. What I'm
interested in is what
are the sort of people who tend to be
tens, sixes, fours, and zeros or ones.
Can you see when somebody walks in or if
you were given a profile of somebody
beforehand? high-powered chief
operations officer, very logistical and
rational, is it less likely that that
person's going to be high in
hypnotizability compared with the
>> artsy creative person who comes in with
dyed hair and tattoo? You know what I
mean? Like that.
>> You're right. And there's some truth to
that. I mean, you can miss sometimes,
but um yes, in general, people who are
organized, who, you know, want to have
things just the way they need to be tend
to be less hypnotizable. I had a guy
recently um who uh had um a ser had bad
lower back problems and and pain in his
knees and was but a very sort of
rational he went to a million doctors
and nothing seemed to work and um and
they took x-rays and they didn't see
anything definitive but there may be
things wrong and routinely I asked what
h what's your handedness are you right
or left-handed tough question and he
said well I'm right-handed but I always
want my left hand to be equally active.
So I always use my left hand the same
way just after I use my right hand. So
like a real simple question, you know,
what handedness do you have? And he had
to analyze that too.
>> Yeah. Yeah.
>> And he was a zero. Like flat out zero.
And I said that to him, you know, he
came to me for hypnosis and I said, you
know, I think your problem is that that
you make everything a problem. You worry
about everything, including whether
you're right or left-handed. and I think
your doctors have been telling you
there's nothing that wrong with your
bones and your joints. Um, and you keep
worrying about it. And he looked sort of
relieved. I thought he'd get mad at me,
you know. He look he said, "You know,
doc, all the doctors I've seen, you're
the first one who's told me that, and I
think you're right." And so I said, "The
problem is the signal is weak, but your
elaboration of the signal is high. So
just think about other things than
that."
>> So you've had to go top down, not bottom
up with him because he's a zero.
>> That's right. That's right.
>> So, it's much closer to actual CBT or
something than than to hypnosis.
>> But it it's also, you know, focus on
what you're for, not what you're
against. Don't fight it. You know, we we
we say with hypnosis, the worst thing
you can tell someone is don't think
about purple elephants. You know, what
are you going to think about? So,
instead, you find a strategy that's
appealing that they can affiliate with
and feel good about from the moment they
do it.
>> Um, for mid-range people, it's more try
it and let's discuss it. You know, it's
kind of they they have the Yeah. You
know, I do I do feel somewhat better.
You know, I had a pianist, a guy who was
a, you know, a professional pianist, but
to make a living, you know, the saying
about the difference between a musician
and a pizza. Um, a pizza can feed an
average family of four, you know, and so
he had to he had he had a day job in
construction and he'd gotten himself
injured and had a lot of pain. And it
got to where he couldn't um uh you know
manage the pedals on the piano well and
it was really awful for him. And uh but
he was frustrated. He was mid-range and
hypnotizability. Frustrated that he kept
getting distracted from his favorite
thing which was to play. So I had him
hypnotized and I said, "Your body is
floating cool and comfortable and I want
you to play air piano for me." So he's
there hypnotized. he's playing and he
says, you know, I can actually enjoy
this. You know, this is good. I wrote
this song. I really like this. And he
reduced his pain from five to like two
to three. And so it was a sort of
negotiation with him, trying out
different things and doing it. And with
the highs, it's like that lady with the
throat and trachea problem. Um, she just
did it. She just she cool, tingly, and
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