Essentials: Using Hypnosis to Enhance Mental & Physical Health & Performance | Dr. David Spiegel

In this first part of the conversation, Dr. David Spiegel, a Stanford psychiatrist and one of the leading clinical researchers in hypnosis, sets out to redefine a word that carries heavy cultural baggage. Most listeners arrive with the image of stage entertainment, but Spiegel's clinical practice treats hypnosis as something quite different: a natural, measurable state of consciousness with therapeutic applications.

Spiegel's working definition is deliberately plain: "Hypnosis is a state of highly focused attention." He compares it to looking through a camera's telephoto lens — detail becomes vivid, but context drops away. The everyday analogue he offers is cinematic absorption: getting so caught up in a good movie that you forget you are watching one. You experience the film rather than evaluate it. Andrew Huberman pushes the definition toward sport, asking whether the bodily thrill of watching a game counts; Spiegel agrees, with a condition — the somatic experience must be part of the event itself. If physical reactions merely distract, the state is no longer hypnotic-like.

The contrast with stage hypnosis is where Spiegel is most pointed. He dislikes it because it involves making "fools out of people," and he identifies the root of public fear: people believe hypnosis takes control away. His claim is the opposite — "You're gaining control." Self-hypnosis, in his account, is a way of enhancing control over mind and body, though he concedes the same mechanism that makes it therapeutic — the suspension of critical judgment — could make it dangerous if misused. Huberman's line of questioning suggests the shared label with stage performance is itself part of what keeps clinical hypnosis looking strange to the public.

The discussion turns to mechanism, and Spiegel describes three consistent neural changes observed when people are hypnotized. The first is reduced activity in the dorsal anterior cingulate cortex (dACC), part of the brain's salience network and what he calls a conflict detector — the region that flags a possible gunshot while you work. Damping it down makes distraction less likely, which is why focused attention feels effortless in the state.

Two further changes accompany induction: (1) the dorsolateral prefrontal cortex (DLPFC) shows higher functional connectivity with the insula, a hub of the mind-body control system and the pain network; and (2) the DLPFC shows inverse functional connectivity with the posterior cingulate cortex, part of the default mode network whose activity falls in meditators. The result is a characteristic combination — doing something without reflecting on what it means for the self — which Spiegel ties directly to the dissociation and cognitive flexibility that make hypnosis therapeutically useful.