Hypnotic suggestion: opportunities for cognitive neuroscience

Journal name:
Nature Reviews Neuroscience
Volume:
14,
Pages:
565–576
Year published:
DOI:
doi:10.1038/nrn3538
Published online

Abstract

Hypnosis uses the powerful effects of attention and suggestion to produce, modify and enhance a broad range of subjectively compelling experiences and behaviours. For more than a century, hypnotic suggestion has been used successfully as an adjunctive procedure to treat a wide range of clinical conditions. More recently, hypnosis has attracted a growing interest from a cognitive neuroscience perspective. Recent studies using hypnotic suggestion show how manipulating subjective awareness in the laboratory can provide insights into brain mechanisms involved in attention, motor control, pain perception, beliefs and volition. Moreover, they indicate that hypnotic suggestion can create informative analogues of clinical conditions that may be useful for understanding these conditions and their treatments.

At a glance

Figures

  1. Modulating the default-mode and attentional networks using hypnosis.
    Figure 1: Modulating the default-mode and attentional networks using hypnosis.

    The 'default-mode' network comprises brain regions that are more active under a low-demand condition (for example, lying quietly in an alert state or when passively viewing a stimulus such as a fixation cross) compared with high-demand task conditions. Hypnosis has been used to vary the resting ('default') state of cognition and brain function; a recent study assessed subjective measures of hypnotic depth and brain activation (using functional MRI) in subjects during hypnosis34. The figure shows that the brain regions in which activity decreased with increasing depth of hypnosis included established 'default network' areas, including cortical midline structures of the left medial frontal gyrus, right anterior cingulate gyrus and bilateral posterior cingulate gyrus, and bilateral parahippocampal gyri. Brain regions that showed increased activation with increasing depth of hypnosis included the right middle frontal gyrus, bilateral interior frontal gyrus and bilateral precentral gyrus (not shown). Thus, hypnotic trance was associated with reduced default network activity and increased activity in prefrontal attentional systems. These data are consistent with the view that hypnosis involves a 'special' cognitive state in the sense that it is associated with an altered pattern of brain activity. Figure is reproduced, with permission, from Ref. 34 © (2012) Taylor & Francis.

  2. Using hypnotic suggestion to abolish the Stroop effect.
    Figure 2: Using hypnotic suggestion to abolish the Stroop effect.

    a | In the classic Stroop task, subjects are asked to name aloud the ink colour of printed words. The colours might be incongruent with the word (for example, the word RED printed in green ink) or congruent with the word (for example, the word ORANGE printed in orange ink). Individuals are typically slower at naming the ink colour of incongruent colour words owing to an automatic tendency to prioritize the reading of words over naming the ink colour, a phenomenon known as the Stroop interference. b | A study using highly hypnotizable individuals showed that a specific hypnotic suggestion — namely, that words would appear meaningless — could eliminate this classic Stroop interference effect17. Without hypnotic suggestion, reaction times are longer in the incongruent condition than in the congruent or neutral conditions, but this Stroop effect disappears under hypnotic suggestion. These findings — recently confirmed19 — showed that hypnotic suggestion (when it is effective) is capable of eliminating the deeply entrenched involuntariness and largely automatic process of reading. Part b is reproduced, with permission, from Ref. 17 © (2002) American Medical Association.

  3. fMRI images of hypnotic pain and physical pain.
    Figure 3: fMRI images of hypnotic pain and physical pain.

    In this functional MRI (fMRI) study, eight highly hypnotically suggestible participants, who were hypnotized throughout the session, received painful (48.5 °C) heat stimuli from a thermal probe placed on the palm of their right hand (the physically induced pain condition)16. On some trials they were given the suggestion that the probe would be activated to the same painful level (the hypnotically induced pain condition) when in fact it remained at a comfortable setting (37.0 °C). Participants reported experiencing pain, and fMRI scans showed similar activation in brain areas associated with painful stimulation in both conditions. The figure shows brain activations for physically induced pain rated 5 on a 1–10 scale (top panel); for hypnotically induced pain (middle panel) rated 5 on a 0–10 scale; and for hypnotically induced pain rated 1 on a 0–10 scale (bottom panel). The activations are shown in red–yellow for physically induced pain and in blue–purple for the hypnotically induced pain. Importantly, for both physically induced and hypnotically induced pain, the amount of brain activation was proportional to the degree of pain reported. The bottom two rows in the figure show this for hypnotically induced pain: a hypnotically suggested pain experience rated at 1 (bottom panel) is accompanied by less brain activity than hypnotically induced pain rated at 5 (middle panel). Figure is reproduced, with permission, from Ref. 16 © (2004) Elsevier.

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  1. Division of Psychology and Language Sciences, University College London, WC1H 0AP, UK.

    • David A. Oakley
  2. School of Psychology, Cardiff University, CF10 3AT, UK.

    • David A. Oakley &
    • Peter W. Halligan

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  • David A. Oakley

    David A. Oakley is Emeritus Professor of Psychology at University College London, UK, and Honorary Professor of Psychology at Cardiff University, UK. In addition to academic teaching and research he was for many years a practicing clinical psychologist and was the founder of the Hypnosis Unit at University College London. His early research interests were in comparative studies on the role of the neocortex in learning and memory and more recently in consciousness and the use of hypnosis as research tool in cognitive neuroscience. He is a Fellow of the Royal Society of Medicine, the British Psychological Society and is a former Fellow of the American Psychological Association. He served for 5 years as the editor of the journal Contemporary Hypnosis and was the hypnosis consultant on the recent Danny Boyle film Trance.

  • Peter W. Halligan

    Peter W. Halligan is Professor of Neuropsychology at Cardiff University, UK, and Head of Strategic Futures at Higher Education Wales. Following training in psychology and philosophy at University College Dublin, Ireland, he spent 12 years in the Departments of Clinical Neurology and Experimental Psychology at the University of Oxford, UK, working on a broad range of acquired and developmental conditions spanning neuropsychology and neuropsychiatry conditions. Awarded the British Psychological Society's Presidents' Award for outstanding contributions to psychology in 2005, he is a Fellow of the British Psychological Society, Irish Psychological Society and Academy of Medical Sciences and co-editor of the journal Cognitive Neuropsychiatry. Peter W. Halligan's homepage.

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