Brain Regions Involved in Hypnosis: Clinical Implications Sarah Hale, Gary R. Elkins, Ph.D.
Abstract
Introduction Hypnosis and hypnotherapy have a history predating modern psychology and psychotherapy. Due to many efforts of researchers and practitioners “during the latter half of the 20th century and leading up to the present time, there has been an increasing amount of empirical testing the effectiveness of hypnotic interventions” (Elkins, 2014). Because of this, hypnosis has been shown to have applications in both the medical and psychotherapy fields. In the medical field, hypnosis has been used to treat various physical conditions, including chronic pain (Artimon, 2015; Mazzola et al., 2017), irritable bowel syndrome (Palsson, 2015), and management of hot flashes (Elkins, Fisher, Johnson, Carpenter, & Keith, 2013; Sliwinski & Elkins, 2017). Hypnosis has also been used to improve palliative care for chronic illness (Brugnoli et al., 2018). In conjunction with psychotherapy, hypnosis has been used to treat psychological disorders, such as Post-Traumatic Stress Disorder (PTSD) (Lynn, Malakataris, Condon, Maxwell, & Cleere, 2012), depression (Alladin & Alibhai, 2007; Kirsch & Low, 2013), and nicotine addictions (Green & Lynn, 2017; Pekala, 2017). According to Landry & Raz (2017), “the hypnotic response is located at the confluence of three central factors: interindividual variability in hypnotizability, the induction procedure, and the content of hypnotic suggestions” (See Figure 1). This paper discusses the brain regions involved in each of the three central factors during hypnotic response. In most of the reviewed articles addressing hypnotizability and/or induction, induction and hypnotizability were primarily studied together and their contributions to the hypnotic response were found to be correlated (Cardeña, Jönsson, Terhune, & MarcussonClavertz, 2013; Deeley et al., 2012; Hoeft et al., 2012; Jiang, White, Greicius, Waelde, & Spiegel, 2017; Lipari et al., 2012; William J. McGeown, Mazzoni, Venneri, & Kirsch, 2009; Picerni et al., 2019). This observation illustrates that the more
hypnotizable someone is, it is probable that they would have a higher response to induction. Multiple sources found patterns of modulation in three principle neural networks when investigating hypnotizability and induction. These attentional neural networks include the Executive Control Network (ECN), the Salience Network (SN), and the Default Mode Network (DMN). The ECN is a neural network in the brain that is associated with the control of intentionality. This system is also referred to as the Central
Induction
Suggestion Hypnotic Responses
Hypnotizability
Figure 1. Note. Adapted from “Neurophysiology of Hypnosis”, by Landry, M., & Raz, A., 2017, In G. R. Elkins (Ed.), Handbook of medical and psychological hypnosis: Foundations, applications, and professional issues, p.20
Scientia 2020 | 49
Review Article
Hypnosis is described as a “state of consciousness involving focused attention and reduced peripheral awareness characterized by an enhanced capacity for response to suggestion” (Elkins, Barabasz, Council, & Spiegel, 2015). The clinical uses of hypnosis include medical and psychological applications. However, it is not yet known whether the “state of consciousness” is an alteration of waking consciousness, similar to other states (i.e. meditation, mindfulness, yoga), or unique to hypnosis. This paper reviews the relevant literature on hypnosis to identify the brain regions that research has suggested may be most likely associated with hypnosis. Studies utilizing electroencephalogram (EEG), magnetic resonance imaging (MRI), functional magnetic resonance imaging (fMRI), and positron emission tomography (PET) scanning were reviewed. Because of the results presented in the studies examined in this paper, I hypothesize that hypnosis can affect certain regions of the brain. Furthermore, targeting and altering activity in those brain regions could enable benefits to be achieved more quickly through hypnotherapy and similar mind-body practices.
