On the Brain’s Activity during Hypnosis
What is “hypnosis”?
Before diving into how hypnosis works in the brain, let’s review what hypnosis is. The word “hypnosis” is derived from the Greek word for sleep (‘hypnos’) and became popular in the 1800s because people who participated in hypnosis sessions appeared as if they were sleeping. However, with the advancement of science and the development of psychological measurements and neuroimaging, we now know that hypnosis is very different from sleep.
So, what is it?
Think of hypnosis as a unique skill your brain can use to assist in change-making. Hypnosis helps facilitate change, and the content of the hypnotic suggestions (through which we design the goal for the hypnosis session) will help your brain know what needs to change and how to do it.
We can use the metaphor of a medicine in a capsule form: what determines the actual effect in the body is the content (the medicinal substance) inside the capsule, but for it to work as intended, it needs to arrive safely to your stomach. If you try to pour the capsule content into your mouth, it might lose its potency. The capsule is the instrument that allows the content to be released at the right place and time to have the best effect. In this comparison, hypnosis is like the capsule – it allows a delivery of content (suggestions) to help your brain change in a way that is both tailored and beneficial to you.
How does hypnosis work in the brain?
In hypnosis, our brains shift the way they work and function differently from most of our everyday brain “states.” Hypnosis can look and feel different for different people, so brain activity in hypnosis could also look different across people.
To understand how hypnosis works in the brain, we first need to understand what brain networks are (if you want to skip the detailed information, feel free to scroll down to the Bottom Line). You might have heard about brain “regions” or “structures.” Modern views on brain activity explain that these brain structures don’t work alone – they create the richness of brain abilities through sharing information with other brain structures. When different regions share information, we say they are “functionally connected.” If a group of brain regions consistently work together every time we use a brain ability, they are called a “network.” There are many networks in the brain, but three are particularly related to hypnosis:
The Salience Network (SN)
The SN is responsible for monitoring information the brain receives and deciding how important it is. Because of its crucial role in controlling attention, the SN participates in various behaviors and cognitive functions. The SN also allows us to be aware of our emotions, thoughts, and bodies. It is mainly represented by two brain regions, the anterior cingulate cortex (ACC) and the insula.
The Executive Control Network (ECN)
The ECN manages the more complex cognitive abilities, frequently referred to as “executive functions.” These functions involve problem-solving, reasoning, working memory (the ability to keep information available and “play” with it), and maintaining focused attention over time. To do that, the ECN uses several brain regions, with the dorsolateral prefrontal cortex (dlPFC) as one of its leading players.
The Default Mode Network (DMN)
The DMN (sometimes referred to as the “mind-wandering” network) is most active when our brains are not focusing on the here and now (for example, when we think about the past or the future, or reflect on ourselves). Because of that, the DMN is less active when the ECN and SN are engaged (when attention is directed to things that are happening in the moment). Several brain regions play a role in the DMN; most relevant to hypnosis are the posterior cingulate cortex (PCC) and the medial prefrontal cortex (mPFC).
The SN, being the “boss” of attention, helps the brain choose which network is more crucial at a given moment – the ECN (for example, when there is a problem to solve) or the DMN (when the brain thinks about things that are not happening in the moment). When something is bothering us, if we are overthinking or in pain, our ECN is probably more active (among other brain networks). Hypnosis is associated with shifts in the activity of the SN, changing the brain’s management of incoming information and its importance. In most hypnosis uses, the SN will reduce its activity as the brain reduces the constant monitoring and management of our self-awareness and information from the senses, allowing for more highly focused attention.
The ECN will then start changing its activity as well, reflecting the type of change we are trying to facilitate using hypnosis. Remember that hypnosis is the instrument (the “capsule”) through which the change we are looking for (the “medicine”) is carried. When some brains are better than others in facilitating these changes using hypnosis, we say that they are more “hypnotizable.” Brains that are more hypnotizable have greater connectivity between the SN and the ECN, making it easier for the SN to affect ECN activity.
Lastly, when using hypnosis, the ECN and DMN reduce their information sharing (they become less functionally connected). This change corresponds to dealing more with the here and now and less with unguided free-thinking in hypnosis. This is also why hypnosis is often referred to as involving focused attention (onto the hypnotic suggestions).
Bottom Line
Hypnosis is a skill your brain can use to help make changes in your behaviors, thoughts, and emotions safely and effectively. In hypnosis, you focus on promoting the change you want in your life as your brain activity changes. The way brain activity changes depends on what you are trying to change using hypnosis. In general, the brain decreases the monitoring and management of information coming from the senses, reduces mind-wandering, and changes its reasoning and planning strategies to fit the hypnotic suggestions given during the hypnosis session.
Further Reading
Jiang, H., White, M. P., Greicius, M. D., Waelde, L. C. & Spiegel, D. Brain Activity and Functional Connectivity Associated with Hypnosis. Cereb. Cortex 27, 4083–4093 (2017).
Hoeft, F. et al. Functional Brain Basis of Hypnotizability. Arch. Gen. Psychiatry 69, 1064–1072 (2012).
Faerman, A. & Spiegel, D. Shared cognitive mechanisms of hypnotizability with executive functioning and information salience. Sci. Rep. 11, 5704 (2021).
Landry, M., Lifshitz, M. & Raz, A. Brain correlates of hypnosis: A systematic review and meta-analytic exploration. Neurosci. Biobehav. Rev. 81, 75–98 (2017).
About the author:
Afik Faerman, Ph.D. is a postdoctoral scholar at Stanford University. He completed his doctoral training in clinical psychology with an emphasis in neuropsychology, and his clinical training at the University of California, San Francisco (UCSF) and Baylor College of Medicine in Houston, TX. Afik’s research centers on identifying key neurocognitive mechanisms in clinical change, focusing on hypnosis, pain, and sleep. His research was supported and acknowledged by the American Psychological Association, the Society for Clinical and Experimental Hypnosis, and the American Society for Clinical Hypnosis.