Stanford researchers found changes in three areas of the brain that occur when people are hypnotized.
Study identifies brain areas altered during hypnotic trances

By scanning the brains of subjects while they were hypnotized, researchers at the School of Medicine were able to see the neural changes associated with hypnosis.
Stanford researchers found changes in three areas of the brain that occur when people are hypnotized.

Your eyelids are getting heavy, your arms are going limp and you feel like you’re floating through space. The power of hypnosis to alter your mind and body like this is all thanks to changes in a few specific areas of the brain, researchers at the Stanford University School of Medicine have discovered.
The scientists scanned the brains of 57 people during guided hypnosis sessions similar to those that might be used clinically to treat anxiety, pain or trauma. Distinct sections of the brain have altered activity and connectivity while someone is hypnotized, they report in a study published online July 28 in Cerebral Cortex.
“Now that we know which brain regions are involved, we may be able to use this knowledge to alter someone’s capacity to be hypnotized or the effectiveness of hypnosis for problems like pain control,” said the study’s senior author, David Spiegel, MD, professor and associate chair of psychiatry and behavioral sciences.
A serious science
For some people, hypnosis is associated with loss of control or stage tricks. But doctors like Spiegel know it to be a serious science, revealing the brain’s ability to heal medical and psychiatric conditions.

David Spiegel:
“Hypnosis is the oldest Western form of psychotherapy, but it’s been tarred with the brush of dangling watches and purple capes,” said Spiegel, who holds the Jack, Samuel and Lulu Willson Professorship in Medicine. “In fact, it’s a very powerful means of changing the way we use our minds to control perception and our bodies.”
Despite a growing appreciation of the clinical potential of hypnosis, though, little is known about how it works at a physiological level. While researchers have previously scanned the brains of people undergoing hypnosis, those studies have been designed to pinpoint the effects of hypnosis on pain, vision and other forms of perception, and not the state of hypnosis itself.
“There had not been any studies in which the goal was to simply ask what’s going on in the brain when you’re hypnotized,” said Spiegel.

Finding the most susceptible

To study hypnosis itself, researchers first had to find people who could or couldn’t be hypnotized. Only about 10 percent of the population is generally categorized as “highly hypnotizable,” while others are less able to enter the trancelike state of hypnosis. Spiegel and his colleagues screened 545 healthy participants and found 36 people who consistently scored high on tests of hypnotizability, as well as 21 control subjects who scored on the extreme low end of the scales.
Then, they observed the brains of those 57 participants using functional magnetic resonance imaging, which measures brain activity by detecting changes in blood flow. Each person was scanned under four different conditions — while resting, while recalling a memory and during two different hypnosis sessions.
“It was important to have the people who aren’t able to be hypnotized as controls,” said Spiegel. “Otherwise, you might see things happening in the brains of those being hypnotized but you wouldn’t be sure whether it was associated with hypnosis or not.”

Brain activity and connectivity

Spiegel and his colleagues discovered three hallmarks of the brain under hypnosis. Each change was seen only in the highly hypnotizable group and only while they were undergoing hypnosis.
First, they saw a decrease in activity in an area called the dorsal anterior cingulate, part of the brain’s salience network. “In hypnosis, you’re so absorbed that you’re not worrying about anything else,” Spiegel explained.
It’s a very powerful means of changing the way we use our minds to control perception and our bodies.
Secondly, they saw an increase in connections between two other areas of the brain — the dorsolateral prefrontal cortex and the insula. He described this as a brain-body connection that helps the brain process and control what’s going on in the body.Finally, Spiegel’s team also observed reduced connections between the dorsolateral prefrontal cortex and the default mode network, which includes the medial prefrontal and the posterior cingulate cortex. This decrease in functional connectivity likely represents a disconnect between someone’s actions and their awareness of their actions, Spiegel said. “When you’re really engaged in something, you don’t really think about doing it — you just do it,” he said. During hypnosis, this kind of disassociation between action and reflection allows the person to engage in activities either suggested by a clinician or self-suggested without devoting mental resources to being self-conscious about the activity.

Treating pain and anxiety without pills

In patients who can be easily hypnotized, hypnosis sessions have been shown to be effective in lessening chronic pain, the pain of childbirth and other medical procedures; treating smoking addiction and post-traumatic stress disorder; and easing anxiety or phobias. The new findings about how hypnosis affects the brain might pave the way toward developing treatments for the rest of the population — those who aren’t naturally as susceptible to hypnosis.
“We’re certainly interested in the idea that you can change people’s ability to be hypnotized by stimulating specific areas of the brain,” said Spiegel.

A treatment that combines brain stimulation with hypnosis could improve the known analgesic effects of hypnosis and potentially replace addictive and side-effect-laden painkillers and anti-anxiety drugs, he said. More research, however, is needed before such a therapy could be implemented.
The study’s lead author is Heidi Jiang, a former research assistant at Stanford who is currently a graduate student in neuroscience at Northwestern University.
Other Stanford co-authors are clinical assistant professor of psychiatry and behavioral sciencesMatthew White, MD; and associate professor of neurology Michael Greicius, MD, MPH.
The study was funded by the National Center for Complementary and Integrative Health (grant RCIAT0005733), the National Institute of Biomedical Imaging and Bioengineering (grant P41EB015891), the Randolph H. Chase, M.D. Fund II, the Jay and Rose Phillips Family Foundation and the Nissan Research Center.
Stanford’s Department of Psychiatry and Behavioral Sciences and Department of Neurology and Neurological Sciences also supported the work.

Sarah C.P. Williams is a freelance science writer.


Sexual Behavior, Definitions of Sex, and the Role of Self-Partner Context Among Lesbian, Gay, and Bisexual Adults
Prior research has examined how heterosexual individuals define sex; however, these studies have rarely focused on sexual minority individuals or included a full range of applicable sexual behaviors. Participants were recruited from a local Pride Festival across two years. Study 1 (N = 329) was primarily descriptive and examined which physically intimate behaviors lesbian, gay, and bisexual (LGB) participants included in their definitions of sex and the behaviors in which they had previously engaged. Study 2 (N = 393) utilized a between-subjects design to assess differences in definitions of sex when judging one’s own behavior compared with that of a partner outside of the relationship. The behaviors in which participants were most likely to have engaged were manual-genital (82%) and oral-genital stimulation (79%). Regarding definitions of sex, a clear “gold standard” emerged for men, with 90% endorsing penile-anal intercourse as sex. No equally clear standard existed for women. Participants who were asked to consider their partner’s behavior outside of their relationship were more likely to endorse the behavior as “having sex” than participants asked to consider their own behavior. This study addressed a major limitation of prior research by investigating definitions of sex among a community sample of LGB adults, with implications for provision of health care and sexual agreements between same-sex couples.

Kelsey K. Sewell, Larissa A. McGarrity & Donald S. Strassberg

Sexual Quality of Life and Aging: A Prospective Study of a Nationally Representative Sample

Unlike other life domains, sexual quality of life (SQoL) has a negative relationship with age. This study disentangled the effect of age in this relationship from confounding sociocultural influences (e.g., the period of time in which data were collected, and cohort differences) and aimed to understand the roles of other sexual domains (i.e., frequency, perceived control, thought and effort invested in sex, and number of sexual partners). We analyzed data from the longitudinal Midlife in the United States study (n = 6,278; age range 20–93), which were collected between 1995 and 2013. Repeated measures linear mixed-effects models showed that age was the most robust time-related predictor of declining SQoL. However, after the sexual domains were included in the model, age had a positive relationship with SQoL and older adults’ SQoL was differentially influenced by the quality—not quantity—of sex. When partnership characteristics were included in the model, age was no longer related to SQoL. These findings suggest that aging may be associated with the acquisition of skills and strategies that can buffer age-related declines in SQoL, particularly in the context of a positive relationship. We summarize these findings as sexual wisdom.

Miriam K. Forbes, Nicholas R. Eaton & Robert F. Krueger

Sexual Desire, Communication, Satisfaction, and Preferences of Men and Women in Same-Sex Versus Mixed-Sex Relationships 


In an online study, measures of subjective sexual experiences in one’s current relationship were compared across four groups: Men and women in mixed-sex (i.e., heterosexual) and same-sex (i.e., homosexual) relationships. Results indicated far more similarities than differences across the four groups, with groups reporting almost identical sexual repertoires, and levels of sexual communcation with partner. Men reported experiencing somewhat more sexual desire than women, while women reported slightly higher levels of general sexual satisfaction than men. Those in same-sex relationships reported slightly higher levels of sexual desire than those in mixed-sex relationships. Compared to the other three groups, heterosexual men reported deriving somewhat less satisfaction from the more tender, sensual, or erotic sexual activities. Implications of these findings for sex therapists are discussed.

Diane Holmberg & Karen L. Blair

Cerebral Mechanisms of Hypnotic Induction and Suggestion


The neural mechanisms underlying hypnotic states and responses to hypnotic suggestions remain largely unknown and, to date, have been studied only with indirect methods. Here, the effects of hypnosis and suggestions to alter pain perception were investigated in hypnotizable subjects by using positron emission tomography (PET) measures of regional cerebral blood flow (rCBF) and electroencephalographic (EEG) measures of brain electrical activity. The experimental conditions included a restful state (Baseline) followed by hypnotic relaxation alone (Hypnosis) and by hypnotic relaxation with suggestions for altered pain unpleasantness (Hypnosis-with-Suggestion). During each scan, the left hand was immersed in neutral (35°C) or painfully hot (47°C) water in the first two conditions and in painfully hot water in the last condition. Hypnosis was accompanied by significant increases in both occipital rCBF and delta EEG activity, which were highly correlated with each other (r = 0.70, p < 0.0001). Peak increases in rCBF were also observed in the caudal part of the right anterior cingulate sulcus and bilaterally in the inferior frontal gyri. Hypnosis-related decreases in rCBF were found in the right inferior parietal lobule, the left precuneus, and the posterior cingulate gyrus. Hypnosis-with-suggestions produced additional widespread increases in rCBF in the frontal cortices predominantly on the left side. Moreover, the medial and lateral posterior parietal cortices showed suggestion-related increases overlapping partly with regions of hypnosis-related decreases. Results support a state theory of hypnosis in which occipital increases in rCBF and delta activity reflect the alteration of consciousness associated with decreased arousal and possible facilitation of visual imagery. Frontal increases in rCBF associated with suggestions for altered perception might reflect the verbal mediation of the suggestions, working memory, and top-down processes involved in the reinterpretation of the perceptual experience. These results provide a new description of the neurobiological basis of hypnosis, demonstrating specific patterns of cerebral activation associated with the hypnotic state and with the processing of hypnotic suggestions.

Pierre Rainville, Robert K. Hofbauer, Tomáš Paus, Gary H. Duncan,

Journal of Cognitive Neuroscience
Volume 11 | Issue 1 | January 1999


What Keeps Passion Alive? Sexual Satisfaction Is Associated With Sexual Communication, Mood Setting, Sexual Variety, Oral Sex, Orgasm, and Sex Frequency in a National U.S. Study

Passion and sexual satisfaction typically diminish in longer-term relationships, but this decline is not inevitable. We identified the attitudes and behaviors that most strongly differentiated sexually satisfied from dissatisfied men and women who had been together for at least three years (N = 38,747). Data were collected in 2006 from cohabiting and married men (M) and women (W) via an online survey on a major national U.S. news Web site. The vast majority of these participants reported being satisfied with their sex lives during their first six months together (83% W; 83% M). Satisfaction with their current sex lives was more variable, with approximately half of participants reporting overall satisfaction (55% W; 43% M) and the rest feeling neutral (18% W; 16% M) or dissatisfied (27% W; 41% M). More than one in three respondents (38% W; 32% M) claimed their sex lives were as passionate now as in the beginning. Sexual satisfaction and maintenance of passion were higher among people who had sex most frequently, received more oral sex, had more consistent orgasms, and incorporated more variety of sexual acts, mood setting, and sexual communication. We discuss implications of these findings for research and for helping people revitalize their sex lives.

David A. Frederick, Janet Lever, Brian Joseph Gillespie & Justin R. Garcia


The Sexual Health of Transgender Men: A Scoping Review

There is a general paucity of research concerning the sexual health of transgender individuals, and most existing research focuses on transgender women. A scoping review concerning the sexual health of transgender men was conducted to identify gaps in the literature and to highlight opportunities for future research and intervention. A comprehensive search of seven databases was conducted. The Joanna Briggs Institute Reviewers’ Manual was used as a framework. Some 7,485 articles were initially identified using a search strategy applied to seven online databases: 54 articles were identified as relevant to the research questions and reviewed in detail; of those, 33 were included in the final analysis. Studies were conceptualized into four broad themes: sexual behaviors, sexual identity, sexual pleasure and sexual function, and transactional sex. Besides an overall lack of research, existing studies were often characterized by small convenience samples that do not allow for generalization to the larger population of transgender men. Significant gaps in the literature regarding sexual coercion, sexual and intimate partner violence, and relationship quality and functioning among transgender men exist. There is a need to improve the scope and depth of research examining the sexual health of this population, especially concerning sexual risk behaviors and structural barriers to sexual health care access.

Rob Stephenson, Erin Riley, Erin Rogers, Nicolas Suarez, Nick Metheny, Jonathan Senda