s3.amazonaws.com · web viewwell the word, mindfulness, obviously can have many different meanings....

Yapko Transcript. Mindfulness Conference. http://www.mindfulnessconference.com/

“Mindfulness and Hypnosis: The Power of Suggestion to Transform Experience” Michael Yapko

[Start of recorded material]

Hi. This is Dr. Michael Yapko. I'm a Clinical Psychologist from Fallbrook, California and I would first like to express my thanks to Rob McNeilly for inviting me to participate in this presentation, a series of lectures on the topic of mindfulness. In fact, my presentation is called mindfulness and hypnosis, the power of suggestion to transform experience.

I have been studying hypnosis for more than three decades. I have been researching hypnosis, writing about hypnosis. In fact, I am the author of Trancework, which is widely regarded as the most popular hypnosis textbook there is. And my considerations of hypnosis over the years have been really from a social psychological perspective more than any other perspective.

I've been interested in how people say things to other people and influence their experience as a result. And so, when I first started hearing about mindfulness, which probably about 10 years ago, I would guess, I had an initial interest in it just because it was so consistent with the things that I was invested in already.

I very much care about people's capacity to pay attention, how to use their intentional capabilities to create different qualities of experience in their lives. I'm very clear that focus is everything and the quality of your focus shapes so much of the quality of your life. Literally what you focus on, determines how you feel, how you react, what you think, what you notice.

And so the literature of mindfulness kind of trickled in slowly, captured my interest, but I was involved in other projects, most notably about treating depression. So it wasn't really until about five years ago that I had the chance to start focusing on mindfulness. And I think right around the same time that I did, so did a lot of other people because the interest in mindfulness has just exploded especially in the last five years.

The volume of information, the number of articles published in peer review journals, the number of workshops and conferences on the subject, it has really been quite an amazing thing to observe. And, especially for someone like me, who's into hypnosis, there is a curiosity why mindfulness has reached a level of acceptance already that hypnosis can only envy.

Hypnosis continues to be the crazy cousin that nobody wants to invite to the family picnic. And I think that issue will have to wait for another day because, in my presentation today, what I'd like to address is the relationship between mindfulness and hypnosis and what I've learned by bringing my hypnosis background to the study of mindfulness.

Over the last five years, as I mentioned, I have intensively gotten involved in the field of mindfulness. I have been studying different people's processes, different people's writings, how people approach the topic, how they bring mindfulness into the world of clinical practice. And that will be one of the themes that I will explore a little bit later on; mindfulness as a spiritual pursuit versus mindfulness as a clinical pursuit.

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http://www.mindfulnessconference.com/


So let me tell you a little bit about what I intend to address then in the next hour or so. In the first section, I want to talk about hypnosis and the foundation of experiential learning that applies to mindfulness. Then the next section, I want to talk about some of the dynamics of employing guided mindfulness meditations and treatment. And then, in the third section of my planned talk, I will talk about suggestions, placebo effects and the power of paradox.

Well, let's jump in. Mindfulness has become an enormously popular topic. And, to encourage a more whole person participation in treatment, clinicians have been begun to use guided mindfulness meditations and these guided mindfulness meditations have already proven themselves to be enormously valuable in reducing anxiety, depression and pain as well as many other conditions.

So these guided mindfulness meditations pragmatically are where a clinician, who is trained in conducting such meditations, will invite the person to close their eyes and focus on their breathing, typically. And then they may go on to suggest other possible kinds of responses from increased sense of compassion towards self and others or greater awareness of being in the moment.

So guided mindfulness meditations have been embedded in clinical contexts, clinical interactions and they have been tracked for their clinical value. And in the scientific literature, the clinical literature in particular, mindfulness procedures have demonstrated that they have a significant contribution to make to improving clinical outcomes.

So that's not what this presentation is going to be about. There's no question that mindfulness is valuable and that mindfulness has the capacity to improve the efficiency of treatments. The larger question, the global question I'm going to start with and then break it down as I answer it, is the question of, since these guided mindfulness meditations work, how do they work?

Well, to answer such a broad question, we really have to consider first what level of analysis we want to consider. Do we want to focus on the biological aspects of mindfulness, which so many people are doing, striving to identify changes in the brain and changes in the nervous system, as a result of a systematic training in mindfulness meditations?

Others will explore the historical roots of the practice. I don't think you can pick up any piece of mindfulness literature without being reminded constantly that this is a product of 2,500 years of practice in the Buddhist tradition.

Do we want to analyse the prevailing social conditions that give rise to its popularity? Do we want to explore the therapeutic relationship in which mindfulness is practiced? Do we want to measure it strictly n terms of clinical benefits? Do we want to contemplate the spiritual dimensions and its intangible benefits?

Well obviously there are many different levels to consider the phenomenon of mindfulness and my own level of analysis is on the language of mindfulness, the linguistic and the semantic components of the things that clinicians actually say to their clients and then, of course the consequences of what they say, the suggested effects.

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Someone wise once said it is much easier to ignore the obvious than to renounce the traditional. Well, I have been really interested in, as I have researched for my new book, which I'll mention in just a moment about mindfulness, I've had the opportunity to speak with many of the experts in the field of mindfulness that the names you know, the people who are very significant in their contributions to mindfulness.

And it was interesting how, as I interviewed them and told them that I was going to be saying something about the relationship between mindfulness and hypnosis, how instantly irritated many of these experts became. It was as if I was saying that mindfulness was the same as hypnosis and I was contaminating the field. I mean people literally had the attitude, if not the words, don't get that icky hypnosis all over my nice mindfulness.

Well as I explored in greater depth, the relationship between mindfulness and hypnosis, looking at some of the semantics, the language, the quality of suggestions that are used, I think you really can't help but notice that mindfulness and hypnosis are very closely related in both form and function.

So the emphasis for me is, since hypnosis has a considerably longer history of exploring many of the key factors, especially unconscious ones, that regulate people's responses to experiential processes in general and experiential processes like hypnosis and guided mindfulness meditations in particular, I think that there's a lot to be said and I will be just scratching the surface of those key points in the course of this short lecture.

But I think now is a good time to mention that all of the research that I did, culminated in the writing of a new book called Mindfulness and Hypnosis: The Power of Suggestion to Transform Experience. It was published by Norton Publishers in New York just a few weeks ago. As I record this, it is late November 2011 and the book just came out a matter of weeks ago. So you might not have heard of it yet.

I hope that you will check it out because I think what I did very methodically was make the case quite powerfully that, understanding something about the language of suggestion, the power of suggestion, the semantics of suggestions that are so powerful in creating transformative experiences such as those people will report through their practice of mindfulness I think is a really important point to have made. And it's a well-researched book and, I think, a well-written book and I think the best evidence for that is that many of the people who were biased against it, ended up becoming for it after they read it.

And in fact, Lama Surya Das, a distinguished Buddhist monk and teacher and author wrote a forward to the book and you'll see the endorsements of other experts in mindfulness, who ended up very much appreciating my considerations of the relationships between mindfulness and hypnosis.

Well hypnosis provides vital information, vital insights regarding brain functions information processing, mind-body relationships, epigenetics, expectancy and treatment responses, the components of clinical effectiveness, relationship, therapeutic alliance, dynamics. And the fact that hypnosis provides such vital information should escape no one's attention because these happen to be the same things that people who are interested in mindfulness are interested in knowing something about.

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Well during hypnosis, of course, people can experience marked shifts in their physiology, their sensory perceptions, their cognitions, the quality of their affect, their behaviour, their temporal orientation, whether they focus on past, present or future and even their self-definition when they come to view themselves as more resourceful and more competent.

And so the fact that hypnosis can produce these measurable shifts that are, in many ways, quite dramatic, what a dramatic thing to induce numbness, for example, a sensory perceptual shift, that allows somebody to reduce or eliminate use of pain medication or even something as dramatic as withstand a surgery with hypnosis as the only anaesthetic.

But interestingly, even though the mindfulness folks do not use this kind of language, when you're conducting guided mindfulness meditations, you're encouraging people to experience the same structural and phenomenological shifts, you're encouraging shifts in physiology and sensory perception and cognition, affect, behaviour, temporal orientation and self definition.

The goals may be different. People who do hypnosis are encouraging their clients to make shifts in perceptions and behaviours for therapeutic reasons so somebody who practices hypnosis is very unlikely to use language like feeling enlightened after a session or after a practice period.

So with that in mind, the fact that we're seeing measurable changes taking place on multiple dimensions of experience when we're using these experiential process - and I'm now introducing the term, experiential processes, in a very specific way. When you do mindfulness with people, when you do hypnosis with people, these are not logical processes. We're inviting people to respond on the level of experience, on the empirical level of what things people actually see, hear, feel, smell, taste. It's very different than simply having a conversation with someone in which you're really sharing information on a more symbolic level, the symbolic level of language.

So the key questions guiding my presentation now are these. How does pain attention focusing translate into non-volitional, non-voluntary, yet meaningful responses? Why do some people respond so dramatically to experiential processes such as mindfulness, finding them transformative? What general factors determine one's capacity to respond to procedures like mindfulness and hypnosis? What roles do specific factors, such as expectancy, suggestibility and dissociation play in patient responsiveness? And, another important question, can an individual's quality of responsiveness be increased?

Well, when we look at all of the individual factors that determine someone's ability to respond, it includes things like their attentional style that is the quality of their focus. The quality of the suggestions that you deliver to someone, what they expect and how their expectancy influences their ability to respond, cognitive style, relational style, their previous history with these kinds of experiential processes, whether they've done things like this before or not, how able they are to literally turn off awareness for one element of experience and turn on awareness for another.

If you're going to do a hypnotic induction or if you're going to do a guided mindfulness meditation, you're literally asking the person to stop focusing there and start focusing

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here. And obviously some people have an easier time doing that than do others. The quality of the therapeutic alliance is another factor and so are other contextual variables.

Well, if we ask the question, does anyone come to therapy specifically looking to learn Buddhist meditations in order to become mindful, I think we can answer it? Or are they instructed in the ways of mindfulness as a means of attaining what they came for?

So that's an important point because what it says is you have somebody coming to therapy, who is looking for something. They're looking for help, they're looking for a solution, they're looking for something that will be therapeutic, that will reduce their sense of distress or suffering.

So the fact that they're looking for something and then the therapist is the one who introduces guided mindfulness meditations as something that has potential to be therapeutic, instantly establishes an expectancy, an expectancy of benefit from participating in these kinds of experiential exercises.

Well the word, mindfulness, obviously can have many different meanings. For some, it's a system of thought. For some it's a vehicle for self-exploration. For some it's a path to enlightenment. For some it's a means of living. But however anyone defines mindfulness, there's an emphasis on the importance of establishing a greater focus on being in the present moment rather than rehashing the unchangeable past or anticipating a future that may never happen.

Most people tend to readily accept Jon Kabat-Zinn's definition of mindfulness, which is mindfulness is paying attention on purpose, in the present moment as if your life depended on it non-judgmentally. He goes on to say it's not about doing; it's about being.

Well as mindfulness continues to expand into mainstream clinical practices, the key question that emerges that provides the foundation of this talk is this one. Does mindfulness, used as a clinical tool in treatment, change its essential nature from mindfulness as a spiritual practice? Now this is an important foundational point.

Mindfulness has its roots in spiritual development and then mindfulness has essentially been transformed and has been hijacked by the clinical field and transformed in the process. It was not originally intended as a clinical intervention. It was philosophical. It was spiritual. It was experiential, but it wasn't clinical.

Now why is that important? It's important because context matters. It's such a different thing to want to encourage someone to grow spiritually versus wanting somebody to get over or reduce problems clinically. Clinical applications differ from spiritual pursuits. And no one has really spelled that out yet, but to me that's a vital point in all of this. Context is everything.

What a difference to introduce an idea to someone in a psychotherapeutic context than it is to introduce it to them in a television commercial. They're two very different contexts with very different outcomes. Therapy is purposeful and goal-oriented. Success is measured in symptom reduction, cure, relapse prevention and risk factor reduction.

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Therapy is an interpersonal process inevitably featuring social demand characteristics. Suggestion is used in straightforward, undisguised ways to deliberately influence the client therapeutically. Now, interestingly, in the realm of mindfulness, so many of the people that I interviewed literally said that they did not use suggestion in their work and they said that, in essence, the goal was to have no goals, that the idea of mindfulness is to pay attention without intention.

Now as I will elaborate later, I believe that is highly self-deceptive on the part of mindfulness advocates that, while the goal of mindfulness might be to pay attention without intention, as soon as you imbed that in a clinical context, that process is meant to serve reducing distress, furthering clinical goals and aims. And I think that it is only honest to say that when people are engaging in guided mindfulness meditations in the clinical context that it is attention with intention.

And that, of course, is a major overlap with hypnosis. Hypnosis is unapologetically goal-oriented; unapologetically goal-oriented. It's always so interesting to me how often people will come up to me in my hypnosis trainings and they'll say to me, you know, Michael, I really like your work a lot, but you're so goal-oriented. And then they give me the mini-lecture, don't you know, it isn't about the destination; it's about the journey.

Well only clinicians say that. Clients never say that. Clients never come into therapy and say, hi, I'd like to go on a journey. They're coming into therapy because they have goals and sometimes they don't even know what the goals are, but they know they need to be changing something.

And so we recognise that, as soon as we're in a clinical interaction and we start providing perspective and we start providing information, whether we do that directly, whether we do that indirectly, it is inescapable that suggestions are a part of the process. So here is the greatest overlap between mindfulness, applied therapeutically in a goal-oriented way, and hypnosis.

Both hypnosis and mindfulness establish an expectation and then gently lead the client with direct and/or indirect suggestions on an experiential path towards fulfilling that expectation. When guided mindfulness meditations are explicit in their goals, their methods are every bit as suggestive as hypnosis.

Now what that means to me specifically is that, for practitioners to say that they don't use suggestion in their work, is such an obvious untruth. And in fact, what I included in the book, Mindfulness and Hypnosis, are transcripts of leading practitioners, who authorised me and gave me permission to transcribe their procedures and then analyse them from a hypnotic, suggestive framework.

And so literally, I went line by line, identifying what type of suggestion was used and what it was meant to catalyse. And I think that these practitioners were very surprised when they discovered that not only were they not not suggestive, they were incredibly suggestive.

So learning about the effective formulations of suggestion and the therapeutic applications of dissociation, which I'll talk about in just a moment, are vital to using these parallel methods of hypnosis and mindfulness. And it's also worth mentioning

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that the techniques really don't mean much. Hypnosis isn't what cures people. Mindfulness isn't want cures people.

Rather, what is curative is what happens during these experiences, the new and beneficial associations that the client forms through the shift in focus and absorption and new possibilities. That's what holds the potential to be therapeutic. Hypnosis cures nothing. Mindfulness cures nothing. It's what happens during these experiences that is potentially valuable.

So if we're going to talk about suggestion and the kinds of experiences that are possible when people are in these focused, relaxed states, it brings us to the phenomenon of dissociation. Now, dissociation is unfortunately only thought of in the pathological sense by most clinicians because that's the only way they learn about it. They learn about dissociation from the standpoint of dissociative identity disorder, fugue states, psychogenic amnesia and other kinds of dissociative processes.

In fact, dissociation is neutral. It's capable of being used to generate the pathological experience. It's also, on the flipside, capable of being used therapeutically. When you teach someone pain management, for example, and you teach this person how to step away from the pain, you're using a dissociation strategy.

When you encourage someone to step back from their thoughts so that they're not so reactive to their thoughts, which is a typical process of mindfulness, you're using dissociation. Dissociation's formal definition is breaking a global experience into its component parts.

In a practical sense, what dissociation means is when we focus on one element of experience, we amplify that element and simultaneously, we diminish awareness from other parts of experience that recede into the background. Well dissociation automatically means then a separation, a separating of this quality of your experience from that quality of your experience.

In that respect, dissociation is absolutely the driving force in hypnosis, the dissociation that separates conscious from unconscious process, but it's true equally that dissociation is evidenced in suggestions for mindfulness that, if you're going to encourage someone to focus on acceptance, that means you're suggesting separating what one wishes for or strives to deny from what is really true.

If you're going to do something as simple as encourage someone to focus on their breathing, then you're suggesting that they separate their attention from other elements of experience in order to focus it on breathing. If you're going to suggest to someone that they focus on compassion, that means you're suggesting that they separate their attention from their usual self-criticism to focus on something more positive and benign.

If you're going to suggest, see your thoughts as if they are clouds, floating across the sky, a very typical suggestion in mindfulness procedures, you're suggesting that someone separate their thoughts from the rest of themselves.

Now that process of dissociation that is evident in mindfulness procedures as well as hypnotic procedures, raises some of the most difficult issues that hypnosis has faced that mindfulness is only now beginning to face in asking the salient questions.

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Hypnosis has paid a great deal of attention to the question, what determines individual differences in responsiveness to these methods. Now, if you do mindfulness, but have never studied hypnosis, have you noticed, of course you have, that your client's differ in their level of responsiveness to your guided mindful meditations.

So that's really what I'm talking about is the question of what does this mean about differences in levels of responsiveness. What does it indicate about individuals and is this something that is fixed, is it something that is variable? Well, it is a well-established fact in the hypnosis literature that people differ in their degree of hypnotisability.

This is one of the things that has been studied scientifically now for nearly 80 years. The first really serious laboratory experiments on hypnosis began in the 1920s, learning theorist, Clark Hull, was an early pioneer in addressing that question. But in the interim, there have been dozens and dozens of hypnotisability scales that have been developed in order to assess people's capacity to respond to suggestion.

These scales have relevance for mindfulness practitioners because, in the same way that people differ in their response to hypnotic procedures, they differ in their response to mindfulness procedures. But if we look at the characteristics of those that have been termed highly hypnotisable, people who are very responsive to suggestive procedures, versus those who are termed low hypnotisables, those who are not as responsive or are minimally responsive to these kinds of procedures, we are still attempting to learn something about what characterises the differences.

So again, different levels of analysis, there have been some who have studied the brains of high hypnotisables in comparison to low hypnotisables through modern scanning technologies, like FMRI and PET scans and SPECT scans and so forth and others who have looked at the social characteristics, some who have looked at the cognitive characteristics and who have looked at the personality styles.

And the findings are really ambiguous, even to this day. But what no one argues is that people differ in their degree of hypnotisability where people differ quite a bit is in their interpretations of what that means. But if we look at the distributions of hypnotisability, we see roughly a bell-shaped curve, that you have a smaller percentage of people who are at the very high end of responsiveness and a small percentage of people, who are at the very low end of responsiveness and most people, who are somewhere in the middle.

Now, when people conduct guided mindfulness meditation sessions, do they assess for people's hypnotisability? The answer is generally no. I have yet to encounter someone who does. And in fact, the same happens to be true for clinicians who use hypnosis. Most clinicians, statistically responding to surveys on the subject do not use hypnotisability scales. Most people simply go ahead and do the procedure and then learn something about the person's ability to respond to it.

But one of the things that we've learned is hypnotisability or responsiveness to a procedure, like guided meditation, is something that is going to be enhanced by a more individualised approach, something that acknowledges the unique attributes of the person undergoing the procedure.

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So part of what that suggests directly is that the use of scripted materials is less likely to be beneficial to people than when those procedures are adapted to their unique attributes.

Well, interestingly, there has been a difference of opinion as to the question, is the capacity to respond to mindfulness procedures or hypnotic procedures, something that is learnable or changeable? Well, when somebody experiences a guided mindfulness meditation session for the first time, when this person is encouraged to close his or her eyes and focus on breathing, some people could do that fairly readily, others can't. When they can't, they're told to go home and practice; practice, practice, practice.

Well it's an interesting question that mindfulness has not yet addressed that the hypnosis literature has addressed; is the capacity to respond learnable? Is it changeable? Well there have been those who have said that the answer is no. They administer a hypnotisability test and score it and then a year later, five years later, 10 years later, 25 years later, they'll administer the test again, score it and compare scores.

Hilgard, Ernest Hilgard, was a principal researcher, a granddaddy of the field of hypnosis, who ran the famed Stanford Hypnosis Research Laboratory and he was of the belief, after testing 10s of 1,000s of people that hypnotisability did not change and the practice would not enhance hypnotic responsiveness. But, keep in mind, he was using a standardised protocol in unvarying language. And was he really testing somebody's hypnotisability or was he simply testing someone's ability to respond to suggestions that were not personalised for them.

So another hypnosis researcher, named Nick Spanos, devised what came to be called the Carlton Skills Training Program. And he was interested, Spanos was interested in the question, if people were trained to enhance their hypnotisability, could they? Well to make a long story short, the answer was yes. He demonstrated quite convincingly that when people were taught practical procedures in how to individualise those procedures to their own personalities in style that, in fact, their capacity to respond hypnotically, was enhanced.

Well, what's another curious side question though is, if what we want to do is promote practice, practice, practice in order for people to have these gains from mindfulness, then how do you explain in the world of hypnosis, the single session, hypnotic interventions that yield enduring results?

I have single sessions that I've done. These are available on video where I have followed up for as long as 10 years, showing long term gains from a single hypnosis session. I find that fascinating and it certainly says something about the capacity for change that can happen relatively quickly.

Well the ability to detach from your own thoughts and other aspects of your internal experience is obviously essential to transforming it. And so it's why learning something about dissociation and the suggestions for dissociation becomes so important as a part of learning to use both hypnosis and mindfulness well.

Any suggestions that encourage detachment of one sort or another are making use of dissociation. So it's pretty interesting to me that one of the things that happens when people are in a dissociative state is the ability to influence unconscious processes.

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Now one of the things that I went into in-depth in the new book is the recent findings of the field of cognitive neuroscience. Cognitive neuroscience addressing the questions of how we absorb information, how we respond to information and, one of the most interesting aspects in this domain is what is called priming; priming or the ability to influence people at an unconscious level.

So in the experimental world of cognitive neuroscience, priming involves exposing experimental subjects or clients to words, images or even objects in the environment at levels outside of their conscious awareness and then exposing them to some task where the unconscious influence might be observed in their responses.

Well interestingly that when looking at the nature of priming in relationship to people's emotional worlds, the findings are unequivocal that these priming influences produce dramatic shifts in people's emotional world as well as in various perceptions including sensory perceptions.

Well, where that leads to then is into the realm of non-volitional responding and this is one of the things that is so interesting about hypnosis; the capacity to encourage responses that the person isn't aware of. So for example, let's say I do a hypnosis session with someone who is in physical pain and I give this person all the necessary suggestions to get focused, to pay intensive attention to me and what I'm saying. And I start offering suggestions about shifts in breathing and shifts in bodily awareness and then I start introducing some very direct suggestions for experiencing numbness in a part of the body.

And is the person aware that I am suggestion numbness? Absolutely. The person knows what I'm saying and fully aware of what I'm saying. They're listening to what I'm saying, but the part that is not volitional, that part that is non-voluntary is when my suggestions for numbness transpose into the actual sensations of numbness that reduce the person's pain.

If you ask the person, how did hearing Michael's suggestions for numbness become the basis for your experiencing an anaesthesia in that part of your body, there is a 99.9999% chance that the person's going to say I don't know. And that's what's so curious about unconscious responses.

Now the interesting thing is, of course, you don't have to call it hypnosis for it to be operational. Mindfulness is encouraging the exact same kinds of experiences that when someone suggests a shift in their breathing, the person doesn't deliberately try to change their breathing. On the contrary, that change in breathing just arises naturally, non-volitionally without any conscious or deliberate effort.

Well in that respect, there are people who have been studying the relationship between suggestion and physiology for decades and in some very specific ways. So for example, the field of placebos and placebo research has all along acknowledged that you can introduce an idea to someone that instils in them an expectation that they then unconsciously, not volitionally, translate into a meaningful and measurable response.

Now my guess is you're already well familiar with placebos and placebo research and, of course, most of the time, the research involves deception by giving someone a drug that is purported to be a very powerful drug that is going to generate a very strong

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response and, of course, it isn't a drug at all. It's a sugar pill. It's an inert substance. And not only have placebo pills been studied, but so have placebo surgeries and other kinds of placebo procedures.

Well that's interesting because, part of what we really don't know yet is how much of people's response to mindfulness is a product of expectations? How much is a product of the placebo effect and is the placebo effect operational even when we don't realize it's operational. The answer is, of course, yes.

But even more interesting than that was a study that was published in 2010, actually December of 2010. It's still online in the online journal, PLOS 1. But it was a study that was done at Harvard Medical School and Beth Israel Deaconess Medical Center. And here they addressed the question, must placebos always involve deception in order for them to work. So they did something no one else had every done before.

They solicited more than 80 patients suffering irritable bowel syndrome and divided them into two groups; one that group that got no treatment, the other group that received placebos, only they were told they were receiving placebos. They were told, we are going to be giving you placebos. These are inert pills. They are sugar pills. They have no known medical value. They are simply placebos, but even though they're placebos, it's still going to be important that you take them twice a day.

And then they would reach into a jar clearly labelled, placebos, and they would hand the person placebos, tell them they're handing them placebos, had them sign a form that acknowledges they know they're being given placebos. And amazingly, six weeks later, six weeks later, the people in the placebo group had a rate of recovery in their symptoms of irritable bowel syndrome that matched people taking the strongest known drugs for IBS. Is that remarkable?

The lead author of this study is a fellow named Ted Kaptchuk. So you can find that online and I think you'll find it very interesting reading to discover how placebos can work even when the patient knows it's a placebo.

Now the relationship to hypnosis is obvious because, for many, many years, there have been some most well-known, Irving Kirsch, a sociocognitive theorist and researcher in the field of hypnosis, but others as well, who have called the hypnotic suggestions, non-deceptive placebos.

Now you're simply leading the person to believe this will be helpful to them and, no surprise then when it is, when the person actually believes it. Well I think that there is an element of that working as well in any experiential process including that of mindfulness.

So the language of mindfulness, now think clinically for a second, how do you introduce mindfulness to the client? What do you tell the person about mindfulness? What information do you provide them with that would motivate them to want to participate in learning and practicing mindfulness?

If you were to tape record yourself some time, I really urge you to do this. If you were to tape record yourself sometime when you're introducing mindfulness to your client and hear what you say and how you set it up to be helpful to them, you will learn

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something about how you are attempting to instil expectancy and how you are harnessing, to some degree, the effects of placebo.

Well the placebo effects, I think, are very, very valuable. Another valuable aspect of mindfulness that also parallels what happens in hypnosis is the use of paradox. You know, paradox has been something that has been explored in the realm of psychotherapy now for decades and there have been some extraordinarily enlightened writings about the relationship between paradox and psychotherapy, you know, authors such as J Haley and Ellen Watts have written extensively about the use of paradox.

Milton Erickson wrote about paradox and he once said in his writings that out of confusion comes clarity. And so often his interventions involved the use of the unexpected. He would use confusion strategies in hypnosis or in behavioural interventions in ways that absolutely parallel the use of Zen Koans and other paradoxical kinds of interventions.

And what paradox does is it rivets your attention and it leads you to try and reconcile two seemingly irreconcilable things. That's how paradox works. But of course, you can't reconcile them intellectually. You can only reconcile them experientially and I think that's a very valuable point.

There's an old Zen proverb, before enlightenment, chop wood, carry water. After enlightenment, chop wood, carry water. Well, there are many paradoxes evident in mindfulness and hypnosis. The first one is you're unique just like everybody else. Erickson acknowledged the uniqueness of each person in his work and we are all taught to acknowledge the uniqueness of each person in our therapies and yet, then we have these scripted approaches as if they're the same procedure that is applicable to everyone.

So the concept of uniqueness and yet, being just like everybody else paradoxically, is one that each practitioner has to resolve, but it is why I am openly dismissive of making use of scripted approaches in either mindfulness or hypnosis.

The mindfulness prescription, don't change, accept, accords the paradoxes that, by not striving to change, rather striving to accept, that's how things will change.

To tell mindfulness clients or mindfulness practitioners to have attention without intention, as I mentioned earlier, I think is quite deceptive. I think it's paradoxical to say that the goal is to have no goal. But J Haley characterised the first and, perhaps greatest, paradox found in hypnosis. The paradox is do as I suggestion, but behave spontaneously.

Well isn't that the same paradox operated in mindfulness, do as I suggest, but behave spontaneously? I do this guided mindful meditation with you where I'm encouraging you to have experiences of one sort or another, perhaps a greater self love or a greater self acceptance, but I'm suggesting that you spontaneously discover compassion, for example. Well you can't will compassion. You can't will emotional kinds of reactions, but clearly people are capable of having these reactions when it's suggested to them.

So there are, in fact, guided mindfulness meditation scripts by the hundreds on becoming more compassionate, becoming more kind, becoming more loving, becoming

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more something - having greater equanimity, something that is meant to change the emotional makeup of the person.

I think it's a really interesting aspect of mindfulness that really hasn't been talked about yet that you are suggesting through these mindfulness meditations, spontaneous experiences, non-volitional experiences and isn't that the best of reasons to study hypnosis and dissociation to be able to encourage those non-volitional responses with a greater sense of understanding of how people process information.

Well there is much, much more that I can say, of course, but I'm coming towards the end of this talk and so I want to be able to provide some key points in a more crystallised way. Let me tell you what some of the overlaps are between mindfulness and hypnosis. Both are non-rational procedures. Both involve utilising attentional capacities.

You know, when you go through the hypnosis literature now, nobody really talks about trance any more. Trance is a pretty archaic term that has become largely obsolete. Instead, where the literature of hypnosis has gone is into the world of attention and how attention fosters dissociation and priming and information processing and non-volitional responses in all the things that I've been talking about.

Both mindfulness and hypnosis emphasise the importance of full participation in the moment. Both emphasise the potential for personal growth derived from the experience. You're literally telling the person this will help you.

Both emphasise acceptance as a precursor to greater wellbeing. We know that Erickson wrote about the essence of acceptance back in the 1930s. Acceptance is hardly a new construct. Both use language as priming agents for stimulating expansive, unconscious, automatic processes.

Well when the overlaps are so great, I think that it is vitally important for every clinician, especially clinicians who want to use guided mindfulness meditations in their work to study hypnosis and study it seriously. I can give you lots of compelling reasons to study hypnosis, the most obvious one is the empirical evidence that it helps, that hypnosis does objectively enhance treatment outcomes.

The mistake that people too often make is in thinking that hypnosis itself is the therapy and, particularly, there are many countries around the world where they use the term, hypnotherapy, as in Australia and in England and in New Zealand and some of the European countries, less so in the United States, not because hypnotherapy, as a term, is incorrect; it's just not very descriptive. It's not as if hypnosis is the therapy itself. Hypnosis is the vehicle for the therapy.

So it's an unreasonable question to ask how does hypnosis compare to cognitive therapy for treating depression, for example. The better question is, if we do cognitive therapy without hypnosis and we do cognitive therapy with hypnosis, will the addition of the hypnosis enhance the effects of the cognitive therapy. And to that question, the answer is yes. We have plenty of empirical research evidence to show that hypnosis enhances treatment outcomes.

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All therapy involves the use of suggestion. Why wouldn't someone take the time to learn about all the different suggestion structures and suggestion styles in order to master the language of suggestion and the process of suggestion in order to amplify the benefits of mindfulness or hypnosis or any other kind of therapeutic procedure?

Hypnosis really provides lots of great insights into subjective experience and certainly highlights the malleability of people's experience and the fact that you can use it in so many different ways. Multidimensionally is, I think, a very, very powerful factor in favour of taking the time to study hypnosis.

Now just as an aside, as most listeners would know, I regularly conduct clinical hypnosis trainings around the world and, if you go to my website, you can read about my hypnosis trainings. There's a video of me describing my hypnosis trainings, but I truly don't know of a longer, more in-depth, more valuable hypnosis training than the one that I do that takes place in three phases of five days each. I invite you to explore more information about that by visiting my website, Yapko.com.

Well there is much, much more to say about the relationship between mindfulness and hypnosis. What I do want to offer you is this; I published an article recently in the therapy magazine, Psychotherapy Networker.

The article is called Suggesting Mindfulness and it is available by contacting me. You can write to me at [email protected] and I'll be - and you can request a copy of the article and I'll be happy to send it to you. I think it's a much more elaborate way of getting many of the major points of this presentation across in clearer and written form.

But by way of summary, I want to leave you with these key points. Key point number one, clinical applications differ from a spiritual interest and I think that, by analysing the semantics of mindfulness and looking at words and the effects of words, that there is a far better understanding that we can develop of how mindfulness works than if we don't analyse mindfulness from that standpoint.

Another key point is that the capacity for absorption varies across individuals and also within individuals at various times. I think it is important therefore to study what it means to try and absorb people in these experiential processes.

It's true that focus can be enhanced by structuring a time and a means for developing the capacity. Practice does, in fact, help. I think it's important to appreciate also that mindfulness is a tool, hypnosis is a tool, but neither of these are curative in and of themselves. They simply help establish new subjective associations that may be therapeutic.

And finally, learning the structure of these processes allows the practitioner to vary approaches according to individual needs. I really like the idea of respecting the individual and adapting our processes to their unique attributes in order to maximise the potential for benefit.

So I hope that I have been able to identify for you some of what makes mindfulness valuable. I want you to appreciate, as I close, that I am a huge fan of experiential learning. It's why I have devoted my live to studying the experiences that can be developed in hypnosis.

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And to see the same kinds of experiences developing in mindfulness, for me, is very exciting, given that so many more therapists now are starting to learn about these experiences and I think your learning will be greatly enhanced by learning something about this relationship between mindfulness and hypnosis.

So again, my thanks to Rob for inviting me to do this, my thanks to you for your kind attention. I hope that you have found this a valuable presentation. You can write to me at [email protected]. Again, you can also contact me through my website, Yapko.com.

Thanks so much. Take care. Bye, bye.

[End of recorded material]

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s3.amazonaws.com · web viewwell the word, mindfulness, obviously can have many different meanings....

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