Hypnosis: a therapeutic tool

Hypnosis is a state of deep concentration and inward focus, with reduced awareness of outside stimuli. In therapy, trained professionals use relaxation and suggestion to influence a patient’s thoughts and perceptions. Research suggests hypnosis can be especially effective for people who are highly receptive to suggestion, and brain imaging studies show widespread changes in brain activity during hypnotic states.

It’s important to separate therapeutic hypnosis from how it’s shown in entertainment. Clinical hypnosis is done with the patient’s consent and is often used as part of an ongoing treatment plan. Hypnosis can change perception and memory, but it doesn’t give superhuman abilities or make someone act against their morals. Hypnosis is sometimes used to help recover past memories, although these recollections aren’t always reliable.

Two main theories of hypnosis

1. Dissociation theory: This theory suggests that hypnosis creates a divide in consciousness, enabling individuals to detach from their usual awareness and enter a more focused mental state.
2. Social influence theory: According to this theory, hypnotized individuals are highly responsive to social cues, often unconsciously aligning their behavior with the hypnotist’s expectations.

Meditation

Meditation involves focusing your attention on a specific target - such as breathing or a repeated sound - to strengthen present-moment awareness. Studies suggest meditation may help lower blood pressure, reduce stress, improve sleep quality, and support the management of mood disorders, anxiety, and pain.

A therapeutic approach that incorporates meditation is dialectical behavior therapy (DBT), a branch of cognitive behavioral therapy (CBT). DBT is often used to treat borderline personality disorder, depression, anxiety, and PTSD. It emphasizes skills in:

• Emotional regulation
• Mindfulness
• Distress tolerance

Conscious-altering drugs and their effects

Psychoactive substances affect the brain by interacting with neurotransmitter systems. These substances can act as:

• Agonists, which increase neurotransmitter activity
• Antagonists, which decrease neurotransmitter activity

Psychoactive drugs are typically categorized into three main groups:

1. Depressants slow down neural activity.
2. Stimulants increase neural activity.
3. Hallucinogens alter sensory perception.

Depressants

Depressants reduce central nervous system activity. Alcohol (ethanol) is one of the most well-known depressants. Other examples include barbiturates and benzodiazepines, which enhance the effects of gamma-aminobutyric acid (GABA), a neurotransmitter that calms the brain. Because GABA slows neural activity, these drugs are commonly used to treat anxiety and insomnia.

With prolonged use, depressants can lead to:

• Physical dependence, marked by tolerance and withdrawal symptoms
• Psychological dependence, which increases the risk of substance abuse

Stimulants

Stimulants increase overall brain activity, often by acting as dopamine agonists. Dopamine is strongly tied to reward and craving. Common stimulants include:

• Cocaine
• Amphetamines (including methamphetamine)
• Cathinones (bath salts)
• MDMA (ecstasy)
• Nicotine
• Caffeine

Amphetamines work similarly to cocaine by preventing dopamine reuptake and increasing dopamine release. Although stimulants are sometimes misused, they’re also prescribed for attention deficit hyperactivity disorder (ADHD). In this context, they increase neurotransmitter activity in brain regions involved in impulse control, including the prefrontal cortex and basal ganglia.

Opioids

Opioids are a subset of depressants that include heroin, morphine, methadone, and codeine. They have analgesic (pain-relieving) effects because they mimic the body’s natural opioid neurotransmitters. By binding to opioid receptors, they reduce pain and can produce euphoria. Because they closely resemble the body’s natural painkillers, opioids have a high potential for addiction.

Naturally derived opioids, called opiates, come from the poppy plant. Heroin has historically been a major drug of abuse, and modern synthetic opioids also have powerful pain-relieving effects and are frequently misused.

Hallucinogens

Hallucinogens significantly change sensory and perceptual experiences and can cause vivid visual or sensory distortions. They may also distort time perception and body sensations, such as feeling much larger or smaller than usual.

Different hallucinogens affect different neurotransmitter systems:

• Mescaline and LSD act as serotonin agonists.
• PCP (angel dust) and ketamine block NMDA glutamate receptors.

Compared with depressants and stimulants, hallucinogens generally have a lower potential for addiction.

Addiction and the brain’s reward system

Addiction is closely linked to the dopamine system, especially activity in the nucleus accumbens, a key part of the brain’s reward circuitry.

• Physical dependence happens when prolonged drug use changes normal bodily functioning, leading to withdrawal symptoms when the substance is stopped.
• Psychological dependence refers to an emotional craving for the drug.

Tolerance develops when a person needs increasing amounts of a drug to get the same effect. As tolerance rises, people may take dangerously high doses, which increases the risk of overdose and death.

Withdrawal symptoms often produce effects that are opposite to the drug’s usual effects. For example, withdrawal from sedatives can cause agitation and increased arousal.

Type of drug	Examples	Effects on the body	Neurotransmitter pathway disrupted
Depressants	Alcohol, Benzodiazepines (e.g., Valium), Barbiturates	Slow brain activity, decrease heart rate and respiration, induce relaxation, impair coordination, memory, and judgment.	GABA (Gamma-Aminobutyric Acid) - Increases inhibitory signals. Glutamate - Decreases excitatory signals.
Stimulants	Cocaine, Methamphetamine, Nicotine, Caffeine	Increase alertness, elevate heart rate, energy, reduce appetite, risk of heart attack/stroke.	Dopamine - Increases release and blocks reuptake. Norepinephrine - Increases release.
Opioids (narcotics)	Heroin, Prescription painkillers (e.g., Oxycodone, Morphine), Fentanyl	Pain relief, euphoria, respiratory depression, risk of overdose, constipation, drowsiness.	Endorphins and Enkephalins - Bind to opioid receptors, reducing pain and inducing euphoria.
Hallucinogens	LSD, Psilocybin (“magic mushrooms”), PCP, MDMA (Ecstasy)	Alter perception, cause hallucinations, distort sensory experiences, increase heart rate, anxiety, paranoia.	Serotonin - Disrupts serotonin pathways, leading to altered perception and mood. Dopamine - In some cases, stimulates dopamine release, causing euphoria and altered perception.
Cannabis	Marijuana, Hashish	Relaxation, altered perception, euphoria, increased appetite, impaired memory and concentration.	THC (Tetrahydrocannabinol) - Activates Cannabinoid receptors, affecting serotonin, dopamine, and GABA systems.