Altered States; Hypnosis can help with problems from anxiety to pain. How it works, and what it does in the brain.(Cover Story)

Byline: David Noonan (With Sarah Sennot in London)

Christina Bodie, 48, was driving with her parents seven years ago when her car was rear-ended. All three suffered whiplash and bruises. Long after the physical pain was gone, Christina would find herself clutching the wheel and hyperventilating. "I found driving very difficult, and would suffer panic attacks," she recalls. At one point she stopped driving altogether, doing her work as a pension manager at a London firm from home. When she'd had enough, she called London-based hypnotist Tim Martin. He had her visualize a white cloud that absorbed all her problems, and then taught her to make the cloud turn black and disappear. Martin walked Bodie through her car accident as though it were playing on a movie screen, adding humorous touches--like put-ting a clown nose on the policeman. Bodie hasn't had a panic attack for a year now, and memories of the accident no longer haunt her. Hypnosis, she says, "is powerful stuff."

Despite widely held misconceptions about hypnosis (in part because of its long history as a type of entertainment), a growing body of research supports the ancient practice as an effective tool in the treatment of a variety of problems, from anxiety to chronic pain. Today, as practitioners work to assess and refine the clinical applications of hypnosis, they are also exploring its underlying mechanisms, using state-of-the-art imaging technology to document changes in the brain that occur when someone is in a hypnotic state. This increased understanding of how hypnosis works and what it does makes it a legitimate option for patients whose needs have not been met by more traditional methods.

To appreciate the therapeutic potential of hypnosis, you first have to forget about things like swinging watches and hapless audience members who prance around onstage, crowing like roosters. "One of the interesting ironies about hypnosis is that old fantasy that it takes away control," says Dr. David Spiegel, professor and associate chair of psychiatry at Stanford University School of Medicine and a leading expert on the practice. "It's actually a way of enhancing people's control, of teaching them how to control aspects of their body's function and sensation that they thought they couldn't."

Hypnosis is "a form of highly focused attention," says Spiegel--an induced state of mind that enables people to alter the way they perceive and process reality. During a typical session, the doctor guides the subject into a state of receptive concentration, asking him to imagine he is in a safe and comfortable place. Once the patient is in a state of hypnosis, the practitioner makes specific suggestions--a hockey player with back spasms was told that when his pads touched his back, the muscles relaxed--to address the problem. (This focus on a problem distinguishes hypnosis from more passive states, like meditation.) The doctor then terminates the trance and teaches the patient how to use self-hypnosis to reactivate and maintain the therapeutic effect. The benefits can last for years.

Besides pain management and stress reduction, habit control is another ...