Can hypnosis enhance the ability to regulate behavioral and brain markers of emotion regulation?

From staying level-headed in a combat situation to keeping your cool in everyday situations, how we respond to emotional challenges is a major determiner of physical and mental well-being1,2. The ability to adaptively regulate these negative emotions is essential for everyday efficacy and well-being. So important is regulatory ability that failures to effectively regulate play a major role in virtually every psychiatric4,5 and substance abuse disorder6. Unfortunately, regulation is not always effective Ð especially in high stress situations that augment negative emotional responses (like fear or panic) while simultaneously disrupting systems that could be used to regulate them9,10. Because we canÕt simply avoid every stressful situation, how can one respond adaptively? This proposal tests the core hypothesis that hypnosis Ð when used to enhance the application of specific regulatory strategies Ð can provide a powerful psychological tool for adaptively regulating negative emotion and enhancing top-down control. To date, however, support for this hypothesis comes primarily, if not exclusively, from clinical observation rather than empirical study. Furthermore, little is known about the neural mechanisms that might support such positive effects of hypnosis. The present study addresses these gaps in knowledge by studying both the neural bases of the hypnotic state and the effects of hypnotic suggestion on negative emotional reactivity and top-down control. Using an innovative combination of behavioral and fMRI methods we will test three kinds of predictions. First, we will test predictions about the nature of the hypnotic state, asking how hypnotic induction may depend on dynamic interactions between networks for control and self-awareness that may endure and impact subsequent behavior and brain function. Second, we will test predictions about the mechanisms underlying hypnotic suggestions, asking how it impacts the function of brain systems for emotional responding and the ability to regulate those responses. Third, we will test predictions about the impact of hypnotic suggestion on ÒcoldÓ (i.e. non-emotional) cognitive control, asking how it can enhance the ability to resist distraction. To determine for whom these predicted effects are most or least powerful, in all cases we will compare behavior and brain function in individuals high vs. low in trait anxiety (which is associated with stronger negative emotion and greater risk for future mental health issues) and hypnotizability (which may influence the impact of hypnotic induction and suggestion). The overarching goal of the proposed work is to provide insight into the mechanisms underlying hypnosis as a potentially powerful tool for enhancing regulatory ability. Such a tool could prove highly valuable to the Army (and DoD more generally) given the prevalence of stressful situations in military service Ð and evidence that many soldiers are suffering the consequences to effectively regulate the resulting negative emotions. Indeed, high rates of substance use and psychiatric issues among active soldiers and veterans Ð including high levels of suicidal ideation Ð highlight the need for psychological tools that can be used to adaptively regulate the responses of brain systems that trigger anxiety, fear, panic and other negative emotions.