**5. The importance of attention and intentionally moving toward the center of the sphere**

Movement, volition, and cognition are deeply related [188, 189] and, as seen above, are all related to theta activity. In fact, it has been suggested that the nervous system has evolved to allow active movement and provide a goal-oriented plan; as such, motivation and emotion represent facets of a common phenomenon. That commonality is the motivational-emotional system, which interacts with learning and higher-order cognition [184, 185]. In contrast to meditation practices, which are thought to involve and cultivate mindfulness (being aware of one's current mental state; about the problems in defining mindfulness, see [186, 187]), different theories of hypnosis posit that the hypnotic response is a form of strategic self-deception in regard to one's mental state [188]. Thus, it has been suggested that hypnotic response implies a lack of mindfulness, at least regarding particular mental states about which one is strategically deceived [188].

However, we suggest that it is also the combination of attention and intentionality (and not self-deception), which should be addressed in regard to hypnosis and other states of mind [13–15]. People often engage in meditation training because they believe it will result in a specific positive outcome, having received suggestions regarding its potential benefits [56]. Such suggestions—here in the form of self-suggestions, also known as outcome expectancies—are in-line with social cognitive views of hypnosis [10, 189] that posit that hypnosis can be viewed as a use of suggestions for creating changes in thoughts, feelings, or behaviors [56]. As such, self-suggestion implies both attention and intentionality.

Importantly, as noted earlier, frontal theta EEG activity correlates negatively with default mode network activity [43]. Recalling that high theta activity facilitates response to suggestions (e.g., [56]) and plays an important role in attention [80] and intention, such as intentional learning, and intentional movement [190, 191], we suggest that the combination of attention and intention may help to explain the known variability in hypnotic responding between individuals. This, in turn, suggests that the level of hypnotizability can be related to the participant's baseline position within the sphere [14, 15]. Together, these may have significant implications for the success of treatments.

**85**

*Inner Navigation and Theta Activity: From Movement to Cognition and Hypnosis…*

Numerous studies have highlighted the importance of hypnosis in various clinical

conditions, such as chronic pain [192]. Pain is a conscious experience, which can be considered an interpretation of the nociceptive input and potentially influenced by many factors, such as memories, emotions, and cognitions [16]. Decreased temporal-parietal theta (as well as alpha) activity during pain is consistent with a pain-related activation of the insula [193], which is known to be involved in pain processes [16]. Decreased theta connectivity was also found between the insula and the DMN in fibromyalgia, which may reflect persistent pain encoding associated with the chronic pain state in the disorder [194]. Maladaptive rumination and the re-experience of symptoms, which occur in many chronic pain conditions [195], and are known to be related to the DMN [196–198], were further found to be related to decreased theta band networks in post trauma [199]. Thus, finding ways to voluntarily move from the maladaptive and automatic narrative, which is predominant in

In fact, studies found decreased DMN activation following hypnosis [138]. Decreased DMN activation, following different therapeutic approaches, is further linked to improvements in pain-related catastrophizing, which is generally selfreferential, negative, and automatic [200]. In addition, there is growing evidence that mindfulness, as a volitionally initiated cognitive act, can significantly attenuate the subjective experience of pain [201]. Thus, cultivating experiential openness and acceptance, anchored in the embodied minimal self, and not in the narrative/ default self, can reduce pain unpleasantness and lead to a reduction of symptoms in

Emphasizing the importance of intentionality and its electrophysiological markers can further aid in differentiating hypnosis from "animal hypnosis" or "tonic immobility." "Animal hypnosis" has been found to effect electrophysiological state, such as altering beta, gamma, and alpha activities, depending on the method of induction, duration, and number of sessions [108, 109]. Nevertheless, one should keep in mind that while "animal hypnosis" can be induced in different ways, ranging from restraint to visual fixation, they are all involuntary [204], while the degrees of freedom in human hypnosis, although debatable, are greater. In fact, "tonic immobility" is physiologically quite different in physiological terms (i.e., defense and anti-predation reactions) [8, 205] and is controlled by a motor inhibitory system [204]. Thus, it is not surprising that in contrast to hypnosis, tonic immobility is more related to decreased theta activity and increased delta activity [108, 109], which are both inversely related to intentionality and volition [206]. Together these emphasize the importance of the intentionality aspect in human hypnosis. Nevertheless, it has been argued that hypnotic ability in humans may have evolved at least in part to allow for the control of pain and anxiety after injury, thereby reducing the likelihood of attack by predators [207]. In conclusion, although not a systematic review of this topic, this chapter offers

three primary ideas for further consideration: (1) hypnosis and other "internal movement" paradigms may be regarded as mental navigation, (2) they can be compared to external movement and navigation in space, and (3) they are electrophysiologically mediated primarily by theta activity and require greater intentionality and attention. Based on the SMC, this may be related to an intentional shift away from DMN activity, which is anticorrelated with theta activity, and toward clear goal direction, represented by the center of the sphere. Thus, combined multidisciplinary examination of the connection between consciousness and hypnosis, encompassing cognitive psychology and motor and contemplative neuroscience, would produce greater theoretical understanding and implications on consciousness and hypnosis practice. First, in order to reach our personal and social aims, one can and should train to internally move intentionally from an automatic Narrative to the Minimal self, and eventually reach the state of Overcoming the Self, in order to know and

*DOI: http://dx.doi.org/10.5772/intechopen.92755*

these conditions, may aid in ameliorating symptoms.

chronic pain patients [202, 203].

*Inner Navigation and Theta Activity: From Movement to Cognition and Hypnosis… DOI: http://dx.doi.org/10.5772/intechopen.92755*

Numerous studies have highlighted the importance of hypnosis in various clinical conditions, such as chronic pain [192]. Pain is a conscious experience, which can be considered an interpretation of the nociceptive input and potentially influenced by many factors, such as memories, emotions, and cognitions [16]. Decreased temporal-parietal theta (as well as alpha) activity during pain is consistent with a pain-related activation of the insula [193], which is known to be involved in pain processes [16]. Decreased theta connectivity was also found between the insula and the DMN in fibromyalgia, which may reflect persistent pain encoding associated with the chronic pain state in the disorder [194]. Maladaptive rumination and the re-experience of symptoms, which occur in many chronic pain conditions [195], and are known to be related to the DMN [196–198], were further found to be related to decreased theta band networks in post trauma [199]. Thus, finding ways to voluntarily move from the maladaptive and automatic narrative, which is predominant in these conditions, may aid in ameliorating symptoms.

In fact, studies found decreased DMN activation following hypnosis [138]. Decreased DMN activation, following different therapeutic approaches, is further linked to improvements in pain-related catastrophizing, which is generally selfreferential, negative, and automatic [200]. In addition, there is growing evidence that mindfulness, as a volitionally initiated cognitive act, can significantly attenuate the subjective experience of pain [201]. Thus, cultivating experiential openness and acceptance, anchored in the embodied minimal self, and not in the narrative/ default self, can reduce pain unpleasantness and lead to a reduction of symptoms in chronic pain patients [202, 203].

Emphasizing the importance of intentionality and its electrophysiological markers can further aid in differentiating hypnosis from "animal hypnosis" or "tonic immobility." "Animal hypnosis" has been found to effect electrophysiological state, such as altering beta, gamma, and alpha activities, depending on the method of induction, duration, and number of sessions [108, 109]. Nevertheless, one should keep in mind that while "animal hypnosis" can be induced in different ways, ranging from restraint to visual fixation, they are all involuntary [204], while the degrees of freedom in human hypnosis, although debatable, are greater. In fact, "tonic immobility" is physiologically quite different in physiological terms (i.e., defense and anti-predation reactions) [8, 205] and is controlled by a motor inhibitory system [204]. Thus, it is not surprising that in contrast to hypnosis, tonic immobility is more related to decreased theta activity and increased delta activity [108, 109], which are both inversely related to intentionality and volition [206]. Together these emphasize the importance of the intentionality aspect in human hypnosis. Nevertheless, it has been argued that hypnotic ability in humans may have evolved at least in part to allow for the control of pain and anxiety after injury, thereby reducing the likelihood of attack by predators [207].

In conclusion, although not a systematic review of this topic, this chapter offers three primary ideas for further consideration: (1) hypnosis and other "internal movement" paradigms may be regarded as mental navigation, (2) they can be compared to external movement and navigation in space, and (3) they are electrophysiologically mediated primarily by theta activity and require greater intentionality and attention. Based on the SMC, this may be related to an intentional shift away from DMN activity, which is anticorrelated with theta activity, and toward clear goal direction, represented by the center of the sphere. Thus, combined multidisciplinary examination of the connection between consciousness and hypnosis, encompassing cognitive psychology and motor and contemplative neuroscience, would produce greater theoretical understanding and implications on consciousness and hypnosis practice. First, in order to reach our personal and social aims, one can and should train to internally move intentionally from an automatic Narrative to the Minimal self, and eventually reach the state of Overcoming the Self, in order to know and

*Hypnotherapy and Hypnosis*

the center of the sphere.

**center of the sphere**

about which one is strategically deceived [188].

self-suggestion implies both attention and intentionality.

tions for the success of treatments.

Each axis of the SMC represents the deployment and polarity of an aspect of experience, with an equilibrium point in the center of the sphere and a graduated scale indicating distance from the center. The center of the sphere represents an equilibrium point, with respect to three spatial coordinates, namely: (1) a horizontal *emotion axis* (e.g., representing the emotional polarities of unpleasant and pleasant), (2) a vertical *self-determination axis* representing the dimensions of value and aspiration [15], and (3) a *time axis* (e.g., representing the temporal deployment of past to future). The center can be considered a state of "Overcoming the Self," that is, a state of neutrality and detachment from the usual experiences of the Narrative and Minimal selves [15], which is crucial to hypnosis and different meditative practices [183]. Berkovich-Ohana and Glicksohn [28] suggested that experiences related to the Narrative Self are perceived as further away from the body, more abstract, and related to the future and the past. Narrative Self, Minimal Self, and Overcoming of the Self are represented in the SMC as concentric circles around the center of the sphere, with greater distance from the center signifying a more abstract experience of oneself. We shall now merge the electrophysiological and neuroanatomical findings in order to see how one can voluntarily move toward

**5. The importance of attention and intentionally moving toward the** 

Movement, volition, and cognition are deeply related [188, 189] and, as seen above, are all related to theta activity. In fact, it has been suggested that the nervous system has evolved to allow active movement and provide a goal-oriented plan; as such, motivation and emotion represent facets of a common phenomenon. That commonality is the motivational-emotional system, which interacts with learning and higher-order cognition [184, 185]. In contrast to meditation practices, which are thought to involve and cultivate mindfulness (being aware of one's current mental state; about the problems in defining mindfulness, see [186, 187]), different theories of hypnosis posit that the hypnotic response is a form of strategic self-deception in regard to one's mental state [188]. Thus, it has been suggested that hypnotic response implies a lack of mindfulness, at least regarding particular mental states

However, we suggest that it is also the combination of attention and intentionality (and not self-deception), which should be addressed in regard to hypnosis and other states of mind [13–15]. People often engage in meditation training because they believe it will result in a specific positive outcome, having received suggestions regarding its potential benefits [56]. Such suggestions—here in the form of self-suggestions, also known as outcome expectancies—are in-line with social cognitive views of hypnosis [10, 189] that posit that hypnosis can be viewed as a use of suggestions for creating changes in thoughts, feelings, or behaviors [56]. As such,

Importantly, as noted earlier, frontal theta EEG activity correlates negatively with default mode network activity [43]. Recalling that high theta activity facilitates response to suggestions (e.g., [56]) and plays an important role in attention [80] and intention, such as intentional learning, and intentional movement [190, 191], we suggest that the combination of attention and intention may help to explain the known variability in hypnotic responding between individuals. This, in turn, suggests that the level of hypnotizability can be related to the participant's baseline position within the sphere [14, 15]. Together, these may have significant implica-

**84**

better master one's own perceptions and mental processing. This idea is also related to the works of Charles Tart [208], who describes our ordinary everyday experience as being in a state similar to hypnotic trance, where we are not sleeping but neither are we truly awake. The solution to this state of affairs, similarly to current contemplative neuroscience results presented here, necessitates waking up to our true selves through a process of self-observation and self-remembrance [11, 12, 14, 208].

Second, the parallels between these two lines of research, namely, the similar electrophysiological modulation present in hypnosis, real movement, and motor imagery and the findings related to diagonal movement, can have a useful impact on the field; it can do so by helping to validate reliable electrophysiological effects of hypnosis and increase our understanding of the related biological mechanisms and connections to internal and external movement. If confirmed in future research, these ideas may have important implications for enhancing the response to hypnosis treatments and for customized, combined therapeutic modalities. In turn, emphasizing the importance of intentional inner and outer navigation and their electrophysiological signature can also aid in differentiating between the different techniques and their possible synergetic effects.

In summary, as we know, hypnosis has many benefits, including the relief of chronic pain. These benefits are possible due to knowledge gained related to how the mind works and thus the possibility of leading it into specific mental and neural states, as is the case with hypnosis. The investigation of the connections between hypnosis and theta activity, among others, further demonstrates an affinity between meditative practices and hypnosis, and that intentionality can play an important role in leading oneself into desired states. In these states we are able to know ourselves better and master our perceptions and the interpretation we give of them. Training ourselves in this direction can, therefore, improve our well-being and quality of life. Future studies should combine behavioral, neuroanatomical, and electrophysiological measures to help in distinguishing different types of hypnotic states and practices, as well as to examine the role of the person's detached and attentive intentionality in reaching them.
