International Journal of Clinical and Experimental

Hypnosis

ISSN: 0020-7144 (Print) 1744-5183 (Online) Journal homepage: http://www.tandfonline.com/loi/nhyp20

Meditation and Hypnosis: Two Sides of the Same

Coin?

Enrico Facco

To cite this article: Enrico Facco (2017) Meditation and Hypnosis: Two Sides of the Same Coin?,
International Journal of Clinical and Experimental Hypnosis, 65:2, 169-188

To link to this article: http://dx.doi.org/10.1080/00207144.2017.1276361

Published online: 23 Feb 2017.

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Intl. Journal of Clinical and Experimental Hypnosis, 65(2): 169–188, 2017
Copyright © International Journal of Clinical and Experimental Hypnosis
ISSN: 0020-7144 print / 1744-5183 online
DOI: 10.1080/00207144.2017.1276361

MEDITATION AND HYPNOSIS: Two Sides of

the Same Coin?
ENRICO FACCO

University of Padua, Padua, Italy, and Italian Center of Clinical and Experimental Hypnosis,
Turin, Italy

Abstract: Hypnosis and meditation, as a whole, form a heteroge-

neous complex of psychosomatic techniques able to control mind
and body regulation. Hypnosis has been pragmatically used for lim-
ited therapeutic targets, while Eastern meditation has much wider
philosophical and existential implications, aiming for a radical libera-
tion from all illusions, attachments, suffering and pain. The available
data on the history, phenomenology, and neuropsychology of hypno-
sis and meditation show several common features, such as the follow-
ing: (a) induction based on focused attention; (b) capability to reach an
intentional control of both biologic-somatic activities and conscious-
unconscious processes; (c) activation/deactivation of several brain
areas and circuits (e.g., the default modality network and pain neuro-
matrix) with a relevant overlapping between the two.

In the past 2 decades, an increasing interest has developed in medita-

tion and hypnosis in Western countries, and a wealth of new relevant data
is now available on the neuropsychological features of both techniques.
The scientific interest has paralleled the increasing appeal of Eastern
philosophies and their related mind–body techniques in the general popu-
lation, like Yoga, Buddhist meditation, and Chinese disciplines stemming
from Taoism, such as Qigōng: (气功) and Tàijíquán (太极拳).
The history, the cultural background, as well as the definition of
hypnosis and meditation look to be entirely different, including their
indications and goals. The analysis of their relationship is far from a
simple matter of comparative analysis of their mechanisms and clinical
effects: It inescapably calls for an insight into Eastern philosophies and
mystic currents of the Western monotheistic tradition to understand the
reasons and aims of meditative techniques. In fact, they are only a tool
and, therefore, wrong or questionable assumptions and aims makes
them meaningless or even harmful procedures, as already emphasized
within Zen tradition by Huai-Jang with the following warning: “If you

Manuscript submitted March 31, 2016; final revision accepted April 26, 2016.
Address correspondence to Prof. Enrico Facco, MD, Dept. of Neurosciences, Via
Giustiniani, 2, I-35128 Padova, Italy. E-mail: enrico.facco@unipd.it

169
170 E. FACCO

try to reach Buddhity sitting with cross-legged position in meditation, this

means killing the Buddha” (as quoted by Suzuki, 1958, p 40. A compre-
hensive analysis of the whole topic is far beyond the limits of an article;
see Facco, 2014, for further details); therefore, only a few essential
aspects will be outlined here in order to summarize the huge overlap
between hypnosis and meditation.

DEFINITIONS OF HYPNOSIS AND MEDITATION

The definitions of both hypnosis and meditation, as reported in
dictionaries, is still inappropriate if not wrong: The Concise Oxford
English Dictionary (2008) still defines meditation as “Discourse expressing
considered thoughts on a subject” (p. 887) and hypnosis as “the induction of
a state of consciousness in which a person loses the power of voluntary action
and is highly responsive to suggestion or direction” (p. 701). The current
meanings of these terms reflect old prejudices and cultural filters,
which further feed misunderstandings or even prevent the perception
of their nature.
The above-mentioned definition of hypnosis reflects the traditional
widespread misperception that it is characterized by loss of control and
free will. On the other hand, Division 30 of the American Psychological
Association (APA) started a process for its scientific definition in 1993,
the last version of which is “A state of consciousness involving focused
attention and reduced peripheral awareness characterized by an enhanced
capacity for response to suggestion” (Elkins, Barabasz, Council, &
Spiegel, 2015, p. 382). As a matter of fact, hypnosis is not a matter of
“loss of the power of voluntary action”; rather, it is a matter of focused
attention, absorption, and the subject’s empowerment, leading to
enhanced control over stress and other disorders, just the opposite of
loss of control (Spiegel, 2013).

MEDITATION
Given that terms properly defining meditation are not available in
common language, I shall try to briefly outline what it is and which
mental activities it involves. Meditation is not a simple monomorphic
activity but involves several different techniques belonging to both
Eastern philosophies and mystic currents of the monotheistic tradition
(Christian Mystics, Qabbala, and Sufi) (see Table 1).
Understanding meditation is not an easy job for modern Western
culture, drenched with the rationalism developed from the seventeenth
through twentieth centuries and mainly aimed to analyze the physical
reality with a conceptual analytic approach. The Indian way (including
the Veda, Yoga, and Buddhist traditions) looks just the opposite of the
Western one: According to the Kaṭhopaniṣad (II,6), the highest aim is
 HYPNOSIS AND MEDITATION 171

Table 1
Main Techniques of Meditation

INDIAN TRADITION
● Veda Sahāja
Yogic meditation in six stages (see Maitreya Upaniṣad)*
● Yoga Kirtan Kriyā
Shabad Kriyā
Sudarśan Kryiā
Yoga Nidrā
● Buddhism Śamatha
Vipaśyanā (Pali Vipassanā)
Zazen
Kinhin
Dzogchen
Tonglen
CHINESE
TRADITION
● Taoism Qigōng (气功)
● Chán (Zen) Buddhism Tàijíquán (太极拳)
Zazen
Kōan practice
JAPANESE Zazen
TRADITION Kōan practice
(Sōtō Zen and Rinzai
Zen)
WESTERN
TRADITION
● Christian Esychasm
Rumination of the Divine word
Mental prayer
Chanting prayer
Techniques drawn from Vipaśyanā meditation
● Hebrew Gherushin (meditation on Torah’s verses)
(Chassidism, Mantra Meditation on God’s name (YHWH) or other
Qabbalah) thoughts (e.g., Ribbonò Shel Olàm, Lord of the
Universe)
● Islam (Sufi) Aldhikr (invocation of God)
Twirling Dervishes
WESTERNIZED
TECHNIQUES
Mindfulness
Transcendental Meditation

*(a) prāṇāyāma (breath control); (b) pratyāhāra (sensory withdrawal); (c) dhāranā (concen-
tration); (d) dhyāna (meditative state, visualization); (e) tarka (reflection); (f) samādhi.
172 E. FACCO

reached when all senses, mind, and reason cease their ordinary activity.
Therefore, it is far from being an intellectual activity based on logic and
conceptual thought; rather, it always involves both mind and body in
their inseparable unity. The bodily activity ranges from a still position,
for example, the classic padmasana (lotus) position, to walking, dancing
(e.g., twirling dervishes), or even practicing physical exercise and mar-
tial arts (e.g., Qigōng and Tàijíquán, respectively).
It is interesting to note that the etymology of Yoga stems from the
Sanskrit term yujir (binding together, joining) (Eliade, 2007). It indicates
the reunion of mind-body, I-non-I (i.e., mind–body–world), individual-
ātman-universal-Ātman. It can be also considered as a combination of
binding-unbinding at the same time, involving the following three
components:

1. Mind and body are closely rejoined, and that unity may also allow for inten-
tional control of functions that are not manageable with ordinary conscious-
ness (e.g., analgesia and control of biological functions); this is a common
ability of Yoga experts, fakirs, as well as highly hypnotizable subjects.
2. According to its ascetic meaning, the term indicates unbinding mind
from all conditionings and illusions, that is, from Māyā, the mask of
illusion of ordinary consciousness, in the Buddhist view. Māyā is the
decisive force of samṣāra (the world of becoming, of the ostensible multi-
plicity and suffering), where our mind is like a mirror reflecting the outer
reality: We only get the mental images of the outer world, but, despite
the correspondence between the two, we inescapably miss the intimate
nature of phenomena in themselves (this idea is compatible with Kant’s
concept of phenomenon and critical dualism).
3. The endpoint of Yoga meditation is to lead one to enlightenment, where the
Reality (i.e., the reality of Reality) and the fusion of ātman-Ātman are reached
(Eliade, 2007), in a condition where the separation between who knows,
knowledge, and what is known is dissolved. Ātman is also sat-cit-anānda
(being-consciousness-bliss), which is eternal, beyond space and time, universal.

This may look odd to the Western scientist, who is inclined to a

materialist monistic view, refusing anything with the flavor of trans-
cendence. Here, it is worth mentioning that “eternal” does not mean
immortal but, rather, timeless and that sat-cit-anānda, samṣāra, and
nirvāṇa are neither physical nor metaphysical places; rather, they are
conditions of mind, here and now, that is, nothing more pragmatic.
The mentioned endpoint of the deep introspective activity yielded by
meditation includes the liberation from all attachments; it is a part of a
sound knowledge of unconscious processes and an epistemologically
well-founded analysis of the relationship between the external reality,
its mental images, and concepts already analyzed in the Laṇkāvatārasūtra
and Vajracchedica Prajñaparamita (Diamond Sutra) over 2,000 years ago,
showing the surprising modernity of ancient Indian thought
 HYPNOSIS AND MEDITATION 173

(Lankavatara sutra, 2013; Nhat Hanh, 1992). In short, meditation has

been the master way for communicating with the unconscious and has
been leading one to a true freedom for over 2,500 years; thus, it is to be
regarded as a powerful tool for psychotherapy and resilience, compatible
with the Jung’s concept of individuation.

Neuropsychological Classification of Meditation

Meditation techniques have been classified into two main categories,
focused attention (FA) and open monitoring (OM), according to the main
feature of involved mental activity (Davidson & Goleman, 1977;
Davidson, Goleman, & Schwartz, 1976). The FA is characterized by the
concentration on a given internal or external object; whenever the atten-
tion decreases and/or is shifted away from the focus, the subject must
gently bring it back in order to restore FA (Cahn & Polich, 2006; Lutz,
Slagter, Dunne, & Davidson, 2008; Raffone & Srinivasan, 2010). OM
consists of an uncontrolled observation of reality in the stream of experi-
ence, here and now. As a whole, it allows the practitioner to develop a
metacognitive perspective, that is, awareness of the nature of emotional
and cognitive patterns (Cahn & Polich, 2006; Raffone & Srinivasan,
2009). Of course, FA and OM do not exclude each other but may be
used in sequence from FA to OM in different sessions or within the same
one. For example, the Buddhist meditation Śamatha (the FA meditation
of dwelling calm) may be followed by Vipaśyanā meditation (OM); the
former is used to induce meditation and to reach the proper state of
meditation, which can be followed by the OM condition.
The ability to regulate the focus of attention, check distractions, shift
them from their source and redirect the attention to the chosen object
enables one to develop an internal witness, that is, a stable, detached,
neutral observer aware of the flow of experience. This process develops
the metacognitive ability of controlling the internal world, of recogniz-
ing the nature of mental objects, and of letting them flow away without
being captured or conditioned by them (Cahn & Polich, 2006). The
Patañjali’s Yoga-Sūtra (2009) clearly mentions the internal witness, dis-
closed by niroḍha. The term niroḍha indicates the insight into pure
consciousness, void of any content (lying beyond any perception, con-
cept, and category of the mind); being ordinary consciousness inclined
to self-identification with mental contents, niroḍha enables one to reach
a pure awareness of the agent, the witness who observes phenomena
and remains detached and untroubled. Metaphorically, the flow of
ordinary consciousness may be compared to an exposed film, where
images are the flow of experience, whereas niroḍha is its unexposed
part, that subtle stripe between subsequent images (the support of
images); thus, niroḍha allows us to perceive the “pure consciousness”
observable in this short stripe, of which one is usually unaware.
174 E. FACCO

Niroḍha is a step towards the enlightenment, where ordinary mental

activity and conceptual thought are overcome. Zen Buddhism strongly
warns against remaining tied to conceptual thought in the progress
towards satori (enlightenment), holding the doctrine of no-mind, a very
hard as well as hardly explainable concept. According to Zen, the
psychoanalytic unconscious still belongs to the superficial layers of
the psyche, since it is part of the empirical mind, directed towards
the outer world (Suzuki, 1958). Again, the aim of no-mind is to reach
the awareness of mind in itself (buddhadhātu, Buddha-nature, original
nature latent in every living creature), beyond the ego, any thought,
category, view, apparent multiplicity stemming from the contact with
the outer world and experience (see Figure 1). In other words, the
anthropocentric perspective with its discursive mode of reasoning is
inclined to substantialize and ontologize, projecting mental categories
into the outer world. This looks to be far from being a true, radical
third-person perspective, able to perceive the reality in itself; if this is
the case, meditation might result in the most relevant and radical
attempt to reach a true objectivity.
In the attempt to briefly summarize the process of meditation, only the
yogic one will be described here, as reported in the Patañjali’s Yoga-sūtra
(2009). It consists of three main steps, dhāranā, dhyāna, and samādhi

Figure 1. The structure of psyche according to Zen Buddhism and the doctrine of no-mind
(Prajñā = superior knowledge, supreme wisdom).
 HYPNOSIS AND MEDITATION 175

(Patañjali, 2009). Dhāranā is the induction, which is realized through FA

and concentration and may include prāṇāyāma (breath control). Dhyāna is
the meditative state, where a flow of images may occur (it must not be
confused with the same term in Mahāyāna Buddhism, where it means
prajñā; see below); the yogic concept of dhyāna is similar to the Buddhist
one of jhāna (Pali), which can be translated as meditative absorption,
contemplation. Samādhi, as already mentioned, is the deepest meditation,
overcoming any concept, duality, and separation and leading to prajñā
(superior knowledge, supreme wisdom). What the novice progressively
achieves with training in formal sessions of meditation may then become
a spontaneous way of being in everyday life of the expert meditator
(Lutz, Slagter, et al., 2008, 2009).
In the West, meditation has been essentially used by mystic currents
of the Abrahamic tradition, within different cultural contexts and goals
with respect to the Indian, Chinese, and Japanese philosophies.
Roughly, in Christian, Hebrew, and Islamic contexts, one is seeking
to reach a direct experience of the divine in a tradition endowed with
rich theological speculations, doctrines, and social rules. Instead, in
Eastern cultures, God is just mentioned (without providing any infor-
mation) or even unmentioned. For example, in Veda tradition Prajāpati
(God the Creator) is absolutely unknowable and may be basically
meant as the creation in itself, while in Patañjali’s Yoga-sūtra, Īşvara
remains undefined or assimilated to puruṣa (pure consciousness);
Buddhism holds a Nobile Silence about the ultimate reality, which is
nameless, while Taoism states that Tao is nameless as well (Facco,
2014). On the other hand, Western mystics mainly adopt the apophatic
theology (or negative theology), stating that God cannot be rationally
defined. According to John Scottus Eriugena's thought (815–877 A.D.),
we cannot knopw what God is and God Himself does not know what
He is because He is not anything; God is not, because He transcends
being and ‘Thus in God you see what God is not’ (Periphyseon, 676A).
This turns the conventional idea of God, with its indefinability, into a
concept much closer to the one of Eastern philosophies; this also
legitimizes the hypothesis that mystics’ meditation, despite its more
dualistic approach and related differences in technical procedures of
meditation, may reach a compatible endpoint, that is, the Unio Mystica
or the fusion ātman- Ātman.

MEDITATION AND HYPNOSIS

An increasing number of studies on the neuropsychological features

of both hypnosis and meditation has been published in the past 2
decades. A first provisional analysis of their possible relationship is of
interest, despite the fact that no comparative studies on meditation and
hypnosis are available yet and the methods and study designs of the
176 E. FACCO

existing ones are dishomogeneous. Besides neuropsychological aspects,

common historical and cultural links show a relevant convergence
between mesmerism and Eastern meditative practices and are worth
appraisal here.

Historical and Epistemological Aspects

The main therapeutic goals of hypnosis show a surprising corre-
spondence with the origin of Buddhism. In fact, hypnosis, since its
birth, provided outstanding evidence of its power in the management
of both suffering and pain (e.g., efficacy in the therapy of hysteria and
hypnotic analgesia).
Buddhism was born some 2500 years ago, following Siddhartha
Gautama’s observation of the omnipresence of pain and suffering
(Sanskrit duḥkha, Pali dukkha), as clearly reported in the following two
passages of Majjhima Nikaya and Saṃyutta Nikāya:
I, too, monks, before my Awakening, when I was an unawakened bod-
hisattva, being . . . subject myself to aging. . . illness. . . death. . . sorrow. . .
defilement, I sought what was likewise subject to illness. . . death. . .
sorrow. . . defilement. The thought occurred to me, ‘Why . . . do I seek
what is likewise subject to illness. . . death. . . sorrow. . . defilement?. . .
What if I . . . were to seek the aging-less, illness-less, deathless, sorrow-
less, unexcelled rest from the yoke: Unbinding?” Bhikkhu (trans.), 2004
In Saṃyutta Nikāya (56.11) a cosmic vision of pain is painted as well:
Birth is pain, ageing is pain, illness is pain, death is pain, joining to what
is displeasing is pain, separating from what is dear is pain, not getting
what is wished is pain. In short, the five skhanda [the clusters of con-
sciousness; author’s note], which are the base of attachment to existence,
are pain.
This cosmic view of pain, despite seemingly pessimistic, is the starting
point of the way to the most radical liberation from duḥkha, according
to the Four Noble Truths. Therefore, the common aim of hypnosis and
meditation, that is, relieving suffering and pain through a proper
reform of mind–body–outer-world relationship, is undeniable.
Some connection between mesmerism, traditional Chinese medicine,
and Indian meditative practices can be found as well. Both the Jesuit
missionary Fr. Jean-Joseph-Marie Amiot (1718–1793) and La Roy
Sunderland (1804–1885) claimed a similarity between magnetism and
the polarity Yin-Yang of Chinese medicine (Schmit, 2010). In the mid-
nineteenth century, a link between hypnosis, self-hypnosis, and Indian
meditative techniques was reported, together with the first translation
into English of the Patañjali’s Yoga-sūtra. As Sandby commented in
1848, the main feature of Yoga meditation was “the restraining of the
mind, and the confining it to internal meditations. . .By withholding the
mind from wandering, the organs are turned from their accustomed
 HYPNOSIS AND MEDITATION 177

objects inwards. The Yogee . . . has induced the ecstatic or mesmeric

condition” (Schmit, 2010, p. 12). At that time, the mesmeric journal The
Zoist published several articles on Indian meditation and healing prac-
tices, including mantras, focused attention, sleep-waking state, analge-
sia, voluntary decrease of heart and breathing rate, and control of
involuntary vital organs (see Schmit, 2010, as a review).

Phenomenological Aspects
Hypnosis and meditation share some common procedural features,
such as FA, concentration, and absorption. Clear differences are also
present. Hypnosis is generally guided by the hypnotist, who provides
several suggestions suitable to specific therapeutic goals, but a novice
needs a master as well, who guides him or her to properly learn
meditation. Rather than administering suggestions, a Buddhist master
teaches novices to observe spontaneous experiences and let them go in
order to detach themselves, to develop the capability of seeing the mind
beyond any object, sensation, emotion, or mental category, and to reach
the dwelling calm. A deep hypnotic relaxation and absorption may
lead to a similar condition too.
Both hypnosis and meditation allow the practitioner to strongly
improve mind–body control, to significantly change self-awareness,
affectivity, memory, rationality, or alter time perception, and to
enhance attention, serenity, imagery, and its vividness (Cardeña,
2005; Venkatesh, Raju, Shivani, Tompkins, & Meti, 1997). Hypnosis
may yield deep experiences similar to those belonging to the world of
meditation, such as “having no thoughts,” “being one with everything,”
“increasing meaningfulness,” “letting things happen,” and “merging with
pure light or energy” (Cardeña, 2005, p. 48). Therefore, in both hypnosis
and meditation FA and its shift to OM as well as the arrest of a
talkative mind up to the level of an absolute calm may occur; this
leads in turn to a thoughtless awareness, fairness, and a closer body–
mind binding, where the sensation of a separate self is lost (Shor, 1979).
The main common aspects of hypnosis and Yoga meditation are
summarized in Table 2. A clear similarity may be perceived between
the components of hypnosis and the stages of dhāranā and dhyāna. Of
course, any hypothesis about samādhi, which is far beyond the practi-
cal, pragmatic therapeutic Western goals of hypnosis, is not possible.
Nevertheless, hypnosis may also be compatible with other features of
meditation, such as OM, the metacognitive detachment, the observa-
tion of one’s states and mental objects, as well as the instructions to
accept pain, to detach oneself from it, and to let it go (Grant &
Rainville, 2009; McCracken, Gauntlett-Gilbert, & Vowles, 2007); in
meditation, tradition suggestions resembling those used in hypnosis
are seldom reported, like the Nanso healing meditation (Otani, 2003).
178 E. FACCO

Table 2
Common Aspects of Hypnosis and Yoga Meditation (from Facco, 2014)

● FA
● Deep relaxation Dhāranā?
● Breathing control → body control
● Visualizations
● Dissociation from competing stimuli
(hypnosis)
● and let thoughts and perceptions go
(meditation)
●
Dhyāna?
Development of new capabilities
● Metacognitive development
● Improvement with training
○ Novice → expert

To reach the inseparable identity of Samādhi

who knows,
knowledge and what is known

Note. Both Dhāranā and Dhyāna include mental activities common to hypnosis, while
Samādhi looks beyond the limits of pragmatic therapeutic western goals of hypnosis.

Neuroimaging
As already mentioned, both hypnosis and meditation are far from
being single monomorphic activities; as a result, each of them shows a
variety of brain patterns, according to the type of meditation and
meditative or hypnotic tasks. FA meditation engenders a complex
pattern of activation and deactivation of several brain areas, mostly
related to attentive processes (including prefrontal, fronto-parietal,
temporal, parahippocampal, occipital and cerebellar cortex, anterior
cingulate cortex [ACC], as well as insula and brainstem), with a pattern
depending on the duration of training (experts vs. novices)
(Brefczynski-Lewis, Lutz, Schaefer, Levinson, & Davidson, 2007;
Newberg et al., 2010). Different patterns of activation-deactivation
have been reported during resting state, induction, and meditative
state (Baerentsen et al., 2010). Furthermore, different techniques of
meditation (even within the FA type) as well as their depth may also
yield different results in the same subjects; for example, kirtan kriyā and
shabad kriyā meditation (both belonging to Kụnḍalinī Yoga) look to cause
a higher activation of anterior regions and limbic-paralimbic ones,
respectively (Wang et al., 2011).
FA meditation also affects the default modality network (DMN). Its
activation during mind wandering is followed by awareness of wan-
dering and a shift of attention to restore FA; this process is paralleled
by an increase of connectivity of the attentional network and frontal
 HYPNOSIS AND MEDITATION 179

medial areas, which persists outside meditation as a trait in expert

meditators, suggesting a steady, increased ability in maintaining atten-
tion and controlling distraction (Hasenkamp & Barsalou, 2012;
Hasenkamp, Wilson-Mendenhall, Duncan, & Barsalou, 2012).
As far as OM meditation is concerned, Yoga Nidrā (sleep meditation,
leading to deep absorption, detachment, and neutrality) is associated
with the activation of areas involved in executive attentional network
and imaginative tasks (including dorsolateral and orbital frontal cortex,
anterior cingulate and left temporal gyri, left inferior parietal lobule,
striatal and thalamic regions, pons and cerebellar vermis and hemi-
spheres) (Lou et al., 1999). It is interesting to note that the meditative
procedure used in the study by Lou et al. involved hypnotic-like
imaginative tasks, such as perceiving the weight of each body part,
the experience of abstract joy, happiness, the perception of self (in the
symbolic form of a golden egg), and visualization of pleasant
landscapes.
Tibetan Buddhist meditation has been reported to activate the cin-
gulate gyrus, inferior and orbital frontal cortex, dorsolateral prefrontal
cortex, and thalamus. The change of perfusion in the left dorsolateral
prefrontal cortex correlated negatively with the one in the left superior
parietal lobe, probably reflecting an altered sense of space experienced
during meditation (Newberg et al., 2001). A similar relationship was
later observed in verbally based (mantra-like) meditation by Franciscan
nuns (Newberg, Pourdehnad, Alavi, & d’Aquili, 2003). Affective reac-
tivity during loving-kindness-compassion meditation (Tonglen medita-
tion, a technique belonging to Tibetan Mahāyāna Buddhism) (Dalai
Lama & Cutler, 1998) was tested by administering positive, negative,
or neutral sounds during meditation (Lutz, Brefczynski-Lewis,
Johnstone, & Davidson, 2008). The results showed the activation of
insula and cingulate cortex; it related to both intensity of meditation
and the administration of negative sounds, while the amygdala, right
temporo-parietal junction, and right posterior superior temporal sulcus
were activated in response to all kinds of sounds. Furthermore, the
reported association between heart rate and the activation of insula,
dorsal ACC, somatosensory cortex, and inferior parietal lobule during
compassion meditation suggests a condition of enhanced emotional
and bodily representation of others’ emotions through the activation
of circuits linked to empathy and theory of mind (Lutz, Greischar,
Perlman, & Davidson, 2009). A similar activation of ACC and dorsome-
dial prefrontal cortex has been observed in vipaśyanā meditation
(Holzel et al., 2007). Finally, the patterns of activated or deactivated
brain areas are clearly different in śamatha and vipaśyanā meditation
(Manna et al., 2010), which are based on FA and OM, respectively.
As far as hypnosis is concerned, both hypnotic relaxation and
absorption activate the ACC (Rainville & Price, 2003), a fact observed
180 E. FACCO

also in śamatha and vipaśyanā meditation (Holzel et al., 2007; Manna

et al., 2010). During relaxation, ACC activation is paralleled by
increased perfusion of the occipital cortex and decreased perfusion of
deep brain structures (such as the brainstem, cerebellum, thalamus and
basal ganglia, and prefrontal cortex). Instead, during absorption, the
ACC activation is associated with increased perfusion of the brainstem
and prefrontal cortex and decreased occipital perfusion, while in both
conditions increased perfusion of ACC, somatosensory, and motor
cortex as well as a decreased perfusion of temporal lobes have been
observed (Rainville, Hofbauer, et al., 1999; Rainville, Hofbauer,
Bushnell, Duncan, & Price, 2002; Rainville & Price, 2003). The constant
activation of ACC is not surprising, since it is a crucial area in pain
perception, conflict monitoring, arousal, attention, cognition, motiva-
tion, and movement control.
Hypnosis has been reported to reduce anterior DMN activity during
rest without increasing activity in other cortical regions (McGeown,
Mazzoni, Venneri, & Kirsch, 2009). Likewise, reduced activity in
DMN and increased activity in the prefrontal attentional systems
were found in attentional absorption following hypnotic induction
under passive visual stimulation; in this study, the anterior DMN
deactivation was also associated with reduced activity extending into
the posterior cingulate and parahippocampal gyri (Deeley et al., 2012).
On the other hand, Demertzi et al. (2011) reported a reduced “extrinsic”
lateral frontoparietal cortical connectivity but also found an increased
connectivity in bilateral angular and middle frontal gyri, as well as a
decreased posterior midline and parahippocampal structures connec-
tivity, probably reflecting an altered awareness of self and posthypnotic
amnesia, respectively. As a whole, these results show the capability of
hypnosis to intentionally change the activity of DMN, where differ-
ences in the results among the available studies may reflect different
hypnotic or meditative procedures and study designs.
Both hypnosis and meditation have been associated with emotion
regulation and pain reduction. Zazen meditation activates primary
pain-processing regions (such as ACC, thalamus, insula) and decreases
activity in executive, evaluative, and emotional areas during pain (pre-
frontal cortex, amygdala, hippocampus), reducing the connectivity
between pain and executive areas (Grant, Courtemanche, & Rainville,
2011). Likewise, mindfulness meditation reduces pain perception
through the activation of the rostral ACC, anterior insula, orbitofrontal
cortex, and deactivation of primary somatosensory cortex and thalamus
(Zeidan, Grant, Brown, McHaffie, & Coghill, 2012; Zeidan et al., 2011).
Hypnotic suggestion to create an experience of pain, unlike imagined
pain, activates the same brain areas directly involved in its generation, that
is, thalamus, ACC, insula, prefrontal, and parietal cortices (Derbyshire,
Whalley, Stenger, & Oakley, 2004). Hypnosis can selectively modulate the
 HYPNOSIS AND MEDITATION 181

activity of the evaluative-cognitive and affective-motivational components

of the pain neuromatrix (including somatosensory cortex and ACC, respec-
tively), as well as alter its connectivity as a whole (Faymonville et al., 2000,
2003; Hofbauer, Rainville, Duncan, & Bushnell, 2001; Rainville, Carrier,
Hofbauer, Bushnell, & Duncan, 1999; Rainville et al., 2002; Rainville &
Price, 2003). Hypnotically induced depersonalization yields an increase of
pain threshold through the modulation of brain areas belonging to pain
neuromatrix, including contralateral somatosensory cortex, parietal cortex,
prefrontal cortex, putamen, and amygdala (Roder, Michal, Overbeck, van
de Ven, & Linden, 2007); the used hypnotic task was similar to the sugges-
tions of neglect and dissociation from the body area to get a hypnotic
focused analgesia in both research and clinical practice (Facco et al., 2011;
Facco, Manani, & Zanette, 2013; Facco, Pasquali, Zanette, & Casiglia, 2013).
In this regard, it is worth recalling that hypnotic analgesia is not a simple
dissociation from pain perception; instead, it is a powerful analgesic tool,
standing the comparison with pharmacological anesthesia, since it is also
able to block the sympathetic stress reaction to pain and prevent cardio-
vascular changes (Casiglia et al., 2007; Casiglia et al., 2012; Facco, Pasquali,
et al., 2013).

Overlap Between Hypnosis and Meditation

It is a hard job, if possible, to trace a map of all correspondences and
differences between hypnosis and meditation, due to three main fac-
tors: (a) Each of them is far from being a single monomorphic activity;
(b) strong differences, involving both mental activities and related
brain areas, are observed within each technique; (c) the available stu-
dies are strongly dishomogeneous and do not allow a direct compar-
ison between series. Nevertheless, a first provisional, rough
comparison is of interest, since it allows a start in considering their
possible common aspects.
In general, meditators, who belong to a philosophical discipline,
have long-term training and aims, potentially lasting their whole lives
(or even several reincarnations, according to the Buddhist view) and
leading to a deep self-transformation on the way to enlightenment.
Instead, subjects submitted to hypnosis in clinical practice are seeking
to recover from a psychological and/or physical disorder, in a more
pragmatic but limited, short-term perspective. Novices do not expect
suggestions but, rather, instructions leading to mindfulness and equa-
nimity in order to overcome the limited ego perspective affected by
Māyā; meditation also involves some imaginative activity, which may
be similar to the one used in hypnosis. Through meditation, novices
learn to observe ordinary perceptions as well as the ego from a
detached perspective and recognize their illusory nature. Anyway,
this way is aimed toward liberation from of duḥkha (i.e., suffering)
182 E. FACCO

and constitutes a powerful tool for resilience, which also pertains to the
field and aims of hypnosis and psychotherapy.
Usually the first perceived difference between hypnosis and medita-
tion regards the procedure (i.e., the former is guided, while the latter is
self-managed), but it looks to be only a formal, not so relevant aspect,
as already mentioned. On the other hand, both hypnosis and Kụnḍalinī
Yoga meditation are associated with relevant changes of arousal, self-
awareness, time perception and meaning, positive affect, and rational-
ity (Cardeña, 2005; Pekala & Nagler, 1989; Venkatesh et al., 1997). This
similarity led Cardeña to conclude that medium to deep hypnotic
phenomena are consistent with phenomena of increasing absorption
mentioned in the classic meditation literature.
Neuroimaging studies have shown that both hypnosis and meditation
may affect the activity of several brain areas and networks, including
prefrontal and cingulate cortex, the DMN, the pain neuromatrix, and
attentional and salience networks. Despite the heterogeneity of available
studies, it is possible to draw a rough, provisional comparison of the main
brain areas involved in both techniques. Table 3 compares Śamatha and
Vipaśyanā meditation (typical examples of FA and OM meditation, respec-
tively) to hypnotic relaxation and absorption; some brain areas are only
roughly identified (e.g., temporal lobe), due to the differences in methods
and labeling or a lack of detail in some studies. It can be observed that FA
and OM meditation are far from being the same condition, as well as
hypnotic relaxation and absorption. The prefrontal cortex looks to be
activated in both meditation and in hypnotic absorption, while the insula
is deactivated both in Śamatha meditation and hypnosis; there seems to be
a similar activation of the lateral posterior parietal cortex in Vipaśyanā and
hypnotic absorption versus deactivation in Śamatha and hypnotic

Table 3
Main brain areas activated (↑) and deactivated (↓) in Śamatha and Vipaśyanā medita-
tion and during hypnotic relaxation and absorption (L = left; R = right. Modified from
Facco 2014)

Meditation Hypnosis

Śamatha Vipaśyanā Relaxation Absorbtion

Prefrontal cortex ↑ ↑ ↓ ↑
Insula ↓L ↓ ↓
Temporal lobe ↓L ↑L ↓ ↓
Lateral posterior parietal cortex ↓L ↑L ↓ ↑
Medial posterior parietal cortex ↓ ↑ ↑ ↓
Precuneus ↓ ↑ ↓L
Anterior cingulate cortex ↑ ↑ ↑R ↑R
 HYPNOSIS AND MEDITATION 183

relaxation, as well as an inverse relationship with absorption and relaxa-

tion in the medial posterior parietal cortex. Finally, the ACC is activated in
all conditions, while the precuneus is deactivated in both Śamatha medita-
tion and hypnosis. Furthermore, both meditation and hypnosis affect
DMN activity and decrease pain perception through a modulation of
the pain neuromatrix.

CONCLUSION
At least a partial overlapping between hypnosis and meditation is
suggested by the history of hypnosis and similarities in both proce-
dures and neuropsychological aspects. Hypnosis and meditation
belong to two different worlds, and their differences may reflect cul-
tural factors, that is, definitions, aims, indications, and managing,
rather than intrinsic, incompatible differences: One has to wonder
whether they are really different “things” or, rather, they are different
ways of managing the same essential, remarkable abilities of the
human mind, misunderstood and prejudicially refused for centuries
by Western rationalistic and mechanistic perspective. The variability
of patterns of activation/deactivation in each technique according to
specific instructions and suggestions seems to reflect more the plasticity
of mind and its ability to reach different targets, precluded to ordinary
consciousness and free will, than different incompatible processes.
Modern Western culture has mainly devoted itself to the scientific
exploration of the external world with a mechanist-reductionist para-
digm. Instead, Eastern philosophies have mainly devoted themselves
to the empirical introspective exploration of the inner world for over
two thousand years, with a nondualistic paradigm and a solid rational
approach. Buddhists had already recognized the unconscious in the
fourth century BC, holding a much wider definition in comparison to
the psychoanalytic one: ālayavijñāna (store consciousness, as described in
the Abhidarma and Laṇkāvatārasūtra), the store of all imprinting, mem-
ories, inclinations, is mostly unconscious. Therefore, it is not surprising
that the first mesmerists were so attracted by Eastern cultures and
considered their meditative and mind–body techniques as the founda-
tion of their discipline; another possible source for hypnosis might be
traced back to ancient Western culture, that is, pre-Socratic philoso-
phers, like Parmenides, Hippocrates, and the Asclepiad rites of healing
(Facco, 2014), but their analysis is far beyond the aims of this article.
If meditation and hypnosis involve a complex and powerful plastic
mind activity, their differences may be more cultural than neuropsy-
chological in nature: If this is the case, relevant aspects of meditation
and its philosophical implications, once recognized, might be imple-
mented in the world of hypnosis.
184 E. FACCO

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Meditation und Hypnose: Zwei Seiten derselben Münze?

Enrico Facco
Abstract: Hypnose und Meditation formen als Ganzes einen heterogenen
Komplex psychosomatischer Techniken, die Körper und Geist kontrollieren
können. Hypnose wurde pragmatisch für begrenzte therapeutische Ziele
benutzt, während die östliche Meditation sehr viel weitere philosophische
und existentielle Auswirkungen hat, die auf eine radikale Befreiung von
allen Illusionen, Bindungen, Leid und Schmerz abzielt. Die verfügbaren
Daten bezüglich Geschichte, Phänomenologie und Neuropsychologie von
Hypnose und Meditation zeigen einige gemeinsame Merkmale, wie: (a)
Induktion basiert auf fokussierter Aufmerksamkeit, (b) Fähigkeit eine beab-
sichtigte Kontrolle sowohl vegetativ-somatischer Aktivitäten als auch
bewußt-unbewußter Prozesse zu erreichen, (c) Aktivierung /Deaktivierung
einiger Gehirnareale und Schaltkreise (z.B. das vorgegebene
Modalitätsnetzwerk und die Schmerzneuromatrix) mit einer relevanten
Überlappung der beiden.
STEPHANIE RIEGEL, MD

Méditation et hypnose: la face et le revers de la même médaille?

Enrico Facco
Résumé: L’hypnose et la méditation forment habituellement un ensemble
hétérogène de techniques psychosomatiques de régulation de l’esprit et du
corps. L’hypnose est utilisée de façon pragmatique à des fins thérapeutiques
limitées, tandis que la méditation orientale a des implications philosophi-
ques et existentielles beaucoup plus larges, visant une libération radicale de
tout attachement, de toute illusion, souffrance ou douleur. Les données
disponibles sur l’histoire, la phénoménologie et la neuropsychologie de
l’hypnose et de la méditation montrent plusieurs caractéristiques qui leur
sont communes, telles que: a) l’induction basée sur l’attention ciblée; b) la
capacité d’atteindre un contrôle intentionnel des activités végétativo-soma-
tiques et des processus conscient-inconscient; c) l’activation/la désactivation
de plusieurs régions et circuits cérébraux (p. ex. la neuromatrice de la
188 E. FACCO

douleur et le réseau de modalité par défaut) avec chevauchement pertinent

entre les deux.
JOHANNE REYNAULT
C. Tr. (STIBC)

Meditación e hipnosis: ¿Dos lados de la misma moneda?

Enrico Facco
Resumen: La hipnosis y la meditación, en general, forman un complejo
heterogéneo de técnicas psicosomáticas que permiten controlar la regulación
de mente y cuerpo. La hipnosis ha sido utilizada pragmáticamente para
objetivos terapéuticos limitados, mientras que la meditación oriental tiene
implicaciones filosóficas y existenciales mucho más amplias, enfocadas hacia
una liberación radical de todas las ilusiones, sufrimiento y dolor. Los datos
disponibles sobre la historia, fenomenología, y neuropsicología de la hipnosis
y meditación muestran muchas características comunes, como: (a) inducción
basada en atención focalizada; (b) capacidad para alcanzar un control inten-
cional tanto de actividades vegetativo-somáticas y de procesos conscientes e
inconscientes; (c) activación /desactivación de varias áreas y circuitos cere-
brales (e.g., la red neuronal por defecto y la neuromatriz de dolor) con un
solapamiento relevante entre las dos.
OMAR SÁNCHEZ-ARMÁSS CAPPELLO
Autonomous University of San Luis Potosi,
Mexico