Memorial to Honor the Life and Work of Herbert Spiegel, M.D.

Friday, February 19, 2010

New York State Psychiatric Institute

1051 Riverside Drive, New York, NY


Dr. Herbert Spiegel’s wife and colleague, Assistant Clinical Professor, Department of Psychiatry, Albert Einstein College of Medicine; Medical Staff, Lenox Hill Hospital, NYC; Fellow: American Society of Clinical Hypnosis; Society for Clinical and Experimental Hypnosis; Private Practice, New York City

International journalist and author of The Inner Source: Exploring Hypnosis with Dr. Herbert Spiegel

Clinical Professor of Psychiatry, Temple University School of Medicine;  Immediate Past President, Society for Clinical and Experimental Hypnosis, Past President, American Society for Clinical Hypnosis; Private Practice, Bala Cynwyd, PA

Professor, Clinical Psychiatry; Chief of Service: Consultation-Liaison Psychiatry, Columbia University College of Physicians and Surgeons; Private Practice, New York City

North Shore University Health System, Chicago;  Past Editor, American Journal of Clinical Hypnosis; Private Practice, Chicago, IL

Associate Professor of Radiology, Harvard Medical School; President and Founder, Hypnalgesics, LLC; President, Society for Clinical and Experimental Hypnosis, Boston, MA

Immediate Past President, International Society of Hypnosis; Associate Professor of Psychiatry, Head of Research, Military Mental Health, University Medical Center, Utrecht, The Netherlands

Chairman of the Dept. of Psychiatry, Weill Cornell Medical College; Psychiatrist-in-Chief of Weill Cornell Medical Center, New York Presbyterian Hospital; Barklie McKee Henry Professor, Weill Cornell Medical College; Professor of Psychiatry, Weill Cornell Medical College, New York City

Dr. Herbert Spiegel’s son and colleague, Jack, Lulu & Sam Willson Professor, Stanford University School of Medicine, Stanford University; Associate Chair of Psychiatry & Behavioral Sciences, Stanford University School of Medicine; Past President: American College of Psychiatrists, Palo Alto, CA

(In order of presentation)

Marcia Greenleaf, Ph.D. Dr. Herbert Spiegel was my husband, best friend, teacher and colleague. In January we would have celebrated our 21st wedding anniversary.

We met at a conference in The Hague in 1988. When he proposed to me one month later, I asked: "How can you be so sure so soon". He said: "You might give me a little credit; I’ve assessed over 50,000 people."

As husband and wife, our professional and personal lives intertwined. Our work together was fitting... My dissertation research proved part of his theory of hypnotizability... I used the same principles with medical patients that he had discovered were effective in combat. It was a match.

Herb’s experience in World War II shaped his clinical thinking and research... As a combat surgeon with the 1st Infantry Division in the invasion of North Africa, he used hypnosis on the battlefield…Wounded when a German tank broke through the allied ranks, he was awarded the Purple Heart and shipped back to the US... Assigned to teach military psychiatry at Mason General Hospital, he used hypnosis to treat pain, trauma and anxiety, began his research and his amazing journey with hypnosis and short-term psychotherapy... He was always ahead of his time.

As a scientist, concepts and results weren’t enough. He had the discipline to develop ways to measure his clinical intuition and observations. The size of his subject samples – in the thousands - was astonishing; his follow-up meticulous.

As an author, Herb’s first publications focused on his experience as a battalion surgeon during the North African campaign in WW II... He wrote his first papers on combat psychiatry and identified physio-neurosis – the first clinical identification of Post Traumatic Stress Disorder. His classic textbook, Trance and Treatment: the Clinical Uses of Hypnosis co-authored with his son, Dr. David Spiegel was published in the 1970’s and revised in 2004.

As a clinician, Herb was respected, admired and loved by patients who came to see him from all over the world... He helped tens of thousands of patients change their perspective, their behavior and manage symptoms... He was a master at giving others mastery over their lives. A woman who called me after hearing of his death is now in her 70’s. In her early 20’s, Herb taught her to conquer a phobia. She said: What I learned from him changed my life forever."

…Herb defined therapeutic trance as a process to develop healthy new brain circuitry to replace old negative patterns... He loved to say: "What fires together, wires together." He lived long enough to see research in brain physiology and memory that supported his early data and clinical concepts...

Herb inspired generations of clinicians, researchers, and patients as well as friends and family. Personally and professionally, he was courageous and dazzling.

We both knew I would carry on alone. He prepared me well but it’s come too soon.

*Sections taken from: Greenleaf, M.(2010). Herbert Spiegel, MD (1914-2009): Art, science and poetry. Am J Clin Hypn, 52(4), 253-258.

Donald S. Connery, journalist & author ... I came to know Herbert Spiegel exceedingly well during the last third of his remarkable life lasting nearly a century. I... attended his legendary Columbia course on clinical hypnosis... traveled with him to courtrooms and conferences…and carried out endless interviews before and after the publication of The Inner Source: Discovering Hypnosis with Dr. Herbert Spiegel.

...We first met in extraordinary circumstances. I told the story in Guilty Until Proven Innocent, a book about a famous miscarriage of justice. The Peter Reilly case of the mid-1970s is now established as a classic false confession catastrophe. In those days there were no confession experts... to explain how cops can extract false admissions by diabolical psychological pressures. But there was Dr. Herbert Spiegel and he was recruited by playwright Arthur Miller, pro bono, to testify at a hearing for a new trial. Herb’s assessment of how Peter [Reilly] had been brainwashed by the police was so powerful that the judge called him to the bench to say that he was the most impressive expert witness he had ever heard in all his years in the law.

... I told myself that Dr. Spiegel—the first psychiatrist to go into combat in World War II and come home wounded--was a man worth knowing... He was a doctor who made it his life’s calling to introduce people to their untapped resources and then give them credit, not himself, for the conquering of their afflictions. They were going through life on four cylinders, he would tell me, unaware of their eight-cylinder possibilities.

Herb was... so eminent that a 60 Minutes broadcast on clinical hypnosis identified him as "the leading expert in the country, perhaps in the world."

... He was forever taking the road less traveled: questioning Freud; shifting from long-term analysis to short - term therapy long before almost everyone else; and finding in hypnosis a way to get miraculous results in many instances.

... Herb had a career like no one else, altogether astonishing for its creativity and originality... He saw as many as two thousand [patients] a year... He stopped counting at 50,000, more than two decades ago.

So I must ask you: ... Was there any other person in the long history of psychiatry or psychotherapy... who did so much good for so many people over such a long stretch of time?

Richard Kluft, M.D. …Herb approached issues and people with an admirable candor that was succinct, honest, and direct...

When people are so good at some particular skill or activity that they make it look easy, it is always possible that others… may come to the erroneous conclusion that what they have witnessed was easy. Perhaps because of what many of us have come to appreciate as the graceful elegance of Herb’s work, with its underlying intellectual athleticism and sophistication, and its powerful potential for the understanding, exploration, and healing of the mind, many people in the hypnosis field have been unable to appreciate the magnitude of Herb’s contributions and gifts to his colleagues.

... Herb Spiegel... developed a delivery system for hypnosis so compact, so portable, ... and, dare I say, so lean and mean, that it held the potential to be learned and applied by practitioners who would never... use traditional methods because they were difficult to fit within the time constraints of their clinical work. It was abundantly clear that Herb’s approach might have profound public health implications, and be used in many settings, medical as well as psychological, to reduce human suffering.

… Herb will be remembered most for his research, his demystification of hypnosis, his novel approach to measuring hypnotizability, the Hypnotic Induction Profile, his character typologies, his technical innovations, his virtuoso demonstrations, such as his incredibly important "Honest Liar" demonstration, and the public health implications of his one-session approach to smoking cessation…

…Herb was good because he was brilliant, courageous, creative and a great observer. He was great because he brought what I will call, for lack of a better word, love, to his pursuit of truth and his endeavors to relieve his patients’ suffering and distress.

…Today we honor the memory of a giant. An amazingly kind, caring, creative, thoughtful, modest, funny and honest giant. A giant all the more remarkable because he never asked us to emulate him or follow in his footsteps, but encouraged us to become the best we could be, and do the best we could do to advance science and to cure, or at least comfort, our fellow man.

Philip Muskin, M.D. I first heard about Herb Spiegel in 1971…I met Herb a few years later when he was still teaching the course at Columbia...And then, for the next 30 some odd years I watched Herb teach the residents on the consult service...

... Herb had an overt secret which has been somewhat suggested. He realized that the trance state is just a normal state of the brain. You have to learn how to use it but you actually experience it all the time and, he would say that, all the time: "This is nothing you have not experienced already. You go into trances, you just don’t know how to use them."

... And, some people like Grade 5’s, may go into trance and it causes them some problems. Some people wish they could, but 0’s and 1’s have less of that plasticity in the brain. But that wasn’t the secret. The secret was that using hypnosis requires skill and creativity. He never said that. He kept it secret because he expected people would get it.

... Though he would sometimes be publically anti-analytic, he was not anti-unconscious; he was not anti-dynamic. He was just anti getting locked into any one theoretical idea and closing out other theoretical ideas. He was a great clinician and a great teacher.

... Herb recognized that hypnosis isn’t a therapy; hypnosis is a process by which you can do therapy... Herb said that over and over again. And if you listened carefully you could hear him say: "It isn’t trance, it's how you use it." And that is a remarkably creative process.

... Herb was always accessible and very few are. When I saw my first Grade 5 who had epilepsy and her eyes disappeared, I called Herb immediately. He said:" I published a paper in 1974 about this." I went into the stacks; in those days we still had stacks at the old PI, and got that paper. I called Herb and said: "Now what do I do." He told me: "Here’s what I would suggest you try." Very few people are accessible like that.

…Herb was not extraordinary. He was charismatic, but he was not Mesmer. What he did in the many years I watched him teach, and in later years he and Marcia teaching together, was that he was regular – he was the most regular guy I ever met. And, because of that, hundreds of residents here at Columbia and thousands of people around the world were exposed to a truly remarkable internal capacity that most people never learn how to use and most health care professional never learn.

What’s so special about Herb was his ability to translate what he knew in a way others could be inspired. And for me, that’s what I will miss – that opportunity to hear Herb talk and hear Herb share. Herb’s self-disclosure goes back many decades in a way that was completely open about how he came to understand what he does. I think very few of us are capable of doing that.

I will miss him very much.

Edward Frischholz, Ph.D. Herb was a pioneer in the fields of clinical and experimental hypnosis, medicine, psychiatry, forensic psychiatry, military psychiatry, academic psychiatry, psychological assessment, cognitive neuroscience, and cognitive psychotherapy. *

Herb discovered the Eye Roll Sign in 1965. He later postulated it was a biological marker of innate dissociative trance capacity... He developed the Hypnotic Induction Profile (HIP) in the context of teaching... the importance of understanding and working with an individual’s hypnotic capacity, rather than trying to talk everyone, regardless of their innate ability, into a trance state. He turned the hypnotic induction into a deduction – all in five minutes! *

…Herb’s discovery of the Eye Roll led him to develop both a unified and testable "bio-psycho-social theory of hypnosis."... Herb later clarified that the Eye Roll was a biological sign while the summary induction score of the HIP [Hypnotic Induction Profile] was comprised of multi-item behavioral and psychological samples.

Herb predicted that the Eye Rolls of patients suffering from a reliably diagnosed form of schizophrenia or... other type of thought disorder (that impaired focal concentration) would be significantly lower than average. In contrast, he also predicted that the Eye Rolls of patients suffering from a reliably diagnosed dissociative disorder (where too much focal concentration on one thing would lead to amnesia for other things) would be significantly higher than average. These... predictions about the ERS were empirically confirmed and published in... The American Journal of Psychiatry. *

I know much to Herb’s chagrin, many in the fields of psychology or psychiatry remained skeptical about the validity of the Eye Roll Sign or failed to routinely assess it... And I have to confess that initially I was one of the disbelievers... I sought to empirically invalidate the theory underlying the Eye Roll... I know this fact amused Herb as much as it vexed me. He always loved it when my computer agreed with the computer in his brain…

I hope... [my remarks] reflect how he wanted to be remembered for the remarkable discovery of the Eye Roll Sign.

Thank you Herb.

*Parts taken from: Frischholz, E.(2010). In Memoriam: Herbert Spiegel, 1914-2009, Int J Clin & Exper Hypnosis, 58(2), 247-249.

Elvira Lang, M.D. Herb Spiegel has touched so many different lives in so many different ways. I will share with you how he has influenced my life and my work...

I’m an intervention radiologist so I do surgeries with patients who are awake. And I thought there has to be a better way than drugging people out to get them through a procedure... One day, just by accident, I saw how hypnosis could get an extremely scared patient through a procedure. I thought – this is good. And I was lucky and fortunate enough that David Spiegel was at Stanford and able to work on this with me. So, I not only owe David the first hypnosis I ever experienced but also inspiration for a clinical trial we were going to do.

Watching Herb teach really gave me confidence that one can do this kind of work... with Herb you see someone who immediately gives you the confidence to say: "OK, I can do this. And, above all, I can do this quickly."

In my line of work… if you come up with a new therapy and it doesn’t go fast, just forget about it... And so Herb, looking at his watch, announces it’s been 4 minutes and 30 seconds. He tells the patient: "You have entered hypnosis, experienced hypnosis and been reoriented." And, I thought, I can do that, 4 ½ minutes, it’s just fine.

... I read a paper in which Herb Spiegel describes how he found the Eye Roll. There must have been thousands and tens of thousands of people and hypnotists who at some point stared into somebody else’s completely white eyeballs – its freakish enough not to notice it – but to take that and tie it together with other observations and... come up with a whole concept of neural wiring... scientifically test it, and publish it - that is... what brings the field forward. From a research point of view this showed absolute genius…

And, lo and behold, his theory about the neural wiring of vertical eye movements, the ability to enter trance and hypnotizability in general, now we have objectified it with functional MRI and sophisticated electrophysiological measurements.

…I also want to thank Dr. Herbert Spiegel for the many contributions he has made to SCEH (Society for Clinical and Experimental Hypnosis) and his dedicated teaching. Dr. Rick Kluft has so eloquently acknowledged Herb’s enormous contributions in the Living Treasure Award, which was established for Dr. Herbert Spiegel from SCEH.

... Herb lives on. Not only through his tremendous contributions but also through the many, many people he has taught who are teaching others. Herb, as a great teacher, will live on forever.

Eric Vermetton, M.D., Ph.D. The width of the contribution and talent of Herbert Spiegel is enormous. It goes far beyond the simple introduction of the HIP. It started long before, and can be read in Trance and Treatment and other contributions. The development of the HIP was embedded in a wider clinical set of observations that came out of war psychiatry...

... Lessons from the combat psychiatric triage concept were elementary for what...was rooted in Herbert’s orientation to psychiatry and hypnosis. ...I very much like the wording Herb chose, "Hermeneutic narrative," because it relates the world observation with a set of verbal descriptors integrating understanding, interpretation of symbolic meaning and appreciation. I relate to the framing of Herbert when he described in his first inauguration of the Herbert Spiegel Lectureship here at Columbia University how the psychological rearranging of reality was observed to be a valuable coping skill that some men were able to do more easily than others…

…This was explained and described by Kardiner and Spiegel in 1947 as "physio- neurosis" – a condition now labeled as PTSD. He differentiated disease from illness behavior. And, as he states in the chapter "Silver Linings in the Clouds of War: a Five Decade Retrospective," "patients displaying illness behavior (when the reactive components to a physical and/or psychological trauma are primary) without significant biological co-morbidity… can be "assessed on the fix-flex continuum to determine appropriate psychotherapy along a spectrum of exploration, confrontation, consolidation, persuasion, and/or supportive care… Timely, common sense intervention strategies are critical. Delay fosters incipient secondary gain and promotes invalidism...With this clinical model, persons are encouraged to tap their imagination and motivation to explore possibilities for the future. The therapeutic alliance is used to affirm the individual's resources and develop a meaningful direction to live life as an imperfect human in the context of an imperfect world." *

I am grateful for having had the opportunity to learn from Herbert, and the opportunity he has given hypnosis to modernize itself…

Thank you Herbert for your insight and contributions to psychiatry and hypnosis.

*Spiegel, H. (2000). Silver linings in the clouds of war: A five decade retrospective. In Menninger R & Nemiah J: American Psychiatry After World War II (1944-1994). Washington, DC: Am Psych Press.

Jack Barchas, M.D. It’s a great privilege to say something about Herbert Spiegel because he was such a towering and great figure in American psychiatry – really world psychiatry. He was a great force here at Columbia ...he had this ability to work without boundaries and to be a citizen in many places.

... I first met him in the late 60’s because he had come to Stanford. David Hamburg was the Chair [Department of Psychiatry] at that time. Dr. Hamburg... felt that Dr. Herbert Spiegel was a truly heroic figure who was so far ahead of everyone else in terms of what he did that it was simply stunning...

I can remember reading his book about war and psychiatry as a resident. I saw him through the years at Stanford, at the Spiegel home, and... over the 16 years I’ve been in New York, he would come to Grand Rounds at Cornell... He was always so alive and bright and interested. He had this sort of ether around him that always radiated energy. It was quite a remarkable thing.

... If you try and make a list of the people who have profoundly influenced psychiatry over this past century, Herbert Spiegel has to be in that very small group... Dr. Spiegel was … so far ahead of everyone else in terms of what he did, it was simply stunning…

I think he’s a heroic, a significant and an historic figure... a trailblazer. The reality of it is, he actually was a genius at a very, very high level.

David Spiegel, M.D. I want to thank you all for being here to honor my Dad’s memory, to celebrate and continue the tradition of our beloved hypnotic heavyweight...

... Dad’s hypnotic and therapeutic skill lay in making it clear he was not there to cure you but to help you cure yourself. Hypnosis was a tool you would use or not use. He was not doing it to you, he was doing it with you. His brilliance was in his capacity to be intensely engaged and observing at the same time. His supervisor, Harry Stack Sullivan, referred to that as participant observation. The process of having a real human relationship yet being able to step back and observe it... Dad would call it being an Odyssean which he was... engaging in an adventure like the mythical hero Odysseus and then stepping back from it. Dad avoided the Scylla of Mesmeric mysticism and the Charybdis of scientific rigidity. Dad loved to say: "If you can measure it, it’s science, everything else is poetry." He did both.

... Dad initially developed the Hypnotic Induction Profile, a remarkable five-minute test of hypnotizability, as a teaching tool for the PM4 Course at Columbia. He was searching for a way to illustrate to his students that you didn’t need charisma to be a good hypnotist – you could elicit the phenomena if the subject had the ability in a very rapid and straightforward way. He took the concept of hypnotizability seriously and made it usable in the clinical setting. In five minutes he [could] turn the hypnotic induction into a deduction, a learning experience for both the doctor and the patient. The doctor learned how to proceed; the patient learned about their own capacity, how their minds could control their body, how they responded to cues they were not even aware of. He then taught us that among the two-thirds of subjects with useable hypnotizability, you could tailor your treatment approach to their personality style – he called them ‘mindstyles.’... He met patients on their own terms…to provide them with a perspective without trying to change them into something they were not and never could be...

…Dad thought for himself-he made a science out of the art of hypnosis and an art out of the science in psychotherapy...[He]... was always ahead of his time: learning psychoanalysis when descriptive psychiatry was everything; becoming an interpersonal psychoanalyst when classical psychoanalysis was everything; empirically assessing the outcome of treatment when process was everything; measuring hypnotizability when the artistry of induction and deepening techniques were everything; pioneering cognitive restructuring when 'why' you did things was more important then 'what' you thought; understanding the neural trance when the mind seemed more important than the brain...

I am so thankful that he had so much time to be ahead of his time. We – his family, his friends, his patients, his students, his colleagues, are so much the better for it. We are still entranced.

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