1. TRANCE AND THEORY OF MIND:AN EVOLUTIONARY POINT OF VIEW
Ambrogio Pennati *, MD, psychiatrist, private practice, Milano, Italy pennati.ambrogio.md@fastwebnet.it
Giampiero Mosconi , MD, psychologist, private practice, Milano, Italy giampieromosconi@virgilio.it
Italian Medical Association for the Study of Hypnosis (AMISI, www.amisi.it),
President and * VicePresident of AMISI

2. EvolutionaryPsychology and Psychotherapy
Evolutionarypsychologyseemstobe a euristically fertile approachto life sciences, suchas medicine, psychology, economics, sociology. Althoughthereisnot (and wehopethatwillneverbe) anevolutionarypsychotherapy, suchpointofviewcouldoffernewperspectives in psychotherapy, as some experiences in jungian and freudianpsychoanalisys, cognitive-behaviortherapy, systemictherapysuggest.

3. EvolutionaryPsychology and Hypnosis
As a matter of fact, onlypioneeristic, short and merely speculative papersabout the relationshipbetweenevolutionarypsychology and hypnosis are available. Wethinkthat the evolutionaryperspective in the study of hypnoticphenomenacould generate newresearch and newconceptualizations in ourfield. Wethinkthat at the coreofEricksonian work thereisanimplicitevolutionary way ofthinking, notfullyblossomedbecauseof the zeitgeist in whichheoperated.

4. A paradigmaticshift
Evolutionarypsycvhologysuggeststhat a shiftfrom the Standard Social Science Model (and itscorollaryofhuman mind asblankslate) to the NaturalisticModelcouldbeuseful in bypassingmostof the conceptualconundrumsofpsychotherapy.
In our case thisshiftcould bypass the state or process issueofhypnosis.
The evolutionaryapproachidentify the abilitytodevelop trance experienceasoneof the mostimportantadaptativemodule in the in the brainfor the individual, the group and the specie.

5. Definitionof Trance
Weoperativelydefine the trance asanAltered State ofConsciousness (ASoC) in which the followingphenomena can consensuallyoccur in a statisticallysignificantpercentages:
Dissociationbetween executive and monitoringfunctionof the Self
High frequencyofideodinamicbehaviors
Verbal and/or motor inhibition
Extremefocusingofattention, internal or external
Facilitationofautoreferentialthinking
Mnesicalterations
Changes in quality and quantityof the timeexperience
Changes in quality and quantityofperceptualexperience

6. The AdaptativeValueof Trance
Social value: increasedgroupidentity, dischargeamong the groupofpeersofotherwiseunacceptablefeelings, self-trascendence, facilitationofmeme-relatedcomplexes, facilitationofmimeticlearning
Individualvalue: self trascendence, modulationofpain, modulationof immune system, modulationofautonomicresponse, increasedefficiencyoffight or flight response, increasedefficiencyofmatingstrategies, increased chance ofactivationofinternalhealingmodules (seebelow)
Biologicalvalue: increasedprobabilityofselectionof the fittest gene or memebyreshufflingofgenetic and memetic pool (ritual and/or orgiastic trance)

7. The EvolutionaryValueofRapport
The mirrorneuronssystemsseemsto play a determinantrole in the abilitytodevelopempathicrelationshipsamonghumans. Suchrelationships are essentialfor the survivalstruggle and reproductive success of the individual and the group, gene (kin) or memerelated. Empathiclearningmaybeactivatedwithoutawareness (procedural), and thereforeitcouldbe more efficient and resilientthan the declarativelearning, whichreliesuponlinguistic and eideticstructuresof information.
WecoulddefineAlteredStates of Consciousness (AsoC) inductors the multifacetedproceduresthat Homo Sapiens utilizedtoachieve trance states. Suchinductorsrelyupon the empathicrapport.

8. Theory of Mind: a Definition
Theory of Mind isgenarallydefinedas the specific cognitive abilitytomakeinferencesaboutmentalstates beliefs, willings, drives, etc - of ourselves and of others. Suchabilityallowsustounderstandathatmentalstatescouldbe the cause of behaviors of the others, and thatthereforesuchbehaviors can bepredicted,can be

9. ToM: AdaptativeValue
The mainhypotesisabout the development of the abilitytohaveToMisthatsuchabilityisassociatedto the incrementalcomplexity of humanrelationships, strictltyrelatedto the increasingnumber of people constituive the primalgroups of homo sapiens. The primaryaimistounmaskcheater and strengthenintragroupcohoperation.
Suchability, detectedalso in big apes, takesplace in the man at the age of 4 ys, as the linguistic competence.

10. ToM and NeuralSystems
Widelydistributedneural System (reviewSiegal & Varley, 2002)
2) Narrowlydistributedneural System (review Gallagher & Frith, 2003)

3)Neural System differientatedby the tipology of requestedmeta-rapresentation (itself vs others(reviewAbu-Akel, 2003)
4) Neural System representative of the evolutionarysteps (reviewSaxe, Carey & Kanwisher, 2004)

11. ToM and NeuralSystems
Twobrainareasseemstobeactivated:
Superiortemporalsulcus (STS) and bothtemporallobes; theiractivationplays a supportiveindirectrole in the abilitytomentalize
(STS) seemstobeengaged in processing of esplicitbehavioralinformations, suchas the perception of intentionalbehaviors
temporallobesseemto play a key role in the processing of personal and episodicmnesic data, which are involved in the ToMactivity

12. ToM and NeuralSystems
Moreover, AnteriorCingulateCingulus (ACC) isdeeplyinvolved in the abilityToM il giro cingolato anteriore (ACC); ACCisstrictlyrelated in the regulaton of motor activitymarousal and cognition
Recentneurophysiological data suggestthat the abilitytomakeinference on the mental state of the others and toempathizewiththemislinkedto a decrease in activity of the cortex of anteriorcingulus; hypnoticinductionseemsto generate the sameeffect.

13. Trance, Rapport, Hypnosis
Fromanhistoricpointofviewhypnosiscouldbedefinedas the processof the complex, bidirectional, fluctuactinginteractionsbetween
ASoCinductorsrecognizedby the western scientificcomunityasempiricallyvalidated and useful in medicine and psychology , accordingto the scientificparadigmof the zeitgeist, and
The trance statesobtainedfollowingsuchinductionprocedures

14. Trance, Rapport, Hypnosis

15. Hypnosis and Psychotherapy
Psychotherapycouldbeoperationallydefinedaseverymodalityofhelping people in copingwith stress, emotionalproblems, relationalproblems, or problematichabits; suchmodalities share the factofbeingall treatment based on talkingotanother people and doingsomethingtogether (RCPychiatrists).
Hypnosiscouldbetherapeuticbecauseboth the induction procedure in s (modeling, emotionaltuning, procedurallearning, based on rapport, ofnewbehavioral or cognitive adaptativestrategies) and hypnotic trance (emotionalreleaseofotherwiseunacceptablefeelings, activation on internalhealingmodules, self-trascendence).

16. Hypnosisassynergicisticempowermentofinnerhealingresources
Hypnosiscouldbeinterpretedas the potentiallymostpowerfuldevicetoactivateinnerhealingresourcesthanksto
Interpersonal powerofrapport
Intrapersonalpowerof trance
thatsynergicallyactivatedinternalhealermodules.

17. Hypnosis and EthiopatogeneticalModelsofIllnesses
The majorityofpsychotherapeuticapproachestriedtodevelopetiopathogeneticalmodelsofdisorderscoherentwiththeirpostulates, butallthesemodelslackofstatistical and scientificvalidation. Hypnosistoosearchedfor a coherentmodel (neodissociative theory), butalso in this case empiricalvalidationisinsufficient or absent.
Metaanalysises show thatthereis no evidence (ie, directlylinkedto the model) of the superiorityof a theoreticalmodelamong the others, and thataspecificvariables are the key factors in the efficacyofpsychotherapies.
Therefore, everytheoreticalapproachtopsychotherapyseemstobemerely speculative.

18. Recentempirical data
Data fromclinicalfieldsuggestthatempatethicalsharingofmemes (beliefs, values, social rituals, ideasabout the cause of the illness) with the clients can enhance the responsetodifferenttreatments.
Sincethere are no evidencesofsuperiorityof a modelofpsychotherapyamong the otherswe can suppose that building a memeticrapportempatheticallybasedis the best operative option in psychotherapy.

19. The Ericksonian way
Nowadayswe can think at Milton Ericksons work as a pionieristic, revolutionary way ofthinking and workingbased on implicit, intuitive evolutionaryapproachtoclinicalactivity. Suchapproachisrooted in shamanictraditions and overtlyproposedby ME in his look and style. ME optimizedhisskillswithanthropological and psychiatricstudies, lookingfor social and biologicalbasisof trance induction and trance states.

20. Hypnosis in Psychotherapy and HypnosisasPsychotherapy

21. Hypnosis in Psychotherapy and HypnosisasPsychotherapy
Hypnosis in psychotherapycouldenhance the effectivenessofdifferentapproachesthroughelicitationofrapportmodules; itisbased on empathiccommunicationskills
Hypnosisaspsychotherapycouldenhanceself-trascendence and innerhealermodulesthroughactivationof trance states

22. Placebo, Hypnosis, InternalHealer
As internalhealer we can identify the biochemical and neurophysiologicalmodulesof placebo:
increasedopioid and dopaminergicactivity
reduction in anteriorcingulatecortexactivity
modulationof immune system
modulationof social neuroendocrine pathways

23. HypnoticPsychotherapy
Hypnoticpsychotherapy can bedefinedas the structuralblendbetweenhypnosis in psychotherapy and hypnosisaspsychotherapy. Itisbased on
Rapport
Trance
Theoryof Mind consciousactivation
In the contextof the aspecificfactorsthatconstitute the goodclinicalsetting.