Hypnotherapy and Irritable Bowel Syndrome (IBS)

The medical profession cannot be sure of the causes, nor have they suitable treatments for IBS, new drugs that may be effective in some individuals are mainly prohibitively expensive for sufferers. Hypnotherapy in the UK and elsewhere has been shown to help in the vast majority of cases of IBS sufferers. The writer is aware of at least one hospital gastroenterology department with its own hypnotherapy team alongside. Hypnotherapy is non intrusive, safe, comfortable and a cost effective and complementary to use along side mainstream medicine, some in the profession would in this case argue ¬Ďalternative’ since the medical profession are generally at a loss with this condition.

Just dealing with the symptoms of IBS is not enough, the individual has to learn to rebuild internal energy, many sufferers feel drained emotionally, and life issues and responsibilities continue to deplete inner emotional strength, leading in some cases to anxiety or even some forms of depression. Before the sufferer even thinks of working through the IBS, they invariably need an emotional ¬Ďpop-up’, they need their batteries charged, after perhaps years of pain and discomfort, of being told by various medical professionals that there is nothing that can be done, even though intrusive and sometimes painful examinations have been undergone, many sufferers feel emotionally drained.

Work and family relationships can be eroded and strained, social life and love life can be virtually non-existent, concentration and recall, may be almost impossible compared to how it used to be, confidence and self esteem of the individual is often very low, and the ability to see things in perspective is greatly reduced. Therefore to tell a sufferer that they must do this or that, without preparing for the journey is almost certain failure.

Hypnotherapy, when conducted correctly can increase self-esteem, confidence, and allow the sufferer to begin a journey of self-improvement and management, by changing their thoughts, changing negative thoughts and feelings for positive ones and thereby equip themselves emotionally to move away from the symptoms and thoughts of IBS and begin moving forward, a journey that many sufferers have or are taking at this moment. Hypnosis represents a brief therapy, which is benign, noninvasive and inexpensive.

Since IBS symptoms are cyclical in nature, the results of any therapy must be evaluated over a long period of time. The greater the number of hypnosis sessions, the longer lasting the relief the client gets. While many clients will report symptom relief after one or two sessions, unless they come back for multiple sessions spaced over a period of three to four months, they will notice a gradual ‘creeping back’ of their symptoms. Clients following the multi-session approach have now maintained their symptom improvements for up to five years after the sessions ended and still counting.

In today’s insurance of managed care system, hypnotherapy is being embraced. It is imperative, however, that you work closely with the client’s personal physician and that you not accept clients who have not gotten a definitive diagnosis of IBS. Successful IBS clients will build a practice for you.

What makes hypnotherapy different than cognitive therapy? Cognitive counseling deals with issues at a cognitive level; and many of life’s problems require just that. When someone has to make difficult cognitive decisions, competent professional help is absolutely essential. For example, hypnotherapy is not a substitute for marriage counseling. But when it comes to changing habits or behaviors regulated by the subconscious, there is nothing faster than competent hypnotherapy to facilitate subconscious change.

Can hypnosis be used to reduce pain and/or suffering from illness? Pain is a warning that something is wrong with the body, and it needs to be diagnosed by someone qualified to do so. Any competent hypnotherapy instructor emphasizes to his or her students the importance of requiring a written referral from an examining physician before ever using hypnosis to reduce pain or other physical symptoms. The exception (for those who are not licensed to practice medicine) is if the examining physician is physically present and/or is supervising the hypnotic process.

Since the time of a Hypnotherapist is not nearly as expensive as the time of a physician, hopefully there will be greater cooperation between the medical profession and the hypnotherapy profession in the future. A competently trained Hypnotherapist should know, even with a medical referral, when to simply use hypnosis for symptom removal, and when and how to use hypnosis to search for subconscious causes of the symptom(s).

Hypnosis can make a difference even with major disease. Hypnosis can be used to reduce pain. Hypnosis can be used to quit smoking. Hypnosis can be used for weight reduction. Hypnosis can be used to overcome phobias. Hypnosis can be used to reduce stress or anxiety. Hypnosis can be used to control irritable bowel syndrome.

Standard medical methods currently used to treat irritable bowel syndrome (IBS) are of some help to the majority of people with the disorder. However, up to half (1) of IBS sufferers are dissatisfied with the results of standard medical management, and many continue to have frequent symptoms after seeing doctors about them. In recent years, other alternatives have been sought to help these individuals. There has been growing interest in the possibility of using the mind to soothe the symptoms of IBS.

Mental states clearly affect the way the gut behaves in people with IBS, and in fact, also in people who have no gastrointestinal problems. Although IBS is probably not caused by stress directly, it is well established from research that psychological stress increases the symptoms of many people who have the disorder. If the mind can have such a powerful negative influence on the intestinal tract, it would seem to make sense that the mind could be used to have a positive or calming influence on the intestines.

Hypnosis for IBS The results of the first formal research study on hypnosis treatment for IBS were published in the Lancet in 1984. The investigators, Dr. Peter Whorwell and his group in Manchester in England, reported remarkable success from a seven-session hypnosis treatment of 15 patients with severe IBS problems who had not responded to any other treatment. All 15 patients treated with seven sessions of hypnotherapy improved, with dramatic improvement seen in all the central symptoms of IBS.

The researchers furthermore showed that this therapeutic impact was not merely due to belief or expectancy of improvement, because a comparison group of 15 IBS patients who were instead treated with the same number of psychotherapy sessions and also received placebo pills (pills with no medication) showed only slight improvement. This was a powerful demonstration of the impact hypnotherapy could have on IBS, and led to considerable subsequent interest in this approach to IBS treatment. Since this first report, more than a dozen other published research reports have confirmed that hypnosis treatment is effective in treating IBS.

Generally, the treatment procedures reported in the literature consists of 4 to 12 sessions (shorter treatment than 7 sessions may be a bit less effective). Hypnosis sessions are typically conducted weekly or once every other week, last 30-40 minutes and consist of induction of hypnosis followed by deep relaxation and the use of gut-directed imagery and suggestions. Patients are commonly given short audiotape hypnosis home exercises to use during the course of treatment in addition to the sessions with the clinicians.

Although it is by now well established that hypnosis treatment often improves the symptoms of IBS, it remains a mystery exactly how hypnosis influences IBS in such a beneficial way. A research team has conducted two studies to try to shed some light on this issue, using completely standardized seven-session protocol with written hypnosis scripts where all treated patients receive the same exact hypnosis treatment word for word.

The first study (6), which was the first hypnosis group trial for IBS in the U.S., was conducted in Dr. Whitehead’s research laboratory at the University of North Carolina at Chapel Hill in 1995-1996. In this study, the focus was to understand how the treatment influenced the intestinal tract, by measuring changes in rectal pain sensitivity and gut muscle tone with a computerized balloon inflation test. The study found no significant changes in pain sensitivity or muscle tone in the gut after hypnosis treatment. However, 17 of the 18 treated patients, all of whom had unsuccessfully tried conventional treatment methods, rated their IBS symptoms significantly improved after treatment. It should be noted that the Manchester group has also conducted two studies to examine the changes in the gut after hypnosis treatment. They similarly found no overall changes in gut pain sensitivity (although in one study (16) a subgroup of the most pain-sensitive individuals showed reduced sensitivity) nor muscle tone changes after treatment, even though the clinical symptoms of their patients improved.

The second study (7) at Eastern Virginia Medical School in Norfolk, Virginia, to examined whether the effects of the hypnotherapy on IBS could be explained by treatment changes in nervous system activity, and also to test further our standardized treatment protocol. Twenty-four people with severe IBS were treated with the standard protocol, and measured the activity of the autonomic nervous system (the part of the nervous system that automatically controls the body’s inner functions) in various ways before and after treatment. It measured sweat gland activity, heart rate, blood pressure, skeletal muscle tension, and skin temperature in the participants, both at rest and in response to a standard mental stress task (problem-solving under time pressure). Twenty-one of the 24 patients (87.5%) treated in the study improved substantially and maintained their improvement at 10-month follow-up. The only change we saw after hypnosis treatment in the nervous system data, however, was a small reduction in sweat gland activity, suggesting somewhat lessened physical stress. This suggests that changes in the mind’s interpretation of, or attention to, signals from the body play some role in the improvement.