This article will explain some of the scientific background regarding how hypnotherapy can help IBS. I do believe that hypnotherapy can and indeed hopefully will help your Irritable Bowel Syndrome (IBS) symptoms.
Scientific evidence showing how hypnotherapy helps IBS
I run a structured IBS programme using hypnotherapy in London. We look at how your IBS or similar gut or digestive symptoms are affecting your daily life. Using advanced hypnotherapy I will help you identify emotional and thought process causes that are exacerbating your IBS symptoms. Treatment of IBS can be session by session. In central London, I also run a six session gut directed programme using hypnotherapy to help IBS symptoms. Together we will ensure that you are starting a new chapter of calmer digestion. We look at the underlying causes of your gastrointestinal (GI) symptoms. This includes looking at those frustrating or sometimes embarrassing symptoms you can experience, such as pain, constipation, diarrhoea, bloating and so on. For more about my hypnotherapy for IBS sessions click here.
Getting past the misinformation and mystery of hypnotherapy help for IBS
Hypnotherapy is a form of therapy which can still hold an aura of mystery. This, unfortunately, continues even now due to misrepresentations in films and the use of hypnosis by stage hypnotists for entertainment. You may be familiar with well known entertainers who use hypnosis, such as Derren Brown. It can be easy to be worried that you will not have control or will be forced into doing things you do not wish to. In truth, there is little to fear or worry about since hypnotherapy is totally safe. Your hypnotherapist will be well trained. During any hypnotherapy work, you will be aware at all times and able to open your eyes if you wish to. You are not sent into an unconscious state in which you are rendered powerless. Ensure you ask all the questions you may have before starting your treatment. As an IBS hypnotherapist, I always encourage people to ask as all questions they may have and I try my best to ensure you feel comfortable and are aware of exactly what will happen during sessions.
Indeed, as we will explain in this article, hypnotherapy helps IBS symptoms by using a treatment protocol called ‘gut directed hypnotherapy’. This has been tested in trials and is not just safe but works better than many alternative IBS treatments. I frequently use this well-researched form of hypnosis treatment. Gut directed hypnotherapy has been accepted as a treatment protocol by the American Medical Association and the American Psychological Association. Clinical hypnotherapy is currently used by thousands of hypnotherapists across the globe to treat both psychological and medical problems.
In the UK, the NHS also mentions the use of hypnotherapy to help IBS. Indeed I receive on a weekly basis referrals from NHS and private gastroenterologists. Since, as we will mention, gut directed hypnotherapy addresses the communication between the digestion and brain (the brain gut axis) hypnotherapy can provide some support also for conditions such as Colitis, Fibromyalgia, Chronic Fatigue Syndrome or Chronic Pain. Until recently, the efficacy of using hypnotherapy to help gastrointestinal symptoms had not gained much attention. In the last 20 years, however, clinical studies have shown that hypnotherapy for IBS can positively effect gastrointestinal functioning in extremely effective ways. Studies have shown also that hypnosis treatment can be particularly effective in helping people living with irritable bowel syndrome (IBS) and to better control nausea and also vomiting.
How hypnotherapy help for IBS works
Hypnotherapy creates a relaxed and calming mental state in which a person’s attention is drawn to focus on a narrow zone, letting go of concern for objects or thoughts in the wider field of thought or vision. This narrowing of attention is exactly the same as when someone concentrates on a book or movie. The attention becomes much narrower and intense, just like the light of a laser beam of torch. in a darkened room. This state is usually created with the support of a hypnotherapist who guides the person to relax, and bring that relaxed attention to focus only on certain images or words. Whatever the mind is guided to focus upon while in a hypnotic trance, will hold the entire attention. Therefore, it is often the case that people will experience images or memories in a more vivid way and more clearly than under usual circumstances. This is why people can sometimes remember events from the distant past under hypnotherapy, whereas they are less able to do so in a normal waking state. The narrow hyper focus of the hypnotherapy trance is also why therapists using hypnotherapy will frequently help clients form strong positive changes in their emotional or even physical functioning. Hypnotherapy can be compared to a magnifying glass, bringing into focus the mind’s focus and works well to influence the body and emotions.
Clinical hypnotherapy for IBS uses word suggestions, imagery and relaxation tools to produce its therapeutic effects. Hypnotic suggestions are words used by a hypnotherapist and guide you to considering new ways of acting or thinking. These can be changing behaviour or habits or simply viewing life in a more positive way. Due to being in a focused and receptive state of mind, the hypnotised person can use these suggestions to make changes quickly almost without conscious decision or effort. For example, if someone is given a suggestion during hypnotherapy that their arm may be getting heavier, they almost certainly will very soon feel it becoming heavy, without actually trying to do anything to cause that heavy feeling. This feeling that changes are happening by themselves, is considered by some to be the hallmark of hypnotherapy. It is often surprising to people experiencing hypnotherapy for the first time.
Hypnotic imagery will consist of picturing events, situations or places in a way that creates a desired positive effect. For example, someone undergoing a dental procedure might be taught by a hypnotherapist to enter a hypnotic state and in so doing experience pleasant feelings and block out any pain felt. When successfully carried out, the person can get completely engrossed in the vivid and enjoyable imagery and will therefore be happily unaware of the pain of the procedure. The hypnotic state is almost always accompanied by relaxation and the physically calming experience is often increased further by the therapist through suggestions and relaxing imagery. It is true to say that some of the benefits resulting from hypnotherapy treatment are often the result of the relaxation that is integral to the hypnotherapy treatment.
Teaching clients how to use hypnosis themselves (self hypnosis) can form a part of an IBS hypnotherapy session. Over decades of clinical research and client sessions, hypnotherapy has been shown to have outstanding and valuable therapeutic uses. Psychotherapists and other talking therapy have sometimes made use of hypnotherapy to use a different perspective or to speed up the therapy process. This might take different forms, for example, by enabling a client’s self-understanding, reducing unhelpful habits, uncovering repressed or forgotten memories, reducing feelings of anxiety and also phobias, and helping a person to take on a new and more helpful or positive outlook. In medicine and health psychology, hypnotherapy can be used to reduce the pain and discomfort associated with medical procedures, which can include childbirth, treatment of burns, or even surgery where anaesthesia cannot be used effectively. Hypnotherapy can also be used to reduce chronic pain and psychosomatic conditions or to reduce unhealthy lifestyle habits that may result in illness. In dentistry, today it is more common to see the use of hypnotic analgesia as a needle-free alternative to topical anaesthetic drugs, reduce bleeding and the pain associated with oral surgery. Hypnosis has been used to treat teeth grinding, thumb sucking or picking at skin.
How hypnotherapy can help IBS and gastrointestinal functioning
Over the past decades the effects of gastrointestinal functioning and GI symptoms have been researched thoroughly. Hypnotherapy alone, even without any particular suggestions, does itself slow down the irritation or unneeded movement of the digestive tract and gut. Concrete and specific alterations in GI functioning can be effectively induced by focusing the attention via hypnosis or guiding the attainment of specific emotional states under hypnotherapy. For example, one clinical study [1] found that when healthy participants were hypnotised and given a simple instruction to relax, the orocaecal transit time (the bowel transit time is the time it takes food to move from the mouth to the first part of the colon) was increased from 93 to 133 minutes. Another study [2] found that the hypnotherapy trance state decreases muscle movements in the stomach. This same study also showed that the emotional state of happiness, created under hypnotherapy, would also suppress gastric muscle activity. However on the other hand anger and excitement would increase muscle movements in the stomach. Two studies [3] have demonstrated that when participants were guided to utilise the imagery of eating a tasty meal while they were under hypnotherapy, surprisingly their gastric acid secretion was increased by 89%. Indeed the acid production of the stomach could in turn also be deliberately decreased during hypnotherapy using similar hypnotic suggestions.
Approximately fifty published studies have reported on the positive effects of hypnotherapy on reducing nausea and vomiting concerns related to chemotherapy, post surgery, and during pregnancy. In conclusion, there is a substantial body of research which indicates that hypnotherapy can be a powerful tool to control nausea and vomiting. Hypnotherapy can be helpful in preventing gastrointestinal problems from resurfacing after treatment by medication. One study [4] looked at a group of thirty patients with relapsing duodenal ulcers. These patients had been successfully treated with medication. The study found that just 53% of the patients who received pre-emptive hypnotherapy sessions went on to relapse within one year. By contrast, all members of the comparison group, who receiving no hypnotherapy at all relapsed in the same period of time.
A 1984 study published in Manchester, England [5] and published in the journal Lancet, demonstrated that hypnotherapy IBS treatment had a dramatic positive effect on the symptoms of IBS patients who had not benefited from other treatments. In the study, patients were randomly divided, with those with severe IBS problems, into two groups. Fifteen patients were then provided with seven hypnotherapy sessions. Fifteen other patients were given seven sessions of psychotherapy, and those participants were also given placebo pills (medication with no medically active ingredients). These participants were told that they were being given a new trial of a medication for IBS symptoms. The result showed that each patient in the hypnotherapy group showed good improvement. This group showed substantial improvement in all common symptoms of IBS. The control group however showed only very small improvement in their symptoms. These positive results with treatment-refractory patients have helped encourage more studies of how hypnotherapy helps IBS. Over a dozen other studies have followed. The overall conclusions from the majority of these studies is that hypnotherapy can be shown to improve the symptoms of 80% or more of participants who lived with the “classic” IBS symptoms (pain, constipation, bloating and so on) , especially if they did not have other complications, such as a psychiatric disorder. The positive results were often maintained for at least a year following the conclusion of the hypnotherapy IBS treatment.
It is important to note that this very good rate of positive response to the IBS hypnotherapy treatment is viewable even in studies where all the volunteering participants had seen no improvement from standard medical care. The dramatic positive results of IBS patients to hypnotherapy IBS treatment leads to the question of how this hypnosis protocol actually makes changes to the symptoms in such a positive way.
To date, four studies, two in the UK and two in the U.S., have aimed to identify how hypnotherapy treatment affects IBS patients. It is well known that some people with IBS will experience unusual pain sensitivity within their intestines. This is considered to be related to the discomfort they experience. A major focus of research studies has been on assessing the impact of gut directed hypnotherapy on intestinal pain thresholds. The two British studies both looked at intestinal pain sensitivity using balloon inflation testing. The second research study also assessed muscle tone, to discover if hypnotherapy would relax the smooth muscles of the GI tract. However no clear indication of any significant changes in pain sensitivity was detected. Also gut muscle tension remained unchanged following after treatment. However a subgroup of unusually pain-sensitive participants did experience a lessening of pain sensitivity in the second study.
In 1995-1996, at the Division of Digestive Diseases and Nutrition at UNC-Chapel Hill, a study was conducted under the direction of Dr. William Whitehead. [8] The study evaluated the effects of a highly standardized hypnotherapy for IBS treatment protocol. Using written hypnosis scripts, the IBS treatment was delivered verbatim for patients, measuring their levels of rectal pain thresholds and muscle tone. Of the 18 patients treated using hypnotherapy, 17 showed significant improvement in their IBS symptoms. However, similar to the British studies, it was found that digestive pain thresholds and muscle tension were found to be unchanged following hypnotherapy treatment. A second study [9], conducted at the Eastern Virginia Medical School, used the same hypnosis treatment protocol, however autonomic nervous system functioning and blood levels of a gut hormone called vasoactive intestinal peptide, were recorded. The study looked at these regulators of GI functioning with an aim to see if they would be affected by the hypnotherapy treatment. Again, no changes in physical measurement were seen following treatment, though there was recorded a reduction in sweat gland reactivity. However 21 out of 24 treated patients did see improvement in IBS symptoms.. It should be noted, however, that in both US studies, a clear improvement in the psychological well-being of participants was observed. In summary, it is clear that in answer to the question, can hypnotherapy help IBS, the answer is clear that hypnotherapy can substantially improve all the common symptoms of IBS in the majority of study participants. Though it remains somewhat a mystery exactly how hypnotherapy brings about this clear positive change within the body of these patients.
The future for hypnotherapy helping IBS sufferers
Since there are so many studies demonstrating that hypnotherapy helps IBS and is an effective treatment, the question might be asked why hypnosis for IBS is not more widely available or more frequently offered to patients with these or similar gastroenterological problems. One minor concern may be regarding whether everybody is equally hypnotisable. General studies show that at least 15% of people are almost unhypnotisable and that even those who are able to enter a hypnotic trance will vary in their level of response. It can be pointed out that being hypnotized is really a stable mental trait. In other words, if you are able to be hypnotised today, you will also be so also in twenty years.
The good news is that most people are basically able enough to enter a hypnotic trance for gut directed hypnosis to be effective. Indeed, my personal experience from seeing many clients in Central London is that it is rare for someone not to be able to enter a trance. Also the level of trance needed to effect positive change is not too deep or difficult to achieve for the majority of people.
A common barrier to using hypnotherapy to help IBS symptoms is that for many people they do not like the idea of being hypnotised. They may be worried about being controlled or concerned about the idea of “letting go”. At my London hypnotherapy clinic I do answer these concerns before people book sessions. Sometimes people may have difficulty trusting a therapist and so I will always talk by phone and rather than insisting people book my six session IBS programme, allow people to come for a session to see what it is all about. It is always important to tailor-make sessions to work for people and what they feel comfortable with.
If someone really does not want hypnotherapy, fortunately, other types of psychological treatment for gastrointestinal problems have clinical research to back up their effectiveness too. In the case of IBS, cognitive behavioural therapy (CBT) has also been shown as effective and is a good alternative. Indeed at my London clinic I use aspects of CBT to help with IBS too. Finally, a common barrier to many patients receiving help for gastrointestinal disorders such as IBS with hypnotherapy is that hypnotherapy is a technique more commonly used by hypnotherapists or psychologists rather that doctors or consultants. Many doctors will see physical symptoms as nothing related to the mind or emotions. This despite the clear and observable connection between the functional symptoms of IBS and experiencing high anxiety. Indeed many find that IBS symptoms are exacerbated by stress. Many consultants view hypnotherapy to be a complementary therapy like acupuncture and do not see the in-depth change that therapy under hypnosis can bring about. These doctors, if shown the clinical evidence would, I’m sure, agree that as a medication free option, hypnosis for IBS is worth exploring.
As the positive benefits of how hypnotherapy helps GI symptoms becomes better publicised then using hypnosis as an IBS treatment will hopefully become a more popular option for GI patients. I am already seeing in London, that many gastroenterologists including paediatric gastroenterologists are seeing gut directed hypnotherapy as a good solution for patients whose functional symptoms do not respond to standard medical management including advice from a dietitian (for example a low FODMAP diet).
If you or someone you know has IBS, I would recommend looking into whether hypnotherapy helps IBS symptoms for you. As mentioned I run a busy Central London hypnotherapy practice and see many people looking for IBS hypnosis sessions. For more information about my IBS hypnotherapy sessions click here.
References
1. Beaugerie, L., Burger A.J, Cadranel J.F, Lamy, P., Gendre J.P., & Le Quintrec, F. (1991). Modulation of orocaecal transit time by hypnotherapy. Gut, 32, 393-394.
2. Whorwell PJ; Houghton LA; Taylor EE; Maxton DG. Physiological effects of emotion:assessment via hypnotherapy. (1992). Lancet, 340, 69-72
3. Klein K.B., & Spiegel, D. (1989). Modulation of gastric acid secretion by hypnotherapy.Gastroenterology, 96, 1383-1387.
4. Colgan, S. M. , Faragher, E. B. , & Whorwell, P. J. (1988). Controlled Trial of Hypnotherapy in Relapse Prevention of Duodenal Ulceration. The Lancet, 1(8598), 1299-300.
5. Whorwell, P.J., Prior, A., & Faragher, E.B. (1984). Controlled trial of hypnotherapy in the treatment of severe refractory irritable bowel syndrome. Lancet, 2, 1232-1234.
6. Prior A., Colgan, S.M., Whorwell P.J. (1990). Changes in rectal sensitivity after hypnotherapy in patients with irritable bowel syndrome. Gut, 31, 896-898.
7. Houghton, L.A., Larder, S., Lee, R., Gonsalkorale, W.M., Whelan, V, Randles, J., Cooper, P., Cruikshanks, P., Miller, V., & Whorwell, P.J. (1999) Gut focused hypnotherapy normalizes rectal hypersensitivity in patients with irritable bowel syndrome (IBS). Gastroenterology,116: A1009.
8. Palsson, O.S., Burnett, C.K., Meyer, K., and Whitehead, W.E. (1997). Hypnotherapy treatment for irritable bowel syndrome. Effects on symptoms, pain threshold and muscle tone. Gastroenterology, 112, A803.
9. Palsson, O.S., Turner, M.J., & Johnson, D.A. (2000). Hypnotherapy for irritable bowel syndrome: Symptom improvement and autonomic nervous system effects. Gastroenterology, 118,(4) A174
