Jessica G. Schairer Ph.D.

Clinical Psychology

HYPNOTHERAPY OFFERS LASTING SYMPTOM RELIEF TO PATIENTS WITH IRRITABLE BOWEL SYNDROME (IBS)

Jessica G. Schairer, Ph.D.

The Los Angeles Psychologist, January/February 2005, p. 7.

In October, 2003 Gonsalkorale et al published an article in the British journal Gut, reporting on a five year follow-up of patients with Irritable Bowel Syndrome (IBS) treated with hypnotherapy. Patients initially averaged a 50 % reduction in symptoms and 80 % maintained their improvement at five year follow-up.  Palsson and Whitehead (2002) argued in the journal Gastroenterology that hypnotherapy may be the most effective therapy available for IBS symptoms.

 Hypnotherapy for IBS has been featured in the mainstream media: the New York Times, Newsweek, the Yoga Journal, and Health Magazine.  Olafur Palsson’s website www.ibshypnosis.com provides information and referrals to hypnotherapists nationwide who are using his seven session protocol with excellent, replicable results.

 What is IBS?

IBS is a “functional” bowel disorder.  Its unpleasant symptoms are not caused by any physical findings of disease in the gut. IBS is defined as symptoms of abdominal pain or discomfort for 12 or more weeks in the past 12 months, with feelings of bloating and abdominal distension, and changes in bowel frequency and habits, often alternating unpredictably between constipation and diarrhea.

Why has IBS been so resistant to treatment up till now?

 Many patients with IBS have other signs of anxiety or depression. Walker et al (1993) found that many adults with IBS are more likely to have histories of trauma than patients without IBS. Patients with IBS were more likely to have suffered lifetime sexual trauma (32% vs. 0%), childhood sexual abuse (11% vs 0 %) and lifetime sexual victimization (54% vs. 5 %).

 While some patients with IBS can tolerate antidepressants, many find that selective serotonin reuptake inhibitors (SSRIs) exacerbate their GI symptoms. Ninety-five per cent of the body’s serotonergic receptors are in the gut. Only five per cent are in the brain. SSRIs can make some patients’ problems worse. And while some patients feel less anxious or depressed with antidepressants, their GI symptoms are at best unchanged (Tapas et al. 2004).

The Hypnotherapy Protocol

In North Carolina, Palsson’s research group uses seven sequential protocols leading to ever deeper hypnotic states.  In Manchester, England, Whorwell’s group uses a protocol of twelve weekly sessions. Each session features a very thorough 30 minute hypnotic induction leading to a very deep hypnotic state, utilizing multiple layers of deepening techniques, double and tripe dissociations, and layers of direct and indirect post-hypnotic suggestions. Different images and suggestions of gastrointestinal symptom reduction, increased comfort, and surprising success are featured in each session.  I give my patients a tape of each session to practice at home for two weeks. Other therapists get good results with a short more generic practice tape.

Clinical Experience

Most patients can tell in the first two weeks whether or not they are benefiting from the program. I have seen the same sort of results as reported in Gut: 80% of my patients can utilize the protocol to feel better and have quantifiably fewer IBS symptoms. Most patients find they do best if they also avoid foods that trigger their symptoms, even if food avoidance alone hadn’t helped these patients in the past. I’ve seen patients ranging in age from 18-90 years old benefit, some with histories of decades of IBS symptoms.

 Who doesn’t benefit?  People who are so anxious they can’t close their eyes, who are afraid to relax or who find trying to relax causes panic attacks. People this anxious need another approach to mitigate their anxiety first.  However, in my experience, a patient does not have to be a highly hypnotizable to get valuable relief when practicing this protocol.

 

Conclusion

The twelve session protocol for hypnotic treatment of IBS has been validated by over 20 years of research. The seven session protocol has equally good results. Hypnotherapy’s effectiveness has been consistently replicated both in research and clinical settings, and patients’ symptoms remain alleviated at five year follow-up. Gonsalkorale (2004) also found lasting cognitive changes in IBS patients treated with hypnotherapy.

 This is all the more remarkable in that many patients with IBS have been told that there is nothing that can be done for them, it’s all in their heads and they just have to put up with it.

 On the contrary, our experience with hypnotherapy indicates that IBS is an example of a complex mind-body interaction in which hypnosis, a psychological intervention, can have profound physical effects and result in a dramatic decrease in physical symptoms, as well as decreasing accompanying anxiety and depression.

 

References

Kathleen Cahill Allison and Lawrence Friedman, M.D. (2004). Soothing a Sensitive Gut. Newsweek, September 27, 2004, p.71

Gonsalkorale WM, Miller V, Afzal A, Whorwell PJ. (2003).Long term benefits of hypnotherapy for irritable bowel syndrome. Gut. 52(11):1623-9.

Gonsalkorale WM, Toner BB, Whorwell PJ. (2004) Cognitive change in patients undergoing hypnotherapy for irritable bowel syndrome. J Psychosom Res Mar;56(3):271-8.

Catherine Guthrie. (2004) Tame Your Ill-Tempered Tummy. Yoga Journal. September/October pg 42

Harvard Health Publications. (2004)www.harvard.edu/newsweek The Sensitive Gut: Special Health Report.

Health, March (2004): pp56-60. Got IBS? Get Hypnotized—It Just Might Help

Mayo Clinic. What is Hypnosis? http://www.mayoclinic.com/invoke.cfm?id=SA00084

Eric Nagourney. (2003)  Therapies: Hypnosis Can Be a Hit in the Gut. New York Times. October 28, 2003.

David Noonan (2004).Altered States: Hypnosis can help with problems from anxiety to pain. How it works and what it does in the brain. Newsweek, September 27, 2004, p.76-77.

Olafur S. Palsson, Marsha J. Turner, David A Johnson et al. (2002). Hypnosis Treatment for Severe Irritable Bowel Syndrome. Digestive Diseases and Sciences, 47 (11) (2605-2614.

Olafur S. Palsson and William E. Whitehead. (2002). The Growing Case for Hypnosis as Adjunctive Therapy for Functional Gastrointestinal Disorders.  Gastroenterology: 123:2132-2147.

Olafur S. Palsson, www.ibshypnosis.com

Tabas G, Beaves M, Wang J, Friday P, Mardini H, Arnold G. (2004)Am. J. Gastroenterology 99:5:914-920, Paroxetine to treat irritable bowel syndrome not responding to high-fiber diet: a double-blind, placebo-controlled trial.
Walker EA, Katon WJ, Roy-Byrne PP, Jemelka RP, Russo J. (1993). Histories of sexual victimization in patients with irritable bowel syndrome or inflammatory bowel disease. Am J Psychiatry. Oct; 150(10):1502-6.

Whorwell PJ, Prior A, Faragher EB. (1984). Controlled trial of hypnotherapy in the treatment of severe refractory irritable-bowel syndrome. Lancet:2:1232-1234.

 

Jessica G. Schairer, Ph.D.  (PSY 6590) has been a Health Psychologist for over 30 years. She is Chair of the LACPA Health Psychology Committee and President of the Southern California Society for Clinical Hypnosis. She is in private practice in Los Angeles. She can be reached at JessicaSchairerPhD@DrSchairer.com.