Hypnosis: Bowel dysfunction

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Hypnosis Bowel dysfunction

• Brigitte Collins, BSc, MSc, Diploma in Hypnosis

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What is hypnosis

• Important to say what it is not
• Not stage hypnosis
• Not sleep.
• Hypnotist does not take control.
• Cannot be stuck in hypnosis.
• Sensationalized treatment results have made
  hypnosis into a magical mystical process.
• The more grandiose the more sceptical.
• Not merely relaxation.

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What is hypnosis

• Does not constitute a form of treatment or
  therapy in its own right.
• Seen as adjunct and best incorporated into
  practice.
• Hypnosis is treated as a means of helping
  patients develop powerful personal resources
  directed towards achieving their therapeutic
  goals.
• Promotes self sufficiency and independence
  leading to control, resourceful and a self
  assured patient.

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What is hypnosis

• Definition
• It is an interaction between one person the
  hypnotist and a subject. The hypnotist influences
  the subjects perceptions, feelings, thinking and
  behaviour by asking them to concentrate on ideas
  and images that may evoke the intended effects.
  (BSCH)
• How does it work?

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How does hypnosis work?

• 90 of our brain is the sub conscious mind and
  handles body functions, emotions and behaviour.
• 10 conscious mind and is responsible for logic
  and reasoning
• Sub conscious mind cannot reason.
• Since SCM cannot reason it acts upon CM
  suggestions, filter beliefs and may interact with
  the environment.

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How does hypnosis work?

• Hypnosis takes hold in the SCM and exerts an
  automatic influence on behaviours, feelings and
  thoughts positive behaviours
• Positive ideas conveyed to SCM by suggestion,
  repetition proceeds to manifest them in to that
  persons experience healing

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Two basic elements

• Trance
• Frame of mind characterised
• Focused attention on experiences e.g. Ideas and
  feelings.
• Disattention to extraneous stimuli e.g. Become
  removed from immediate realities.
• Absorption in an activity be it images, thoughts
  and feelings.
• Most people have a natural capacity for trance.

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Two basic elements

• Suggestion
• Differs from everyday suggestion/instructions.
  E.g. Numbness.
• Hypnotist conveys communication in such a way
  that directs the subjects imagination to elicit
  intended alterations in sensations, perceptions,
  feelings, thoughts and behaviour.
• Mind body link, chevreuls pendulum, lemon.
• Post hypnotic suggestion.

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Self hypnosis

• Yes!
• Reinforces self mastery and coping.
• Encourages active involvement in treatment.
• Extends treatment beyond the therapists office.
  (Heap and Aravind 2002)
• Rehearse coping strategies.
• Manage stress symptoms.
• Manage pain.

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Who can be hypnotised?

• All of the population in one way shape or form
  can be hypnotised (Yapko, 2011 )
• Like any treatment some may respond better than
  others and some may not.
• Scales for measuring hypnotisability. Creative
  imagination scale.
• Can we tell?

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Evidence for hypnosis

• Whorwell (1984) RCT where two groups of 30
  patients, one hypnotherapy and control group
  supportive therapy with medication. 3 months
  later hypnotherapy group saw a greater
  improvement in bowel habit and well-being, pain
  and bloating when compared to control group.
• Palsson et al 2002 Whorwell et al 2005.
• Gonsalkorale et al 2003
• Tan et al 2005 Systematic review
• Nice guidance (2008)

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Evidence for hypnosis

• Bremner 2012
• Neural changes of the brain and brain activity
  have been noted during hypnosis.
• Process of pain exaggerated in IBS
• Hypnosis has shown to influence such activity and
  therefore change that area of the brain that can
  overreact.

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Case study

• 48 year old woman
• Teaching assistant/ stressful at times
• Diagnosed with slow transit constipation/IBS some
  years later
• Using Senna x1-2 or more each day
• Suffering with abdominal pain/discomfort,
  decreased bowel frequency, bowel movement once
  per week sometimes less, bloating, increase in
  girth and anxiety regarding symptoms.

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Case study

• Sleep disturbance, prescribed Amitriptylline
• Appeared calm on the outside although cauldron
  bubbling on the inside
• Relaxation techniques previously for feeling
  anxious, worked really well.
• Interests Holidaying in Jamaica, visiting a park

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Case study

• Following assessment hypnotherapy was discussed
  and how we ourselves can bring about
  physiological changes. E.g. job interview, exams
• Demonstration of lemon and chevreuls pendulum
• Discussion on working with anxiety first.

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Case study

• First session incorporated within assessment.
• Breathing technique, using calmness and releasing
  tension, anxiety, worries, concerns
• Deepener, progressive muscle relaxation, massage
• Special place, steps down to deepen the process.
  Talked through description, makes this realistic.
• Session recorded on phone
• Homework Self hypnosis. Weekly sessions for 6
  then monthly.

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Case study

• Session2 Completed self hypnosis each day
• Bowels open when arriving home and next day.
  Using Senna x 1 per day. Other symptoms continued
• As previous session. Special place with more
  description. Felt some numbness in hands. Relaxed
  much quicker.
• Homework Self hypnosis each day with use of
  recording

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Case study

• Session 3 Much better. BO each day. Felt more
  positive. Senna x 1 per day
• RB, PMR and gut related hypnotherapy.
• Liquid in bottles. Biggest spoon
• Bottle 1 Calm, pale blue
• Bottle 2 Confidence, pale purple
• Bottle 3 Bloating, Bright pink with sparkles
• Soothing and cool, flat stomach
• Self hypnosis Recording to be done each day and
  if can manage without recording to use parts of
  session

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Case study

• Session 4 BO 4 out of 7 days. Bloating
  decreased. No laxatives
• Repeated last session
• Could see purple liquid on top of blue liquid and
  working through gut like gaviscon
• Pink liquid went to head.
• Self hypnosis Reduce use of recording and do
  self with the bottles

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Case study

• Session 5 Used liquid bottles a lot, feeling
  more relaxed about bowels, BO 4 out of 7 days, no
  bloating, no laxatives
• RB, PMR
• Own visual imagery of how she visualised bowels.
  Stool got stuck in the corners of the colon
  mainly on the left side, stool gathered in the
  rectum and no messages could get through to brain
  so no regular bowel movement

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Case study

• Visualised bowel in hypnosis
• Solution was to drink more water which would help
  stool to get through and therefore pushing stool
  along faster and so empties in to the rectum more
  quickly. This was related to a slot machine where
  there is a prize and she could see a flashing red
  button that she pressed, which sent messages to
  the brain. This relaxed the rectum and as a
  result had a bowel movement.
• Self hypnosis To repeat when having a drink

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Case study

• Session 6 Not feeling so good. Did self hypnosis
• Repeated last session
• Homework Self hypnosis with recording and self
  each day.

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Case study

• Session7 After last session BO each day, no
  laxatives, complete evacuation, no bloating,
  feeling very good. No amitriptylline.
• Feels that this has had an impact on other things
  where sleep pattern has improved greatly, more
  confidence at work, therefore less stressful
• Overall well being Feeling great and extremely
  well. MORE POWERFUL THAN ANY TABLET

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Conclusion

• Hypnosis is best used as part of an integrated
  approach
• Can be costly to provide because of time,
  although the sustained effects could be offset
  against a reduction in medication and other
  healthcare demands (Bremner 2012 Gonsalkorale et
  al 2003)
• Sustained effect has been noted after 5 years.