Introduction
Whether you’ve heard of gut-directed hypnotherapy before or are brand new to the concept, it is true that is has been gaining widespread acceptance as a safe, reliable and effective alternative or adjunct to for IBS. In fact, the response rate of 76% in the largest study to date1. Plus it also has the added advantages of improving psychological and cognitive function and quality of life, and reducing the need for as many healthcare appointments2.
Gut-brain communication
With IBS, the communication between the gut and the brain is misfiring, with the brain interpreting normal gut sensations as pain. Essentially, gut-directed hypnotherapy aims to change the way the brain processes information sent from the gut. It teaches the gut to be less reactive to strong emotions as it helps change thought patterns, overall attitude, and behaviour. It is based on the idea that the way you think about and respond to situations affects how your body responds to them. And by changing your mental state, it can positively affect your physical state.
For example, people with IBS might get stressed thinking about potential flare-ups during ‘normal’ activities such as driving to work or going out for a meal. It can be perceived as stressful if bowel habits have been unpredictable in the past or toilet emergency incidences have unfortunately happened when going about these ‘normal’ activities. Negative thoughts alone can lead to negative changes in the digestive tract (aka the gut-brain axis communication misfiring). With gut-directed hypnotherapy, you are taught to think of you gut as being strong, smooth and calm, so you can override any negative response when your gut speaks to your brain.
What happens in a gut-directed hypnotherapy session?
There’s nothing mystical about being in a gut-directed hypnotherapy trance, so please don’t be expecting purple cloaks and swinging watches! The feeling of trance is akin to a daydream. It’s simply a state of inner absorption, concentration and focused attention.
Gut directed hypnotherapy begins with a consultation with a certified hypnotherapist who will assess your individual needs. Once your therapist has determined what works best for you, you’ll be induced into a hypnotic trance, which you start by closing your eyes and engage with deep body relaxation exercises and positive visualizations and calming imagery such as wandering through a beautiful garden or walking along a beach. This helps to reduce stress and open up communication between the conscious and subconscious mind and create a safe place to begin exploring your gut issues.
Using specific scripts, your therapist will introduce suggestions and specific therapeutic metaphors and tasks such as reframing negative thoughts and affirming positive statements. During these instructions, hypnosis may be used to increase mental focus and access the subconscious mind at a deeper level.
Hypnotherapy sessions can be tailored to your specific symptoms and concerns. For example, you may be asked to imagine your gut as a river and modify its flow according to its needs depending on whether they have predominant diarrhoea or constipation. For abdominal pain, placing your hand on your abdomen, feeling warmth, and using this to alleviate pain. Similarly, an inflated balloon being slowly deflated can be used as a metaphor to reduce abdominal bloating1.
Between gut-directed therapy sessions, you are asked to practice self-hypnosis most days at home. In these sessions, you\’ll listen to a recorded version of your guided hypnotherapy, and this can really help reinforce the messaging and response.
As you continue to work with your therapist, for at least 6 sessions3, your new thought processes and behaviours should become more automatic and habitual. These newly established patterns help you to better navigate life’s challenges and find it easier to cope with stress. As this is realised, people often see other aspects of health improve too such as mood, sleep and fatigue.
Why is a dietitian combining dietary interventions with gut-directed hypnotherapy?
I recently launched the Diet-Hypno Programme which combines personalising dietary interventions and 6 sessions of gut-directed hypnotherapy to help optimize long term outcomes. I was inspired to complete hypnosis training and develop this programme after reading a study by Basnayake et al,4 where patients with IBS who received either standard care (gastroenterologist only) or a multidisciplinary approach that included a dietitian and trained gut-directed hypnotherapist. Researchers found those in the multidisciplinary group were far more likely to have a significant improvement in symptoms and quality of life than the group that received standard care from a gastroenterologist only.
In fact, the growing body of evidence showing just how effective gut-directed hypnotherapy is in relieving IBS symptoms and improving gut function have propelled both the British Society of Gastroenterology5 and the American College of Gastroenterologists6 to recommend its practice in their 2021 clinical guidelines.
Overall, science convinces that gut-directed hypnotherapy is worth a shot. Results don’t usually happen overnight, but it may just be the thing you need to manage your symptoms and improve your quality of life!
References:
1.Miller V, Carruthers HR, Morris J, et al.Hypnotherapy for irritable bowel syndrome: an audit of one thousand adult patients. Aliment Pharmacol Ther 2015;41:844–55.
2.Vasant, DH, Whorwell, PJ. Gut-focused hypnotherapy for Functional Gastrointestinal Disorders: Evidence-base, practical aspects, and the Manchester Protocol. Neurogastroenterol Motil. 2019; 31:e13573.
3.Hasan, S et al. Six vs 12 Sessions of Gut-focused Hypnotherapy for Irritable Bowel Syndrome: A Randomized Trial, Gastroenterology, 2021; 160(7): 2605-2607.e3,
4.Basnayake et al, Standard gastroenterologist versus multidisciplinary treatment for functional gastrointestinal disorders (MANTRA): an open-label, single-centre, randomised controlled trial, The Lancet, Gastro and Hep, 2020; 890-899
5.Vasant DH, et al. British Society of Gastroenterology guidelines on the management of irritable bowel syndromeGut 2021;0:1–27.
6.Lacy, B. et al. ACG Clinical Guideline: Management of Irritable Bowel Syndrome. The American Journal of Gastroenterology, 2021; 116(1):p 17-44
