Saw a clinical psychologist/hypnotherapist who indicated he could treat my IBS. My first visit involved a lot of questioning, no hypnosis, and I got the feeling this was conventional psychotherapy. Did your treatment start off this way as well? At $140 per hour I don't want to let him wander too far afield unless it is essential. I know what the stressors in my life are and I am just trying to get the link between my GI tract and my brain severed. I don't have a traumatic past or a bunch of beurosis that I need dealt with. How much rope should I give the guy?
A ? for those who received hypnotherapy for IBS
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They may have been doing a fairly generalized assessment of you as the patient before getting into doing any actual work. You might be clear on the next visit what you expect/want and make sure that you and this person are a good match. K.
Nuck - can you confirm that the hypnotist is to charge $140 per hr, and that this is not a misprint ??I am sceptical, but haven't yet reached the point of outright dismissal, of hypnotherapy (as far as it relates to ibs treatment). Can anyone explain what a hypnotherapist can achieve, over and above a simple "pull yourself together", or "chill out" ? Incidentally, I am a big fan, and intermittent practitioner, of yoga, which I think performs at least the "chill out" option, and may well help with ibs symptoms. (I have, however, no medical or therapeutic training; this is merely my own considered judgement.)
Nuck,"3. How to Choose a Therapist?Although legally, anyone can practice hypnotherapy without either special training or a license, it is important to make sure your hypnotherapist is a clinical professional with a thorough training. Also make sure he or she has experience in treating your particular condition. In this case Irritable Bowel Syndrome."http://www.ibsaudioprogram.com/faq's.htmTreating IBS with HT uses "gut focused HT" for IBS, they should not did up your past (regression) and should generally have two years experience with treating IBS. IBS HT therapists use specific IBS processes.Are you in the states?you should read this site also. This is a leading IBS researcher and a leading HT therapist for IBS.http://www.ibshypnosis.com/Hope that helps and ask any questions about this you want.
I started seeing a hypnotherapist in October. Yes, my first session he explained how hypnotherapy works and asked me a bunch of questions. I also told me to write down the pro and cons or myself(what i like and don't like) and also what i wanted to achieve through hypno. BUt on my first session he also did the first hypno session because i was really sick and he said he could start right away.I've had 3 sessions and i havbent' noticed a difference in my IBS yet but i have noticed that i'm not as depressed and i dont' have as much anxiety.YOu pay 140$ and hour? Seems a bit much. I've been paying about 40-50$ a session. perhaps you should look around and see if there is a cheaper hypnotherapist or if 140$ is normal where you are.Have you tried the IBS audio 100 program? if not maybe you should go that route first.
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Welcome Nuck and Mekis to the BB
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Some therapists, including Mike Mahoney, who authored the IBS Audio Program in England, do an intensive intake consultation session prior to the actual hypnotherapy session(s). This is the sign of a good therapist, who needs to get an accurate evaluation and base. As a former therapist, I too did intake evals prior to therapy. Some therapists charge more for the initial intake eval, and less for ongoing sessions, but the charges vary of course. A good therapist will give you all the charges up front, if they don't, then ask them.Clinical hypnotherapy may not be for everyone, but it has a lot of positive research to back it up. It(Mike's program) was the last thing I tried after every other treatment method, after Eric urging me to do so from the success he and others have had - and that was over 5 years ago.There are organizations - professional ones - that can give you some guidelines on proper charges, etc. Many psychologists and psychiatrists use clinical hypnotherapy as a part of their treatment - and many clinical hypnotherapists, who are properly trained, will do some counseling and discussion in addition to the actual hypno sessions. This too me, would indicate a good therapist.For more info on my journey, see the links below.Hope this helped a tad bit!
Hi Marilyn, Nuck, Eric & others.1) I don't mean to hijack Nuck's thread; hope he/she continues with q's re hypno. My problem is, still, no-one has told me what the hypnoguys actually do. If I ask you about a particular drug, or manipulation, or operation, I will get a (more or less) specific answer. But what do I get for my money from a hypnotherapist, particularly in respect of a relatively non-specific problem such as ibs ?
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http://www.ibshypnosis.com/ has some info on the program that is taught here at UNC's functional GI clinic. That might have some of the info you are looking for.I did Cognitive Behavioral Therapy at the clinic for a different clinical trial (some 70% of people on CBT got better, much better than coming in and just getting info/sympathy. Most of the CBT continued to get better in a one year follow up, the people in the drug part of the trial did not)Basically the nerves in the GI tract (the ones you would manipulate with drugs) also communicate up the spinal cord to the brain. How the brain/mind reacts to the communication and what communication is sent back can effect what the nerves in the gut do. For me it is like I can now tell the nerves down there to calm down. I did continue medication for a few years at much lower doses after the 3 months of CBT. Mostly because with meds at the time I was 99.95% symptom free and without them I was about 90-95% symptom free and no pain was worth the price of the meds.While some hypnotherapists will automatically say they can fix anyone with IBS, I would stick to those that had specific training in this area.K.
mekis I feel the same way about not outright dismissing hp as it relates to ibs. I think it is geared to reduce symptoms of pain and urgency. But then there are so many other ibs symptoms and many of us don't have pain or urgency issues and wonder how the h/p tapes will help those kind of ibs problems,- see threads on lg.
Gut focused hypnotherapy is for global IBS symptoms.It is also one of the things studies on non gi symptoms.One of these doctor is one of the senior gastroenterologists in the UK Dr Whorwell , who started studying HT for IBS some twenty years ago.Here they studied 250 IBS patients."Hypnotherapy for Functional Gastrointestinal Disorders By: Peter J. Whorwell, M.D., University Hospital of South Manchester, England Unfortunately, the word "hypnosis" often conjures up a whole variety of frequently quite negative connotations even within the medical profession. Many equate the phenomenon with the mind being taken over by the hypnotist and with loss of control by the recipient, which needless to say, is completely erroneous. As a consequence of this, the whole subject is surrounded by a cloud of mystery, which regrettably is often encouraged by those who practice the technique. Although unlikely to ever happen, it would probably be best if a completely new word could be coined for that of hypnosis so that all the "baggage" that accompanies it could be left behind. ""We recently published an audit of the first 250 patients treated and found that hypnosis not only helps the symptoms of IBS but also significantly improves quality of life.(1) Interestingly, it also relieves the additional symptoms from which so many patients with IBS suffer such as nausea, lethargy, backache, and urinary problems. This is in sharp contrast to the medications currently available for IBS, which often help one or two symptoms if at all. We have also undertaken some research in an attempt to ascertain how hypnosis might lead to benefit. There is no doubt that it can improve anxiety and coping capacities as might be expected. However, of far more interest, was the observation that motility and visceral sensitivity could also be modified in the desired direction. Thus, this approach to treatment appears to offer symptomatic, psychological, and physiological benefit and this presumably explains why it appears to be so effective. ""One concern over the use of hypnotherapy is the possibility that patients might relapse once a course of treatment has been completed. We have recently addressed this question with a study on the long-term follow up of patients attending the unit. This has shown that after a period of between one and five years, 83% of responders remained well with 59% requiring no further medication at all. Patients also took much less time off work and consulted the medical profession less often."http://www.aboutibs.org/Publications/hypnosis.html"IBS Beyond the Bowel:The Meaning of Co-existing Medical ProblemsOlafur S. Palsson, Psy.D. and William E. Whitehead, Ph.D.UNC Center for Functional GI & Motility Disorders"IS IT POSSIBLE TO REDUCE NON-GI SYMPTOMS IN IBS?It is unknown to what degree standard medical treatment for IBS, when successful, alsoresults in improvement in non-GI symptoms. The problem is that most IBS treatmentresearch has not examined how non-IBS symptoms change. Non-IBS symptoms havealso not been a focus of standard IBS treatment. An exception to this is psychologicaltreatment trials for IBS, which sometimes have included general physical symptomquestionnaires among the measures of treatment effects. We, therefore, know from ourtwo studies of hypnosis treatment for IBS(22) as well as from research in England(23) thathypnosis treatment for IBS regularly improves non-GI symptoms substantially in additionto its beneficial effects on bowel symptoms."http://ibsgroup.org/eve/forums/a/tpc/f/712...610974#86610974It helps IBS.It helps non gi symptoms.It often last years after treatment. That in itself is really important. Something that continues to work and help after treatment stops.Overview of Published Research To Date on Hypnosis for IBSBy Olafur S. Palsson, Psy.D.Last updated August 13, 2004bhttp://ibshypnosis.com/IBSresearch.htmlandWhy Consider Hypnosis Treatment for IBS?by Olafur S. Palsson, Psy.D.Hypnosis is only one of several approaches to treating irritable bowel syndrome and may not be the most suitable option for all patients (click here for discussion of treatment options for IBS). However, hypnosis treatment has some advantages which makes it an attractive option for many IBS sufferers with chronic and severe symptoms:- It is one of the most successful treatment approaches for chronic IBS. The response rate to treatment is 80% and better in most published studies to date. - The treatment often helps individuals who have failed to get improvements with other methods (see for example: Whorwell et al., 1984, 1987; Palsson et al., 1997, 2000).- It is a uniquely comfortable form of treatment; relaxing, easy and generally enjoyable.- It utilizes the healing power of the person's own mind, and is generally completely without negative side effects. - The treatment sometimes results in improvement in other symptoms or problems such as migraine or tension headaches, along with the improvement in IBS symptoms.- The beneficial effects of the treatment last long after the end of the course of treatment. According to research, individuals who improve from hypnosis treatment for IBS can generally look forward to years of reduced bowel symptoms. http://ibshypnosis.com/whyhypnosis.html
Yes they do charge $140 per hour but I am in Canada so more like $110 USD. I could certainly find hypnosis much cheaper but in order to recover the money from my health plan I need a clinical psychologist treating me.I do expect benefits and everything I have read supports this. Unlike ulcers, or Crohns a lot of our symtoms don't relate to a particular injury to the intestinal tract. Spastic colon is literally intestinal muscles cramping. There is a definite correlation between IBS symtoms and stress for many people so anything that reduces that stress should reduce the pain. To take that one step further, I think IBSers have a mind to bowel link that they didn't have prior to getting the disease and that healthy people don't have. A twinge in an area where a non sufferer wouldn't recognize it, and we lock in on that. Our brains shouldn't be able to affect non voluntary muscles but they apparently do. I know I personally get stomach pain often when stressed and doing a mind clearing mental exercise offers rapid relief. I am not so successful with my colon pain but I have noticed making an effort to distract myself from paying attention, or at least focusing on it really helps. The hypnotherapy will just take this a step further. Of course staying away from certain foods helps me avoid the initial stabs the get the pain started. Now I seem to have Chronic Functional Abdominal Pain which is kind of like IBS without the D or C. I still consider it IBS because all my other symptoms, including the locations of the pain and the triggers is the same as IBS. Everything I read about how to deal with IBS I try to use and so far things are working.I wonder how many of us are under greater than average stress and how many people are suffering needlessly because they aren't able to reduce that stress? I know my discomforts are always less after a few days away from the office.
As far as stress goes (and I gather that what we call stress is pretty much what the medics prefer to call "anxiety"), my experience has been that once a diagnosis of ibs has been made, it's pretty much a given that they assume you to be suffering from stress; whether you agree or not ! Personally, I am rapidly coming to the conclusion that much of the problem can be ascribed to too much thinking about the problem, too much self-analysis. Perhaps the best thing a hypnotherapist could do (for me, at least) would be to make me forget I even have a digestive tract !?
NuckYou don't live in Toronto by any chance do you?alsoDiagnosing and Treating Patients with Refractory Functional Gastrointestinal Disorders "Conversely, constant pain not associated with changes in gastrointestinal function (such as chronic functional abdominal pain [13]) is modulated by higher brain centers; thus, gut-acting agents are not helpful. Treatment involves behavioral methods, psychopharmacologic methods, or both. "http://www.annals.org/cgi/content/full/123/9/688There has been research going on in IBS for years now that the Anteior Cingulate cortex a part of the brain involved in pain is not "working well enough" to "turn down the pain."From the last caht with the experts Drossman."To varying degrees, these disorders are characterized physiologically by any of 3 components. The first as shown here for IBS is that of increased motility or muscle contractions. In this slide, after eating a meal, the pressure generated in the lower bowel (sigmoid motility index) is similar to but greater in intensity for IBS (shown in yellow) compared to normal subjects. The second physiological component, is that of visceral hypersensitivity or a lower pain threshold. Here with IBS, after progressive rectal distension using a balloon, there is a predictable rise in the number of people reporting pain with greater distension. Drossman: The 3rd component is that of brain-gut dysfunction or difficulties with the brain controlling gut function or painful sensation. This slide shows that there is a 2-way connection between brain and gut. Pain in the intestines goes up the spinal cord to the brain where it is experienced as pain.Drossman: But what we see in IBS and other functional GI disorders (e.g., functional esophageal pain, functional dyspepsia, functional abdominal pain) is that the brain is not working well enough to “turn down†the pain." as mention a the ACC is involved.Serotonin is a very important signaling nuerotransmitter for the signal going from the gut, up the spinal cord to the brain.It seems in IBS that signal goes to the prefrontal cortex, involved in anxiety.""Neuroimaging has provided evidence of physiological differences between normal individuals and those suffering from IBS in the way a visceral stimulus (ie, rectal distention) is processed inthe brain."
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Hypnotherapy for one is believed through research to work on that part of the brain the acc."Another suggests hypnotherapy may have an impact on a part of the brain which processes pain called the anterior cingulate cortex (ACC). "The reasonBrain Imaging Studies Investigate Pain Reduction By Hypnosishttp://www.sciencedaily.com/releases/2005/...50326100346.htmMore research and pet and fmri scans are being done on this as we speak.Stress and anxiety reduction, which can also contribute to pain is also help by hypnotherapy, but that is a side effect.There is evidence for HT working on IBS, physiologically and psycologically. That is important.I will post some more.
Absolutely Mekis. Stressfull times in your life can be the triggering cirumstances, but when I refer to taking my mind off the pangs, and distraction as ways to get relief, it is really anxiety that I am dealing with. Anxiety and obsessing over feeling discomfort in the GI tract leads to more discomfort. Before I understood I had IBS and was fearful of things like colon cancer the pain had my stress levels going through the roof. Appetite lost, digestion slowed down to a crawl, and bloating all directly related to my state of mind. Once I found a name for what I had, and understood it wasn't something that would kill me, my symptoms dramatically improved. Too much thinking about the problem, and analizing every little twinge of discomfort that I felt was fueling it, and my actual goal is in fact that the hypnotherapy will disconnect me from thoughts about my GI tract. Whether this is something that can eliminate the symptoms or just reduce them, I don't know, but I am certain it can help(although maybe not this particular therapist).To Eric, no, I am in western Canada. I do undertand there is a difference between the stress that I feel, and the discomfort in my gi tract. Two separate things the therapy will hopefully deal with as the stress is only a trigger and not the pain itself. When I am away from work and my personal stress levels are very low I feel almost normal but the wrong food will still cause a stab of pain. I have what I consider to be a mental connection where there shouldn't be one, but the description of "increased motility or muscle contractions"makes sense whether it is due to ongoing mental stimulus or simply an acquired propensity for sigmoidal spasms that won't leave of it's own accord. On the one hand it seems like by relaxation the pain levels could be turned down, but at the same time, there is actual cramping which I don't think should be experienced at all, or at least not on a regular basis and in the same specific areas.
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Nuck, that is pretty much what happened in my situation - the IBS was always in my thoughts - my every waking moment. With the hypno, I started to think less and less of the IBS, less often, and when I did think of it, it was with less intensity and duration. But it was very subtle and gradual - but it did happen. The hypno (for me) drew me away from thinking about it - and if I do get a twinge, I am able to sort of "dismiss" it in an absent minded way, and the twinge goes away. This is compared to over 20 years of almost 4 hours or so in the bathroom almost everyday - almost housebound, with nothing else helping. The hypno turned it around. It can reduce or even eliminate symptoms, but it is a process. If your therapist has training and experience in IBS therapy - gut-directed - then you may experience some success. You should ask if he has had experience in treating IBS, and what is his success rate for the various symptoms - sometimes when they are new to it, but do have the training, they will reply that the method they are using has a good track record, and that would be helpful to know as well.Good luck in your healing journey...
The IBS therapists use specifc gut focused scripts for IBS. Not so much "therapy."HT, like CBT for in general should help IBS, but even more so when its targeted.Stress in regards to Functional disorders.Readers' ExchangeDefining Stress in IBSFall 2003"Comment from Emeran A. Mayer, M.D. -- In contrast to the common interpretation of the term "stress" as a psychological phenomenon, it should be understood as any real or perceived perturbation of an organism's homeostasis, or state of harmony or balance. For example, in this viewpoint a severe hemorrhage, starvation, extreme temperature, or worry about the unpredictable onset of abdominal pain all qualify as stressors -- some as "physical" stressors, others as "psychological" stressors. The fear to leave the house in the morning without knowing if one can make it to work without having to stop on the freeway because of an uncontrollable bowel movement, or the fear of experiencing uncontrollable abdominal discomfort during an important business meeting are sufficient stressors to activate the central stress system."http://www.aboutibs.org/Publications/StressDefined.htmlThis is an excellent article on this."The Neurobiology of Stress and EmotionsBy: Emeran A. Mayer, M.D., UCLA Mind Body Collaborative Research Center, UCLA School of Medicine, California http://www.aboutibs.org/Publications/stress.htmlThe bodies "stress system" is the HPA axis. The HPA axis is majorally connected to the fight or flight responce and that is really important in IBS. Because at the end of that system are mast cells in the gutthat release histimine onto the smooth muscle of the gut, which is toxic and can contribute to pain, this is especially important in PI IBS that develops into clinical IBS.What is the "fight or flight response?""This fundamental physiologic response forms the foundation of modern day stress medicine. The "fight or flight response" is our body's primitive, automatic, inborn response that prepares the body to "fight" or "flee" from perceived attack, harm or threat to our survival."Also the role of serotonin in gut function and in signaling pain to the brain is abnormal in IBS. To much serotonin in the brain causes anxiety, the right amount relaxation. The central nervous system try's to stay balanced with the enteric nervous sytem, the brain can trigger the gut and the gut can trigger the brain. Calming the brain gut axis can significantly help the symptoms. From one of the chat with the experts."psychophysiological arousal is the core of treating functional gi disorders. There is so much distress, anxiety, antisipatory anxiety, and negative reaction to symptoms, that calming the mind and body often makes a significant difference to symptoms."
One of the major problems I personally have in accepting that my gut problems are due to (stress-related or stress-triggered) ibs is that they started at a point in my life where I was probably at my most relaxed & happy. Almost a decade ago I had quit my job in medical research and moved to the country. I was living healthily, exercising and had become very fit. So no long term anxiety/stress to potentially trigger any problems.I have read Mayer's article on the neurobiology of stress posted by Eric above. The only point which gives me personally food for thought is the bit about anger stimulating the upper GI and inhibiting the lower GI tract. Certainly late 2003, when my gut problems started, was a time when I felt great anger at certain events occuring in the World, and although I eventually found a personal way of downplaying those specific issues, to a degree at least, I now feel a lot of anger at my doctors, who I feel have let me down. I still don't logically believe that anger is the trigger for my problems - there are other potential causes - but would be interested to know if anyone else suspects such a link in their own cases. (Of course the interesting experiment to perform here would be a simultaneous change of political leadership in the US & the UK, but even to me this seems an over-the-top way to cure one man's gut problems!)
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There is another aspect to think about.Pain and GI symptoms are pretty much universally stressful (one of the reasons for shooting/punching someone in the gut is that it distracts them from other things like aim, throwing a punch, etc.). IBS is not started by or caused by stress, most people's is probably started by the fall-out of the immune system fighting off a GI infection. Stress didn't cause it, but stress can effect how your symptoms/episodes go. There is some evidence some people's psychosocial or coping skills seem to help them calm the IBS started by a GI infection back down on their own over time. Other people don't have what they need to calm it down on their own so interventions that induce that in them may help (and it is usually about 70% of people that get helped by these techniques in studies)Physical stress is stress. Most people do not respond to pain, discomfort, or other GI symptoms in a relaxed and happy manner. That stress response to the symptoms (no matter which thing triggered them, be it diet, other stressors, the phase of the moon, etc) can effect the GI symptoms. I think of it like a feedback loop. You get the pain (or whatever) that increases your stress response, the stress response sends feedback to the gut, the pain continues/gets worse, that increases your stress response, the stress response sends feedback to the gut...It is like a vicious loop you can't get out of. For me it is like 'rebooting' and getting out of the loop. When the symptoms hit instead of responding to them in a way that gets me into the endless loop of symptoms I can get out of the loop and send signals that allow things to calm down as fast as it is possible for them to calm down. The more I was able to interupt the looping the shorter/less severe the symptoms became.It may not be totally accurate, but that is about the best way I have to explain it.K.
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