Hypnotherapy and IBS (Irritable Bowel Syndrome)
by Peter Bernfield
MSc, D.Hyp. PDCHyp
Following an article in the Daily Mail, entitled ‘Hypnotherapy fixed my irritable bowel after six years of suffering', I was contacted by a 79 year old lady who asked if I could be of any assistance:
- Patient is 79 years young and a widow
- Has been diagnosed by her GP as suffering from IBS
- Symptoms are described as ‘the runs' and feeling bloated
- Patient has to use the lavatory at least four times a day
- Symptoms first occurred shortly after a holiday abroad when the patient suffered from a ‘tummy bug'. The original medical report was in Spanish and the ‘bug' was not identified
- Symptoms have persisted for almost 15 years and the patient has not responded to conventional treatment.
- Periodically (approximately once every six weeks) patient suffers a serious attack and is bedridden for 24 hours.
The patent's elder sister lives a two minute drive away. During the last three years the sister has undergone a mastectomy and subsequently suffered from a stroke. Because the patient was a nurse and has been a ‘pillar of strength' over the years, her brother in law tends to contact her rather than a son who also lives locally if the elder sister has any problems (which unfortunately is a fairly frequent occurrence). Additionally, a friend who lives in the same block of flats and requires 24 hour care relies on the patient to do her shopping and generally be a shoulder to cry on. As the patient has other medical conditions which restrict her mobility somewhat, she finds the almost constant running around debilitating but has not felt able to refuse to help unless she is actually bedridden herself. She describes herself as being ‘in dread of the phone ringing early in the morning or later on in the evening'. Despite this, the patient has a positive outlook on life and takes care of herself (having her hair done regularly, periodic manicures and foot massage).
The patient had just returned from a short visit to a relative in the Channel isles when she contacted me. During the conversation it emerged that the symptoms of the IBS had virtually disappeared within 24 hours of arriving in the Channel isles and did not return until a couple of days before the patient was due to return, giving her approximately ten days when ‘things were almost normal and certainly not a problem'. I opined that whatever the organic cause of the IBS it would appear that stress played a major part in causing the symptoms. Initially the patient felt that this was not right as she felt that she led a fairly stress-free life, being reasonably comfortably off, but on reflection agreed that actually on the island she felt that ‘she was out of reach and nobody could contact her. This came as a welcome relief'.
During the first session I taught the patient a simple method of self-hypnosis as a method of stress relief and we established a ‘safe place of relaxation'. This was a place where she felt relaxed and enjoyed being, a place that held pleasant memories for her. Using guided visualisation I asked the patient to actually imagine being in her safe place and gave suggestions for relaxation and regular practice of the self-hypnosis.
The second session took place a week later. The patient had assiduously practiced the self-hypnosis twice a day, ten minutes each time and reported feeling much more relaxed. As is common initially she did not feel that ‘other things' had changed that much, but when I asked her specific questions relating to bowel habits it emerged that:
- She had not had to take any anti-diarrhoea medication all week (previously she had taken a lomotil a day to try to control the symptoms)
- The occurrence of ‘the runs' was markedly less
- She had not felt bloated
- The number of bowel movements per day had decreased
The session itself consisted of guided visualisation to help control ‘the runs'. Using the patient's safe place visualisation, which had included looking out over a bay, suggestions were made about the sea being calm, sun sparkling off the waves, a feeling of warmth in the stomach area and waves gently, regularly washing up on the beach. The patient reported feeling very relaxed and experienced a ‘calming feeling' in the stomach area.
The patient agreed to keep a daily diary of her symptoms so the progress can be more accurately monitored.
The third session took place after a further seven days. The patient report no unusual bowel movements (now one a day and ‘no runs') and only occasional stomach spasms. This session concentrated on producing a warming sensation in the stomach area to help ease the spasms. No further sessions are scheduled at the moment and the patient is continuing to keep a dairy.
Many patients report improvements after the first session. Although the clinical studies carried out in Manchester * involved twelve one hour sessions, the majority of patients find that four or five sessions are usually sufficient to improve their quality of life. Treatment is not available on the NHS at the moment, although hopefully this will change in the future. Patients should be prepared for a minimum of three sessions however benefits may well be felt before that.
* Hypnotherapy in Irritable Bowel Syndrome: A Large Scale Audit of a Clinical Service With Examination of Factors Influencing Responsiveness. W Consalkorale Ph.D., L Houghton Ph.D., P. Whorwell MD. F.R.C.P. Department of medicine, University of South Manchester .