Hypnosis: Bowel dysfunction Brigitte Collins, BSc, MSc, Diploma in Hypnosis

Hypnosis: Bowel dysfunction
Brigitte Collins, BSc, MSc, Diploma in
Hypnosis
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.
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.
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?
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.
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
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.
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.
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.
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?
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 wellbeing, 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)
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.
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.
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
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.
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.
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
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
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
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
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
Case study
• Session 6: Not feeling so good. Did self
hypnosis
• Repeated last session
• Homework: Self hypnosis with recording and
self each day.
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’
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.