Alyssa Bland struggled for years with gastrointestinal issues that started when she was a high school freshman. By senior year, her diet consisted mostly of rice cakes, she was afraid to go on dates, she had lost 10 pounds and was only attending school half the day because of the discomfort.
Now a 21-year-old college student in Hawaii, Bland had undergone years of tests that ruled out everything but irritable bowel syndrome (IBS), a chronic condition characterized by abdominal pain, often accompanied by changes in bowel habits. Medications, a strict diet and other treatments didn’t help.
Finally, in her senior year, her doctor suggested another option: hypnotherapy.
Bland was dubious but gave it a shot. “I was able to start eating foods almost immediately after the first session,” she said. “It was pretty surprising.” She attended three or four sessions where a trained therapist guided her into a state of deep relaxation and concentration to help her overcome her intestinal discomfort, and for months after that, she regularly listened to a recording her therapist gave her.
Now, four years later, she said, “I can live my everyday life, I can eat most foods, it doesn’t bother me anymore.”
Bland’s experience is not a fluke. While IBS treatment usually consists of dietary changes or medications to relieve symptoms, decades of research has established that hypnotherapy can ease the condition in children and adults.
“Scientifically, it’s well known,” said Ali Navidi, a clinical psychologist in Burke, Va., whose practice, GI Psychology, offers hypnotherapy for IBS. “The tragedy is that it’s not well known among the patients, and it’s not well known also by the clinicians, the doctors.”
IBS is a debilitating disorder. Sufferers can experience pain, bloating and cramping, along with diarrhea or constipation, or a combination of the two. IBS can also lead to or worsen anxiety and depression.
Studies suggest that, in the United States, the condition affects about 12 percent of the population and is more common in women than men. Research involving American children has found prevalence rates of 2.8 percent to 5.1 percent.
Children who have IBS are understandably sensitive about the issue, and, like Bland, may avoid school and social situations. “They fall behind in their work, which causes anxiety toward school, and then that anxiety toward school makes their IBS symptoms worse,” Navidi said.
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Although the cause of IBS is unclear, scientists think it is the result of dysfunctional communication between the brain and the gut.
After you eat, the nerves lining the stomach and small intestine sense the churning, contraction and gas formation happening during digestion and send signals to the brain that something’s going on, said Miranda van Tilburg, a researcher and professor of medicine at the University of North Carolina Center for Functional GI and Motility Disorders. “For … people who don’t have IBS the brain’s going to go, ‘Yeah. You just ate. Stop sending these signals,’”van Tilburg said.
In the case of IBS patients, however, the brain says, “ ‘Wait. Tell me more,’ ” she continued. “And so the signal gets magnified,” resulting in pain and discomfort.
When explaining hypnotherapy to parents and children, Jennifer Webster, an attending physician in the Division of Gastroenterology, Hepatology and Nutrition at the Children’s Hospital of Philadelphia, uses underwear as an analogy. You know your underwear is there under your pants, she tells them, but you generally don’t feel it unless it’s necessary.
Your gut should work similarly. “All day long it is active and moving gas, liquid and food around, but you should only feel it when you need to,” say, if you are hungry or need to use the bathroom, Webster explained. “If you have abnormal interaction between your gut and your brain, it is often sending signals to the brain at times it shouldn’t be. These can sometimes be pain signals and other times can be other signals like nausea or bloating.”
In 1984, a physician named Peter Whorwell was the first to help IBS patients decrease those signals through what is called gut-directed hypnosis (GDH). Subsequent research replicated the results: In one of the largest studies, involving 1,000 patients with difficult-to-treat IBS, 76 percent of participants benefited from hypnotherapy, reducing their symptoms by about half. The treatment also reduced the anxiety and depression that can accompany IBS.
Research into GDH in children showed similar improvements. A 2007 study conducted on children with IBS or functional abdominal pain (FAP) found that 59 percent of patients were considered cured, compared with 12 percent of the kids who received standard therapy. Follow-ups an average of 4.8 years later found that two-thirds of the children who had hypnotherapy were still in remission.
The research has shown that “you really, truly teach people skills, so you don’t have to give them pills. And these skills will remain with them for long term,” said van Tilburg, who recommends trying hypnotherapy for children ages 6 and up.
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If a person is susceptible to hypnosis (up to 25 percent of the population is not), a GDH session puts them into a deeply relaxed but focused trance-like state. In a trance, people are open to suggestion, van Tilburg said, but they cannot be forced to do something they don’t want to do. Hypnotherapy is not like stage hypnosis — those performances where someone is put in a trance and ordered to quack like a duck.
After a child is in a trance, van Tilburg said, she will suggest strategies that will help their gut feel better. For example, she might suggest that they imagine consuming their favorite drink, which is coating their stomach so no pain can get through. Or she might suggest they give their hand special powers, so when they put it on their tummy, the pain goes away. She said children can be trained to treat their own pain in three to six sessions. It may take up to 12 for adolescents and adults.
Some experts think hypnosis for IBS should be the first-line therapy for children, who are more open to hypnosis than adults. The problem is that much treatment is currently connected to hospitals and research institutions, or must take place in an office with a trained therapist, leaving it out of reach of many patients, whether adults or children.
But there are efforts to make hypnotherapy more available. The Rome Foundation, an organization that focuses on brain-gut issues, offers training for clinicians, as do some hypnosis institutes. Research is being done into other ways of delivering treatment, such as group hypnotherapy for adults and recordings children can listen to at home. Some companies are exploring digital options. MetaMe Health is working on a smartphone app to connect patients with a trained therapist that has received premarket FDA clearance.
Navidi, who started out as a generalist, said that after he started offering hypnotherapy for IBS, his practice was flooded with patients. He established GI Psychology in 2020 to help fill the treatment gap. The clinic has eight practitioners, who can provide teletherapy in 30 states. Treatment is typically 10 50-minute sessions that include clinical hypnosis and cognitive behavioral therapy to help children reframe anxious thoughts about their stomach, he said. The children also receive recordings they practice with at home.
The cost is about $2,100, and parents generally get about half of that back from their insurance company.
Bland, the college student, isn’t quite sure why the hypnotherapy worked — perhaps, she said, it was necessary to reach a subconscious level where healing could occur. But she has a message for adults and children with IBS: “Don’t stop looking for those answers until it feels correct,” she said. “It took me a long time to get where I am today, but I’m really happy I never gave up on it.”
Advice by Elizabeth ChangReporter
October 4, 2022 at 7:00 a.m. EDT.
Published by The Washington Post. To read from original link please click here.