# Sticky  Compilation of Various Studies, Abstracts ,Articles on Hypnotherapy/CBT



## cookies4marilyn

*Compilation of Various Studies, Abstracts and Articles on Cognitive Behavioral Therapy and Clinical Hypnotherapy* ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~------------------------------------------------With permission from the UNCCognitive-behavioral therapy, hypnosis can help soothe irritable bowel syndrome Back to Good Medicine By DR. OLAFUR S. PALSSONUNC Health Care Irritable bowel syndrome (IBS) is a common gastrointestinal disorder that is characterized by abdominal pain associated with disturbed bowel functioning such as constipation, diarrhea or both. It affects 10-15 percent of the U.S. population, and is at least twice as common in women as in men.The causes of IBS are poorly understood in spite of much research, and medical treatments have proven relatively ineffective for that reason. Our research team found in a study of more than 1,600 patients that only 51 percent of them were at least somewhat better six months after seeing a doctor for IBS.Until recently, there were no medications available specifically for IBS, but doctors used more general medications to treat individual symptoms of the disorder. In the past few years, two prescription medications for IBS have been in use -- one for IBS where constipation is predominant and another for patients who have mostly diarrhea. However, these medications only help at best about half of patients.The limited success of standard medical treatment has led researchers to seek different treatment alternatives for IBS. So far, the most promising of these have been psychological treatments.Although it may at first seem far-fetched to treat bowel problems by talking to people, there are, in fact, a couple of good reasons for using psychological treatments for IBS. One is that studies have indicated that stress and other psychological symptoms substantially affect the bowel symptoms of many IBS sufferers. The other reason is that there is increasing evidence that a "dysfunction" in the brain's normal regulation of the sensations and activity of the bowels plays a role in causing IBS, and this problem might be correctible with psychological methods.Many types of psychological treatment have been tested for IBS. The two that have been most consistently successful are cognitive-behavioral therapy and hypnosis. The majority of studies on both of these therapies have shown that they substantially improve all the central symptoms of IBS in up to 70-80 percent of treated patients and that the benefit often lasts for years after treatment.Both hypnosis and cognitive-behavioral therapy typically require about 8-12 visits to a therapist. In cognitive-behavioral therapy, the therapists work to help patients to overcome distorted and negative thinking patterns that adversely affect life functioning and amplify symptoms, and help them to adopt more effective ways to handle life situations that aggravate the bowel problems.Hypnosis uses a special altered mental state of heightened focus to produce its beneficial effects. Mental imagery and hypnotic suggestions are used to bring about overall relaxation of the bowels and the whole body, lessened sensitivity to gut discomfort, and increased mental control over bowel symptoms. These psychological treatments have proven to have several important advantages that make it likely that they will be increasingly important in the care of IBS in the coming years. They often work well for patients who have not improved from regular medical treatment, they have no uncomfortable side effects and they produce long-term improvement in symptoms. Finally, they often enhance psychological well-being and quality of life in addition to improving gastrointestinal symptoms. At the present time, the main limitations to widespread use of psychological treatments for IBS are the costs of treatment and the lack of therapists who are experienced in these specialized applications of hypnosis and cognitive-behavioral therapy. However, most communities have therapists who use these methods to treat IBS, and the costs may seem reasonable considering the probability of good improvement.IBS sufferers who do not gain satisfactory symptom relief from standard medical treatment may therefore want to discuss these psychological treatment options with their doctor.Olafur S. Palsson, Psy.D., is an associate professor of medicine in the Division of Gastroenterology and Hepatology at the University of North Carolina at Chapel Hill.This column was released for publication in July 2004.-------------Comment In reference to the above article:[QUOTE: "At the present time, the main limitations to widespread use of psychological treatments for IBS are the costs of treatment and the lack of therapists who are experienced in these specialized applications of hypnosis and cognitive-behavioral therapy. However, most communities have therapists who use these methods to treat IBS, and the costs may seem reasonable considering the probability of good improvement."]Although there are communities who do have clincical hypnotherapists who MAY treat IBS, it is important for the reader to note that there are several IBS treatment hypnotherapy protocols - some are whatever that particular therapist does in practice, and may or may not be geared for IBS, and then there are therapists who use the UNC protocol of gut-directed therapy - and this can be determined by asking a therapist if they have this protocol. There are only a few per state that are actually listed who do this, but it is always best to ask.But the third, most cost effective and certainly the easiest way to treat IBS with hypnotherapy may be by using the treatment method many BB members as well as myself have used successfully, which is the IBS Audio Program 100 - the advantage being that you can do it in your own home - this overrides the objections above to finding a therapist - and comprises a clinically proven method costing less than one - in person therapist visit.You can find out more info for in-person IBS therapy from the UNC site, and you can find out more info for the IBS Audio Program 100 from the UK at this link: www.ibscds.com -------------------------HOW AND WHY HYPNOSIS WORKSThomas Yarnell, Ph.D.Licensed Clinical PsychologistHypnosis SpecialistModern hypnosis has been used for hundreds of years to build self-confidence, change habits, lose weight with weight loss programs, stop smoking, improve memory, end behavior problems in children and eliminate anxiety, fear and phobias.The question is, WHAT IS HYPNOSIS? Hypnosis is a state of mind characterized by relaxed brain waves and a state of hyper-suggestibility. Hypnosis and hypnotic suggestions have played a major role in healing for thousands of years. According to the World Health Organization, 90% of the general population can be hypnotized. Hypnosis is a perfectly normal state that just about everyone has experienced. What we call "highway hypnosis" is a natural hypnotic state. You drive somewhere and don't remember driving or even remember seeing the usual landmarks. You are on automatic pilot. The natural hypnotic state also exists when you become so involved in a book, TV show or some other activity that everything else is blocked out. Someone can talk to you and you don't even see or hear them. Whenever you concentrate that strongly, you automatically slip into the natural hypnotic state.The hypnotic state, by itself, is only useful for the relaxation it produces. The real importance of hypnosis to the healing and emotional change process is that while you are in the hypnotic state, your mind is open and receptive to suggestions. Positive and healing suggestions are able to sink deeply into your mind much more quickly and strongly than when you are in a normal, awake state of mind. I say positive suggestions because all research has demonstrated that while in the hypnotic state, you cannot be made to do anything against your moral values. All of our habitual and behavior controlling thoughts reside in what is called our subconscious mind. It's called that because it is deeper than our conscious mind. It's below our level of consciousness. We are unaware of the thoughts and feelings that reside there. Did you ever forget you had a dental appointment or some other appointment that you really didn't want to keep? Your subconscious mind is where that thought or memory that you had to go to the dentist at 2 PM went when you forgot you had the appointment. Once it was too late to go, your conscious mind relaxed and the memory came back.Imagine that there is a trap door between your conscious mind and your subconscious mind. Normally, the trap door is closed until your brain waves slow down to a relaxed, alpha brain wave level. This happens when you are asleep. The door opens for short periods of time and ideas, images and thoughts come out of your subconscious mind. We call what comes out in your sleep, "dreams". When you are in a state of hypnosis, the door also opens so helpful suggestions can be directed into your subconscious mind or forgotten memories can be retrieved.The hypnotic induction that hypnotists use is simply a way to focus your attention and concentration so you will go into that natural, normal hypnotic state. Once in the state of hypnosis, the trap door opens and suggestions to help you can be given. The list of ways hypnosis has been used to help children, adolescents and adults is practically endless but does include: weight loss, stopping smoking, building self-confidence and self-esteem, improving academic performance at every age level, improving test taking ability from children through high school, college, medical and law school as well as the National Teacher Certification Exam, pain management, eliminating anxiety, fear and phobias, stress management, insomnia and other sleep problems and helping to heal physical problems.2. To really work well, suggestions must be reinforced by repetition. Most of the habits, feelings and emotions we want to change are deeply implanted in our subconscious mind and will not just "go away" with one set of suggestions. Most of the time, the hypnotic suggestions need to be repeated on a regular basis until you notice a change. This is one reason that most specialists in hypnosis give clients cassette tapes of their sessions so they can listen to them every day. It's also the reason why hypnosis tapes you buy can work so well. You get to listen to them every day or often enough that the suggestions become permanently a part of you. There is no way to predict how long it will take to see change. It will depend partly on your motivation and commitment.The Three Keys to the successful use of hypnosis for self improvement and personal growth are self motivation, repetition and believable suggestions.1. The motivation to change must come from within you. If you are trying to change because someone else wants you to "lose weight" or "stop smoking", the chances are greately reduced that the hypnosis will work. For example, I've worked with many people for weight loss or to quit smoking who came to me because their physician or spouse wanted them to change. These people do not respond as well to the hypnosis as those who really want to change. Those who came because they wanted to quit smoking or lose weight responded quickly and easily. Before you start to use hypnosis for your self improvement, you should get it clear in your own mind why you want to change. This clear intention to change will help the hypnotic suggestions to take hold and manifest themselves in your everyday life.3. The third key to the successful use of hypnosis for personal change is believable suggestions. If you are to accept a suggestion, your mind must first accept it as a real possibility. Telling a chocoholic that chocolate will be disgusting to them and will make them sick is too big a stretch for the imagination. If a suggestion like this even took hold, it would only last a short time because it would be so unbelievable to a real chocolate lover. In cases like this, one of the successful weight loss suggestions I use is that the next time the individual eats chocolate, it will not taste quite as good as the time before. This is far more acceptable and believable to most people. Then, with enough repetition over a period of time, chocolate loses much of it's positive taste and control over that person.One final note is that HYPNOSIS IS NOT DANGEROUS. There are almost no risks when used by trained professionals. You cannot be made to do anything that is against your moral values. An amateur or stage hypnotist might give you suggestions that might embarrass you, might not work or that might make you feel uncomfortable or self-conscious at the time. To avoid this, stick with professionally trained hypnosis specialists. The one risk I know about involves falling asleep. If you are tired or if you become too relaxed, you may move from the state of hypnosis to the normal sleep state. This is fine if you were going to go to sleep right after the trance but if you have other plans after listening to a hypnosis tape, you may want to set an alarm clock just in case you fall asleep. I've even had students fall asleep because they became too relaxed. In relation to this, never listen to a hypnosis tape while driving. It is very dangerous for you and everyone else on the road. Don't even listen to it if you are a passenger as the relaxation suggestions could make the driver fall asleep.Over the years, self improvement and personal growth using hypnosis has helped millions of people change their lives permanently because it is a safe and powerful tool for changing your thoughts, feelings and habits.Copyright C 2001 by Thomas D. Yarnell, Ph.D., Clinical Psychologist. All rights reserved.This material may be copied for educational purposes as long as full credit is given to Dr. Yarnell.----------------------------------------Medical Abstract *General practitioners believe that hypnotherapy could be a useful treatment for irritable bowel syndrome in primary care.* BMC Fam Pract, October 13, 2004; 5(1): 22. Stephen Cox, Simon de Lusignan, and Tom ChanBACKGROUND: Irritable bowel syndrome is a common condition in general practice. It occurs in 10 to 20% of the population, but less than half seek medical assistance with the complaint. METHODS: A questionnaire was sent to the 406 GPs listed on the West Sussex Health Authority Medical List to investigate their views of this condition and whether they felt hypnotherapy had a place in its management RESULTS: 38% of general practitioners responded. The achieved sample shared the characteristics of target sample. Nearly half thought that irritable bowel syndrome (IBS) was a "nervous complaint" and used a combination of "the placebo effect of personal care," therapeutic, and dietary advice. There is considerable divergence in the perceived effectiveness of current approaches. Over 70% thought that hypnotherapy may have a role in the management of patients with IBS; though the majority (68%) felt that this should not be offered by general practitioners. 84% felt that this should be offered by qualified hypnotherapist, with 40% feeling that this should be offered outside the health service. CONCLUSIONS: General practitioners vary in their perceptions of what constitutes effective therapy in IBS. They are willing to consider referral to a qualified hypnotherapist.PMID: 15482597 http://highwire.stanford.edu/cgi/medline/pmid;15482597 --------------------------------------------December 7, 2004The New York TimesTHE CONSUMER New Remedies for a Frustrating Illness. But Do They Work?By MARY DUENWALD he women in the television commercial pull up their shirts to display the words "abdominal pain," "bloating" or "constipation" scrawled in black marker on their abdomens.Some viewers probably respond by reaching for the remote control. But others may be prompted to ask their doctors whether Zelnorm, the Novartis drug in the advertisement, can actually ease the symptoms of irritable bowel syndrome.The answer, experts say, is, "It depends."Zelnorm is one of two drugs - the other is Lotronex from GlaxoSmithKline - approved by the Food and Drug Administration for the treatment of irritable bowel syndrome, or I.B.S., a disorder that is estimated to affect about 45 million Americans.Twice as many women as men suffer from it. Their search for relief is often frustrating, because it has no single cause and no cure, and doctors are sometimes dismissive of patients' complaints. The symptoms vary. About a third of sufferers have constipation, another third have diarrhea and the rest alternate between the two. Bloating after meals and lower abdominal pain are also common, as are severe fatigue, sleep difficulties, low interest in sex, hopelessness and tension, a recent study in The Archives of Internal Medicine says.Zelnorm, the trade name for tegaserod, has been shown to be effective in treating the syndrome in large clinical trials. It works just for people who suffer constipation. A chief side effect is diarrhea."Because I.B.S. is so heterogeneous, an agent that may treat one symptom can potentially exacerbate another one," said Dr. Robert S. Fisher of the Temple School of Medicine in Philadelphia.Zelnorm is specifically approved for women, but also prescribed for men. Most studies of its safety and effectiveness have been conducted mainly on women. Doctors say that people with irritable bowel syndrome typically require both medications and changes in their routines, the exact regimen depending on a patient's symptoms and their severity. The syndrome was once thought to be simply a visceral response to stress, because doctors could find no biological explanation. As a result, many patients felt that their doctors gave their problem short shrift or, worse, implied it was all in their heads. "People with I.B.S. are sensitized to doctors' thinking they're crazy," Dr. Fisher said. Recent studies indicate that the syndrome may arise from problems in the working of the colon and in the connection between the brain and the colon. "The brain and bowels are wired with a series of nerves," Dr. Brennan M. R. Spiegel, a gastroenterologist at the University of California, Los Angeles, said. "If you have I.B.S., you're wired up in a slightly different way, and that can cause diarrhea, constipation or pain."Studies have shown that people with the syndrome are more sensitive to colon pain and that their brains process the pain abnormally. Stress and anxiety can lead to symptoms or worsen them, but those factors do not cause the disorder, experts say.Abnormal functioning of serotonin in the colon also appears to promote irritable bowel syndrome. In the brain, serotonin is thought to influence mood. But in the colon, where 95 percent of the body's serotonin is found, it helps produce the normal contractions of peristalsis.Zelnorm stimulates serotonin receptors, enhancing peristalsis and relieving constipation. Alosetron, sold as Lotronex, works in an opposite manner, blocking serotonin receptors and slowing peristalsis. Lotronex is for patients whose primary symptom is diarrhea. But the F.D.A. restricts its use because in some patients it has caused extreme diarrhea or restricted blood supply to the colon, problems that have in some cases been fatal. Patients given alosetron have to sign releases stating that they understand its risks.Bacteria may also play a role. Dr. Henry C. Lin of the University of Southern California and others have found that in many patients bacteria that normally reside just in the large intestine move into the small intestine, where they interfere with digestion and generate excess gas, producing symptoms.Because bloating and pain often occur after meals, patients are advised to cut back on foods that seem to set off the worst symptoms, including caffeine, alcohol, fats and milk. For mild cases of the syndrome with constipation, doctors recommend fiber laxatives like Metamucil or FiberCon. Loperamide - Imodium or Kaopectate, for example - can relieve diarrhea.Low doses of old-fashioned antidepressants like amitriptyline and desipramine have been shown to relieve abdominal pain. Newer antidepressants like Prozac do not seem to be as effective. *More helpful, studies suggest, are techniques like cognitive therapy and hypnosis, which Dr. Spiegel says may help patients "get some control over their own symptoms."* --------------------------------------Hypnotherapy in the treatment of irritable bowel syndrome.Eur J Gastroenterol Hepatol. 2005 Jan;17(1):15-20. Related Articles, Links *Hypnotherapy in the treatment of irritable bowel syndrome.* Gonsalkorale WM, Whorwell PJ.Department of Medicine, University Hospital of South Manchester, UK.There is accumulating and compelling evidence that hypnotherapy is an effective treatment for irritable bowel syndrome. Recently, studies have shown that hypnotherapy has beneficial effects that are long lasting, with most patients maintaining improvement, and with decreased consultation and medication needs in the long term. The particular gut directed approach used, which is aimed at normalizing and controlling gut function, is also described. While the mechanisms of how hypnotherapy brings about its therapeutic effect are not fully known, changes in colonic motility and rectal sensitivity have been demonstrated, although changes in central processing and psychological effects may also play a role.PMID: 15647634 -----------------------------------------Eur J Gastroenterol Hepatol. 2005 Jan;17(1):11-4. Related Articles, Links Cognitive behaviour therapy for irritable bowel syndrome.Hutton J.Department of Psychological Medicine, King's College Hospital, London, UK.The UK Department of Health states that there is suggestive, although not conclusive, evidence for the efficacy of cognitive behavioural therapy (CBT) in irritable bowel syndrome (IBS) and that CBT should be considered as a treatment option for the syndrome. This paper provides a general introduction to CBT, the principles which underlie it and how they can be applied to IBS. The components of CBT for IBS are described in some detail. Guidelines for gastroenterologists are provided on how these principles can be used to inform their practice and the existing outcome data are reviewed.PMID: 15647633--------------------------------------------MOTILITY AND VISCERAL SENSATION Visceral sensation and emotion: a study using hypnosis L A Houghton, E L Calvert, N A Jackson, P Cooper and P J Whorwell Department of Medicine, University Hospital of South Manchester, Manchester M20 2LR, UK http://gut.bmjjournals.com/cgi/content/full/51/5/701 ------------------------------------Harvard Health"Hypnosis: Theory and Application Part IAlthough it has been familiar for more than 200 years as a means of entertainment, self-help, and psychotherapy, hypnosis is still a misunderstood practice and the hypnotic experience an elusive state of mind. Most of us think we know what it is to be hypnotizedï¿½until we are asked. But by now enough research has been conducted and enough knowledge accumulated to make it clear that hypnosis is neither a parlor trick nor an occult phenomenon. The ExperienceThe term ï¿½hypnosis,ï¿½ invented in the 19th century, is derived from the Greek word for sleep, but the derivation is misleading. Subjects are often physically relaxed, and they may be told to close their eyes to enter a hypnotic state, but all the while they are fully awake and alert. The best descriptions point to three related features of hypnosis: absorption or selective attention, suggestibility, and dissociation. Selective attention is a tendency to focus narrowly, noting certain aspects of experience while becoming oblivious to others. Suggestibility is high responsiveness to social and other environmental cues, including the instructions of a hypnotist. Dissociation is an apparent loss of the unity and continuity of consciousnessï¿½a seemingly divided awareness or the capacity to shut out certain perceptions and memories. Vivid and unusual phenomena may occur under hypnosisï¿½automatic writing, negative hallucinations (not seeing something that is clearly there), and reliving the distant past as though it were present. During hypnotic age regression, subjects may talk and act like small children while responding like adults to a command to move forward and backward through time. Their physical reactions may indicate pain while they say they donï¿½t feel it. They sometimes have apparent amnesia for the experience or respond to posthypnotic suggestionï¿½instructions given during the hypnotic state to be obeyed afterward on the snap of a finger or other cue. Inducing the state generally takes 10ï¿½20 minutes (sometimes only seconds), and there are many ways to do it. Perhaps the best known is to have the subject stare at a target like a swinging pocket watch or a dot on a blank sheet of paper. Or the subject may be helped to relax and then repeatedly told in a rhythmic and monotonous voice something like, ï¿½Your eyelids are getting heavy.ï¿½ Sometimes it is enough just to repeat, ï¿½Relax, focus, float.ï¿½ Visual imagery may be used to deepen the trance: ï¿½Imagine riding down a long escalator.ï¿½ There are also many indirect ways of diverting and fixing attention. Some practitioners even claim to be able to induce hypnosis over the telephone. To end a session, the hypnotist simply tells the subject to come out of it. Hypnosis is not mind control. People in a hypnotic trance may feel as though their actions are compelled, and they usually respond to instructions and requests from the hypnotist. But hypnotists have no special powers, and they are not necessarily charismatic or flamboyant. Stage magicians, as everyone knows, can get volunteers to do entertainingly ridiculous things. But people cannot be hypnotized against their will or obliged to do or say anything that conflicts with their moral standards or seriously offends their sense of decorum. And they can usually bring themselves out of the hypnotic state whenever they want. In fact, hypnosis does not require a hypnotist. Some people become hypnotized spontaneously as they lose themselves in daydreams or drifting thoughts or become deeply absorbed in work or play. Most can also learn to hypnotize themselves deliberately. The hypnotist is just an instructor or guide. In an important sense, hypnosis is always self-hypnosis. HypnotizabilityResearchers have devised tests of hypnotic susceptibility and scales to measure it, mostly involving the ability to hallucinate, alter physical sensations, forget and remember in unusual ways, and produce seemingly involuntary movements or paralysis. Some common tests are the ability to roll the eyes far upward, the willingness to fall backward on command, the capacity to produce a feeling that an arm or leg is paralyzed or levitating, the capacity to conjure up a sweet taste in the mouth, and the capacity to show no signs of pain when pricked with a pin. Subjects may be told they have no sense of smell and then watched as a bottle of ammonia is waved in front of their noses. There is some dispute about whether these tests are definitive and even whether hypnotic susceptibility can be measured on a single scale. Still, researchers generally agree that individual differences in the capacity to respond to hypnosis exist and are remarkably stable over a lifetime. The capacity peaks at ages 5ï¿½10 and then slowly declines until it levels off in the early 20s. Studies comparing identical and fraternal twins indicate that hypnotizability is highly heritable. It is estimated that, by standard scales, about 90% of us can achieve at least a light hypnotic state, while 10%ï¿½20% are highly (or deeply) hypnotizable, and 10%ï¿½15% are not susceptible at all. It is less clear what kinds of people are most easily hypnotized. It is often said, and seems intuitively plausible, that the best subjects are imaginative, trustful, and emotionally unguarded rather than literal-minded, skeptical, and cautious. But personality tests do not consistently indicate these characteristics, so the issue remains in doubt. Theories of HypnosisA related doubt concerns the nature of hypnosisï¿½whether it is a distinct state of consciousness and how it differs from other experiences of relaxation, suggestion, and imaginative absorption. The most influential theories of hypnosis emphasize dissociation, which is said to explain the amnesia of hypnotic subjects and the fact that they often say their actions are not willed but happening spontaneously. Further evidence for dissociation comes from experiments indicating a so-called ï¿½hidden observer.ï¿½ For example, the hypnotist instructs a subject that he or she is deaf and then says, ï¿½Although you are deaf, perhaps part of you can hear. If so, raise your finger.ï¿½ The finger rises. When asked later, the subject says he heard nothing but suddenly felt his finger rise. The experiment suggests that two distinct systems of consciousness are operating, separated by a partial or total barrier of amnesia. A different understanding is reflected in the social-cognitive theory of hypnosis, which emphasizes suggestibility rather than dissociation. Social-cognitive theorists interpret the hypnotic trance not as an altered state of consciousness but as one striking effect of the human susceptibility to social influence. Their idea is that the hypnotist and the subject have entered into an implicit agreement that certain things will be allowed to happen and the subject will describe or confirm certain experiences. The subject responds to these ï¿½demand characteristicsï¿½ of the situation, doing and saying what is expected to win the hypnotistï¿½s approval. The hypnotic trance is a performanceï¿½not mere playac ting but the sincere adoption of a role. If this view is correct, hypnotic susceptibility is a result of willingness to comply with suggestions, sensitivity to nuances in personal communication, and a high capacity for sincere make-believe and self-dramatization. Social-cognitive theorists say that they can increase or decrease a personï¿½s apparent hypnotic susceptibility simply by changing the instructions and therefore the subjectï¿½s expectations. For evidence, they rely heavily on experiments with people who, according to standard tests, are not easily hypnotized. When these simulators pretend to be hypnotized and act accordingly, they are said to respond just like a person in a ï¿½genuineï¿½ trance. Social-cognitive theorists add that the hidden observer of dissociation theory is not real but a product of suggestion that can also be manipulated by changes in the instructions. Apparent individual differences in hypnotic susceptibility are explained by differences in suggestibility and in the expectations brought to the situation. In response, advocates of the dissociation theory argue that people who are pretending to be hypnotized respond to suggestions only when they are being observed, unlike people who are truly hypnotized. Also, some people who are told to pretend may actually go into a trance, and susceptibility to social influence may itself sometimes be a hypnotic effect. Some believe the dispute between the theories cannot be resolved, because in the end there is no difference between entering a special state of consciousness and immersing oneself in a performance so deeply that it is no longer experienced as playacting. In either case there are likely to be signs of imaginative absorption, divided attention, and selective recall. Resources A therapeutic hypnotist should be a licensed practitioner in one of the mental health professionsï¿½psychology, psychiatry, social work, or psychiatric nursing. The following organizations train and license therapists who use hypnosis and provide referrals for hypnotic therapy. American Society of Clinical Hypnosis, 130 East Elm Court, Suite 201, Roselle , IL 60172-2000 . Telephone: 630-980-4740 . On the Web: http://www.asch.net. Society for Clinical and Experimental Hypnosis, Washington State University, P. O. Box 642114, Pullman , Washington 99164-2114 . Telephone: 509-332-7555 . On the Web: http://www.hypnosis-research.org Hypnosis: Theory and Application Part IIIn Part I we described the hypnotic experience and discussed theories about its nature. This month we cover the results of brain imaging studies and the therapeutic uses of hypnosis. Research has shown that brain activity often changes during the hypnotic state. The brainï¿½s response to pain is reduced, and many hypnotic subjects have high electrical activity of the type that indicates a relaxed state in the left frontal region of the cerebral cortex, which controls planning and decision-making. In one experiment, hypnotized volunteers were instructed to put their hands in hot water and told how intensely to experience the pain. Positron emission tomography (PET) scans showed that changes in pain perception were correlated with changes in blood flow to the anterior cingulate gyrus, a region involved in the control of attention and the relationship of emotions to perceptions. Activity in that area increased in response to a suggestion that the pain was becoming worse and decreased in response to a suggestion that it was milder. Seeing HypnosisAnother experiment using PET scans shows a different correlation between the hypnotic state and brain activity. Volunteers chosen for high hypnotic susceptibility were shown a grid of colored squares, then told they were colorblind and able to see only shades of gray. They performed the experiment both while hypnotized and while not under hypnosis. When they were not hypnotized, blood flow and energy consumption were reduced in color vision areas of the brain, but only in the right hemisphere of the cerebral cortex. Under hypnosis, color vision areas lost blood flow in both hemispheres. If the subjects were not told they were colorblind but simply asked to visualize the images as gray, only the right hemisphere was affected. All the same effects occurred in reverse when subjects were presented with a black-and-white grid and instructed to see it in color. If this result is confirmed, it will be evidence that the hypnotic experience and the exercise of visual imagination correspond to different states of the brain. These experiments do not resolve the dispute about the nature of hypnosis, because other forms of absorption and concentration might produce similar effects. But the brain imaging research at least suggests that hypnotism has a real neurophysiological correlate. Hypnotic TherapyDespite their limited understanding of the nature of hypnosis, physicians and psychotherapists recommend it to manage stress, change physical sensations, and heighten emotional sensitivity. Altered states of consciousness that might now be called hypnotic have been a part of religious and healing rituals for thousands of years. Meditative techniques like the yogic mantra rely on similar procedures. In the late 19th century, Pierre Janet used hypnotic suggestion to reproduce the forms of mind-created anesthesia and paralysis that occur in patients with conversion disorders (at that time called hysteria). He introduced the term ï¿½dissociation of consciousnessï¿½ to describe the condition. Freud was influenced by Janetï¿½s work, and although he eventually abandoned the practice of hypnosis, it left a mark on his idea of the dynamic unconscious. Today, the popularity of therapeutic hypnosis is sustained by the increasing interest in mind-body connections and alternative medicine. Hypnotic therapy attempts to take advantage of hypnotic subjectsï¿½ high sensitivity both to their own sensations and feelings and to everything the hypnotist says and does. One approach is simply to suggest that symptoms will go away. The results are rarely lasting, although even temporary relief can be important in some situationsï¿½acute illness or surgery, for example. Today, hypnosis is also applied in subtler ways, to help patients not by controlling them but by helping them take control. Therapists teach patients self-hypnosis and encourage them to make up their own suggestions. Hypnotic techniques are almost always used not alone but as an aid to psychotherapy or medical treatment. Despite Freudï¿½s rejection of hypnosis, some psychodynamic therapists have hypnotized patients to generate emotional reactions for examination, liberate fantasies and associations, retrieve memories, and accelerate the establishment and resolution of the transference (the relationship between patient and therapist that recapitulates earlier emotional ties). However, there is little evidence that these methods are effective, and they pose some danger of evoking unmanageable emotional reactions. In behavior therapy and cognitive therapy, hypnosis is used to enhance relaxation, generate imagery, heighten the expectation of success, and alter self-defeating thoughts. It can facilitate covert reinforcement, in which a patient imagines a reward after imagining the desired actions; and desensitization, in which relaxation and imagery are used to relieve anxiety and eliminate phobias. Therapeutic UsesOne of the best confirmed therapeutic uses of hypnosis is the control of pain. Under hypnosis, patients can learn to alter their experience of pain by concentrating on the other parts of the body or making the painful area feel numb, warm, or cold instead. Images can be invokedï¿½a switch turning off the pain, an ice cube cooling an aching head, a vision of teeth being removed from the mouth before a dentist goes to work. Hypnosis can reduce the discomfort of medical procedures and, at least partially, control the pain of chronic backache, migraine, childbirth, and cancer. Hypnotic techniques have also been used with varying success to treat other physical symptoms, including bedwetting, sexual problems, asthma, warts, gastrointestinal disorders, and side effects of chemotherapy. Hypnosis has not proved effective for alcohol and drug addictions, although some practitioners believe it can help smokers quit. In the treatment of anxiety and phobias, hypnosis may serve to dissociate physical discomfort from mental anxiety and prevent a spiral of physical and emotional distress. Many people with phobias can use self-hypnosis to help master their fears. Hypnotic methods are also used to treat physical symptoms complicated by anxiety; for example, people with asthma can be taught to control their reactions to breathing difficulties. Hypnosis has been used in the treatment of post-traumatic stress disorder (PTSD) since World War I, when it was introduced as a therapy for shell-shocked soldiers. Experiences like combat, rape, assault, and child abuse often cause pervasive demoralization. Victims feel helpless, emotionally numb, and compelled to avoid reminders of the traumatic event. The experience returns in the shape of nightmares, flashbacks, and involuntary memories. Therapists who advocate hypnotic treatment describe it as a safe, comfortable, and voluntary form of dissociation that can help people suffering from post-traumatic symptoms to interrupt and control intrusive reliving experiencesï¿½and eventually, in some cases, to confront the past and free themselves from it. Dissociative identity disorder (formerly known as multiple personality disorder) is a controversial diagnosis given to people who, apparently because of severe child abuse, have lost access to various aspects of identity, memory, and consciousness. They may describe themselves as possessed, or abruptly enter altered states of consciousness in which they seem to adopt new personalities. These patients are highly hypnotizable, and hypnosis or self-hypnosis has been used to help them integrate disparate personalities by breaking the barriers of amnesia. Hypnosis and MemoryCritics are concerned that a focus on recovering memories and reliving experiences will divert attention from the need to change present behavior, improve general functioning, and reduce symptoms in patients with PTSD or dissociative identity disorder. The hypnotic treatment of people suffering from the after effects of child abuse is particularly controversial because of fears that the recovered memories will be fictions resulting from suggestion acting on an all too lively imagination. There is some evidence that hypnotically induced memoriesï¿½often vivid, emotionally intense, and produced effortlesslyï¿½inspire greater confidence than they deserve. Studies show that hypnosis tends to cause people both to remember and to imagine more, thereby increasing both true and false memories. Responsible psychotherapists warn that autobiographical memories, whether evoked under hypnosis or not, should never be accepted without corroboration as historical truth. Controlled research has found hypnosis helpful in a variety of ways:One study evaluated the effectiveness of self-hypnosis for relieving pain and anxiety in people undergoing local anesthesia for angioplasty and other medical procedures. Compared with a control group, patients trained in self-hypnosis required half the amount of painkilling drugs on average and were less likely to have troublesome variations in blood pressure and heart rate. On average, hypnosis reduced the cost of intravenous sedation by more than $100 per patient and the time needed for the procedure by a third. Another study shows that self-hypnosis can be useful in preparing for childbirth and reducing labor pains. In this study, 66 pregnant adolescents were divided into three groups and assigned to hypnosis preparation, counseling, or standard care beginning in the sixth month of pregnancy. The first group was taught to use labor contractions as a signal to go into a mild hypnotic state. Compared with women in the other two groups, they needed less anesthesia during delivery, took less pain medication afterward, and left the hospital sooner. In a meta-analysis of 18 controlled studies, hypnosis was found to have provided significant pain relief for more than 75% of 900 patients. Another meta-analysis of 18 studies indicated that patients who received cognitive-behavioral therapy along with hypnosis for such problems as pain, obesity, insomnia, anxiety, and high blood pressure showed, on average, greater improvement than 70% of patients who received cognitive-behavioral therapy alone. Therapeutic research and psychological experiments have brought hypnosis out of the realm of magic. The hypnotic experience is not a fraud, not a placebo, not a panacea, but one striking and potentially illuminating effect of a common human capacity to experience changes in consciousness. As brain imaging and other new techniques improve our understanding of hypnosis, we will come to know better when and how it should be used in research and therapy." http://www.health.harvard.edu --------------------------------------------- http://www.twincities.com/mld/pioneerpress/6974868.htm Pioneer PressPosted on Sun, Oct. 12, 2003 HEALTH: Hypnosis gaining respectability among doctors, patientsBY MICHAEL WALDHOLZWall Street JournalHypnosis, often misunderstood and almost always controversial, is increasingly being employed in mainstream medicine.Numerous scientific studies have emerged in recent years showing that the hypnotized mind can exert a real and powerful effect on the body. The new findings are leading major hospitals to try hypnosis to help relieve pain and speed recovery in a variety of illnesses.At the University of North Carolina, hypnosis is transforming the treatment of irritable bowel syndrome, an often-intractable gastro-intestinal disorder, by helping patients to use their mind to quiet an unruly gut.Doctors at the University of Washington's regional burn center in Seattle regularly use it to help patients alleviate excruciating pain.Several hospitals affiliated with Harvard Medical School are employing hypnosis to speed up postsurgical recovery time. In one of the most persuasive studies yet, a Harvard researcher reports that hypnosis quickened the typical healing time of bone fractures by several weeks."Hypnosis may sound like magic, but we are now producing evidence showing it can be significantly therapeutic," says David Spiegel, a Stanford University psychologist. "We know it works, but we don't exactly know how, though there is some science beginning to figure that out, too."Hypnosis can't help everyone, many practitioners say, and some physicians reject it entirely. Even those who are convinced of its effect say some people are more hypnotizable than others, perhaps based on an individual's willingness to suspend logic or to simply be open to the potential effectiveness of the process.GOING MAINSTREAMThese days, legitimate hypnosis is often performed by psychiatrists and psychologists though people in other medical specialties are becoming licensed in it, too. It can involve just one session, but often it takes several ï¿½ or listening to a tape in which a therapist guides an individual into a trancelike state.Whatever the form, it is increasingly being used to help women give birth without drugs, for muting dental pain, treating phobias and severe anxieties, for helping people lose weight, stop smoking or even perform better in thletics or academic tests. Many health-insurance plans, even some HMOs, now will pay for hypnosis when part of an accepted medical treatment.Until the past decade, many traditional science journals regularly declined to publish hypnosis studies, and research funding was scarce. That's changing. Spiegel, for instance, is co-author of a widely referenced randomized trial involving 241 patients at several prestigious medical centers. Published several years ago in the Lancet, a respected medical journal, it found that patients hypnotized before surgery required less pain medication, sustained fewer complications and left the hospital faster than a similar group not given hypnosis.Using new imaging and brain-wave measuring tools, Helen Crawford, an experimental psychologist at Virginia Polytechnic Institute in Blacksburg, Va., has shown that hypnosis alters brain function, activating specific regions that control a person's ability to focus attention."The biological impact is very real and it can be quantified," Crawford says.STAYING LEGITIMATEStill, proponents say they typically spend a great deal of time dispelling commonly held myths and answering skeptics. Hypnosis, they say, cannot make people do or say something against their will.Credible hypnotists don't wave a watch in front of their clients, as portrayed in many old movies. People who enter into a so-called hypnotic trance are not, generally, put to sleep. On the contrary, practitioners say, they refocus their concentration to gain greater control.Even so, the field continues to be hurt by quacks, says Marc Oster, president of the American Society of Clinical Hypnosis. His group, along with the Society for Clinical and Experimental Hypnosis, publishes research studies, conducts educational seminars for health providers and certifies those who complete course work and meet other standards.Oster suggests that people interested in hypnosis see a health provider licensed in a medical discipline who is also certified by one of the hypnosis societies ï¿½ someone who "uses hypnosis as an adju


----------



## cookies4marilyn

Definition of the Process of Hypnosis and Trance StatesHypnosis is a process during which an individual, usually with the aid of another, allows themselves to become more suggestible. One can experience changes in sensations, perceptions, thoughts, or behavior. Hypnosis is generally established by an induction procedure. Although there are different hypnotic inductions, they are based on imaginative involvement with focused attention and concentration. People respond to hypnosis in different ways. Some describe their experience as an altered state of consciousness. Others describe hypnosis as a normal state of focused attention, in which they feel very calm and relaxed. Regardless of how and to what degree they respond, most people describe the experience as very pleasant. A person's ability to experience hypnotic suggestions can be inhibited by fears and concerns arising from some common misconceptions. Everyone has a conception of hypnosis. It probably comes from depictions of hypnosis in books, movies or on television. Those who have been hypnotized do not lose control over their behavior. They remain aware of who they are and where they are, and unless amnesia (the inability to recall past events, in this context the inability to recall what has occurred during the hypnotic session), has been specifically suggested, they usually remember what transpired during hypnosis, the only exception to this is what is called a somnambulist. A somnambulist is an individual who has the ability to go very deeply into hypnosis. A somnambulist will have total amnesia. Hypnosis makes it easier for people to experience suggestions, but it does not force them to have these experiences. Although scientists have different theories about the nature of hypnosis, all seem to agree that hypnotized people report changes in the way they feel, think, and behave, and these changes are in response to suggestions. People vary in their of responsiveness to hypnotic suggestions, what is called their hypnotizability or hypnotic susceptibility, but most people can be hypnotized to some degree. Hypnosis is a naturally occurring phenomenon. We go in and out of hypnosis constantly, while watching an interesting program on television, reading a book, driving a car, or day dreaming, just to name a few. People who appear to be low in hypnotizability often can improve their response to suggestions with practice. If an individual is unable to use all of their hypnotic ability during a testing session, it might appear that they are a poor subject, but with improved rapport, many are able to improve hypnotic ability. Most clinical uses of hypnosis have been designed for the average individual, and a deep state of trance is not usually needed for most clinical treatment. American Psychotherapy & Medical Hypnosis AssociationAPMHA Consumer Information January 2000------------------------------------------Treating IBS by Hypnosis?Summarized by Robert W. Griffith, MD November 6, 2003IntroductionSurprisingly, the irritable bowel syndrome (IBS) takes up to 50% of the gastroenterologist's workload, according to British researchers. Symptoms - abdominal pain, bloating, and constipation or diarrhea - can be sufficiently severe to impair the patient's quality of life. Although specific medications have recently become available to address the condition (see related links below), treatment remains unsatisfactory for many patients.Hypnotherapy has been shown in earlier studies to be an effective form of therapy, at least in the short term. Now a study has been reported in the British journal Gut that describes the long-term benefits of this form of treatment.What was doneA gut-directed hypnotherapy unit was established in the UK some years ago. Recently, questionnaires were mailed to 273 patients with IBS who had completed a course of gut-directed hypnotherapy at least one year previously. A full course comprised up to 12 one-hour weekly sessions. The patients had already completed such questionnaires immediately before and after their course of hypnotherapy. The aim of the study was to see if the apparent benefits of hypnotherapy persisted for at least a year.The questionnaire covered IBS symptoms, an anxiety and depression scale, a subjective assessment of symptoms (how the patients themselves felt about their condition), doctor's visits, and medications used.What was foundOf the 273 questionnaires sent out, 204 were returned - a 73% return rate. The time between treatment and the return of questionnaires ranged evenly between 1 and 6 years.Immediately after completing the course of hypnotherapy, 52% of the patients reported they were "very much better", 19% were "moderately better", and 15% as "slightly better", while 13% reported "no change".The questionnaires collected at varying interval greater than one year (and up to 6 years) after finishing hypnotherapy showed that 81% of the original responders had maintained their improvement; 29% had "improved much more", 24% "improved moderately more", 11% "improved slightly more", and 17% were "about the same as at the end of hypnotherapy". The remaining 19% had experienced deterioration, mostly described as "slight worsening".The specific IBS symptoms (pain severity, pain frequency, bloating, bowel habit dissatisfaction, life interference) showed a similar response. All of them were significantly improved immediately after hypnotherapy, and showed little change at the follow up survey, whether this was after 1, 2, 3, 4, or 5 years.Quality of life, anxiety, and depression scores were significantly improved immediately after hypnotherapy, but were more likely to show some deterioration by the time of final follow up; however, they were still significantly better than those before the hypnosis therapy. Visits to the doctor and the amount of medication taken showed similar changes after treatment.CommentThis is the first report of the long-term benefits of gut hypnotherapy for IBS. The results are quite favorable - 71% of patients were improved by hypnotherapy, and 81% of these responders maintained the benefit, or reported further improvement, for periods up to 6 years.As many as 85% of the people who returned questionnaires had continued to practice hypnotherapeutic techniques on their own, after the end of the hypnotherapy course. It wasn't possible to say whether this was associated with a better result over the follow-up period.Gut-directed hypnotherapy, first developed in the UK in 1984, is a technique that clearly requires specific experience, and is unlikely to be successful in untrained hands. IBS patients considering such an approach should consult with their physicians and find a center that is able to provide this particular service.Source Long term benefits of hypnotherapy for irritable bowel syndrome. WM. Gonsalkorale, V. Miller, A. Afzal, PJ. Whorwell, Gut, 2003, vol. 52, pp. 1623--1629 http://www.healthandage.com/Home/gm=2!gid2...79238!7537!7038 ------------------------------Abstract of above referenced article:Gut. 2003 Nov;52 11:1623-9. Links Long term benefits of hypnotherapy for irritable bowel syndrome.Gonsalkorale WM, Miller V, Afzal A, Whorwell PJ.Department of Medicine, University Hospital of South Manchester, Manchester, UK.BACKGROUND: and aims: There is now good evidence from several sources that hypnotherapy can relieve the symptoms of irritable bowel syndrome in the short term. However, there is no long term data on its benefits and this information is essential before the technique can be widely recommended. This study aimed to answer this question. PATIENTS AND METHODS: 204 patients prospectively completed questionnaires scoring symptoms, quality of life, anxiety, and depression before, immediately after, and up to six years following hypnotherapy. All subjects also subjectively assessed the effects of hypnotherapy retrospectively in order to define their "responder status". RESULTS: 71% of patients initially responded to therapy. Of these, 81% maintained their improvement over time while the majority of the remaining 19% claimed that deterioration of symptoms had only been slight. With respect to symptom scores, all items at follow up were significantly improved on pre-hypnotherapy levels p<0.001 and showed little change from post-hypnotherapy values. There were no significant differences in the symptom scores between patients assessed at 1, 2, 3, 4, or 5+ years following treatment. Quality of life and anxiety or depression scores were similarly still significantly improved at follow up p<0.001 but did show some deterioration. Patients also reported a reduction in consultation rates and medication use following the completion of hypnotherapy. CONCLUSION: This study demonstrates that the beneficial effects of hypnotherapy appear to last at least five years. Thus it is a viable therapeutic option for the treatment of irritable bowel syndrome.PMID: 14570733---------------------------- http://news.bbc.co.uk/1/hi/health/3207972.stm Hypnotherapy seems to be an effective long term treatment for irritable bowel syndrome, research finds. IBS is a very common disorder affecting up to 15% of the population at any one time, but is difficult to treat. Researchers from Withington Hospital, Manchester, found hypnotherapy helped 71% of patients - and its effect lasted up to five years after treatment. The research, based on 200 patients, is published in the journal Gut. Symptoms of irritable bowel syndrome Abdominal pain Diarrhoea Constipation Bloated stomach A feeling of incomplete emptying of the bowels Nausea, belching and vomiting A need to rush and open the bowels The patients were given one hour sessions of hypnotherapy for up to 12 weeks. They were asked to assess their symptoms, quality of life and levels of anxiety and depression before and after treatment - and for up to six years after completing the course. The majority of patients found that hypnotherapy reduced the severity of their IBS symptoms, and continued to do so for years. Even those who said the effect began to wear off with time, found that the deterioration was slight. Cost effective Hypnotherapy also seemed significantly to reduce levels of anxiety and depression - however, the effect here did begin to tail off slightly over time. But patients also said they took fewer drugs and did not need to see their doctors as often after they had had a course of hypnotherapy. The researchers say the sustained improvements in most of the patients cannot be attributed to other treatments as fewer than one in 10 patients attempted alternatives after completing their hypnotherapy sessions. Previous research has shown hypnotherapy to have a beneficial effect on IBS in the short term - but not over a longer period. Critics say hypnotherapy is an expensive treatment. But the researchers argue that the cost would be more than offset by a reduction in demand for prescription drugs. Lead researcher Dr Wendy Gonsalkorale told BBC News Online: "While other studies have shown that symptoms have improved by the end of the course of treatment, the real significance is our finding that these effects are sustained after treatment sessions have finished, rather than patients just reverting back to their original state. "We firmly believe that hypnotherapy should be available as a standard treatment for all patients with IBS." Effect unclear Dr Gonsalkorale said it was unclear what caused IBS, and why hypnotherapy should help. However, she said the condition was possibly linked to problems with muscle movement, or to increased sensitivity of the gut lining. She said hypnotherapy may help the patient to gain better control over the way their gut works by influencing the release of hormones, or the nerve links between the gut and the brain. It may also alter the way that the brain responds to incoming pain messages. "For some patients, psychological factors and stresses may play a role in triggering or at least exacerbating symptoms. "Whether or not they are the primary cause is still very debatable. Hypnosis can be used as a form of relaxation, to reduce stress. "But it is not the whole story by any means. We know also that the therapy alters the way patients think about their symptoms." Dr Mark Cottrill, a trustee of the IBS Network and a GP in Wigan, told BBC News Online his practice had employed the services of a hypnotherapist to treat IBS patients for a short time. "She proved extremely popular and within months she had a three to four month waiting list," he said. "But we had to end the sessions because we had no funding for them. It can cost ï¿½600 per patient and the money has to be found upfront." --------------------------American College of Gastroenterology 68th Annual Scientific Meeting "Hypnosis for IBSPalsson and colleagues 17 previously reported positive results associated with the use of hypnosis in patients with IBS. It was found that hypnosis 45 minutes every other week for 12 weeks as well as self-hypnosis techniques improved both IBS symptoms pain, bloating, and disturbed defecation and psychologic parameters somatization and anxiety scores. However, the real-world effectiveness of hypnotherapy presupposes motivated patients and ready access to an appropriately trained therapist.During this year's meeting of the American College of Gastroenterology, Palsson and colleagues 18 expanded on their previous work by reporting the results of a 3-month home hypnosis program for patients with IBS. The study authors compared the improvement in multiple symptom parameters of 19 patients with IBS treated with self-hypnosis conducted via audio compact disc instruction with 57 age-, sex-, and symptom severity-matched controls treated with standard medical therapy. Fifty-three percent of the hypnosis patients had improvement in overall IBS symptoms compared with 26% of the controls 10 of 19 vs 15 of 57; P < .05. Quality of life was also significantly improved among patients who underwent hypnosis, and these treatment differences were shown to persist at 6 months. These investigators also found that patients exhibiting greater degrees of anxiety were less likely to respond to hypnotherapy, suggesting that other methods of therapy may be more useful in this subset of patients with IBS." http://www.medscape.com/viewarticle/463080 ---------------------------------Virtual Hospital.Understanding IBS Irritable bowel Syndrome: A Primer for Patients Chapter 1: What Does IBS Mean to Doctors and to Patients? James Christensen, M.D. and Robert W. Summers, M.D.Peer Review Status: Internally Peer Reviewed http://www.vh.org/adult/patient/internalme...rome/chap1.html Chapter 2 : What Parts of the Gut May Be Misbehaving in IBS? http://www.vh.org/adult/patient/internalme...rome/chap2.html Chapter 3: What is the Structure of the Nerves and Muscles of the Gut that Might Be Related to IBS? http://www.vh.org/adult/patient/internalme...rome/chap3.html Chapter 4: How Can the Muscles and Nerves of the Gut Go Wrong in IBS? http://www.vh.org/adult/patient/internalme...rome/chap4.html Chapter 5: How Does a Doctor Arrive at a Diagnosis of IBS? http://www.vh.org/adult/patient/internalme...rome/chap5.html Chapter 6: How Do Doctors Analyze Your Symptoms in Order to Distinguish IBS from Other Conditions? http://www.vh.org/adult/patient/internalme...rome/chap6.html Chapter 7: Some Common Conditions Where Diarrhea and Gas with Bloating Can Be Misinterpreted as Evidence of IBS http://www.vh.org/adult/patient/internalme...rome/chap7.html Chapter 8: Some Common Conditions Where Abdominal Pain Can Be Misinterpreted as Evidence of IBS http://www.vh.org/adult/patient/internalme...rome/chap8.html Chapter 9: Some Common Conditions Where Nausea and Vomiting Can Be Misinterpreted as Evidence of IBS http://www.vh.org/adult/patient/internalme...rome/chap9.html Chapter 10: What Could IBS Be? http://www.vh.org/adult/patient/internalme...ome/chap10.html -----------------------------------GastroenterologyThe growing case for hypnosis as adjunctive therapy for functional gastrointestinal disorders"This is most recently shown by the largest systematic assessment to date (250 consecutive patients) of the therapeutic impact of this treatment, reported in 2002 by the Manchester group.3 Based on the more than 50% average reduction in IBS severity, substantial reduction in anxiety and depression, significantly reduced health care costs and improved quality of life noted in this report, and good maintenance of symptom improvement beyond 2 years after treatment, it might be argued that hypnotherapy is more effective than any other single treatment modality for severe IBS. ""In conclusion, although some of the studies to date on hypnotherapy for functional GI disorders have been small and lacking in methodological rigor, and many research questions remain unanswered, the cumulative and consistent evidence for efficacy of hypnotherapy for these disorders seems to warrant serious consideration of its use as a regular adjunct in primary care and gastroenterology treatment of patients with FD and IBS. " http://www2.us.elsevierhealth.com/scripts/...16508502004821& ----------------------------Brain Imaging Studies of the Hypnotic Modulationof Pain Sensation and Pain Affect http://www.mcmaster.ca/inabis98/woody/rainville0419/two.html ------------------------ http://my.webmd.com/content/Article/57/65943.htm Hypnosis Soothes IndigestionHypnotherapy May Reduce Need for MedicationsBy Jennifer WarnerWebMD Medical NewsDec. 17, 2002 -- Getting rid of chronic indigestion may be as easy as closing your eyes, relaxing, and imagining your symptoms going away. A new study shows hypnotherapy can ease the pain, nausea, and bloating caused by an upset stomach and help prevent future episodes. Researchers found hypnotherapy provided both immediate and long-term relief to people with persistent indigestion and eliminated the need for anti-indigestion medications as long as a year after treatment. The findings appear in the current issue of Gastroenterology. Indigestion is an extremely common condition that causes discomfort after eating. According to researchers, the problem affects up to 25% of adults, and the few effective medications available for the condition are expensive. Previous studies have shown that hypnotherapy can be effective in reducing the symptoms of irritable bowel syndrome (IBS), and in this study researchers tested a similar technique for the first time in people with indigestion. The hypnotherapy consists of inducing hypnosis through eye fixation and closure followed by progressive muscle relaxation and guiding the patient through a series of imaginary and touch-based suggestions of disease improvement, such as placing a hand on their abdomen and imagining a reduction of symptoms. For the study, researchers evaluated improvements in the quality of life and symptoms in the different treatment groups. Symptoms and quality of life were assessed using a scale. They compared hypnotherapy with both standard medical treatment using a commonly used drug (Zantac) and supportive therapy with a placebo among 126 patients with indigestion. After 16 weeks of treatment, symptoms scores were improved by 59% in the hypnotherapy group compared with 41% in the supportive group and 33% in the medication group. A year later, the hypnotherapy showed an even greater improvement in symptoms (79%) compared with the supportive and medication groups (34% and 43%, respectively). The quality of life of the patients who used hypnotherapy also improved significantly more than those in the other groups. But researcher Peter James Whorwell, of Wythenshawe Hospital in Manchester, U.K., and colleagues, say the most striking finding was that no one in the hypnotherapy group started taking anti-indigestion medications during the year-long follow up period after treatment. But 90% of those in the medication group and 82% of the patients in the supportive group did so. Those in the hypnotherapy group also visited their general practitioners or gastroenterologist less often than the others. In an editorial that accompanies the study, Olafur S. Palsson, PsyD, and William S. Whitehead, PhD, of the Center for Functional Gastrointestinal & Motility Disorders at the University of North Carolina say this and other recent studies show hypnosis warrants serious consideration as a secondary treatment for indigestion and irritable bowel syndrome. But the editorialists say hypnotherapy has many stumbling blocks to overcome before it can become a widely used treatment for gastrointestinal (GI) problems. For example, few insurance companies cover the cost of hypnotherapy for GI disorders, and few specialists are trained to practice the techniques. ------------


----------



## cookies4marilyn

Feel free to post recent studies or articles on the use of CBT or HT with IBS.Thank you to Eric for originally posting most of these throughout the forum.


----------



## cookies4marilyn

In the article above it states:Quote: [But the editorialists say hypnotherapy has many stumbling blocks to overcome before it can become a widely used treatment for gastrointestinal (GI) problems. For example, few insurance companies cover the cost of hypnotherapy for GI disorders, and few specialists are trained to practice the techniques.]============Many of us on this BB, including myself have found help and even relief by using the at-home clinical hypnotherapy program: the IBS Audio Program 100 by Michael Mahoney of Cheshire England.The advantages to this program are: It is cost effective - the whole program consisting of 5 therapeutic sessions, a comprehensive introduction and the IBS Companion which explains IBS to others in the IBS patient's life and full program booklet costs less than the fee for most one single session of in-person clinical hypnotherapy. No worry of searching for a qualified clinical hypnotherapist in your area - Michael Mahoney has worked with thousands of IBS patients upon referral from their gastroenterologist in his medical centre in England.No travel or appointments to keep - this is especially essential for severe refractory IBS - D - all sessions done in the privacy, comfort and familiarity of your own home. No embarrassment.For more info on this program which has helped many IBS patients in over 30 countries, including many on this BB, please take a peek at the IBS Audio Program 100 website:www.ibscds.comBest wishes for feeling better ~


----------



## cookies4marilyn

"By Charles K. Burnett, Ph.D., Dr.P.H.Associate Clinical ProfessorUNC School of MedicineAlthough it is quite a bit morecomplicated than this, CognitiveBehavioral Therapy (CBT) is just asit sounds: psychological therapy thatfocuses on cognitions (thoughts) andbehaviors. The basic principle of CBTis that what a person believes affectshis or her emotions and behavior. CBT focuseson the inter-relationships between cognitions,actions (behaviors), and feelings (affect) andthe role they play in a personï¿½s symptoms,functioning and quality of life. By focusing onthese three components, changes can be madein how a person thinks, acts and feels about hisor her difficulties.Research studies have shown that CBT isan effective treatment for a wide rangeof psychological illnesses and symptomsincluding panic disorder, depression,generalized anxiety disorder, simple phobias,obsessive-compulsive disorder, social phobia,posttraumatic stress disorder, and agoraphobia.Cognitive behavioral therapy is helpful inhelping couples with relationship problemsincluding some types of sexual dysfunction."


----------



## cookies4marilyn

Recent update of related articles showing the successful use of clinical hypnotherapy for IBS treatment:=====================================http://www.ncbi.nlm.nih.gov/entrez/query.f...l=pubmed_docsumPalsson OS. Standardized hypnosis treatment for irritable bowel syndrome: the north Carolina protocol. Int J Clin Exp Hypn. 2006 Jan;54(1):51-64. University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.The North Carolina protocol is a seven-session hypnosis-treatment approach for irritable bowel syndrome that is unique in that the entire course of treatment is designed for verbatim delivery. The protocol has been tested in two published research studies and found to benefit more than 80% of patients. This article describes the development, content, and testing of the protocol, and how it is used in clinical practice.http://www.ncbi.nlm.nih.gov/entrez/query.f...l=pubmed_docsumGonsalkorale WM. Gut-directed hypnotherapy: the manchester approach for treatment of irritable bowel syndrome. Int J Clin Exp Hypn. 2006 Jan;54(1):27-50. University Hospital of South Manchester, Manchester, UK.This article describes the particular approach of using hypnosis as an adjunct to treating irritable bowel syndrome, developed within the Department of Medicine at the University Hospital of South Manchester, UK, since the 1980s. Patients receive up to 12 sessions over a 3-month period, and the majority of patients achieve marked improvement in symptoms and quality of life, an effect that is usually sustained. The therapy has a "gut-directed" framework that aims to teach patients the necessary hypnotic skills to control gut function and reduce symptoms, such as hand warmth on the abdomen and imagery. Other interventions based on particular lifestyle and psychological factors commonly found to influence symptoms are also included as appropriate for the individual patient.http://www.ncbi.nlm.nih.gov/entrez/query.f...l=pubmed_docsumWhitehead WE. Hypnosis for irritable bowel syndrome: the empirical evidence of therapeutic effects. Int J Clin Exp Hypn. 2006 Jan;54(1):7-20. University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.Irritable bowel syndrome (IBS) is a complex and prevalent functional gastrointestinal disorder that is treated with limited effectiveness by standard medical care. Hypnosis treatment is, along with cognitive-behavioral therapy, the psychological therapy best researched as an intervention for IBS. Eleven studies, including 5 controlled studies, have assessed the therapeutic effects of hypnosis for IBS. Although this literature has significant limitations, such as small sample sizes and lack of parallel comparisons with other treatments, this body of research consistently shows hypnosis to have a substantial therapeutic impact on IBS, even for patients unresponsive to standard medical interventions. The median response rate to hypnosis treatment is 87%, bowel symptoms can generally be expected to improve by about half, psychological symptoms and life functioning improve after treatment, and therapeutic gains are well maintained for most patients for years after the end of treatment.http://www.ncbi.nlm.nih.gov/entrez/query.f...l=pubmed_docsumWhorwell PJ. Review article: The history of hypnotherapy and its role in the irritable bowel syndrome. Aliment Pharmacol Ther. 2005 Dec;22(11-12):1061-7.Hypnosis is a technique by which an individual can gain a degree of control over physiological as well as psychological function. This paper reviews the history of the phenomenon as well as the accumulating evidence that it is effective in relieving the symptoms of irritable bowel syndrome and improving the quality of life of sufferers. The physiological effects of hypnosis are also discussed coupled with an outline of how a hypnotherapy service might be provided.====================================


----------



## cookies4marilyn

Kindly posted by Robby - take a peek! "Prevention" magazine - March issue has an article on hypnotherapy. It talks about all of the different things hypno is being used for with great success including IBS. Here is a link to the article: http://www.prevention.com/article/0,5778,s...-6610-1,00.html===============================


----------



## cookies4marilyn

http://highwire.stanford.edu/cgi/medline/pmid;16627548Treatment of non-cardiac chest pain: a controlled trial of hypnotherapy.H Jones, P Cooper, V Miller, N Brooks, and PJ WhorwellGut, October 1, 2006; 55(10): 1403-8. Education and Research Centre, Wythenshawe Hospital, Southmoor Rd, Wythenshawe, Manchester M23 9LT, UK. Peter.Whorwell###smuht.nwest.nhs.uk. Download to Citation Manager Article Text Alert me when this article is cited PubMed Citation Related Articles in PubMed This article has been cited by other articles BACKGROUND: Non-cardiac chest pain (NCCP) is an extremely debilitating condition of uncertain origin which is difficult to treat and consequently has a high psychological morbidity. Hypnotherapy has been shown to be effective in related conditions such as irritable bowel syndrome where its beneficial effects are long lasting. AIMS: This study aimed to assess the efficacy of hypnotherapy in a selected group of patients with angina-like chest pain in whom coronary angiography was normal and oesophageal reflux was not contributory. PATIENTS AND METHODS: Twenty eight patients fulfilling the entry criteria were randomised to receive, after a four week baseline period, either 12 sessions of hypnotherapy or supportive therapy plus placebo medication over a 17 week period. The primary outcome measure was global assessment of chest pain improvement. Secondary variables were a change in scores for quality of life, pain severity, pain frequency, anxiety, and depression, as well as any alteration in the use of medication. RESULTS: Twelve of 15 (80%) hypnotherapy patients compared with three of 13 (23%) controls experienced a global improvement in pain (p = 0.008) which was associated with a significantly greater reduction in pain intensity (p = 0.046) although not frequency. Hypnotherapy also resulted in a significantly greater improvement in overall well being in addition to a reduction in medication usage. There were no differences favouring hypnotherapy with respect to anxiety or depression scores. CONCLUSION: Hypnotherapy appears to have use in this highly selected group of NCCP patients and warrants further assessment in the broader context of this disorder.


----------



## cookies4marilyn

Research Overview - Hypnotherapy in the Treatment of IBS - Adults and ChildrenThe hypnotherapy protocols used in these studies are not readily accessible. Mind/Body Psychological Treatments for Irritable Bowel Syndrome, Bruce D. Naliboff1,2,3, Michael P. Fresé1,2,3 and Lobsang Rapgay2 1UCLA Center for Neurovisceral Sciences and Women's Health, 2Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA and 3Veterans Administration Greater Los Angeles Healthcare System, Los Angeles, CA, USA, Evidence-Based Complementary and Alternative Medicine, Oxford Journal, eCAM Advance Access published online on May 17, 2007, eCAM, doi:10.1093/ecam/nem046 Currently, the goal of treatment for those with IBS is to improve the quality of life through a reduction in symptoms. While the majority of treatment approaches involve the use of traditional medicine, more and more patients seek out a non-drug approach to managing their symptoms. Current forms of non-drug psychologic or mind/body treatment for IBS [which] include hypnotherapy&#8230;have been proven efficacious in clinical trials&#8230;The effect of nurse-led gut-directed hypnotherapy upon health quality of life in patients with irritable bowel syndrome: Hypnotherapy Substantially Improves Quality of Life in IBS. Smith, Graeme D. University of Edinburgh, Scotland. J Clin Nursing 2006;15:678-684Gut-directed hypnotherapy for irritable bowel syndrome: piloting a primary care-based randomised controlled trial. Roberts, L. et. al. Br J Gen Pract. 2006 Feb;56(523):115-21 Gut-directed hypnotherapy benefits patients via symptom reduction and reduced medication usage.Effects of tailored and manualized hypnotic inductions for complicated irritable bowel syndrome patients. Barabasz A, Barabasz M. Int J Clin Exp Hypn. 2006 Jan;54(1):100-12.Hypnosis home treatment for irritable bowel syndrome: a pilot study. Palsson OS, Turner MJ, Whitehead WE. Int J Clin Exp Hypn. 2006 Jan;54(1):85-99. University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA. - Hypnosis treatment often improves irritable bowel syndrome (IBS), but the costs and reliance on specialized therapists limit its availability. A 3-month home-treatment version of a scripted hypnosis protocol previously shown to improve all central IBS symptoms was completed. Hypnosis subjects improved more in quality of life scores compared to controls. Hypnosis responders remained improved at 6-month follow-up. Hypnosis home treatment may double the proportion of IBS patients improving significantly across 6 months.Hypnosis for irritable bowel syndrome: the quest for the mechanism of action. Simren M. Int J Clin Exp Hypn. 2006 Jan;54(1):65-84. Sahlgrenska, University Hospital, Goteborg, Sweden.Standardized hypnosis treatment for irritable bowel syndrome: the North Carolina protocol. Palsson OS. Int J Clin Exp Hypn. 2006 Jan;54(1):51-64. University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA. - The North Carolina protocol was found to benefit more than 80% of IBS patients.Gut-directed hypnotherapy: the Manchester approach for treatment of irritable bowel syndrome. Gonsalkorale WM. Int J Clin Exp Hypn. 2006 Jan;54(1):27-50. University Hospital of South Manchester, UK. Hypnosis for irritable bowel syndrome: the empirical evidence of therapeutic effects. Whitehead WE. Int J Clin Exp Hypn. 2006 Jan;54(1):7-20. University of North Carolina at Chapel Hill, Chapel Hill, North CarolinaSystematic review: the effectiveness of hypnotherapy in the management of irritable bowel syndrome. Wilson S, Maddison T, Roberts L, Greenfield S, Singh S; Birmingham IBS Research Group. Aliment Pharmacol Ther. 2006 Sep 1;24(5):769-80. Review. - The published evidence suggests that hypnotherapy is effective in the management of IBS. Over half of the trials indicated a significant benefit. www.medscape.com/viewarticle/543563Review article: The history of hypnotherapy and its role in the irritable bowel syndrome. Whorwell PJ. Aliment Pharmacol Ther. 2005 Dec;22(11-12):1061-7.Hypnosis and irritable bowel syndrome: a review of efficacy and mechanism of action. Tan G, Hammond DC, Joseph G. DeBakey, M. E. Review. Am J Clin Hypn. 2005 Jan;47(3):161-78. - A total of 14 published studies (N=644) were reviewed on the efficacy of hypnosis in treating IBS. It was concluded that hypnosis consistently produces significant results and improves the cardinal symptoms of IBS in the majority of patients, as well as positively affecting non-colonic symptoms. When evaluated according to the efficacy guidelines of the Clinical Psychology Division of American Psychological Association, the use of hypnosis with IBS qualifies for the highest level of acceptance as being both efficacious and specific. Hypnosis in Contemporary Medicine. Mayo Clinic Proc. 2005;80:511-524 © 2005 Mayo Foundation for Medical Education and Research - Overview of several trials &#8230; confirmed that "in addition to relieving the symptoms of irritable bowel syndrome, hypnotherapy profoundly improves the patients' quality of life and reduces absenteeism from work." - www.mayoclinicproceedings.com/inside.asp?AID=888&UIDTreatment with hypnotherapy reduces the sensory and motor component of the gastrocolonic response in irritable bowel syndrome. Simren M, Ringstrom G, Bjornsson ES, Abrahamsson H. Psychosom Med. 2004 Mar-Apr;66(2):233-8.Cognitive change in patients undergoing hypnotherapy for irritable bowel syndrome. Gonsalkorale WM, Toner BB, Whorwell PJ. J Psychosom Res. 2004 Mar;56(3):271-8. Gut-focused hypnotherapy normalizes disordered rectal sensitivity in patients with irritable bowel syndrome. Lea R, Houghton LA, Calvert EL, Larder S, Gonsalkorale WM, Whelan V, Randles J,Cooper P, Cruickshanks P, Miller V, Whorwell PJ. Aliment Pharmacol Ther. 2003 Mar 1;17(5):635-42.Hypnosis home treatment for irritable bowel syndrome (IBS): exploratory study. Palsson OS, Whitehead WE, Turner MJ. Am J Gastroenterol. 2003;98:S274. [Abstract #822] Long term benefits of hypnotherapy for irritable bowel syndrome. Gonsalkorale WM, Miller V, Afzal A, Whorwell PJ. Gut. 2003 Nov;52(11):1623-9. - 204 patients completed questionnaires scoring symptoms, quality of life, anxiety, and depression before, immediately after, and up to six years following hypnotherapy. This study demonstrates that beneficial effects of hypnotherapy appear to last at least five years. Viable therapeutic option for the treatment of IBS.Hypnotherapy in irritable bowel syndrome: a large-scale audit of a clinical service with examination of factors influencing responsiveness. Gonsalkorale WM, Houghton LA, Whorwell PJ. Am J Gastroenterol 2002 Apr;97(4):954-61. - 250 unselected IBS patients were treated in a clinic in Manchester, England, using 12 sessions of hypnotherapy over a 3-month period plus home practice between sessions. Marked improvement was seen in all IBS symptoms, quality of life, and anxiety and depression, with reduced overall IBS severity.Hypnosis treatment for severe irritable bowel syndrome: investigation of mechanism and effects on symptoms. Palsson OS, Turner MJ, Johnson DA, Burnett CK, Whitehead WE. Dig Dis Sci 2002 Nov;47(11):2605-14. Hypnotherapy for irritable bowel syndrome: Symptom improvement and autonomic nervous system effects. Palsson, OS, Turner, MJ, Johnson, DA. Gastroenterology 2000;118(4): A174. Hypnotherapy for severe irritable bowel syndrome: Gender differences in response? Gonsalkorale WM, Cooper P, Cruikshanks P, Miller V, Randles J, Whelan V, Houghton LA, Whorwell PJ. Gastroenterology 1999;116:A999. Hypnotherapy in the treatment of irritable bowel syndrome: methods and results in Amsterdam. Vidakovic Vukic M. Scand J Gastroenterol Suppl, 1999, 230:49-51. - Treatment of 27 patients of gut-directed hypnotherapy tailored to each individual patient. All of the 24 who completed treatment were found to be improved.Gut focused hypnotherapy normalises rectal hypersensitivity in patients with irritable bowel syndrome (IBS). Houghton LA, Larder S, Lee R, Gonsalcorale WM, Whelan V, Randles J, Cooper P, Cruikshanks P, Miller V, Whorwell PJ. Gastroenterology 1999; 116: A1009.Treatment of irritable bowel syndrome with hypnotherapy. Galovski, T.E., Blanchard, E.B. Appl Psychophysiol Biofeedback,1998 Dec, 23:4, 219-32. - Eleven patients completed hypnotherapy, with improvement reported for all central IBS symptoms, as well as improvement in anxiety. Hypnosis treatment for irritable bowel syndrome. Effects on symptoms, pain threshold and muscle tone. Palsson, OS, Burnett CK, Meyer K, and Whitehead WE. Gastroenterology 1997;112:A803. Hypnoanalgesia in the irritable bowel syndrome. Koutsomanis D. Gastroenterology 1997, 112, A764. - French study showed less analgesic medication required and less abdominal pain experienced by IBS patients after a course of 6-8 analgesia-oriented hypnosis sessions.Symptomatology, quality of life and economic features of irritable bowel syndrome--the effect of hypnotherapy. Houghton LA; Heyman DJ; Whorwell PJ. Aliment Pharmacol Ther, 1996 Feb, 10:1, 91-5. - This study compared 25 severe IBS patients treated with hypnosis to 25 patients with similar symptom severity treated with other methods, and demonstrated that in addition to significant improvement in all central IBS symptoms, hypnotherapy recipients had fewer visits to doctors, lost less time from work than the control group and rated their quality of life more improved. Those patients who had been unable to work prior to treatment resumed employment in the hypnotherapy group but not in the control group. The study quantifies the substantial economic benefits and improvement in health-related quality of life which result from hypnotherapy for IBS on top of clinical symptom improvement.Cognitive change in patients undergoing hypnotherapy for irritable bowel syndrome. Gonsalkorale, WM; Toner, BB; and Whorwell, PJ. J Psychosom Res, March 1, 2004; 56(3): 271-8.Changes in rectal sensitivity after hypnotherapy in patients with irritable bowel syndrome. Prior A, Colgan SM, Whorwell PJ.Gut 1990; Aug 31:896-8. Individual and group hypnotherapy in treatment of refractory irritable bowel syndrome. Harvey RF; Hinton RA; Gunary RM; Barry RE. Lancet, 1989 Feb, 1:8635, 424-5. - Patients with refractory irritable bowel syndrome treated with four sessions of hypnotherapy improved and maintained at a 3-month treatment. Hypnotherapy in severe irritable bowel syndrome: further experience. Whorwell PJ; Prior A; Colgan SM. Gut, 1987 Apr, 28:4, 423-5. - This report summed up further experience with 35 patients added to the 15 treated with hypnotherapy in the 1984 Lancet study. For the whole 50 patient group, success rate was 95% for classic IBS cases.Controlled trial of hypnotherapy in the treatment of severe refractory irritable-bowel syndrome. Whorwell PJ; Prior A; Faragher EB. The Lancet 1984, 2: 1232-4. - This study is the earliest and perhaps the best study in this research area to date, as it was thoroughly placebo-controlled and showed dramatic contrast in response to hypnosis treatment above the placebo group. Thirty patients with severe symptoms unresponsive to other treatment were randomly chosen to receive 7 sessions of hypnotherapy (15 patients) or 7 sessions of psychotherapy plus placebo pills (15 patients). The psychotherapy group showed a small but significant improvement in abdominal pain and distension, and in general well-being but not bowel activity pattern. The hypnotherapy patients showed a dramatic improvement in all central symptoms. The hypnotherapy group showed no relapses during the 3-month follow-up period.Research Overview for the use of Clinical Hypnotherapy for CHILDREN with Functional Abdominal Pain, Irritable Bowel Syndrome and Related Symptoms*The hypnotherapy protocols used in these studies are not readily accessible. However there is the IBS Audio Program 60 for children, which will soon be available - ibsinchildren.com *Home Based Guided Imagery to Treat Pediatric Functional Abdominal Pain. Van Tilburg, M., UNC Center for Functional GI and Motility Disorders, Chapel Hill, NC 2007 - Randomized trial using home based guided imagery CDs for treatment of FAP showed 85% in the treatment group as having somewhat to remarkably better symtptom improvement.Hypnotherapy for children with functional abdominal pain or irritable bowel syndrome: a randomised controlled trial. Vlieger A et al. St. Antonius Hospital in Nieuwegein. Abstract 914. Digestive Disease Week, May 2007 - Mean pain intensity scores in the hypnotherapy group decreased from 13.5 at the start of the study to 3.0 at the end of treatment and 1.4 after a year of follow-up. After a year of follow-up, the hypnotherapy had resulted in a successful pain elimination in 85% of the children, compared to 25% of those getting standard care.Treatment options for chronic abdominal pain in children and adolescents. Miranda A, Sood M. Division of Pediatric Gastroenterology, Hepatology and Nutrition, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI. - Curr Treat Options Gastroenterol. 2006 Sep;9(5):409-15. Treatment should be &#8230; based on the severity of symptoms&#8230; and the impact the disorder has on the child's school attendance and normal functioning. Various psychological interventions, such as cognitive-behavioral therapy, hypnosis, and guided imagery, have been successfully used in children with chronic abdominal pain.Evaluation of guided imagery as treatment for recurrent abdominal pain in children: a randomized controlled trial. Weydert JA, Shapiro DE, Acra SA, Monheim CJ, Chambers AS, Ball TM. BMC Pediatr. 2006 Nov 8;6:29 Integrative Pain Management, Children's Mercy Hospital, 2401 Gillham Road, Kansas City, Missouri 64108 - The therapeutic efficacy of guided imagery with progressive muscle relaxation found in this study is consistent with our present understanding of the pathophysiology of recurrent abdominal pain (RAP) in children. Although unfamiliar to many pediatricians, guided imagery is a simple, noninvasive therapy with potential benefit for treating children with RAP.Hypnosis: An important multifaceted therapy. Ran D. Anbar, MD Journal of Pediatrics, Volume 149, Issue 4, Pages 438-439 (October 2006) - Why should a clinician be interested in learning about hypnosis? Patients often have complaints that sometimes do not respond to traditional allopathic treatment. Clinical hypnosis has been shown to improve or reduce many such ailments, including anxiety &#8230; irritable bowel syndrome, insomnia, recurrent abdominal pain&#8230;Treatment of functional abdominal pain in childhood with cognitive behavioral strategies. Youssef NN, Rosh JR, Loughran M, Schuckalo SG, Cotter AN, Verga BG, Mones RL. J Pediatr Gastroenterol Nutr. 2004 Aug;39(2):192-6. Division of Pediatric Gastroenterology, University of Medicine & Dentistry, New Jersey Goryeb Children's Hospital, Morristown 07962 - Guided imagery and progressive relaxation can safely and effectively reduce chronic abdominal pain in children with FGIDs. This treatment also improve social functioning and school attendance.A pilot study of the use of guided imagery for the treatment of recurrent abdominal pain (RAP) in children. Ball TM, Shapiro DE, Monheim CJ, Weydert JA. Clin Pediatr (Phila). 2003 Jul - Aug;42(6):527-32. Department of Pediatrics, Steele Memorial Children's Research Center, University of Arizona, College of Medicine, Tucson 85724-5073 - The use of relaxation along with guided imagery is an effective and safe treatment for childhood RAP.Self-hypnosis for treatment of functional abdominal pain in childhood. Anbar RD. Clin Pediatr. 2001;40:447-451. - Functional abdominal pain&#8230; can respond to psychological intervention &#8230; functional abdominal pain of 4 of 5 pediatric patients resolved within 3 weeks after a single session of instruction in self-hypnosis. Potential impact of widespread application of such hypnotherapy may be large, because abdominal pain is thought to be the most common recurrent physical symptom &#8230;among children and adolescents..


----------



## cookies4marilyn

Here are some independent sources regarding the use of clinical hypnotherapy protocols for severe refractory IBS as well as for long-term results for children with IBS.While these protocols may not be readily available to the public - there is hope via the IBS Audio Program 100 for Adults and Teens and the IBS Audio Program 60 For Children which is available now and has been helping sufferers for many years. Very cost effective, no travel and free support if needed.Here are the studies... http://www.nature.co...jg2011487a.htmlPediatricsThe American Journal of Gastroenterology , (7 February 2012) | doi:10.1038/ajg.2011.487Long-Term Follow-Up of Gut-Directed Hypnotherapy vs. Standard Care in Children With Functional Abdominal Pain or Irritable Bowel SyndromeArine M Vlieger, Juliette M T M Rutten, Anita M A P Govers, Carla Frankenhuis and Marc A BenningaAbstractOBJECTIVES:We previously showed that gut-directed hypnotherapy (HT) is highly effective in the treatment of children with functional abdominal pain (FAP) and irritable bowel syndrome (IBS). Aim of this follow-up study was to investigate the long-term effects of HT vs. standard medical treatment plus supportive therapy (SMT).METHODS:All 52 participants of our previous randomized controlled trial (RCT) were invited to complete a standardized abdominal pain diary, on which pain frequency and pain intensity were scored. Furthermore, the Children's Somatization Inventory (CSI) and a general quality of life (QOL) questionnaire were filled out. Clinical remission was defined as >80% improvement in pain scores compared with baseline.RESULTS:All 27 HT patients and 22 out of 25 SMT patients participated in this study. Two patients of the SMT group were lost to follow-up and one refused to participate. After a mean duration of 4.8 years follow-up (3.4-6.7), HT was still highly superior to conventional therapy with 68 vs. 20% of the patients in remission after treatment (P=0.005). Pain intensity and pain frequency scores at follow-up were 2.8 and 2.3, respectively, in the HT group compared with 7.3 and 7.1 in the SMT group (P<0.01). Also, somatization scores were lower in the HT group (15.2 vs. 22.8; P=0.04). No differences were found in QOL, doctors' visits, and missed days of school or work between the two groups.CONCLUSIONS:The beneficial effects of gut-directed HT are long lasting in children with FAP or IBS with two thirds still in remission almost 5 years after treatment, making it a highly valuable therapeutic option.------NEW YORK (Reuters Health) - Hypnosis may bring lasting relief to some kids with irritable bowel syndrome or chronic stomach pain, a small study suggests.Researchers found that of 52 children with the tummy troubles, those who had six hypnosis sessions -- plus at-home "self-hypnosis" -- were still doing well five years later.More than two-thirds were free or mostly free of abdominal pain. That compared with just 20 percent of kids who were given standard therapy alone.Researchers led by Dr. Arine M. Vlieger, of St. Antonius Hospital in the Netherlands, reported the results in the American Journal of Gastroenterology.Many people may think of hypnosis as someone waving a pocket watch in front of your face, then making you do strange things, noted Miranda van Tilburg, an assistant professor of medicine at the University of North Carolina at Chapel Hill.But in medicine, hypnosis is used to help people create relaxing images in their minds to ease symptoms like pain and anxiety, explained van Tilburg, who was not involved in the current study but researches and uses "guided imagery" -- basically, self-hypnosis -- for kids' abdominal pain."Gut-directed" hypnotherapy may, for instance, suggest images for normalizing bowel function -- like picturing a smoothly flowing river.A number of studies since the 1980s have found that hypnosis helps some people with irritable bowel syndrome (IBS) when standard treatment fails. There's also evidence it can help kids with so-called functional abdominal pain.Functional abdominal pain -- which is thought to affect up to 20 percent of children -- refers to persistent stomach pain that cannot be traced to a particular disorder. IBS involves abdominal pain too, but people also have bouts of constipation, diarrhea or both.Often, tactics like diet changes, pain medication or extra fiber are enough to ease the symptoms of either disorder.When that fails, there's behavioral therapy. Cognitive behavioral therapy -- which targets the unhealthy thinking patterns and behaviors that can contribute to health problems -- has been shown to help some cases of IBS or functional abdominal pain.But no one knows yet if cognitive behavioral therapy helps beyond one year, van Tilburg pointed out.The current findings are important, she told Reuters Health, because they suggest that hypnosis can offer lasting relief."We've known that it has short-term effects, six months to a year," said van Tilburg. "But the hope is that people will master the skill, and then practice it as a lifelong skill."It's not clear whether kids in this study did keep using self-hypnosis over the long term, van Tilburg noted. But the advantage in pain relief was still there.The findings are based on 52 children and teenagers who were randomly assigned to either have gut-directed hypnotherapy or stick with standard care alone, like diet changes and fiber.Kids in the hypnosis group had six sessions with a therapist and were given CDs to help them practice self-hypnosis at home.Five years later, 68 percent of kids in the hypnosis group were still largely free of abdominal pain, compared with 20 percent of kids who'd received only standard care.The hypnosis group was also faring better in other symptoms, like bloating and bowel problems.It's not clear why hypnosis might help with abdominal pain or other gut symptoms, according to van Tilburg. One theory had been that it alters pain sensitivity in the intestines, she noted -- but recent research suggests that's not what is happening.Instead, hypnosis might affect how the brain processes pain signals from the gut. But for now, that's speculation, van Tilburg said.One obstacle to trying hypnosis for your child's belly problems is availability. More psychologists and pediatricians are doing training in hypnosis these days, Vlieger told Reuters Health by email.But there's still a dearth of properly trained professionals, van Tilburg said.And, she cautioned, "there are a lot of people out there who call themselves hypnotherapists, but they don't have the right training to treat medical conditions."If parents want to find a health professional who uses hypnosis, van Tilburg suggested trying the American Society of Clinical Hypnosis website, http://www.asch.net.Of course, there's a cost, which only some insurance plans would cover. Six or seven hypnotherapy sessions could run around $1,000, on average.Van Tilburg and her colleagues are looking at making the therapy more widely available via CD. In a small 2009 study, they found that kids who learned self-hypnosis by CD were able to soothe their functional abdominal pain over eight weeks; nearly three-quarters said their pain had lessened by at least half.Vlieger said her team is now doing a clinical trial to compare CD-based self-hypnosis against face-to-face hypnosis with a therapist. They should know how the two tactics size up -- in effectiveness and costs -- in about two years.http://wtaq.com/news...woes-long-term/-----Long-term effects of hypnotherapy in patients with refractory irritable bowel syndrome.Scand J Gastroenterol. 2012 Feb 20;Authors: Lindfors P, Unge P, Nyhlin H, Ljótsson B, Björnsson ES, Abrahamsson H, Simrén MAbstractAbstract Objective. Gut-directed hypnotherapy is considered to be an effective treatment in irritable bowel syndrome (IBS) but few studies report the long-term effects. This retrospective study aims to evaluate the long-term perceived efficacy of gut-directed hypnotherapy given outside highly specialized hypnotherapy centers. Methods. 208 patients, who all had received gut-directed hypnotherapy, were retrospectively evaluated. The Subjective Assessment Questionnaire (SAQ) was used to measure changes in IBS symptoms, and patients were classified as responders and non-responders. Patients were also asked to report changes in health-care seeking, use of drugs for IBS symptoms, use of alternative non-pharmacological treatments, and if they still actively used hypnotherapy. Results. Immediately after hypnotherapy, 103 of 208 patients (49%) were responders and 75 of these (73%) had improved further at the follow-up 2-7 years after hypnotherapy (mean 4 years). A majority of the responders still used hypnotherapy on a regular basis at follow-up (73%), and the responders reported a greater reduction in health-care seeking than non-responders. A total of 87% of all patients reported that they considered gut-directed hypnotherapy to be worthwhile, and this differed between responders and non-responders (100% vs. 74%; p < 0.0001). Conclusion. This long-term follow-up study indicates that gut-directed hypnotherapy in refractory IBS is an effective treatment option with long-lasting effects, also when given outside highly specialized hypnotherapy centers. Apart from the clinical benefits, the reduction in health-care utilization has the potential to reduce the health-care costs.PMID: 22339617 [PubMed - as supplied by publisher]


----------

