If you’ve ever been seriously worried about something and then ended up with a case of diarrhea, you may have guessed that your mind and gut are as tightly wed as an old married couple. For many people with irritable bowel syndrome (IBS), that close relationship can look like a revolving door: Anxiety causes constipation, cramps, stomach pain, and diarrhea, which then leads to stress followed by more symptoms—it’s a vicious cycle.
The good news is that there are therapies that can break the cycle, including one that often gets some side-eye: hypnosis. If you’re skeptical, keep in mind that this isn’t about some mystic who wants to make you cluck like a chicken. Known medically as gut-directed hypnotherapy, it’s a real thing that’s recommended by experts, particularly for folks with IBS that’s triggered by psychological factors.
“The ideal patient for gut-directed hypnotherapy is someone who really notices that when they’re stressed, it increases their symptoms,” Megan Riehl, PsyD, a GI psychologist at University of Michigan Health who has been providing the therapy for 12 years, tells SELF.
You definitely don’t emerge from your first hypnotic state IBS-free. But, she says, studies show that many people see improvements in their symptoms over the course of therapy, and even for years afterward.
Hypnotherapy aims for a gut-brain reset.
IBS is officially considered a “disorder of gut-brain interaction,” which basically means there’s a messed up communication somewhere. “As an example, the brain may misinterpret a normal digestive sensation as something abnormal,” Kathryn Tomasino, PhD, a GI psychologist and assistant professor at Northwestern University Feinberg School of Medicine, tells SELF.
So you might have the same amount of gas anyone would after eating a bean burrito, but your brain reads it as trouble and suddenly you feel super bloated and crampy. That reaction—or overreaction—doesn’t stop there, says Dr. Tomasino: The brain can also send signals to the gut that affect its motility (the way the GI muscles contract). If it’s too fast, that can equal diarrhea; too sluggish and you’re stuck with constipation. Irregular motility can also cause spasming and cramping, Dr. Tomasino notes.
And then there’s all the stress and anxiety those unpredictable symptoms can conjure up. It’s totally understandable, Dr. Tomasino says, but it can also make matters worse. If you’re worrying about everyday things like going to a restaurant or hopping on public transportation because you might have diarrhea, you can easily become hyper-focused on how your gut is feeling. (“Should I try to poop before I leave?”) And that may feed your brain’s tendency to overreact to gut sensations.
“We think of hypnotherapy almost as resetting the gut-brain connection,” Dr. Tomasino says.
What happens during hypnosis
Like we said, there are no mind-control shenanigans during clinical hypnotherapy. “You’re in complete control the entire time,” Dr. Tomasino stresses. According to Dr. Riehl, if you’ve ever tried guided meditation, or even been led through a muscle relaxation exercise at the end of a yoga class, you have some idea of what hypnotherapy feels like.
- COVID-19 (Coronavirus)What Does Competing With COVID Do to an Athlete’s Body?
- COVID-19 (Coronavirus)A Massive New Study Suggests Getting COVID Might Really Mess With People’s Mental Health
The specifics of gut-directed hypnotherapy sessions vary, but each one is typically around 30 minutes and has four phases:
- Induction: Essentially, you get comfortable and go through a guided exercise to release body tension, control your breathing, or work on a visual focus.
- Deepening: At this stage, the therapist introduces soothing imagery (maybe the sensation of floating down on a cloud) then builds to a more vivid “therapeutic scene” (You’re lying on a beach with warm water lapping at your feet, etc). This readies your brain for the next step.
- Hypnotic suggestions: This is what Dr. Tomasino calls “the active ingredient.” The therapist might address some specific issues, like your hyper-focus (You’re paying less and less attention to unpleasant sensations inside of you), the way you perceive what’s going on in your gut (Your intestines are untwisting and relaxing), or your self-confidence (You’ll be better able to navigate and cope with stress as it comes your way).
- Emergence/reorientation: In the final step, the therapist guides you back to the surface, typically using counting and imagery.
Michele Mitchell, a patient of Dr. Riehl, tells SELF she didn’t think she’d be “good” at hypnotherapy because she figured her anxiety would make relaxation impossible. And during her first session, she says, her mind did float to thoughts of laundry and grocery lists. Despite that, she emerged feeling relaxed.
“I did feel a little better when we completed the session, and that was motivating,” says Mitchell, 64. “I thought, Okay, this may be something that could help me.”
Does hypnotherapy really help with IBS?
The short answer is, it can. Studies vary, but up to 70% or more of patients have shown improvements in their IBS symptoms, Drs. Riehl and Tomasino say. In one study of 1,000 patients who’d already tried other IBS treatments, 76% reported symptom relief after 12 hypnotherapy sessions. A small 2016 study found that people with IBS got as much benefit from hypnotherapy as from a low-FODMAP diet (which is commonly recommended for IBS).
- COVID-19 (Coronavirus)What Does Competing With COVID Do to an Athlete’s Body?
- COVID-19 (Coronavirus)A Massive New Study Suggests Getting COVID Might Really Mess With People’s Mental Health
Nothing happens with a snap of the fingers, and to benefit from hypnotherapy, Dr. Tomasino says, people really should stick it out. That generally means seven to 12 sessions with a therapist, with homework between sessions (listening to audio recordings at least four times a week). After that, though, you’re done. There’s some research showing the benefits can last anywhere from one to five years.
Jess King, 34, had her first hypnotherapy session for IBS just over a year ago (as detailed on her TikTok). “Right after and during the session, I felt great,” she tells SELF. “I was really relaxed and at ease in my mind and my gut.”
King, of Melbourne, Australia, says her GI doctor actually suggested hypnotherapy early on. But because of the time commitment and cost, she tried other options first, including low-FODMAP, supplements, and an antidepressant.
Now post-hypnotherapy, King still has IBS symptoms, but feels more aware of how stress affects her and “more forgiving” of her body. “To be honest,” she says, “I think what helped me most was the education aspect of hypnotherapy. My psychiatrist explained how my gut worked in a way that eased a lot of my fears.”
Mitchell, who was scheduled for her final hypnotherapy session as of this writing, says her IBS symptoms, including chronic constipation, are “pretty much resolved.” Her care at the university has also included acupuncture and nutrition counseling (she makes herself a fiber shake every morning now), but Mitchell credits hypnotherapy with giving her a “tool” to help her deal with life’s stressors.
Where can I find a hypnotherapist?
Gut-directed hypnotherapy is becoming more accessible, with some providers offering it virtually. Mitchell does her sessions over Zoom and says it’s “perfect” because there’s no commute and she gets to lie on her own couch. Some providers also do online group sessions, Dr. Tomasino says, and there’s research suggesting the group approach can be as good as one-on-one.
Still, this is not the kind of thing you’ll find in every town. To fill the gap, apps that deliver gut-directed hypnotherapy have been popping up, including Nerva, Ayble Health and Regulora (which is FDA-cleared for IBS abdominal pain and requires a prescription). “I think [apps] are one way we’re going to improve access for patients who really need it,” Dr. Riehl says.
Her suggestion is to start with your doctor, to see whether hypnosis might be a good option for you. And if your doctor can’t give you a referral, Dr. Tomasino says you can try romegipsych.org, to search for a GI behavioral health professional in your area. (The site is from the nonprofit Rome Foundation, which focuses specifically on problems related to gut-brain interaction.) Apps are worth considering, Dr. Tomasino adds—just make sure you feel ready for the commitment of an app-based program.
And yes, all of this costs money. If you have insurance, plans often cover behavioral therapy for IBS, Dr. Tomasino says, but you’d need to check. Insurance might help pay for certain apps; without insurance, these apps can cost between $45 and $135 to use them for three months.
The big picture here is that hypnotherapy can be one strategy for dealing with your digestive trouble, along with diet changes and any other steps that work for you. “A lot of times, good management of IBS means you have the right toolbox in place,” Dr. Riehl says. “That can be really empowering for people, to know they’re not just dependent on a pill.”
Related:
