Irritable Bowel Syndrome
Techniques may differ between therapists
The following information was kindly supplied by Tony Capper
Irritable Bowel Syndrome
Irritable Bowel Syndrome or IBS, is a collection of symptoms rather than being a medical condition with a known organic cause. It is a functional disorder.
It is diagnosed after a number of tests have been carried out e.g. endoscopy and it is most important not to attempt treatment without having it properly diagnosed by qualified medical personnel.
The client is asked to sign a declaration to this effect. The reason is that certain life threatening conditions can produce the same symptoms. If they were overlooked then the results could be catastrophic for client and therapist.
IBS sufferers complain of some or all of the following:
Bloating, Constipation and /or diarrhoea, reflux, pain. Some clients will need to visit the toilet up to twenty times per day. They are often afraid to leave their home due to uncertainties about other toilet facilities being available.
Different clients may respond differently to the same medical intervention. For example, whilst codeine may be prescribed to help reduce diarrhoea, it can crease some clients up with pain.
The often repeated advice to, “eat more fibre” can result in even more bloating and pain.
Clients often seek relief from the symptoms from their doctor until eventually they may be told that, “It’s all in the mind, you must learn to live with it.”
As a result clients are often disillusioned and will try anything to have an improvement in their condition.
As hypno psychotherapists we may be having “the last grab” at them.
It has been found that many sufferers – but not all, have a history of stress or some trauma in their life. I.B.S. may follow on from having an operation, it can be secondary to cancer, the client may also present with symptoms of OCD, for example.
When the client is first seen, they may wonder why they are being referred to a hypno psychotherapist. It is essential to reassure them that they are not beginning to lose their mind.
A full medical, psychiatric and social history is taken to ensure that there are no contra indications and to gain insight into the client’s condition. The client is asked to rate themselves on each visit to the therapist on terms of pain, bloating, bowel disturbance, upper gut disturbance, physical, emotional and general wellbeing.
The workings of the gut are explained in readily understood terms, with reference to a diagram. The roles of the parasympathetic and sympathetic nervous systems are also explained with particular reference to the ‘flight or fight’ reflex and its effects on the gut.
The client is then told how they can control their symptoms by the use of hypnosis.
At the first session, all the taking of details, the explanations of the workings of the gut and allaying any fears about hypnosis, signing consent forms can take up to one and a half hours. The client will have been told beforehand that the consultation will take around this length of time but they are given an opportunity to sample hypnosis at the consultation.
The induction of my choice is by using progressive relaxation. Most clients like to begin with their eyes closed. This is followed by suggestions of calmness, relaxation, and confidence building.
At the second and subsequent sessions any matters arising from the previous session are discussed. The client is asked to rate him/hersef for pain, bloating etc., as before.
The client is then induced into hypnosis and deepened then an appropriate ego strengthening technique is used.
The client is then invited to place their hand on their “tummy” and to experience the sensation of warmth radiating from the area throughout every muscle, fibre, and tissue of their gut. They are then invited to reinforce those feelings by placing the other hand on top of the original hand. They are assured that this is a ‘healing glow’ and that by doing this they can control their own gut rather than their gut controlling them.
Their gut is likened to a slow, steadily flowing river and the suggestions are reinforced that they can control their gut.
A similar technique is used for gastric emptying, where required.
After four to six sessions many clients will be reporting that their symptoms have reduced significantly. Many will be able to travel from home for two hours or more without being apprehensive. Some will be considered able to attend for therapy every two or four weeks instead of weekly. To aid them in this they are given a supplementary therapy tape to listen to at home.
A few clients will make progress up to a certain point then “plateau”. The reason for this may be that they have some underlying psychological reason which needs to be resolved.
This can be dealt with using, for example, brief focussed Mnemodynamic therapy, after which the client can progress further.
As we all know, everyone comes to therapy with their own, unique set of problems and the means of tackling them should be suited to the client. Everyone progresses at their own rate and whilst many can lead a “normal” life again in four to six weeks others may take up to twelve or sixteen weeks with the aid of the tape and “four weekly” follow up sessions.
Of those who respond to hypnosis , researchers have claimed that 80% remain symptom free in a five year follow up.
It has been reported by workers in the NHS that those who respond poorly may belong to “self help” groups, which tend to perpetuate the problem. Other poor responders appear to be those who put their condition down to their diet and are always experimenting with food. For some clients there may be secondary gains in remaining unwell – they may have to go to work if they recover and, for some on benefits, it has been said that their condition is their identity.