Hypnotic imagery as an adjunct to therapy for Irritable Bowel Syndrome: an experimental case report

Modern and traditional trance language: a comparison

This study compares the effects of two trance texts using different language patterns, i.e., modern trance language (MTL) characterized by indirect suggestions as well as narrative style and traditional trance language (TTL) found in traditional societies (e.g., Navajo, San, Aranda aborigines, etc.) that uses multiple repetitions along with narrative sequences. The Phenomenology of Consciousness Inventory (PCI) was used to evaluate the effects of both texts regarding cognition, emotion, physical experience, and trance depth. In this randomized controlled online study, 178 participants were assigned either to the MTL group or to the TTL group. The PCI and other tests (e.g. Positive and Negative Affect Schedule, State-Trait-Anxiety Inventory) were presented to the participants before and after listening to the hypnosis audio of the respective trance text. There were no significant differences between groups concerning trance depth, emotional, and physical experience. However, on the cognitive-imaginative level it was shown that the TTL group experienced more imaginations (PCI-subdimension "visual imagery," p = .009, d = 0.38) and less cognitive activity (PCI-subdimension "inner dialogue," p = .002, d = 0.40) than the MTL group. The results indicate that TTL increases imagery and decreases cognitive activity to a larger extent than MTL. This further indicates the potential of TTL to facilitate more vivid and intensive trance experiences.

Scientometric analysis of psychological interventions based upon the use of Hypnosis

Hypnosis is a therapeutic technique that has developed for centuries, and every time with greater clinical and scientific weight. Currently, hypnosis constitutes a solid support method for treatments against chronic pain and for emotion control under situations that generate fear and anxiety -such as surgery or other type of phobias-, so it is presented as an alternative to the use of medicine/drugs by health specialists. On the other hand within the field of behavioral sciences, apart from controlling fear and anxiety responses, hypnosis serves as support to the various cognitive behavioral techniques by facilitating their assimilation and development. This work presents a scientometric study of the research done on hypnosis over the last fifteen years, from publications -in Spanish and English- in specialized journals, indexed in SCOPUS (a specialized international bibliometric database). The contemporary applications of hypnosis are presented and critically discussed; as well as the fields in which its application has proven successful; its limitations; the research networks generated within the time of the study; plus, probable projections for future research are also mentioned. 

Review article: gut-directed hypnotherapy in the management of irritable bowel syndrome and inflammatory bowel disease

BACKGROUND

Gut-directed hypnotherapy is being increasingly applied to patients with irritable bowel syndrome (IBS) and to a lesser extent, inflammatory bowel disease (IBD).

AIM

To review the technique, mechanisms of action and evidence for efficacy, and to identify gaps in the understanding of gut-directed hypnotherapy as a treatment for IBS and IBD.

METHODS

A review of published literature and a systematic review of clinical trials in its application to patients with IBS and IBD were performed.

RESULTS

Gut-directed hypnotherapy is a clearly described technique. Its potential mechanisms of action on the brain-gut axis are multiple with evidence spanning psychological effects through to physiological gastrointestinal modifications. Six of seven randomised IBS studies reported a significant reduction (all P < 0.05) in overall gastrointestinal symptoms following treatment usually compared to supportive therapy only. Response rates amongst those who received gut-directed hypnotherapy ranged between 24% and 73%. Efficacy was maintained long-term in four of five studies. A therapeutic effect was also observed in the maintenance of clinical remission in patients with ulcerative colitis. Uncontrolled trials supported the efficacy and durability of gut-directed hypnotherapy in IBS. Gaps in understanding included to whom and when it should be applied, the paucity of adequately trained hypnotherapists, and the difficulties in designing well controlled-trials.

CONCLUSIONS

Gut-directed hypnotherapy has durable efficacy in patients with IBS and possibly ulcerative colitis. Whether it sits in the therapeutic arsenal as a primary and/or adjunctive therapy cannot be ascertained on the current evidence base. Further research into efficacy, mechanisms of action and predictors of response is required.

Comment on Zimmerman's use of the river metaphor in irritable bowel syndrome treatment

The river approach has been used effectively in the treatment of irritable bowel syndrome within the U.K. National Health Service (Gonsalkorale, Houghton, & Whorwell, 2002; Whorwell, 2006) and in single case studies (Galovski & Blanchard, 2002; Zimmerman, 2003; Kraft & Kraft, 2007). Zimmerman (2003) pointed out that this metaphor was extremely powerful in that it linked the altered motility of the digestive system to an emotional disturbance: by encouraging his patient to imagine a smooth flowing river, he helped her to come to terms with her emotional conflict and, in turn, to experience normal gut activity. The author reviews this approach to treatment and offers an alternative which utilizes process suggestions, accessing questions and truisms while providing clients with the space to imagine their own tailor-made scene.