Hypnotherapy for persons with irritable bowel syndrome

Abstract

ABSTRACT Background: Irritable bowel syndrome (IBS) is a common functional bowel disorder. Its symptom-based diagnostic criteria require the absence of detectable organic causes. The prevalence of IBS in Hong Kong appears to be lower than Western countries. It runs a chronic course with repeated occurrence. Significant impairment on the quality of life and the economy is in evidence globally. The aetiology of IBS is multiple-dimensional. The brain-gut interaction is the core framework for investigation and development of treatments. Apart from pharmaceutical and nutritional interventions, psychotherapy provides alternative treatment to IBS. Hypnotherapy, especially traditional hypnotherapy, has been shown to be effective to IBS in improving quality of life and controlling symptom. With reference to local clinical experiences with both integrative (IH) and traditional hypnotherapy (TH), the mechanism of hypnotherapy, the influence of hypnotic susceptibility and the effects of different hypnotherapy approaches captured the attention of researchers for further in-depth investigation.

Objectives: This research aimed to investigate the effect of integrative hypnotherapy for persons with IBS. The specific objectives were: (1) Explore if there was different effect on the participants among integrative hypnotherapy, traditional hypnotherapy and educational talk (ET); (2) Investigate if there was difference in the manifestation of effect among integrative hypnotherapy, traditional hypnotherapy and educational talk; (3) Identify the effect of hypnotic susceptibility on the participants under different hypnotherapy approach.

Method: Research method was primarily quantitative that was complemented by qualitative interviews. Study 1 was a quantitative study – a 3-arm randomized control trial. Study 2 was a qualitative study – group interviews were conducted after completion of the 3-month follow up measure with the participants of the clinical trial. Result: Totally 162 participants were recruited in this study. Concerning the result of 3-month follow up, there was a statistically significant difference between groups as determined by one-way ANOVA (Fs > 4.50, ps < .05). It showed an exceedingly advancement on social catastrophizing, symptom-related social hypervigilance and SF-12 mental components in IH groups. It was demonstrated that the clinical outcomes of IH groups were superior to TH groups and ET groups. Concerning the result of post-test, similar pattern as 3 - month follow up was found. Exceptionally, there was no statistically significant difference among all groups in SF-12 physical components. There was no significant impact of hypnotic susceptibility on the outcomes in IH groups. In the follow-up focus group interviews, there were four domains found to be different between IH and TH. The differences were delayed effect of indirect hypnotic strategy, an immediate effect of direct hypnotic strategy, the multiple functioning of deep breathing technique, and the shifting of life focus.

Discussion and Conclusion: The findings suggested that different hypnotic approaches generated different degrees of change. Integrative hypnotherapy tended to tackle the psychosocial behavioral issues and led to a self – transformation. The traditional hypnotherapy tended to create an immediate effect that reassuring symptom alleviation. Regarding hypnotic susceptibility, this study had showed its less influence on integrative hypnotherapy group. Given that hypnotherapy had shown positive outcomes on IBS in this study, it was worthwhile to pursue further more in-depth investigations, for examples, on exploring the “sham”, “net”, and “supreme” efficacy of hypnotherapy.