A surprise medical solution: hypnosis

A surprise medical solution: hypnosis

Major hospitals are finding hypnotherapy can help sufferers of digestive conditions like heartburn, colitis, acid reflux and irritable bowel syndrome.

Sarah Blau settles into a wicker chair, stretching her feet onto an ottoman. In a soothing voice, Laurie Keefer, says, “I’m going to count from one to three, and as I count, your eyelids will get heavy and they’ll close whenever it feels right.”

Dr. Keefer, a health psychologist at Mount Sinai Health System, has Ms. Blau progressively relax each part of her body and guides her to “a place of rest and comfort and healing.” “Enjoy the beauty of this natural, healing place,” she tells her, “and as you do, something very powerful and healthy and positive is taking place deep inside your body. Your body knows what it needs to maintain healing your gut. It knows how to keep pleasant sensations in and avoid pain and discomfort.”

Hypnotherapy—when patients enter a trance-like state using relaxation and visual images—is often associated with alternative medicine. But increasingly medical centers are using it to treat digestive conditions like acid reflux, irritable bowel syndrome and ulcerative colitis, a disease Ms. Blau learned she had in 2016.

Studies have shown hypnotherapy is effective reducing symptoms associated with these gastrointestinal disorders. Insurance companies usually cover the treatments. The body of evidence is strongest for IBS, but a 2013 study found hypnotherapy was effective at prolonging remission in colitis patients. And a 2016 pilot study found patients with functional heartburn reported fewer symptoms.

Dr. Keefer works at the Susan and Leonard Feinstein Inflammatory Bowel Disease Clinical Center at Mount Sinai. There she does hypnotherapy for patients with Crohn’s disease and ulcerative colitis, diseases caused by inflammation of the intestines.

The treatment usually consists of about seven sessions over three months, with home practice in between. Studies have found the effects can last more than a year and work in more than half of patients.

In addition to Mount Sinai, hypnosis for patients with digestive conditions is available at University of Michigan, Beth Israel Deaconess Medical Center in Boston, University of Washington in Seattle, Baylor College of Medicine in Houston and Loyola University Medical Center and Northwestern Memorial Hospital in the Chicago area. Mayo Clinic in Rochester, Minn., also is exploring adding hypnotherapy for IBS patients.

Laurie Keefer, a health psychologist at Mount Sinai Health System, conducts hypnotherapy research and treatments on patients with inflammatory bowel disease. There is a three-to-six-month wait list for the treatment.

Some patients get a little uneasy about the word ‘hypnosis,’ ” says Andrea Bradford, an assistant professor of medicine at Baylor, which started offering the treatment in 2016. “It conjures up images of some guy in Vegas making you bark like a dog. It takes some education to explain to them what it constitutes and what it does not.” She says about one-third of patients are open to it.

Experts theorize that hypnotherapy works because many gastrointestinal disorders are affected by a faulty connection between the brain and the gut, or digestive tract. The gut and brain are in constant communication. When something disrupts that communication, the brain misinterprets normal signals, which can cause the body to become hypersensitive to stimuli detected by nerves in the gut, causing pain. Experts believe hypnosis shifts the brain’s attention away from those stimuli by providing healthy suggestions about what’s going on in the gut.

“It doesn’t get rid of the stimulus. Your GI tract is still moving. It’s just changing the threshold of perception so you’re not paying attention or feeling it with the same intensity,” says John Pandolfino, chief of gastroenterology and hepatology at Northwestern, which started offering hypnotherapy in 2006 and has plans to expand to two regional hospitals. Northwestern has trained health psychologists in GI disorders who have moved on to start programs at other academic centers.

Sarah Quinton, a gastrointestinal psychologist at Northwestern, is part of a team that conducts hypnotherapy treatments, along with two other psychologists and students in training. . They plan to expand treatments two local hospital due to patient demand and success rates.

Because there aren’t many treatments for IBS, hypnotherapy has become “the front-line therapy,” Dr. Pandolfino says. Dr. Pandolfino says he will take patients with reflux problems whose symptoms aren’t improving off their medication. After that, if their acid levels are normal but they still experience symptoms, like chest pain, he recommends hypnotherapy. This happens with “a large number of patients,” Dr. Pandolofino says.

David Dewey, a 58-year-old real-estate developer in the Chicago suburbs, says hypnotherapy helped rid him of abdominal pain that sometimes kept him up at night. His doctor at Northwestern told him that his diagnosis of IBS was incorrect and that the real problem was related to his brain.

His doctor said, he recalls, “It sounds crazy, but we’ve been having great success with hypnotherapy.” He figured he had nothing to lose, since nothing else had helped for two years. The pain disappeared in under 10 sessions. “Sometimes it creeps back a little, and I just do one or two [home] sessions and it goes away,” Mr. Dewey says.

Olafur Palsson, a professor of medicine and clinical psychologist at the University of North Carolina at Chapel Hill, developed the first script, or protocol, for hypnosis treatment for IBS in 1995. The script has been adapted for use in other GI disorders.

He has trained hundreds of therapists in the protocol, which he says 600 therapists across the country use today. Most professionals who conduct hypnotherapy treatments are psychologists. Shoba Krishnamurthy, a gastroenterologist at the University of Washington, got training and decided to incorporate it into her practice about three years ago.

“It’s mostly for patients who have had a work-up but we haven’t found anything abnormal in tests, so there is not a specific abnormality to treat,” she says. Ms. Blau, a 32-year-old who has been undergoing hypnotherapy at Mount Sinai, began the treatments in the fall, when her colitis was under control, as a preventive measure. It has remained that way. “I’ve been feeling really good,” she says.

By: Sumathi Reddy

Hypnotherapy can help manage IBS symptoms

Hypnotherapy can help manage IBS symptoms

Irritable bowel syndrome is a chronic condition that affects many people across the world. Due to symptoms such as abdominal pain, this disorder can have a big impact on life quality. New research, however, reveals that hypnotherapy can improve life for those with the condition.

Can hypnotherapy truly relieve IBS symptoms?

People with irritable bowel syndrome (IBS) can experience symptoms such as abdominal pain and abnormal bowel movements to various degrees of severity, and they can also face mental health problems, including anxiety and depression.

Some common approaches to managing IBS are by carefully controlling one’s diet, improving one’s lifestyle choices, and, if necessary, seeking mental health therapy.

In the past, some research has suggested that people with IBS may also benefit from hypnotherapy sessions. Now, specialists at the University Medical Center Utrecht and other institutions in the Netherlands have decided to delve deeper into the question of whether hypnotherapy can improve IBS symptoms — and if so, in what way. The researchers recently conducted a randomized controlled trial, the findings of which now appear in The Lancet Gastroenterology & Hepatology.

Improved symptom relief

The study assessed the efficacy of individual and group hypnotherapy in IBS. It is the largest study to date to look into this issue.
In the study, the researchers worked with 354 participants aged 18–65 with IBS.

The scientists randomly selected participants to take part in one of three interventions:

– individual 45 minute hypnotherapy sessions twice per week for 6 weeks (150 participants)
– group hypnotherapy sessions with the same timeframe (150 participants)
– dedicated educational supportive care sessions (54 participants)

For the delivery of the hypnotherapy sessions, the team recruited psychologists who had trained in hypnotherapy. During the sessions, the hypnotherapists applied techniques of positive visualization, providing suggestions about pain and discomfort management.
They also gave the participants CDs containing materials that would allow them to practice hypnosis techniques on their own for 15–20 minutes on a daily basis.

The researchers asked the participants to fill in questionnaires assessing various factors relevant to the study — including the severity of their IBS symptoms, their quality of life, how much they spent on healthcare, and how often they had to miss work due to the condition.

The assessments took place at baseline, at the 3-month mark, and at the 9-month mark. The team also evaluated to what extent participants experienced relief immediately after the intervention (at the 3-month mark) and then again 9 months later.

The scientists found that the people with IBS who had participated in hypnotherapy — whether individual or group-based — experienced the most satisfactory degree of symptom relief, compared with participants in the educational supportive care group.

Participants who underwent hypnotherapy were still enjoying the benefits 9 months after the treatment. However, the researchers claim that despite reporting satisfactory rates of symptom relief, the participants did not actually see a significant improvement in symptom severity as such.

“We do not know exactly how gut-directed hypnotherapy works,” says lead researcher Dr. Carla Flik, “but it may change patients’ mindset and internal coping mechanisms, enabling them to increase their control over autonomic body processes, such as how they process pain and modulate gut activity.”

Group sessions just as promising

Other than symptom relief, the tested-for factors — including quality of life, psychological problems, healthcare costs, and work absence — remained roughly the same among all the participants following the interventions.

The researchers also admit that their study faced a few limitations. For example, some participants — 22 (15 percent) of those in the individual hypnotherapy group, another 22 (15 percent) of those in the group hypnotherapy sessions, and 11 (20 percent) of those in the educational supportive care group — dropped out of the study.

Also, a significant number of participants did not manage to fill in all the questionnaires, which, the researchers say, may have impacted the findings. However, the researchers note that the results they recorded in the recent study may, in fact, have been an underestimation, since the hypnotherapists did not have previous experience in treating people with IBS, specifically. Also, the participants only received six hypnotherapy sessions, which is only half the number of sessions that a person would normally expect to receive.

“Our study indicates that hypnotherapy could be considered as a treatment option for patients with IBS, irrespective of symptom severity and IBS sub-type. It is also promising to see that group hypnotherapy is as effective as individual sessions, which may mean that more people could be treated with it at lower cost, should it be confirmed in further studies.”

“What’s striking about these findings is the extent to which patients’ perception of their illness has an effect on their suffering, and that their perception of symptoms appears to be as important as actual symptom severity,” adds Dr. Flik.

By: Maria Cohut

5 ways mindfulness is good for your health

According to thousands of years of tradition, Buddhists meditate to understand themselves and their connections to all beings. By doing so, they hope to be released from suffering and ultimately gain enlightenment.

In recent decades, researchers have been gaining insight into the benefits of practicing this ancient tradition. By studying more secular versions of mindfulness meditation, they’ve found that learning to pay attention to our current experiences and accept them without judgment might indeed help us to be happier.

Studies to date suggest that mindfulness affects many aspects of our psychological well-being—improving our mood, increasing positive emotions, and decreasing our anxiety, emotional reactivity, and job burnout.

Recently, researchers have been exploring this question—with some surprising results. While much of the early research on mindfulness relied on pilot studies with biased measures or limited groups of participants, more recent studies have been using less-biased physiological markers and randomly controlled experiments to get at the answer. Taken together, the studies suggest that mindfulness may impact our hearts, brains, immune systems, and more.

Though nothing suggests mindfulness is a standalone treatment for disease nor the most important ingredient for a healthy life, here are some of the ways that it appears to benefit us physically.

Mindfulness is good for our hearts

Heart disease is the leading killer in the United States, accounting for about 1 in 4 deaths every year. So, whatever decreases the risks or symptoms of heart disease would significantly impact society’s health. Mindfulness may help with that.

In one study, people with pre-hypertension were randomly assigned to augment their drug treatment with either a course in mindfulness meditation or a program that taught progressive muscle relaxation.

Those who learned mindfulness had significantly greater reductions in their systolic and diastolic blood pressure than those who learned progressive muscle relaxation, suggesting that mindfulness could help people at risk for heart disease by bringing blood pressure down.

In another study, people with heart disease were randomly assigned to either an online program to help them practice meditation or to a wait list for the program while undergoing normal treatment for heart disease. Those who took the mindfulness program showed significant improvements on the six-minute walking test (a measure of cardiovascular capacity) and slower heart rates than those in the wait list group.

While one review of randomly controlled studies showed that mindfulness may have mixed effects on the physical symptoms of heart disease, a more recent review published by the American Heart Association concluded that, while research remains preliminary, there is enough evidence to suggest mindfulness as an adjunct treatment for coronary disease and its prevention.

Mindfulness may also be good for hearts that are already relatively healthy. Research suggests that meditating can increase respiratory sinus arrhythmia, the natural variations in heart rate that happen when we breathe that indicate better heart health and an increased chance of surviving a heart attack.

Mindfulness may decrease cognitive decline from aging or Alzheimer’s

People tend to lose some of their cognitive flexibility and short-term memory as they age. But mindfulness may be able to slow cognitive decline, even in people with Alzheimer’s disease. In a 2016 study, people with Alzheimer’s disease engaged in either mindfulness meditation, cognitive stimulation therapy, relaxation training, or no treatment, and were given cognitive tests over two years.

While cognitive stimulation and relaxation training seemed to be somewhat beneficial in comparison to no treatment, the mindfulness training group had much more robust improvements on cognitive scores than any other group.

Why might that be true? A 2017 study looking at brain function in healthy, older adults suggests meditation may increase attention. In this study, people 55 to 75 years old spent eight weeks practicing either focused breathing meditation or a control activity.

Then, they were given the Stroop test—a test that measures attention and emotional control—while having their brains monitored by electroencephalography.

Those undergoing breath training had significantly better attention on the Stroop test and more activation in an area of the brain associated with attention than those in the active control group.

While this research is preliminary, a systematic review of research to date suggests that mindfulness may mitigate cognitive decline, perhaps due to its effects on memory, attention, processing, and executive functioning.

Mindfulness may improve your immune response

When we encounter viruses and other disease-causing organisms, our bodies send out troops of immune cells that circulate in the blood. These cells, including pro- and anti-inflammatory proteins, neutrophils, T-cells,immunoglobulins, and natural killer cells, help us to fight disease and infection in various ways. Mindfulness, it turns out, may affect these disease-fighting cells.

In several studies, mindfulness meditation appeared to increase levels of T-cells or T-cell activity in patients with HIV or breast cancer. This suggests that mindfulness could play a role in fighting cancer and other diseases that call upon immune cells. Indeed, in people suffering from cancer, mindfulness appears to improve a variety of biomarkers that might indicate progression of the disease.

In another study, elderly participants were randomly assigned to an eight-week Mindfulness-Based Stress Reduction (MBSR) course or a moderate-intensity exercise program. At the end, participants who’d practiced mindfulness had higher levels of the protein interleukin-8 in their nasal secretions, suggesting improved immune function.

Another study found increases in interleukin-10 in colitis patients who took a mindfulness meditation course compared to a mind-body educational program, especially among patients whose colitis had flared up. Yet another study found that patients who had greater increases in mindfulness after an MBSR course also showed faster wound healing, a process regulated by the immune system.

Studies have found effects on markers of inflammation, too—like C-reactive protein, which in higher levels can harm physical health. Research shows that people with rheumatoid arthritis have reduced C-reactive protein levels after taking an MBSR course versus being on a waitlist for the course. Overall, these findings suggest that mindfulness meditation can have disease-fighting powers through our immune response.

Mindfulness may reduce cell aging

Cell aging occurs naturally as cells repeatedly divide over the lifespan and can also be increased by disease or stress. Proteins called telomeres, which are found at the end of chromosomes and serve to protect them from aging, seem to be impacted by mindfulness meditation.

Studies suggest that long-time meditators may have greater telomere lengths. In one experimental study, researchers found that breast cancer survivors who went through MBSR preserved the length of their telomeres better than those who were on a wait list.

However, this study also found that general supportive therapies impacted telomere length; so, there may not be something special about MBSR that impacts cell aging. On the other hand, another study with breast cancer survivors found no differences in telomere length after taking an MBSR course; but they did find differences in telomere activity, which is also related to cell aging.

In fact, a 2018 review of research ties mindfulness training to increased telomere activity, suggesting it indirectly affects the integrity of the telomeres in our cells. Perhaps that’s why scientists are at least optimistic about the positive effects of meditation on aging.

Mindfulness may help reduce psychological pain

Of course, while the above physiological benefits of mindfulness are compelling, we needn’t forget that mindfulness also impacts our psychological well-being, which, in turn, affects physical health. In fact, it’s quite likely that these changes have synergistic effects on one another.

First of all, a great deal of research suggests that mindfulness can help healthy people reduce their stress. And thanks to Jon-Kabat Zinn’s pioneering MBSR program, there’s now a large body of research showing that mindfulness can help people cope with the pain, anxiety, depression, and stress that might accompany illness, especially chronic conditions.

For example, drug addictions, at heart, come about because of physiological cravings for a substance that relieves people temporarily from their psychological suffering. Mindfulness can be a useful adjunct to addiction treatment by helping people better understand and tolerate their cravings, potentially helping them to avoid relapse after they’ve been safely weaned off of drugs or alcohol. The same is true for people struggling with overeating.

Fascinating though it is, we shouldn’t overplay meditation’s effects on physical health at the expense of its importance to emotional health. In fact, it may be difficult to separate out the two, as a key impact of mindfulness is stress reduction, and psychological stress has been tied to heart health, immune response, and telomere length.

This idea is further supported by the fact that other stress-reducing therapies also seem to impact physical health, as well. Still, it’s encouraging to know that something that can be taught and practiced can have an impact on our overall health—not just mental but also physical—more than 2,000 years after it was developed. That’s reason enough to give mindfulness meditation a try.

By: Jill Suttie

Study says hypnosis could tackle painkiller crisis

Study says hypnosis could tackle painkiller crisis

Hypnosis can reduce pain by up to 42% and may offer a genuine alternative to painkillers, according to UK researchers.

They said their findings suggest that hypnotic intervention could deliver “meaningful pain relief for most people” and, therefore, may be an “effective and safe alternative” to drug intervention.

The analysis, led by psychologist Dr Trevor Thompson from the University of Greenwich, found that hypnosis was more effective with people who are especially amenable to suggestion. “This is by far the largest review of its kind and presents very compelling evidence”.

However, it also found that those who were moderately suggestible – essentially most people – saw a 29% drop in pain after hypnosis.

Data was used from 85 studies across 14 countries, with a total of 3,632 people subjected to different forms of pain stimulation including extreme cold, heat, pressure, exercise and even lasers.

People typically rated the pain they felt as 5.5 on a scale of zero to 10, according to the study published in the journal of Neuroscience and Bio-behavioral Reviews.

According to the researchers, a five level of pain would significantly disrupt daily lives and have most people using medication.
Dr Thompson said: “This is by far the largest review of its kind, examining the effects of hypnosis in over 3,500 people, and presents very compelling evidence.

“About 15% of the population are highly receptive to hypnosis, and those people saw just over a 40% drop in pain,” he noted.
“Based on these findings, most people would experience around a 30% drop in pain or more, which is generally considered to be clinically meaningful pain relief,” he said.

Dr Thompson highlighted that the misuse of prescription painkillers such as codeine and fentanyl had increased massively over recent years and was a crisis in some countries, most notably the US.

“Our findings suggest hypnosis could be a safe and effective alternative,” he said. “It can be administered quickly, cheaply and easily at home with a 20-minute audio recording.”

He added: “The next step is to extensively test hypnosis on people with chronic pain, such as back conditions, which people live with every day.

“Available data on this are not of a high enough quality or quantity,” he said. “We need to go and try this with people in their day-to-day lives.”
By: Nursing Times News Desk