NBC News: For tummy troubles, hypnosis might be the answer

NBC News: For tummy troubles, hypnosis might be the answer

Sixty million Americans deal with this uncomfortable sensation at least once a month: heartburn. It’s not only painful, but can be life-altering, or even deadly if ignored. No wonder that heartburn and other gastrointestinal medications are among the most popular drugs on the market. But these “miracle drugs” are far from perfect; some patients report mixed results and long-term side effects.

For patients who don’t get relief from medication, their gastroenterologists are turning to psychologists for help. Hypnotherapy can be an effective treatment for heartburn and other stomach conditions. It’s a powerful alternative treatment, backed with plenty of scientific evidence, which is increasingly being offered at the nation’s leading medical centers.“

There’s a robust amount of literature behind hypnotherapy beginning in the 1980s,” said Laurie Keefer, Ph.D, director of psychosocial research at the Icahn School of Medicine at Mount Sinai. “We’ve really taken to calling it brain-gut therapy.”

Hypnosis, which exploits the relationship between the mind and digestive system, can also help with conditions like GERD and the inflammatory bowel diseases, Crohn’s disease and ulcerative colitis. Untreated GERD has been linked to esophageal cancer.

Amber Ponticelli, 35, started having digestive problems in 2007. Initially, she only felt dizzy and weak in the morning, but soon developed severe abdominal pain. Unable to eat or drink for months, she lost 20 pounds and was ultimately left bedridden.

After seeing multiple gastroenterologists at leading medical institutions, she was eventually diagnosed with a genetic condition that is associated with many GI symptoms.
“I thought I was dying. I had to quit my job and ended up moving to the city with my boyfriend just to be closer to the doctors I was seeing in the city,” Ponticelli told NBC News.
After traditional treatment like medications and lifestyle changes, a wary Ponticelli was referred to Keefer for a hypnotherapy session.

Hypnosis uses progressive relaxation techniques through suggestions of calming imagery and sensations. Patients are able to concentrate on improving their symptoms which often range from abdominal pain and constipation to diarrhea and bloating.

For the therapy to be effective it takes a series of eight or more visits and some homework is required of the patient, like listening to tapes at home. The treatment is covered by most insurance plans and cost for each visit ranges between $100 and $150.

Contrary to many popular portrayals on television and in fiction, a clinical hypnotherapist does not have mind-control over the hypnotized patient. The patient is usually aware of what is happening and their surroundings, both during and after a hypnosis session. A session can be offered in-person and remotely, via a service called telemedicine.

“Telemedicine is critical because not every place in the country has somebody qualified or trained to provide this treatment, so it allows us to have a much broader reach for these very common disorders,” Keefer told NBC News.

Studies show more than three quarters of patients experience at least a 50 percent reduction in symptoms. Many are able to stop medication, including popular acid reducing drugs.
Hypnosis optimizes the brain depth function, but it’s not a fix for everyone.

Approximately 15-20 percent of people can’t be hypnotized, said Dr. Olaf Palsson, psychologist and professor of medicine at the University of North Carolina School of Medicine. Fortunately, patients do not have to be highly hypnotizable to benefit from gut-directed hypnotherapy, so many could find relief.

According to gastroenterologist Dr. Rajeev Jain of the American Gastroenterological Association, gut-directed hypnosis therapy can treat functional disorders of the GI tract, such as irritable bowel syndrome, where there is often a large overlay of depression and anxiety disorders. He views hypnotherapy as one form of complementary and alternative medicine (CAM). Lifestyle factors such as diet are also important and should be taken into account.

Today, Ponticelli, who lives outside of Chicago, is back to work as a Pilates instructor, and eating her favorite foods, an activity she had not enjoyed in years. She’s also eating for two. “I’m 17-and-a-half weeks along now and feel good,” said Ponticelli.

She still takes some medications, but adding hypnotherapy to her regimen has been life-changing. “I’m extremely grateful that I’m actually doing this and I don’t think I would have been able to do anything without this treatment. That’s the real truth of it.”

By: Parminder Deo 

Healthday News: Hypnosis eases pain of breast cancer surgery

Healthday News: Hypnosis eases pain of breast cancer surgery

Instead of pills and needles, hypnosis may ease the pain of surgery — both during and after the procedure. According to a new study, women who received hypnosis before breast cancer surgery needed less anesthesia during the procedure, reported less pain afterward, needed less time in the operating room and had reduced costs.

“This helps women at a time when they could use help, and it has no side effects. It really only has side benefits,” said Guy Montgomery, lead author of the report and associate professor in the department of oncological sciences at Mount Sinai School of Medicine in New York City.

Montgomery hopes that the study, published online in the Aug. 28 issue of the Journal of the National Cancer Institute, will promote greater use of hypnosis in medical treatments. Side effects such as pain, nausea and fatigue — both during and after breast cancer surgery — are commonplace. Previous research has suggested that hypnosis, a simple and inexpensive procedure, can help ease these problems. One small clinical study indicated that hypnosis was also effective for breast cancer patients about to undergo surgery.

For the new study, 200 women set for breast cancer surgery were randomly assigned to receive either 15 minutes of hypnosis with a psychologist or assigned to a group that simply spoke with a psychologist.

During the hypnosis session, the patients received suggestions for relaxation and pleasant imagery as well as advice on how to reduce pain, nausea and fatigue. They also received instructions on how to use hypnosis on their own.

The researchers found that women in the hypnosis group required less anesthesia and sedatives than patients in the control group, and also reported less pain, nausea, fatigue, discomfort and emotional upset after the surgery.

Those who received hypnosis also spent almost 11 minutes less time in surgery and had their surgical costs reduced by about $773, mainly as a result of the shorter time.
Although people think that hypnosis strips a person of control, it actually does just the opposite, said Dr. David Spiegel, author of an accompanying editorial in the journal and Willson professor and associate chairman of psychiatry and behavioral sciences at Stanford University School of Medicine.

“This is something that empowers patients,” Spiegel explained. “If you’re fighting, you think you’re protecting yourself, but, actually, you’re losing control, because you’re getting into a struggle with your own body. You can teach people to float instead of fighting. You get the body comfortable and think more clearly. The weird thing is it actually works. If thoughts can make the body worse, it follows that thoughts could actually make the body feel better.”

But will hypnosis catch on with health-care providers?
“We have this in-built skepticism of what goes on in the brain and the mind, and the idea is that the only real intervention is a physical one. Yet what supposedly distinguishes us is this huge brain on top of our bodies,” Spiegel said. “It seems more scientific and desirable to give drugs than it does to talk to people and have them reorganize the way they’re managing their bodies.”
There are other obstacles. Many doctors find it more expedient to write a prescription than learn to perform hypnosis.

Also, there’s no industry pushing the technique as there is with drugs, Spiegel said. On the positive side, little investment is needed to get a hypnosis program going, Montgomery said. “A psychologist or nurse could get training in a short period of time,” he said. “It’s not that involved.”

Dr. Darlene Miltenburg, assistant professor of surgery at Texas A&M Health Science Center College of Medicine, called the new study “superb.” “Anybody who has an open mind would realize that this treatment works and is scientifically proven. It’s not black magic,” Miltenburg said. “It’s real, and we do use it here. It’s very time consuming, that’s part of the problem, taking a pill is much easier. But just like many things in life, we want a quick fix rather than something that takes longer.”

To learn more, visit the National Center for Complementary and Alternative Medicine.
SOURCES: Guy Montgomery, Ph.D., associate professor of oncological sciences, Mount Sinai School of Medicine, New York City; David Spiegel, M.D., Willson professor and associate chairman of psychiatry and behavioral sciences, Stanford University School of Medicine, Palo Alto, Calif.; Darlene Miltenburg, M.D., assistant professor of surgery, Texas A&M Health Science Center College of Medicine, and chief, Section of Breast Surgery, Scott & White, Temple; Aug. 28, 2007, Journal of the National Cancer Institute, online

By: Amanda Gardner

Wall Street Journal: hypnosis a surprise medical solution

Wall Street Journal: hypnosis a surprise medical solution

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.

There is a three-to-six-month wait list for the treatment at the University of Michigan, says Megan Riehl, an assistant professor of medicine and gastrointestinal psychologist.
“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, conducts the treatments there, along with two other psychologists and students in training. 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

Research supports stress hypnosis

In a research study done with 60 college student volunteers (Spring of 2004 at Northern Arizona University, Flagstaff, Arizona), using hypnosis with ego-enhancement suggestions showed “significantly dramatic effects” in brain-wave patterns, subjective sense of self-confidence, and test scores.

In an ongoing pilot study being done by University of Florida counseling psychologist Paul Schauble, preliminary results show hypnotized patients with hypertension are more easily able to make lifestyle improvements that can lower blood pressure.

Faymonville ME. Mambourg PH. Joris J. Vrijens B. Fissette J. Albert A. Lamy M. Psychological approaches during conscious sedation. Hypnosis versus stress reducing strategies. 1997; 73(3): 361-7. This study suggests that hypnosis provides better perioperative pain and anxiety relief, allows for significant reductions in alfentanil and midazolam requirements, and improves patient satisfaction and surgical conditions as compared with conventional stress reducing strategies support in patients receiving conscious sedation for plastic surgery.

Stanton HE Overcoming fear of public speaking with the diagnostic trance Australian Journal of Clinical & Experimental Hypnosis 1991 May; 19(1): 41-7. Subjects in both the experimental group of the 1st stage and the control group of the 2nd stage were able to reduce their fear of public speaking level significantly through use of the diagnostic trance procedure. Three months later, this improvement had been maintained.

Stanton HE Self-hypnosis: one path to reduced test anxiety Contemporary Hypnosis 1994; 11(1): 14-8. Results indicate a significant reduction of TASC scores in the experimental group, maintained over a 6-mo period, which was not matched by the control group.

Hammarstrand G. Berggren U. Hakeberg M. Psychophysiological therapy vs. hypnotherapy in the treatment of patients with dental phobia. European Journal of Oral Sciences 1995; 103(6): 399-404. The PP group reported a statistically significant decrease in dental fear as well as a rise in mood during dental situations, as opposed to the HT group. Treatments, became less fearful of dental care and were able to manage conventional dental care, including changing dentist.

Taylor DN. Effects of a behavioral stress-management program on anxiety, mood, self-esteem, and T-cell count in HIV positive men.  Analysis showed that compared with the no-treatment group, the treatment group showed significant improvement on all the dependent measures, which was maintained at a 1-mo. follow-up. Since stress is known to compromise the immune system, these results suggest that stress management to reduce arousal of the nervous system and anxiety would be an appropriate component of a treatment regimen for HIV infection. Psychological Reports. 1995; 76(2): 451-7.