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.”
Hypnosis is a clinical technique typically used to treat conditions like anxiety and pain but some say it could also help as a parenting tool. “Hypnosis and parenting is a natural solution,” Lisa Machenberg, a hypnotherapist and mother of three, told ABC News. “You naturally influence your child anyway, let’s learn how to do it with intention.”
Machenberg began hypnotizing her own children to help them get through the night without wetting the bed. She now uses it as a tool to help her kids deal with everything from performance anxiety to difficulties focusing.
“My children are able to use logic and reason,” she explained. “They have a form of diligence or perseverance that you don’t see in other children.”There is no science to support the idea that hypnosis is an effective parenting tool. The method, experts say, should only be done by trained clinicians.
Machenberg charges $125 per hour for her sessions and said she has worked with more than 1,000 kids in her years of practice. She also works with parents on strategies they can try at home and teaches kids self-hypnosis strategies.
Machenberg’s 17-year-old daughter, Rayna, said she has “always known” that her mom used hypnosis on her and said it has had a positive impact on her life. “Being able to push back on stress and think about it deeply and do self-reflecting was a skill that I’m really grateful that my mom taught me,” she said. “I think it still influences me a lot today and helped me develop into the person I am right now.”
ABC News Chief Health and Medical Editor Dr. Richard Besser, whose parents are both clinical hypnotists, said hypnosis works for shaping behavior but the evidence is still out on whether or not it is a good tool for children.
“The evidence on the clinical use is really, really strong,” Besser said. “I haven’t seen that kind of evidence for parenting and that bothers me a little bit.”
Besser said other strategies parents can use to help their kids perform better include offering praise for good behaviors, using a star chart for school-age kids to track achievements and staying consistent on discipline and expectations. “Not idle threats,” Besser said, adding again that hypnosis should only be done by a trained professional.
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
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.
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.
A Boston area Hypnotherapist, with 10 years of medical experience as an RN, Paul has been helping clients since 2001 to overcome everyday challenges. Read more
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