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Hypnosis Bowel dysfunctionBrigitte Collins BSc MSc Diploma in What is hypnosisImportant to say what it is not Not stage hypnosis. Not sleep Hypnotist does not take control Cannot be stuck in hypnosis Sensationalized treatment results have madehypnosis into a magical mystical process . The more grandiose the more sceptical Not merely relaxation What is hypnosis Does not constitute a form of treatment ortherapy in its own right . Seen as adjunct and best incorporated into Hypnosis is treated as a means of helpingpatients develop powerful personal resourcesdirected towards achieving their therapeutic Promotes self sufficiency and independence.leading to control resourceful and a selfassured patient What is hypnosis Definition It is an interaction between one person the.hypnotist and a subject The hypnotistinfluences the subjects perceptions feelings thinking and behaviour by asking them toconcentrate on ideas and images that mayevoke the intended effects BSCH . How does it work How does hypnosis work 90 of our brain is the sub conscious mindand handles body functions emotions andbehaviour . 10 conscious mind and is responsible forlogic and reasoning Sub conscious mind cannot reason Since SCM cannot reason it acts upon CMsuggestions filter beliefs and may interact.with the environment How does hypnosis work Hypnosis takes hold in the SCM and exerts anautomatic influence on behaviours feelingsand thoughts positive behaviours. Positive ideas conveyed to SCM by suggestion repetition proceeds to manifest them in tothat persons experience healing Two basic elements Trance. Frame of mind characterised Focused attention on experiences e g Ideas and Disattention to extraneous stimuli e g Becomeremoved from immediate realities Absorption in an activity be it images thoughts.and feelings Most people have a natural capacity for trance Two basic elements Suggestion Differs from everyday suggestion instructions E g . Hypnotist conveys communication in such a waythat directs the subjects imagination to elicitintended alterations in sensations perceptions feelings thoughts and behaviour Mind body link chevreuls pendulum lemon . Post hypnotic suggestion Self hypnosis Reinforces self mastery and coping Encourages active involvement in treatment Extends treatment beyond the therapists.office Heap and Aravind 2002 Rehearse coping strategies Manage stress symptoms Manage pain Who can be hypnotised . All of the population in one way shape or formcan be hypnotised Yapko 2011 Like any treatment some may respond betterthan others and some may not Scales for measuring hypnotisability Creative.imagination scale Can we tell Evidence for hypnosis Whorwell 1984 RCT where two groups of 30patients one hypnotherapy and control group. supportive therapy with medication 3 monthslater hypnotherapy group saw a greaterimprovement in bowel habit and well being pain and bloating when compared to control Palsson et al 2002 Whorwell et al 2005 . Gonsalkorale et al 2003 Tan et al 2005 Systematic review Nice guidance 2008 Evidence for hypnosis Bremner 2012. Neural changes of the brain and brain activityhave been noted during hypnosis Process of pain exaggerated in IBS Hypnosis has shown to influence such activityand therefore change that area of the brain.that can overreact Case study 48 year old woman Teaching assistant stressful at times Diagnosed with slow transit constipation IBS.some years later Using Senna x1 2 or more each day Suffering with abdominal pain discomfort decreased bowel frequency bowel movementonce per week sometimes less bloating .increase in girth and anxiety regarding Case study Sleep disturbance prescribed Amitriptylline Appeared calm on the outside althoughcauldron bubbling on the inside. Relaxation techniques previously for feelinganxious worked really well Interests Holidaying in Jamaica visiting a park Case study Following assessment hypnotherapy was.discussed and how we ourselves can bringabout physiological changes E g jobinterview exams Demonstration of lemon and chevreuls Discussion on working with anxiety first . Case study First session incorporated within assessment Breathing technique using calmness andreleasing tension anxiety worries concerns Deepener progressive muscle relaxation . Special place steps down to deepen the process Talked through description makes this realistic Session recorded on phone Homework Self hypnosis Weekly sessions for 6then monthly . Case study Session2 Completed self hypnosis each day Bowels open when arriving home and nextday Using Senna x 1 per day Other symptoms As previous session Special place with more.description Felt some numbness in hands Relaxed much quicker Homework Self hypnosis each day with use of Case study Session 3 Much better BO each day Felt more.positive Senna x 1 per day RB PMR and gut related hypnotherapy Liquid in bottles Biggest spoon Bottle 1 Calm pale blue Bottle 2 Confidence pale purple. Bottle 3 Bloating Bright pink with sparkles Soothing and cool flat stomachSelf hypnosis Recording to be done each day and if canmanage without recording to use parts of session Case study. Session 4 BO 4 out of 7 days Bloatingdecreased No laxatives Repeated last session Could see purple liquid on top of blue liquid andworking through gut like gaviscon. Pink liquid went to head Self hypnosis Reduce use of recording and do selfwith the bottles Case study Session 5 Used liquid bottles a lot feeling.more relaxed about bowels BO 4 out of 7days no bloating no laxatives RB PMR Own visual imagery of how she visualisedbowels Stool got stuck in the corners of the.colon mainly on the left side stool gathered inthe rectum and no messages could getthrough to brain so no regular bowel Case study Visualised bowel in hypnosis . Solution was to drink more water which wouldhelp stool to get through and thereforepushing stool along faster and so empties in tothe rectum more quickly This was related to aslot machine where there is a prize and she.could see a flashing red button that shepressed which sent messages to the brain This relaxed the rectum and as a result had abowel movement Self hypnosis To repeat when having a drink. Case study Session 6 Not feeling so good Did self Repeated last session Homework Self hypnosis with recording andself each day . Case study Session7 After last session BO each day nolaxatives complete evacuation no bloating feeling very good No amitriptylline Feels that this has had an impact on other.things where sleep pattern has improvedgreatly more confidence at work thereforeless stressful Overall well being Feeling great and extremelywell MORE POWERFUL THAN ANY TABLET . Conclusion Hypnosis is best used as part of an integrated Can be costly to provide because of time although the sustained effects could be offsetagainst a reduction in medication and other.healthcare demands Bremner 2012 Gonsalkorale et al 2003 Sustained effect has been noted after 5 years A systematic review has also shown that hypnotherapy qualified for the highest level of acceptance as being both effective and specific. Audit 273 patients of which 204 returned 81% maintained benefit or reported further improvement Bremner showed in 50 patients showed statistically significant improvement in symptoms, qol and general health.