Assignment - Module 8 Word Count 2221 This essay will be describing the condition irritable bowel syndrome. I will also be discussing the possible uses of hypnosis in helping to treat the aspects of this condition. Irritable bowel syndrome (IBS) is a condition of the gut and it has been noted that it is a condition which affects about 1 in 10 people at some time. Statistically it has been recorded that it is more prevalent among people between the ages of 25 – 45 and females are more affected than males. However this condition can cause problems at any age to both sexes and ethnicity may be a factor to be considered. For example data for Pakistan shows that males between 16-30 have a higher rate of IBS. There are many symptoms that many IBS suffers endure such as:
Feeling and being sick by vomiting
Diarrhoea
Constipation
Pain in the abdomen
Bloating/wind
Feeling that you haven’t fully emptied all faeces from the rectum
Stress and anxiety
Depression
to list a few.

This condition causes great problems with the sufferer as it can destroy and disrupt their day to day life. Before a person with IBS and a hypnotherapist work together the IBS patient should have already seen a GP and consequently been diagnosed. An ethical hypnotherapist would need to know that all other, more serious conditions such as bowel cancer, have been ruled out and that the problem is IBS for a fact. The doctor should have already ruled out thyroid problems, colon cancer, inflammatory bowel disease as these problems present similar symptoms such as abdominal pain and unusual defecation.
There are other possible symptoms that are not necessarily related to the gut area and these have been listed as
Headaches
Backache
Tiredness
Urinary symptoms
Some people experience constipation whereas others will have problems with diarrhoea and about a third of sufferers will have trouble with both together.
So what are the causes of IBS?
At this point in time the exact cause of IBS hasn’t been identified but there are a few factors that have been recognized as “triggers’ for the symptoms to manifest. Although it may differ from person to person there may be certain foods that can exacerbate the symptoms such as irregularity of meal times and insufficient fibre in the diet can also factor as triggers as well as stress. There is no known cure for this condition but there are a few treatments used as reduction in symptom techniques used widely today.
It is very important for the patient to educate themselves or be educated about their condition. This will promote awareness and enable them to understand IBS better. Advice given would include adjustments to diet and methods of relaxation. The GP will prescribe any medication suitable for their patient. As there is no identified exact cause of IBS it is commonly known as a disorder of the interaction between the brain and the gastro-intestinal tract. Routine clinical investigation for patient symptoms normally result in no abnormalities. IBS is not life threatening and does not reduce life expectancy in an individual but its effects can and are quite devastating to some. It can cause chronic pain and fatigue and consequently sufferers will have more problems with employment as more time is taken off work due to IBS related problems. Some studies have stated that 60% of IBS sufferers are found to also be sufferers of psychological problems such as depression and/or anxiety and it has been noted that up to 50% of IBS sufferers have turned to alternative medicine and methods of dealing with their problems after feeling that their treatment with their GP has been unsatisfactory for them. Examples include probiotics, herbal remedies, acupuncture, yoga and relaxation techniques among others. An ethical hypnotherapist must consider talking to the patients GP [with their permission ]to clarify information and put them in the picture of the work you intend to undertake with their patient.

What is happening to the IBS sufferer?
Physiological problems that will affect the day:
The IBS sufferer can feel terrific abdominal pain
A patient has wind problems
Needing to rush to the toilet due to diahorrea
Being ‘stuck ‘on the toilet due to constipation
Feeling and being sick
These are some of the physiological problems that can cause countless problems in the day to day functioning of an IBS sufferers life.

Psychological problems:
These can be extremely debilitating.
Depression and anxiety are prevalent conditions associated with IBS
The constant anxiety of whether or whether not you will need to get to the toilet would be enormous. An IBS sufferer can be so preoccupied with their condition that it will have a detrimental affect of their general well-being. This exposure to constant anxiety could and has resulted in depression for some people. The IBS sufferer can have many problems trying to deal with their work issues as well as living with their condition. It is often easier for the sufferer to stay at home to avoid the stresses and embarrassment they may feel, this in turn will cause problems at work and the anxiety and stresses become circular for the IBS sufferer. As I previously mentioned a lot of IBS sufferers are not fully satisfied with their ‘traditional’ treatment and seek alternative ways to enable them to manage their health issues. Hypnotherapy is one of the methods that can prove very useful and effective in treating IBS sufferers. A competent and ethical hypnotherapist will ask their client many questions before they could treat them. During the Initial consultation they will need to establish what the client would like to achieve through hypnotherapy. The hypnotherapist must be certain that the client has had a full medical investigation by their GP concerning their problems as it would be dangerous and unethical to continue to, for example, mask the pain if it needs to be investigated first. When the hypnotherapist is satisfied with the clients information and IBS is confirmed then he can endeavor to help the individual. Through their GP and a person getting to know their own body, symptoms can often be managed and controlled to a satisfactory level but not cured as such.
“IBS is no longer a bizarre and incomprehensible condition. The principle underlying its successful management is the same as that of any other disease - find the cause and treat it logically” (Hunter 2007)
Hypnotherapy can be used to help alleviate the IBS sufferer from at least some of the pain and it can go a long way in reducing the psychological problems that may be present. It is widely accepted that hypnotherapy to treat an IBS sufferer is a great alternative or complimentary form of treatment to use successfully. To the sufferer IBS can be colossal in how it affects their day to day life.
“Bowel symptoms always have the potential to cause great embarrassment, but in IBS this sort of problem can continue indefinitely, often with no apparent relief in sight, making sufferers lives a misery. Patients with IBS do sometimes die because of the condition – they commit suicide.” (Hunter 2007)
So therefore the seriousness of IBS to an individual is of great significance and should never be underestimated.

So what can be done using hypnotherapy to help an IBS sufferer?
“a comparative study of experimental pain found that, among hypnotizable people, hypnotic analgesia was superior to morphine, diazepam, aspirin, acupuncture and biofeedback” (Kihlstrom 1998)
A good starting point for treating the IBS sufferer with hypnotherapy could be employing relaxation techniques.
A progressive muscle relaxation script is useful. This is where the hypnotherapist will guide the client from the top of the head and slowly move down through the whole body paying more attention to areas of concern and finally reaching the tips of the toes. The hypnotherapist will be suggesting relaxation and calm flowing through the clients body in an eyes closed process. The PMR is often a beginning to more in depth hypnosis and suggestive work but it can also be taught to the client on its own for their own use ie: for self hypnosis/relaxation. The hypnotherapist should encourage this as it can enable the client to be empowered to act at any given time or place in the future. Another area where hypnotherapy is useful, would be in dealing with the anxiety the IBS sufferer has to daily endure. “A certain amount of stress can be beneficial, providing a stimulus to action, but too much will often result in anxiety, which might be described as fear or apprehension not caused by real danger” (BMA 2004) Therefore the psychological response of anxiety can increase the physical symptoms, so the intention is for the hypnotherapist to help reduce the clients anxiety thus further reducing the physical aspects of this chronic condition.
Chronic illness – “This type of pain persists over a longer period of time and is made worse by the environment the person is living in and their psychological state. Chronic pain is often resistant to orthodox medical treatment” (Chrysalis Notes Module 8 pg3)
To reduce anxiety the hypnotherapist could construct a full screed including the PMR, using deepeners. The client can be gradually relaxed and guided to their special place. A good and ethical hypnotherapist will have fully prepared the way this will be presented and worded to suit their client as they would have gained lots of information on the individual through the initial consultation. Modalities and the way it will be delivered such as authoritarian or permissive are very important. From the special place the hypnotherapist will lead on to the issues that need to be addressed and suggestive statements will be given. For example :
‘if you feel the need to go to the toilet you will not panic, you will just calmly make your way there, knowing that you are in control at all times.’ There would be lots of this type of wording and it can lead to affirmations the client can repeat. Such as ‘I no longer worry’ ‘there is no need to panic I have control’ etc.
The aim of the hypnotherapist would be to instill coping mechanisms within the client and reduce their overall anxiety levels.
Hypnotherapy can also be very useful in enabling an individual to become more motivated in maximizing their potential within the limitations of their condition, so effectively the person can be ‘living with’ as opposed to ‘suffering from’ their condition or health problem. Hypnotherapy can encourage a more positive outlook for the present and the future. At times the IBS sufferer may periodically be in more pain than usual. They will have acute pains such as abdominal cramps. The hypnotherapist can teach the client a method of immediate action that could be successfully employed such as ‘glove anesthesia’. This has proven effective by many therapists. The idea is to encourage the client to ‘numb’ one of their hands by imagining, for example putting it in a bowl of ice, during hypnosis. When the hand becomes numb they can place it on the area of their body which is ‘troublesome’ therefore transferring the numbness to the affected area and reducing the pain. The hypnotherapist can install a trigger for the client enabling them to access this method in the future. Such as when they state ‘ My hand will become numb’ it will happen and they can place it wherever they need to at the time to relieve their pain. The human body contains its own natural pain killers. These are known as endorphins. Endorphins give us a feeling of euphoria or well-being. A hypnotherapist can encourage visualization techniques within a client where they can encourage endorphin production within themselves. For example ‘ Imagine hundred/thousands of miniature orange smiley faces all gathered in your mind, all feel good smiley faces ready to be released into your body, and when you feel ready let them go, release them, feel how they flow through your body and notice it good it feels and how fantastic your body feels so good, so good, so good’ etc.
A well written positive script encouraging endorphin release within the body is a great way to help the client with IBS as well as many other conditions. When treating the IBS sufferer I would also be looking at how the client can deal with their frustration and anger and other emotions that may be indicated. It is quite likely low self esteem and fatigue may be present.
A good hypnotherapist would consider if there were any possible secondary gains within the client ie: attention from others due to their condition. Consideration for regressive techniques might be useful and referral to a counsellor/ psychotherapist may be an option if the other methods were exhausted first. The hypnotherapist must: “remain aware of their limitations and wherever appropriate be prepared to refer a client to another practitioner (regardless of discipline) who might be expected to offer suitable treatment”(National code of ethics GHR section 7)
In conclusion I have demonstrated the various methods I could employ to treat the IBS sufferer. I have also described the ways in which they can continue to help themselves in the future with proven techniques to help both mentally and physically consequently establishing the fact that hypnotherapy is a great complimentary or alternative to traditional medical treatment today.