Pain relief for IBS clients using regression to transfer analgesia

The opinions expressed in this article are the author’s own and do not necessarily reflect the view of the American Council of Hypnotist Examiners.


by Aksel Sogstad

As I have recently started a cooperative effort with a hospital where I assist in the treatment of patients who suffer from Irritable Bowel Syndrome (IBS), I would like to present a method I have developed for pain relief in the abdomen. When I was younger, I did experience this painful condition myself, and it is therefore particularly meaningful for me to help others who suffer from this condition.

There is currently no effective medical treatment for these patients, apart from the low FODMAP(1) diet. IBS patients who do not respond well to the low FODMAP diet may benefit from reducing stress and tension. They are sometimes offered prescribed medication for relaxation, like barbiturates, but these types of medications have side effects that some consider undesirable.

There have recently been published several papers on the benefit of using hypnosis to treat IBS. The most well known protocols are the Manchester protocol (2) and the North Carolina protocol (3). These protocols use fairly basic scripted hypnotherapy techniques for relaxation, based on visual imagery and suitable direct and indirect suggestions.

The author of the North Carolina protocol included several posthypnotic suggestions for pain relief.  Although the hypnotherapy treatment was successful on the whole, the study showed that patients who did get suggestions for pain relief did not experience less pain than patients who did not receive any pain relieving suggestions, implying that the suggestions for pain relief did not work. The reason, I suspect, is that simple post hypnotic suggestions are not that effective for managing pain.  In order to deal with pain, it is necessary to get a bit more physical. I therefore wanted to create a simple but effective method to give pain relief in the abdominal area. This method is based on transferring induced analgesia from the jaw to the abdominal area by combining several techniques, ideomotoric movement, as described by Ernest Rossi (4), inducing analgesia in the jaw, as in Dave Elman’s “Green, Green, Green” (5), regression, as in Transforming therapy by Gil Boyne, and the analgesia work done by Dr. John Butler.

The method is not restricted to treatment of IBS, as it could be used to sooth pain in any area. It is also a very efficient method to teach one how to induce arm levitation or analgesia, which are phenomena which both therapist and patient often find a little challenging at first. The method is presented in four parts: introducing analgesia, testing analgesia, regression to induce arm levitation, and transferring numb relaxation to the abdominal area. In order to make it work for the patient in the best way possible, it is advisable that the therapist make it work for him or herself first. Fortunately, the method is easy to apply in self hypnosis. Also, it is quick to administer. Having introduced analgesia to the patient in a previous session, this method can be applied in about 20 minutes of one session.

One could of course use other methods to improve the pain management in the referred papers, for example visualising a rotating shape as a representation of the pain, and then counter rotating it or changing other “pain defining parameters” in other ways. In fact, almost any hypnotherapeutic method may be applied to reduce pain as well, as shown by Elmer (6). The method presented here, however, has the advantage of creating instant manifestations of trance and proofs of analgesia, and I believe that this will help to motivate the patient to develop these skills further. Successful treatment always depends on some dedication on the part of the patient.

Introducing analgesia
It is necessary to first remove uncertainty and introduce a real experience of analgesia. As said, this is done in a previous consultation. Introduce the patient to Dave Elman’s “Green, Green, Green.”  It is a simple method for producing relaxation in the jaw area. By relaxing the jaw, saliva production is activated, and this serves as an unconscious signal that we are safe and can relax even more.

It works by saying “Green” 3 times. The first time we say “Green” we close our eyes, the second time we say “Green” we imagine getting a shot of anesthetic in the jaw, perhaps given by a dentist, and the third time we say “Green” we open our eyes and become aware of the numbness and relaxation in the jaw. Obviously, this is not a spell, and you can make your own variation of it if you wish. As a side note, I would like to mention that once I did this with a dentist, he obviously did not get a numb feeling in the whole of the jaw, only in half of it. The mind is funny like that, creating a reality that suits our inner belief system.

It would also be advantageous if the patient is introduced to the power of suggestion before performing the arm levitation in the next session, for example by a standard routine like holding her hands out in front of her, and imagining that one hand is very heavy, being pulled down by a bag full of stones, while the other is very light, being pulled up by 50 helium balloons.

The client should practice the “Green, Green, Green”-session for a few minutes every day before the next session. During this time, if the client is unfamiliar with the trance experience, she should also practice going into trance by using a recording or performing self hypnosis. I ask clients to choose between using a recording and doing self hypnosis themselves. Some are quickly bored by recordings and want to learn how to do things themselves; others are fine using the same recording repeatedly.

Testing analgesia
In the next session we can now test the analgesia. For reference, before doing any hypnosis, ask the client to pinch the skin on the back of one hand between the nails of the thumb and the index finger on the other hand. Ask her to pinch the skin so she can feel it well, but obviously not in order to hurt herself.

Now guide her into hypnosis. If she feels confident to do this by performing self hypnosis, it is a good idea to support her by following her into trance, going into a light trance yourself. Now ask her to repeat the “Green, Green, Green” session a couple of times, and tell her to stay focused on the numb relaxation in the jaw, and ask her again to pinch the skin on the back of the hand. This time she will almost not feel the pinching, so advise her to be careful not to pinch too hard. The purpose of this testing is just to demonstrate that we have an ability to create analgesia ourselves.

Regression to induce arm levitation
Explain to her first that you will help her guide her mind back in time to a meaningful experience, and that she will allow her lightest hand to ascend as a manifestation of the energy she experiences while she investigates that experience. If she is apprehensive about letting her arm levitate, you can explain that most of our physical movements are in fact done without any direct conscious thought, for example by pointing to the fairly complicated process of tying our shoe laces.

Guide her mind back in time, for example by counting down from 10 and to 1, adding suitable suggestions and imagery of clocks and dates going backwards etc. At the count of 1, tell her that she has arrived, and begin to ask her open questions to help her build up a situation alá Gil Boyne “Is it day or night?”, “Are you inside or outside?”, “Are you alone or with somebody?”. Soon the situation will be clear for her, and ask her to describe what is happening. Now, ask her to let the energy of the situation manifest by raising her lightest arm a little above her lap, and continue to let that arm move upwards as she investigates and experiences the various sensations of the situation. You might also tell her that it is perfectly okay if the situation changes naturally into something else, where she may find even more interesting energy. Soon the hand will be going upwards. If it stops, you may have to tell her to allow her elbow rise as well.

As an example of such a situation, one patient imagined being alone in a cabin in winter, reorganizing the bookshelf. It can be a simple self-organising, constructive image like this, but it does not really matter, any situation that will stir the required energy in the patient to do the hand levitation will do. Just remember not to do any therapy whatever the situation.

Transferring relaxation to the abdominal area
Tell her now that when her hand touches her face, all the numb relaxation of the jaw flows into the hand, producing a warm feeling.

Tell her that when all the numb relaxation has flowed into the hand, the hand begins to descend toward a special place in her abdomen that needs the relaxation of the hand. Tell her to feel the heat leaving the hand and enter her abdomen as she places her hand on the required spot. Let her relax for a little while and observe the difference.

You can give now give her some appropriate positive suggestions, for example “imagine that you are lying comfortably on the beach, taking a rest, knowing that you can now experience the feeling of healing yourself, all inner organs loose and limp, being healed and restored to the best condition possible. And you may find it interesting to experience how this practice will change your perception and the workings of your digestive system, as you practice this healing method every day for the next two weeks”.
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Aksel Sogstad works as a hypnotherapist in Oslo, Norway. He is particularly interested in medical hypnosis, transforming negative patterns, and stress and pain management. His website is www.helesinnet.no

References

1. The FODMAP was initially developed by researchers at Monash University. See: http://www.med.monash.edu/cecs/gastro/fodmap/. The diet consists of reducing intake of short chain carbohydrates and sugar alcohols found in foods naturally or as food additives. See http://fodmapfriendly.com/what-are-fodmaps/ for more information.
2. Gonsalkorale, W. M. (2007). Gut-Directed Hypnotherapy: The Manchester Approach for Treatment of Irritable Bowel Syndrome. International Journal of Clinical and Experimental Hypnosis, 54:1, 27-50. Link: http://dx.doi.org/10.1080/00207140500323030
3. Palsson, O. S. (2006). Standardized Hypnosis Treatment for Irritable Bowel Syndrome: The North Carolina Protocol. International Journal of Clinical and Experimental Hypnosis, 54:1, 51-64. See also: http://ibshypnosis.com.
4. Cheek, D. B., Rossi, E. L. (2014). Ideodynamic Healing in Hypnosis. W. W. Norton & Company.
5. Elman, D. Findings in Hypnosis. CD set. Glendale: Westwood Publishing Company, Inc.
6. Elmer, B. N. (2008). Hypnotize Yourself Out of Pain Now!. Crown House Publishing Ltd.