While patients with anxiety or depression should be referred to a mental health expert, most IBS patients, following a diagnosis, should consider mind-body strategies such as diaphragmatic breathing, visual imagery, mindfulness meditation—or clinical hypnosis, says Dr. Niemiec.
Despite its bad rep—which Dr. Niemiec attributes to “stage” and lay hypnotists, who start practicing after attending weekend workshops, though untrained to safely handle the powerful technique—hypnosis is being explored and applied by medical schools worldwide (including Duke University and Johns Hopkins) in treating patients with IBS, chronic pain, psoriasis, obesity and other conditions. At St. Louis University, where he is a behavioral health consultant in the Primary Care and Prevention Center, Dr. Niemiec teaches IBS patients self-hypnosis techniques.
Hypnosis is just another natural state of mind that everyone experiences, explains Dr. Niemiec. Everyone at some points has gone into a “highway trance”—focusing on nothing but the road—or has become absorbed in a movie, book or conversation to the point of ignoring surrounding noise and other distractions.
For IBS patients, hypnosis involves “focusing attention and letting go to achieve deeper relaxation.” Next, the practitioner makes “suggestions for healing and decreasing pain sensitivity,” says Dr. Niemiec. Ultimately, patients learn to bring themselves into the relaxation state by using a cue, such as a breathing pattern or a phrase.
While hypnosis may sound too good to be true, researchers are investigating how it works. Possible hypotheses include the effect of relaxation on the body or increased motility of the colon, says Dr. Niemiec.