Her stomach ached. A subconscious suggestion helped it heal

Lina Gutierrez remembers her mother’s late-night hug. Tears. And a cramping pain, deep in her stomach, waking her suddenly from her slumber.

Her parents couldn’t understand the pain that seemed to come and go from their daughter without explanation. It was 20 years until she got a diagnosis: irritable bowel syndrome.

Lina Gutierrez: “I did everything under the sun to get better.”

Unfortunately, diagnosis does not mean cure. About one in 10 people, most of them women, have the painful cramps and bloating that characterise the disease.

“I was having flare-ups once a week,” said Gutierrez. “I did everything under the sun to get better.”

When you’ve tried everything, you’ll try anything. Including things that seem, well, magical. One of Gutierrez’s aunts had turned to a hypnotist to quit smoking. It worked. “Why not?” Gutierrez thought.

Credit: Matt Golding

For decades, hypnotists were associated with swinging pocket watches in circus tents and grown adults clucking like chickens.

But medicine is now starting to embrace hypnotism, spurred on by studies showing it really does seem to work for a certain set of conditions, particularly those linked to chronic pain. Even if we don’t fully understand how.

Modern hypnotherapists look more like psychologists, operating from calm offices and comfy couches, no cloaks in sight – like Dr Simone Peters.

Studying IBS treatments at Monash University, she was initially sceptical about hypnotherapy’s promising trials. Then she ran her own study – and got the same results.

There’s no one more passionate than a convert. Peters trained as a hypnotherapist and soon set up a clinic at the Alfred Hospital.

Dr Simone Peters, seen here at her St Kilda office.Credit: Simon Schluter

To emphasise again, no one really knows how hypnotherapy works. But here’s our best theory: humans have a conscious and an unconscious mind. Your conscious mind is reading these words; your unconscious mind is tending to your heart rate, breathing, and making sure your breakfast is being smoothly digested.

During hypnotherapy, you lie back on the couch and are placed in a state of deep relaxation – typically by following a progressive muscle relaxation technique, similar to yoga.

That lets the therapist bypass the conscious mind and make suggestions to the unconscious.

Peters has her IBS patients imagine walking into a pharmacy to collect a bottle of medicine specially formulated for just them. They swallow the medicine and it goes down, down, all the way down, coating the stomach in a protective gel, shielding it from irritation.

Reviews of randomised controlled trials of high-volume hypnotherapy for IBS suggest it halves the risk of symptoms – not a cure, but a big improvement (it remains a third-line treatment behind medication and dietary changes). It shows a similar efficacy to a low-FODMAP diet.

IBS may be a particularly good target because it is driven by a breakdown in the relationship between the stomach and the brain. IBS overlaps strongly with anxiety and stress. “These patients are probably much more attuned to what’s going on in the gut than a normal person,” says Peters.

For all its promise, hypnotherapy has a big problem: a lack of hypnotherapists. The clinic at the Alfred has an 18-month waitlist, for example.

What if you could deliver the treatment on the patient’s own couch, using an app? Peters and Mindset Health co-developed Nerva, which delivers a six-week daily program of recorded hypnotherapy sessions along with educational articles.

Her colleagues were very sceptical. Surely hypnosis would be dependent on the skill of the hypnotist – could you really deliver that through an app?

But in a paper published in American Journal of Gastroenterology in June, Peters showed 71 per cent of patients undertaking a six-week course through the app improved their pain by at least a third. Patients reduced their stomach symptoms by almost a third on average.

“It is a very credible study that I would take seriously, despite the mechanisms for how it works remaining completely uncertain,” said Professor Nick Spencer, a leading gut neuroscientist at Flinders University. “Based on these findings it presents a genuine therapy for IBS patients”.

Professor Nicholas Talley, who does foundational research on IBS at the University of Newcastle, was more circumspect. “This is not curative therapy,” he said, pointing out most patients still had symptoms at the end of the trial. “Some benefit, yes, but arguably at moderate at very best.”

The patients also knew if they were receiving hypnotherapy or not, which may explain some difference between groups. And the patients did not see an improvement in depression, anxiety or stress compared to the active control group, “which is concerning given the strong correlation between IBS severity and mental health”, said Dr Leticia Tavares, who studies the genetic causes of IBS at Monash University (both groups improved).

Lina Gutierrez’s symptoms haven’t vanished. But after five weeks of treatment, her flare-ups started spacing out. Now she will often go three months without cramping. “It’s amazing,” she said. “Now I don’t worry, I just go on and enjoy life.”

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