Impact of hypnotic safety on disorders of gut-brain interaction: A pilot study

ABSTRACT

Functional gastrointestinal disorders, i.e., abdominal conditions without identifiable structural etiologies, are seen frequently in primary care and specialty practices. As subtle physiological processes have been identified as potential contributing factors to these functional disorders, these disorders have been recently relabeled, Disorders of Gut-Brain Interaction (DGBI). Moreover, some of these processes, e.g., sympathetic nervous system activity and inflammation, are being increasingly related to psychosocial factors such as situational stress and histories of trauma, abuse, and neglect. As the activity of the autonomic nervous system (ANS) has been long considered to be a contributory factor for DGBI, the present study utilized a theory-driven model based on the Polyvagal Theory to optimize ANS activity for the promotion of healthy digestive activity. Specifically, a hypnotic intervention to increase neuroception of safety was employed with three female college students diagnosed with functional dyspepsia and irritable bowel syndrome in a single-subject design. This intervention was found to be associated with increases in the experience of safe/warm positive affect and decreases in symptoms of functional dyspepsia and irritable bowel syndrome as well as depression and anxiety. The hypnotic intervention for the promotion of a sense of safety is recommended for the treatment of other functional somatic disorders as well as trauma-related conditions. Potential complications related to individuals with prolonged trauma and attachment issues also are reviewed.

KEYWORDS:

• Disorders of gut-brain interaction
• functional gastrointestinal disorders
• hypnosis
• Polyvagal theory
• safe-place imagery
• trauma

Acknowledgments

We would like to thank Dr. Allan F. Chino and Dr. Akira Otani for their feedback on earlier versions of this article. The first author would like to thank Dr. Daniel P. Brown for introducing him to the field of clinical hypnosis and providing him with a solid foundation of knowledge. M. Skyler Hamilton is now at Healing Passages Counseling, LLC, Clermont, Florida, United States.

Notes

¹ The present study was reviewed and approved by the Human Subjects Review Committee of Regent University.

² The name of the Safe/Content subscale was changed to Safe/Warmth when the final measure was published. Consequently, both labels refer to the same subscale.

³ Of the eight administrations of the PAGI to each participant, three items were responded to in an unclear manner and were regarded as missing data. These missing values occurred twice for Participant 2 on different administrations and once for Participant 3. All missing values were on different PAGI items. Missing items were excluded from the calculation of means when they occurred.