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Zach Rogers’ transformation was sudden. During his 12th birthday party, he started having stomach pains. He went to bed early that night, missed most of the slumber party, and missed all of school the next week. His stomach pains were so bad he couldn’t throw up food. In just a few weeks, he’d lost 40 pounds.
Zach spent the next three years in and out of hospitals, trying ineffective medications. Doctors eventually told the family they had only one option: surgery to remove most of his damaged colon. But Zach’s mother, Angela Rogers, wasn’t buying it. She didn’t trust Zach’s medical team and was afraid of such an invasive procedure, so she sought a second opinion from a different gastroenterologist. The new doctor suggested Zach try one last treatment before surgery: hypnotherapy, in which clinical experts help patients deeply focus, relax and change their thought patterns.
This time the change was gradual, but dramatic. The night after his first hypnotherapy session, Zach felt nauseous, but didn’t throw up at dinner. Over the next few weeks, he didn’t throw up at school and regained the strength to play basketball and ride his bike. Now Zach is a freshman in college and lives away from home. Before hypnosis, this never seemed possible. “If I hadn’t been hypnotized, I’d be a total mess,” he told me. “I have no idea what I’d be doing right now.”
It may seem far-fetched, but science backs up the idea that psychological interventions, including hypnosis, can treat digestive disorders. Studies dating back to the 1980s have shown that hypnotherapy can be an effective treatment, at least in the short term, for irritable bowel syndrome, a gut disorder characterized by painful gastrointestinal symptoms but without visible damage to the intestine. Now, scientists are investigating whether hypnotherapy can also help patients with inflammatory bowel disease who, like Zach, have visible damage to their digestive tract.
While hypnosis is a powerful relaxation tool on its own, in clinical settings it is most often used in combination with other, more well-studied psychological therapies, such as cognitive behavioral therapy. Research suggests that CBT, which is often used to treat conditions such as depression and anxiety, may also be useful in treating gastrointestinal disorders.
Unlike CBT, hypnosis retains a reputation for fraud and is frequently portrayed in pop culture and on stage as a tool to control participants (whether they will or not), and some practitioners use hypnosis in debunked treatments such as recovered memory therapy. But the real question is whether hypnotherapy should be legalized as a medical tool. Hypnosis practitioners believe (and there is research to back this up) that the technique may enhance the effectiveness of more established psychological interventions and therefore provide rare benefits to patients.
Hypnosis has a long history as a painkiller. In the early 19th century, before anesthetic drugs were widely available, some surgeons hypnotized their patients. Even today, proponents of hypnosis argue that it could be an effective alternative treatment for chronic back pain or the stress of childbirth. A growing body of research suggests that hypnosis can be a cost-effective, side-effect-free painkiller for some people with chronic pain, but good clinical data is hard to come by.
The first randomized controlled trial of hypnotherapy for IBS was published in 1984. Among participants (a small group of mostly female patients with severe, treatment-resistant disease), those who received hypnotherapy experienced greater improvements in abdominal pain, bloating, and bowel function than those who received psychotherapy plus a placebo. A 2014 meta-analysis found that about half of IBS patients who tried hypnotherapy saw at least short-term improvement in their symptoms.
The evidence for hypnotherapy is less robust in treating IBD, which is actually an umbrella term for ulcerative colitis (Zach’s diagnosis) and Crohn’s disease. But there’s reason to believe hypnotherapy could have similar success in addressing the symptoms of these diseases. The line between IBD and IBS can be blurry; more than a quarter of IBD patients in remission also suffer from IBS. And while the evidence is still mixed (for example, a study published in 2021 found no difference in treatment outcomes between standard drug treatment and hypnotherapy), some early evidence suggests that hypnotherapy can reduce inflammation in patients with ulcerative colitis. One small study found that just one hypnotherapy session lowered levels of several blood inflammatory markers in patients with ulcerative colitis.
Perhaps most importantly, a wealth of research shows a strong connection between cognition and digestion. Millions of neurons, collectively known as the enteric nervous system, control digestion and are in constant communication with the central nervous system. This connection, called the “gut-brain axis,” may be why we feel so many emotions in our gut, like the pounding of our heart from anxiety or the tension of anger. It may also explain why both anxiety and depression are more prevalent in patients with inflammatory bowel disease compared to the general population. “Without a doubt, stress plays a big role in all digestive disorders,” Gary Lichtenstein, professor of gastroenterology and director of the Center for Inflammatory Bowel Disease at the Hospital of the University of Pennsylvania, told me.
When this brain-gut connection goes haywire, it is known that some digestive disorders worsen. In patients with gastrointestinal disorders, gut tissue can become oversensitive over time. The brain learns to interpret signals from the gut (including normal function) as discomfort. This miscommunication results in what experts now call “disordered gut-brain interaction (DGBI),” which includes IBS, functional dyspepsia, and other digestive disorders (but not IBD). According to proponents of hypnotherapy, it helps to reconstruct the connection between a patient’s cognition and their digestive system. In many IBS and IBD cases, “we know that there is a mind-gut connection that can only be helped by a mental health professional,” says gastroenterologist Mark Matar, director of the IBD Center at MedStar Georgetown University Hospital.
Matar works closely with Ali Navidi, a clinical psychologist who was introduced to Zach in 2020. Navidi told me that at his clinic, GI Psychology, 83% of DGBI patients who complete at least 10 hypnotherapy sessions achieve their treatment goals, typically allowing them to live their daily lives with less pain, bloating, and other unpleasant symptoms. His data is unpublished, but it’s consistent with other studies of IBS, where more than 80% of patients who receive gut-targeted hypnotherapy as part of their treatment plan experience improvement in pain and other GI symptoms. These figures are even higher in children and adolescents.
These findings led the American Gastroenterological Association to recommend gut-targeted psychotherapy (such as hypnotherapy and cognitive behavioral therapy) to treat IBS symptoms in its 2021 guidelines. But they are not commonly used, even among IBS patients. No one seems to have studied how prevalent hypnotherapy is among IBS patients, but a 2017 survey found that only 15% of people diagnosed with IBS had received any kind of “psychotherapy.”
For many patients who undergo hypnotherapy, the experience isn’t what they expected. They might confuse clinical hypnosis with recreational hypnosis, in which subjects quack like ducks or forget their own names. But at places like Navidi’s, therapists focus on helping patients enter a trance state, the same kind of consciousness we all experience while at work, scrolling through Instagram, or when we’re driving and suddenly arrive at our destination. “When we’re in a trance, we’re hyper-focused, and that can be harnessed in powerful ways,” Navidi said.
Once the patient is in a trance, the therapist uses guided imagery and suggestion to target specific gastrointestinal symptoms. “The patient gets into a very relaxed state, and I start to give suggestions about ways that the brain and gut can work better together,” says psychologist Jessica Gershon of the Center for Inflammatory Bowel Disease at NYU Langone. Gershon teaches IBD patients to imagine their intestinal lining healing. While in the trance, Zach could visualize a pain control room and turn the knob up or down. “I would turn my stomach pain down to one or zero, and it would go away,” Zach recalled recently, sounding astonished.
Gerson told me that many patients are initially nervous about ceding control of their minds and bodies to the hypnotherapist while in a hypnotic state, but they are “fully aware and fully in control” at all times. In fact, Navidi and Gerson use the trance state to show patients exactly how much control they have over their bodies. “Feeling in control is therapeutic,” Gerson told me.
These days, many gastroenterologists consider psychotherapy, such as hypnosis, an important part of a holistic treatment plan, even for IBD. (IBD patients who respond to hypnotherapy will likely still need medical monitoring and intervention, Lichtenstein says.) While gut-targeted hypnotherapy has yet to be proven to help IBD patients who don’t also have IBS symptoms, there’s no big downside to giving it a try. The experts I spoke to agreed that hypnotherapy is relatively risk-free, as long as it’s administered by a clinician, patients continue to be monitored by their primary care physician, and therapists screen potential patients for severe mental illness or untreated trauma. Patients should also consider whether they can afford hypnotherapy. Like many mental health services, hypnotherapy isn’t always covered by insurance. Zach’s sessions were $265 out of pocket, but Angela says, “it wasn’t worth a penny.”
Zach remembers getting stressed out as a kid about grades, making friends, basketball games, or nothing in particular. He credits Navidi with helping him not only with his stomach aches, but also with his constant anxiety. He still uses the relaxation techniques Navidi taught him when he gets anxious about school or a basketball game.
Zach still takes medication for his ulcerative colitis — he gets an injection of Stelara, a drug that blocks inflammatory proteins, every eight weeks — but after two years of seeing Dr. Navidi for the first time since his 12th birthday, his symptoms are firmly under control, and he no longer gets flare-ups from stress. He hasn’t had a relapse in about a year and a half. Most days, he doesn’t think about his diagnosis at all.
