Opinions of people with IBS towards Hypnotherapy
Recently I presented at the Society for Academic Primary Care (SAPC) Conference at Warwick University (UK). Below is a short video covering some of the main points and below that is the written out full length presentation.
Full Text – presented to clinicians
Science or Magic! … well if you were asked which one you represented I suspect you know what you would say? … not so much for me … I’m a hypnotherapist … and none of us control my own image … So what I want to know is which do people see me closer to the scientific world, with a body of knowledge which can be taught, is structured and replicable … or the magical world where the ability to heal is not explicable … not strictly learnable … but comes from something unknowable
And why does this question matter, why is this question important to primary care?
Back in 2008 Hypnotherapy was accepted into NICE guidelines as a treatment for refractory IBS, refractor IBS is IBS which hasn’t responded to primary treatment and has developed an ongoing profile of symptoms.
There was good reason for this inclusion
· IBS is a substantial problem with prevalence rates around 10% internationally, we don’t know exactly how many of those people are classified as ‘refractory’ but it could be as many as 1/3rd.
· IBS is expensive for the NHS, with approximate 0.1% spent within the NHS being on IBS, 50 million of which alone is accounted for by anti-spasmodic and laxatives, the rest being in other forms of medication to controls symptoms, but one of the biggest expenses being in GP time.
· And although it’s not life threatening it does make people’s lives a misery. Its effects their attendance at work, their ability to work (so called presentism) and they usually are paying out of their own pocket for treatments and remedies, some studies suggest the this is roughly equal to the amount the NHS spend.
So there is good reason to integrate any effective tool, particularly if it provides and actual cure, rather than just a control.
But to the best we can tell, people with IBS are not interested Hypnotherapy for their condition, they are not seeking it out either in the public or private sector and we wondered why. One of the things we considered was the image of hypnotherapy and the hypnotherapist, may present a barrier, specifically we were interested in seeing if the perception of the hypnotherapists was more medical or more magical?
I am conducting 1-2-1, semi-structured, qualitative interviews with adults with refractory IBS to find out their opinions about hypnotherapy. These will be analysed using the framework method for indications of what the Sociologist Weber characterised as the Bureaucratic and Charismatic,
· Bureaucratic meaning reliable, teachable, learnable
· Charismatic meaning having power from within
So far the main finding has been that it’s very hard to recruit for this stuff, possibly there are too many elements – IBS, refractory, hypnosis but the one interview which I have conducted has raised some interesting findings
Firstly, the phrase ‘Cluck like a chicken’ was used, a phrase I’ve heard a lot as a hypnotherapist, another one was “funfair comedy magician thing” suggesting that the musical hall associations of hypnosis are strongly present. This points to a third image which is not science nor magic but frippery, entertainment … and who’s going to consider using hypnotherapy for their IBS if they perceive it as an entertainment.
However, this should be balanced against another observation the interviewee made
“But I’ve not heard of hypnotherapy for an actual medical reason, it’s always been for phobia or … maybe depression, that what I associate hypnotherapy with”
So the connection with mental health appears established in her mind but not with physical health, and although it’s very early days on this research perhaps this is the true barrier to usage, People just don’t think of hypnotherapy for physical problems. They don’t see the connection.