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Abstract
BACKGROUND:
Gut-directed hypnotherapy can reduce IBS symptoms, but the mechanisms underlying this therapeutic effect remain unknown.
AIM:
To determine the effect of hypnotherapy and educational intervention on brain responses to cued rectal distensions in IBS patients.
METHODS:
Forty-four women with moderate-to-severe IBS and 20 healthy controls (HCs) were included. Blood oxygen level dependent (BOLD) signals were measured by functional Magnetic Resonance Imaging (fMRI) during expectation and delivery of high- (45 mmHg) and low-intensity (15 mmHg) rectal distensions. Twenty-five patients were assigned to hypnotherapy (HYP) and 16 to educational intervention (EDU). Thirty-one patients completed treatments and posttreatment fMRI.
RESULTS:
Similar symptom reduction was achieved in both groups. Clinically successful treatment (all responders) was associated with significant BOLD attenuation during high-intensity distension in the dorsal and ventral anterior insula (cluster size 142, P = 0.006, and cluster size 101, P = 0.005 respectively). Moreover HYP responders demonstrated a pre-post treatment BOLD attenuation in posterior insula (cluster sizes 59, P = 0.05) while EDU responders had a BOLD attenuation in prefrontal cortex (cluster size 60, P = 0.05). Pre-post differences for expectation conditions were almost exclusively seen in the HYP group. Following treatment, the brain response to distension was similar to that observed in HCs, suggesting that the treatment had a normalising effect on the central processing abnormality of visceral signals in IBS.
CONCLUSIONS:
The abnormal processing and enhanced perception of visceral stimuli in IBS can be normalised by psychological interventions. Symptom improvement in the treatment groups may be mediated by different brain mechanisms. Clinical trial number: NCT01815164.

The additive benefit of hypnosis and cognitive-behavioral therapy in treating acute stress disorder.
Bryant RA, Moulds ML, Guthrie RM, Nixon RD.
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Abstract
This research represents the first controlled treatment study of hypnosis and cognitive- behavioral therapy (CBT) of acute stress disorder (ASD). Civilian trauma survivors (N=87) who met criteria for ASD were randomly allocated to 6 sessions of CBT, CBT combined with hypnosis (CBT-hypnosis), or supportive counseling (SC). CBT comprised exposure, cognitive restructuring, and anxiety management. CBT-hypnosis comprised the CBT components with each imaginal exposure preceded by a hypnotic induction and suggestions to engage fully in the exposure. In terms of treatment completers (n=69), fewer participants in the CBT and CBT-hypnosis groups met criteria for posttraumatic stress disorder at posttreatment and 6-month follow-up than those in the SC group. CBT-hypnosis resulted in greater reduction in reexperiencing symptoms at posttreatment than CBT. These findings suggest that hypnosis may have use in facilitating the treatment effects of CBT for posttraumatic stress.
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Does 'hypnosis' by any other name smell as sweet? The efficacy of 'hypnotic' inductions depends on the label 'hypnosis'.
Gandhi B, Oakley DA.
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Abstract
Hypnosis is associated with profound changes in conscious experience and is increasingly used as a cognitive tool to explore neuropsychological processes. Studies of this sort typically employ suggestions following a hypnotic induction to produce changes in perceptual experience and motor control. It is not clear, however, to what extent the induction procedure serves to facilitate suggested phenomena. This study investigated the effect on suggestibility of (a) a hypnotic induction and (b) labelling that procedure 'hypnosis.' Suggestibility of participants was tested before and after an adapted hypnotic procedure, which was either labelled as 'hypnosis' or as 'relaxation.' The hypnotic procedure produced a modest increase in suggestibility when it was called 'relaxation,' but a very significant increase if it was labelled 'hypnosis.' The results are important for both clinical and experimental applications and indicate that labelling an induction procedure 'hypnosis' is an important determinant of subsequent responses to suggestion.