Barriers to hypnotherapy – lessons from an interview study of people with IBS

Hypnotherapy is a well-established and demonstrably effective treatment for IBS.1  It has even been recognised by the UK’s arbiter of best medical practice, the National Institute of Health and Care Excellence (NICE) in their guidelines for clinicians as a legitimate treatment strategy. Which means it seems odd that more people don’t use it.  Recently I finished a piece of research into what people with irritable bowel syndrome (IBS) think about hypnotherapy as a treatment for their condition2. In my study none of the people I interviewed had ever received hypnotherapy for their IBS so they were approaching it as a potential patient might.  Amongst the key findings was what keeps them from going to see a hypnotherapist, some of which are generalisable to many areas of hypnotherapy.


Barriers to hypnotherapy – Lack of knowledge and fear of side-effects

People as a whole don’t seem to have a clear understanding of what hypnosis is and how it works, although this does not prevent the majority of them from having a broadly positive view of it.3 However for many of the participants a lack of knowledge both about hypnotherapy in general and how it would help with IBS specifically were barriers. When knowledge is absent fears tend to arise the most prominent of which is the concern about possible side-effects.  Although there is evidence that hypnotherapy has few side effects4 this message has clearly not made it into the public consciousness. Providing information about how hypnotherapy can work for specific conditions, with references to valid medical and psychological sources may counter this problem to some degree.


Barriers to hypnotherapy – Vulnerability

Most of the people I spoke with for the study were women, and a concern was expressed by several about being under the influence of another. One person, being unsure about how much control a hypnotist has over a subject, drew a direct comparison with the case of a dentist in the US who committed sexual assaults whilst patients were under sedation. In an age where suburban Doctors have been found to be mass murderers and celebrities’ serial rapists such concerns should not be ignored. It’s hard to counter these wider social forces but little things like inviting patients to bring a friend along can make a real difference.


Barriers to hypnotherapy – Dancing chickens!

Multiple (yes multiple) participants referred to dancing chickens. There is clearly a lingering connection with the world of stage show hypnosis, with words like “fun fair” being used to summarise participants feel towards hypnotherapy. Others alluded to black magic. It should be noted that most participants who used these descriptions stated that they knew this not to be the case. This suggests a conscious–unconscious division of understanding which may be subtly undermining the validity of hypnotherapy in the public’s mind. Although it should not be forgotten that the entertainment side of hypnosis does much to nurture the image of hypnosis as powerful. Evidence suggests that for many people formal validation of hypnotherapy through association with the medical or psychological establishment leads to hypnotherapy being more acceptable.3 The reverse may also be true.


Barriers to hypnotherapy – Time, travel and cost

Many participants expressed difficulties of a practical nature; travel, time and cost. These may have been especially acute as people with IBS often experience difficulties with travel (access to facilities, cramped conditions etc). However, in the modern world we all seem to live busy lives and the time required to go somewhere might just be the tipping factor for some people. Other than concentrating marketing efforts quite locally there is little to be learnt here for the average hypnotherapist. Although not a formal finding of the study I did observe that wealthier people were willing to travel further for specialist services, so if you have a noted specialism then promoting this at well-to-do areas which are a little further afield may be profitable.


The author – Matt Krouwel is a hypnotherapist and post graduate researcher into hypnotherapy for IBS at the University of Birmingham (UK)

Barriers to hypnotherapy – references
  1. Ford AC, Lacy BE, Harris LA, Quigley EMM, Moayyedi P. Effect of Antidepressants and Psychological Therapies in Irritable Bowel Syndrome: An Updated Systematic Review and Meta-Analysis. Am J Gastroenterol. 2019;114(1): 21-39.
  2. Krouwel M, Jolly K, Greenfield S. How do people with refractory irritable bowel syndrome perceive Hypnotherapy?: qualitative study. Complementary Therapies in Medicine. 2019;45(August 2019): 65-70.
  3. Krouwel M, Jolly K, Greenfield S. What the public think about hypnosis and hypnotherapy: A narrative review of literature covering opinions and attitudes of the general public 1996-2016. Complementary Therapies in Medicine. 2017.
  4. Lindfors P, Unge P, Arvidsson P, et al. Effects of gut-directed hypnotherapy on IBS in different clinical settings-results from two randomized, controlled trials. American Journal of Gastroenterology. 2012;107(2): 276-285.