Hypnotherapy for overactive bladder

Recently I’ve been seeing a lot of clients for various bladder related issues, including overactive bladder. Naturally it was of interest to me when my research gate account suggested a recent systematic review of the research covering hypnotherapy for overactive bladder.

Hypnotherapy for overactive bladder – what is over active bladder? (NAFC)

Overactive bladder is when a person experiences an excessive need to urinate. Often this disrupts sleep and in many cases is accompanied by urinary incontinence. It appears to be more common in women than men and affects at least 3% of adults. (Freeman & Adekanmi 2005)

What causes  overactive bladder is unclear. It is understood that the bladder may not be giving the ‘normal’ warning prior to emptying, and/or that the bladder itself is spasming prematurely.

There is no biological test for overactive bladder. The National association for continence suggests that if you visit the toilet more than 8 times a day on average and more than once at night you might be classed with an overactive bladder.

Hypnotherapy for overactive bladder – the evidence (Osborne & Reed 2019)

Lisa Osborne, under the guidance of Prof. Phil Reed sifted through all the available research literature looking for randomised controlled trials (RCT’S) of hypnotherapy for overactive bladder. RCT’s were targeted as they provide the most robust statistical information and are at reduced risk of biasing from researcher or participants. They identified numerous case reports dating back as far as the 1950’s, which generally reported good results, but only found two RCT’s.

One RCT (Komesu et al. 2011) compared behavioural therapy (BT) to BT with adjunctive hypnotherapy. Both approaches improved symptoms and unsurprisingly the BT with hypnotherapy produced better outcomes. However, BT with hypnotherapy was not so much better as to be statistically significantly better, and thus has not reached the threshold.

The second RCT was specifically focused on the urinary aspects of interstitial cystitis. (Carrico et al., 2008) In this group hypnotherapeutic imagery was compared to relaxation work. Nearly three times as many people in the hypnotherapy group reported ‘Moderate or marked improvement’ than in the relaxation only group.

Sadly, the two studies do not report the data in such as way that a meta-analysis could be run (I tried) so we can’t see what the combined results look like. However, ultimately hypnotherapy is looking like a promising treatment of overactive bladder.

Hypnotherapy for overactive bladder – treatment guidance

Osborne and Reed (2019) provide key elements for the treatment of Overactive bladder from their research. They suggest 4-6 sessions including;
• Education on the bladder and urinary tract.
• Introduction of a timed voiding regime.
• Integrated pelvic floor exercises.
• Relaxation based inductions to enhance general relaxation.
• Relaxing exercises at home, possibly combined with self-hypnosis.
• Imagery work based on the patient’s own conception of their overactive bladder.
• Personalised suggestions and mental rehearsal of responses preferred response to urinary urgency.
• Work relating to underlying emotional problems if apparent
• Stress reduction hypnosis.
• Empowerment and self esteem work.

If you are planning on working with overactive bladder the list gives some solid guidance but leaves plenty of room for personal interpretation. I personally recommend that you polish up your knowledge of the urinary process, and consider carefully the best way in introduce pelvic floor exercises.

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

Hypnotherapy for overactive bladder- References


Carrico, D.J., Peters, K.M., & Diokno, A.C. (2008). Guided imagery for women with
interstitial cystitis: results of a prospective, randomized controlled pilot study. The
Journal of Alternative and Complementary Medicine, 14, 53-60.

Freeman, R.M., & Adekanmi, O.A. (2005). Overactive bladder. Best Practice & Research Clinical Obstetrics & Gynaecology, 19, 829-841.

Komesu, Y.M., Sapien, R.E., Rogers, R.G., & Ketai, L.H. (2011). Hypnotherapy for
treatment of overactive bladder: An RCT pilot study. Female Pelvic Medicine &
Reconstructive Surgery, 17, 308-320.

Osborne, L. A., & Reed, P. (2019). A Review of Hypnotherapy for Overactive Bladder. International Journal of Clinical and Experimental Hypnosis, 67(3), 278-296.