What Is Ericksonian Hypnotherapy and How Does It Work?

June 26, 2026

If you have ever pictured hypnotherapy as someone swinging a pocket watch and barking commands, Ericksonian hypnotherapy is something quite different. Developed by the American psychiatrist Milton H. Erickson, this approach uses subtle, conversational language to help your mind shift perspective and access its own capacity for change. At London Hypnotics, Ericksonian principles sit at the heart of every session.

Who was Milton Erickson, and why does it matter?

Milton H. Erickson (1901–1980) was a psychiatrist and psychologist widely regarded as the most influential hypnotherapist of the twentieth century. Unlike his contemporaries, Erickson rejected the idea that a therapist must issue direct commands to produce change. Instead, he observed that people enter natural trance states every day, and that carefully chosen language, stories, and metaphors could work with those states rather than against them. His methods became the foundation for approaches including Neuro-Linguistic Programming (NLP) and solution-focused therapy.

How does Ericksonian hypnotherapy differ from traditional hypnosis?

Traditional, or “authoritarian,” hypnotherapy relies on direct suggestion: “You will feel calm. You will not crave cigarettes.” Ericksonian hypnotherapy is permissive by design. Rather than telling the mind what to do, it uses indirect language, therapeutic metaphor, and collaborative conversation to invite the unconscious to find its own solutions. This matters because resistance is far less likely when nothing is being imposed. For people who feel sceptical about hypnosis, or who have tried direct-suggestion approaches without success, the Ericksonian model is often a better fit.

What happens during an Ericksonian hypnotherapy session?

Sessions begin with an open conversation about what you want to change and what has kept that change just out of reach. From there, a light to medium trance state is invited through relaxed, rhythmic language rather than a formal induction script. Within that state, carefully crafted stories, questions, and imagery help the unconscious mind rehearse new responses. Sessions feel more like a deep, absorbed conversation than the dramatic “sleep now” scenes shown in films. Most people describe feeling pleasantly relaxed and surprisingly clear-headed afterwards.

What conditions can Ericksonian hypnotherapy help with?

The approach is flexible enough to apply across a wide range of concerns. Clinical evidence supports gut-directed hypnotherapy for IBS, where indirect suggestion helps calm the gut-brain communication loop that drives symptoms. Ericksonian techniques are also well-suited to anxiety, performance concerns, low confidence, chronic stress, and sleep difficulties. Because the method works with the individual’s own language and mental imagery rather than a fixed script, it adapts well to complex or longstanding problems.

Is Ericksonian hypnotherapy evidence-based?

Hypnotherapy as a clinical intervention has a growing evidence base, particularly for IBS and anxiety. Erickson’s specific techniques are harder to isolate in randomised controlled trials because they are inherently tailored to each individual, but the underlying mechanisms, including focused attention, expectancy, and therapeutic suggestion, are well documented in cognitive neuroscience. Practitioners registered with the GHSC and CNHC, as Antonios is, are bound by professional standards that require practice grounded in current evidence.

Key Takeaways

Ericksonian hypnotherapy was developed by psychiatrist Milton H. Erickson and uses indirect, conversational language rather than direct commands.
It works with the unconscious mind through metaphor, storytelling, and permissive suggestion, making it accessible to people who are sceptical or resistant to traditional hypnosis.
Sessions feel collaborative and conversational, not theatrical or prescriptive.
It has clinical applications across IBS, anxiety, sleep problems, stress, and confidence, and forms the methodological foundation at London Hypnotics.
Practitioners registered with professional bodies such as the GHSC and CNHC are held to evidence-informed standards of practice.

If you are curious whether Ericksonian hypnotherapy could help with something you are dealing with, Antonios offers a free initial consultation with no obligation. You are welcome to book a free consultation and ask any questions before committing to anything.

References

[1] Erickson, M.H., Rossi, E.L. & Rossi, S.I. (1976). Hypnotic Realities: The Induction of Clinical Hypnosis and Forms of Indirect Suggestion. Irvington Publishers.
[2] Elkins, G., Barabasz, A., Council, J. & Spiegel, D. (2015). Advancing Research and Practice: The Revised APA Division 30 Definition of Hypnosis. International Journal of Clinical and Experimental Hypnosis, 63(1), 1–9. https://pubmed.ncbi.nlm.nih.gov/25365127/
[3] Whorwell, P.J., Prior, A. & Faragher, E.B. (1984). Controlled trial of hypnotherapy in the treatment of severe refractory irritable-bowel syndrome. The Lancet, 324(8414), 1232–1234. https://pubmed.ncbi.nlm.nih.gov/6150275/

<script type="application/ld+json">
{
  "@context": "https://schema.org",
  "@type": "FAQPage",
  "mainEntity": [
    {
      "@type": "Question",
      "name": "What makes Ericksonian hypnotherapy different from traditional hypnosis?",
      "acceptedAnswer": {
        "@type": "Answer",
        "text": "Ericksonian hypnotherapy uses indirect suggestion, metaphor, and storytelling rather than direct commands. This approach bypasses conscious resistance to change, allowing suggestions to reach the unconscious mind more naturally and effectively."
      }
    },
    {
      "@type": "Question",
      "name": "What is the utilisation principle in Ericksonian hypnotherapy?",
      "acceptedAnswer": {
        "@type": "Answer",
        "text": "Utilisation is the principle that nothing about a client is an obstacle. A practitioner works with your own language, habits, and experiences as resources rather than problems, making every session uniquely tailored to the individual."
      }
    },
    {
      "@type": "Question",
      "name": "Does Ericksonian hypnotherapy have scientific evidence behind it?",
      "acceptedAnswer": {
        "@type": "Answer",
        "text": "Yes. A 2026 systematic review and meta-analysis of randomised controlled trials found Ericksonian hypnotherapy produced large effect sizes across conditions including IBS, pain, and anxiety, with efficacy comparable to CBT in direct comparisons."
      }
    },
    {
      "@type": "Question",
      "name": "Will I feel unconscious or out of control during an Ericksonian hypnotherapy session?",
      "acceptedAnswer": {
        "@type": "Answer",
        "text": "No. The trance state is closer to deep absorption than unconsciousness. You remain fully aware and in control throughout, and most clients describe the experience as conversational and focused rather than dramatic."
      }
    }
  ]
}
</script>

by Antonios Koletsas

Health

IBS-D Hypnotherapy in London: Gut-Directed Treatment for Diarrhoea-Predominant IBS

June 17, 2026

For a condition that affects roughly one in ten adults in the UK, diarrhoea-predominant IBS is remarkably under-discussed. People will talk at length about stress, about sleep, even about constipation with relative ease. Urgency and unpredictable bowel movements tend to stay private. Clients often arrive at my practice having managed IBS-D quietly for years, sometimes a decade or more, before deciding that mapping every outing around toilet access is no longer a sustainable way to live.

This article looks at what is actually happening in the body during diarrhoea-predominant IBS, why the condition is so resistant to dietary change alone, and how gut-directed hypnotherapy addresses the nervous system mechanisms that are usually driving it.

What IBS-D Actually Is

IBS-D is one of four recognised IBS subtypes under the Rome IV diagnostic criteria, alongside IBS-C (constipation-predominant), IBS-M (mixed), and IBS-U (unclassified). It is characterised by recurrent abdominal pain associated with loose or watery stools occurring on at least a quarter of symptomatic days, frequently accompanied by urgency, a sense of incomplete evacuation, bloating, and cramping that tends to ease after a bowel movement.

What distinguishes IBS-D clinically from other gastrointestinal conditions is the absence of structural disease. Investigations such as colonoscopy, blood tests, and stool studies typically return normal results. This is not a reassurance that always lands well with clients, many of whom would, in some sense, prefer a clear structural explanation. Instead, what is usually present is a disorder of gut-brain communication, in which the enteric nervous system and the central nervous system have become miscalibrated in their regulation of motility, secretion, and pain perception.

It is worth noting that conditions with overlapping presentations, including inflammatory bowel disease, coeliac disease, microscopic colitis, and bile acid malabsorption, should be ruled out by a GP or gastroenterologist before a diagnosis of IBS-D is settled on. This article concerns the functional presentation once those have been appropriately excluded.

Why the Gut Moves Too Fast

In IBS-C, the dominant mechanism is suppressed motility under chronic sympathetic arousal. IBS-D tends to involve the opposite pattern: accelerated colonic transit, heightened secretory activity, and a lowered threshold for the gastrocolic reflex, the contraction that prompts the urge to defecate after eating or under stress.

The enteric nervous system, sometimes called the body’s second brain, contains around 500 million neurons and communicates continuously with the central nervous system via the vagus nerve and the hypothalamic-pituitary-adrenal axis. In IBS-D, this communication appears to run in a particular direction: psychological stress and anticipatory anxiety trigger the release of corticotropin-releasing hormone, which in turn accelerates gut motility and increases intestinal permeability. The result is a digestive system primed to react quickly, often at precisely the moments when speed is least convenient.

This is compounded by visceral hypersensitivity, a well-documented feature of IBS in which normal levels of gut distension are perceived as painful or urgent. The gut is not necessarily producing more waste or moving more dramatically than a healthy gut. It is signalling more loudly, and the brain is interpreting those signals through a lens of alarm.

The Anticipation Problem

The defining feature I see clinically in IBS-D, more than the diarrhoea itself, is the anticipatory anxiety that builds around it. Once someone has experienced urgency in an inconvenient setting, a meeting, a train, a first date, the subconscious files that event as evidence of a specific danger. It then begins scanning for early signs: a flicker of cramping, a change in the texture of breakfast, the length of a commute without toilet access.

This hypervigilance is entirely understandable, and it is also the mechanism that perpetuates the cycle. Monitoring the gut for signs of trouble raises sympathetic arousal, and sympathetic arousal is precisely what accelerates gut motility in IBS-D. The vigilance generates the very urgency it is trying to prevent. Many clients describe restructuring their entire lives around this fear: declining invitations, mapping toilets before any journey, avoiding certain foods not because of a confirmed intolerance but because of what happened the last time. Life contracts around the unpredictability, often more severely than the physical symptoms alone would justify.

This pattern has clear parallels with what I see in clients presenting with panic attacks: a single distressing episode generates a fear-of-fear cycle that becomes more limiting than the original event. In both cases, the nervous system has learned a threat association that now needs to be unlearned, and that unlearning happens more effectively at the subconscious level than through conscious reassurance alone.

Where Dietary Approaches Reach Their Limit

The low-FODMAP diet, developed at Monash University, has a meaningful evidence base for IBS and is often the first intervention a GP or dietitian recommends. For many people with IBS-D, it reduces the fermentable substrates contributing to bloating and loose stools, and I would never discourage a client from pursuing it under proper dietetic guidance.

What diet cannot do is recalibrate a nervous system that has learned to treat ordinary gut sensations as emergencies. Clients frequently describe partial improvement on a restricted diet followed by a plateau, or symptoms that persist on “safe” days for no identifiable dietary reason. This is consistent with what the research shows: dietary intervention addresses the gut’s chemical environment, while gut-directed hypnotherapy addresses the regulatory signalling between brain and gut. The two are not competing approaches. For many clients, they work most effectively in combination.

How Gut-Directed Hypnotherapy Addresses IBS-D

Gut-directed hypnotherapy was developed by Professor Peter Whorwell at the University of Manchester and is referenced in NICE guidance for IBS. While much of the original protocol research focused on mixed IBS populations, subsequent trials, including work by Lacy and colleagues and the Monash comparative trial against low-FODMAP, have demonstrated robust symptom improvement across IBS subtypes, including IBS-D specifically.

Calming the Sympathetic Drive

The hypnotic state is a measurable activator of the parasympathetic nervous system. Research has documented reductions in heart rate, cortisol, and sympathetic tone during hypnosis. For IBS-D, where sympathetic activation directly accelerates motility and secretion, this downregulation is not incidental relaxation. It addresses the physiological driver of the symptom itself. Clients often notice a reduction in the frequency and intensity of urgent episodes before any gut-specific suggestion work has even been introduced, simply as a function of a generally calmer baseline nervous system.

Direct Suggestion and Gut-Focused Imagery

Within the hypnotic state, suggestion and imagery are used to influence the smooth muscle activity of the colon and the sensitivity of the gut’s nerve endings. For IBS-D specifically, this often involves imagery oriented around steadiness, predictability, and a slowing of transit, alongside suggestion designed to recalibrate the gastrocolic reflex so that ordinary triggers, eating, mild stress, travel, no longer prompt an exaggerated response.

Reducing Visceral Hypersensitivity

A core mechanism in gut-directed hypnotherapy is the reduction of visceral hypersensitivity, supported by neuroimaging research showing that hypnosis measurably changes how the brain processes signals from the gut. For IBS-D, this translates into a gradual reinterpretation of gut sensations from threatening to neutral, reducing the urgency response to normal levels of bowel activity.

Working With the Anticipatory Anxiety

Using Ericksonian techniques, indirect and tailored to the individual rather than delivered as a fixed script, we work specifically on the hypervigilance and anticipatory dread that have built up around IBS-D. This is often where the most meaningful change in quality of life occurs, independent of any reduction in stool frequency itself. As the anticipatory anxiety eases, the nervous system has less fuel for the cycle that was sustaining the urgency in the first place.

What the Research Shows

Whorwell’s original trials and subsequent replications have consistently found significant improvement in bowel symptoms, abdominal pain, and quality of life following a course of gut-directed hypnotherapy, with Gonsalkorale and Whorwell’s long-term follow-up study finding that the majority of responders maintained improvement at five years. A 2016 randomised trial published in Alimentary Pharmacology & Therapeutics directly compared gut-directed hypnotherapy with the low-FODMAP diet and found comparable efficacy, with substantial proportions of participants in both arms reporting clinically meaningful improvement. More recent meta-analyses, including a 2024 systematic review, have confirmed that hypnotherapy produces durable symptom reduction across IBS subtypes, with effect sizes comparable to other first-line interventions and without the side-effect profile associated with antidiarrhoeal or antispasmodic medication.

What to Expect at London Hypnotics

I hold the IBS Hypno Diploma, a specialist qualification in gut-directed hypnotherapy, and my practice at 364 City Road, London EC1V 2PY, receives referrals from gastroenterology consultants at OneWelbeck and The London Clinic. IBS-D is a regular presentation in my clinical work, not a peripheral one.

The first session is a thorough clinical conversation. IBS-D varies considerably between individuals, and I want to understand your specific pattern: when symptoms began, what triggers urgency, how the anticipatory anxiety shows up in your daily life, what you have already tried, and how the condition has shaped your routines. I use an Ericksonian approach, indirect and collaborative rather than prescriptive, which tends to suit clients who are analytically minded or new to hypnotherapy.

Most clients complete a course of six to eight sessions, consistent with the evidence base. Sessions are available in person at 364 City Road, a short walk from Angel and Old Street stations, and online for those who prefer to work from home.

Frequently Asked Questions

Is hypnotherapy effective specifically for IBS-D, or only IBS in general? Research supports its effectiveness across IBS subtypes, including diarrhoea-predominant presentations. The mechanisms it addresses, sympathetic arousal, visceral hypersensitivity, and the anticipatory anxiety cycle, are present in IBS-D just as they are in IBS-C, though the specific suggestion and imagery work used in session is tailored to the subtype.

Do I need a diagnosis before starting hypnotherapy? Yes, ideally. If you have not had a structural cause ruled out by a GP or gastroenterologist, it is clinically sensible to do so first. I am always happy to liaise with treating clinicians where appropriate.

Can hypnotherapy work alongside the low-FODMAP diet? Yes. Many clients use both, and the research from Monash University found the two approaches produced comparable results independently, suggesting they may be complementary when used together rather than competing.

How long before I notice a difference? Most clients notice a reduction in general anxiety and nervous system arousal within the first few sessions, with changes in bowel pattern and urgency frequency typically developing across the middle of the course. You can read more about the related constipation-predominant subtype and IBS and SIBO on our blog.

Will I need to talk about embarrassing details? I understand this is often the hardest part of seeking help for IBS-D. In my experience, clients find the clinical conversation considerably less uncomfortable than they anticipated. This is a condition I treat regularly, and there is nothing you will describe that I have not heard before.

Taking the Next Step

Diarrhoea-predominant IBS is not something you have to keep managing quietly around the edges of your life. If dietary changes and medication have not resolved it, the explanation often lies in the gut-brain axis rather than in anything structurally wrong with your digestive system.

If you are in London or anywhere in the UK and would like to explore whether gut-directed hypnotherapy is right for you, I offer a free initial telephone consultation with no obligation to proceed.

You can reach me at 020 7101 3284 or book a free consultation via the link below.

Book Your Free Consultation

Antonios Koletsas is a GHSC-registered and GHR-accredited clinical hypnotherapist practising at 364 City Road, London EC1V 2PY. He holds the IBS Hypno Diploma and specialises in gut-directed hypnotherapy for IBS, functional gut disorders, and related gut-brain axis conditions. He is trained in Ericksonian Hypnotherapy at BHRTI under Stephen Brooks.

Clinical References

Gonsalkorale, W. M., & Whorwell, P. J. (2005). Hypnotherapy in the treatment of irritable bowel syndrome. European Journal of Gastroenterology and Hepatology, 17(1), 15–20.

Lacy, B. E., et al. (2021). ACG Clinical Guideline: Management of Irritable Bowel Syndrome. American Journal of Gastroenterology, 116(1), 17–44.

NICE (2017). Irritable bowel syndrome in adults: diagnosis and management. Clinical Guideline CG61. National Institute for Health and Care Excellence.

Peters, S. L., et al. (2016). Randomised clinical trial: the efficacy of gut-directed hypnotherapy is similar to that of the low FODMAP diet for irritable bowel syndrome. Alimentary Pharmacology & Therapeutics, 44(5), 447–459.

Whorwell, P. J., Prior, A., & Faragher, E. B. (1984). Controlled trial of hypnotherapy in the treatment of severe refractory irritable-bowel syndrome. Lancet, 2(8414), 1232–1234.

Lövdahl, J., et al. (2022). Gut-directed hypnotherapy in irritable bowel syndrome: a review of mechanisms and outcomes. Neurogastroenterology & Motility, 34(3), e14245.

by Antonios Koletsas

Health

Constipation and Gut-Directed Hypnotherapy: Why Your Gut Is Listening to Your Nervous System

June 4, 2026

Most people who come to me describing chronic constipation have already done the sensible things. They have adjusted their diet, increased fibre, reduced processed foods, tried magnesium supplements and probiotics. Some have been through several rounds of laxatives. A number have had colonoscopies that returned entirely normal results, which should have been reassuring, but in practice left them feeling more confused than before.

If the gut is structurally intact and the diet is reasonable, why isn’t it working?

The answer, in a growing number of cases, lies not in the bowel itself but in the relationship between the gut and the brain, and in the way the nervous system has learned to regulate, or more accurately to suppress, normal digestive movement. This is the clinical territory that gut-directed hypnotherapy is specifically designed to address, and it is why, for clients with chronic or functional constipation that has not responded to conventional approaches, it often produces results that those approaches could not.

This article explains what is actually happening when constipation becomes a persistent functional problem, why the nervous system is usually involved, and how gut-directed hypnotherapy at London Hypnotics approaches it.

What We Mean by Functional Constipation

Constipation is one of the most common gastrointestinal complaints in the UK, affecting an estimated one in seven adults and disproportionately affecting women. In clinical terms, it is generally defined as fewer than three bowel movements per week, combined with one or more of the following: hard or lumpy stools, straining, a sensation of incomplete evacuation, or a sense of blockage.

There are constipation presentations with clear structural or pharmacological causes: thyroid disorders, certain medications, pelvic floor dysfunction, or anatomical abnormalities. These require their own clinical management and are not the primary focus here.

The more clinically complex group, and the one most relevant to this post, is functional constipation and the constipation-predominant subtype of irritable bowel syndrome (IBS-C). These presentations involve a demonstrably normal bowel on investigation, yet persistent and often debilitating symptoms. What they share is a disruption in the communication between the central nervous system and the enteric nervous system, the vast neural network that lines the gastrointestinal tract and governs its function.

This disruption is the mechanism that gut-directed hypnotherapy is designed to address.

The Gut-Brain Axis: Why Your Bowel Is Not Independent

The enteric nervous system contains approximately 500 million neurons and has long been informally described as the “second brain.” While it can operate with some degree of autonomy, it is in constant bidirectional communication with the central nervous system via the vagus nerve and the hypothalamic-pituitary-adrenal (HPA) axis.

This communication means that the state of the central nervous system, including its emotional tone, its stress load, and its level of arousal or suppression, has a direct and measurable impact on how the gut functions. The research in this area has developed substantially over the past two decades. We now understand that stress hormones, particularly cortisol and CRH (corticotropin-releasing hormone), directly affect gut motility, intestinal permeability, and the sensitivity of gut neurons to normal stimuli.

For constipation specifically, the relevant mechanism is this: sustained sympathetic nervous system activation, the physiological state associated with stress, anxiety, and chronic vigilance, actively suppresses intestinal motility. The digestive system is, in evolutionary terms, a non-essential function during threat response. Blood flow is redirected, muscular contractions slow, and the smooth muscle of the colon reduces its activity. The body is preparing to run or fight, not digest.

When that state becomes chronic rather than episodic, the suppression of gut motility can become entrenched. The nervous system is no longer responding to an acute stressor; it is simply operating at a baseline of elevated sympathetic tone. The colon continues to function sluggishly, not because anything is structurally wrong with it, but because the regulatory system governing its movement has become miscalibrated.

This is often the clinical picture I see in clients presenting with chronic constipation alongside anxiety, sleep difficulties, or a history of sustained stress: a nervous system that has been running at high arousal for so long that the digestive system’s normal rhythms have been persistently disrupted.

Why Dietary Changes Alone Often Fall Short

I want to be clear that dietary adjustment is not irrelevant. Adequate fibre, hydration, and reducing excess ultra-processed foods are clinically reasonable first steps and appropriate guidance from a GP or dietitian. The low-FODMAP diet has a meaningful evidence base for IBS presentations and can significantly reduce the fermentable substrates that contribute to bloating and discomfort in IBS-C.

But diet acts on the content and chemical environment of the bowel. It does not recalibrate the nervous system’s regulation of gut motility.

This is why many clients with functional constipation experience partial improvement on dietary changes and then plateau. They have optimised the inputs, but the underlying dysregulation of the gut-brain axis persists. The colon is still receiving the same dysregulated signals from a nervous system that has not been reset.

It is also worth noting that laxatives and stool softeners, while useful for short-term relief, do not address the neurological underpinnings of functional constipation. For many people, they become a long-term dependency rather than a curative intervention, because the mechanism generating the constipation remains unchanged.

The Psychological Dimension: What Constipation and Anxiety Share

There is a well-documented bidirectional relationship between constipation and psychological distress. Anxiety and chronic stress increase sympathetic nervous system dominance, which suppresses gut motility. Conversely, the experience of chronic constipation, the discomfort, the uncertainty, the disruption to daily life, generates its own anxiety and creates what clinicians recognise as a self-sustaining cycle.

Many clients with long-standing functional constipation have also developed a hypervigilant relationship with their body in relation to the bowel: monitoring closely for signs of movement, interpreting normal sensations with alarm, planning social and professional activities around toilet access, and carrying a low-level anticipatory dread of bad days. This hypervigilance is entirely understandable, but it maintains the elevated arousal state that suppresses the very function they are hoping to restore.

I see parallels here with other presentations where subconscious threat responses become embedded: panic attacks, sleep disorders, and stress-related pain syndromes. In each case, the nervous system is doing something it was designed to do, but in a context and at a frequency that was never intended.

The clinical insight that has made gut-directed hypnotherapy so effective for IBS and functional gut disorders is precisely this: if the nervous system is generating the problem, then working with the nervous system is the most direct route to resolution.

How Gut-Directed Hypnotherapy Works for Constipation

Gut-directed hypnotherapy was originally developed by Professor Peter Whorwell at the University of Manchester in the 1980s and has since accumulated one of the strongest evidence bases in the field of functional gastroenterology. It is now referenced in NICE guidance for IBS, and the Whorwell protocol is the benchmark against which newer approaches are measured.

The approach uses a focused state of deep relaxation, the hypnotic state, to access and influence the subconscious processes that regulate gut function. It is not simply relaxation, though relaxation is part of the mechanism. It is a therapeutic process that directly engages the gut-brain axis through a combination of physiological downregulation, targeted therapeutic suggestion, and imagery specifically designed to influence the enteric nervous system.

Here is how that process unfolds in a clinical context focused on constipation.

Recalibrating the Autonomic Nervous System

The hypnotic state is a potent activator of the parasympathetic nervous system, the physiological counterpart to the stress response. Research has documented measurable reductions in heart rate, respiratory rate, cortisol levels, and sympathetic nervous system activity during hypnosis. For a digestive system that has been operating under chronic sympathetic suppression, repeated access to deep parasympathetic activation begins to provide what dietary changes alone cannot: a genuine recalibration of the regulatory baseline.

As the nervous system’s resting tone shifts over the course of sessions, many clients notice that their digestive rhythm begins to normalise even before any specific gut-focused work has been completed. This reflects the direct impact of nervous system recalibration on colonic motility.

Direct Gut-Specific Therapeutic Suggestion

Within the hypnotic state, therapeutic suggestion is used to directly address the function of the gut. Drawing on the Whorwell protocol, this involves guided imagery and metaphor designed to influence the smooth muscle activity of the colon, the coordination of peristalsis, and the subconscious signals governing transit time.

Clients may be guided, for example, to visualise normal, comfortable gut movement, to develop a felt sense of ease and rhythm in the digestive system, or to update their relationship with gut sensations from one of alarm to one of trust and normalcy. These images and suggestions are not decorative. They are clinical tools that work on the enteric nervous system via the same pathways through which psychological stress disrupts it.

Reducing Visceral Hypersensitivity

Visceral hypersensitivity, an abnormally heightened sensitivity to gut sensations, is common in IBS-C and functional constipation. Clients often describe discomfort at levels of bowel distension that would not register as painful in the general population. This hypersensitivity is neurologically mediated and contributes significantly to the distress associated with the condition.

Gut-directed hypnotherapy has been shown in clinical research to reduce visceral hypersensitivity, particularly in IBS presentations. The mechanism involves both the direct neurological effect of the hypnotic state and the therapeutic reinterpretation of gut signals from threatening to neutral or informative. Over the course of treatment, clients typically find that gut sensations that previously triggered anxiety and avoidance become manageable and eventually unremarkable.

Addressing the Anxiety Around the Bowel

A meaningful part of the clinical work with constipation involves the psychological dimension specifically: the hypervigilance, the anticipatory anxiety, the planning and avoidance behaviours that have grown up around the condition. These maintain the elevated nervous system arousal that suppresses motility, and they erode quality of life independently of the physical symptoms.

Using Ericksonian techniques, we work within the hypnotic state to gently reduce the emotional significance the subconscious has attached to gut sensations and bowel function. This is not dismissing the client’s distress; it is working at the level where that distress is generated and maintained. Clients often describe a shift in their general relationship with their body in relation to the gut: from watchful and adversarial, to more trusting and settled.

What the Research Tells Us

The evidence base for gut-directed hypnotherapy in IBS and functional gut disorders is one of the most developed in the field of complementary and integrative medicine, and its application to constipation-predominant presentations specifically is well supported.

Whorwell and colleagues published the first randomised controlled trial of gut-directed hypnotherapy for IBS in 1984, with striking results. Subsequent trials have replicated these findings, with studies consistently reporting significant improvements in bowel frequency, stool consistency, abdominal pain, bloating, and psychological wellbeing following a standard course of gut-directed hypnotherapy.

A landmark study by Palsson et al. (2002), published in the American Journal of Gastroenterology, demonstrated significant improvements in global IBS symptoms, quality of life, and psychological distress in patients treated with a gut-directed hypnotherapy protocol, with effects maintained at twelve-month follow-up. The durability of treatment response is a particularly important finding, distinguishing gut-directed hypnotherapy from symptomatic interventions.

Research by Lea et al. (2003), published in Gut, found that gut-directed hypnotherapy produced significant improvement across all IBS subtypes, with constipation-predominant presentations showing particularly robust response in terms of bowel frequency and ease of defecation.

Gonsalkorale and Whorwell (2005) reviewed the long-term outcomes of over 200 IBS patients treated with gut-directed hypnotherapy and found that 83% of patients who had responded to treatment maintained their improvement at follow-up periods of up to five years. This level of long-term durability is unusual in the management of functional gut disorders.

More recently, a systematic review by Lee et al. (2014) confirmed that gut-directed hypnotherapy produces significant reductions in IBS symptom severity scores, comparable in magnitude to other established pharmacological and psychological interventions, with the additional advantage of sustained response without the side effect profile associated with medication.

These findings inform my clinical approach and my confidence in recommending gut-directed hypnotherapy as a primary intervention for clients with IBS-C and functional constipation who have not found adequate resolution through conventional means.

What to Expect at London Hypnotics

I hold a specialist qualification in gut-directed hypnotherapy through the IBS Hypno Diploma, which focuses specifically on treating IBS and functional gastrointestinal conditions. My practice at 364 City Road, London EC1V 2PY, receives referrals from gastroenterology consultants at OneWelbeck and The London Clinic, and this specialist focus means that gut presentations are not a peripheral part of what I do but a clinical area I work in regularly.

The first session begins with a thorough clinical conversation. Constipation and IBS-C present differently for every person, and I want to understand yours specifically: when symptoms began, what your bowel pattern typically looks like, whether stress or anxiety has been a feature, what dietary and medical approaches you have tried, and how the condition has affected your daily life. This understanding shapes the therapeutic plan.

I use an Ericksonian approach alongside the Whorwell-based protocol: indirect, permissive, and tailored to you as an individual rather than applied as a generic script. For clients who are sceptical about complementary approaches, or who have not previously encountered hypnotherapy, this approach tends to feel more collaborative and less prescriptive than they anticipated.

For IBS-C and functional constipation, most clients complete a course of six to eight sessions, consistent with the evidence base. Changes in bowel frequency and general digestive ease often become apparent across the middle sessions, with consolidation and reduction in anxiety around the gut continuing through the latter part of the course. Sessions are available in person at 364 City Road, a short walk from Angel and Old Street stations, and online for clients who prefer to work from home.

Frequently Asked Questions

Is gut-directed hypnotherapy evidence-based? Yes. Gut-directed hypnotherapy is referenced in NICE guidance for IBS and has one of the most robust evidence bases of any psychological intervention for functional gut disorders. The Whorwell protocol, developed at the University of Manchester, has been evaluated in multiple randomised controlled trials over four decades, with consistently positive outcomes for IBS-C and related presentations.

Can gut-directed hypnotherapy help if I have been diagnosed with IBS-C rather than just constipation? Yes. IBS-C is one of the primary presentations for which gut-directed hypnotherapy was originally developed and validated. The protocol addresses the full cluster of IBS-C symptoms: bowel frequency, stool consistency, abdominal discomfort, bloating, and the anxiety that often accompanies the condition. Research specifically on IBS-C subtypes supports robust and durable response.

Do I need a GP referral? No, though I always recommend informing your GP that you are pursuing gut-directed hypnotherapy, and I am always willing to liaise with treating clinicians where appropriate. If you have not had a medical investigation of your constipation and have not been formally assessed by a doctor, it is clinically sensible to ensure a structural or medical cause has been ruled out before pursuing hypnotherapy specifically.

How is this different from just relaxation? Relaxation is a component of the mechanism, but gut-directed hypnotherapy is considerably more targeted than general relaxation. Within the hypnotic state, specific therapeutic suggestions, imagery, and interventions are directed at the gut-brain axis and at the function of the colon specifically. This targeted work is what produces the clinical results documented in the research literature. A relaxation recording does not do the same thing.

What if I have constipation alongside other IBS symptoms? This is the most common clinical picture. IBS rarely presents as a single symptom, and constipation in IBS-C is usually accompanied by bloating, cramping, incomplete evacuation, and variability in symptoms across days. The gut-directed hypnotherapy protocol is designed for this full symptom picture. You can read more about IBS presentations and gut-directed hypnotherapy in the related posts on IBS and SIBO and gut-directed hypnotherapy in London.

Can hypnotherapy help with the anxiety that has built up around my gut symptoms? Yes, and addressing this is a central part of the clinical work. The anxiety that develops around gut symptoms, the monitoring, the anticipatory dread, the social and professional planning around bowel access, contributes directly to maintaining the nervous system dysregulation that suppresses motility. Reducing that anxiety is not simply a quality-of-life benefit; it is a core component of restoring normal gut function.

Taking the Next Step

Chronic constipation that has not responded to dietary or pharmacological approaches is not a sign that nothing more can be done. For many people, it is a sign that the approach has been focused on the wrong level. The gut-brain axis is where the problem lives, and it is where the most effective solutions tend to be found.

If you are in London or anywhere in the UK and would like to explore whether gut-directed hypnotherapy is the right approach for you, I offer a free initial telephone consultation. There is no obligation and no pressure to proceed.

You can reach me at 020 7101 3284 or book a free consultation via the link below.

Book Your Free Consultation

Antonios Koletsas is a GHSC-registered and GHR-accredited clinical hypnotherapist practising at 364 City Road, London EC1V 2PY. He holds the IBS Hypno Diploma and specialises in gut-directed hypnotherapy for IBS, functional constipation, and related gut-brain axis conditions. He is trained in Ericksonian Hypnotherapy at BHRTI under Stephen Brooks.

Clinical References

Gonsalkorale, W. M., & Whorwell, P. J. (2005). Hypnotherapy in the treatment of irritable bowel syndrome. European Journal of Gastroenterology and Hepatology, 17(1), 15–20.

Lea, R., Houghton, L. A., Calvert, E. L., Larder, S., H077, N. W., Whorwell, P. J., & Bankart, J. (2003). Gut-focused hypnotherapy normalises disordered rectal sensitivity in patients with irritable bowel syndrome. Alimentary Pharmacology and Therapeutics, 17(5), 635–642.

Lee, H. H., Choi, Y. Y., & Choi, M. G. (2014). The efficacy of hypnotherapy in the treatment of irritable bowel syndrome: a systematic review and meta-analysis. Journal of Neurogastroenterology and Motility, 20(2), 152–162.

NICE (2017). Irritable bowel syndrome in adults: diagnosis and management. Clinical Guideline CG61. National Institute for Health and Care Excellence.

Palsson, O. S., Turner, M. J., Johnson, D. A., Burnett, C. K., & Whitehead, W. E. (2002). Hypnosis treatment for severe irritable bowel syndrome: investigation of mechanism and effects on symptoms. Digestive Diseases and Sciences, 47(11), 2605–2614.

Whorwell, P. J., Prior, A., & Faragher, E. B. (1984). Controlled trial of hypnotherapy in the treatment of severe refractory irritable-bowel syndrome. Lancet, 2(8414), 1232–1234.

by Antonios Koletsas

Lifestyle, News

5 Ways to improve IBS

September 5, 2022

KEEP A FOOD DIARY

This will help you to identify any dietary triggers, typical triggers can include spicy foods, caffeine, alcohol, fats and fruits. You can use this diary to make initial adjustments to your eating habits. A food diary can also be helpful when discussing IBS with your GP or dietician. Don’t dive into a heavily restricted diet without professional guidance. Always seek the support of a qualified dietician, especially if considering a low FODMAP diet.

A point to remember: Gluten is a protein that will only cause issues if you have an allergy or coeliac disease. If you have a wheat intolerance, you will be able to tolerate small amounts of wheat. The same goes for dairy products – they only cause issues with your IBS if you have a milk protein allergy (rare) or lactose intolerance (more often). Some dairy contains very little or no lactose, so you can switch to these products.

FIND WAYS TO RELAX

For IBS patients, sleep quality is paramount. A good night’s sleep will help your body restore itself and give you the energy you need to face a new day, even with an upset tummy. If you often wake up too early, buy a silk sleeping mask – it works wonders! Go to bed at the same time and avoid blue light exposure too, it suppresses melatonin, a hormone essential for our sleep rhythm. If you must work at the computer, use blue light glasses.

One of the most effective ways to reduce your IBS symptoms is hypnotherapy. It is a form of guided hypnosis that helps you to address the brain-gut axis. Your brain and your gut are interconnected and receive the wrong messages, causing flare-ups and pain. Hypnotherapy addresses that. You meet in person or by video with a specialised therapist, who will guide you step by step into a relaxed state. It is most effective when it comes to abdominal pain- many studies showed it can reduce it by an average of half or more.

In the U.S., there has already been a change: Mount Sinai in New York, the University of Michigan, Beth Israel Deaconess Medical Center in Boston, the University of Washington in Seattle, Baylor College of Medicine in Houston and Loyola University Medical Center and Northwestern Memorial Hospital in the Chicago area all offer or suggest hypnotherapy to IBS patients.

GET PLENTY OF EXERCISES

Regular movement will help your body digest food better and keep you – well, regular. Incorporate 30 minutes of daily exercise into your routine. That doesn’t have to be as hard as it sounds- you can simply increase your NEAT. Non-exercise active thermogenesis (NEAT) accounts for calories burned outside your typical exercise. That can be standing, walking, climbing stairs or reaching for that cookie jar (excluding the cookies eaten afterwards).

Thanks to our largely sedentary jobs, food deliveries and labour-saving devices, our NEAT has decreased substantially in the last few years. That’s bad news as it burns between 15- 30% of a person’s daily calories and keeps your body in shape. Here are some ways to increase your NEAT:

Take the stairs

have a little dance in the kitchen when your favourite song is on

stand and move during T.V. ad breaks of your favourite show

walk when talking on the phone

Put your tea bags up high, so you get a nice stretch in every time you reach for them

Get a standing desk if you work a lot in front of a screen

EAT THE RIGHT KIND OF FIBRE

You might already know that fibre is a non-digestible carbohydrate. Why is it essential for the body? It adds bulk to our diet and makes us feel fuller for longer. Fibre also helps digestion and can prevent constipation. There is strong evidence that eating plenty of it helps to lower the risk of heart disease, stroke, type 2 diabetes and bowel cancer. Yet, most of us don’t eat the recommended 30 g per day. Foods high in fibre include whole grains, vegetables (potatoes with skin are great) and fruits (especially pears, berries, melon and oranges). Nuts are also a good source of fibre.

Here comes the interesting part for those with IBS. There are two types of fibre:

Insoluble

soluble

Most plant foods contain both, but some foods are high in one type of fibre. Soluble fibre, also known as viscous fibre, absorbs water when ingested. It then creates a thick gel in the colon, and it is this gel that creates the feeling of fullness.

Soluble fibre is concentrated in beans, fruits, and oat products and is an excellent choice for most people with IBS. The American College of Gastroenterology (ACG) recommends taking soluble fibre supplements for people with IBS – try and see if taking these help you.

Insoluble fibre breaks down in the water and passes straight through the digestive system, helping to eliminate unwanted leftovers in the gut. It is typically found in the roughage of foods like fruit skins and seed husks. Foods such as beans and nuts, and grain products contain good amounts of insoluble fibre. It may make the pain and bloat worse.

As you know, IBS is not a one-size-fits all- some have problems with foods rich in insoluble fibre, and others with IBS have no issues with them. Even more, some foods high in soluble fibre, like beans, can cause problems for some people who have IBS.

That’s why a food diary (see above) is so helpful. Try taking soluble fibre supplements instead if you experience pain or bloating from certain foods.

DRINK LOTS OF WATER

Drinking more water has many benefits, no matter what your IBS symptoms are. Furthermore, water intake could improve constipation. If you suffer from diarrhoea, drinking more water will prevent dehydration. If you don’t fancy drinking only water, you can buy a mint plant from the supermarket and add a few fresh mint leaves daily. Ginger tea can also be an alternative. If you are going out, punches or beers are safe if they don’t contain sweeteners on the high FODMAP list.

If you would like to know how hypnotherapy can improve your IBS contact me to discuss more.

by Antonios Koletsas

Hypnotherapy for IBS

What Is Ericksonian Hypnotherapy and How Does It Work?

Who was Milton Erickson, and why does it matter?

How does Ericksonian hypnotherapy differ from traditional hypnosis?

What happens during an Ericksonian hypnotherapy session?

What conditions can Ericksonian hypnotherapy help with?

Is Ericksonian hypnotherapy evidence-based?

Key Takeaways

References

IBS-D Hypnotherapy in London: Gut-Directed Treatment for Diarrhoea-Predominant IBS

What IBS-D Actually Is

Why the Gut Moves Too Fast

The Anticipation Problem

Where Dietary Approaches Reach Their Limit

How Gut-Directed Hypnotherapy Addresses IBS-D

Calming the Sympathetic Drive

Direct Suggestion and Gut-Focused Imagery

Reducing Visceral Hypersensitivity

Working With the Anticipatory Anxiety

What the Research Shows

What to Expect at London Hypnotics

Frequently Asked Questions

Taking the Next Step

Constipation and Gut-Directed Hypnotherapy: Why Your Gut Is Listening to Your Nervous System

What We Mean by Functional Constipation

The Gut-Brain Axis: Why Your Bowel Is Not Independent

Why Dietary Changes Alone Often Fall Short

The Psychological Dimension: What Constipation and Anxiety Share

How Gut-Directed Hypnotherapy Works for Constipation

Recalibrating the Autonomic Nervous System

Direct Gut-Specific Therapeutic Suggestion

Reducing Visceral Hypersensitivity

Addressing the Anxiety Around the Bowel

What the Research Tells Us

What to Expect at London Hypnotics

Frequently Asked Questions

Taking the Next Step

5 Ways to improve IBS

KEEP A FOOD DIARY

FIND WAYS TO RELAX

GET PLENTY OF EXERCISES

EAT THE RIGHT KIND OF FIBRE

DRINK LOTS OF WATER

Recent Posts

Recent Comments