by Jo Marchant
She also suffers from searing back and shoulder pain, migraines and stomachaches. She can’t sleep because of the pain, and she’s exhausted. She works full time, which leaves her with no energy to do anything else, but is determined to support herself rather than relying on benefits. “I want to show my daughter, you go to work.” Then she calmly asks Whorwell to cut out her colon. “If a colostomy will fix it, just do it,” she says.
Emma, Fraser and Gina are all suffering from irritable bowel syndrome (IBS), just like Linda Buonanno, whom we met in chapter two. IBS is frequently dismissed as psychological, and a nuisance rather than life threatening. Yet it’s clear from just one morning in Whorwell’s clinic that this condition can devastate people’s lives.
Around 10–15% of the world’s population suffers from the pain, bloating, diarrhea and constipation of IBS. Conventional treatments are not particularly effective. Doctors offer lifestyle advice (on diet or exercise, for example) or prescribe drugs including laxatives, muscle relaxants and antidepressants, but many patients fail to respond.
Like chronic fatigue syndrome, IBS is a “functional” disorder, which means that doctors don’t see anything physically wrong with the gut in diagnostic tests. And in common with sufferers of chronic fatigue syndrome, IBS patients often feel that they’re not taken seriously. “I’d rather have a broken leg and it would heal in six weeks and I’d be done with it,” says Gina. “And then people could see, I’ve got a cast on my leg and that’s what’s wrong with me. With IBS, people don’t understand.”
Whorwell, a world expert in irritable bowel syndrome, thinks the unexplained nature of these conditions probably reflects the inadequacy of medical tests, and that they will eventually be recognized as having a biological basis. But for now, he says, patients are often faced with physicians who use the term “functional” as a veiled insult, with the implication that they should just pull themselves together: “Often their doctor has told them it’s all in their head.”1
He’s slim and smartly dressed in trousers and a button-down shirt, with dark brown hair that’s flecked with gray. His accent is polished but his sentences are peppered with mild swearwords like “blooming” and “bloody”—and “shit,” which once earned him a reprimand when a patient complained. For the most part, though, his patients seem to appreciate his direct manner and sense of humor.
When Whorwell qualified as a gastroenterologist in the 1980s, he was moved by the plight of IBS patients, and felt that they were being let down by the medical profession. Most consultants simply diagnosed them and then discharged them. Instead, Whorwell determined to find a way to help. He had read that hypnosis is a good way to relax muscles, and wondered if it might help to relax the gut, too, so he went on a training course. When he got back, he hypnotized his secretary. “She almost fell out of her chair,” he says. “I thought, crikey, this is a potent phenomenon.”
—
TRANCE STATES reminiscent of hypnosis have been around for as long as humans have existed, and still exist in traditional cultures around the world. The Kalahari bush people hold ritual healing dances during which painful “boiling energy” rises up from their bellies. Villagers in Bali change caste by trance dancing with knives and hot coals. Young men in Tibet dance to a drumbeat with needles and spokes in their cheeks, tongues and backs—apparently without feeling pain or bleeding from the wounds. The modern history of hypnosis, however, is generally said to begin in the eighteenth century, with an Austrian doctor named Franz Mesmer; an unfortunate origin that forever set up hypnosis as an enemy of rationalism and science.
Mesmer concocted the idea of a mysterious fluid called “animal magnetism” that flows through and connects all living things. He claimed that people get sick when this fluid becomes blocked and that he could cure all manner of ills by re-establishing its proper flow. At first he used magnets to manipulate the fluid, but eventually he simply waved his hands to direct it through his patients’ bodies—the origin of those melodramatic hand motions that stage hypnotists use today. His patients, afflicted by ailments from paralysis to blindness, typically became more and more agitated before being overcome by convulsions or fainting. When they came around, they pronounced themselves cured.
Working in Paris, he attracted a large and devoted clientele, and Mesmerism (the origin of the verb to “mesmerize”) became the height of fashion. Groups of patients (mostly women) sat in big wooden tubs filled with water and iron filings while the doctor walked around them, rubbing his hands over their bodies and triggering hysterical fits.
Paris’s conventional medics hated Mesmer for his morally dubious methods, not to mention for stealing their business, and they were desperate to discredit him. In 1784, King Louis XVI convened a panel of top scientists to evaluate Mesmer’s technique.2 Its members included Benjamin Franklin, an expert on the newly discovered force of electricity and America’s ambassador to the French court; and Antoine Lavoisier, who discovered oxygen and is often described as the father of modern chemistry.
The king’s esteemed panel could detect no trace of Mesmer’s magnetic fields using an electrometer and compass. They were also unable to magnetize themselves or members of the public. So Lavoisier designed a series of clever experiments to prove that the effects Mesmer claimed were fake. In one test, a colleague of Mesmer’s magnetized a single apricot tree in a garden. A young volunteer was then blindfolded and asked to embrace a series of trees in turn, but was not told which one was magnetized. He became increasingly affected at each tree, before collapsing unconscious by the fourth one. The mesmerist had magnetized only the fifth tree.
“Not a shred of evidence exists for any fluid,” Franklin wrote in his report on Mesmer. “The practice of magnetization is the art of increasing the imagination by degrees.”
The commission’s cunning investigation provided the model for the clinical trials that form the basis of medicine today. As we saw in chapter one, scientists test whether a treatment is effective by comparing it against a fake treatment, or placebo, while subjects are “blinded” to which one they are receiving, just like the young man in the apricot garden. Franklin and his colleagues’ work is generally hailed as a pioneering triumph for evidence-based medicine.
But just as controlled trials have caused doctors to overlook the power of the placebo effect, perhaps the king’s commission made a similar mistake. They were right to debunk Mesmer’s magnetic fluid. But by dismissing his therapy as rubbish because it relied solely on suggestion, did they miss the fact that it really might have the ability to heal?
—
JUST LET yourself go and relax.
What I notice first are the cards. They’re everywhere, 50 or 60 at a rough count, bearing pictures of butterflies, flowers, coastal scenes, dogs in hats. They’re covering the desk, lined up on the bookshelves and pinned on the wall. Inside are long, handwritten messages: “Thank you for everything…I just want you to know how grateful I am…It has been a huge difference in my life.”
Letting those feelings of relaxation spread through you.
There are posters on the wall too, showing the structure of the gut, and a heavy door painted hospital green, with a notice: “DO NOT DISTURB. HYPNOTHERAPY IN PROGRESS.” It’s quiet except for a ticking clock. The sun slants through the blinds from the parking lot outside.
Spreading through the little muscles of your feet and ankles. Spreading up to your knees, and to your thighs, and to your tummy.
Most of the space in this office is taken up by two leather armchairs, which face each other. Sitting in the smaller one is Pamela Cruickshanks, a hypnotherapist who has worked with Whorwell at the Wythenshawe Hospital for the last 20 years.
Going to wherever it would be good for it to flow to.
Cruickshanks is leaning forwards, arms folded, notes in her lap. Her eyes are closed. With dark, wiry hair, a necklace made of green square beads and half-rim glasses, she looks like a librarian or a caring aunt. She’s speaking softly, in a soothing norther
n accent that reminds me of caramel.
Imagine that lovely feeling spreading through your shoulders. Down your arms into your hands and fingertips. Through your neck and head, and down through the muscles of your face.
A few feet away, with her feet up in an oversize reclining armchair, is Nicole. Her eyes are closed too, and she’s breathing deeply, slowly. The 48-year-old is slim, with chestnut-brown hair, silver stud earrings and a slick of lip gloss.
Everything is more comfortable and relaxed. Enjoy that lovely flow.
Fourteen years ago, Nicole was enjoying her career as a flight attendant, and expecting her first child. But her son was born with an unexpected cleft lip and palate, as well as hearing and speech problems. Then the father left, taking all of the couple’s money. Unable to pay the rent, she became homeless.
Imagine that you are really relaxed before eating. Enjoy your food. Eating slowly, chewing thoroughly, feeling comfortable with your food as it goes down into your stomach.
Within a few weeks, Nicole was suddenly a single mother, with no job, money, partner or home, and a child with special needs. She managed to get herself and her son into public housing, and saw her son through several operations while studying to be a dental nurse. She would get up at five in the morning to study while he slept, before taking him to preschool and going to work.
Your stomach sends little waves through, like waves on the sea on a lovely calm beach. Imagine your gut is learning from the waves of the sea.
But the stress caught up with her. She felt sick and in constant pain, as if razor blades were being dragged inside her body. And she became hugely bloated. Naturally slender, she now looked nine months pregnant.
Imagine the little waves in the small intestine, moving the food along. Absorbing it into the body.
It took 12 years for Nicole to get a diagnosis of IBS. Her consultant prescribed more and more drugs, until she didn’t know which drug was doing what. But nothing helped the pain, vomiting or constant diarrhea. A low point was when she was admitted to the hospital, struggling to breathe, with blood pressure so high that she required emergency treatment and her stomach so distended that staff refused to believe she wasn’t pregnant.
Everything is calm and comfortable. See how the water sparkles in the sunshine.
Nicole was transferred to Peter Whorwell’s care, and when he suggested that hypnotherapy might help, she was skeptical, to say the least. But she was so desperate, she was willing to try anything. Today is her sixth session with Cruickshanks. The lines are gone from her face. She looks serene.
Rather than your tummy controlling you, you control your tummy. I’m asking your unconscious mind to please help. Please put in place the right way for the gut to work.
When Cruickshanks finishes, Nicole takes a deep breath. She scratches, stretches her arms above her head and opens her eyes.
—
MESMERISM DIDN’T disappear after being discredited by the French king’s commission. Instead, it was reinvented—and given a new name.
Despite Franklin’s scathing report, Mesmerists continued to practice into the nineteenth century throughout Europe and the U.S. Rather than experiencing hysterical convulsions, however, their patients tended to fall into sleep-like trances. This was demonstrated in compelling stage shows, during which practitioners often claimed that the trance state induced paranormal powers such as telepathy and clairvoyance. Not surprisingly, the medical establishment remained convinced that the whole thing was fake.
In 1841, a Scottish doctor named James Braid attended one of these shows intending to debunk it, but after examining the mesmerized subjects, he came away convinced that beneath all the dramatics was something worth studying. He concluded that no hand waving was needed; he could induce a trance in people simply by asking them to focus their attention on an object such as a bottle top or a candle flame. There was nothing paranormal, just a physical phenomenon that could be studied scientifically. He called it “neurohypnosis” after Hypnos, the Greek god of sleep.
Hypnosis was subsequently embraced by psychotherapists like Sigmund Freud, who used it early in his career to uncover and resolve psychiatric problems, and Milton Erickson, who broke away from the authoritarian approach of earlier hypnotists. Instead he developed indirect methods of suggestion to overcome patients’ resistance to being hypnotized, and repeated true phrases during inductions—such as “You are sitting comfortably”—to gain patients’ trust. Both were convinced that the unconscious mind plays an important role in physical health.
For the most part, though, the medical profession has remained unimpressed. Links to wacky practices such as past-life regression; cases in which therapists have unwittingly planted false memories of abuse; and the continuing popularity of stage shows have all added to the reputation of hypnosis as seedy and unscientific.
Another problem is that scientists struggle to understand what hypnosis does to the brain. It turns out that being hypnotized is easy enough to describe, but much harder to explain. “It’s like you’re entering the imagined world,” says David Spiegel, a psychiatrist at Stanford University and one of the world’s leading researchers in hypnotherapy. “There’s less judgment, there’s less contrasting and comparing, you’re just in the flow of the experience. What you are experiencing seems very vivid and real. You’re not conflicted about doing it, you’re not counting the seconds. It’s a mental roller-coaster ride where you are just hanging on and seeing what’s happening.”3
Psychologists usually give a bland definition such as “a state of highly focused attention combined with suspension of peripheral awareness.” When hypnotized, people seem more suggestible than normal, and more susceptible to distortions of reality such as false memories, amnesia and hallucinations. They can also feel as if they lose conscious control of their actions. For example, if the hypnotist suggests that their arm will rise, it appears to them as if it moves on its own.4
A common explanation for these strange effects is that during hypnosis, different parts of our awareness become separated from one another. This means that our unconscious brain can comply with suggestions without our conscious self knowing. The hypnotist asks us to raise our arm and we do so, but it feels as though someone else is lifting it for us. When we experience amnesia, the unconscious mind registers events that occur but these sensations don’t make it through to our conscious awareness.
We probably flit in and out of hypnotic states all the time. Have you ever driven from one place to another, and realized when you arrived that you couldn’t remember anything about your journey? Or been so caught up in the story of a fascinating book or film that you failed to notice when someone called your name?
This could mean that there’s nothing much special going on at all. Indeed, some researchers argue that there isn’t any such thing as hypnosis, and that the feats people perform when apparently hypnotized have other explanations, from peer pressure and playacting to having a vivid imagination. Or perhaps it is just a way to boost our expectation that a particular thing is going to happen, like a turbocharged placebo effect. This nicely explains why hypnosis takes so many forms, from hysterical fits to sleepy stupors to the boiling energy of the Kalahari bush people. Hypnosis is simply a self-fulfilling prophecy, in which whatever people expect to experience comes true.
Recent brain-scanning studies suggest, however, that something significant does happen in the brain when we are hypnotized. One example is what Spiegel calls his “believing is seeing” experiment.5 He showed volunteers a series of grids—some color, some gray-scale—while scanning their brains. Then (while they were still looking at the grids) he told them that the color grid was black and white, and that the black-and-white grid was in color.
In people who were hypnotized, the part of the brain that processes color vision changed when they received Spiegel’s instruction. It became less active when he told them that a color grid they were looking at was black and white, and more active when he told them a black-and
-white grid was in color. It was a crucial result, showing that the subjects didn’t just pretend that the color grid had been drained of its hues (or vice versa), they really saw it that way. This didn’t happen in low-hypnotizable people, or in volunteers instructed to fake their response.
Hypnotized people behave differently too. Hypnotized subjects who have been asked not to see a chair that is in front of them will insist that it has disappeared. If asked to walk across the room, however, they will still move to avoid it (this fits the idea that their unconscious mind still knows the chair is there). By contrast, non-hypnotized subjects asked to fake the experience generally walk into the chair.
Thanks to research like this, doctors do generally acknowledge that hypnosis can reach beyond our conscious awareness to deep-seated thought patterns and beliefs. Hypnosis is recognized as a legitimate medical tool by the British and American Medical Associations, at least as a treatment for psychological problems such as addictions, phobias and eating disorders. But I’m interested in whether hypnotic suggestions can directly affect the physical body—particularly in a way that’s medically useful.
Remember pediatrician Karen Olness, who treated Marette’s lupus with cod liver oil and rose perfume? She is now a respected hypnosis researcher, and among other positions has served on the NIH Council for Complementary and Alternative Medicine. She claims that hypnosis helps us to reach the same unconscious parts of the brain as conditioned responses do, tapping into the autonomic nervous system to influence physical systems that aren’t usually under voluntary control.
