The North Carolina Protocol
Hypnotic Treatment for IBS
The North Carolina Protocol owes its existence to its creator’s early university research work exploring the use of standardized hypnosis interventions for physical problems. Later work with another University of North Carolina academic, Dr William Whitehead, an expert in the psycho-physiology of irritable bowel syndrome, led Dr Olafur Palsson to develop the protocol as a fully-scripted hypnosis intervention specifically for IBS.
The course of treatment consists of seven sessions of hypnotherapy, in each of which one of Dr Palsson’s scripts is delivered in the conventional manner for clinical hypnosis. An audio recording for clients to use at home reinforces the effect of the scripted sessions.
The protocol is generally applicable to all IBS patients, regardless of their abilities as hypnotic subjects (in their capacity to visualize, for example).
The protocol uses a number of specific therapeutic elements – or suggestions – to bring relief to the IBS patient. It is when these focused suggestions are made to a hypnotized person that IBS symptoms can be profoundly improved. Just being in hypnosis is not in itself therapeutic – however pleasant and relaxing the experience might be. The suggestions are the essential “therapy”. This is the underlying principle of hypnotherapy (hypnotherapy = hypnosis + therapy).
When Dr Palsson tested the efficacy of his protocol, he found the results both “pleasing” and “somewhat perplexing”. In terms of IBS symptom relief, four out of five people benefited. However, the physiological mechanisms underlying their improvement remained poorly understood.
“In short, the conclusions of our empirical testing…are that [the protocol] produces highly replicable results that constitute substantial and long-lasting improvement in bowel symptoms for most patients [and] improved psychological well-being. On the other hand, it remains unclear…through which mechanisms hypnosis achieves its beneficial effects on bowel symptoms,” he said.
The Protocol in Practice
The protocol consists of seven sessions of hypnotherapy, conducted at two-weekly intervals. The first session generally takes an hour-and-a-half; subsequent sessions are each an hour long.
Clients are also asked to monitor their IBS symptoms.
The first session gathers information about the client’s medical and psychological history, discusses the nature and severity of current symptoms, reviews past treatments and the conclusions of any medical evaluations and tests. This is because the protocol practitioner needs to ensure that the client has been properly medically diagnosed. The session is also used to establish rapport, give information about IBS (and hypnotherapy) as needed, further explain the protocol and answer any questions the client may have. The session then proceeds to the first of the seven hypnotic interventions.
The subsequent session sees the client hypnotized and absorbing the suggestions from the second of the carefully-crafted hypnotherapy scripts. The client is also given the protocol’s “self-hypnosis” audio recording to use at home. This “homework” is an integral part of the treatment.
Sessions three to seven follow the pattern of induction into hypnosis followed by the presentation of the therapeutic suggestions via the scripts.
With the completion of the seven sessions, the therapy is finished and no further treatment for IBS is generally required.
“The protocol offers advantages that make it an excellent therapy option for patients who do not experience adequate relief of symptoms from standard medical interventions. It provides a brief and fixed course of therapy…it is well received by practically all patients, and the experience to date shows that it can be expected to reliably improve the bowel symptoms of the great majority of IBS patients who have been unresponsive to other treatments.”
– Dr Palsson (writing in the International Journal of Clinical and Experimental Hypnosis
The Small Print (Fees, etc)
The North Carolina Protocol is for adult clients with a confirmed diagnosis of IBS who have not responded to standard medical treatments. Hypnotherapy is offered as an adjunct to standard medical care.
The protocol is not a cure for IBS. However, research to date indicates that about four out of every five protocol clients experience a noticeable improvement in their IBS symptoms. Sometimes these benefits are immediate; sometimes they take a few sessions to become apparent.
The protocol is a brief, time-limited therapeutic programme of seven sessions of hypnotherapy, with a two-week gap between the sessions. The first session generally takes an hour-and-a-half; subsequent sessions are each an hour long. There are no shorter or longer versions of the course of treatment.
The total fee for the seven-session course is £385, payable in three instalments.
An initial payment of £55 covers the cost of the 90-minute consultation (session one).
The second payment (£165) is paid at the start of session two and the third payment (£165) at the start of session five.
The fee of £385 (£55 + £165 + £165) covers the seven sessions, the audio recording for the client’s use at home and an optional
follow-up “booster” session three months after completing treatment.