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Presenter: Eva Szigethy, MD

Background: Patients with early or chronic psychological trauma often have chronic gastrointestinal symptoms (e.g., pain, nausea). While in many patients, these symptoms can respond to cognitive behavioral or scripted hypnotic therapy interventions, in a subset, these somatic symptoms persist together with associated emotional distress remain treatment refractory. Aims: This workshop will discuss two different hypnotherapy approaches, Eye Movement Desensitization and Reprocessing (EMDR) and egostates re-integration therapy (Phillips & Frederick 1995) in helping resolve refractory gastrointestinal and psychological symptoms. Methods: Patients with a variety of clinical conditions will be presented including irritable bowel syndrome, cyclic vomiting, and inflammatory bowel disease. EMDR primarily involves recalling and reprocessing of traumatic memories with concurrent bilateral stimulation that often consists of guided, rhythmic back-and-forth movement of the eyes or tapping on alternating sides of the body. EMDR represents a useful method of treating trauma in part through addressing somatic sensations in a less reactivating and re-traumatizing way than other approaches. Ego-state therapy is based on the premise that trauma is associated with pathology of personality development. Hypnotherapy, including indirect Eriksonian techniques can be useful in integrating ego parts and associated gastrointestinal distress, often which represents a psychic somatic equivalent. Didactic materials and clinical case examples will be used to present the theory, neurobiological underpinnings, and application of these techniques. Objective ways to measure both psychological and somatic outcomes from a small parallel open trial case series for each method will be presented.