Reversing Gut Disorders Through Clinical Hypnosis with Dr. Ali Navidi

Welcome to The Perfect Stool: Understanding and Healing the Gut Microbiome. This is your host, Lindsey Parsons, and today I'll be speaking with Dr. Ali Navidi, a leading expert in integrating psychological practices in gastroenterological care. Dr. Navidi is a licensed clinical psychologist, co-founder and CEO of GI Psychology. With over a decade of experience, he has developed innovative treatments combining clinical hypnosis and cognitive behavioral therapy for patients with GI disorders and chronic pain. But before our conversation, if you haven't yet followed or subscribed to the show, be sure to do so. And if you want to get transcripts of the podcast, pop over to my website, HighDesertHealthCoaching.com, and sign up for my newsletter. You'll also get my free ebook, Finding Your Root Cause Through Stool and Organic Acids Testing, when you sign up. And if you haven't yet done my quiz on which stool test would help you get to your root cause, you can find a link in the show notes and take that. Now on to the show. Welcome to the podcast, Dr. Navidi.

Oh, great to meet you, Lindsey Parsons. I'm excited to be here.

Yeah, I'm happy to have you.

So I'm curious how, as a psychologist, you ended up with a focus on GI issues.

That is a great question. That kind of cuts right to it. Well, I can tell you, I did not expect that to be the case. I came in as a generalist. I just enjoyed treating all different kinds of patients. Different ages, kids to elderly. Yeah, there's no plan to focus on GI. If someone had told me that while I was starting, I don't think I would have believed them. But what I did have was a love of clinical hypnosis as a tool in therapy. And at the time, at the beginning, I didn't realize what an amazing tool it was for the GI and how much research there was already. Supporting it. I slowly discovered that and slowly started to use it with patients and it was just such an incredible response that I just kept doing it and adapting it and building it. And eventually it became like 80% of my practice cuz the gastroenterologist in the area would find out about me and then they would tell other gastro and, and it was like, those are all the people that were coming to me and there was no one else. There was no one else in the area that was trained to do this stuff. So I really felt bad turning any these people away.

Yeah. And so initially these weren't people who had come to you for GI issues. They were seeing you for other things, but they had a GI issue just by chance. And you happened to realize that that could also be dealt with.

Yeah. I had done a training years and years back about treating IBS with clinical hypnosis and it was part of a larger training in clinical hypnosis. And I was like, this is interesting, but I'm never gonna use it. I just put it in my back pocket and turned out to be useful. But yeah, the first patient I, I used it with was someone I was treating for anxiety, and I already knew they responded well to hypnosis. And they were talking about going through this process of figuring out what was going on with their gut, and they had gotten scans and tests and been scoped, and they didn't find anything. And eventually they came back to them with this diagnosis of IBS. And that's why I said, well, you know, I've done this training, so if you want, we could try this thing. And it ended up working.

Wow. Wonderful. And was that person a person who tended towards loose stool and diarrhea or towards constipation? Or I'm curious.

I'm going back into my memory banks. I wanna say it was IBS-D.

Yeah, cuz I, I can imagine that that's probably more the type that would be associated with anxiety because when you're nervous, the bowels tend to loosen.

Yeah. I found that while IBSC is treatable with these techniques, IBSD tends to respond even better. And it might be good to like get into the model behind why this works. Because the anxiety is a part, but there's more. It's not just anxiety. And I think that's a big misunderstanding. A lot of times with patients, they'll be like, well, I don't think I'm that anxious. I don't think that's the reason this is happening., and it's more than just anxiety.

So yeah, go ahead and delve in.

Yeah. So basically, there's 4 elements to understand. First off, something you're super familiar with is the brain-gut axis. So that communication system between the brain and the gut and between the gut and the brain. I was just looking at your podcast list and you've got quite an impressive list. You've been doing this for a while and you've covered a lot of interesting stuff. A lot of what I saw is from the gut up, what's happening in the gut, how it affects the brain and how it affects the body. In my world, it's what's going on in the brain and how that affects the gut. So the elements are the brain-gut axis. So this powerful communication between the brain and the gut, and then hypervigilance, catastrophizing, and something called visceral hypersensitivity. And so when I talk about hypervigilance, I'm not talking about general hypervigilance. I'm talking about body-focused.

Yeah.

And so usually people lock in on something. Maybe there's a certain area of the gut where they usually get pain or discomfort. Maybe it's in the upper GI, but there's an area where they're getting symptoms. Could be nausea. It could be pressure, bloating. So there's this hypervigilance, and then when they notice there's something happening there. Then they're like, oh, oh man. And then they start catastrophizing. And then that anxiety feeds down into the gut and it can cause a worsening of those symptoms. And then before that gets sent back to the brain, we've got visceral hypersensitivity, which is essentially the brain turning up the volume on those sensations and distorting them. So what might feel like a little bit of bloating can feel like an intolerable amount of bloating. What might just be hunger cues could be pain, or the feeling of digestion could also turn into pain or nausea. So there's an amplification and distortion that's occurring. And so you've got all these four elements happening.

Yeah.

My, in my list of podcasts, the most recent one I published was Asha Gupta, the Gupta Program, and that is a brain retraining program specifically. And I'm doing the program because I have autoimmune SIBO. So I, figured why not give it a try. But it's, it's an interesting question because I would also say I don't feel like I'm anxious about this. I feel like I've got it roughly under control. It flares up, I treat it. Yeah, I bloat a decent part of my meals, but I also overeat a decent part of my meals. So, you know, I'm curious if you are somebody who doesn't feel like you're hypervigilant of your symptoms, would that be somebody who's probably not such a good candidate for this kind of treatment or not a necessary? Component.

Not necessarily the case. So people will differ in how they're acting out these different variables. Like I said, there's the hypervigilance and there's catastrophizing. But let's not forget about our good friend visceral hypersensitivity. And this is a tricky one because most people have a very linear concept of how pain works in their body. It's like something happens, the sensation of pain travels up to our brain. And we're aware of the pain. When in actuality, it's much more complex. And that sensation is processed in multiple areas of the brain in different ways. And the idea that our brain has this kind of tuning mechanism where it can turn up the volume or it can even turn down the volume. And so it's hard to say how much that is playing a role in somebody's symptoms. And then there's just this mind-body connection where there can be these feedback loops created where what we expect to happen is being made to happen in some way. I've seen many patients that, you know, you talk to them, their self-report and what you observe, you don't see much hypervigilance. You don't see much catastrophizing. They're pretty level-headed people. So you believe them. Just doesn't seem to be the case, yet they still respond well to treatment.

Yeah.

Right.

I mean, to some extent it really just shows the power of our brain to alter our physiology. Yes. Whether or not it was fully brain-caused, it can be brain-solved, right?

Yeah.

Yeah.

A lot of patients that I've had with functional dyspepsia where they've got a lot of bloating, a lot of gas, kind of decreases their appetite. It's hard for them to eat big meals because it feels like it just kind of sits there. For example, when using hypnosis, a number of those patients, we've had experiences where they can literally feel the gas going away during the hypnosis session. And at the end of it, they're like, wow, I feel hungry for the first time in however long.

That's awesome. So if someone has GI issues, do you suggest they start with the gastroenterologist doing the full workup or maybe starting with a psychological approach?

Definitely want them to, at the very least, see their primary care. Often primary care with a good history and a few simple tests. They don't need a full workup. I think that's what they've been finding more and more nowadays. They used to do a full workup on everybody and they're finding, I think, that that's not really needed. With a good history and a, a few simple tests, they can usually figure out if it's IBS or another of the DGPIs. So in case people don't know, that's a disorder of gut-brain interaction, and it's a class of maybe about 30 different disorders. So I would say definitely start with some sort of a physician, and then you can maybe come to us earlier rather than later. What I think people do a lot of times is they'll go to their doctor. The doctor's pretty sure it's IBS. They do the few simple tests. They say, hey, it doesn't look like there's anything wrong with you. And then the person responds with, yeah, but I've got all this pain and you must have missed something. So they want more. And so they complain enough that they're going to get the endoscopy, they're going to get the colonoscopy, they're going to spend 6 months to a year chasing their tail before they end up seeing somebody like myself.

Yeah.

And so you mentioned a few simple tests. So I don't see a lot of people getting anything related to GI from their primary. What simple tests are we talking about?

I wish I, I remembered cuz there are these certain kind of like red flag things.

Like fecal lectoferrin or calprotectin or things like that for checking for IBD.

Yeah, exactly. They need to rule out IBD, at least rule out minimally IBD. They need to rule out something like celiac. You probably know them.

Yeah, probably H. pylori, I would think. And then maybe occult blood parasites, whatever, things like that. Yeah.

And look at their blood and make sure there's no indications that it's, maybe there's some kind of cancer or something like that happening.

Right.

Or maybe CRP to check for inflammation, things like that. Yeah. I do see all the time people who are like, yeah, they wanna do a colonoscopy and I'm young and I think I can see the root cause of this. Like I took a bunch of antibiotics or maybe they had food poisoning, something like that. And do I really need to go get the colonoscopy? And people wanting to avoid that. And I, I always sort of wonder, well, why don't they just do a fecal lactoferrin? I mean, I don't know how. Sensitive and specific it is for IBD, but there's both calprotectin and fecal lectiferin. If you do 'em both, then it seems like together that would be a pretty good indication if you really need to do the colonoscopy. But I guess for a doctor who does colonoscopies every day, it's probably like no big deal for them. But for a person, you're just like, oh my gosh, I'm gonna have to drink this stuff and then I'm gonna have to go through this whole medical procedure and it could be expensive. And yeah.

And what you said reminded me, there's two main paths that you can develop these kinds of disorders.

So.

IBS is the most well-known of the DGBIs. Like I said, there's a bunch of others. The two main paths are trauma, gut trauma, like they ate some bad sushi and they're feeling sick, or they got a virus or they got a bacterial infection. And even though that has passed, their symptoms are remaining. And so the brain-gut has kind of learned a pattern and now it's just rolling with it. The other way this can happen is if they are going through something in their life and it could be positive or negative stress. So if somebody is getting married, somebody loses their job, they're fighting with somebody in their fam— like something that's stressing them out often is associated with the beginning of these. And then there's certain classes of people that tend to be more vulnerable. So someone with an anxiety disorder, history of trauma, someone who's on the autism spectrum, or someone with a history of eating disorders. Those 4 groups, they all tend to be more vulnerable to developing these DGIs.

Interesting.

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So yeah, tell me a bit more about the approach, about the hypnosis.

So I'd say majority of people may be listening to this, they hear hypnosis and they're immediately thinking of entertainment hypnosis. So what are they thinking of? They're thinking of the movies where magic or mind control or a stage show. If we take all of that stuff, which is usually what most people know, and just put it to the side. And say, okay, that's entertainment hypnosis. What is clinical hypnosis? Then you get something really interesting. What you get is a technique that has been studied for 40 years for IBS. Let's say if we just talk about IBS, it's been studied for 40 years and we're talking about serious medical studies, randomized controlled trials, all that good stuff. It's in the guidelines for the American College of Gastroenterology. In England, it's kind of a standard of treatment also. It's really legitimate and sadly, very few people with IBS would even think of it for their treatment. So what is it exactly if it's not entertainment hypnosis? It's just deliberately teaching someone how to go into a state of trance. And trance is something that happens naturally that everybody does. So I'm driving to my office. I drive the same way every time. And I'm listening to my book on tape right now. And then I get there and I'm at the office. And how did I get there? I'm not sure what happened. I don't know. But I know what happened in my book on tape. And that's an example of transit. It's happening all the time.

Yeah.

Or worse, you're going somewhere else, but you still drive to your office. Yes.

Yes.

This is something I do a lot. Yeah.

Or like you're used to dropping your kids off and you drive to their school or So you've got this naturally occurring state. And so we're just teaching people how to go into this state on purpose rather than accidentally. And why do we care about trance? Well, it turns out that in trance, one of the things we can do is we can turn down that visceral hypersensitivity, turn that volume down. And there also seems to be more of an ability to access that brain-body connection. In trance. So I'll do a lot of work with patients with chronic pain. I'll do a lot of work with patients with GI issues also, because in that trance, for whatever reason, they have a stronger ability to, to make shifts in that brain-body connection.

And then what about the cognitive behavioral therapy and how that plays in? Yes.

So most people, I think, would have heard of cognitive behavioral therapy. For this kind of work, it's not generic CBT. So CBT is cognitive behavioral therapy. It's not generic CBT, it's more focused protocol. And I make that distinction because a lot of patients get sent by their doctors, oh, you've got IBS, go get some CBT. That's a good instinct, but your standard CBT practitioner doesn't know what to do with IBS. They don't know what to do with functional dyspepsia or chronic functional nausea. They'll treat the anxiety, they'll treat the depression. But a lot of these patients will come back and when we talk to them, we'll, we'll say, okay, we're gonna use CBT in your treatment. They'll say, oh yeah, I tried that. It didn't work for me. But what they tried was kind of general CBT, not those protocols that are specifically designed for GI problems.

And what does that look like?

Well, we wanna address various components. So we wanna address that habit of hypervigilance. We wanna address the catastrophic thinking. We also wanna address the various types of avoidance. You often will get avoidance of places and situations. Like, I don't wanna go on that car trip, or if I'm giving a talk at work, I'm worried that I'm gonna have GI issues, so maybe I talk my way out of it or something. That— so there's a lot of different kinds of avoidance that occurs. And then there's also avoidance of food.

Right. Right.

And some of that is legitimate and some of that actually is based on factors that are not related to the food. The poor food gets kind of lumped in there with a bunch of other things. And then there's actually what's called interoceptive avoidance. So they develop a kind of anxiety that's associated with their body and specifically the sensations in their gut. So we wanna address those levels of avoidance. I usually like to save the food till the end because while people's systems are hypersensitized, if you try to introduce the foods back in, they're just gonna have a bad reaction to it. So what you do is once you desensitize the system, turn down the visceral hypersensitivity, reduce the hypervigilance, the catastrophizing, get the system calmed down. Then you can go back and start trying to reintroduce foods and you've got a better chance of doing it without them having a, a negative reaction.

Yeah.

I see a lot of people who are down to a very small list of foods and in almost every case they'll say, well, I had that once and I had this reaction and I think, well, I suspect that that wasn't the only thing that was at the meal, right? I mean, it's not usually that you did a one item trial. And you might've had something else going on, like it may not actually be that food, but yeah, slowly but surely they just keep crossing things off the list or entire categories. Say it's histamines, oxalates, categorically eliminating foods till they're down to ridiculously small number of foods.

So, and then we're in the realm of ARFID, avoidant restrictive food intake disorder. It's a type of eating disorder where they're limited what they'll eat. To such an extent that it's affecting them in life socially, physically, mentally.

Yeah.

And exactly, you hit it right on the head. Exactly what you just said. So they're having a meal, maybe they're just having a bad day. They've got a higher background level of anxiety for whatever reason that day. So that's feeding also into their system. So their stomach is more reactive. They eat their slice of pizza or whatever it is they eat and they have a bad reaction. Then they conclude, well, it seems like pizza's bad for me. So then the next time they have pizza, they come into that pizza with the level of anxiety and fear, which of course is going to cause more symptoms. And then those symptoms are going to confirm that they're right and pizza is bad. And that's how pizza gets crossed off the list, right?

Yeah, I do find it's interesting because obviously when you work with someone, you're not seeing them, at least I'm not, I might see 'em every 2 to 3 months, so I'm not able to monitor their diet and the minutia of what items they eat and don't eat on a regular basis. And there are some types of clients that restrict and just stay restricted. They can live off of 12 foods if that's what makes them feel good. They'll live off of 12 foods for the next 10 years. And then there's others that just kind of keep going, well, can I reintroduce? Can I reintroduce? And I'm like, yeah, yeah, definitely reintroduce. Sometimes I forget to say, hey, are you trying now to reintroduce some of these things? Because you're more interested in making sure their symptoms are gone than you are in, in reintroducing foods. But of course it's much better if people are pushing and saying, hey, when can I start retrying these foods? Just a note to people out there.

Yeah. And you're right, it's so much easier for me also when they have that desire, that excitement about reintroducing, and they even start testing on their own.

Yes. Yes.

Versus those other people you were talking about that they're firmly lodged into, okay, this is safe and things outside of that aren't safe and I wanna stay safe, and almost have a belief that they're injuring themselves if they have the wrong food, like it's doing harm to them.

Yeah.

That actually makes me think of a podcast I was listening to that was talking about just physical pain and that you might have a physical pain on doing some type of action or sport or whatever. And if your belief is that that physical pain is injuring you and is hurting you, then it will seem worse. And then if somebody tells you, no, it's just a pain, it's just your brain's perception of it, but it's not actually making you any worse, then all of a sudden they were like, oh, okay, well now I can walk or now I can play tennis.

Oh my God.

Yeah.

Yeah. You're opening up a subject that I love to talk about. I work with a lot of patients with chronic pain also. And that's one of the fundamental concepts that people should understand is that not all pain equals harm.

Yeah.

Right. And there's a really cool story about that. Have you ever heard the story of the two nails?

No.

It's kind of a classic in the pain literature. Essentially, somebody's working in a construction site and they kind of jump down and they accidentally jump on one of these long nails that were sticking up out of a board. Goes through their boot and it's sticking up the other side. They look down, they freak out. Everyone around them freaks out, pick him up, they carry him. The guy's screaming and yelling and he's in all this pain. And then you get to the hospital and they give him a bunch of painkillers. It's not helping. They're losing it. They cut off the boot and the nail had gone right between the toes. There was no harm, but there was lots very, very real pain because when the brain thinks it's been harmed, it's going to take those sensations and again, amplify and distort. So this person believed he had been badly harmed. And so his brain gave him the pain that it expected to see. There's another example. So the second nail is another construction worker who I guess was holding a nail gun and it kind of went off accidentally and like bashed him in the face. The the back of it. Then for about a week or so, it was like just kind of hurting. It was like a dull pain, not too bad. Eventually he was like, this isn't going away. I should probably go to the doctor, but no urgency there. I think they did a, maybe an MRI or something, maybe an X-ray. And they saw that he had shot it and I guess it had ricocheted and come back and lodged in his sinus. And it had been there for at least a week, maybe two, and very minimal pain. Because just the way things had happened, his brain did not expect to be finding any pain or much pain at all. Right?

Yeah. Yeah. No, that thing makes me think of a trick that I do every time they take blood. I pinch above the arm where they're taking the blood on the inside real hard just as they're poking me. And half the time I literally don't feel the nail go in because your brain can only interpret so many signals at one time, especially on the same arm, right?

Yes, yes. That's an awesome trick. Everyone should listen to that. And I think that follows what's called the gate control theory of pain. It's why also if a kid hurts themselves, knocks into something, if you kind of rub around it and like give them all this other stimulus, their brain will kind of will mask the pain and the pain will like decrease.

Yeah, that's why I sometimes see dads like punching kids in the shoulder when they hurt themselves because it's like, yeah, get over it. You won't It's just a distraction.

And there's good truth in that. It actually works.

Okay. So I've been playing with the Reverie app and they have this thing where you look up and then close your eyes and then keep looking up as you close them. And that's supposed to be a test for being hypnotizable. So I'm wondering, first, is everyone hypnotizable? Because you did mention everybody can be in a trance state. And how do you test for it or how do you find out?

Yeah, that's a great question. And what they were doing is what's called the eye roll that's been around for a really long time. And so hypnosis is interesting because it's probably one of the most studied concepts within psychology. I mean, if you go on to PubMed and just type in hypnosis, you will see thousands of articles, studies, various things that have been done with hypnosis. So you're asking about hypnotizability. That's been really well studied.. And so they've done population studies using these concepts. And so what they found is that it's a bell curve. It's essentially a bell curve. And so you've got a few people on the end who are just amazing at it, a few people at the other end who it's like talking to a brick wall for them in hypnosis. And then most people are average. The vast majority of people are average. And what I say to people is we don't need you to be amazing. We just need you to not be terrible for this kind of treatment to work. And so the vast majority of the people, it can be helpful. If you're wanting to do chronic pain work, if you're wanting to do GI work, we just need you to be average or better and it can be helpful for you. How do you test? There's certain tests that have been developed over the years. The eye roll test is one of them. They're kind of fun, actually. For example, there's one called finger magnets. Where you have them put their fingers out like this and you give them some suggestions. And I'd say 95% of the time, the fingers come together almost like they're being pulled together by magnets. The thing to understand is that trance is natural and it's happening all the time. And how do people enter trance? Well, pretty much you just need two things, focusing your attention and engaging your imagination. And that'll usually do it. So, for example, if you're thinking deeply about all the different things you want to do today, and so you're focused your attention, and now you're imagining your day, you'll probably go into a light trance just doing that. If you're reading a book, you're focused your attention, and maybe the story is really interesting and you're imagining the characters and all this stuff, you're going to go into a trance just doing that. Does that answer your question?

Yeah.

Yeah.

I mean, I was curious too about the eye roll because I don't feel like I can do it. I mean, maybe I'm wrong because it seems like my eyes go down when I close my eyelids.

Well, let me see. Maybe there are instructions. Here's how I do it. And it takes a little bit of practice. So what you do is first you look up as if you're looking through the top of your head, and then you slowly close your eyelids until you feel a flutter while keeping— yep, perfect. Right there.

Yep.

And then let your eyes relax. So that was it.

Okay.

Yeah. Yeah. I was wondering because I didn't do it super easily, but then there was an Are You Hypnotizable little thing you could run through. And I did that. And one of the things was, your left arm is floating up even though you're not purposely doing it. And I'm just like, I'm not going to just lift it. I'm not going to just lift it. But I'm like, I do feel like it's being drawn up.

Nice.

And then at the end they tell you you're either a poet or a, I don't know, there were 3 people, you know, if you're like a poet type. And I'm like, I am the least sort of poet-like person. I'm not very woo-woo. So I just was sort of surprised that it was hypnotizable. 'Cause I thought I'm not the kind of person I would expect to be hypnotized.

You do not need to be a woo-woo poet person to be hypnotizable. Absolutely not. We've worked with plenty of doctors and scientists and various medical professionals I think the one factor they found to be really important is people's ability for absorption. How good are you at getting absorbed in things that you do? The kind of person who could be working and then just lose track of time.

Oh, yeah, that's me. Right?

Yeah. Or, you know, you're working for so long and then you don't even notice your body and then you're done and you're like, oh, and you're like all stiff and whatever, but you didn't notice any of that stiffness or any of that. While you were working. That is the key. You don't have to be woo woo, but if you have the ability to get absorbed in things, you'll probably be pretty good at hypnosis.

So are people who have ADHD who are super distractible, are they not good candidates?

Well, that is actually a misconception because I think a lot of people with ADHD, they have this thing called ADHD hyperfocus.

Right, right. But it's usually on like computer games, isn't it? Yeah.

Well, it's on things that they like, right? And that's the problem with ADHD. They have real trouble getting focused on things that they don't like, whereas people without ADHD can kind of force themselves to lock in, whereas they have a lot of trouble doing that. But they can be amazing hypnotic subjects because they really can get hyper-focused if you can make the experience of enjoyable for them.

Yeah.

Hey, this is Lindsey here, just letting you know that if you're tired of dealing with digestive issues like bloating, indigestion, soft stool, diarrhea, constipation, reflux, IBS, IBD, or the numerous health conditions that come about when your gut is off, like brain fog, weight gain, UTIs, fatigue, mental health issues, or complex conditions like fibromyalgia and ME/CFS, That's my specialty. With my 3 or 5 session gut health coaching packages, we'll discuss different stool and functional medicine tests to find out the root cause of your symptoms. I'll interpret the results and provide clear explanations, empowering you to make informed choices for your gut and overall health. And together we'll develop a customized action plan based on your test results so you can find relief and regain your health and vitality. I come from a functional medicine perspective, trying to incorporate the latest peer-reviewed research and educating you on protocols used by functional medicine practitioners but devoting lots of time and support to my clients the way a doctor simply can't. If you're interested in a 3 or 5 session coaching package, you can sign up for complimentary 30-minute breakthrough session. Or if you can only afford one appointment at a time, you can book an initial 60-minute consultation. Links for those are in the show notes. Now back to the show.

So how long is a typical course of CBT hypnosis before a person will find resolution of their GI issues?

Yes. I don't think I mentioned, so about 4 years ago, I kind of responded to the fact that there's nobody out there that does this treatment. I think they did the numbers and there's like 500 in the world, right?

Okay.

Myself and another psychologist, we got together and created a bigger group practice called GI Psychology. And the idea of GI Psychology is that we were gonna make this kind of treatment more accessible to people. We worked really hard to make it available. Now it's available in all 50 states by telehealth. And so looking at the data from our practice, what we've found is that on average, people take about 10 sessions. That seems to be the average. To put it in perspective, that's a relatively short-term treatment when you're talking about behavioral health stuff.

Yeah, for sure.

And do you take insurance or is this all out of pocket?

We're out of network for insurance and our patients tend to get about half back.

If they've got a non-HMO plan.

Mm-hmm.

Yeah.

Yeah. If they don't have Kaiser or something like that.

Right. Right.

Yeah.

The other thing though is that there's something called a single case agreement. It's also called a gap exception. And we help the patients get this. And basically you're, you're saying to the insurance company, hey, are there any other gut-brain therapists in network for you?

Right. Yeah.

The answer is always no. And so when they grant that, and they grant it like 90% of the time, then the patient gets reimbursed as if we're in network for them. So they end up getting a lot more back.

Okay, great. So I know that some people may have concerns about hypnosis and maybe even more so if it might involve a child. So what would you say to reassure them about that?

Yeah, I think that The concerns, for the most part, I think, rest in that category that we talked about at the beginning, which is entertainment hypnosis. If all I knew about hypnosis was the stuff I saw in movies and TV and stage shows, I would be concerned too. I wouldn't want to do it. As long as they can understand that there's a very big difference from what Hollywood is showing you about hypnosis and what it clinically is, So then we get common fears that you're going to be under somebody's control. Nobody would want that. But is that actually reasonable? When you're daydreaming, you're in a trance. Can somebody control you? Can somebody just suddenly tell you like, hey, give me, give me all your money? No. Can you get stuck in a trance if you're watching a football game and you're really into football and you kind of zone everything else out? Is somebody be able to control your mind or Are you going to get stuck in that state? No, of course not. What I'm saying is this is actually a very natural thing that we're teaching people to do. And what I tell my patients is when they're learning this, instead of losing control, they're actually gaining more control over themselves because we want to teach our patients self-hypnosis also. And what that means is then they have this skill that they can use to decrease pain, to reduce GI symptoms. It's a great way to calm down if you're feeling stressed or anxious. I mean, I've had patients come back 5, 10 years later and say, you know, I'm still using self-hypnosis. They're just using it for other things. They're using it, you know, if they're stressed or they need to figure something out and they need to get away from everything. And you brought up children. It turns out children are even better at hypnosis, especially, or between like 8 to 12 years old. When we look at the data, children are even better at hypnosis and they respond better to the treatment. So for example, adults, 75% of the time they're going to reach their treatment goals. That's a super effective treatment. But kids are even better. They're like 80, 85% are going to reach their treatment goals. They're even better candidates for this kind of treatment.

Yeah, that's great.

One thing that surprised me in using the Reverie app is that the introduction to moving you into a state of hypnosis is very quick. It's like, do the eye thing, you're in, basically, practically. And is that really the case in like the therapeutic setting?

Yes. So there's stages to hypnosis. It's kind of the pre-hypnosis stage where you want to explain things to people. Then there's what's called an induction. All that is, is the transition between normal consciousness and a trance state. Then they have what's called a deepening. So that's where you're getting deeper into the experience of the trance and kind of letting go of that outside world. And then there's the intervention, whatever that intervention is going to be. And then there's the re-alerting phase. They're going to shift you back into your regular state of consciousness. There's thousands and thousands of different ways to do that induction. It sounds like what they've chosen to do is a pretty rapid one.

Mm-hmm.

And based on what you're saying, I don't know what they're doing for a deepener.

Well, it's probably just part of what they're saying after that.

Yeah, that's probably not the way I would go with someone who's learning hypnosis.

Mm-hmm.

Because just like anything in life, there's a learning phase to hypnosis and people will get better at it with practice. And so when people first start, you want to give them time to make that transition. And you want to work with them, which is the difference between an app and like a human working with you is, yeah, I want to work with them to figure out what works best for them. What's the type of language? What's the type of imagery? What's the style that's going to work for them? Because like I said, there's thousands of ways to do it. And then once people have been working with me for a while, they can go into trance in like a minute. Once they've kind of learned and trained themselves. But at the beginning, I would opt for a longer period of transition to give people time.

Yeah.

And so if somebody's experiencing GI issues, when do you think it's gone beyond, my kids, when he's nervous, for example, or me when I'm nervous, I have to run to the bathroom versus like, this is actually an issue that requires intervention of this kind.

That's a good question. I would say that when you start adapting your life to the problem, if you're just going along and you got to run to the bathroom every once in a while, but it doesn't actually cause you to do anything different in your life and it doesn't really cause you a lot of stress or anxiety, or you're not up at night thinking about what might happen tomorrow, or your life is not getting influenced by this, just kind of keep on keeping on. But once you start shifting your life around this problem, I think it's time to start thinking about getting it treated because these problems are so treatable that it's almost to me like a no-brainer. It's a short-term treatment. They're highly effective and they last. So when they do studies longitudinally, the results stay. These patients are not having to come back. To keep this up. For the most part, they're good to go. Very occasionally they might come back and it usually takes like one session to remind them of some of the skills they learned, and then they're off and running again.

Yeah. So we were talking a lot about the functional GI disorders and IBS and such, but I assume that there is also a mental component even to the ones that are autoimmune, even IBD. Is there a role for hypnosis or CBT in those types of conditions?

Yeah, there recently was a protocol that came out for IBD, also a hypnosis protocol, and it found that it was helpful for IBD patients. Patients with IBD, it's a different type of treatment, obviously it's a different disorder, but there is a lot of overlap. There's dealing with chronic pain. If you can help people get better at dealing with chronic pain, they're going to have better quality of life. We know that stress is a big component in almost all the autoimmune disorders.

Absolutely.

When people are stressed, it's going to be worse on their immune system. So if we can reduce that stress, they're going to tend to do better. There's also— I forget the right name for it, but basically I think of it as like an overlap. So you might have IBD and then at different points in your life you've had flares. And that's when your GI system is really gonna be causing you trouble. And then the flares go away or the flares are treated and they're gone. But what happens with a lot of IBD patients is they have a flare, the flare is treated, but some of the symptoms don't go away. And that's usually because they've developed a DGBI on top of the IBD symptoms. And so there's an autoimmune component and then there's also a brain gut component.

Component.

Mm-hmm.

The final part is that IBD, there's a lot of comorbid anxiety and depression, especially for us. We understand IBD, we know what's going on. And so treating that anxiety or depression with somebody who's already familiar with IBD and some of the challenges that are involved there just tends to go better. So we do work with a lot of IBD patients. In fact, we're working on a joint project with the Crohn's and Colitis Foundation right now. We're developing a therapeutic group, which is another option. So patients can see us individually, but we also have groups where we're trying to teach patients core skills that are gonna be useful for helping their gut. And that's a much more financially accessible option than individually.

And if someone's doing work with, say, someone like me working on their gut health from a microbiome standpoint or working with a GI doctor on maybe they're taking their immunotherapy or steroids or whatever they may be getting from their regular doctor. Would you recommend that they do all that first before coming to see you or do it simultaneously or in sequence or you see you first? What's the best order for these things?

I think for the most part, it works well in conjunction. What we say is we play well with others, meaning we're often dealing with patients that have complex medical issues.

Yeah.

They don't just necessarily have IBS. They might also have SIBO. They might also have fibromyalgia, POTS, chronic migraines, other musculoskeletal issues. So there might be a lot going on. And so we frequently work with other providers on the treatment team. For example, there's a naturopathic physician who specializes in SIBO. We've kind of worked together really well for many years because often he'll treat the SIBO and there'll still be symptoms. There's always something to treat. Usually it can be pretty resistant and you might have to do multiple rounds. So he'll continue that treatment while we start the brain-gut therapy. And there tends to be really good results because there's often a brain-gut component in a lot of these problems.

Any final thoughts before you tell us where people can find you?

Yeah, I think my final thought is, you know, I was in private practice for years and years and I started this bigger practice because I just felt it was just a terrible shame that people might have these disorders and they're so treatable and we have so much good evidence showing that these treatments work. They might go their whole lives and never get this treatment. And I thought that was really just a terrible thing. My hope is that people will understand that these treatments are out there and that they don't have to live with these symptoms. And that if they have a loved one that's going through this, they'll let them know. People should not have to go through this because these treatments, they really work well. And to answer that final question, they can find— so the clinic is called GI Psychology and And that's the website also. So it's just gipsychology.com and they can get a free phone consult. We have a clinically trained person that can answer all their questions, see if it's the right treatment for them.

Perfect.

Great.

Well, this was really interesting and useful, and I'm sure there are heaps of people who can benefit from this that I've seen and that are listening.

So thank you.

Yeah, I appreciate you providing this opportunity. Like I said, you've got so many great topics on here, so I'm just privileged to be one of the, the many. So thank you.

It's my pleasure.

Thank you. Well, that was really interesting conversation and I'm really excited about the work that Dr. Navidi is doing, and I'm sure many of you and many of my existing clients could benefit from it. So do check out the links about his practice in the show notes. If you'd like to support the podcast, you can buy supplements at a discount from my Fullscript dispensary, order tests at a discount from my Rupa Health Lab store, or use my affiliate links to iHerb, which is available worldwide, Bulk Supplements, or Amazon. If you'd like to connect with me online, you can follow my High Desert Health Facebook page, join my Gut Healing Facebook group, or join my newsletter list at highdeserthealthcoaching.com, as well as follow me on X, Instagram, TikTok, and Pinterest. Links for those are in the show notes. Thanks for joining me today, and here's wishing you all the perfect stool.