Hypnosis may be used effectively to alleviate constipation whether or not the problems of the particular individual are of psychosomatic origin. The case history described in detail immediately after the word-for-word general therapy for constipation is an excellent example of the use of hypnosis to help a boy suffering from congenital megacolon.

However, the attending doctor in more "normal" cases of constipation might well think in terms of certain types of early childhood training. The baby does not distinguish between the various pleasures it experiences during its first year. The joy of eating, the relief of urination and defecation are part of life. The mother has a different outlook. There comes the time, usually too early, when the mother attempts to train the child to "use the potty." Some children, when they discover that giving feces brings praise, immediately start a pattern of giving.

During the early part of the training period, the baby does not know what is expected of it. The baby continues to defecate and urinate on impulse and without regard to time or place. The mother adopts a firm attitude. A painful slap is sometimes administered, words like "Nasty" and "Dirty" are freely used, and by the time the baby "gets the idea," a connection has been established in its nervous system between the words, the act, and the organs involved. (127) One child discovers how eager the mother is for an habitual movement, and holds back to spite the parent. Another child, confused by the sharp words, holds back out of fear that his bowel movements offend no matter where they are delivered.

In using hypnosis to relieve constipation, the childhood experiences can usually be overcome without it being necessary to explain the possible causes to the patient. But if the problem does not yield readily to the hypnotic word-forword technique that follows, it might be advisable to explore the back history and explain to the patient some of the unconscious processes that lie behind constipation.

It should be noted that a daily bowel movement is by no means a universal requirement. For some people twice, or even once a week is normal. The hypnotist should avoid changing the basic habit patterns of the individual's body functions.

FOR THE DOCTOR: Hypnotize the patient to the light trance stage or deeper. Go deeper and deeper to sleep. Deeper and deeper to sleep. Much deeper and deeper to sleep. As you go deeper, your body is relaxing more and more, more and more. Now, your lips are beginning to relax. They are becoming loose and limp and flexible, and the jaw muscles are relaxing, so that your teeth do not quite touch. The throat muscles are relaxing, relaxing more and more. Now a wave of relaxation is starting down the esophagus towards your stomach.

Go deeper and deeper to sleep. Deeper and deeper to sleep. You know that your whole gastro-intestinal system is simply a muscular tube which is coiled round and round inside your body. Various parts of this tube have various purposes, just like the specialized departments in a factory. The mouth is the receiving department, where goods are (128) accepted and unpacked. The throat and esophagus are the conveyor system. The stomach is a processing room in which the materials are prepared for use, and so on throughout the whole system. And finally we have the useful products which go into the body itself, and the waste products which we must eliminate.

This whole factory has a continuous conveyor system. The tubes which make up this conveyor system are composed of rings of muscles. These muscles in their contractions and relaxation push the material along through the factory just like the assembly line chain in an automobile factory. When we start the relaxation at the throat, that is automatically followed by the natural rhythmic alternate relaxation and contraction of the muscle. These contractions occur in waves always traveling from the receiving room down toward the waste disposal departments.

The wave of relaxation, which we started a few minutes ago, in the mouth and throat, is now moving down through the stomach towards the duodenum. Following the wave of relaxation come the peristaltic waves-alternate relaxation and contraction of the muscles, down through the stomach, the duodenum, and into the intestine. Your whole intestinal tract is becoming relaxed, and soon these waves will reach through the colon to the rectum. The rectum is a kind of storage bin, just like a waste basket. We don't run to empty a waste basket every time we get something in it. We do empty it when it gets full.

That is the way your body functions, too. These peristaltic waves carry the waste material through the colon and into the rectum where it is stored. As soon as it becomes full, an automatic signal is sent out, and you realize you are about to have a bowel movement. As soon as you have that feeling, you go to the toilet. When you sit down on the toilet, the contact of your body with the toilet seat automat.. ically sends a signal to the round muscle which keeps the (129) waste valve closed the rest of the time. This round muscle we call the sphincter. The waste valve we call the anus.

When you sit down on the toilet, the sphincter muscle relaxes. It becomes soft and flexible and stretches easily. And these waves of muscular contraction in the colon and rectum force the material out. These waves are working on down through your intestines now. And soon after you leave here you will feel the urge to have a bowel movement. When you feel this urge, go to the toilet, sit down and wait. Make no effort. Your body will take care of that part automatically and without effort. Make absolutely no effort. Your body can dispose of its waste material perfectly, if you do not interfere. Make no effort at all. Simply sit on the toilet and wait. The act of sitting on the toilet will be a signal to your unconscious mind. The sphincter mus.cle will relax. The rectum will empty itself easily and automatically.

Every time you eat, your jaws automatically tense and relax. Eating is an automatic signal which starts the entire process in motion. You eat. Your throat swallows the food, alternately relaxing and contracting. The wavelike action proceeds all through your stomach, duodenum and intestines. Soon after eating, you feel the urge to go to the toilet. Soon after eating, you feel the urge to go to the toilet. When you feel the urge, you go. The act of sitting on the toilet is automatically a signal to the sphincter muscle. It relaxes. The muscle relaxes. There is no effort on your part. The whole process is automatic. When you eat, the relaxation starts. Soon after eating, you experience the urge to go to the toilet. You go to the toilet. You go to the toilet immediately when you feel the urge. When you sit on the toilet, that is automatically a signal for the anus to relax and become soft and flexible. Then the rectum automatically empties itself. There is nothing for you to do consciously but go to the toilet when you feel the urge. Alllhe rest happens automatically and naturally. (130)

Shortly after you awaken, you are going to have the urge to go to the toilet. When you have that urge, go. And you will have an easy, natural bowel movement. Every time you eat, it is automatically the start of the process that will bring about an easy, natural, bowel movement. When you have the urge to go to the toilet, go immediately. Your body will take care of the rest. You are going to have a bowel movement shortly after you awaken, and you will have another one after your next meal.

FOR THE PATIENT: Auto-hypnotic formulations can provide a frequent reinfm'cement of the suggestion given by the doctor. The patient who has s1tccessf'nlly responded to the hetero-hypnotic technique printed on the preceding pages, may be given the following suggestion for "homework."

EASY is the symbol for the following suggestion: Every time I eat a meal I start the natural process which ends in an easy, natural bowel movement. When I start to chew and swallow, the alternate waves of relaxation and contraction carryon down through my entire intestinal system. By the time I finish eating, my body is proceeding in a natural and easy way toward a perfect elimination. Eating is the signal for me to have a bowel movement soon after the meal is finished. When I eat breakfast, I arise from the table with the urge to have a bowel movement. When I go to the toilet, the act of sitting on the toilet relaxes the round muscles, and without effort I have an easy natural bowel movement. When I eat lunch, I arise from the table with the urge to have a bowel movement. When I go to the toilet, the act of sitting on the toilet relaxes the round muscles and without effort I have an easy, natural bowel movement. When I eat dinner (or supper), I arise from the table with the urge to have a bowel movement. When I go to the toilet, the act of sitting on the toilet relaxes the round muscles, (131) and without effort I have an easy, natural bowel movement. Every time I have an easy natural bowel movement, it makes the habit stronger. Each time it makes the habit of easy, natural bowel movement stronger.

This whole idea is symbolized by the thought EASY.

INSTRUCTIONS FOR THE PATIENT: Copy this suggestion on a card or paper. Read it to yourself aloud. Hypnotize youself. Test the hypnosis (with an eye catalepsy or hand levitation). Think the symbol once lightly. Let your mind flow in reverie or fantasy for a few minutes while the suggestion is "sinking in." Awaken yourself, much relaxed and refreshed. Give no conscious thought to the suggestion or its meaning except when you a1'e reading it aloud. A void thinking of the suggestion while you are eating or when going to the toilet. Give yourself the suggestion at least once a day, if possible, two or three times daily.

CASE HISTORY: Some of the possibilities of the use of suggestion in correcting gastro-intestinal malfunction are illustrated by the following case. Johnny had never experienced a natural, unaided bowel movement. That portion of his nervous system which should have produced a normal muscular contraction was defective at birth. He suffered from congenital megacolon.

At age 18 months, a sympathectomy was perfonned in an effort to achieve a balance in nervous control of the bowel. This operation was not successful in giving him the ability to move his bowels naturally. His childhood was normal except for the unceasing round of visits to the hospital for (132) colonic irrigation and the constant search for a physician who "might be able to do something."

When he was twelve, his parents heard of Dr. X, who was giving a great deal of attention to the psychosomatic side of medicine. Dr. X combined the usual medical therapies with diets and hypnotherapy. He hypnotized Johnny and gave him strong positive suggestions that the bowels would move naturally. Shortly thereafter, Johnny had his first unaided bowel movement. A program of therapy was then undertaken, and very shortly the hypnotherapy was referred to a psychologist. Johnny continued to receive medication and diet supervision from the busy physician while the psychologist handled the more time-consuming hypnotic re-education. Within three months, Johnny was having three or four natural bowel movements a week. During the first month, he was hypnotized three times a week. Thirty minutes of each trance period were devoted to giving Johnny a "good time." He was given the illusion of participating in airplane flights, etc. (See Chapter XXI on Working with Children.) This was found necessary because in the course of 12 years, Johnny had become slightly "allergic" to doctors' offices. He begrudged the time spent there, which was of course taken from his play-time, rarely from school or chores. After school started, it proved especially difficult to convince Johnny that it was "all worth-while." But the hypnotic analysis of the relationship between physical health, success in sports, and personal popularity gave him the incentive to continue. After six months of therapy, the psychologist suggested to Johnny's father that the reading of a technique might produce effective results if done at home by the father or mother.

Johnny was taught to hypnotize himself. A suggestion was then prepared. Every night at bedtime, Johnny was to hypnotize himself, and his father or mother was to read the suggestion to him. (133) (The word-for-word suggestion given to Johnny follows after the next paragraph.)

A year after the start of the therapy, Johnny was allowed to go to a boy scout camp. He won the medal for excellence in swimming, and in general was one of the outstanding boys. On returning home, he reported that he had had a natural bowel movement every day. At present, he goes to the hospital for a colonic irrigation about every two weeks, and has a natural bowel movement almost every day.

The following is the word-for-word conditioning used with Johnny, whose problem was congenital megacolon. Johnny was tmined to hypnotize himself. The technique was read to him by his father or mother each night when he went to bed.

Please close your eyes, Johnny, and hypnotize yourself. (Wait for eyes to close and the appearance of relaxation.) You are going deeper and deeper to sleep. Deeper and deeper to sleep. As soon as I stop talking to you, you will be sound asleep, sound asleep. You sleep perfectly tonight. You sleep perfectly tonight. If any gas forms, you roll over on your side as Dr. X showed you and get rid of the gas without even awakening. You do this automatically in your sleep. You sleep restfully and peacefully all night long, and tomorrow morning you awaken promptly at (---) o'clock full of pep and energy, all ready to get up and have a wonderful day.

You awaken with a good appetite and enjoy a fine breakfast. Right after breakfast you go to your room and expel the gas if there is any. Every day there is less gas. Soon, there will be no gas, but when there is any, you get rid of it. That makes you full of pep and energy for your day at school. You feel wonderful and at noon you have a good appetite for lunch. Eating lunch automatically starts your bowels working. When you finish lunch you feel that your bowels are all ready to move. You go to the toilet and have (134) a big, healthy, easy, natural bowel movement. You have an easy, natural bowel movement every day right after lunch. You have a bowel movement every day. You have a bowel movement every day. Every time your bowels move, the muscles grow stronger. Every time your bowels move, the muscles grow stronger. The nerves leading to the bowels are growing stronger and stronger. The nerves are growing stronger. Every time your bowels move they grow stronger. Every time your bowels move they grow stronger. Each movement makes the next one easier. Every time your bowels move the next movement comes easier. Your bowels are getting stronger and stronger.

After your bowel movement you feel fine. You feel fine all day. At dinner time you have a good appetite. You eat a good dinner and you thoroughly enjoy it. You enjoy your dinner. You have lots of fun during the evening, and at bedtime you are all ready to have another night of perfect sleep. Now, you are about to go to sleep. As you sleep, your body is growing stronger. The nerves are growing stronger. The muscles are growing stronger. Your bowels are growing strong and perfect, strong and perfect. Your bowels are growing strong and perfect. When I stop talking you will be sound asleep. Don't bother to answer me when I say goodnight. Just go deeper and deeper to sleep. Sleep perfectly until (---) o'clock. Wake up at (---) o'clock feeling full of pep and energy. Sleep perfectly. Good night. Sleep perfectly. Sleep perfectly. Sleep perfectly. (135)