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Comment by kamocyc | Hacker News Reader

The Hypnotherapy is interesting. But the Wikipedia page [1] says "there was insufficient evidence to support its efficacy."

And in the research paper, there are also statements like "the current evidence is limited" [2], "it is unlikely hypnosis will be helpful to all clients" [3] or "the number of patients enrolled in the studies has tended to be low and lacking long-term follow-up" [4].

So, I think for some people Hypnotherapy may work. But it may be risky to pay a lot of money upfront for the therapy.

[1] https://en.wikipedia.org/wiki/Hypnotherapy [2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5786848/ [3] https://www.ncbi.nlm.nih.gov/books/NBK66430/ [4] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2752362/

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The efficacy and amount of evidence definitely varies per condition - I wouldn't say it's a pancea for every health condition and there's more research to be done for sure.

As we build these programs we'll focus on where there is the most evidence and conduct our own research to further back up the work we're doing. Thanks for checking it out!

Can you point us to the conditions for which the strong evidence of efficacy exists?

Isn't it a bit backward to enter an industry when the entire basis of efficacy is highly suspect? You mentioned that the mechanism of action was that hypnotherapy 'focuses people so they are more open to new ideas and perspectives'; how is that supposed to assist in the treatment of IBS?

I second the request, and consider a lack of answer to be somewhat damning.

For the most part I feel that the 'general' HN toward various forms of therapy is often a bit too harsh. If research indicates that an approach works for 'some types of cases', HN comments often criticize it for not working across the board. Or a lack of overwhelming evidence is considered enough reason to reject the whole thing.

My personal 'minimum' is that there should be some evidence, that isn't too shoddy, that an approach works.

If that minimum isn't met and if users can try an approach for free (like this app?), I feel the placebo effect makes it too easy for people to end up paying anyways, and that makes the product all but snake-oil.

An app like that will always have to generalize, thus limiting its efficacy to either light or very specific cases. That's why I'm interested to see how they can manage to personalize their offering.

The subscription model however seems counterproductive - the business side wants to continue subscriptions as long as possible while the stated goal is to solve a problem thus minimizing subscriptions. I wonder if a 'pay it forward' model would work. So that if it was effective for you, you could pay for a month of a stranger's subscription.

> An app like that will always have to generalize, thus limiting its efficacy to either light or very specific cases.

Very specific cases was what I meant. Focusing on those for which there is evidence.

Yep this is our exact aim! I've responded with some of the studies above, if you have any questions about the studies or areas, I'd be more than happy to speak about them.

If it were strongly effective in treating any one of those use cases then the app would be an absolute hit! They have, so far, declined my invitation to provide evidence. It seems like a relatively simple concept to test in a double blind study.

Sorry about the delay, we're based in Melbourne, Australia so time zones are an issue. The two most researched areas include IBS and Chronic Pain, which is why they're the first focuses for us.

Here are some studies on IBS using hypnotherapy: - https://onlinelibrary.wiley.com/doi/full/10.1111/apt.13706 (the study we're based off) - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1773844/ (5 year effects showed) - https://pubmed.ncbi.nlm.nih.gov/25736234/ (1000 patients, 76% responding) - https://pubmed.ncbi.nlm.nih.gov/24840368/ (meta analysis of IBS hypnotherapy studies)

In terms of how hypnotherapy works for IBS, the exact mechanism isn't known. It's been shown to help with reducing visceral hypersensitivity and improving intestinal motility, thought to be due to utilising the gut-brain connection.

And for pain management: - https://www.semanticscholar.org/paper/Controlled-trial-of-hy... (fibromalgia) - https://pubmed.ncbi.nlm.nih.gov/16025734/ (disability related pain) - https://pubmed.ncbi.nlm.nih.gov/19459087/ (low-back pain)

There's also more research into other areas including: erectile disfunction, exam anxiety, depression, etc.

The harder part with a double blind study is developing the placebo side, since from a patients perspective it's very easy to know if you're getting the psychological treatment (hypnotherapy) or not. It's possible using a sham treatment or something similar, or using a waitlist or active control.

Yeah we're actively trying not to generalize,which was a big reason we split the IBS program into its own product (Nerva). We plan on continuing the issue-specific product development rather than building a broad app including all issues.

Interesting idea - I'll see if there's a way we could implement this. We've definitely tried to align ourselves with building an effective program, if you pay through the website and don't see an improvement in symptoms after the program, you can get a full refund.

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