An AuDHD review of the Nerva gut-directed hypnotherapy program for IBS

Many neurodivergent people have symptoms of IBS – Irritable Bowel Syndrome. There may be lots of reasons for this, but a common reason that you may not know is the gut-mind connection.

What is the gut-mind connection?

When our bodies enter a sympathetic autonomic nervous system response (also known as fight-or-flight), blood is diverted away from the digestive system to your extremities, where your body needs it most to fight or run away from the threat. This alters how your digestive system works by slowing it or making it faster until you are no longer in a sympathetic response.

This isn’t really a big deal when you are in sympathetic every once in a while, but neurodivergent people tend to spend a lot of time in sympathetic because the world is one big threat to a neurodivergent nervous system! So, our digestion tends to be affected by this and consequently we end up with symptoms of IBS including constipation/diarrhea, bloating, gas, heartburn, acid reflux, stomach pains, and more.

How does gut-directed hypnotherapy work?

When IBS happens, the gut tends to be hypersensitive to small changes that people without a hypersensitive gut wouldn’t notice. This hypersensitivity puts us in a loop of feeling an uncomfortable IBS symptom, getting worried about it, which then makes the symptom stronger because the worry engages the sympathetic response which makes digestion unstable, and repeat.

The parasympathetic part of the autonomic nervous system is also called the rest-and-digest system because it engages natural and neutral digestive processes. Gut-directed hypnotherapy engages the parasympathetic to give the body a break from constant fight-or-flight and allow the digestive system to experience what healthy, normal digestion feels like. This can actually re-train your brain and your gut to have less gut hypersensitivity and more normal digestive processes.

What about the Low FODMAP Diet?

The Low FODMAP Diet is generally what doctors will recommend for those with IBS to reduce symptoms. It involves an elimination phase where you stop eating FODMAP foods (ones that have short-chain carbohydrates that tend to trigger gut fermentation that is associated with IBS symptoms), then a reintroduction of these foods to rule out which ones are causing problems for the individual.

While this diet has been shown to be effective for about 86% of people, it’s important to remember that this research is not autism-specific. While the Low FODMAP Diet may be effective for Autistics too, the elimination phase may be difficult for those of us who already have limited foods we can eat due to sensory needs and/or preferences. Particularly if you are someone who has experienced disordered eating, cutting foods out of your diet may not be advisable, and doing so may cause increased anxiety and fight-or-flight which then deepens your gut issues instead of solving them!

How effective is gut-directed hypnotherapy?

Gut-directed hypnotherapy has been shown in research to be comparable to the Low FODMAP Diet, with about 80% of people seeing significant improvement in their IBS symptoms. 

What is the Nerva program like?

Nerva is an app-based gut-directed hypnotherapy program so you can download it on the Apple Store or Google Play by searching “Nerva.” It is a 6-week program that includes (ideally) daily hypnotherapy sessions of about 15-20 minutes each, a short informational article that teaches you about different aspects of the gut-brain connection, and deep breathing exercises. The program lasts for six weeks, and you can continue it for as long as you’d like afterwards for maintenance (although the original fee only covers a one-year subscription). There is a 7-day free trial so you can see what it is like before you have to pay (as of July 31, 2024 the yearly subscription costs $199 USD).

Each hypnotherapy session includes a relaxation exercise (such as tense-and-release or sensory grounding), guided visualizations, and affirmations. The visualizations are kind of like listening to a story and imagining what is happening, so if you are someone that has aphantasia, it may be like listening to someone read a story to you without the imagination aspect – that’s okay, it is likely to still work since it is working on your sub-conscious. Hypnotherapy is much different than entertainment hypnosis – you just feel deeply relaxed but are still very much in control. I like to describe it as a tool that helps get your conscious and sub-conscious onto the same page.

My review

Let me first give the caveat that I am only one AuDHDer – others may have different experiences! I am also hyperphantasic meaning that I have a strong ability to visualize in my mind and I generally enjoy guided visualizations. I don’t find it difficult to sit still for them.

I listened to Nerva almost every evening before bed using headphones – I found that helped me focus solely on the voice so that I could cut out other distractions and get deeper into a hypnotic parasympathetic state. I chose before bed because it helped me stack my habits – adding on listening to Nerva with an already expected time of pre-bedtime routines. This helped me remember to do it!

During the hypnotherapy sessions I found that I was able to become very relaxed, and when they ended, I felt refreshed and calm. I honestly didn’t do the deep breathing exercises – they just weren’t for me. Nerva says that most people see results about 4-6 weeks into the program. I found I saw results more around the 3-week mark, but they deepened during those last three weeks.

Pre-Nerva I had been experiencing lots of IBS symptoms – gas, bloating, and more, and they were making life sub-optimal. After completing Nerva, my IBS symptoms have been greatly reduced. I still get some symptoms, but Nerva helped me re-train my brain to see those as normal, like little hiccups in my gut homeostasis that happen but are not really a problem. I also just feel calmer and more parasympathetic in general.

One of the biggest surprises after Nerva is that I no longer react to dairy. I have been lactose intolerant for as long as I can remember, but it comes and goes in intensity. I never made the connection before that this may have something to do with where my stress levels are at! I now don’t react to dairy at all, which is honestly so weird since it’s something I’ve just been used to being a problem.

It’s been 14 weeks since I started Nerva, and my gut health is still feeling soooo much better than it was! I have been continuing to listen to it before bed each night as a way to help me fall asleep since it is calming and because I had stacked the habit of doing it before bed so I’ve just continued with that. Nerva has research showing that the results of doing the program last at least two years afterwards so fingers crossed this is true!

What didn’t Nerva fix? It didn’t take away all of my gastro issues – I still get some minor discomfort from time to time. It also didn’t take away my gluten intolerance. However, even with these limitations, I would wholeheartedly recommend it!

Some tips for if you try Nerva:

• Listen with headphones on
• Make sure you are in a space without distractions as distractions keep you out of going fully parasympathetic
• Choose a time each day to listen as the more days you listen the more likely it is to work for you – make it part of your routine (try stacking habits)
• Read the accompanying informational articles – they do contain info that will help make Nerva more effective
• Do the deep breathing exercises if you like them – if not, skip them
• You don’t need to listen to it more than once a day – this actually doesn’t make it work faster
• Give yourself grace if you miss a day – just get back to it the next day
• If you find it hard to sit or lie still and listen to it, try going for a walk and listening – you may not get as much parasympathetic activation, but it is likely to still help!

So that is my review of Nerva as an Autistic-ADHDer. It worked for me, so maybe it will work for you too! I sure hope it does!