
Launch HN: Mindset Health (YC S19) – Hypnotherapy apps for chronic conditions - alexnaoumidis
Hey HN!<p>We&#x27;re Alex &amp; Chris, brothers from Melbourne, Australia, and the founders of Mindset Health (<a href="https:&#x2F;&#x2F;www.mindsethealth.com" rel="nofollow">https:&#x2F;&#x2F;www.mindsethealth.com</a>). We create mobile apps to help people manage chronic health conditions at home. Our programs use hypnosis-based techniques, developed by clinicians, to help people manage conditions like anxiety, depression &amp; Irritable Bowel Syndrome (IBS).<p>Mindset Health came out of a difficult period after Chris and I wound down our first startup. During this time, we experienced a lot of anxiety and stress. I ended up being prescribed anti-anxiety medication, but the side effects and the lack of control I felt caused me to look for non-pharmacological options, like CBT and biofeedback.<p>Someone we trusted recommended hypnotherapy. Chris and I were skeptical about hypnosis (the &#x27;being made to cluck like a chicken&#x27; reputation), but after coming around to the benefits of meditation a couple of years before, we were open enough to say we&#x27;d look more into the science. We ended up spending a few weeks diving deep into the hypnosis research and were surprised at what we found. Since many HN readers are probably as skeptical as we were, we&#x27;re going to saturate the rest of this post with references. Hopefully not too many!<p>Contrary to stereotypes of stage shows with outlandish mind control stunts, hypnosis simply involves becoming focused enough to become more receptive to new ideas or perspectives. Turns out that not only can this help with areas like smoking cessation [1], but conditions like anxiety [2], depression [3], IBS [4], sleep issues [5] and chronic pain [6] can be improved using hypnosis-based treatments. Like many topics in neuroscience, the mechanisms behind hypnosis are still being explored, but a 2016 brain scan study by the Stanford School of Medicine identified changes in brain activity related to absorption, executive control, and awareness [7] which is thought to create a more effective context for the delivery of therapeutic techniques like CBT [8].<p>It took some time but we decided to look into booking sessions with local &#x27;hypnotherapists&#x27; to try it for ourselves. However, many of the people we came across weren&#x27;t psychologists or qualified practitioners, and most of this wasn&#x27;t covered by insurance. So we switched to trying pre-recorded sessions from a well-regarded psychologist who practices hypnosis. Those sessions were deeply relaxing and absorbing. Through using them I was able to learn coping skills helped me stop taking my anxiety medication.<p>This experience gave Chris and me an idea: could we help more people access hypnotherapy by removing the stigma and barriers to trying it? Calm and Headspace had succeeded at doing so for meditation. Similarly to how meditation has become a powerful self-care habit for a healthy mind, perhaps hypnotherapy could become a tool for self-managing chronic health conditions.<p>Chronic and mental health conditions account for a massive portion of the global healthcare cost (80–90% of the $3.5 trillion annual healthcare spend in the United States [9,10]). For many of these conditions, treatment is more about managing symptoms than &#x27;curing&#x27; the condition, meaning that patients are reliant on drugs, surgeries, and&#x2F;or restrictive diets for long periods of their life - with all of the cost and side effects involved.<p>We decided to make our idea into reality, and began Mindset Health with the intention of helping people with these conditions strengthen their self-regulation skills and reduce reliance on pharmacological interventions. We currently have two apps that use hypnotherapy to help people manage health conditions (with more on the way, including chronic pain and smoking cessation).<p>The first app is called Mindset (<a href="https:&#x2F;&#x2F;www.mindsethealth.com&#x2F;mindset" rel="nofollow">https:&#x2F;&#x2F;www.mindsethealth.com&#x2F;mindset</a>), which is based on the work of Dr Michael Yapko, an expert in the clinical uses of hypnosis (he literally wrote the textbook) [11]. It involves a series of hypnosis-based audio sessions that teach coping skills that can help manage anxiety and depression. Each hypnotherapy session dives into a specific thought pattern or life challenge and helps you improve by teaching you new skills and perspectives.<p>The second app, Nerva (<a href="https:&#x2F;&#x2F;www.mindsethealth.com&#x2F;nerva" rel="nofollow">https:&#x2F;&#x2F;www.mindsethealth.com&#x2F;nerva</a>), is designed for users with Irritable Bowel Syndrome (a condition affecting 10-15% of the population, so 33-49 million Americans). It&#x27;s based on the work of Dr Simone Peters, who led a randomized controlled trial that deployed a 6-week gut-directed hypnotherapy program; this approach was shown to help 71% of participants improve their symptoms by a clinically significant amount [12]. Nerva delivers this 6-week hypnotherapy approach (audio sessions that use visualization and suggestion to improve self-regulation skills, as well as sychoeducation and breathing exercises), plus a maintenance plan to help users to build on their progress.<p>From past discussions, including the recent HN thread at <a href="https:&#x2F;&#x2F;news.ycombinator.com&#x2F;item?id=23410690" rel="nofollow">https:&#x2F;&#x2F;news.ycombinator.com&#x2F;item?id=23410690</a>, we know that the topic of hypnosis can bring up a lot of understandable skepticism. That&#x27;s why we&#x27;ve included so many links below. We&#x27;re also happy to talk about it. We&#x27;ve been there ourselves, so please feel free to be skeptical, ask questions, and share your experiences in this area. We want to hear them! And if there&#x27;s anything you want to say that isn&#x27;t right for a public forum, you&#x27;re welcome to email us at founders@mindsethealth.com as well.<p>[1] <a href="https:&#x2F;&#x2F;pubmed.ncbi.nlm.nih.gov&#x2F;18569754&#x2F;" rel="nofollow">https:&#x2F;&#x2F;pubmed.ncbi.nlm.nih.gov&#x2F;18569754&#x2F;</a><p>[2] <a href="https:&#x2F;&#x2F;www.tandfonline.com&#x2F;doi&#x2F;abs&#x2F;10.1080&#x2F;00207144.2019.1613863?journalCode=nhyp20" rel="nofollow">https:&#x2F;&#x2F;www.tandfonline.com&#x2F;doi&#x2F;abs&#x2F;10.1080&#x2F;00207144.2019.16...</a><p>[3] <a href="https:&#x2F;&#x2F;www.tandfonline.com&#x2F;doi&#x2F;abs&#x2F;10.1080&#x2F;00207140601177897" rel="nofollow">https:&#x2F;&#x2F;www.tandfonline.com&#x2F;doi&#x2F;abs&#x2F;10.1080&#x2F;0020714060117789...</a><p>[4] <a href="https:&#x2F;&#x2F;pubmed.ncbi.nlm.nih.gov&#x2F;25736234&#x2F;" rel="nofollow">https:&#x2F;&#x2F;pubmed.ncbi.nlm.nih.gov&#x2F;25736234&#x2F;</a><p>[5] <a href="https:&#x2F;&#x2F;www.ncbi.nlm.nih.gov&#x2F;pmc&#x2F;articles&#x2F;PMC5786848&#x2F;" rel="nofollow">https:&#x2F;&#x2F;www.ncbi.nlm.nih.gov&#x2F;pmc&#x2F;articles&#x2F;PMC5786848&#x2F;</a><p>[6] <a href="https:&#x2F;&#x2F;www.ncbi.nlm.nih.gov&#x2F;pmc&#x2F;articles&#x2F;PMC2752362&#x2F;" rel="nofollow">https:&#x2F;&#x2F;www.ncbi.nlm.nih.gov&#x2F;pmc&#x2F;articles&#x2F;PMC2752362&#x2F;</a><p>[7] <a href="http:&#x2F;&#x2F;med.stanford.edu&#x2F;news&#x2F;all-news&#x2F;2016&#x2F;07&#x2F;study-identifies-brain-areas-altered-during-hypnotic-trances.html" rel="nofollow">http:&#x2F;&#x2F;med.stanford.edu&#x2F;news&#x2F;all-news&#x2F;2016&#x2F;07&#x2F;study-identifi...</a><p>[8] <a href="https:&#x2F;&#x2F;www.ncbi.nlm.nih.gov&#x2F;books&#x2F;NBK66430&#x2F;" rel="nofollow">https:&#x2F;&#x2F;www.ncbi.nlm.nih.gov&#x2F;books&#x2F;NBK66430&#x2F;</a><p>[9] <a href="https:&#x2F;&#x2F;www.rand.org&#x2F;content&#x2F;dam&#x2F;rand&#x2F;pubs&#x2F;tools&#x2F;TL200&#x2F;TL221&#x2F;RAND_TL221.pdf" rel="nofollow">https:&#x2F;&#x2F;www.rand.org&#x2F;content&#x2F;dam&#x2F;rand&#x2F;pubs&#x2F;tools&#x2F;TL200&#x2F;TL221...</a><p>[10] <a href="https:&#x2F;&#x2F;www.cms.gov&#x2F;Research-Statistics-Data-and-Systems&#x2F;Statistics-Trends-and-Reports&#x2F;NationalHealthExpendData&#x2F;Downloads&#x2F;highlights.pdf" rel="nofollow">https:&#x2F;&#x2F;www.cms.gov&#x2F;Research-Statistics-Data-and-Systems&#x2F;Sta...</a>).<p>[11] <a href="https:&#x2F;&#x2F;en.wikipedia.org&#x2F;wiki&#x2F;Michael_D._Yapko" rel="nofollow">https:&#x2F;&#x2F;en.wikipedia.org&#x2F;wiki&#x2F;Michael_D._Yapko</a><p>[12] <a href="https:&#x2F;&#x2F;onlinelibrary.wiley.com&#x2F;doi&#x2F;10.1111&#x2F;apt.13706" rel="nofollow">https:&#x2F;&#x2F;onlinelibrary.wiley.com&#x2F;doi&#x2F;10.1111&#x2F;apt.13706</a>
======
kamocyc
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](https://en.wikipedia.org/wiki/Hypnotherapy)
[2]
[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5786848/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5786848/)
[3]
[https://www.ncbi.nlm.nih.gov/books/NBK66430/](https://www.ncbi.nlm.nih.gov/books/NBK66430/)
[4]
[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2752362/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2752362/)

~~~
alexnaoumidis
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!

~~~
scoopertrooper
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?

~~~
mercer
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.

~~~
spython
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.

~~~
scoopertrooper
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.

~~~
chrisnaoumidis
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](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/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1773844/)
(5 year effects showed) \-
[https://pubmed.ncbi.nlm.nih.gov/25736234/](https://pubmed.ncbi.nlm.nih.gov/25736234/)
(1000 patients, 76% responding) \-
[https://pubmed.ncbi.nlm.nih.gov/24840368/](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...](https://www.semanticscholar.org/paper/Controlled-trial-of-
hypnotherapy-in-the-treatment-Haanen-
Hoenderdos/5614d22c1e50713ad316aec4044f8cab5931a448) (fibromalgia) \-
[https://pubmed.ncbi.nlm.nih.gov/16025734/](https://pubmed.ncbi.nlm.nih.gov/16025734/)
(disability related pain) \-
[https://pubmed.ncbi.nlm.nih.gov/19459087/](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.

------
spython
I've had good experiences with hypnotherapy, the most effective being a self-
recorded audio. I took a more or less standard hypnotherapy text from Brian
Alman and Peter T. Lambrou's book and adapted it to my needs. Experiencing my
past self wishing me well, encouraging me, calming me was quite a bit more
powerful and trustworthy than any abstract 'radio voice'.

Well worth the time to try and record it yourself, for yourself.

~~~
alexnaoumidis
That’s really cool, its taking self-hypnosis to the next level. I personally
dislike hearing the sound of my own voice haha but glad to hear you’re finding
it helpful.

~~~
spython
Haha, yes, I took a few tries to get the tone of the voice quite right. Maybe
something for to explore in future releases of your app? A guided, self-
created hypnotherapy session. Could take away the fear of and resistance to
'losing control' that many experience when the idea of being subjected to
hypnosis comes up.

~~~
alexnaoumidis
Yeah I think it’s a great idea - we’re really interested in expanding the
level of personalisation our programs provide and this could be a feature.
Definitely, it’s harder to fear losing control when it’s your own voice.

------
libra1
I started using the Mindset app the last time I read about it on HN, maybe a
month or so ago. I've found it to be very useful--in addition to therapy,
meditation and self-help videos on YouTube--in helping me fight some
depression, low self-esteem and guilt that I've been trying to resolve. I hope
that your app catches on and more people realize that "focusing sessions" can
help them detach from work, social media, and their own toxic thoughts about
themselves.

Two pieces of feedback for you though. First, once someone does a program, it
seems that there are unlimited "reinforcement stages" where you repeat the
program again to reinforce the learnings. It would be nice to cap the
reinforcement stages at say, 3 stages, to encourage users to feel a sense of
completion and either try the other programs or just repeat the whole program
again. Second, I think a program centered around facing one's past would be
really useful--at least, I'd use it. Other than that, I think the app is
really well done, and congratulations to you and Michael Yapko on your hard
work.

~~~
alexnaoumidis
Awesome, glad to hear you've found it so useful!

Yeah that's a great idea! I guess our thinking regarding the stages was to
allow further progression if people wanted to keep listening longer than say 3
stages but allowing people to redo the entire program would accomplish the
same while also allowing for that 'completion' feeling.

Thanks for the suggestion! We'll bring the idea up to Dr Yapko around
developing some sessions for it.

------
minibronco88
This is great, guys! I have IBS, and there's always been a lack of research-
backed options for alleviating symptoms besides the low-FODMAP diet. I
actually have a friend who has tried this program and has had tremendous
results, and it's cool to see that there's another app for broader purposes.
Wishing you guys luck!

~~~
internet_user
Some say fecal transplants are also great (for many things including IBS), is
that true from your research?

~~~
alexnaoumidis
Fecal transplants are not currently an approved treatment for IBS but there
has been some recent research indicating it could potentially be helpful in
some cases: [https://www.jwatch.org/na50649/2020/01/09/fecal-
microbiota-t...](https://www.jwatch.org/na50649/2020/01/09/fecal-microbiota-
transplantation-irritable-bowel-syndrome)

------
graeme
Very interesting. I’ve had promising initial results with hypnotherapy for
bruxism, though I need to go a few more night doing hypnosis while tracking
bruxism to see.

~~~
chrisnaoumidis
That's great to hear. It's actually one of the areas we're looking at building
a product into due to the effectiveness of hypnotherapy with it.

~~~
graeme
I’m going to try the ibs version, as I have that too. Have tried low fodmap
before incidentally, it helped.

~~~
chrisnaoumidis
I hope you enjoy and see results from the program - I'd love to hear your
feedback and thoughts.

------
achow
Why not on Android?

Particularly considering that these apps most probably only plays and controls
audio files, a single codebase for both the platform would have been easy to
consider.

~~~
alexnaoumidis
Initially when we developed Mindset we could only program in Swift so Mindset
was built for iOS only.

We are now moving to React Native so should be getting Mindset out on Android
soon. Ideally we want to have a single codebase for all of our apps.

------
throwaw4y-plate
The lack of skepticism here is genuinely surprising.

~~~
tomhoward
Surprising in a good way or a bad way?

They've provided a lot of peer-reviewed research, which makes it difficult to
hold the skeptical line.

~~~
angrais
What's with HN folk these days thinking peer-reviewed research is some
infallible process that results in groundbreaking, objective research?

You should absolutely be skeptical of ALL research. A responsibility of other
researchers is to evaluate the methods used and claims made in papers. The
peer review journal is not a perfect process and nor are research processes
more generally.

Most research cannot be reproduced ... So be skeptical of any and all claims
made! (i.e. the reproducibility crisis)

The research they linked does not provide evidence for hypnotherapy as an
effective solution, and itself states it as needing more research. See the top
comment above.

~~~
tomhoward
Funnily enough I'm normally the one casting doubt on medical science research
on HN. So, I somewhat agree with you, though my issue with the mainstream
academic funding and peer review system is that it too often sidelines
research that may be promising but may threaten the status quo and its
beneficiaries (most commonly pharmaceutical companies), or cannot attract
sufficient funding because it offers no path to large profits.

With that said, it's the best system we currently have, and where someone
doubts the validity of the results of an accepted study, the onus is on them
to explain why they should be questioned.

> The research they linked does not provide evidence for hypnotherapy as an
> effective solution, and itself states it as needing more research. See the
> top comment above.

Wikipedia is a notoriously unreliable and biased source of information on
medical topics even slightly outside the establishment, and those statements
mentioned in that top comment do not disprove efficacy, just point to the need
for more research, which is always true for this field.

> So, I think for some people Hypnotherapy may work.

Great! So do I. No treatment like this works for 100% of people who try it,
but for those for whom it does work, we should be very pleased.

> But it may be risky to pay a lot of money upfront for the therapy.

That's why this company's apps are great; they cost very little, compared to
1:1 professional hypnotherapy or other forms of therapy, and are paid monthly
or quarterly and can be discontinued any time. There's even a 7-day free trial
and a money-back guarantee if you pay via their website.

------
pedalpete
Congrats guys!

My parents sent me to a hypnotherapist when I was a kid for treatment of
insomnia. Unfortunately, it didn't help, but it was an amazing experience.

We're just up the road in Sydney, and working on some sleep tech. I'd be keen
to hear about your experience at YC as an alternative therapies company.

------
tomhoward
Great stuff guys.

I’ve had a look at some of the research papers but didn’t find any detail on
these questions:

\- Aside from direct physiological response to the hypnosis, is there also
evidence of efficacy due through changes in behavior? I.e., greater adherence
to diets or other lifestyle changes? I note that some of negative comments in
this thread focuses on efficacy relative to diets like low FODMAP, but I can
imagine these approaches could be complementary rather that dichotomous.

\- Is much known about why it works on a psychophysiological level? I.e., a
reduction in cortisol changes the way the digestive system functions, or a
change in one’s beliefs about their place in the world leads to a change in
the way certain food ingredients are rejected vs accepted by the body?

~~~
alexnaoumidis
Thanks!

There hasn't been any research that I've found around increasing adherance to
diets but it makes logical sense. If hypnosis amplifies CBT and increases the
ability to learn then it make sense that it would help changing the attitudes
and perceptions around behavior.

For IBS specifically, it's thought to work on the gut-brain axis by improving
motility (i.e. the speed of transit of food through the digestive tract) and
reducing gut sensitivity (a large portion of IBS patients have visceral
hypnersensitivity). It has also been shown to improve psychological
functioning by reducing levels of stress, anxiety and depression which often
act as IBS triggers and worsen symptoms.

------
LionBlack8
I've heard good things about gut-directed hypnotherapy from my gastro. I'll
download it and see how it goes! Low FODMAP has helped me in the past but it's
just way too restrictive - if this app can actually get me the same results
without changing what i can eat then i'm sold. I also find this resource
[https://www.canadadrugsdirect.com/](https://www.canadadrugsdirect.com/)
helpful for health

------
phnofive
The comparatively effective treatment for IBS was essentially a taped
hypnotherapy session - is the rest of the Nerva platform undergoing review?
Will you discourage users who’ve used FODMAP, even inadvertently, from signing
up?

~~~
alexnaoumidis
Great question! The approach used in the study also used psychoeducation and
breathing exercises as well and we’re in the early stages of an observational
study into the Nerva program. What do you mean re discouraging users who’ve
tried FODMAP?

~~~
graeme
I read their comment as perhaps meaning that the study showed fodmap +
hypnotherapy was no more effective than fodmap + hypnotherapy. A result I
found surprising. (Unless it means the problem was effectively solved in both
case, so no more improvement was possible)

~~~
alexnaoumidis
Ahhh I understand - that’s a good point. Many people follow the low FODMAP
diet without the direction of a dietitian (against the recommendation on how
to do it) and likely aren’t getting the full result so GDH will still provide
benefit, as well as helping the psychological side of IBS.

Interestingly, it’s possible they both help with visceral hypersensitivity -
FODMAPs ferment in your gut causing gas and your gut to expand and
hypersensitive nerves could then be alerting the brain to potential (but
false) danger, so by avoid FODMAPs you avoid this process. Hypnotherapy could
potentially be coming at the same process but from the top down instead.

~~~
graeme
Do you have a link to the studies on ibs being caused by hypersensitive
nerves? Just going through onboarding in the app and was curious about that.

~~~
alexnaoumidis
Yeah, no worries you can read a study about the role of visceral
hypersensitivity in IBS here:
[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5056566/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5056566/)

------
achow
Since you have done extensive research in this field - are there any
hypnotherapy 'solutions' for overcoming fear of Public Speaking? Is it in
realm of possibility at all?

~~~
alexnaoumidis
It's definitely within the realm of possibility! There's been a lot of
research in hypnosis for state anxity (i.e. before a test) so I think it makes
logical sense that it would help with the fear of public speaking.

On the anecodtoal I know someone who has had significant success using
hypnotherapy for public speaking.

Definitely worth exploring.

------
tomComb
Do you have an Android version of Mindset?

If not, can you point us to the "pre-recorded sessions from a well-regarded
psychologist who practices hypnosis" that worked for you (or similar)?

~~~
alexnaoumidis
We're working on it! Until then you can listen to some of Dr Yapko's sessions
on his website here: [https://yapko.com/audio/](https://yapko.com/audio/)

~~~
tomComb
Great, thanks.

------
imtavi
I'm curious to try this out, but I can't justify spending $97 for Nerva
without any kind of trial period. A promise of a full refund isn't enough,
unfortunately.

~~~
alexnaoumidis
I'd love to learn more about that as we though the money-back guarantee would
help assuage hesitation around trying the program - why doesn't it?

If you do want a free trial the mobile app store subscription has a free trial
but doesn't come with a money-back guarantee (Apple's control).

In your view, what's more compelling - a free trial or money-back guarantee?

~~~
imtavi
A money-back guarantee isn't compelling for me, for several reasons. First, I
know that I would feel guilty asking for money back, and I want to avoid being
in that situation. Second, I don't fully trust money-back guarantees. Third,
that's ~$100 that I need to part with when I might see within 1 hour that the
product is not a fit.

A free trial would be far more compelling.

FYI I'd be using this on Android.

~~~
alexnaoumidis
Thanks for this feedback, it's really helpful! it's something we're thinking a
lot about atm so this is great.

If you're interested, you can download the app from the Play Store and try the
program with a 7-day free trial. Let us know what you think.

------
TACIXAT
I believe the IBS product is dangerous. There are foods I cannot digest
because my gut has been damaged from celiac disease (high fructose foods).
Even if Nerva is effective at treating IBS (perhaps, especially if it is
effective) that would be treating a symptom for an underlying disease while
maintaining the activity that damages your body.

I am incredibly grateful I never heard about this before trying an elimination
diet. The simple fact is that if I pursued and did not also restrict my diet I
would be destroying my body and likely end up sicker than I was before. If you
have IBS please pursue a real diagnosis and treat or manage any underlying
conditions.

~~~
alexnaoumidis
As someone with Celiac disease I know where you’re coming from but you’re
conflating two different conditions.

Celiac disease occurs when your immune system damages your stomach lining in
response to eating gluten. It’s why a strict gluten free diet is required.
Many gluten contain foods also contain FODMAPs but that’s not what’s causing
the immune response.

IBS on the other hand is a functional condition which means it’s problem with
how the gut works but doesn’t lead to any damage of the gut/stomach lining.
Instead, it’s thought that visceral hypersensitivity could be at play, where
the nerves in the gut are overreacting to the gas and expansion caused by the
fermentation of FODMAPs. By avoiding FODMAPs you limit this process and reduce
symptoms - it’s thought that GDH helps with this process from the top-down and
that’s potentially why the Monash study (creators of the Low FODMAP diet)
found the response rate was so similar between the two treatment groups.

~~~
TACIXAT
People with celiac often have IBS and are often misdiagnosed with IBS. [1]
They are not disjoint problems and often difficult to differentiate. It seems
really reckless to offer this as a treatment without requiring people to
consult a physician for a proper diagnosis.

1\. [https://www.beyondceliac.org/celiac-disease/related-
conditio...](https://www.beyondceliac.org/celiac-disease/related-
conditions/irritable-bowel-syndrome/)

~~~
alexnaoumidis
Nerva is for people have been diagnosed with IBS, not for people who have
self-diagnosed themselves. I definitely agree, many conditions present similar
symptoms like IBD, celiac disease etc so it’s important people are properly
diagnosed before attempting any management options including the low FODMAP
diet and GDH.

Nerva isn’t a treatment, it’s a program that teaches people self-regulation
skills and relaxation exercises that can help them self-manage their symptoms.

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forgot_user1234
Marvelous. Thanks for providing the links. I will try it out.

~~~
chrisnaoumidis
No worries! I'm interested to hear your thoughts after you do.

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Daiimi05
Cool

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gnicholas
Kind of weird that there's a review for the IBS app on the Mindset page. Also,
when you tout what percent of reviews is 5-star, that actually made a flag go
up in my mind. Reviews are notoriously easy to game, and app devs don't
usually brag about reviews for this reason.

~~~
alexnaoumidis
We actually had our IBS program within Mindset when we first launched it
before we spun it out into it's own standalone app.

Interesting feedback! It's just one element of social proof, the written
reviews are more valuable 100% as I would imagine their much harder to game.
What social proof would be better in your opinion?

~~~
gnicholas
Thanks for responding! Makes sense about the IBS reference where it is, but
presumably this can be replaced by a more current quote in time.

Regarding reviews, I think people are pretty jaded about this. Most of my
startup friends whose apps had good reviews had gamed the system. App reviews
are more meaningful for established companies like Box or Dropbox. In that
case, you already know what the company does and you're just getting a rating
of how well the mobile app of that company works. That is, if Dropbox had 2
stars and Box had 5, you'd figure probably something is better about Box.

But when it's some rando new company, the scale of reviews is so small that it
could be 95% the founder and their friends/family. If there were a way to show
what reviews were paid subscribers, that would be much more valuable. Sort of
like Amazon's Verified Purchaser reviews. Still possible to game, but it would
require the company to launder money through Apple (and lose 30% along the
way).

~~~
alexnaoumidis
Oooh good catch! We just uploaded the App Store reviews to our site but can
just take out that one - cheers!

Yeah that's fair enough, imo I would think it's difficult to game 400+
ratings/reviews from friends and family but I can see where you're coming
from.

I'm surprised Apple/Google don't do that - it's beneficial for both the user
and us as a business. We could always do it for reviews on our site but it
could always be gamed when it's not held accountable with a third-party like
with Amazon reviews.

