IBS & Psychotherapy

IBS & Psychotherapy

The Tummy Clinic | September 19th, 2022

For those distressed by IBS, psychotherapy can offer several valuable benefits

Irritable bowel syndrome, or IBS, is a group of symptoms affecting the digestive system. It is a fairly common though uncomfortable gastrointestinal disorder. People with IBS get excessive gas, abdominal pain, and cramps. A disorder of the gut-brain interaction, IBS causes the digestive tract to be very sensitive. It also changes how our bowel muscles contract, resulting in abdominal pain, diarrhoea and constipation.

Managing IBS

It can be challenging to cope with IBS symptoms. Managing IBS can be broadly divided into two parts – consulting a registered dietician to monitor diet and eliminate foods that could trigger your symptoms; and stress management, which can include counselling with a registered psychologist.

The Gut-Brain Connection

Often, our thoughts and fears can trigger a pattern of distress which can actually make IBS symptoms worse. Our stress, negative thoughts, and experiences can also impact the ability of our gut to function. The vagus nerve is one of the biggest nerves connecting our gut and brain. It sends signals in both directions. It is found that stress inhibits the signals sent through the vagus nerve and also causes gastrointestinal problems. As living creatures, we are programmed to look for threat, in order to avoid pain and prevent harm. When experiencing IBS symptoms, the gut suddenly sends signals to the brain signalling distress. The brain anticipates a threat, and looks for ways to predict and avoid danger. As we have feelings of discomfort, the mind engages the sympathetic nervous system, triggering the fight or flight response. When this system is activated regularly, the body moves into survival mode more often and gut irritation is increased. Our gut also impacts our mood, with the feeling of being unwell bringing on feelings of depression or anxiety.

How Psychotherapy Helps

Combined with medical and dietary support, psychotherapy can help in learning skills in stress management. It can help grow and empower us to manage IBS symptoms more confidently and with self-compassion. A psychologist can help us safely and compassionately explore our fears and reactionary responses, helping build strength in regulation.

Role of Therapy

Therapy helps us identify the stressors in our life. These stressors could be external, internal, past experiences, automatic thoughts, or fears about the future. With therapy, we can learn to train the brain to respond calmly instead of fearfully. As psychotherapy helps us explore difficult emotions, stress and discomfort, we learn to treat ourselves with self-compassion and patience. Rather than being harsh with ourselves or pushing away our feelings, we learn to slowly take care of our body and comfort it.

Cognitive Behavioural Therapy

In cognitive behavioural therapy (CBT) and mindfulness based cognitive therapy (MBCT), we see how our thoughts influence our beliefs and our behaviours. These therapies help identify automatic thoughts, patterns of thoughts and behaviours. It gives us a different perspective on how our thoughts control us, and redirects us to more helpful ways of thinking. Thoughts are reframed and beliefs are shifted to encourage a different behaviour and pattern. They teach us to take control over our thoughts. Known as gym training for the mind, these therapies help us to remain present and to be aware of our thoughts without reacting to them. With the help of these therapies, we learn to stay action-focused on what can be controlled in the present moment.

Power of Mindfulness

While therapy helps to manage stress levels and in turn reduce IBS symptoms, it also trains us to be able to respond calmly to IBS symptoms rather than react impulsively. It can increase flexibility and adaptability to changing sensations, emotions, and thoughts. Mindfulness is the ability to stay in the present moment, and builds awareness of our thoughts. It strengthens the front part of our brain, which controls attention, planning, and rational thinking. When we engage in many automatic thoughts and create imaginary stressors by worrying about the future, a marked change occurs in our brain. The reactive part of our brain is activated and a survival response kicks in. Imagining possible worst case scenarios triggers anxiety and the sympathetic nervous system (SNS). However, with mindfulness we can effectively bring us back into our front brains and out of the survival mode. We learn to consciously watch what’s happening without reacting in fear or shutting down our emotions. It helps us to go with the flow, thus reducing stress levels.

IBS & Meditation

Meditation helps increase the functioning of the vagus nerve. It encourages our ability to regulate and hold discomfort, without becoming fearful or anxious. Through meditation, we can strengthen our ability to remain calm yet alert as well as to be able to handle mild discomfort and trust our body again. Meditation, yoga, and breath work also help to reduce our stress, and help us remain mindful.

Conclusion

While psychotherapy cannot cure IBS, it is valuable in stress management. Using psychotherapy, along with medical and dietary support, can help us manage IBS symptoms with more confidence and self-compassion.

Sources:

  • https://ignitenutrition.ca/blog/psychotherapy-for-irritable-bowel-syndrome-ibs/
  • https://aboutibs.org/treatment/psychological-treatments/
  • https://my.clevelandclinic.org/health/diseases/4342-irritable-bowel-syndrome-ibs
  • https://www.healthline.com/nutrition/gut-brain-connection#TOC_TITLE_HDR_2

Frequently Asked Questions

Irritable bowel syndrome (IBS) is characterized by a variety of symptoms, including cramping, abdominal pain, bloating, gas, and diarrhea or constipation, or both. IBS is a chronic condition that you’ll need to manage long term. The cause is not well understood.

There is no definitive test to diagnose IBS. IBS is diagnosed after your doctor has reviewed your symptoms and occasionally ordered tests to rule out other conditions.

Visits at the Tummy Clinic are not covered by OHIP, however most extended healthcare plans cover many aspects of the care you will receive here, such as visits to Naturopathic Doctors, Dietitians, Social Workers or Psychotherapists. Check your benefits package or contact your insurance company for more information.