Psychological Treatments


It’s important to dismiss the idea that undertaking psychological treatment for IBS means accepting that it’s ‘all in your head’. It’s not in your head. IBS is a real condition with real symptoms.

However we can’t ignore the major impact that the gut brain connection plays. In IBS, the gut-brain connection is thought to be dysregulated, leading to alterations in the gut function and the experience of gastrointestinal symptoms. Ever had that feeling where you don’t need the toilet and then as soon as you need to step out the house you do? (I know my IBS-D type people can relate!). This is a simple example of the gut-brain connection in action. Our anxiety might build, peaking as we head out the door, perhaps in fear that there’s no toilets on our route or we’re heading to a social event where we’re desperately hoping we won’t get a flare-up. Sometimes the impact of the gut-brain connection on IBS symptoms is even more hidden. For example, stress is repeatedly linked to worsening IBS symptoms, often with the individual not realising they’re actually stressed. Therefore, psychological treatments such as talking therapies, CBT and hypnotherapy can really help reduce IBS symptoms and are definitely worth a try!

Cognitive Behavioural Therapy (CBT)

 

Cognitive Behavioural Therapy (CBT) is a type of psychotherapy that focuses on identifying and modifying negative thought patterns, emotions, and behaviours. It is a goal-oriented and evidence-based approach that helps individuals develop healthier coping strategies. CBT aims to break the cycle of negative thinking and replace it with more positive and constructive thoughts, leading to improved emotional well-being and overall functioning.

Research has shown that individuals with IBS often experience an exaggerated response to stress and anxiety, leading to increased gut sensitivity and altered bowel movements. This hypersensitivity can exacerbate IBS symptoms. CBT can help regulate the gut-brain connection by addressing the psychological factors that contribute to stress and anxiety. One way it can achieve this is by addressing the fight-or-flight response that is so prominent within the gut-brain-connection.

The fight or flight response is a physiological reaction triggered by stress or perceived threats. When activated, it releases stress hormones such as cortisol and adrenaline, preparing the body for immediate action. In individuals with IBS, chronic activation of the fight or flight response can lead to heightened gastrointestinal symptoms. CBT targets the cognitive and behavioural aspects of this response by helping individuals identify and reframe their thoughts, manage stressors effectively, and develop relaxation techniques. By reducing stress and anxiety, CBT can mitigate the impact of the fight or flight response on IBS symptoms.

One specific cognitive restructuring technique that can be used to help someone with IBS is called “catastrophising to realistic thinking.” Catastrophising refers to the tendency to automatically jump to the worst-case scenario and believe that the outcome will be catastrophic. This type of thinking can increase anxiety and exacerbate IBS symptoms. Here’s an example of how to restructure catastrophic thoughts into more realistic ones:

  1. Identify the Catastrophic Thought: Start by identifying the catastrophic thought that arises when experiencing IBS symptoms. For example, the thought might be, “This abdominal pain means something is seriously wrong with me. I’m going to end up in the hospital.”
  2. Challenge the Thought: Once the catastrophic thought is identified, challenge it by asking yourself evidence-based questions. For instance:
    • What evidence do I have that supports this catastrophic thought?
    • Have I experienced similar symptoms in the past without any serious consequences?
    • Are there alternative explanations for the symptoms, such as stress or dietary factors?
  3. Generate Realistic Thoughts: After challenging the catastrophic thought, generate more realistic and balanced thoughts. For example:
    • It’s possible that this abdominal pain is a temporary flare-up of my IBS symptoms, which I’ve experienced before without any long-term harm.
    • I have visited my healthcare provider, and they have reassured me that my symptoms are consistent with IBS.
    • I have learned techniques to manage my symptoms, and I can use them to alleviate the discomfort.
  4. Repeat and Reinforce: Repeat the realistic thoughts to yourself regularly, especially when you notice catastrophic thoughts arising. Reinforce the realistic perspective by reminding yourself of the evidence and alternative explanations that support it.

By actively challenging catastrophic thoughts and replacing them with more realistic ones, individuals can reduce the anxiety and stress associated with IBS symptoms. This cognitive restructuring technique helps to shift the focus from worst-case scenarios to more balanced and grounded thinking, promoting a sense of control and well-being.

Hypnotherapy

 

Hypnotherapy is a therapeutic technique that utilises hypnosis to facilitate positive changes in thoughts, emotions, and behaviours. It involves guiding individuals into a relaxed state of focused attention, where the subconscious mind becomes more receptive to suggestions and imagery.

When it comes to IBS, hypnotherapy can be a beneficial treatment approach. It aims to target the gut-brain connection, which plays a significant role in IBS symptoms. By inducing a state of deep relaxation through hypnosis, hypnotherapy helps individuals access their subconscious mind and work on the underlying psychological factors contributing to their IBS.

During hypnotherapy sessions, a trained therapist provides suggestions and imagery related to the gut’s normal functioning and relief from IBS symptoms. These suggestions may include visualising a calm and balanced digestive system, reducing gut sensitivity, and promoting healthy bowel movements.

Hypnotherapy for IBS often involves a series of sessions, typically conducted over several weeks or months. The number of sessions may vary depending on individual needs and response to treatment. It’s important to note that hypnotherapy should be conducted by a qualified and experienced therapist specialising in gut-directed hypnotherapy.

Research studies have shown that hypnotherapy can be effective in reducing IBS symptoms. It has been found to alleviate abdominal pain, bloating, and bowel irregularities, and improve overall quality of life for individuals with IBS. The exact mechanisms behind its effectiveness are not fully understood, but it is believed that hypnotherapy helps regulate the gut-brain connection, reduces stress and anxiety, and promotes relaxation, leading to symptom relief.

Gestalt Therapy


Gestalt therapy is an approach to psychotherapy that focuses on the present moment and emphasises the integration of mind, body, and emotions. It encourages individuals to become aware of their thoughts, feelings, and physical sensations, and to take responsibility for their own experiences.

Here’s how Gestalt therapy can be beneficial for IBS:

  1. Mind-Body Connection: Gestalt therapy recognises the interconnectedness of mind and body. It encourages individuals with IBS to explore their bodily sensations and emotions, and to become more attuned to the signals their bodies are sending. By developing this awareness, individuals can gain insights into how their emotional states and stress levels may impact their gut functioning.
  2. Holistic Perspective: Gestalt therapy takes a holistic approach, considering the individual as a whole rather than focusing solely on the symptoms of IBS. It explores the person’s thoughts, emotions, relationships, and overall life experiences. This broader perspective can help uncover underlying patterns, conflicts, or unresolved issues that may contribute to IBS symptoms.
  3. Emotional Awareness and Expression: IBS is often influenced by stress, anxiety, and emotional factors. Gestalt therapy provides a safe and supportive space for individuals to explore and express their emotions related to their condition. By giving voice to these feelings, individuals can release emotional tension, gain clarity, and potentially reduce the impact of emotional stressors on their symptoms.
  4. Personal Responsibility and Empowerment: Gestalt therapy encourages individuals to take responsibility for their experiences and choices. This includes taking an active role in managing their IBS symptoms. Through increased self-awareness and self-acceptance, individuals can develop a sense of empowerment and take steps towards implementing lifestyle changes, stress reduction techniques, and self-care practices that may positively influence their IBS.

In short, Gestalt Therapy is similar to counselling. It allows you to tackle a wide-range of issues in your life and hopefully unlock the one that is contributing most to your IBS symptoms. For example, feelings of low self-esteem can be common alongside IBS and so dealing with those thought-patterns can help you feel freer from IBS. If you’re not worrying about how people perceive your IBS, you’ll probably find you get symptoms less. Sometimes it can be that simple.