Maybe you are like a lot of my Evanston and Chicago counseling clients and you know the feeling all too well. Sometimes it’s like clockwork: an hour after you eat. You can feel the gas swirling around in your stomach. Then that gas pain leads to back pain. It’s unbearable.
Nothing seems to help the gas pass. Yoga poses. A foam roller rubbed hard on your stomach. The gas won’t budge. It can go on for days.
The chronic pain gnaws at your optimism, pride, and self-worth. You miss important occasions because of the pain and the anxiety of not knowing the bathroom situation where you are going.
You feel like you’ve put too much of your life on hold (waiting to get married, have kids, do the adventurous things you want to do). You don’t want to end up a lonely woman.
Even when you find a treatment or a medication that seems to help with the chronic pain, you can still feel trapped. The anxiety of having gas or going in your pants in public won’t go away and sometimes freaks you out. Could IBS have hard-wired your brain to have constant anxiety?
I see so many women in both my Chicago and Evanston based practices who experience these same anxieties. I deeply empathize with you. The beautiful hope is many different methodologies can give you your life back.
What is CBT? How can it help with the chronic pain of IBS?
Cognitive Behavioral Therapy or CBT is a form of therapy that works to modify your thinking and behavioral patterns. It can work wonderfully to lessen the feelings of anxiety, loneliness, and despair that often accompany IBS gastrointestinal distress and chronic pain.
CBT works through the brain-gut pathway. Take a look at this blog to learn more about the brain-gut pathway.
You might want to think of it like this. Your thoughts, emotions, and behaviors are all influencing one another. You might be thinking that you could have an IBS flare-up on your first date with a hot guy.
Just thinking about not being able to manage the situation might cause you to feel a little anxious. The more you think about it, the more the anxiety grows and worsens your stomach pain. Your body’s autonomic nervous system or “fight or flight” response system has kicked into high gear.
You end up canceling the date. This behavior then reinforces the thought that your gastric distress is ruining your life and that you will be alone forever dealing with your chronic pain.
Practice CBT with a Therapist Trained in GI Psychology
Practicing CBT with me in the situation I described might work like this. We would work together to create a strategy to manage your thoughts so that your anxiety lessens and you can develop the dating life you desire. In a session, you would work on this strategy, and you would also practice at home.
None of us can live with our body in a state of constant arousal from stress. Luckily, your body has a way to counteract the stress response. You have a parasympathetic nervous system, the “Rest and Digest” response, which you can activate. CBT activates the parasympathetic nervous system through deep breathing, muscle relaxation, and guided imagery. These components change your body’s behavioral response that can then feedback to influence your thoughts.
In a relaxed state, you change the thoughts and the messages you are sending yourself about managing a flare-up during your date. Over time, you may feel more relaxed and less anxious about going on the date. Your quality of life goes up as a result.
Beating chronic pain and gastrointestinal distress
The chronic pain you feel is real and can leave you feeling helpless, wondering when the pain and anxiety will stop. Your thinking patterns spiral downwards and you might start to tell yourself, “I’ll never feel better” or “I’ll never find relief for my symptoms.”
With CBT, you will learn powerful coping strategies that will modify those patterns. Ultimately Cognitive Behavioral Therapy will aid in lowering your pain levels.
When you first come to see me, I will spend a good amount of time asking questions, listening to you and getting to know you better. You will have a chance to ask me questions, too.
We will then begin to focus on your physical symptoms. You can tell me about the following:
what type of symptoms you are having
when the symptoms and anxiety started
what triggers the symptoms
how your pain affects and limits your quality of life
what has worked for you in the past to lessen the pain and anxiety
how you perceive your illness
how you deal with the pain and anxiety
what your prognosis is
Once I have a good grasp of this information, we will turn to working on your thinking patterns (the cognitive behavioral therapy). I will ask you to begin noticing how you feel before and during a flare up. We will develop strategies for calming your mind, which will help to relax your body.
Our focus will also be centered on the coping strategies you have used in the past which no longer serve you. You will learn how to quietly notice them during a flare up. You might discover that these thoughts could possibly be causing your symptoms or making them worse.
The next step would be to replace these unhelpful strategies with more positive, effective ways of relaxing and handling stress. Acknowledging your feelings is key to understanding how feelings affect thoughts. You will learn to set up boundaries around what you think. How you react will help your mind and body to relax.
You will learn to use “problem-focused/active coping” or “emotion-focused/passive coping” when faced with events beyond your control (like the date). With active coping skills, you will devise a “what-if” game plan for dealing with more controllable stressful situations. Ahead of time, you will create an action-oriented way of dealing with likely possibilities.
And with emotion-focused/passive coping, you will learn that it is ok to turn to your friends, family, for support. This strategy is most useful in highly uncontrollable stressful situations when you aren’t looking directly at the problem. Instead, you are centering your attention on your feelings in the situation and how to manage those feelings.
As your CBT skills grow, you will know which coping strategy will best fit a situation. Your feelings of empowerment will increase as well. All of these positive thoughts will feed back to your emotions. The positive emotions have now taken the place of the anxiety, which made your symptoms worse. The better you become at coping, your perception of your pain will lessen.
Start to heal your gut and lower your anxiety with a phone call.
If you have never tried Cognitive Behavioral Therapy, I think it could play a vital role in helping you to feel better about managing your chronic pain. My patients find that once they feel more calm and in control of their thinking their body feels better too. They experience fewer flare ups with their IBS and less GI discomfort. I would love to discuss a plan for making CBT part of your treatment of IBS. All you need to do is call 773-983-8444 or click here to schedule your free consultation. Your gut will thank you.I provide virtual CBT in the Chicago, Evanston area and across the state of Illinois.
Dr. Boyce provides Cognitive Behavioral Therapy, Hypnotherapy, and Relationship Therapy for women in Evanston and Chicago IL. For the pet lovers out there, she also provides Pet-Assisted Therapy. Dr. Boyce helps women who feel isolated, anxious, and overwhelmed in their lives to find more happiness, satisfaction, and self-acceptance. She helps women manage and think differently about chronic pain, fibromyalgia, IBS, and other forms of GI distress.