GI Health Psychology for GI Disorders

The main purpose of GI Health Psychology is to improve the patient’s quality of life and manage GI symptoms, not to cure or eliminate the GI disorder. When it comes to chronic problems, a combination of medical and psychological treatment may help patients attain or maintain remission, but the disorder itself will not be completely eradicated. (People with "curable" GI disorders are likely not reading this article!).

It is also important to point out that GI Health Psychology is almost always an adjunct treatment, which means that it is used in coordination with your primary, or medical, treatment.

Traditionally, health psychology has focused on Cognitive Behavioral Therapy (CBT) for patients suffering from chronic problems; however, this may not be the most helpful or effective for all patients. Dr. Dug uses a combination of clinical hypnotherapy and Acceptance and Commitment Therapy (ACT) to help patients live a life in which decisions are led by values and goals rather than symptoms.

DGBIs

Disorders of Gut-Brain Interaction are aptly named. Extensive research has demonstrated that these disorders are triggered/worsened by unhelpful interactions between our thoughts/perceptions/feelings and our digestive system.

For example, when people say they have a “nervous stomach," this usually means that before any big event (e.g., public speaking, job interview, wedding, etc.) they find themselves suddenly unable to control their bowels and in dire need of a toilet. Another example is when people lose their appetite because they are feeling anxious.

In both of these examples, there is a process in the mind (e.g., imagining catastrophic outcomes, focusing on the likely disappointment of others, having a general sense of dread), which then sets off a chain reaction, which ultimately leads to the triggering or worsening of GI symptoms. This process can become a chronic feedback loop when GI symptoms then cause further mental processes, which exacerbate the chain reaction and GI symptoms.

Although this already sounds pretty bad, it can get worse.

The more chronic these experiences become, the more that we try to stop the cycle using unhelpful strategies like avoidance. One common form of avoidance is to stop exposing ourselves to potentially stressful situations out of fear that that will trigger symptoms. This strategy has the tendency to snowball until we are avoiding those things that actually bring value to our lives, like attending family gatherings, starting a new career, or even leaving the house.

You may have correctly guessed that those avoidance tactics themselves further exacerbate the cycle! In other words, the choices that we make in order to avoid symptoms, actually contribute to the continuation or worsening of symptoms.

GI Health Psychology helps to break this cycle so that patients focus less on symptoms and focus more on having meaningful and valuable lives.

Structural GI Diseases

Can structural GI diseases also be helped with psychological treatment? Recent research has shown a positive impact on Inflammatory Bowel Diseases (IBDs) and Celiac Disease by decreasing GI-related distress and improving quality of life. Other GI diseases, such as hemorrhoids, polyps, diverticulosis, etc., can be helped by improved management of pain/discomfort and support of necessary lifestyle changes.