IBS psychology - The every-day psychological effects of living with IBS

A personal account by Rick

IBS psychology is a side of living with IBS that seems to attract the least discussion, yet for many, it can be a major aspect of the condition.

The chances are if you are reading this then you will already know, at least to some degree, what IBS is and what treatments might be available for it.
So in this article I'd like to talk about what it's actually like to live with IBS, how it can effect the way we think and behave in everyday situations, and how it curtails the lives of people, like me, who suffer from it on a daily basis.

I want to Perhaps offer a glimmer of hope, or at least a firm reassurance that if you are one of these people, you are certainly not alone.

It is my hope that this IBS psychology article will be useful to both the people who have IBS, and the people who don't have it, but perhaps live with someone who does, so they can appreciate more the implications of the psychological impact this distressing condition can have on a person's life.

The near-miss trigger - IBS psychology
To those of us who have been diagnosed with IBS, we usually realise early-on that it's a lot bigger than just the inconvenience of the occasional dodgy stomach.

More often than not it soon becomes a psychological game, where the mind feels obliged to get involved, trying to plan-ahead on our behalf, often with undesirable consequences.

That "near-miss" while out shopping the other week, where the sudden need for a restroom had you rushing through the mall like a gazelle could be all it takes to trigger it off.

Over time, if these thought processes go unchecked, they can spiral out of control and eventually start you thinking about things the non IBS sufferer wouldn't give a moment's thought to.

You might find yourself looking at the issues in a kind-of 'layered' perspective; "What if I get to the restroom and it's engaged? What if it's out of order? What if the escalator is crowded and I have to queue?"

In your mind, these can all become rational and obvious questions, reasonable problems to consider and find back-up solutions to, like a secondary line of defence. A backup plan of your backup plan, so to speak.

Meticulous Planning - IBS psychology
You can find yourself avoiding or stressing about situations that most non IBS sufferers do everyday without thinking. Something as simple as a bus journey can suddenly take on the same monumental-ness as climbing Mount Everest.

The planning, the thinking ahead, the back-up plans, the secondary backup plans;
"Now there's a pub at this point on the journey, a restaurant is here, oh, but they might be closed at this time of day, but there's a garage further up the road, I'm sure they have a restroom, but would I have to buy something first? What if there's a queue at the checkout? Or worse, what If I have to buy fuel to qualify to use the bathroom? Should I take a fuel can on the bus with me?...."

Making a journey becomes an exercise in military-precise strategy.

OK that last example was a little extreme, but I promise you, there will be many IBS sufferers reading this who have planned even the simplest journey with a level of detail that would impress the most high-ranking military generals. I know, I'm one of them! (An IBS sufferer, not a general!)

Even when driving a car, the journey may not feel like a single flowing journey from departure to destination. It can easily evolve into a mad dash between what one might perceive as "safe zones", where each safe zone contains a garage, or a bar or a services area, essentially somewhere that has a public restroom.

As time moves on and the tension builds, you find yourself almost holding your breath with them, feeling the stress and fear of drowning build within you.

That's my description of what it can feel like on a car journey when you are travelling outside a safe zone. Like holding your breath and hoping you get to the other side without incident.

The ultimate indignity - IBS psychology
IBS Sufferers can engage in some fairly extreme IBS psychology thought processes as a simple matter of course, as a matter of perceived 'survival'.

It's all done in the name of safeguarding against what is perceived as the ultimate humiliating indignity that any Human Being could face; loosing control of ones bowels in public.

For most of us, the social programming against doing such a thing, even accidentally is so in-built and overwhelmingly powerful, we will go to whatever extremes are necessary to avoid it happening.

More often than not, the fear of this nightmare scenario can eventually lead to avoiding situations altogether. This tends to be a gradual process that happens over time.

Many IBS sufferers will start to find more appeal in staying at home rather than attending events and social functions that they perhaps once enjoyed.

Avoidance tactics can become extreme - IBS psychology
To an IBS sufferer in this situation, going out requires a lot of planning and thinking ahead, this in-turn requires considerable energy and determination.

In short, it can be a very energy-draining experience, so the natural tendency can lean towards, firstly, avoiding events that one is not particularly bothered about attending, and then, if left unchecked, this can develop into more generalised avoidance's, eventually leaving the IBS sufferer virtually house-bound and in a situation where just the mere though about leaving the house causes anxiety and dread - IBS psychology at its worst.

Simple things like going to get a haircut or visiting the dentist can become almost impossible. Necessary goods are ordered by mail and shopping is done online.

The barber shop is exchanged for a mobile hairdresser who comes to you, and the dentist only gets to see you when the pain of your toothache becomes greater than the anxiety of leaving the house.

Social events can seem overwhelming - IBS psychology
Some IBS sufferers can be filled with dread about having to attend social situations, family functions, work events etc because they know from experience just how much energy they are going to need to muster from somewhere to plan ahead and make the day work.

Remember that 'holding ones breath' example I gave a few paragraphs ago? The same feelings can apply to the duration of social situations.

My nieces wedding
A good example I can give here is sitting in a private wedding ceremony not knowing if you will have to get up and find a bathroom just as the vows are being exchanged. An indignant-looking move at best, but a very real scenario facing some IBS sufferers.

This is a situation I personally found myself in earlier this year. My Niece was getting married at a private hotel.

For several months prior, I was filled with a certain degree of anxiety about having to attend, and my mind would often dwell on the "what if's".

Had the door been at the back of the room, I could have sat near it and quietly, unobtrusively done a disappearing act had the need arisen, but with the door at the front, every person in the room would have watched me leave.

The number-crunching in my mind instantly began. Could I make it through the 30 minute ceremony without the need for a bathroom? My stomach was turning somersaults and my thoughts were now focused not so much on the potential need for a bathroom but on the devastating (in my panicking mind) indignity of having to walk out halfway through a wedding ceremony.

The self-fulfilling prophecy - IBS psychology
Extreme though it may seem, this is the kind of IBS psychology and decision-making that many, many IBS sufferers have to face every day, which brings me on to the subject of the self-fulfilling prophecy.

Some IBS sufferers constantly worry about the ever present threat of being caught-short, with no bathroom nearby. This way of thinking seems to be a natural result of accumulated experiences and the brain doing its best to cope and process the situation.

But worrying and fretting about it can actually bring about that which the IBS sufferer fears the most.

The anxiety about IBS can actually trigger an IBS attack. In fact, the psychological fears and triggers that IBS can initially cause, can go on triggering IBS attacks even if the sufferer generally stops suffering from the majority of IBS symptoms.

It can change the way we think - IBS psychology
It seems in some cases, the fear of an IBS attack can eventually re-program the brain to kick-in with certain automatic reactionary responses including the well documented "fight or flight" panic response.

This could be a sense of panic or feeling uneasy, at which point the brain could also start to signal the stomach that a bathroom will be required very soon or visa-versa, as it is preparing for a fight or flight event. Through these learned automatic responses the need for a bathroom could quickly become a very real, self-induced need.

Suffice to say, I was not in the room when my Niece got married.

After weighing up everything, I totally chickened out. But, as it happened, my 6 month old Nephew was not settling down as planned after his feed, so I volunteered to look after him outside while the ceremony took place, sparing everyone from the unpleasantness of trying to hold a wedding ceremony with a crying baby in the room.

It's funny, despite the rest of the day passing without incident, the wonderful food, the great company and the fabulous surroundings, the fondest memory I have of that day is watching my baby Nephew fall asleep in my arms.

IBS psychology - The cure?
This article so far has been somewhat autobiographical, generated mainly from my own experiences.

I know many others do have these exact same or similar issues because I made a You Tube video back in 2006 about it, and have been receiving letters ever since.

So far, as far as I am aware, there is currently no magic pill that can deal with these psychological issues brought about by IBS, however, when the IBS symptoms have lessened, or are more under control, and much of the anxiety is generated automatically through learned thought patterns, (i.e. when the problem is the fear of the fear), I do understand there are some treatments and therapies that can effectively help with this.

One of them, often reported as quite effective is cognitive behavioural therapy.

Another success story for some in the battle with IBS psychology, comes in the form of Hypnosis, although it doesn't work for everyone.

I have personally tried it myself. I went for the NLP Hypnotherapy (Nero Linguistic Programming), although I did give up after about 4 sessions of treatment because I felt it wasn't helping, in fact, to be honest, I found it all a little bit patronising.

It has since been suggested to me that had I seen the course through, I may have seen a noticeable difference, so I may go back to try it again in the future with a more open mind.

Other general approaches to treating / controlling IBS
Although this article concentrates mainly on the emotional and psychological impact of IBS, there are many other treatments for IBS and things you can do to alleviate the more general symptoms.

The best changes for most can occur when you alter your diet to avoid well known IBS trigger foods.

Other effective steps include relaxation and similar general de-stressing techniques and treatments, reflexology, Pilates, Aromatherapy Yoga etc

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