People are not born with IBS. It may commence with an attack of gastroenteritis, but for many of the people who contact the IBS Network, it starts with something that happens to them. Trauma seems too big a word for this. Our thoughts tend to be drawn to papers on major trauma, war, imprisonment, sexual abuse, because these are easy to define and study. But for most people, trauma occurs in a domestic context; a devastating disagreement, the collapse of a relationship, the death of a parent, moving town, going to university, their first sexual experience. The severity of trauma depends not so much on what happened, but the meaning of what happened to the person who experienced it and how they were able to deal with it.
We all know that the best way to deal with a potentially traumatic situation is by thinking it through, talking about it with others and adjusting the way we behave, but this is not always possible. Some things are so upsetting that our emotional brain (our inner chimp) takes over and we either escalate the situation by arguing or fighting or we run away from the danger, creating the time and distance to be able to think. But what if we are stuck and we can’t fight and we can’t escape? Then our only recourse is to freeze, to disconnect our thoughts from what is happening and do nothing until it stops.
Freezing is a strategy for survival. If animals cannot escape, they will play dead and may be ignored. Similarly, when we feel that our life or our identity, the sense of who we are, is threatened and we cannot escape it, the cognitive, rational human part of our brain goes off line, and we behave like other animals and go into a state of inertia or helplessness. The problem with that strategy is that the trauma is not defused and dealt with, it comes back to haunt us. Sure, we may forget about it and get on with our lives, but what has happened does not go away, it remains as a traumatic memory, locked away in our mind and our body and only accessed when something triggers the memory and elicits symptoms that represent the original situation.
Sometimes, illness is the trauma. In her book, Sophie Lee writes eloquently about how the trauma of a particularly virulent attack of gastroenteritis as a teenager and the reaction of others to it instigated her longstanding IBS.
Emotional tension so often goes to the gut. Just think of the metaphors we use to describe traumatic experience, gut wrenching, gut reaction, gut feelings, you make me sick, it ties my guts in knots and it gives me the shits. Most of the sympathetic and parasympathetic nerves from our emotional brain go to and from the gut. Thus it is not surprising that gut reactions can be evoked by trauma and rekindled by anything that reminds them of that experience
So trauma can remain not only locked in our brain, causing flash backs, sleep disturbance, anxiety dissociation, the memory is also locked in our gut, triggering pain, bloating or bowel disturbance. If your bloating could talk, what would it say?