The Sensitive Gut

Understanding IBS

Don’t be victim; be a survivor.

growthResearch has indicated that people who have undergone an episode of trauma are four times as likely to develop IBS than those who have not.  Survivors of floods, concentration camps,  conflict trauma, physical or sexual abuse suffer a range of long term symptoms, most of them unexplained and many referred to the gut.  Stress and emotional upset at the time of an attack of gastroenteritis predicts the development of post infectious IBS.

Brain imaging studies in people with post traumatic stress disorder have demonstrated that increased activity in the brain stem ‘limbic system’, the parts of the brain that react and express emotion (the inner chimp).  Their thinking, planning human brain, the prefrontal cortex,  is switched off.  They are frozen in a state of helplessness, one foot on the accelerator, the other on the brake, unable to think about or even recall what happened but reacting to anything out of the ordinary or anything that connects with the original trauma with a  flare up of their emotional and physical symptoms.

As time passes, it seems that the memory of the trauma becomes walled off and people get over it and get on with their lives, but there is always a part of their mind that is for the most part inaccessible.  It’s a no go area.  If anybody or anything comes close, people can react with distress, often accompanied by a flare up of their physical symptoms.  Anything that connects in some way with the emotion or the context of the original trauma is enough to rekindle all the symptoms.

Now I’m sure that many of you reading these will be thinking.  ‘I have not survived an accident, a disaster, been abused, caught up in a war’.   I don’t doubt that.  I am not suggesting that all cases of IBS are instigated by trauma, but from what you, the people who write to The IBS Network, tell us, many are.   And most of the events and situations that can traumatise us are domestic; fights, betrayals, the death of a close relative, a miscarriage,  the break up of a love affair, a serious illness.  These occur in everybody’s life from time to time, but they nevertheless feel so devastating they strip away meaning and purpose, robbing life of any hope and leaving us, their ‘victims’ with no motivation to do anything.  And the trauma does not always go way, but may be sustained by a continuous drip feed of fear, aggravation and hopelessness.  Examples include entrapment in an abusive relationship, worries about the children,  everyday struggles to cope with illness, chronic disappointment, erosion of trust.   That’s life and many people take it in their stride, get over the bad times and go on to lead a happy, healthy and fulfilled existence. But many don’t.  What has happened erodes their confidence and saps any will  to change.  Everything seems hopeless.

So what can we do about it?   How can we let go of what has happened, recover the meaning and the purpose in life and grow as a person?   The answer is by reconnecting, opening up channels of communication, thinking and talking.  It’s about adapting our life script and growing out of what happened.

Post traumatic symptoms are not a mental illness, they are a strategy for survival.  Shutting down, walling off the memory of what happened, not thinking about it and never going there may have allowed you to get on with your life.  You should congratulate yourself for that, but it has come at a cost.  The things that happen to us never go away, if they cannot be acknowledged and allowed to change the course of our lives, they lurk in the cellars like a saboteur, reacting to anything that reminds us of what happened by emotional outbursts or exacerbations of  illness. So in time we may  become vigilant and sensitive to everything in our lives: travel, changes in routine, the people we meet, even the food we eat …. especially the food we eat!

Trauma makes us feel bad.  Even if it is not our fault, we feel that it is.  But we don’t have to be  victims.  Understand that you are not responsible for what has happened, you are only responsible for what you make of it.  Recovery from trauma involves moving from a place where we feel wretched and ill to one where we can  feel good about ourselves and other people and see possibilities in life.

Viktor Frankl survived the loss of his family and incarceration in a  Nazi concentration camp and became a psychiatrist.  In his book, ‘Man’s Search for Meaning’, he wrote of the characteristics that helped people survive and get over that most extreme trauma.  These were work, courage and relationships (a supportive environment). One might also add faith.  He observed that the Jehovah’s Witnesses often retained their resilience in the face of the most dreadful abuse.  They had an indestructible belief in a much higher power. No,  I am not saying you should all go to church, but I am suggesting you develop a stronger belief in yourself and what you stand for.

Connecting the areas of our brain stem, that ‘react’ to threat, with the thinking and planning, goal oriented part of the brain  can restore that sense of meaning and agency and allow us to grow away from your illness.  As Frederich Nietzsche once said.  ‘Whatever does not kill you, makes you stronger’.

If post traumatic symptoms are a coping strategy in the face of an unbearable reality,  no wonder our animal brain (our inner chimp) hangs on to them.  They are  our security shield.   It takes courage to go into therapy and recover traumatic memories.  The danger is that by talking about what happened we may be retraumatised all over again.   So I am not suggesting that you necessarily need go and see a therapist versed in the dark arts of psychoanalysis.

Trauma is represented visually and viscerally in our brains as images (dreams and flashbacks) and bodily symptoms.  What we find so difficult to talk about, we may be able to draw or act out.   Recently, trauma therapists have been using art therapy and body work, exercise, dance, rhythmic movement, massage and tapping on acupressure points to relax those basal parts of the brain are firing off and to bring the thinking human part of the brain in the frontal cortex on line so that we can begin to think and talk about what happened.  Creativity also allows us to think and connect. Drawing, painting, photography, sculpture, needlework, making models, cooking, writing stories, poetry, making music (but not Facebook) can free us up to see what has happened in perspective.  Exercise, dance, sport, walking, swimming can do the same thing.  They are all ways to achieve mindfulness, to get in the zone so we can rediscover ourselves and grow.

Several of the ideas for this post came from a recent workshop by Lisa Ferentz, organised by Khiron House in London.   

6 comments on “Don’t be victim; be a survivor.

  1. patientj
    October 27, 2015

    Please keep these articles about the psychological causes of IBS coming. They are a new ray of hope for me. I used to think that there must be some other biochemical or microbiological cause to my IBS, but after a seven-month loving but anxiety and depression-inducing relationship (that paradoxically saw my IBS symptoms improve dramatically), and reading your recent articles, I can’t help thinking that maybe there’s something deeper behind both my IBS and my fear of emotional intimacy that I simultaneously craved and rejected. Thank you.

    Liked by 1 person

  2. nickwread
    October 27, 2015

    Thank you so much for your comment, which is both moving and very encouraging. Working as a psychotherapist/medic, I have been so aware of how everybody has their story to tell and how much sense it makes regarding the onset and meaning of their symptoms. The mission of The IBS Network is to help people understand and manage their condition themselves, but it can be quite difficult to know how to get the message about life trauma across without exciting defence and rejection from other health professionals. My forays into blogging and social medial encourage me to think that the people who suffer from IBS know these things but may also be nervous of rejection.

    i am collecting people’s stories for an upcoming book. So if you have time and feel like doing this, do email me with your story (in confidence) to The IBS Network (nick@theibsnetwork.org). Rest assured, your anonymity will be maintained.

    Like

  3. lindabishoppLinda Bishopp
    November 1, 2015

    Hello Nick I suffered a series of traumatic incidents about 14 years ago and this is when I developed IBS. I believe I had complex PTSD. I had therapy and indeed in the last 10 years have trained to be a psychotherapist myself in order to try to understand what happened to me (and for other reasons as well, of course!). I love your articles and they have helped me enormously. One thing I feel, though, is that I do believe that I am now on the route to final recovery from these series of traumas, but it has taken a long time. If I had read your articles 10 – 14 years ago I am not sure I would have been able to process/fully understand what was being said sufficiently to use this information in my recovery. Most therapists I saw did not understand the effects of the complex trauma/IBS link, however, perhaps we cannot recover until our brain re-connects, so to speak? We need to take charge, come out of victim mode, but perhaps we cannot until our brain will ‘connect the dots’ again? Do you have a concept of time-span in recovery from IBS/trauma – I realise I may be asking for a length of a piece of string!!! thank you for your articles – they have helped me ‘join up the dots’!

    Like

    • nickwread
      November 1, 2015

      Thank you for your comment, Linda. I like the metaphor of joining up the dots and reconnecting. There has been a lot of advance in our understanding of the sequelae of trauma in the last few decades though for obvious reasons this has come from major trauma and not necessarily the sort of domestic trauma many of us experience during our lives. And, although it fits perfectly, trauma theory has not been applied specifically to IBS, probably because the philosophies of different entities tend to exist in their own academic bubbles.

      Yes, our brain has to be ready to reconnect and, as you indicate, this can take time. This is partly because events can trigger memories which cannot be properly processed and just retraumatise us and partly because the adjustments we make to stop ourselves thinking of what happened just keep us in it – we live our lives too aware of a big no go area. Trauma is dreadful because it makes us feel so bad about ourselves, so diminished. Replacing these bad feelings with new experience and thought can restore feelings of self worth and efficacy and is crucial to recovery and growth. There has been a lot of important work recently on how movement, exercise, dance, drama, creative arts can all help get people to a place where what happened can be thought about and put into perspective. Victor Frankl declared that work, courage and relationships were the major determinants in holocaust survivors.

      Of course, it takes time, but how long depends partly on how the environment carries residues of what happened which can drag us back. My experience has been that there are certain milestones. These are when you can say to yourself, it’s over and I must now get on with my life, and, somewhat later, when you can look back and realise that what happened was not the end of your world, but conversely, life may be richer for it. What does not kill you can make you strong enough to see it all from a different perspective.

      If you set a deadline for recovery, then counting off the days keeps you in it. The knowledge that you can get over it, grow from it and be better for it restores you in hope, instead of living out your life in despair.

      Like

  4. Pingback: IBS: the irritable bowel symptom – Patient J

  5. Pingback: No, it’s not all in your head, but at least you can do something about that. | The Sensitive Gut

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This entry was posted on October 25, 2015 by in Post traumatic growth, Post Traumatic IBS and tagged , , .

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