For most people, IBS starts in young adulthood, teens or early twenties. It may last for years, even most of their lives, but more often it tends to come and go, relapsing at times of change and then receding into the background of life as things settle down. There is no cure for IBS, but there are treatments that calm the symptoms and there are changes that can be made life style or situation that may make IBS less likely to recur. But for many, it is always there in the background ready to attack when life is tough. This trajectory is similar to other unexplained medical illnesses, such as eating disorders, chronic fatigue, fibromyalgia, backache, headaches and also to anxiety and depression which are so often a feature of all those conditions.
So why should some young people develop a tendency to gut reactions and other overlapping ailments just as they are setting out on life’s great adventure? Exposure to gut pathogens, courses of antibiotics, radical diets may be part of the answer for some people, but these can occur at any time of life.
The second and third decades of life; between the ages of 14 and say 24, is a period of massive change. This is the time when children begin to assert their independence, make decisions about their lives, establish friendships that will last for life, become sexually active, forge group identities, test themselves in examinations, enter employment, start a career. There is just so much going on. It is also the time when young people may be desperate to demonstrate hey are different, but what they carry from their parents may conflict with their new environment and the ideas of their peers, that for a time they reject their parents values and try out different identities, which are often a source of tension and conflict. Facebook is predominantly a medium for young people to show who they are, what they like, how they feel about the issues of the day. Everybody seems to be trying to outdo each other. Look at me, aren’t I cool, wicked, crazy – so random? (Before you say anything, I am aware that many of you will be accessing this post from The IBS Network’s Facebook page. Some of us never quite grow up!). Teenage now seems to go on much longer and it is a time not only of great change but also of great risk. Drugs, eating disorders, abuse, violence, rape and now radicalization are all part of this territory and can damage a person for life.
The task for parents is so hard. They need to facilitate this vulnerable metamorphosis from callow youth to responsible adulthood, allowing their children the freedom to explore, to discover for themselves, make their own mistakes, while providing containment, guidance and a refuge when things go wrong. They must do all that while still providing their children with the sense that who they are matters, offering a subtle balance of unconditional positive regard accompanied by correction when necessary and a consistent appreciation of right or wrong and the knowledge that you can’t always get what you want. This is so necessary for socialization. Only by negotiating and surviving the rites of passage can children become well regulated individuals, confident of their own identity in the company of others, and able and willing to make their own way in the world, contribute to their society and bring up their own children in turn. But it may all go horribly wrong.
These days, both parents often go out to work, leaving their children at nurseries or in the care of paid minders. By the end of the day, they may be too tired to play with their children. As a result too many infant children are abandoned to the mindless hypnosis of television, while older children may be allowed to obsess for hours over computer simulations of death and destruction. Such children may miss out on the one to one engagement that teaches them about real life and are instead subjected to constant stimulation by images of danger and excitement.
Some parents may be driven by guilt and obligation to devote themselves to the care of their children, but are too scared to let them explore their own independence and too guilty to say no. Affection can so easily give way to anger and exhaustion, leaving children feeling insecure, not knowing how they are meant to be, wanting reassurance but not quite knowing how to obtain it. Insecurity and tension makes it difficult for children to regulate their behavior or their bodily functions, ill equipped to face independent life. No wonder that as soon as they try to become independent, they suffer from disorders in the regulation of the most basic functions in life, sleep, eating and digestion and defaecation, which inevitably results in an extension of childhood dependence. Food is a big area of impaired regulation. Not only do many people grow up not knowing what to eat or how to prepare it, they also suffer from multiple food intolerances. So many children now remain at home well into their late twenties and thirties.
If grown up children cannot develop a life of their own, they may not only cleave to other people but they also cleave to their illness. Any illness or disorder of bodily regulation can become such a focus of identification, they people with people with IBS may find their lives ruled by worries about their bowel function and which foods they cannot eat. If so, getting out of IBS may not be so much a matter of medication or diet, it may be more about developing an alternative focus of identification. Ideally this is something independent or creative but all too often it is their own children, who may in turn suffer from disorders of regulation. In this way illnesses like IBS may be transmitted down generations.
But like so many aspects of our current existence, if these ideas carry some credibility, adolescent IBS is less the ‘fault’ of lazy or feckless parents and much more the result of the social and economic pressures on contemporary family life.