Cognitive Behavioural Therapy (CBT) for IBS

A highly affective and alternative approach to regaining control of your IBS symptoms is to target the mind using psychological tools such as gut directed hypnotherapy and cognitive behavioural therapy (CBT). Why the mind? Because with IBS, the symptoms you are experiencing are due to ''disrupted communication'' between your gut and your brain. This is why IBS is known as a Dysfunction of the Gut Brain Interaction (DGBI).

Under normal circumstances your gut and brain are constantly communicating with each other in both directions via hormonal and nerve signals. They send messages about your appetite, digestive patterns and emotions. However, IBS symptoms can arise when this two-way communication stops working as it should. You can read more about the gut and brain connection, and its role in IBS here.

The good news is that you can use mind-gut therapies to target and ‘’fix’’ this miscommunication between your brain and gut. In fact, psychological approaches such as CBT and gut directed hypnotherapy can help improve IBS symptoms because they work on 2 specific pathways, with one pathway targeting visceral hypersensitivity and the other targeting gastrointestinal motility and abdominal pain. This is why I use a combined approach in all my IBS programs.

How does CBT help with IBS?

CBT is a form of talk therapy or psychological treatment which involves looking at the link between your thoughts, feelings and behaviours. Over the years CBT has become one of the most popular types of therapy, probably because it’s generally short-term, goal-oriented, hands-on and has been proven to work.

Why CBT? CBT is used to help manage IBS because your thoughts, feelings, behaviours and IBS symptoms are all connected. For example, unhelpful thoughts negatively impact how you feel, and these negative feelings can impact how you behave, and can also trigger gut symptoms. CBT helps you to understand this connection, so that you can recognise and challenge the unhelpful thoughts and beliefs you have about your symptoms. Unfortunately for many IBS sufferers, unhelpful and negative thinking keeps them stuck in what is called the stress-symptom cycle which can be difficult to break free from.

For example, depending on how you think and feel about your IBS symptoms and your diagnosis, you may pay greater attention to what’s going on inside of your body, and in turn feel more anxious, which actually increases your sensitivity to pain. This increase in sensitivity can then result in you feeling even more worried, and so the cycle repeats. For many of my clients, even thinking about ‘’what if X happens?’’ is all it takes to trigger a nasty flare up of symptoms. A simple analogy of a mosquito bite can be used to highlight the impact of our thoughts and where we focus our attention. For example, just like with a mosquito bite the more you think about and focus on the bite, the more it itches. And the more its itches, the more you scratch it, and the redder, sorer and itchier it gets.

In addition to helping you to identify, challenge and replace unhelpful thoughts around your IBS symptoms, CBT is also a valuable tool in helping you to create changes in your behaviour. This is because IBS symptoms and the associated anxiety those symptoms can trigger, can lead to patterns of avoidance behaviours (e.g. avoiding foods or situations) and/or safety behaviours (e.g. checking stools or access to the toilet). These changes in behaviour can have a huge impact upon your life and being able to address these can be life changing for my clients.

This brings us onto relaxation, including various breathing techniques, which is another key component of CBT for IBS, and is usually introduced early on inside of my programs. Relaxation is used for various reason, with the main two being:

Helping you to become more aware of the physical tension in your body which may be contributing to symptoms.
Helping to stop the harmful effects of the fight or flight response (triggered by stress) by instead turning on your “rest and digest” response.

Over time, CBT can help you to better control your mind’s response to the sensations of pain and discomfort with IBS, and ultimately help you get back to living and enjoying life again! CBT is a well-established and effective treatment for IBS and consistently demonstrates long lasting symptom improvement.

Does CBT work for IBS?

Cognitive behavioural therapy and gut directed hypnotherapy are considered the two leading psychological therapies for treating IBS, and have the largest evidence base between them.

When it comes to the actual research, there are many studies demonstrating that CBT can improve not just IBS symptoms, but also enhance the quality of life. One of these studies into CBT for IBS which was conducted by researchers at King’s and the University of Southampton in the UK, showed that those who received CBT were more likely to report significant improvement in severity of symptoms and impact on their work and life after 12 months of treatment compared to those who only received current standard IBS treatments.

In fact, when it comes to different modalities of psychotherapy in the treatment of IBS, CBT has been the most rigorously tested with at least 20 published randomised control trials. These studies consistently demonstrate CBT as an effective treatment for alleviating IBS symptoms and these gains are maintained for at least 1 year after treatment.

It is clear from decades of research and clinical trials that CBT is an effective treatment option for clients with IBS, and thankfully the use of mind-gut therapies is becoming more and more widely accepted. In fact, the American Gastroenterological Association recommends psychological interventions for patients with moderate-to severe IBS or who do not respond to standard medical care, and for whom psychological factors exacerbate their symptoms.

Research also suggest that many IBS sufferers respond to CBT in as little as four sessions, and I frequently see significant client improvement in two sessions when combined with gut directed hypnotherapy.

What is the best psychological treatment approach for IBS?

Both CBT and gut directed hypnotherapy have been show to be effective treatments for reducing the symptoms of IBS. Both approaches do not involve stressful and confusing diets, or taking medication and having to live with the side-effects. They are both safe and effective options for getting long-term relief from IBS.

The main difference between the two approaches is that CBT is designed to build healthy coping strategies and thought patterns, whereas gut directed hypnotherapy targets the nervous system e.g., oversensitive nerves in the gut, and the miscommunication between the gut and the brain. Psychoeducation is also a key component of working together, which involves dispelling myths about IBS, explaining the brain–gut axis, the physiological stress response, and the rationale for using mind-gut therapies. By taking the time to help you really understand what’s happening inside of you body, you understand why standard medical treatments have been ineffective at adequately treating your symptoms and why the approach I take is different.

Inside of The Mind Gut Reset, the unique approach I take with clients, I combine both CBT and gut directed hypnotherapy so that I can maximise the results my clients achieve.


The Calm & Happy Gut

Natural relief from IBS symptoms without restrictive diets or medications. Science backed gut directed hypnotherapy and CBT programs.

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