Mind Over Tummy Turmoil

How changing your thinking can change how you feel.

By Judy Jones
Photograph: Christopher Silas Neal

The number of therapists trained to use CBT to treat physical disorders is very limited, but in his book Controlling IBS the Drug-Free Way: A 10-Step Plan for Symptom Relief, Jeffrey Lackner, PhD, director of the Behavioral Medicine Clinic at the University at Buffalo School of Medicine, SUNY, has outlined an at-home self-care program for people suffering from IBS. Lackner says that these tips can be useful for anyone with the kind of physical problem, such as chronic pain or migraines, that might be worsened by the ways we think and act upon our environment.

Here are some key steps in Lackner’s program.

Track your symptoms It’s one thing to feel stressed out during the holidays; it’s another to get the runs every time you try to shop at the mall. Learning to recognize what triggers your bowel problems helps you to find
alternatives (do your shopping online) and to understand that you actually have some control over your symptoms.

Pay attention to your thoughts A key element of CBT is learning to tell the difference between the kind of worry that helps you solve problems and the kind that merely exacerbates physical symptoms. An example of the former might be: “I have a meeting across town, and I don’t know my way around. I’d better get a map and allow some extra travel time.” An example of the latter is: “I’m sure to get lost. What if I’m late for the meeting? I’ll be
in so much trouble!”

Solve problems more effectively with a problem-solving worksheet First, write down the issue in clear, specific terms, then answer the following questions: Why is this a problem? Why is it bothering me? How much control do I really have over the situation—for example, am I taking on too much responsibility for things I can’t control or ignoring aspects of the problem that I can control? Write down all the options you can think of, no matter how silly they may seem. Consider your options and the consequences of each. Then choose the one that’s best for you and act on it. “Don’t wait for the perfect solution,” Lackner suggests. “Pick one that’s ‘good enough.’ ”


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