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Gut-directed Hypnotherapy

Woman happy hypnosis gut

Gut-directed Hypnotherapy

Advances in our understanding of the nature of functional gastrointestinal disorders (FGIDs) have continued to advance beautifully. That is a wonderful thing. Unfortunately, all that understanding hasn’t yet effectively translated into what sufferers of FGID’s (IBS, dyspepsia, globus, aerophagia, and more) can do to feel and function better. Studies clearly show that more than 25% of people suffering with FGIDs and who find a treatment that helps will find that the help is only temporary. All too often, people find themselves right back where they started within a matter of weeks or months, except that they feel more frustrated, disillusioned, or despairing. There must be a better way, right?

The Proven Alternative

Happily, there is a proven alternative for relief from the

     • pain
     • bloating
     • dietary struggles
     • social inconveniences
     • negative symptom stigma
     • and chronic worry
that so many sufferers of FGIDs experience. After FODMAP diets, gluten restrictions, and dietary supplements of all stripes have done what they can do, FGIDs can continue to pose major obstacles to the re-establishment of healthy functioning and enjoyable daily living. Therefore, it is so important to recognize a major missing piece of the proverbial treatment pie.
The digestive tract is the most ancient of the organ systems we have. Our GI system is older than our brain in evolutionary terms. Long ago, the GI system developed right along with the various bacteria and other microbiota living on the planet. Gradually, the early GI system developed the ability to move and primitive organisms grew a brain to coordinate all that movement that was necessary to capture food or to escape from being eaten.
Still later, the GI tract, the brain, and the muscle/skeletal systems that emerged and that allowed us to move also developed the ability to feel and to think. Today, we call that sensing, feeling, thinking system THE MIND. Failure to include THE MIND in the effective control of FGIDs is an inexcusable oversight.
There are many ways of including the mind in treatment protocols. I commonly see people advocating involvement in meditation and yoga. Both are wonderful mind-body practices. However, the strongest scientific research shows that the largest and longest lasting benefit for FGID sufferers comes from obtaining treatment including clinical hypnosis as well as learning how to do self-hypnosis.

How Does Hypnosis Work?

Brain imaging studies, blood workups, electrophysiologic measurements, and other forms of research protocols have established how hypnotic absorption involves shifts in various “states” of mind-body activity. Greater activation of the vagal nervous system can produce a powerful quieting of the state of bodily alarm that is a hallmark of FGIDs. Moreover, when the vagus nerve system is humming along well, digestive functioning improves dramatically. In turn, using hypnosis to activate the vagus system results in changes to the microbiome involving more optimal bacterial balance (right amount of “good” bacteria and much less of the “bad” bacteria, as well as mind-body-wide benefits such as less reactive immune system functioning (less runaway inflammation), better sleep patterns, clearer thinking, and reductions in worry/anxiety, as well as improvements in energy.
Does this sound too good to be true? A very recent article published in the American Journal of Medicine (July 2020) aimed at primary care physicians and entitled, Hypnosis: The Most Effective Treatment You Have Yet to Prescribe, argued that if hypnosis were a drug and produced the kinds of results it does for many people, it would be considered the standard for of care and treatment.

What to Do?

If you are interested in learning more about clinical hypnosis, look up “gut-directed hypnotherapy” and find well-trained health professionals in your area. Don’t be fooled by the false promises touted by poorly trained individuals who are not professionally licensed clinicians practicing as accredited health professionals overseen by State Licensing Boards. In the right hands, working with a health professional trained in gut-directed hypnotherapy can be remarkably beneficial. Alternatively, you can reach out to me at drdavidalter.com or ibsreliefnow.com with your questions. I will either respond to you directly or, if the volume of responders is just too high, I will collate and categorize the concerns, and then respond to them in a future blog or vlog.

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Essen Oder Fressen: A Helpful Practice for Digestive Relief

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Essen Oder Fressen: A Helpful Practice for Digestive Relief

Grandmotherly Memories

Growing up, I recall wonderful times sitting at my grandmother’s table. She would not be sitting, of course. She was instead too busily engaged in shuttling from the table to the kitchen and back again, hovering and then bringing other foods to assure that regardless of how much I ate, there would be still more that was served. Apparently, anything less than a continuously overflowing plate violated some timeless grandmotherly ethic.

Along with a full plate came the requirement that my belly reach absolute fullness. She would work toward that goal by repeatedly saying, “Ess mein kind, ess.” (Eat, my child, eat). There was always more to be served and my role at the table was to continuously “ess,” to eat. I typically indulged her, sometimes to the detriment of what my stomach could comfortably hold.

Later I learned that German has two words for eating. Essen is what people do. Fressen is what animals do. Fressen implies gorging or eating with a ravenous and urgent appetite unbecoming to a “civilized” person. While I was encouraged to “ess, mein kind, ess” there was a clear line between that gastronomic indulgence and ill-mannered fressen.  I’ll get to how that relates to digestive wellness in a moment.

Developing Simple Strategies in a Sea of Complexity

The memories of times at my grandmother’s table come to mind as I think about people who struggle with digestive disorders. We are flooded with information about what supplements to use, whether gluten sensitivity is the source of those struggles, how to adhere to a low FODMAP diet, why bacterial imbalances are the root cause of our anguish and why upping or adjusting our prebiotic and probiotic intake is necessary. When it comes to this flood of information, we are encouraged, like my grandmother did with me, to “ess, mein kind, ess”: to digest all this abundance of health information despite the fact that much of it is contradictory and finding out what is right for any one of us is a continuing challenge: what helps one person one week can hurt that same person the next and what seems good to eat in November doesn’t seem to sit as well in July.

I don’t dismiss or discount the importance of this digestive health information. It can be helpful, and we are learning more about food/gut interactions all the time. My concern is that we often overlook practices that are universally helpful all the time in favor of over-emphasizing unusual, narrow, and overly specific solutions that too often fail to fulfill their promise for far too many people. As the saying goes, “when you hear hoofbeats, think horses not zebras.” In other words, at times it is useful to focus on what is most likely to help most often for the most people instead of what is the unusual or rare solution.

Are You an Esser or a Fresser?

If we step back from what we should eat and ask ourselves how to eat, the “esser/fresser” distinction becomes relevant. Here is what I mean. Our digestive system operates best when our mind and brain are in a settled and comfortable state. Digestion is energy intensive, so any unnecessary agitation, worry, arousal, or distress sucks precious bodily energy away from digesting and into supporting our readiness to act to address the source of the distress. Skeletal muscles get nutrient-rich blood, while the majority of that blood is shunted away from the smooth muscles of our digestive tract. When we are rushed and pressured or overly worried while we eat, we are literally, partially turning off our digestive system. At best we will digest what we eat less efficiently. At worst, the act of eating in this harried context activates or worsens the very digestive problems we work so hard to overcome. In short, we become fressers and suffer digestive consequences.

The Benefits of Healthy Essen

Eating like a “fresser,” which involves eating quickly, getting as many calories in as fast as we can, preparing what is easy instead of what is nutritious, and looking at the act of eating as something to get through rather than to savor, are all examples of digestive distress-inducing practices.

Instead, being an “esser” looks very different. When we ess, we are selecting food for its nutritional value, freshness, and flavor instead of merely easy availability. When we ess, the social connection aspect of eating becomes easily as important as what we eat. Taking time to linger while we eat, at least 20-minutes seated at the table, to sit and socialize and converse is powerfully soothing and supportive of greater digestive wellness.

When we practice essen vs. fressen, we perceive bodily signals that support effective digestion; we are less prone to ignore bodily cues tuned to satiety (nutritional sufficiency) vs. fullness (muscle discomfort associated with stomach wall distension); through essen we impact the interactions between the enteric immune system, our gut microbiota, or vagal (parasympathetic) nervous system; and we support the production and secretion of “psychobiotics” molecules that have a positive impact on mood, anxiety, mental clarity, and sounder sleep. In sum, essen is a universal practice to cultivate no matter how much wheat grass, selenium, Bifidobacterium, or deglutenized food is part of your digestive health regimen.

I encourage you to conduct a self-check about your eating habits. Committing to ess more and fress less may be a simple step you can take now on the road to achieving digestive wellness.

Worried about the future thinking
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Noticing or Analyzing: Your Gut Knows the Difference

Worried about the future thinking

Noticing or Analyzing: Your Gut Knows the Difference

How often have you heard or been told that learning to meditate can be good for your gut? My question to you is whether you have ever been offered an explanation for why this might occur and simple guidance on how you are supposed to meditate for improved gut health? I suspect not. Very few of the many hundreds of clients who have come to me with digestive distress have ever been told the why’s of the connection and the how’s of what to do. I intend to correct that with this blog.

Ideally, our brain shifts back and forth between two states of processing information. The first state is designed to process sensory information about our world, including our inner world. It is sensation based – what we see, hear, feel through touch, smell, and taste. This is the “noticing” brain state. Because sensations are present-moment focused, this brain state is a here and now state. Its focus is on what is occurring right now, not preoccupied with what has already happened in the past or thinking and worrying about what might occur in the future. Chemically, it is a brain state dominated by serotonin, endocannabinoids, and endogenous opioids. The effect of this chemistry is a sense of calm, patience, acceptance, and, as far as the gut is concerned, a state optimally designed for healthy gut functioning. 

The companion brain state is designed with a never flinching eye toward the future. This brain state is engaged in constantly comparing what has been with what can be in the future, whether there is a desire to be satisfied, a worry to be attended to, or a goal to be achieved. Most importantly, this brain state, under the influence of dopamine, stimulates us to manufacture a plan for how to get to the future that we picture, regardless of whether that involves successfully avoiding a threat or fulfilling a deep desire. This is the “analyzing” brain state. Dopamine drives our attention and, like a pit bull, will not let go until the goal is achieved. The effect of this chemistry is arousal, intensity of focus, and bodily activation, especially when dopamine works in tandem with epinephrine or adrenalin. The activation of the body includes activation of the gut, but not necessarily in a way that is compatible with healthy digestive functioning. Gut functioning under the influence of excess dopamine is not a happy gut. 

Living under Dopamine’s Dominance

The modern world is oriented toward dopamine. The 24/7 flow of information to our phones and computers, the ability to distort our body’s natural rhythms by functioning in ways that ignore the concept of day and night, the pressure of giving into the perceived demand to complete “just one more thing” or the constancy of FOMO (fear of missing out) if we don’t stay vigilant and connected, are all driven by dopamine.

The emotional experience of chronically high dopamine levels is perpetual discomfort and distress. How can we be comfortable if we are not chasing after what dopamine has us focused on attaining? The sad truth is that dopamine does not lead us to be satisfied and to feel pleasure when we achieve what we wanted. Instead, it leaves us feeling empty. After all, once we achieve what we wanted, it is no longer in the future: it is in the here and now, which is not dopamine’s concern. Dopamine does not allow us to stop and smell the roses. Instead, our attention is quickly turned toward what we can chase next. Dopamine forever raises the bar of desire and, at the same time, never gives us time to pause and enjoy what we have.

Constructing Contentment

There is much about dopamine for which we ought to be grateful. Without it, our ability to set and meet goals would not be possible. As with much in life, there can be too much of a good thing, undoubtedly true of dopamine. To achieve a healthy and balanced relationship with dopamine, this potent molecule must be counterbalanced with other brain chemicals we possess. The question is, how do we stimulate the production of serotonin, endocannabinoids, and endogenous opioids?

While dopamine drives analysis and action - an orientation to the possible and, therefore, a brain state that is not present-focused - the other chemicals enable us to connect with our senses. These chemicals encourage us to “be here, be now, and to be present.” These molecules solidify relationships with others and even a calmer and potentially less judging relationship with ourselves. Rather than experiencing ourselves as in need of constant renovation and repair, a perpetual work in progress, these present-moment molecules allow us to enjoy, at least for a while, who we are and to feel we are sufficient as we are. In short, the present-moment molecules allow us to be content, and that is a state of being in which the gut thrives.

Meditation's Role

Building a state of contentment, a state of brain and body that is optimally designed for healthy gut functioning, is where meditating comes in. To create the balance between dopamine and our present-moment chemicals is a matter of mind. Meditation strengthens our ability to direct what our mind notices and what our brain and body do in response to that noticing. If when we notice something, such as a feeling of slight pressure in the gut, we dive deeply into analyzing it, attempting to control it and keep it from getting worse, fearing that we might be headed for another bout of diarrhea or hyper-acidity in our esophagus, we have jump-started a flood of future-focused dopamine. Our digestive system will not respond well to that.

On the other hand, if we notice the same sensation of gut pressure but respond to it by noticing what else is happening in our body: whether our skin feels warm or cool, what sounds our ears detect in the room, what scents are floating in the air, how allowing our eyes to gently close has a quieting and calming effect on the body and mind, and the pattern of our breathing, we are orienting to the here and now.

Whenever we notice that our mind races into the future, carried there by worries and concerns in response to a sensation in the body, we can use our minds to bring our attention back to the here and now with gentle intention. Gradually, with this practice of learning to notice without analyzing what we notice, we become able to disconnect our brain from the habit of always rushing pell-mell into the future. We realize that not every sensation has to hold our analytical attention hostage. Bodily sensations come and go. The present moment forever renews itself in the next moment. Pleasant and unpleasant co-exist, and both are replaced by something else if we simply keep noticing what comes next. 

Developing a noticing practice (a simple name for a type of meditation) can not only build up a sense of contentment. Our digestive system can sense, though our central brain and the “enteric brain” that runs the gut, our contentment. In turn, it fulfills its primary functions much more effectively. Even if not everything is perfect, the gut’s ability to digest what we eat, distribute the nutrients where they are needed, and comfortably excrete what we no longer need is so much easier to accomplish. So, here’s to happy noticing!

Forest for the Trees
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Missing the Forest for the Trees

Forest for the Trees

Missing the Forest for the Trees

For anyone suffering from gut pain, abdominal bloating, diarrhea, constipation, excessive belching, or a host of other digestive system symptoms, seeking help to alleviate and manage those symptoms instead of focusing on getting better sleep or learning to meditate makes perfect sense…or does it? 

When we take a symptom-focused perspective, looking past the bigger picture of what affects our health is natural. Unfortunately, all too often, taking a symptom-focused perspective can prolong our suffering needlessly. Vigorous health is the result of a huge number of interacting biological, psychological, and social systems within which we function each day. Getting too narrowly focused on one narrow slice of that system, such as whether you effectively digest gluten, can be like “missing the forest for the trees.” Yes. Gluten sensitivity may be part of the overall “forest” of interconnected parts that impact health, but it isn’t the whole picture.

I’ve learned to adopt a holistic view through meeting with hundreds of clients who come to me stating various permutations of the following:

    • I’ve tried many diets, like a low FODMAP diet. It works for a while and then the symptoms return.
    • I’ve been prescribed supplements to correct my leaky gut syndrome or my problem with small intestine bacterial overgrowth syndrome (SIBO), and still, I suffer, and I’m out $350 dollars per month!
    • I don’t sleep well due to gut pain.
    • I’m exhausted much of the time and have trouble concentrating.
    • My social life is a mess because I can’t trust what my gut will do, what I can eat safely, or whether I’ll embarrass myself with a bowel accident if I am out with others.
    • I’ve seen gastroenterologists and other specialists. The tests they’ve done show nothing definitive that is wrong.
    • I’ve been told to take anti-spasmodics, anti-depressants, antacids, and anti-anxiety medications.
    • I don’t know what to do anymore. I just know I don’t want to live this way for the rest of my life.

Heading for DIATA

Surprisingly, this litany of complaints holds a key for obtaining lasting relief. That key involves recognizing that we are ALWAYS functioning as a complex living system of billions of pieces and parts. The social anxiety and resulting isolation are as much of the problem as is the amount of fiber or processed sugars you consume. 

The pacing of your days, the quality of your sleep, and the lingering memories of past emotional wounds weigh as heavily in achieving stable gut health as is attention to systemic inflammation stemming from compromised gut lumen integrity. Harnessing and channeling runaway worries and fears, or addressing the quality of your intimate relationship, is as important to gut health and overall well-being as is assessing whether fresh fruit and vegetable consumption currently functions as a path to comfort or a path to increased symptom activation. 

You may find yourself overwhelmed by the prospect of having to pay attention to all the different dimensions of health I outlined when you shift from a narrow symptom focus to what I call a DIATA-based focus. Diata is a word that orients to the elements of our lifestyle – literally, how we live – as it determines our daily health and functioning. The good news is that adopting a Diata-based focus allows the enormously complex components of our mind, brain, and body to fall into place more easily. 

Assembling the Pieces of a Healthy Puzzle

Think for a moment about a thousand-piece jigsaw puzzle. Taking any two pieces and hoping they fit would be futile and overwhelming. Most people begin by assembling the border to the puzzle. This provides a framework that makes it easier to locate, at least in a general sense, where the remaining pieces fall. Also, most people place the top of the puzzle box within easy reach, where it can serve as a guide to the overall goal and further guides where the individual pieces of the big picture best fit.

Similarly, when pursuing a Diata-based orientation, maintaining a focus on lifestyle is like focusing on building out the framing border and having the puzzle box cover to orient to what the healthy goal looks like. That is why higher level practices, such as a focus on sleep restoration, lifestyle pacing - including the pacing of your eating habits, anxiety management, and empathic social connections are so important. When they are in place, it is as though the whole body breathes a deep sigh of relief. In turn, when these dimensions of your bodymind are attended to, the digestive pressures on your gut are reduced and your ability to metabolize what you eat with greater comfort and ease are easier to achieve. 

All the pieces and parts that make up you and me exist together in a complex web of inter-dependent interconnections. I encourage you to explore what adopting a Diata-based perspective means for you. To get a taste of what is possible for you, I invite you to explore my free, 3-session sample of my gut health program. Also, if you have further questions about how this orientation and approach can work for you, drop me an email. Together, let’s help you get the pieces of your health puzzle to fit together well.

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Early Gut Shapes Lifelong Disease-Fighting Abilities

Your Gut Is As Unique As Your Fingerprint

We all know that no one, not even identical twins, share the same fingerprint. But, did you also know that every person’s gut is uniquely their own? No two gut microbiomes are the same. Because bacteria are everywhere and are undergoing changes on a constant basis, there is no way that two people can perfectly mimic the exact experience that another has as they move through their day. Surfaces, breezes, contacts with others, and even our moment-to-moment changes in mood all result in subtle changes in the bacteria inside of us.

Baby Bacteria

The significance of this finding lies in the discoveries of the profound ways that our unique bacterial mix shapes our thinking, our feeling, our functioning, and our overall health. Scientists have discovered that this health influence begins much earlier and lasts much longer than we had ever imagined. We are learning that the bacteria that establishes themselves in our gut in the first weeks of life have a lasting impact on our vulnerability to illness over the rest of our lives! Recent research suggests that adding together the adult’s genetics, diet, lifestyle, living environment, and physiology makes up only 30% of the variation in an individual’s gut microbiome. Much of the remaining 70% is traceable to the unique mix of bacteria we carry within us. One research track being explored is that in the first days of life, the bacteria that get established first, colonize the gut in ways that continue to impact how other bacteria, including illness-causing bacteria, can get established later. When the baby’s first bacterial colonists are healthy and beneficial to the infant’s health, the odds are greater that he or she will be better able to remain healthy, more resilient when facing illness threats, and more effective at maintaining the thriving, diverse, and active microbiome we need to support whole health throughout our lives.

Upsetting the Apple Cart

This line of thinking isn’t all that surprising. The process of developing a cooperative (commensal) relationship with our gut microbiome has been fine-tuned for millions of years. The better we do, the better the bacteria do. And, the more vibrant our bacterial health, the more our health benefits in countless ways. But, it is also obvious that we are far from perfect at remaining healthy. In fact, the rapid rise in inflammatory diseases shows just how vulnerable this two-way relationship between our bacteria and our overall health is. IBS, is just one of many examples of conditions that are traceable to imbalances in body-bacterial relationships.   Examples of practices that damage this finely-tuned gut-brain-microbiome balance include:
  • Overuse of medications that affect microbiomic health (e.g., antibiotics) when ill
  • Over-consumption of foods that have had their natural nutritional benefits removed and their bacterial contents altered through industrial over-processing (i.e., processed foods, over-feeding of antibiotics to animals we consume)
  • Creation of a modern society that often results in more chronic stress - compromising the critical microbiological communication that integrates and coordinates our immune system, our gut bacteria, and our gut wall, which serves as the front line defender of our body’s health
  • Cultivation of habits that disconnect us from life’s natural rhythms of sleep, work, rest, play, and connection ( e.g., social media, staying up late, too much time indoors, eating foods out-of-sync with the local season)

Action Steps

Knowing that only 30% of a person’s gut microbiome is determined by diet, lifestyle, and several other factors, while the rest of what impacts the microbiome is established very early in life could leave people with the wrong impression. Early life does matter when it comes to establishing a good and healthy gut foundation. But, the important takeaway is that what we were given at birth is subject to change later, so long as we adopt the kind of health-positive practices that help us keep realigning the necessary elements that support gut-brain-microbiome balance over the course of our days. In turn, we can, with continued practice, regain the radiant health upon which joyful living rests. Here are practical steps you can take to orient yourself in that direction. Take advantage of evolution’s lessons. Whole foods remain the best pre- and probiotics. Learn to shop for foods rich in the kinds of vitamin, mineral, and healthy-bacterial balance-promoting foods (Mediterranean and Paleo Diets do this quite well for many people.). Adopt timeless lifestyle habits that are fundamental to maintaining good health and that have the added benefit of being highly anti-inflammatory. These include:
  1. Obtaining at least 7-hours of sleep each night
  2. Increasing movement and exercise into your day, every day
  3. Seek mental challenges, but balance them with regular playtime and general relaxation time
  4. Seek connection. The benefits of intimate social connections for long-term brain health (see my book, Staying Sharp) are well-established. The benefits of social connections to gut health and general physical/emotional health are being established, too.
  5. Build private, self-reflective time into your weekly routine. If you don’t get to know your deeper thoughts, yearnings, and dreams better, they cannot serve as the road map to living your life that they are meant to be. And, without this, the rate of anxiety, depression, and general life distress skyrocket.
When your life does include illness patterns like IBS, shift your focus from just eliminating the symptoms to building adaptive, flexible, and resilient health. After all, symptoms are often just a signal of something that is off farther “upstream.” Get appropriate consultation about how to treat your illness condition, but make sure that in designing the treatment process that you look beyond treating just the symptoms. Lifestyle medicine, as outlined in the previous bullet points takes you farther faster and helps you stay there longer. Enjoy your journey...
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How Journaling Can Heal a Hurting Gut

Secret-keeping Affects Your Health

Keeping painful secrets, stuffing embarrassing memories, or hiding certain worries or fears, even from ourselves, are what many of us do. Science shows us that when we do this, we are putting our physical and mental health at risk. People suffering from disorders like IBS often experience patterns of emotional avoidance that can make it difficult to release painful secrets even when one is ready to let go. Expressing what we carry hidden in our hearts and minds can also release what we carry in our guts - and journaling can help in that effort. Several thousand years of human history show that we long ago recognized the healing benefit of sharing our pain with others, whether through intimate conversations with a spouse, a close friend, or even with a relative stranger. The act of disclosing what hurts is a direct path to healing. The good news is that there are many channels we can use to do that disclosing.

Tears are words that need to be written.

- Paulo Coelho

The Biochemistry of Writing

Keeping a journal in which you express what you feel about people, events, and circumstances in your life is a powerful and portable method for discharging the emotional distress associated with those circumstances. Expressing yourself in this way changes your physiology. When you appreciate that every thought and every emotion has a specific chemical signature, you can recognize the chemical link between your mind and your body, including your guts. So, when you release an emotionally painful memory or worrisome concern, you are actually changing your biochemistry! And, since no organ system in the body is more closely linked to your gut’s “second brain,” the benefits of learning to “let go” are often felt first in the gut. Moreover, because of the connections between your gut and your immune and nervous systems (your gut-brain-mind axis), what changes in the gut rapidly impacts these other core body systems in ways that increase digestive wellness and improve overall health levels.

Tips To Get Started

Drawing on important research work begun more than 30 years ago, the following journal practice has shown positive and lasting benefits for sufferers of a variety of physical health challenges.

1. For 10-15 minutes a day each day for one week, write down the thoughts and feelings that you have about an event from your past (or that are still present) that troubled (or troubles) you and touches you deeply.

2. If appropriate, the event should be something you haven’t spoken to others about in great detail.

3. In your writing, write about what happened, what you felt about it then, and how you feel about it today.

4. Don’t censor what you write. This practice isn’t about getting the details right; it is about getting the lingering toxic effects out!

As simple as this sounds, the surprising truth is that the results can be powerful, especially when you combine this practice with other gut-healthy practices. And, if you do find yourself already feeling better, then by all means, keep the practice going! Happy and healing writing...
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IBS and Expressing Emotions

Emotions and Our Body

Everybody has emotions. Without them, life would lose its color and flavor. But how we choose to express (or not express) those emotions can have drastic, physical results on and in the body.

But why do we have feelings. What role do they play in our lives? Read through the phrases that I list below. Allow yourself to wonder what came first: the words of these phrases or the body state that the words describe.

Said another way, are the words our best attempt at describing emotions that originate in the body, or does the body attempt to feel what the words are saying? The answer has dramatic consequences for managing IBS.

• I just had to tell you. I couldn't hold it in any more!

• I need to get this off my chest. I am tired of carrying it around.

• The memory turns my stomach every time I think of it.

• I was so scared I went weak in the knees.

• My heart skipped a beat when I heard the news.

Emotional phrases in all spoken languages routinely utilize “the language of the body” in an attempt to describe the experience of the emotion being felt. This universal way of expressing ourselves exists because emotions are intimately connected to the body.

Emotions arise from the body and reflect specific patterns of activity within its various parts. The brain interprets those patterns as a specific emotion - anger, fear, sadness, love, security, disgust, alarm, etc. - but unless the body is involved, the brain has nothing to interpret.

The Second Brain and the Emotional Gut

Of all the body’s organ systems, the one most closely linked to emotional experiences is the gut. Our digestive tract has its own nervous system that is so chock full of nerves it is called the Second Brain (the enteric brain).

The nerves linking the second brain of the gut with the central brain in your head are part of a massive communication highway that process bodily sensations that are the building blocks of our felt emotions.

So, when an external situation makes you feel distressed, worried, angry, sad, suffering in pain, or experiencing some other negative emotional state, your gut is feeling it too! Conversely, IBS symptoms expressed in the gut give rise to negative emotional states through this same complex communication network that lives in our bodies.

Why Expressing Ourselves Matters So Much

Understanding the evolutionary ties that link our body and our emotions is one thing. Knowing how to use those connections to better manage IBS is something else entirely.

The first step is appreciating that emotions developed to help us quickly determine how to act. Something scary grabs attention over something comfortable. And, action to escape danger takes priority over action to seek security. But, to fulfill this guiding purpose, emotions need to be felt and their energy expressed.

Emotions and gut responses work together to prioritize what has immediate survival value and what can be deferred until later, what safety and security have been re-established.

But, the importance of emotions for gut health doesn’t mean running around all the time telling everyone how you are feeling. It does, however, mean that YOU need to know how you are feeling, and YOU need to take appropriate actions in response to those feelings.

Sometimes that action involves talking with someone in your life, whether that’s a spouse, a friend, a boss, or a therapist. Sometimes that action involves pursuing solitude and self-reflection. And sometimes that action requires something else.

But, to bottle up the feelings by denying them or running away from them is to defeat their purpose with health-damaging consequences, including exacerbation of IBS symptoms.

Getting Started

From ancient sages to recent scientific researchers, the results are clear. Learning to express what you are feeling by channeling it into effective action is an essential way to help you regulate your gut and to manage your gut symptoms more effectively.

Mark Nepo, a poet and author makes this clear when he says,

Here are some action steps to help you incorporate expressing your emotions and telling your story as part of your IBS healing path

• Begin a journal

For 10 minutes once a day, take pen to paper and write about what you are thinking, feeling, and dreaming about.

Alternatively, you could talk to yourself by creating a voice memo in your cell phone. Remember: This is not the time or place to censor. No one else has to read it. The more you simply express what is on your mind and in your heart, the more effective the exercise becomes when practiced consistently.

• Set up periodic “playdates” with a spouse or friend

These are special times when you can simply share what is on your mind  - your hopes, your fears, your longings - with this special someone. This practice can increase the strength of the social bond with that individual, which is a fantastic foundation for building more resilient intimacy with that person.

• Record your dreams

Sometimes, when we are not offloading what is on our minds during the day, those concerns get expressed through our dreams at night.

By recording what you recall of them, you begin to recognize the themes that recur so you more fully appreciate what these deeper yearnings are trying to express. Then, through careful attention, you can develop actions plans so that these dreams can finally find a path to greater fulfillment and satisfaction.

Until next time...

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Breaking the Bad Sleep – Bad IBS Cycle

Breaking the Bad Sleep - Bad IBS Cycle

Anxiety, Sleep, and IBS

The majority of the clients I see for IBS also struggle with poor sleep. There is good evidence that links better sleep patterns with better control of IBS, and this isn’t all that surprising when we recognize the central role that sleep plays in regulating and coordinating all of our body’s natural rhythms.

Poor sleep can be both a cause and an effect of IBS. In other words, poor sleep can cause IBS, and IBS can disrupt sleep.

In addition to the “gut-sleep connection,” the “gut-brain connection” is another important area of exploration. Our expanding knowledge of this pathway uncovers the need to understand how the brain is generating anxiety, and how that anxiety leads to poor sleep and poor gut functioning.

What is an Axious Gut?

The latest research reveals that when certain bacteria gain an upper hand in the gut, the brain develops an anxious outlook.

The body goes into hyper-arousal mode. Everything, including other people, appear more threatening. Digestive health goes off the rails, with diarrhea, constipation, bloating, and pain increasing. Social relationships suffer, too, when we start to favor avoidance over connection.

But, we’ve also learned that the influence moves in the other direction such that anxiety is also capable of causing bacterial imbalances in the gut. Anxiety alters our microbiome in ways that make it harder for the body’s systems, including the gut, to remain well-regulated. So, reducing anxiety, regardless of the source, is an important component of IBS self-management.

How Can Sleep Help?

Sleep patterns sit right at the intersection of brain and gut rhythms. When IBS is active, sleep disturbances increase. When anxiety levels are higher, being able to fall and stay asleep is a major challenge.

But, because everything in the body is connected to a multi-directional communication network, focusing on getting good sleep not only reduces anxiety, it also helps to re-regulate gut functioning to reduce IBS symptoms. So, what can you begin doing right away?

Creating Conditions for Good Sleep

Here are tried and true methods for restoring sleep to reduce anxiety and increase IBS control.


Practice Good Sleep Hygiene

This involves synchronizing your body with the natural rhythms of sunrise and moonrise. Slow down in the evening. Turn down lights and lower sounds as evening falls. Disconnect from electronic devices.

Approach getting good sleep as essential as getting good nutrition. (I offer much more on sleep and IBS control in our Free Mini-Course and, of course, in our full IBS Relief Now program).


Pre-sleep Routine

Develop a pre-sleep mental and physical quieting routine. That may involve meditation, prayer, a warm bath, a yogic shavasana relaxation practice, self-hypnosis or guided imagery, a slow and leisurely walk, or sipping a cup of chamomile tea.


Try Natural Supplements

Research has shown that intermittent use of natural supplements to be helpful in obtaining good sleep for certain individuals. This should be undertaken after consulting with a qualified health professional who knows you and your specific health status.

But, melatonin, magnesium, zinc, glycine, L-theanine, passion flower, and valerian root have all shown variable degrees of benefit when used appropriately.


Get Out and Get Moving

Increasing activity levels during the day has been proven to have a major benefit in improving sleep at night. This doesn’t have to be vigorous exercise. Walking is the most universally accessible and widely beneficial movement activity in which you can engage.


Self Reflective Journaling

Finally, consider developing a journaling practice taking 10-15 minutes to jot down, without self-censorship, what’s on your mind.

It is a good time to gain control over runaway worries. It is a time to develop the practice of writing down three things for which you are grateful. It is a time to identify fear or worries or matters about which you are angry and learn to let them go through imagery or breathing practices or other proven approaches.

Regardless of the paths and practices you choose, bringing together good sleep, improved IBS control, and a more optimistic and positive outlook is a well-established way of regaining control of both your gut and your life. Sweet dreams!