Irritable bowel syndrome (IBS) is a condition where the digestive system does not function properly. Symptoms include diarrhea, constipation, abdominal pain or discomfort, bloating, and gas.
Psychological therapies (psychological interventions) may be suggested due to the brain-gut axis, a pathway between the brain and gut that becomes dysregulated in patients with IBS.
These therapies focus on treating the causes of symptoms to help prevent flares of IBS symptoms and helping to cope with symptoms, rather than just managing the symptoms.
These psychotherapy techniques with a psychiatrist and/or psychologist have been shown to have efficacy in treating IBS symptoms:
- Cognitive Behavioral Therapy
- Mindfulness Based Cognitive Therapy
- Relaxation Training
Cognitive Behavioral Therapy
Cognitive behavioral therapy (CBT) is a type of psychotherapy that focuses on changing negative thoughts and behaviors related to anxiety and depression.
CBT is used to treat anxiety disorders, depression, eating disorders, obsessive compulsive disorder, panic attacks, phobias, post-traumatic stress disorder, and substance abuse.
The goal is to change how an individual thinks, so they feel less anxious or depressed. This may require several sessions with a trained therapist.
In CBT, people learn new ways to think about their problems by identifying unhelpful thinking patterns. They also practice exercises replacing these thought patterns with more helpful ones throughout the day.
For example, if someone has trouble sleeping at night due to excessive worrying, then they would work on learning relaxation exercises to reduce worry, resulting in better sleep.
This can help people cope with stressful situations without getting overwhelmed.
Hypnotherapy is another form of psychological treatment that uses hypnosis as part of its therapeutic process. Some studies have shown that hypnotherapy reduces IBS symptoms.
Hypnosis is based on suggestion and relaxation techniques. A trained therapist guides patients through hypnosis sessions where they learn new ways of thinking and behaving. These experiences often lead to changes in behavior.
A hypnotist might use guided imagery during which the patient imagines themselves relaxing into a deep meditative state.
A person under hypnosis will often experience vivid dreams while asleep. These dreams usually involve positive messages from the subconscious mind.
This helps reduce feelings of fear and worry. Hypnotic suggestions can make it easier to relax and are useful when dealing with fears and pains.
Mindfulness Based Cognitive Therapy
Mindfulness Based Cognitive Therapy (MBCT) teaches individuals to pay attention to present moment awareness, being aware of one’s surroundings, and management of emotions in stressful situations.
MBCT helps to reduce anxiety and stress related to IBS and digestive symptoms. Patients learn to recognize triggers for emotional distress and manage them before they become overwhelming.
Patients practice mindfulness meditation during weekly group meetings. Participants learn meditation practices such as focusing on breathing, body sensations, and thoughts.
It works best for those who suffer from chronic pain and recurrent episodes of abdominal discomfort. MBCT is most effective when combined with other forms of treatment.
Learn more about MBCT and finding practitioners.
Biofeedback involves using electronic devices to monitor physiological responses and provide feedback to users. It aims to teach participants self-regulation skills to control bodily functions.
Examples of physiological responses include changes in heart rate, blood pressure, skin temperature, muscle tension, and respiration. Feedback to users are through visual, tactile, or auditory means.
Some biofeedback systems measure electrical activity within muscles, nerves, organs, glands, or brain waves. The user learns to regulate this activity by controlling external stimuli.
Biofeedback helps individuals learn relaxation strategies to reduce anxiety and increase feelings of calmness.
For example, if an individual monitors their heart rate through relaxation sessions, they can recognize what relaxation techniques result in a calming response and slower heart rate. They can use those same calming techniques with other stressors, physical (GI symptoms) or emotional, to help reduce symptom severity.
Learning relaxation skills and techniques can help with multiple behavioral therapies. The goal is to develop a habit that reduces stress levels and improves overall health.
Relaxation practices can help improve the brain-gut connection. Reducing anxiety and stress can help reduce abdominal pain signals and other bowel symptoms.
Relaxation training includes learning:
- Deep breathing techniques
- Progressive muscle relaxation
- Guided imagery
- UCLA Medical School: Mind/Body Psychological Treatments for Irritable Bowel Syndrome
- University of Washing School of Medicine: Complementary and alternative medicine for IBS in adults: mind-body interventions
- University of Gothenburg, Sweden: Meditation over medication for irritable bowel syndrome? On exercise and alternative treatments for irritable bowel syndrome
- Johns Hopkins University School of Medicine: Psychologic considerations in the irritable bowel syndrome
- Loyola University Medical Center: Cognitive-behavioral therapy for patients with irritable bowel syndrome
- University Hospital of South Manchester: Long term benefits of hypnotherapy for irritable bowel syndrome
- Bastyr University: Biofeedback for treatment of irritable bowel syndrome