Magazine article Clinical Psychiatry News

Uncorking Negative Emotions Reduces IBS Symptoms

Magazine article Clinical Psychiatry News

Uncorking Negative Emotions Reduces IBS Symptoms

Article excerpt


CHICAGO -- For patients with irritable bowel syndrome, expressing rather than bottling up negative emotions might be just what the doctor ordered, according to Elyse R. Thakur, Ph.D.

A novel psychological intervention designed to elicit negative emotions was associated with a significantly greater reduction in IBS symptom severity at 4 weeks than standard medical care (mean, 3.62 vs. 4.68; P = .004) and reductions similar to those seen with relaxation training (mean, 3.62 vs. 4.16; P = .126).

By 12 weeks, there were no differences between groups, and all patients continued to improve, Dr. Thakur of the DeBakey VA Medical Center and Baylor College of Medicine in Houston reported at the meeting sponsored by the American Gastroenterological Association.

One patient who had IBS-related nausea off and on for years wrote after Emotional Awareness and Expression Training (EAET): "I feel lighter, and after the exercise to deal with a particularly traumatic event, I feel less angry and less tense. I can't say that my IBS is completely gone, but the symptoms have definitely gotten better."

Psychological interventions for IBS have traditionally emphasized suppressing negative emotions such as anxiety and sadness through psychophysiologic strategies such as relaxation training (RT).

Recent research, however, suggests this suppression might prove counterproductive. In a study involving 47 healthy controls, self-reported anger suppression predicted greater pain intensity in response to the cold pressor ice water immersion test (Ann Behav Med. 2010 Jun;39[3]:211-21).

While at the Wayne State University stress and health lab in Detroit, Dr. Thakur and her then graduate school adviser Mark Lumley, Ph.D., opted to take a different tact and developed the EAET based on the principle that emotional awareness and suppression can lead to stress-related symptoms and a dysregulated brain-gut system.

The goal of the intervention is to help patients reduce stress by having them learn about connections between stressful life experiences and physical symptoms; by teaching them to identify, experience, and express their emotions related to these stressful situations; and by encouraging them to engage in healthy emotional and interpersonal behaviors in their daily lives, including assertive and genuine communication, Dr. Thakur explained.

To facilitate this process, patients undergo a life-history interview, which helps them connect their IBS episodes to their life experiences. The therapist then conducts experiential exercises such as role playing and imagery to help patients engage with their avoided feelings, behaviors, memories, and relationships through their tone of voice, words, and body language.

Finally, patients are encouraged to communicate more genuinely in their relationships, she said. …

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