Ed: In the following interview The Environmental Illness Resource asks clinical psychologist Barbara B. Bolen, Ph.D. about how she helps people suffering from irritable bowel syndrome IBS in her private practice.
EIR: What is your background and how did you become interested in helping IBS patients?
Dr. Bolen: I am a clinical psychologist in private practice who sees adults with various problems. Early in my career I began to hear many patients complaining about an intestinal disorder called IBS. I had never even heard of this at any time during my clinical training, so I began to look into the subject. I was amazed to find out how prevalent IBS is and gratified to see that the type of treatment I use, cognitive behavioral therapy (CBT), was helpful in alleviating IBS symptoms.
EIR: How do you approach the treatment of IBS?
Dr. Bolen: Treatment generally begins with a lot of education about the disorder, including the workings of the digestive system, the role of stress, and the various theories that attempt to explain why people get IBS. As stated above, I primarily use a CBT approach which involves changing the way people think about the disorder and teaching them new skills for handling the disorder. Early in treatment I teach relaxation techniques as they are excellent for calming the body. Other techniques include systematic desensitization, calming self-talk, assertiveness training, and a non-CBT technique called guided imagery.
EIR: The cause of IBS seems to be multi-factorial. Do you find you have to tailor treatment to each individual patient?
Dr. Bolen: It is true that IBS can manifest itself so differently in different people. Therefore my treatment approach is going to be different based on the individual’s needs and symptoms. The one thing that I do with almost all patients is relaxation techniques – it is a shame they are not taught in school! If anxiety is a major trigger for symptoms, then I will use specific anxiety management techniques. When pain is a predominant symptom, I will use guided imagery as it can be effective in alleviating pain. If there is accompanying depression, then attention will be focused on increasing self-esteem and pleasurable experiences.
EIR: You have written two popular books on IBS. What do you focus on in each of these?
Dr. Bolen: My first book, “Breaking the Bonds of Irritable Bowel Syndrome”, was written to offer patients a CBT approach to IBS management. The book includes many of the strategies that I would use in working with a patient in my office. My second book, “IBS Chat: Real Life Stories and Solutions”, co-authored with Jeffrey D. Roberts, offers a compilation of many of the most helpful posts from the online IBS Self Help and Support Group. It was written to help to alleviate the isolation that many IBS patients experience and to offer practical strategies for managing the disorder – information that patients rarely get from their doctors.
EIR: There has been much talk of the gut-brain axis recently. Do you think this is important in IBS?
Dr. Bolen: The research into the gut-brain axis helps to explain the complicated relationship between stress and IBS symptoms. It also helps to finally do away with the notion that “IBS is all in the head”. I also think the attention focused on the role of bacteria is worthwhile and that the eventual answer is going to be some complicated relationship among all of these factors.
EIR: If you could offer our readers 5 key tips to help them deal with IBS, what would they be?
1. Take probiotics – There doesn’t seem to be a downside and they have helped many individuals.
2. Learn relaxation techniques – The ability to calm the body helps to offset the effect of stress on the way the colon functions.
3. Get rid of shame – Work to view symptoms matter-of-factly and present difficulties to others without unnecessary feelings of anxiety (which will only make things worse).
4. Improve your overall diet – Avoid fried, processed, and nutritionally empty foods. Increase intake of omega-3s as well as a gradual increase in dietary fiber (but not bran!)
5. Keep trying different approaches – Don’t give up. It often takes a combination of approaches (medication, supplements, nutrition, therapy) to bring about symptom relief.
Barbara Bradley Bolen, Ph.D. is a clinical psychologist with a private practice on Long Island, New York, who writes extensively about IBS. She serves as the Guide to Irritable Bowel Syndrome for the web site About.com, and is the author of Breaking the Bonds of Irritable Bowel Syndrome and the co-author of IBS Chat: Real Life Stories and Solutions.
You can read more of Dr. Bolen's writing at About.com: Irritable Bowel Syndrome.
Learn more from Dr. Bolen's books: