The woman with irritable bowel syndrome
“Stacey” was a female in her 60s, who was referred to me by her psychiatrist for severe anxiety leading to gastro-intestinal symptoms. Specifically, she experienced panic attacks and loose bowels (diarrhoea) whenever she travelled too far from home which had been onccurring for the past 8 months. She had on more than one occasion, soiled herself which understandably brought about immense embarrassment and fear of a repeat occurrence. She had suffered with depression for most of her adult life beginning in her early 20s.
She was managing this, through taking valium (prescribed) each time she needed to travel any significant distance from her home. Medically, she was diagnosed with a progressive and degenerative neurological condition and had caretaking responsibilities for her husband, quite a few years her senior as well as her aging parents.
She had a history of significant physical and emotional abuse from family members and from previous relationships.
In the initial stages, therapy focussed on helping Stacey to regulate her anxiety. Specifically, cultivating self awareness of the situations and underlying feelings that led to her experience of anxiety and gastrointestinal symptoms. As she could more clearly see the links between her feelings, anxiety and gastrointestinal symptoms, the frequency and severity of her symptoms improved. Said another way, her ability to tolerate feelings and anxiety tolerance both increased.
The next phase of therapy helped her to uncover and process repressed feelings of anger towards previous partners and family members (who had each mistreated her significantly) throughout her life, and how a pattern of helping others and denying her own needs further served to repress her anger leading to severe anxiety.
Stacey was seen for a total of 15 sessions. She was referred on to a colleague after I moved interstate. By the end of our contact she was no longer taking valium to settle her gastro intestinal symptoms and had travelled a distance of two hours in the car without experiencing any anxiety symptoms or diarrhea. Previously, the longest car journey she had been able to take was 15 minutes. Feedback she had received from her daughter was that she was no longer trying to problem solve everything for her and could just “be present with her.”
She had previously completed 6 sessions of a mindfulness based group therapy program however she stated that her anxiety symptoms were severe and so she could not concentrate on the course or retain any of its information (anxiety affects thinking and our ability to take in and process information).
*NB names and certain demographical information has been altered in order to preserve client privacy and confidentiality