EIGHT STEPS CBT USES TO EASE THE PROBLEM
Step 1 Get to know your gut
Understanding digestion, what happens when you eat and why bloating, pain, constipation or urges occur, can help reduce uncertainties around symptoms. This step highlights the link between brain and gut, how your digestion and autonomic nervous system (responsible for stress) interact, and the impact on IBS.
Step 2 Build a personal model
This step is an opportunity to reflect on IBS-related behaviours, thoughts and emotions. For instance, you skip meals when you have symptoms (behaviour) because you think eating will make things worse (thought) but you feel anxious (emotions). Understanding this can help identify triggers.
Step 3 Create a food routine
Good dietary habits are crucial in selfmanaging IBS, and this step helps build a consistent routine of eating a healthy, balanced diet. Inconsistencies can make IBS worse because your bowel doesn’t know what to expect. Monitoring food too closely and becoming obsessed may mean you end up blaming symptoms on a particular food when it could be due to anxiety or diet change.
Step 4 Exercise for wellbeing
Exercise can help counteract the stress hormones triggered by anxiety. Whether you’ve exercised before or not, this step helps establish a routine that will suit whether you’re having a good or a bad day – neither too much or too little.
Step 5 Recognise thought patterns
Unhelpful thoughts can cause us to look at a situation in a way that provokes stress or anxiety. You may worry, for instance, that people think there’s something wrong with you because you keep going to the bathroom. Once you recognise these thoughts, you can start to change them.
Step 6 Look for alternatives
There’s always a different way of seeing a situation. Alternative thoughts don’t have to be positive, but they will challenge the problem. So instead of assuming cramps will ruin your evening, decide you won’t focus on them and will enjoy your night. This can be a key moment in breaking the vicious circle.
Step 7 Embrace relaxation
Stress can contribute by making your symptoms worse. Relaxation techniques, a focus on better sleep quality and practising your breathing exercises can all be incorporated into your healthier lifestyle.
Step 8 Managing flare-ups
There’s no magic bullet for IBS, so some flare-ups and setbacks are inevitable. Knowing to expect them is half the battle, and having the tools to manage them will help you move past this obstacle. This means learning to recognise your IBS-related emotions, learning to accept them, and setting yourself long-term goals for selfmanagement.