IBS: When Nothing Else Works For Chronic Symptoms

What do you do when medical and alternative treatments, natural products, folk remedies and other great-sounding approaches fail to help you recover or reduce painful, debilitating and chronic symptoms? How do you respond when you receive detailed diagnoses for which effective treatments seem to work for others but don’t for you? Or when you can’t tolerate the treatments themselves? ⁽¹⁾I have been diagnosed with small intestinal bacterial overgrowth (SIBO), candida, methane-producing-constipating and other irregular gut flora, a need for pancreatic enzymes and support for improved stomach acidity, and more. Or when you can’t bear the idea of risking one more set of side effects?

When my chronic symptoms get to a certain intensity or take me past some threshold into fear I find the willingness to test another treatment because the symptom is more worrisome than the risk.

But when these, too, fail I find myself returning to the enormous capacity of trauma perspectives to explain my chronic symptoms. And to the increasingly reassuring observation that treating trauma therefore offers something different from other approaches I have tried – even at it’s slow, plodding pace that offers no guarantees.

Irritable Bowel Syndrome from a Trauma Perspective

From a trauma perspective I see my chronic symptoms of irritable bowel syndrome (IBS) and altered gut function as representing a state of unmetabolized trauma.

For some people this shows up as increased motility – which is seen with states of fight and flight in animals and humans during times of intense fear. An example is the need to empty bowels before battle, which is a common experience in soldiers at war. When this same state of sympathetic arousal does not return to baseline due to unresolved trauma, I believe it leads to increased motility and for some, to intermittent or chronic diarrhea. From a trauma perspective my own state of decreased gut motility represents a state of freeze. What some refer to as an “atonic” or “lazy” bowel is, I suspect, a gut that has evolved into a state of hibernation. This reflection of trauma can express itself over time as a symptom of constipation.

States of freeze can be likened to hibernation, which occur when the only good option is to sleep and slow metabolism until there’s enough food again for survival. Bears don’t have bowel movements during their 5 to 7 months of hibernation. Our nervous systems put everything on hold until a viable option appears, such as spring. This is similar to the freeze state where the period of shut-down waits for the threat to disappear or rescue to arrive. Fight, flight and freeze are the way our nervous systems maximize our survival. They do so as a natural process that occurs outside of conscious awareness.

I’ve had hints over the years that intense emotions have been stuffed into my gut, too overwhelming to cope with at the time they occurred and never fully processed. They’ve lead to chronic symptoms of immobility, both in my gut and in the form of fatigue.

Different symptoms – same cause.

My hunch is that underlying states of gut immobility create the perfect micro-environment for altered gut flora, including SIBO (small intestinal bacterial overgrowth) and candida (yeast). These and other means are recruited by the body to support a survival state that is actually trying to help me. To protect me as best it can.

What I love about the trauma perspective is that it also allows for compassion because it explains the intelligence behind a symptom. Even when that intelligence is caught in the past and no longer serves.

When Treating Trauma Doesn’t Seem To Be Effective

I sometimes worry that the trauma perspectives I have been formulating are based solely on belief or blind faith. And then, when I recover from the disillusionment and cynicism of still being symptomatic despite years of trauma therapy –  I remind myself that these perspectives have grown out of detailed and solid research, years of clinical experience, and seeing my clients recover enough to return to work or get back into their lives more fully. That they come from watching my own gradual improvement with my chronic symptoms of intense fatigue.

At the very least trauma therapy is helping me recognize and recover from triggers more easily, at least more of the time. I am less reactive in my daily life. I experience more gratitude, self-compassion and satisfying connection. I am more gentle and patient with myself during symptom flares and they are less debilitating than they used to be. Working with trauma is helping me regain my sense of self and the health that underlies it all, regardless of my chronic symptoms.

What I am slowly learning to accept is that my world seems to be telling me – over and over and over again – to trust myself. Each time a medication, supplement, vitamin, herbal remedy or food stimulates another side effect I feel as though my body is giving me the opportunity to test this trauma hypothesis more fully.

To Keep Going For It.

To follow my impulses and trust my gut. My poor gut that has been containing old experiences of overwhelm for so many years.

It’s very humbling to find the process of trauma therapy to be more indirect and lengthy than I ever imagined – along with no clarity that I will recover. But the truth I come back to is that THERE IS NO RIGHT WAY to recover from chronic illness. It’s not as if there is even a known pathway. There is simply no promise of healing for those of us dealing with incurable chronic illness and chronic symptoms of all kinds.

And so I see the one greatest facilitator for healing – in whatever form healing will take – as trusting our own personal and unique instincts. To follow our guts and impulses. And to keep adjusting the sails as we go.

Treating Chronic Symptoms By Trusting Impulse And Gut Feelings

After writing about the link between my symptoms of constipation and subtle childhood trauma 4 months ago I started focusing more specifically on working with my gut. I decided to take a more active stance in listening to it and to listening to my impulses. I’ve been exploring which new treatments to try and which ones to let go of.

Rooting into this process of discovery may be one of the contributing factors to the fatigue exacerbation I’ve been experiencing in recent months. I see this flare-up as suggesting the extent to which unprocessed trauma and unmet needs in childhood can interact with genetic predispositions and epigenetics in the development of symptoms.

Hints That I Am On The Right Track

In June I started Mayan abdominal massage. The 4th session opened me up to grief. There was no identifiable source of the grief or any story to go with it. I cried off and on, a little here and a little there, for a couple weeks. During that time I once had bowel movements three days in a row for the first time in more years than I can remember.

I also had impulses to create containers. I started playing with sand tray, boxes, and paper mache.

When I felt the need for guidance and support to help me interact more directly with the metaphors and objects that were emerging, I started art therapy.

I consulted a traditional acupuncturist with 40 years of experience and a reputation for being able to solve just about anything 6 weeks back. I saw him 6 years ago when he helped me with acute symptoms but made no progress with my fatigue. On the 3rd visit, as he was getting more clarity about the underlying patterns for my symptoms he looked into my eyes with surprise. “You’re gut is in hibernation!” he exclaimed. He has sounded shocked with my body’s lack of response to his treatments and herbs.

I have most recently added sensorimotor trauma therapy for working specifically with developmental trauma. This type of trauma occurs in childhood relationships with parents and family, and I introduced it in a post called “When Your Ace Score Is Zero.”

Although my gut function hasn’t improved since that one temporary shift in August there is evidence for transformation in the visual metaphors that are arising. These visuals are striking.

I’ll share another phase of my explorations with you soon.

Related Posts:

Constipation, metaphor and symptoms of childhood trauma

Working with Food, Diet and Survival Patterns

10 Under-Utilized Tools for Treating Chronic Illness: Building on lessons from brain plasticity, epigenetics, and trauma