# arrogance and condescenscion



## trbell (Nov 1, 2000)

I've come to realize that psychologists are capable of coming across this way when they say they know IBS. i'm guilty of it myself at times and think it might be worthwhile to jon together and come up with a list o questions about ibs that can be asked to test therapists. Unlike many others psychologists would not be offnded if asked questions.tom


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## AZMom (Oct 13, 1999)

I spent years in "therapy" for IBS. The therapists had NO CLUE what IBS is. They diagnosed me as agorophobic, when all along it was IBS. I see no reason for an IBS patient to see a therapist. Did me no good, just increased my stress having to sit there each week. I'd rather see IBS patients go to a hypnotherapist or cognitive behavioral therapist for skills on coping with stress. Traditional therapy is useless for IBS. If there are other issues-sexual abuse, etc. that's a different story. But IBS alone, don't bother.AZ


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## Nikki (Jul 11, 2000)

My doctor told me to see a counsellor, who had NO qualifications at all. I don't think seeing a psychologist would help IBS at all. Maybe with anxiety issues and whatnot. But not IBS itself. I have found most medical professionals talk bollocks when it comes to IBS.


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## trbell (Nov 1, 2000)

so did you tell these people they were wrong? If you did did they listen?tom


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## trbell (Nov 1, 2000)

AZ, hypnotherapy and CBT are part of psychotherapy. They are techniques and apparently your therapist disn't know these techniques which is unfortunate. That's why I emphasize finding a therapist who is experienced with IBS. If your therapist used talk therapy as you say for agoraphobia that might also not have been the best choice ut i don't know enough about you to say what would have been helpful and I certainly wouldn't diagnose by internet.tom


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## Guest (Jul 12, 2003)

if they know hypnotherapy then it could be helpful. or maybe help in dealing with the psychological affects of chronic illness. but i do not think most traditonal therapy is helpful with ibs symptoms. infact, most therapists have no idea was ibs is and how bad it is. i went to one for years and she would sit there and say "and how did that make you feeeeeeeel?". and "do you feel better today" what a waste. its like NO i do not feel better! why would talking about something make someone stop having these symtpoms???? i can't believe we pay these people $120/hour for that kind of help. plus i could have seen her for years and it would never have occurred to her that we weren't getting anywhere. she had no intention of trying to make my symtpoms better. if i were taking someone's money i'd be concerned that i was alteast helping them get better to some degree. so i think if therapists are going to attempt to help ibs people they need to know hypnotherapy that is gut-directed and they shoudl learn about the of ibs as a disease and not a mental problem. otherwise they should refer that perosn to a hypnotherapist and then treat the patient with relaxation and learning how to deal with a chronic illness-but knowing that these 2 things will not actually change the symptoms, most likely. bottom line is-has anyone ever gotten better from seeing a therapist?


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## Ganas (Jun 24, 2003)

As a fellow IBS sufferer/therapistLet me first say "Sorry that you had such a bad experience" It appears that you got a bad apple out of the bushel. Before mental health counseling of any sort should always check for licensure and credentials. This does not determin effectiveness but lets you know that they have met a certain standard of skill & ethics. Also if they know nothing of the disorder it is "Unethical" (American Counseling Association ethics code) for them to treat you" If they follow APA or ACA ethics another point to insist on.There are studies that are in stark cantrast to your opinion about counseling being no good for IBS. In fact it is just the opposite for many other chronic mentally stressfull disorders lke IBS. In being fortunate to read and study these things as well as work with people who are under chronic stress on a daily basis I am lucky to be able to see the other side? You are perfectly right to have the opinion that it did not work for you. But I must defend the theraputic community and those people who have been helped buy it or who may be willing to try it.Myself included. Since my IBS a year ago I am seeing a therapist, to help with stess, pain,loss,change,anger and a list of things that come with this disorder that one can just not seperated. I find it extreamly helpful. When I got ahold of this IBS I would love to specialize in treating IBS sufferers with the talking cure(Basic Therapy). I would love to know if the board shares your opinion? How about it gang do you feel that therapy has been helpful with your struggles and IBS?


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## trbell (Nov 1, 2000)

probably need to continue n the general forum?tom


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## Guest (Jul 12, 2003)

CBT has been very beneficial for me in many realms. I believe it is an essential part of healing and goes hand in hand with hypno, biofeedback as well as meds.Finding the right psychotherapist isn't easy, but with the right one, great things can happen.I guess I also believe that it's easier to say that going to a therapist doesn't help than it is to really want to try to get better.... I know this... because I've been there. We often play mindgames with ourselves, and the end result is usually that we shortchange ourselves by doing so. It took me years to figure this out.Evie


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## AZMom (Oct 13, 1999)

I've had IBS for 30 years. I've done all the therapies. I saw a psychiatrist, and 4 different psychologists over the years. The psychiatrist gave me drugs and diagnosed agorophobia, then sent me off to a psychologist. The psychologists did talk therapy with me. One gave me a relaxation tape. I did CBT twice, hypnotherapy twice, and a course in stress management.The psychologists simply had NO idea about IBS and did no good at all. CBT helped somewhat. One time I did CBT for relaxation (the raising the temp in the fingers bit) and the other was CBT for bowel control (learning which muscles to relax and which to tense to have a BM.) I did hypnotherapy too in 1989. It helped as well. I learned how to relax my body and mind in a matter of minutes. This helped me cope further with my symptoms.I did Mike's tapes in around the first part of 2000. This gave me the most dramatic improvement. Really put me over the top, to a point that I can say my IBS is much better. I'm at a point that I can live with IBS now. Now I have a life.AZ


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## trbell (Nov 1, 2000)

AZ, The CBT you mention for bowel control sounds more like biofeedback. I'm glad you found a psychological treatment that would help at last. What was it about Mike's tapes do you think that helped. This is what I'm trying to pass on to other psychologists.tom


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## Guest (Jul 12, 2003)

maybe someone (therapist here) could explain how talk therapy could help ibs. that's all i'm asking. i just see massage therapists and hypnotherapists really helping people. i don't think talk therapists have ever helped ibs people. maybe a few, but i do not believe this is has been a helpful strategy. i can say that going twice a week adn talking about my ibs to someone who did not understand it actually made things worse. i think the further we get ibs out of our conscious minds, the better.


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## AZMom (Oct 13, 1999)

You're right Tom, it was 2 courses in biofeedback, my apologies. The CBT was a course through Midwest Center for Stress and Anxiety. This was very good for anyone suffering with agorophobia or severe panic. Learning to use positive self-talk, recognising negative self-talk, realizing the excitement felt like anxiety, learning to under-react and not to fear fearful thoughts. They also recognize IBS as a symptom of stress. In fact, this was where I first heard of IBS, 17 years after my symptoms started. AZ


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## trbell (Nov 1, 2000)

Now i see the misunderstanding. Psychologists do a variety of therapies depending on what's needed and for ibs it would likely be CBT or hypnosis as reasearch shows talk therapy is not a therapy of choice for IBS. There is a good book from APA by Blanchard that goes into it further. i think actually Mike is a masters level psychologist who does hypnosis.tom


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## Guest (Jul 13, 2003)

Tom,that clears is up for me - thanks


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## trbell (Nov 1, 2000)

thanks, I guess I'm tired of the psychologist bashing and jeff suggested I take a break. I've agreed.tom


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## Guest (Jul 13, 2003)

"Talk therapy" is enabling. It teaches us how to view situations from different perspectives. For example: rather than beating ourselves up over a mistake, instead we LEARN from the mistake. OR... when something "bad" happens to us, rather than giving up, instead we LEARN to try again. For me, CBT gave me the ability of understanding that even though I did something "bad".... I could pick myself up by my bootstraps and carry on.Ever notice how your gut feels when you are upset about something? CBT teaches the gut to "relax". From my readings, I have surmised that when a patient has true IBS, the communication mechanism between the gut and the brain do not function properly. Rather than the transmission going to an internal part of the brain like it does in normal people, instead the transmission goes to the prefrontal cortex.... and triggers anxiety. Just knowing that this happens....can help to offset the symptoms of IBS as well as the anxiety.Further, "Talk Therapy" or CBT..... teaches us self-esteem. From my readings I have ascertained that lack of self-esteem is responsible for about 90% of behavioral health disorders. And like it or not.... our thoughts DO control our emotions which in turn control our physiology.... including the immune system and the autonomic nervous system, inclusive of the parasympathetic and sympathetic nervous systems.Tom... if I am not mistaken.... UNC and Drs. Palsson and Drossman RECOMMEND CBT in conjunction with hypnotherapy and medications for treating IBS, based on the patient's individual needs.And if it helps anyone to know this.... I went through 7 or 8 therapists before I finally found one with whom I could relate and make some real progress.Evie


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## trbell (Nov 1, 2000)

I think they recommend cbt, hypno, medication, OR talk therapy depending on a in-person assessment of what will help the patient. Different things work for different people. the case study eric recently got from Dr. D used medication, hypno, and psychoanalysis, for example. The point i've been trying to make is that psychologists generally know all these techniques (aside from medication) and can decide with the patient what will work best.tom


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## Guest (Jul 13, 2003)

hijacking this thread:how come the 3 therapists i've been to just sit there and say the same things:when you get there: "how are you today" then complete silence till you start talking about somethingthen they nod and say "hmmmmmmm" alot and "how did that make you feel". if therapy is helpful to ibs then i'd like to know how i can find a therapist that would not do this-b/c i just feel like i'm talking to myself and i know that doesn' help. i also suffer from generalized anxiety disorder-have suffered for years so i would like to get some help with that. can anyone recommend anyone in the bay area(san francisco) who is a good therapist, knows CBT and knows hypnotherapy? is there such a thing?thanks-Susan


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## Guest (Jul 13, 2003)

by the way essence tries-i find you so inspiring!


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## Guest (Jul 13, 2003)

Susan... I think we're all an inspiration to each other here, don't you?







If it helps to know this, I was diagnosed with generalized anxiety disorder 12 years ago. It's not been an easy disorder to live with or treat, but I've made great progress in recent years.This is just a guess, but I think maybe the reason therapists ask questions and then wait for us to speak is because if they're going to be able to help us, they need to be able to get inside of our heads....and that's the only way they can do it. If we don't speak, they aren't going to know what's on our mind, what is troubling us, how we feel about it or what we want to do. Also.... even though this is difficult early on in treatment, CBT can only help if/when we make a decision that we want to get better. I think I was in therapy for 5 years on and off before I finally came to this decision. And it only happened when I started therapy with someone with whom I was able to relate and be very comfortable.I still have anxious moments, but I've learned that no one but me knows that I am feeling the way that I am feeling, so I've learned to "act" even when I AM anxious.I've also learned to become "breathing conscious" because how fast or slow or shallowly or deeply we breathe has an effect on our level of anxiety.Probably the best thing I've learned from CBT is how to think of myself as worthy of respect from others. It's been a great self-esteem booster and this also helps to alleviate anxiety. Regarding how to find the right therapist, you may simply need to keep trying until you find the right one for you.Best wishes,







Evie


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## AZMom (Oct 13, 1999)

"Talk Therapy" and CBT are different. CBT is appropriate for IBS and anxiety disorder because it teaches us to talk to ourselves in a positive manner, and to recognise how our thoughts can bring about symptoms. Changing the way we think and talk to ourselves can reduce symptoms.After all these years I've tried virtually every treatment there is. I would tell an IBS patient to find a specialist that knows more about IBS than you do (good luck there). CBT, biofeedback, and hypnotherapy in combination is appropriate. However, although most psychologists CAN do these treatments, they still need to be IBS specific. What you have to watch is the health professional that says they can treat IBS even though they have only a vague understanding of what it is. I called a bunch of hypnotherapists in my area and asked if they could treat IBS. They all assured me they could treat me, even though they had no clue as to what IBS is.AZ


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## GailSusan (Dec 23, 2000)

I'm a former psychotherapist, who just went to a highly qualified hypnotherapist (Ph.D. psychologist with tons of accreditation) for help with dieting (not for the IBS, which I have pretty much under control with Zelnorm and hypnotherapy tapes). I told the hypnotherapist that I needed afternoon appointments because of the IBS. She shocked me by claiming she could take care of my IBS by taking a over-the-counter drug (which turned out to be Fibercon under a different brand name). I told her that I would check out the medication she was recommending, but would still prefer an afternoon appointment. She insisted that there would be no need for an afternoon appointment as I would be fine after taking the medication! As you can imagine that was my first and last appointment with her.I wish there were more CBT and hypnotherapy trained psychologists who knew how to treat IBS. I haven't come across any in Connecticut despite keeping in contact with people in the field.


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## trbell (Nov 1, 2000)

GailSusan, As you know, psychologists have an ethical obligation to be informed on IBS if they claim to treat. Obviously the therapist you saw hadn't read Blanchard or kept up with the literature that's been appearing. People don't seem to realize that incidents like you describe are reportable?tom


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## Guest (Jul 14, 2003)

Don't feel bad, Gail... the gastroenterologist who diagnosed my IBS prescribed Fibercon for me as well...







Needless to say, I never saw him again.I've gotten much more relief of IBS symptoms from CBT and Hypno. Although the one thing neither of those modalities has ever been able to correct is the GAS !! That seems to be more related to diet.Gail... I'm happy to see you over here on this forum and hope that you will continue to post here.Could you or AZ explain the difference between talk therapy and CBT? I'm a bit confused with the two I think?Evie


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## GailSusan (Dec 23, 2000)

Hi Tom, Yes, I probably should report her.Hi Evie, Talk therapy can range from the Freudian (tell me about your childhood) to Rogerian (what I hear you saying is...). CBT is basically the approach that you use a lot. It requires disciplining your thoughts so that they don't focus on the negative (e.g. catastrophic thinking, negative self-talk, worrying) and instead reframe situations so as to look at things realistically and figure out what you can control. My first CBT therapy occurred when I was an undergraduate and it changed my life. I had been buffeted by feeling of severe depression since the age of 16. I have been able to live most of my life free of depression thanks to CBT. Now I need to use CBT to deal with anxiety. I was just about to start work with a therapist when all the problems started with my mom last October and haven't gotten back to it yet. However, I am dealing with my anxiety better anyways thanks to Mike's new CD "Towards Inner Peace", which I play whenever I'm feeling anxious.


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## AZMom (Oct 13, 1999)

If psychotherapy works for IBS why are there so many psychotherapists on this board with IBS?AZ


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## trbell (Nov 1, 2000)

I'm not sure I've seen anyone say psychotherapy works for IBS. In fact research shows it's not as effective as brief CBT or hypnotherapy. Blanchard's bood on IBS is the best source of research on this, I think. Do you know any other sources of research on this question? As a poet I would say IBS also appears to be an occupational disease for poets.Bada


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## GailSusan (Dec 23, 2000)

> quote: As a poet I would say IBS also appears to be an occupational disease for poets.


You've lost me, Tom. My mom is a published poet and she doesn't have IBS. Please explain.AZMom, No, I don't see that psychotherapy in general has a significant impact on IBS symptoms, but certain techniques such CBT can reduce stress over all (which exacerbates symptoms) and others such as hypnotherapy, using IBS specific scripts, can target the mind-gut connection directly (through hypnotic suggestions). I haven't been able to find a psychotherapist who can help me with the IBS in my area and even though I have psychological training that doesn't mean I can treat myself any more than a surgeon can take out his/her own appendix. I do understand certain techniques and apply them, but so can anyone else who picks up a book on CBT or hypnotherapy. It's the practice of it that's difficult and often requires a live person to guide you though. I've gained a lot from my CBT and hypnotherapy therapists over the years.


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## BQ (May 22, 2000)

Bada, Getting back to your original question about what inquiries to make of a Psychologist:First, I think it is the _patient_ who should ask questions of him or her self before going to a therapist. I asked myself questions like this before I went to a therapist: Questions like: "What do I expect to achieve via this therapy?" (What is the goal?) "Am I willing to do the work, which may entail being brutally honest with myself?" Then after answering those questions of myself AND sharing my answers with the therapist at the first appt, here's what I asked:I wanted to know if they (the therapist) had experience treating folks with chronic illnesses.I wanted to know how they conduct their sessions period. In other words, if it is "How are you doing today?" type stuff & that is it and that is not what I as the patient thought I needed, I would not be interested in continuing with that therapist. (I also shared that I had been to other therapists who conducted their sessions in that manner and found no help from them whatsoever.) And I asked if the therapist thought he/she could help me achieve the goal stated.My goal wasn't to get my IBS cured. My goal was to lower my anxiety levels and hopefully through that, I could lower the incidence and frequencies of my IBS flares. I went in knowing this therapist wasn't going to stop my IBS diarrhea. I knew I had too much anxiety and I suspected, that for _my_ IBS, anxiety was an agrravator of symptoms and a possible trigger. I think it was my responsibility as a patient to make the decisions and choices about the goals I expected to achieve via therapy. I bounced that info off the therapist and asked if they could help me or not. Turned out they thought they could and I worked my butt off and did.Establishing clear cut goals really helped me. It also helps me to have a clear realistic goal in mind when going to see any professional.BQ


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## trbell (Nov 1, 2000)

nice assertive response, BQ. I think many people can't do that though so I'm trying to figure out how to get psychologists to be more understanding of IBS.tom


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## Guest (Jul 15, 2003)

...Maybe take one of them into the bathroom with us when we're having a severe attack?(Just kidding, of course)Gail: I wish my parents had sent me to therapy at the age of 16. We were farmers and very poor and the stigma associated with mental illness was overbearing. I was 39 before I was ever even diagnosed. Lots of negative foundation can be built during such a timeframe. This is why it's so important to get an evaluation early on.Evie


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## BQ (May 22, 2000)

Ok Bada, perhaps not everyone could do that. Hmm, as a very practical and simple means, maybe bringing along a copy of "Molly's Brochure" for the professional to read might be helpful?Here's the link to that brochure if anyone hasn't seen it: http://www.ibsgroup.org/main/aboutibs.html I know it is simple, but it could give some insight to the professional that hasn't much knowledge of IBS.BQ


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## trbell (Nov 1, 2000)

Thanks, BQ. That's the kind of thing I was looking for but maybe more what are the top five things a psychologist should know. I think more and more people will be referred by the doctors now that doctors are starting to understand the importance. I also think psychologists are trained to understand it's not all in the mind. What else would you like them to know?Bada


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## BQ (May 22, 2000)

Did you know:1) IBS feels like an invisble entity has invaded my body? It's reach can be all encompassing and impact every aspect of my life; from what clothes I put on to whether or not I can make it out of the house. It's treatment therefore requires changes in every aspect of my life.2) IBS is very difficult to manage. It is chronic and can be exacerbated by simple, well within the norm, everyday responses to very common life stressors? Nevermind the BIG stressors! When one of those happens, I must not only process the stressors, but I must also do so while trying to manage symptoms which may be severe.3) IBS WILL effect when, how or whether I can actually attend appointments, work, functions, vacation, etc. 4) IBS is little understood in the mainstream by professionals, colleagues, family, friends etc. It can be very isolating.5) IBS requires 'turn on a dime' flexibility. It can be dormant for a time and then erupt when I least expect it.Is that more the kind of questions you meant Bada?BQ


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## Guest (Jul 18, 2003)

You said it all, B.Q.







Have I told you yet that we've all missed you?A WHOLE LOT ??????


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## trbell (Nov 1, 2000)

right, BQ. are these statements or things for psychologists to think about? I think most psychologists are used to hearing similar things from clients all the time. rememeber that we are trained to listen to people and unlike doctors have time to listen. we also ask questions. Maybe this could be combined with what Marilyn posted from Mike. I think I'll write him about it.Bada


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## BQ (May 22, 2000)

Bada, Sorry I didn't see your last post sooner. In answer to your last question; the things I posted would be things I would want the psychologist to know. Yes good professionals do ask lots of questions and listen. I feel fortunate to have had one that did practice that way. We didn't talk about IBS all that much believe it or not. It seemed more like we concentrated on the stressors, anxieties and plain old fears that I wanted to manage or eliminate. The three change mechanisms described by Blanchard that Bonnie posted:"Therapeutic work was directed at activating three change mechanisms:1) ï¿½rational self analysisï¿½ or self understanding (in which the patient explores idiosyncratic beliefs and fears, their connection to the cognitive, behavioral, and affective components of their IBS, and in which they reach an understanding of their fundamental maladaptive orientation to self and world)2) The second part of the therapeutic change mechanisms was ï¿½decentering,ï¿½. in which the patient gains distance from self by identifying his or her self talk and labeling it as self talk, thereby ï¿½explicitly ï¿½owningï¿½ automatic thoughts.3) Lastly one begins to involve experential disconfirmation (admittedly focused) in which patients are led to challenge their maladaptive beliefs through strategically planned behavioral experiments and deliberately acting differently so as to experience the self in different ways."seems to have been exactly what the therapist did with me. I told her I had IBS and what symptoms I was having the most trouble with at the time. She listened, asked a some questions for clarification and that was pretty much the end of IBS discussions. She offered to "do" appointments over the phone if I had trouble making it to her office. I did manage to get to her office though for all of them. But I was relieved to hear her offer the phone appointments. To me, that offer told me she completely understood the impact of IBS on my life. So we really didn't talk much more about IBS itself. She only asked me to tell her if I noticed any change in symptoms. And I did tell her when I experienced changes. When I had cjanges to report, she would ask how I felt about those changes, etc. Sometimes I knew and other times, I didn't. She asked loads of other questions about other issues. (I mean ALOT, LOL of other questions) The hard part, answering them _honestly_







, was my job. and I had "homework" to do between each session. This was just my experience. And I know I was very fortunate to find someone who could really help me. She was only the 2nd one I tried and she WAS good. I felt like a much more empowered person, much more in control of me and consequently, of my IBS too. I had to work hard at new thought habits and positive self talk, even after seeing her, but I found it was kinda like learning to ride a bike. Once you know how to change one's thinking, one can do it with a bit more ease each time. It is kind of doing those change mechanisms on your own.BQBQ


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## trbell (Nov 1, 2000)

sounds like you had a good experience. I'm glad to hear it. Did she ask you to keep a log like Blanchard suggests? Sometimes I feel it helps to not focus on symptoms with any problem and sometimes it helps to focus on symptoms.Bada


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## BQ (May 22, 2000)

No Bada she didn't ask me to keep a log. But I would have a "homework" question to answer each time. They were the types of questions that would take some thinking to answer. Ya know, it just occurred to me that she didn't ever say that she 'knew IBS'. I just asked do you think you can help me and she said yes. Believe it or not, I just assumed she didn't know much about it. BQ


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## trbell (Nov 1, 2000)

she didn't make an unrealistic promises which is good but it also sounds like it helped your coping with your IBS.Bada


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## BQ (May 22, 2000)

Exactly, among many other things it helped me cope with, Bada. This all took place about 8 years ago now. But I shudder to think what I'd be like or feel like now if I had never done the work with her.BQ


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