Chronic Pain & Irritable Bowel Syndrome (IBS)

Understanding Chronic Pain

Chronic pain is a multifaceted condition that can take many forms, including headaches, back and neck pain, arthritis, neurogenic pain (resulting from nerve damage), and psychogenic pain (pain existing without medical explanation). Its unrelenting and debilitating nature can rob you of the life you once knew; it can hinder your ability to engage in routine activities, such as going to work and running errands, and it can prevent you from exercising, socializing, and getting restful sleep. With increased dependency on others for support, people suffering from chronic pain can feel like a burden to those they love, which may negatively impact those relationships as well.

Seeking treatment for chronic pain often adds another level of frustration, requiring a significant investment of time and money to pursue the most effective remedies. Despite medications and steroid injections, procedures, use of TENS units, and visits to physical therapists, chronic pain seems to return with a vengeance. Impediments to daily functioning, combined with often futile attempts at relief, can leave sufferers feeling hopeless and with a diminished sense of identity and self-worth.

What does Chronic Pain have to do with Mental Health?

It’s easy to underestimate the impact of psychological factors on pain, since chronic pain is broadly viewed as a purely physical problem. But this widespread belief has caused sufferers of psychogenic pain in particular to be stigmatized and have their experiences invalidated. The International Association for the Study of Pain (IASP) defines the experience of chronic pain as both a physiological and psychological/emotional phenomenon:  Our thoughts and feelings about pain can actually influence our sensory perception at the neural level, which indicates a powerful mind-body connection between pain and our emotions.

This mind-body connection is also found in the vicious cycle between chronic pain and anxiety/depression. In many cases, as a person’s pain increases, their engagement in activity decreases as they attempt to reduce discomfort or prevent reinjury, and this leads to maladaptive thoughts about their limitations and overall situation. The resulting anxiety and depression reinforce their inertia through avoidance and withdrawal, which further perpetuates the physical experience of pain, and in turn, feeds deepening feelings of hopelessness, uncertainty, and despair. Learning how to end this cycle and better manage your experience of chronic pain begins with learning how to identify and regulate your thoughts and emotions.

What does psychotherapy for chronic pain entail?

Research shows that one of the most effective approaches for treating chronic pain is a combination of managing the condition and engaging in therapy to address related emotional distress. As a foundation of treatment, Dr. Kimberly Fishbach uses Cognitive Behavioral Therapy for Chronic Pain (CBT-CP), an evidence-based approach to chronic and acute pain that has been supported by over 30 years of empirical support. To promote the most effective outcome, she incorporates additional therapeutic modalities, such as Acceptance and Commitment Therapy (ACT), interpersonal therapy, mindfulness techniques, and hypnosis to help clients redefine their relationship with pain, increase acceptance, accomplish a deeper state of relaxation, and minimize the severity of pain symptoms. While never a quick fix, the use of hypnosis in conjunction with these therapies can further facilitate relief by redirecting the mind away from pain while clients learn to relax and mitigate the mental anguish associated with physical pain.

In addition to addressing their personal experience with chronic pain, Dr. Fishbach helps clients identify the cognitive and behavioral factors that contribute to the pain cycle, teaches adaptive strategies to overcome these factors, and empowers clients to reclaim their lives and live more fully again.

Irritable Bowel Syndrome (IBS)

The symptoms of Irritable Bowel Syndrome (IBS) include abdominal pain, constipation, gas, bloating, and diarrhea; all of which can have a significant and negative impact on quality of life. While functionally, IBS is a gastrointestinal disorder, it can often occur with other non-GI concerns, such as chronic fatigue syndrome, depression, and anxiety. Those suffering from IBS understand that episodes can be triggered as much by stress as by diet.

Dr. Rebecca Hoffenberg relies on an integrative approach to IBS that takes the whole person into consideration, from dietary triggers to psychological and other stress factors. Having trained with the American Society of Clinical Hypnosis (ASCH) in Hypnosis Interventions for IBS and working in consultation with top gastroenterologists, she uses hypnosis in combination with other modalities, such as CBT and mindfulness techniques. By combining these modalities in a supportive and therapeutic environment, Dr. Hoffenberg is able to help her clients achieve improvements in their IBS symptoms, as well as decrease stress levels and improve overall well-being. By promoting lifestyle changes, Dr. Hoffenberg also helps her patients navigate the additional symptoms associated with IBS, such as fatigue, nausea, and backache, which also greatly impact a person’s quality of life.

As with treatment for chronic pain, the mind-body connection is at the core of a holistic, integrative approach to IBS. While there is no conventional cure, clinical studies have shown that hypnosis is effective in treating IBS by providing both psychological and symptomatic relief, and that hypnosis may help reduce abdominal pain by an average of half or even more. In combination with addressing dietary changes, lifestyle choices, and other factors, and in conjunction with other therapeutic modalities, hypnosis is evidence-supported as an effective treatment for IBS.

By helping her clients identify and better manage the dietary, mental, and emotional triggers which can lead to and worsen IBS flare-ups, Dr. Hoffenberg empowers her clients to reduce the pain and discomfort associated with IBS and to regain their quality of life.

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