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IBD & Medical Trauma

Medical trauma is such an under-recognized issue for the chronnically ill. It's a hard topic to talk about because it can seem like we are pointing fingers at healthcare workers. Maybe that's why there are only, now, 4 studies on the topic in patients with inflammatory bowel disease (IBD). If you are someone who treats people with IBD please know I am not here to demonize or criticize. I am both a patient and a GI psychologist. I know the medical system from both sides. I know how messed up and broken it is. But ignoring this or rationalizing it away as only affecting a few folks is wrong. So let's talk about it. Post-traumatic stress (PTS) is the term we use for medical trauma due to technicalities in the Diagnostic and Statistical Manual for Mental Disorders (DSM-5) for post-traumatic stress disorder (PTSD). PTS can be less severe that full on PTSD, or it can be full on PTSD. Regardless, the symptoms are identical: Feeling hypervigilant/on-edge (increased
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Primal

Greetings!  It's been a while. I'll blame COVID brain on my lack of writing over the past year. Can you believe it's been a year of this shit? And it looks like we're about to ride another wave, this time the variants B117 and P4.  I'm not here to write about COVID. I'm here to talk about food. Specifically, the psychology of eating. There's a lot of attention being given to this idea of "ARFID" or Avoidant Restrictive Food Intake Disorder, in patients with chronic digestive disease. This is a psychiatric diagnosis conceptualized mostly for children with sensory issues or similar concerns. The main questionnaire used to assess ARFID, the Nine Item ARFID Scale (NIAS), is only validated in children .  While I absolutely agree there are adults with chronic digestive disease who meet the criteria for ARFID, this whole thing makes me a bit twitchy. Here's why. First: Did you ever drink too much tequila and puke and maybe have one of the worst hango

Core Beliefs and COVID19

Hello! I'm here today to talk about the key psychological concept to a major theory of how and why humans behave the way they do. Sounds super exciting, doesn't it? What if I say I'm doing this in the context of COVID19, kids, and returning to school? Ooooo, controversial. Thursday evening I watched our local school board meeting for about 6 hours. The meeting went from 5:00 to 11:30-ish, pm. The entire time was dedicated to discussions around our "Return to Learn" plan. About 2 weeks prior, the board voted for 5 days, in person schooling. This is for the elementary and middle schools only. On Thursday, the board voted 5-2 to do the same thing except now with a "phased in" approach. Starting with 2.5 hours in person initially, with the goal of 6 hour, on-site, 5 day-a-week learning by late October. Districts around us are starting out 100% online, and this was proposed by the 2 ultimately dissenting board members. Parents who don't want to do t

Why You Don't Have Access to A GI Psychologist

Hello! Day, what, 120-ish of the global COVID-19 pandemic and I haven't written a post since March 27th when I talked about accepting this BS situation we're in. I guess I've been kind of distracted. Today I'm not here to talk about COVID. Except at the end and not in a way you'd probably  expect. Today I'm here to tell you why you don't have access to a psychologist who specializes in helping patients living with chronic digestive diseases. My kids have been playing a shit-ton of Minecraft I've been at this "psychogastroenterology" thing since 2005, when I was a wee pup in my 2nd year of graduate school. Before we even had a name for the field, rather we were just a few clinical psychologists with training in chronic diseases (i.e. clinical health psychology) that noticed many people with GI conditions needed a lot of help navigating things. And the stigma, oh the stigma, especially toward patients with irritable bowel syndrome. It w

Yep I Want You To Accept This Reality

Hi! Ok, what day is it?  Friday?  Star date: March 27, 2020. How's everyone doing? Everyone "coping" ok? Yeah, it's perfectly fine if you're not. But I would prefer if you were, so I'm going to try to help. Before I get into it, it's time for the sakura (cherry blossoms) to spread their beauty in Japan. Unfortunately the traditional gatherings of friends underneath their blooms to meet for food and drink and good cheer (Hanami) is officially canceled due to COVID-19. But, we can still think about the meanings behind sakura and hanami. In Japan the Sakura represents a time of renewal and optimism at the end of winter and start of spring, and remind us that life is short and beautiful. And since life is short and beautiful, no matter what's going on on the CNN news ticker (turn it off....really.....just turn the news off), we should fill it with meaningful time. I'm going to first ask you to accept that shit sucks. It's going to suck f

A Harsh Reality

Me again. This post is going to suck. On March 10, 2020 my gastroenterologist sounded the alarm to me about COVID-19. She told me to stop taking the train to work via a text conversation. I even tweeted about it, how I asked if she was blowing things out of proportion. Clearly she wasn't, but back then I hesitated and thought "what will others think if I do this now?" But I followed her advice. And now look where we are. Today is March 23, 2020. I have a lot of friends and colleagues who work in hospitals. A lot. Whether they're at the hospital I too work at but have the privilege to be "non-essential" and work from home or the people I've connected with at conferences or via Twitter. I know a lot of people in health care all over the world. My gastroenterologist, the one who sounded the alarm, is a close friend. Her husband, the head of pulmonology and intensive care at a major hospital in Chicago. In my own department, we have a video-meetin

So You Have IBD During a Pandemic

Hey! What's going on? Been pretty boring over here in Chicago. Ok I don't need to elaborate on what the hell is going on in the world. We are being bombarded with information - some accurate, a lot inaccurate - about this pandemic. It's very easy to become completely overwhelmed by it all. We've been forced, pretty damn quickly, to completely overhaul our way of life for the greater good. To reduce the strain on our healthcare system of the sick and dying. And us humans are generally bad with rapid, monumental change that we really don't have a lot of say in. Our little reptilian brains do what they're supposed to do (prime us for fight or flight or freeze) but our advanced "thinking" parts of our brain have to interject with all sorts of unhelpful thoughts, thereby sending some of us off the rails. Before we start, turn off the news. Seriously. In the days following 9-11 we found people who consumed more 24-hour news channel information were mor