Talk therapy: does it play a role in gut health?
Is there more to gut health than just diet? Nutritionist and chartered psychologist Kimberley Wilson looks at the role of talking therapy in gut health.
We've become accustomed to thinking about the brain as separate from the body, leading us to underestimate (or ignore) the role of the mind in physical health. However, recent research highlights the complex interplay between the brain and the body and in particular, what’s known as the gut-brain axis. Nutritionist and chartered psychologist Kimberley Wilson looks at this link and the role of talking therapy in gut health.
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Stress and the gut
When we’re stressed, the Sympathetic Nervous System (SNS) (aka ‘fight or flight’ response) diverts blood away from the gut and towards the limbs, providing the energy to fight or run away. This, effectively, shuts down digestion and is why we are prone to lose our appetites and develop gut symptoms when we’re nervous or under pressure. Furthermore, the parts of the nervous system responsible for the stress response also form part of the limbic system, an area of the brain crucial for emotion.
Vagus: a two-way information highway
Going from the base of your brain to your gut, the vagus nerve is the major structural component of the gut-brain axis. In addition, the vagus nerve is also the main structural feature of the Parasympathetic Nervous System (PSNS). The PSNS is known as the ‘rest and digest’ system, the flip-side of your ‘fight or flight’ response; while the SNS prepares the body for action, the PSNS returns it to a state of calm.
This complex and multifaceted stress-brain-gut relationship opens up the possibility that talking therapies, especially those designed to reduce stress, could be effective tools to support gut health. In fact, studies on Irritable Bowel Syndrome (IBS), a common gut disorder, have already shown this. The main symptoms of IBS are abdominal pain or discomfort, associated with either diarrhoea, constipation or a combination of both, and a study published in 2019 looked at the effectiveness of online and phone CBT for IBS symptoms. 558 patients were randomised to either:
- Phone (eight one-hour sessions with a therapist alongside treatment as usual [TAU])
- Web (eight online modules and five 30-minute calls with a therapist and TAU)
The CBT provided education on how the gut works and techniques for addressing unhelpful thoughts and managing stress. Patients were followed up a year later and those who had received therapy had significantly fewer symptoms, improved quality of life and better social functioning than TAU. In another IBS study, emotional expression and awareness training significantly reduced physical symptoms.
Usually, when people start experiencing gut symptoms they assume that the problem is food and may start, unhelpfully, to cut foods out of their diet. Though some foods can trigger gut symptoms in those sensitive to them, it is important to remember the link between the gut and the brain. Here are some tips to harness the power of the mind to ease gut symptoms:
- Don’t work and eat. All work is a bit stressful and this can impair digestion.
- Breathe out. Long, slow exhalations help to stimulate the vagus nerve, helping to turn on that ‘rest and digest’ response. Try this for a minute before meals.
- Try to manage stress. Ease back on unnecessary commitments, get enough sleep and perhaps try a meditation app to help ease the pressure.
- Consider therapy. Sometimes the things that stress us out are too big for one person. A professional can provide expert support and guidance to help lighten the load.
What do you do to support your gut health? Would you try talk therapy? Comment below and let us know...
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This article was published on 26th August 2020.
Kimberley Wilson is a chartered psychologist and visiting lecturer working in private practice in central London. She is a Governor of the Tavistock & Portman NHS Mental Health Trust and the former Chair of the British Psychological Society's Training Committee in Counselling Psychology - the group responsible for monitoring and assessing the standards of Counselling Psychology training across the UK.
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