Bill said, “Are you kidding me? I observe this distress 24/7! It's always with me, never leaves me alone!”
“Yes,” Dr. Weisberg responded, “but how much of that time do you actually just sit and notice the sensations? If you're like most of our patients, when you feel a spike of pain, bloating, or pressure, you probably notice the feeling of it for about five seconds. This annoys you and makes you anxious, and then you probably start thinking things like, Oh no, not this again. How long is it going to last this time? What happens if the pain and bloating interfere with my sleep tonight?
Bill thought about it for a minute, smiled slightly, and said, “Now that you mention it, I think you're right! How did you know?”
“These are very natural responses. I see this all the time.”
Dr. Weisberg told Bill to point to where he felt the pain and bloating. Bill pointed to an area about six inches long in the center of his lower abdomen. He rated the intensity of the discomfort at five out of ten.
“Good,” said Dr. Weisberg. “Now focus on the sensations in that area you just showed me. Imagine you're just going to pull up a chair and sit right next to those sensations exactly the way they are, without changing them or trying to make them relax in any way.”
Bill looked puzzled. “But I do want to change them—I want those bad feelings to go away as quickly as possible.”
“Of course you do, but the way that you've been trying to make them go away hasn't been working very well, has it? So let's experiment on a new way of working with all of this, okay?”
Bill nodded and settled more fully into the chair. As he sat with the sensations and focused on them, he looked puzzled, almost surprised, as if he had never really paid such close attention to his sensations before. “It's interesting,” he said. “There's actually a lot of movement going on there. The left side of it feels now like a slight throbbing sensation, and the right side feels kind of dull.”
“Very good,” Dr. Weisberg replied. “Just make room for the left side of it to throb and the right side to feel the way it does. All you have to do is keep observing it and make room for it to do whatever it's doing.”
Bill watched his intestinal show unfold for six or seven minutes and then looked up with a pleasant, yet surprised, expression. “It's really something!” he exclaimed. “The left side throbbed more, and then the throbbing moved over to the other side. The area of bloating seemed to get bigger, and then smaller. I was really amazed to see how much everything was moving and changing. That fact was comforting to me because it meant my gut wasn't stuck and could actually change. It seemed like the more I made room for all those different sensations to be there, the less noticeable they became.”
Plus the pain decreased. “It was at a five, but I can barely notice it now—I'd say it's a one out of ten. I didn't think it was possible.”
Bill learned to observe his gut on his own, and when he returned for the second appointment ten days later, he was very pleased to report that the frequency and intensity of the pain in his gut was noticeably reduced. His third appointment became his last, because the symptoms hardly bothered him at all anymore.
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Not all patients find relief from their symptoms as quickly as Bill did. But practically all of our patients do experience relief and an improved sense of control over their symptoms by learning to notice and observe the sensations in this passive way. Ironically, they're learning to control their symptoms more by not trying to control their symptoms at all.
As a little experiment, just take a minute or two right now to focus on a sensation somewhere in your stomach or abdomen. Just imagine that you're going to pull a chair up to it and simply observe it. Don't try to change it, fight it, or make it relax. Just let that sensation in your abdomen be there exactly the way it is. If it stays the same, that's fine. If it moves, changes location or intensity, that's fine, too. Just be curious to notice what happens without you trying to change it in any way. Afterward, jot down on a piece of paper what you observed.
As you practice this skill and gain experience with it, your brain and nervous system will learn that these sensations are not threats. You will begin to feel the sensations diminish in intensity. What's more, you'll find that the anxiety, dread, and muscle tension associated with those sensations will also diminish. You will feel better and calmer, and you can then begin the process of actually listening to what the sensations are trying to convey.
You may be put off by this whole idea. You might be thinking, Why on earth would I want to make room for and accept sensations that I hate so much? I want to fight that sensation with everything I've got! This is a common reaction to something that seems counterintuitive. Skepticism is normal. As one of our patients said at this stage, “No offense, Doc, but are you crazy? This pain in my gut has taken over my life in every way. The last thing I want to do is pay any more attention to it. I'd rather stick my finger in an electric socket.”
We are biologically predisposed to be alarmed when we feel something painful or unusual in our body, especially when it's new. This is meant to protect us from harm. If you accidentally put your hand over a flame, that natural alarm activates a signal in your brain to pull your hand away as quickly as possible. You don't just watch it. If you suddenly notice pain or pressure in your chest with pain radiating down your left arm, you should not simply make room for that sensation. Instead, start calling 911! Similarly, if you experience new abdominal symptoms of pain, pressure, bloating, and diarrhea and have not seen a physician, you should definitely call now for an appointment.
However, if your symptoms have become chronic—and you have already been medically examined and tested—then the alarm function is not needed. It's a false alarm. The mix-up is that your more primitive, reflex-level limbic brain never got the memo. Unfortunately, most people still react with alarm, anxiety, or panic when they feel that all too familiar discomfort in their gut. Calmly observing those sensations helps to short-circuit the primitive brain.
At first, it may feel awkward or scary to observe your gut symptoms with a sense of passive curiosity. But we want to assure you that it is perfectly safe. We will be with you through this process, step-by-step, to help you master these new empowering skills. Over time, it will help you feel relief and gain more control over your symptoms.
Why Fighting Symptoms Doesn't Work
When you go on the offensive and try to fight your symptoms, it only makes them stronger. Try this: whatever you do, do not think of an elephant. What happens? The harder you try not to think of it, the elephant's image becomes even more prominent.
That's exactly what happens when you try the same game with a more emotionally charged topic: whatever you do, do not think of your gut distress. Instead of not thinking about your gut, your reactions become all the more amplified and disturbing. The harder you try to not think about the symptom, the more powerful the image. And the more powerful the image, the more likely you are to assign emotional value to it. Your body then responds automatically, unleashing multiple reactions, including the release of stress hormones and other factors that perpetuate or worsen gastrointestinal distress.
Say you get a burning pain in your upper abdomen every time you eat pizza. It's nothing new—a chronic problem. You've seen your doctor to rule out physical pathology. As you feel that all too frequent sensation, your body sends out a cascade of emotional and physiological processes in response.
First, your sympathetic nervous system shouts out for the release of stress hormones such as adrenaline (also called epinephrine) and cortisol as your primitive limbic brain mistakenly encodes the pain as a threat. Because emotions often express themselves in physical ways, when you