Dr. Clarke Can PPD/TMS cause Gastrointestinal Symptoms?

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Question

I LOVE that I can ask a TMS therapist a question. Thank you!

My question is this:
I have read all the books, completed the SEP and am happy to say my migraines, back pain, tension headaches have for the most part, disappeared.

I am however, still bloating. I never considered bloating to be a TMS issue but I am beginning to question this. I have no major internal issues going on. I do have 2 small fibroids that are too small to cause any interference, so I am told. I been on a very healthy diet (no sugar, no wheat, no gluten, no dairy, no nightshades) for about 6 months now and the bloating still continues. It doesn't seem to be what I eat but THAT I eat! I wake up with no bloat, but as soon as I eat, it starts. I know that there is guilt attached to eating. Which comes from watching my mother feed us all before she fed herself and somehow, there is shame there too. I have no idea why, but I know its there. I wonder, has anyone dealt with bloating from a TMS perspective. I am a tall, slim woman with very little fat. I exercise moderately, eat well and the bloating is not uncomfortable or painful. I have no other gastro issues, I am not constipated nor do I get diarrhea. I have however, noticed that I hold my stomach in ALL THE TIME. It seems automatic. Probably because I think it will hold my stomach in! And I notice that holding my stomach tight all the time stops me from belly breathing. So my breathing is shallow and I am not getting any air into my stomach. That's all I got!

Hope someone can give me some guidance. I am so fed up with being offered a seat on the subway (although it does have its perks) because I look pregnant. Even this morning, walking to work, I had a 'knowing smile' from a heavily pregnant woman. Funny. But not so funny.

Thank you.

 

Answer

Bloating has many possible causes including slow stomach emptying (from nerve damage in the stomach wall (usually from long-term diabetes) to partial blockage at or near the entrance to the intestine), slowed contractions or partial blockage in the bowel, increased gas production from intestinal bacteria, food intolerance and other problems. None of these is particularly likely in your case since your symptoms are mild, appear to have been present for a long time without getting worse and are not associated with other worrisome problems such as vomiting, weight loss or bleeding.

It is always worthwhile to check any symptom that concerns you with your doctor, but along with that it is reasonable to look for sources of stress (past or present) that could be responsible. If you find one or more of these, work to relieve them and if you find the bloating improves then you have excellent circumstantial evidence that you are on the right track.

Two giant clues in your question are Shame and Guilt. That you remember this from childhood, and tense your abdominal muscles "all the time" says to me your mother was doing a lot more to inflict stress and tension on you than just feeding you first. The more you can recall how that shame/guilt was created, the more successful you will be in ridding yourself of it. Some techniques that might help:
1. Relaxation technique with deep abdominal breathing followed by
2. Imagine what it would take to treat a child you care about exactly as your mother treated you as a child. Then,when you feel ready, move on to
3. Write a letter (usually not mailed) to your mother, expressing your thoughts and emotions about #2. This will help convert the bodily expression of emotion (which causes symptoms) into verbal expression and that often leads to relief. A therapist experienced in helping people cope with past emotional abuse may be necessary to provide essential support for this process because it is rarely easy to recognize you are angry at someone you also care about.

Based on experience with other patients, I believe you will do well with this problem because you have already overcome even greater challenges. My best wishes for a rapid and full recovery.

David Clarke, MD
Clinical Assistant Professor of Gastroenterology Emeritus
President, Psychophysiologic Disorders Assn
www.stressillness.com

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Questions may be edited for brevity and/or readability.

 

Hi, kindlethe light. Dr. Clarke's reply is terrific and if you follow it, should help you heal the stomach problems.
I think a lot of our repressed emotions from childhood such as guilt and shame give us abdominal symptoms.

My stepfather was so terrible to my mother that she developed a spastic colon and couldn't eat. He was full of anger about two
previous bad marriages and took it out on mom, even though he loved her. There's the old song, "You Always Hurt the One You Love."

Your mom loved you, I'm sure. She just had her own TMS and needed someone to take out her anger on, and you were handy.
Reflect on it all, write that letter Dr. Clarke suggests, and work on forgiving her. Then your stomach will be at peace and so will you be.

 

I really like the steps Dr. Clarke outlined. Getting into a relaxed state is definitely key to successfully do the other two steps. Given what you wrote earlier, @kindlethelight , about holding your stomach in and not breathing deeply, though, this may not be as easy as it sounds. Deep abdominal breathing expands your belly, so this can be a fairly challenging exercise when you're both self-conscious about that particular area of your body and have the strong emotions of shame and guilt added to the mix. (I don't have the bloating symptom, but I have pretty strong feelings around that area of my body, including shame, and have found in the past that the physical sensation of deep breathing, combined with those feelings, is not exactly relaxing, if you know what I mean...)

It's important to be as relaxed and centered as possible when trying to work through experiences of shame and guilt. So I wonder if preparing for this relaxation step, as weird as that may sound, could be helpful in order to successfully tackle those next two steps that are far more emotionally involved.

Something that worked really well for me is practicing deep breathing on its own (sometimes with some sort of guided meditation) in a place that's comfortable and safe, both physically and emotionally. I think this could be a good way to get used to the physical feeling of deep abdominal breathing, especially if you aren't used to it. It also lets you see if there are any emotions that come up while in a safe space. (Mindfulness/meditation techniques help here - noticing that they're there, but not engaging with them.)

 

I went through a time in my life with intense stomach pain and bloating. Nothing wrong. All TMS. Interestingly, it was either one or the other at any time - either had the pain or the bloating. Never both at the same time. Each one seemed to be enough to cause me to obsess about it. As I found a path to worry about it less and less, it all went away.

 

Becca, I too like Dr. Clarke's deep breathing meditation techniques.
I try to always follow the suggested method of inflating the belly, holding the breath, and then letting it out.
But sometimes I may just be lazy and in hale without filling the belly with air, holding a second, then breaking out
and I feel a good calming effect. If I concentrate more, I can do deep breathing the suggested way.

Either way, deep breathing is one of my favorite relaxation techniques and helpers in getting to sleep.

 

Hi Kindlethelight, I had similar symptoms a long time ago after one of my kids was born. She had some stomach problems that made feeding difficult-- after a few minutes she would stop nursing and start screaming her head off. Very nerve wracking. Anyway, I began to get stomach pain (sympathetic maybe!) or bloating and it took me a couple of weeks to realize that every time I went to nurse the poor wee thing, I was tensing up my stomach. I didn't know it was TMS, but I stopped tensing, and the problem in my stomach went away, but of course turned up elsewhere.

 

I have known a number of women who look pregnant, they usually have issues with pregnancy itself. They have either had a miscarriage, abortion, still-born or giving a baby up for adoption. They hold in guilt about what they have done or what has happened to them and the lost child. I guess there can be many reasons for guilt and shame as Dr. Clark and tarala suggest. This may not apply to you, it's just something I have noticed in women, being the observer that I am.

 

Negative emotions can cause all kinds of TMS symptoms.

I recently found a YouTube video I like a lot, to reframe our negative emotions to positive.
I don't know who the fellow is, but I like what he says: