Alleviating the Emotional Suffering
In 2016 I completed a program to become a certified Change Coach, specializing in helping people overcome anxiety. Three years later, I went a step further and participated in an intensive training and mentorship with Dr. Amy Johnson in order to better support those with gastroparesis when it comes to the overwhelm, frustration, and often debilitating worry that’s so common following a GP diagnosis.
I came to all of this training as a result of my own struggle with anxiety and panic, which started shortly before my gastroparesis diagnosis and escalated dramatically following the birth of my daughter in 2012. I'd always considered myself an "anxious person," something I hear repeated often with the clients I work with. I'd tried all of the usual ways of "reducing stress" — meditation, mindfulness, yoga, breathing exercises, biofeedback. I'd spent years in therapy. I gave up caffeine, I started tapping, I posted affirmations. I got acupuncture and Reiki and hypnosis. I went on retreats. I bought crystals. I spent thousands of dollars... and none of it worked.
Finally, I found a podcast that led me to Kelli Walker and Dr. Amy Johnson. I participated in an online program that they co-led and then I worked with each of them individually in private coaching sessions. Through those sessions, I was able to see some really important truths that, at the risk of sounding like a cliché, changed my life.
For years now people have said to me, "I know that stress plays a role in how I feel, but what do I do about it?" And it's absolutely true; we know that chronic stress negatively impacts digestion... but they didn't just mean how they felt physically. They meant their emotional suffering. The anxiety, the worry, the fear, the anger that was becoming more and more prevalent. I didn't have much to offer beyond the usual things mentioned above and it never felt like quite enough.
That's why I enrolled in that initial training program, it's why I now dedicate my coaching practice to this work, and it's why I'm sharing what I've learned here. So let’s dive in…
You feel your thoughts, not your circumstances.
One of the first things that I heard Dr. Amy say was, "we're only ever feeling our own thinking." That was a huge a-ha for me.
I've long said, "the circumstances of your life don't have to dictate the quality of your life." What I've come to realize, is that the circumstances of our life don't have much to do with our experience of life at all.
Does that sound a bit outrageous? I can hear myself, about eight years ago, saying, "Then clearly you've never had gastroparesis!"
But if our circumstances were responsible for how we experience life, wouldn't everyone with the same circumstances have the same experience? And wouldn't we always have the same experience as long as our circumstance remained the same?
In reality, neither of those is true. I used to blame the constant stress, anxiety, and overwhelm that I felt on having gastroparesis. This makes sense. It certainly looks like the circumstance of having gastroparesis is causing all of this mental and emotional suffering. But is it?
I've worked with hundreds of clients with gastroparesis, and I can tell you that they were not all having the same experience. Some were so anxious that I was jittery by the time I got off of the phone with them. Some were pretty darn relaxed and most fell somewhere in between. The difference had nothing to do with who was "sicker." One of the most grounded, peaceful coaching sessions I ever had was with a man who had not just gastroparesis, but also type 1 diabetes, cystic fibrosis, and chronic pain from a serious car accident.
And if gastroparesis were the cause of our emotional suffering, wouldn't we always be feeling that suffering for as long as we had gastroparesis? I don't know about you, but even in the midst of my sickest days, I had moments of joy, happiness, relief, contentment. Sometimes they were super fleeting, but they were there... even though I still had gastroparesis.
So, if my circumstances weren't causing my feelings, what was? My frantic thinking.
“Will I need a feeding tube?
Will I ever get better?
What if I get worse?
I bet this meal is going to make me sick. What if I do get sick?
What will people think?
This isn’t fair!
I can’t do this anymore.
I should be managing this better.
Gastroparesis sucks... this all sucks.”
Do any (or all) of those sound familiar? Those aren't circumstances. Those are thoughts and those are what I was feeling when I was feeling anxious, overwhelmed, and stressed out.
This was illustrated in one of my coaching programs when someone said:
“... I have had 3 really good weeks. One would imagine I would be ecstatic about feeling well, but I can’t help but worry. I keep waiting for the shoe to drop and for me to start feeling bad again.”
This person was physically feeling really good... for three weeks! Yet she was overwhelmed with worry. It wasn't the gastroparesis causing the worry, it was her thoughts (more specifically that she was innocently holding on so tightly to these thoughts). This is so common. We all do it, all the time.
Thoughts are not personal, and thoughts are not facts.
When I first learned about this, I thought it meant that I just needed to start thinking "better" thoughts. Turns out it wasn't the content of my thoughts that was the issue... it was how I thought about those thoughts.
I used to take my thoughts really seriously. I gave them a lot of attention. I thought they were fact and I thought they were important. The thing is, studies have found that about 95% of our thoughts are the same from day to day. Most of the rest are likely things you've heard from others. They're more habitual than meaningful.
Thoughts continually arise within us, regardless of whether those thoughts are helpful, appropriate, or true in any given situation. Sadly, life is not fair. People are dealt difficult, sometimes heart-breaking circumstances. In a difficult circumstance, "difficult" thoughts are likely to arise.
The "a-ha" for me was that we don't have to take those thoughts personally. We also don't have to try to "think positively" or to suppress our "negative" thoughts. Again, what I came to see is that what gets us stuck isn't the content of the thoughts. It's the thinking about the thoughts.
Besides, thought suppression doesn't work. There's always a part of your brain that is thinking about what you're trying not to think about in order to make sure you're not thinking about it. You don't need to be doing all of those mental gymnastics.
So, what do you need to do?
There's nothing you need to do.
Another big "a-ha" for me was this: there's nothing we have to do to change our thoughts. Unless we ruminate on them, thoughts naturally come and go pretty quickly. We think tens of thousands of thoughts per day. Like clouds that cover the sky, they're always moving. Clouds are never permanent. Neither are thoughts.
I did not buy this for a long time.
As someone who has struggled with anxiety, my thoughts seemed to stick around. What I eventually realized is that they stuck around so long because I kept looking at them, analyzing them, trying to not think them (so I wouldn't feel them), and trying to figure out why I was thinking them.
Since I was feeling my thinking and anxiety doesn't feel good, it seemed like I needed to do something to feel better. All of the things I mentioned in the beginning of this post fell into that frantic search for relief. Little did I know, relief would come much more quickly by not doing.
I love the comparison of our thinking to a snow globe that's been shaken up. If you want the snow to settle, what do you do? You leave it alone. There is nothing you can do, aside from leaving it alone, that will cause the snow to settle. In fact, anything you do aside from leaving it alone will just stir up the snow and it will take longer for it to ultimately settle.
The same goes for our anxious, worried, and overwhelmed thoughts. If you see them for what they are and leave them alone, they'll settle down. And as your thinking settles down, you will feel better. Your emotional suffering will lessen.
Children provide us with a great example of how quickly our feelings come and go if we don't get attached to our thinking. I have a four-year-old and I can tell you that she feels all kinds of feelings everyday -- including anger, frustration, and fear -- and she feels them strongly. But she doesn't get in stuck in them. She'll throw a tantrum because something didn't go her way but ten minutes later, she's back to laughing and playing because she's not wondering why she felt that way or ruminating on her previous thoughts.
"Snowy" thinking is normal. All kinds of feelings are normal. There's nothing to do but to see it all for what it is and leave it alone. It seems counter-intuitive but there's so much less suffering in that... it all passes so much more quickly, and we return to our natural state of clarity.
This doesn't mean there aren't things you can do, such as exercise, yoga, and meditation, to help "rewire" a habitually anxious brain, use up excess stress hormones, and put the body in "rest and digest" mode. All of the stress reduction techniques that I mentioned at the beginning of this post can be beneficial and contribute to well-being. But there's nothing that you have to do.... especially in the midst of stirred up thinking.
What does this mean for managing GP?
So does this mean you should just be satisfied with your situation and not do anything to better manage gastroparesis symptoms? Of course not! What we're talking about here is alleviating emotional suffering. Worry, overwhelm, fear, hopelessness, anxiety, etc. We're not talking about the nausea, vomiting, bloating, or pain.
You can absolutely work on your personal comprehensive management plan to reduce your symptoms and improve your physical health. But what I have come to see -- and what I hope this might help you to see -- is that our emotional well-being is not dependent on our physical well-being. I have worked with so many people with gastroparesis and I've seen time and again that the emotional upheaval is often just as disruptive, often even more so, than the physical pain and discomfort.
When we can get out from under all of the "what ifs" that often overwhelm us, we're better able to address the physical symptoms from a more rational state of mind. It's hard to make good decisions -- about what to eat, which doctor to see, whether or not to take a medication, how to make lifestyle changes -- when your head is always spinning.
If you're sick all the time, will you have more anxious thinking? Yes, maybe. But when you realize that you don't have to do anything with those thoughts, you have more time and more headspace to take care of yourself physically.
We also know that our emotions play a role in how our digestive system is functioning at any given moment. As Dr. Emeran Mayer says in his book, The Mind Gut Connection, "the gut is in fact a theater in which the drama of emotion plays out." A stressed-out mind is a stressed-out gut. My hunch is that, for many of us, giving our thoughts less attention and meaning could play a significant role in overall symptom management.
I recently got to experience all of this firsthand. After many, many months of normal gastric emptying and freedom from GP symptoms, I had a miscarriage followed closely by a severe bout of norovirus (stomach flu). Together, those two things did a number on my GI tract and I found myself with a recurrence of gastroparesis symptoms.
Physically, it feels very much like it did at the beginning of my gastroparesis diagnosis. Fullness, nausea, bloating, stomach pain. Yet this time, unlike all of those years ago when the symptoms first showed up, I have very little thinking around it. No anxiety, no "what ifs?" I know what I need to do to reduce my symptoms and my thinking doesn't go beyond that. It all feels so much easier without the anxiety, fear, and worry.
Same circumstance. Profoundly different experience.
Update (2018) : a month or so later, the symptoms again resolved. As of 2018, I've had a second normal gastric emptying study and I'm still doing great!
Update (2019): I started noticing an increase of gastroparesis-like symptoms again in 2019. My experience of these symptoms, however, is still totally difference. I still feel the freedom and relative ease that I wrote about above. I recently talked with Dr. Amy Johnson about this in depth on her podcast Changeable. Check it out here.
The Next Step
It took me a long time to really get these simple ideas, but this understanding has changed so much for me. And of course there's more than what I've written here. So I'm pleased to be able to share that Dr. Amy Johnson has released an outstanding online program called The Little School of Big Change that teaches these concepts and offers support through live calls and a community forum.
I cannot recommend this program highly enough. Enrollment will open again in the Fall and if anything in this post has resonated with you, I encourage you to check it out and sign up for the waiting list.
Learn more about the Little School of Big Change here.
Relevant Resources
If you'd like to explore these ideas further, I recommend the following resources:
Podcast: Not Another Anxiety Show
Video: The Anxiety Cycle by Kelli Walker
Blog: Dr. Amy Johnson
Book: Being Human
Book: The Untethered Soul
Book: The Mind Gut Connection