Psychosomatics of Crohn’s Disease

Crohn’s disease is a chronic gastrointestinal tract illness characterized by inflammation throughout the intestine or its sections. The disease predominantly affects the end of the small intestine and the large intestine. It is marked by alternating periods of remissions and relapses. The more advanced the disease stage, the deeper the infection penetrates (affecting the mucosa, submucosa, and muscles), making treatment more challenging.

Causes of Crohn’s Disease

The causes of Crohn’s Disease can be divided into biological and psychological. It’s believed that the bacterium Helicobacter pylori is the causative agent. However, it’s important to note that this bacterium is always present inside us. There is a tolerable level of these bacteria which doesn’t interfere with normal body functions, and which beneficial bacteria can manage. But when Helicobacter pylori proliferate beyond the norm, inflammation ensues. The bacteria themselves are not the problem, but rather their toxic waste products.

Abnormal bacterial growth is often triggered by weakened overall immunity. This, in turn, is influenced by several psychological factors:

  • Stress;
  • Disrupted eating, sleeping, and resting patterns;
  • Eating disorders, leading to overeating or undereating;
  • Exhaustion and burnout;
  • Harmful habits (smoking, alcoholism, drug addiction, etc.);
  • Frequent injuries and illnesses due to a risky lifestyle;
  • Subconscious programs of self-destruction and illness.

Thus, Crohn’s Disease is caused by:

  • Infectious invasion;
  • Allergy;
  • Autoimmune malfunctions;
  • Stress and an unhealthy lifestyle;
  • Genetics.

Stages, Symptoms, and Signs of Crohn’s Disease

Crohn’s disease has three stages: mild, moderate, and severe, each with distinct symptom severity:

  1. Mild stage: Diarrhea up to four times daily, temperature not exceeding 37.5 °C, normal pulse, occasional blood in stool.
  2. Moderate stage: Diarrhea more than six times daily, temperature not exceeding 37–38 °C, pulse around 90 beats per minute, blood in stool.
  3. Severe stage: Diarrhea more than ten times daily, temperature above 38 °C, significant blood loss, pulse over 90 beats per minute, complications (fistulas, abscesses, intestinal obstruction).

With Crohn’s Disease, cracks and ulcers form on the intestinal walls, and muscle tone increases, causing pain and spasms. Bloating and a sensation of heaviness are common. The onset can be either acute or gradual.

Psychosomatics of Crohn’s Disease

In psychosomatics, the intestine serves the same function as in physiology: digesting not food, but life experiences. Consider the phrase, “I need to digest this information.” Now, correlate this knowledge with the disease’s characteristics. It appears that Crohn’s Disease is an inability to accept certain aspects of life.

People with Crohn’s Disease often exhibit:

  • Depressive tendencies;
  • Emotional instability;
  • Inability to set and achieve goals;
  • Sensitivity and weakness, combined with a prohibition on expressing emotions;
  • Passive-defensive or avoidant behavior in conflicts;
  • Symbiotic family relationships combined with emotional coldness;
  • A tendency for introspection;
  • Nervousness and impatience;
  • Inability to relax and enjoy life;
  • Fears and unrealistic expectations;
  • High self-control, including in matters of bowel movements or other cleanliness issues.

Individuals with Crohn’s Disease attempt to internally process all conflicts through their own bodies, thereby protecting their social interactions. Such individuals crave social contact and fear losing someone or offending them during conflicts. The need for protection and closeness paradoxically coexists with a desire for independence.

Key Psychosomatic Concepts of Crohn’s Disease:

  1. Crohn’s Disease represents an inability to “digest” something in life.
  2. Diarrhea indicates a desire to eliminate something dangerous, trivial, or a signal of problems with time and resource management.
  3. Digestive issues reflect a reluctance or inability to fully analyze, listen, or resolve work or personal life problems.

Psychotherapist Liz Bourbeau, in her book “Your Body Says, ‘Love Yourself!'”, writes that the psychological cause of Crohn’s disease is the fear of not meeting others’ expectations, of being rejected, or of not being the best. This could also signal the presence of obsessive ideas and a tendency to reject everything. In addition to interpreting the disease’s meaning, Bourbeau differentiates causes based on the location of the lesions:

  • Small intestine: an inability to take in and absorb what is useful from life; rejecting everything when it slightly deviates from personal perceptions; focusing on minor details where it is unnecessary and ignoring important things.
  • Large intestine: obsessing over old ideas and beliefs, denying and rejecting new, potentially useful things; irritability in conflicts, inability to find positives in conflicts and derive benefits from them.

To resolve intestinal problems, Bourbeau recommends refocusing on positive thinking, catching good thoughts, switching from fears and doubts. It is also necessary to let go of the old and useless, step out of the comfort zone, explore something new, revisit personal beliefs and values, and plan further development.

Dr. Sinelnikov, another psychosomatic specialist, also suggests that the intestine symbolizes the processing of new ideas and thoughts. According to his theory, diarrhea reflects a fear of reality and an unpreparedness to accept something from the outside world. His theories can be explored in his book “Love Your Disease.”

Healing Methods

Crohn’s disease is a dangerous illness that can lead to exhaustion and even death if untreated. Constant pain, stool problems, and abdominal discomfort diminish the quality of life and interfere with daily activities. The disease gradually spreads to new sections of the intestine, affecting the eyes, skin, and musculoskeletal system. It can lead to disability. Therefore, treatment is crucial.

However, since Crohn’s disease is considered incurable in medical terms, treatment aims for stable remission and maintaining healthy intestinal function, preventing flare-ups, and alleviating symptoms during relapses.

Nevertheless, psychology offers a different perspective on this illness. Since it has a psychosomatic component, there is a chance of minimizing its manifestation or even curing it completely. Essential for healing are:

  1. Full emotional peace and stability, eliminating stressors, and enhancing stress resilience.
  2. Changing lifestyle and discarding harmful habits.
  3. Preventing emotional and physical overloads.
  4. Maintaining an adequate work, rest, and sleep schedule.
  5. Regular visits to a psychotherapist.

Psychotherapy for Crohn’s disease focuses on developing autonomy and trust in oneself, resolving the internal conflict between the need for closeness and the need for independence. This is the primary conflict that led to the development of the disease. However, other personality traits that contribute to the “self-destruction” of the intestine and childhood traumas should not be overlooked.

People with Crohn’s disease often come from demanding families or have experienced early separation from a significant, close person. However, it is essential to remember that this is just one of the possible causes, not a mandatory condition for the disease’s development.

Identifying not only the disease’s predispositions and negative biological and psychological factors but also the hidden benefits the disease provides to the patient is crucial. This question is raised in the treatment of any psychosomatic illness: what is the hidden benefit of the disease?

Psychotherapy for Crohn’s disease requires an individual approach. Positive effects are achieved through methods like self-suggestion (autogenic training), suggestion, hypnosis, Gestalt therapy, art therapy, transactional analysis, and sometimes group therapy in closed groups.

Conclusion: Without personal changes in the patient, it is impossible to overcome the disease. Even if the patient faithfully takes medications and follows a diet, full healing requires comprehensive treatment: medication, diet, and psychotherapy. A gastroenterologist and a psychologist should prescribe the treatment after a complete medical and psychological examination.

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