Cognitive Therapy for Crohn's - Which is Best?

[hopeful]

Being that Crohn's has long been considered a psychosomatic disease or a diseases with psychosomatic elements, different cognitive therapies should be helpful.

What have you found to be the best cognitive treatment method? Personally I have found hypnosis to be very helpful, but I know there are many other modalities out there, and would like to hear what others have been successful with.

Thanks

 

[Cookie]

Is it true that Crohn's is considered psychosomatic? I have never heard that, only that stress can aggravate an already active disease, which I believe to be true of most any illness. Please correct me if I'm wrong.

 

[hopeful]

The studies done showing this are from the 1970's, I have not looked into each and every one of them, but I have heard from many doctors that this is accepted. That does not mean its not autoimmune etc - its just an additional dimension. We all know that Crohn's incidence is on the rise, that the cause is a combination of some infectious agent and susceptibility, yet the question is what influences the susceptibility.

Ulcers were always considered to be psychosomatic - and then Dr Barry Marshall discovered that they were caused by bacteria - helicobacter pylori. Yet that doesn't explain why 50% of the population has the bacteria yet only 4% develop ulcers. So it must be a combination of factors.

 

[scottmyster]

Hi Hopeful, i have had crohn's for 21 years and bipolar disorder(manic depression) i don't know about hypnosis. But isn't all about what is in your head because i haven't been depressed and stressed out, but in saying that stress doesn't help. it has flared up out of the blue again now i am on preds and other meds to calm down the inflammation and it's wasnt' due to depression because i am not depressed and i haven't been stressed out as of lately. so, somtimes it is biological , sometimes it's all about or depends on your diet and the meds your on. Maybe the meds isn't working. or the diet isn't working. when i was in remission i could eat what i wanted i stopped taking my meds because i thought that i didn't need them any more and it caught up on me. so, now i am on a fluid diet for a while to give my bowel time to rest. like you said it's a combination of factors. best wishes

scott

 

[outlier]

if there was anything psychosomatic about it we wouldn't need colonoscopies to be diagnosed.

There is some controversy over IBS (irritable bowl syndrome), but that is also now believe to be a neuralgic problem, meaning nerves are miss firing which is why the GI track often looks normal. also why meds for depression often help.

 

[hopeful]

Not quite. Psychosomatic merely means that there are real symptoms but they are influenced by the mind. What mind means - can be very varied. This is more a field for neuro-immunologists, and there are many ways to influence bodily symptoms from using neuro-pharmacological agents (such as the research done by Dr. Fuad Lechin and team) and more.

Don't forget that placebo works for about 25% - 30% of Crohn's patients - placebo influences real effects in the body - which can be seen with a colonoscopy.

Talking about placebo - in gastric ulcers you get 65% ENDOSCOPICAL healing with placebo vs 82% with the ulcer medications (these were the studies in the 1970's - before the bacteria that causes ulcers was discovered).

 

[outlier]

that's not that high of a % for the placebo effect. many studies say the placebo effect in general is 25% to 30%. The question is not how high the placebo effect but how high the over the placebo effect is the medication.

 

[hopeful]

True, but in some diseases its lower. 30% or so is average. Crohn's meds (Humira, Infliximab, 6-MP - Imuran) are usually about 20 - 25% better than placebo.

The new studies use NNT values - meaning number needed to treat. So for 6-MP Imuran - the NNT is close to 6 meaning you have to treat 6 patients in order for one to benefit (if you ignore placebo).

 

[peleburrows]

I've long considered a significant element of (my) Crohn's has been psychosamatic. I actually think that the gastroenterology doctors, nurses et al have a narrow minded view and will only seek solutions to the problem with an equally narrow minded mindset. i.e not exploring the health of the patient as a whole but focusing on stopping a physical symptom.

I've not made my point too clear - but hopefully someone can decipher that!

On you're original post I did a course of Cognitive Behavioural Therapy which was useful but you need to be committed - which I wasn't, but will enroll in another course one day and give it another go.

 

[hopeful]

I agree, but that is because medical training for the past few decades has focused on splitting the body into different specialties - so one expert doesn't understand how an area outside of his expertise is connected to his area...

Did you do the Cognitive Behavioural Therapy in person or online? Any leads would be appreciated. Thanks

 

[outlier]

as for that question, I know for depression you can do computer in England, but in general it's done in person. if you have insurance search the directory their is usually a section under mental health for CBT or if you see a clinic talk about specializing in Behavioral Treatment, they usually mean CBT.
Can I ask (i understand this is personal), whats your thought/behavior are you going to approach? a symptom?

 

[hopeful]

I honestly don't know what I am hoping to get to. The point of therapy is that, to influence psychosomatic factors that could lead to disease being active.

 

[outlier]

when i picture therapy for crohn's i picture bio feed back, for some reason. Usually CBT is used once a diagnose is made and thoughts and behaviors are identified (behaviors meaning a behavior that you actively control). You might want to start with talk therapy. Since you don't actively control symptoms of crohn's unless you actively don't take meds or eat something that makes you flare.

 

[peleburrows]

I did it in person after getting a recommendation. It was mainly to try and break down anxieties that I had (and didn't know I had at the time). It takes quite a lot of dedication but is the best way to go if you're having irrational thoughts and bad patterns of thoughts.