How Can Psychotherapy Help with Chronic Pain and Chronic Illness?

Although pain is a natural function of the human body, millions of people experience pain that is chronic, debilitating and that interferes with their daily lives. The same can be said for illness. Everyone gets sick here and there. But there are millions of people who suffer from chronic, sometimes invisible, illnesses that can be incapacitating.

If you ask anyone who experiences chronic pain or illness, you will find that, for most, dealing with chronic pain or illness means not only physical burdens, but mental burdens as well. It may mean not only unrelenting doctor visits, procedures and/or surgeries, but also difficulties with employment, an inability to engage in once enjoyable activities, anxiety about the future, friends and family who do not understand, etc. The list goes on.

So how can psychotherapy help you with your chronic pain or chronic illness?

Many individuals with chronic pain or chronic illness grieve for the life they once had and the person they once were. This grieving process is normal and it is a very important part of learning to accept ones condition. Psychotherapy can help you through this process by helping you deal with the anger, frustration, and loss that often accompanies chronic pain and chronic illness. Psychotherapy can also teach you coping skills that will help you minimize the stress, anxiety and depression you may be experiencing and move toward acceptance.

Chronic pain and chronic illness can change a person’s thought process. The once cheerful, outgoing, positive person may find themselves feeling sad and negative, isolating themselves and unable to enjoy life. Psychotherapy can help you identify and adjust negative thinking patterns so that you are able to focus on the positive aspects of your life, redefine who you are, and make accommodations in your life that will help you reestablish a sense of self control.

Having chronic pain and/or a chronic illness can often make you feel isolated from friends and family. Not only do they not understand what you are going through, having chronic pain or a chronic illness often makes it hard to engage in social activities. It may make it difficult to complete household chores, which can be frustrating to you and your significant other. You may find it difficult to talk about anything other than your chronic pain or chronic illness with your friends and family because it is always on your mind. Psychotherapy can help you learn to pace your activities and chores which will help you accomplish your goals, it will help you with the anxiety that often accompanies social activities, and it will help you learn to deal with the constant ruminations about your illness that make it so difficult to think about anything else.

Many people suffering from chronic pain and chronic illness have difficulty sleeping. It has been proven that lack of sleep exacerbates pain. Therefore, adequate sleep is extremely important. Psychotherapy can help patients with sleep hygiene, which involves developing or redefining a bedtime ritual, relaxation techniques, thought stopping techniques, and identification of environmental factors that may contribute to difficulty sleeping.

If you can relate to anything I have talked about above, don’t hesitate to seek help! It can help you gain back your self-control and begin enjoying life again!

Rollercoaster of Emotions

Last Friday I had my annual flex sigmoidoscopy to take a look at my J-pouch. After a whole year of doing fantastic and feeling great I went into this appointment a little nervous but very confident. So after two hours of waiting (no fault of my doctor’s but still very annoying) my nerves kept building. Throughout the exam everything was looking great, until the very end when my doctor found a small piece toward the top of the pouch that was a little inflamed with a small ulcer. One ulcer. Upon seeing that my mind started racing and I started freaking out inside but remained calm so my doctor wouldn’t think I was a crazy person. After he took a biopsy and I got my pants back on, I asked him “what could it be?”, “is it Crohn’s?”, “when will the results be back?” After giving me a smile and trying to calm me down a bit he told me that he didn’t know what it was, it could possibly be Crohn’s but he didn’t think so and not to worry (REALLY?!), and that the biopsy results should be back within a week or two.


So since Friday morning I’ve been able to think of nothing else. I’m trying to remain positive, but having that camera up my butt again and seeing an ulcer again has really played mind games with me. It’s brought back that whole flood of emotions that I felt when I was sick with UC and while I was going through my surgeries. The thing I’ve realized is that those emotions and these experiences will never go away. Even if the results come back and it’s not Crohn’s , this is something I’m going to have to go through every year when I have that exam. The nerves beforehand and the praying to God that nothing shows up during the exam. So it makes me think. For those of us who have had J-pouch surgery as a “cure” for UC, is it really a cure? Possibly it is a cure for the actual physical ulcerative colitis (although not always for those who find out after that they really had Crohn’s all along, or the small percentage who have complications after the surgeries). But emotionally, having these surgeries is definitely not a complete cure. It is something that will always be with us. Those emotions, those memories, that fear. I’m not saying I wouldn’t have had the surgeries. Not that I had a choice, but if I had, I still would choose to have them and I would still recommend them to anyone. They saved my life and gave me a better quality of life. For that I’m definitely grateful. I guess I’ve just realized that for most people it doesn’t end once the surgeries are over. It’s a process. Which is why I think it is so important to take care of yourself both physically and psychologically, during the illness as well as after. I think it’s also the reason I’m so passionate about counseling people with IBD…because I GET IT. And you can’t get all the emotions and fears unless you’ve been through it. So for now, I’m going to do some of the things I tell my clients to do…try and remain positive, deal with my emotions, and since I’m feeling good, enjoy life…and pray that the ulcer is nothing.

Cosmopolitan Magazine

Recently I had the pleasure of sharing my story with one of the editors at Cosmopolitan Magazine. Here is the link to the story:


http://www.cosmopolitan.com/advice/health/jennifer-kaplan-ulcerative-colitis-story?click=cos_latest

J-Pouch Surgery Basics

I know the possibility of surgery is really scary for some people. It definitely was for me. I recently heard from another J-pouch buddy of mine that before she had surgery some people were actually trying to talk her out of it and were telling her that she was weak for having the surgeries. When I heard this I absolutely couldn’t believe it! I know for a lot of people who have the J-pouch surgeries, myself included, it is not an option. If I had not had these surgeries I would have died, plain and simple. Because there is so much misinformation out there and because of the negative ideas that some people have about these surgeries, I wanted to share some information about the J-pouch surgeries.

J-pouch surgery is an option for people with ulcerative colitis as well as for people with FAP. For people with ulcerative colitis, it is typically done when all other medical options have failed, which was the case for me. These surgeries can be done in one, two, or three different surgeries, usually depending on how sick the patient is. In my case, I had three surgeries because I was so sick and malnourished. The first surgery was simply to remove my colon. After my colon was removed, I had a temporary ileostomy, which is a small opening in the abdomen where a piece of small intestine sticks out in order to remove waste into a bag attached to the abdomen. Three months later was surgery number two in which the J-pouch was formed out of small intestine. The J-pouch’s job is to essentially act as a “new colon”. After this surgery, I still had the ileostomy. The third surgery is called the “takedown” and consists of removing the ileostomy and attaching that piece of intestine to the newly formed J-pouch. After this surgery the person will be able to go to the bathroom normally again.

After takedown surgery, the patient will most likely have to go to the bathroom several times per day until their body adjusts to the J-pouch. Some people say that it’s almost like having ulcerative colitis again at first. It does get better though! After the body adjusts, which can take up to one year but is usually much sooner, the average person uses the bathroom around six times per day.

What’s hard about these surgeries is that everyone is different. One person may have a lot of problems and go to the bathroom a lot each day, whereas another person may do great and only go to the bathroom three times every day. You just never know. I think maybe that’s what scares people so much about these surgeries.

In my opinion, J-pouch surgery is a fantastic option for people with ulcerative colitis. Yes, as with any surgery, there are risks and things that can go wrong (obstructions, pouchitis, cuffitis…) and there’s always a risk that the J-pouch will not work as it should. But these risks are rare and for most people, life with a J-pouch is a million times better than life with UC.

Life after J-pouch surgery…for most people, including myself, is great! There are things that are a little different, like going to the bathroom more often, but they are completely manageable and although there are more bathroom trips, unlike with UC you can hold it until you can find a bathroom. For me, there is nothing I can’t eat and nothing I can’t do.

I want people to know that J-pouch surgery is not the end of the world. If you have to have surgery you are not weak and you did not do anything wrong. It is possible to live a normal life and a good life after these surgeries. For more information you can visit my website at www.ccddsupportnetwork.com.

Mourning After J-Pouch Surgery

I have been asked quite a few times "Dr. Martin, why is it that I feel so sad after my takedown surgery? Aren't I supposed to be happy? Is this normal?" My answer...Yes, it is completely normal. I wondered the same thing after my takedown. When I went in for my surgery, I felt so relieved. I thought "Finally I'm going to be done. I can get on with my life, be happy again, and not think about this anymore." About a month later, I started feeling sad and angry and I didn't know why. I finally realized that I was feeling this way because of all of the trauma I had been through in the last year. I mean, being incredibly ill, spending more time in the hospital than out, having three major surgeries, and losing an organ is a lot to deal with! I realized that I was in what I call my "mourning period" and that I just needed to give myself time to deal with everything that I had been through.

So for those of you who may be experiencing the same emotions after your surgeries...you are not alone. You are not crazy for feeling this way. It will get better. Give yourself time to deal with what you have been through. If you feel it would help to talk to someone about what you are going through, do so. Find a support group in your area or a therapist who gets what you are going through. Just remember that this is part of the process and that you will be happy and able to live life again. Sometimes it just takes a little longer than expected.

Surgery Number 4

So I got home a couple days ago from the hospital after having surgery number 4: Surgery to tack down my j-pouch to my tailbone. Yep, it was as wonderful as it sounds. I will continue this chapter of the saga from my last post so that I don't have to repeat everything. If you read my last post you will know that I ended up in the hospital because my j-pouch twisted. I am one of the lucky but unlucky ones who apparently doesn't grow a lot of scar tissue. See, most people who have the j-pouch grow enough scar tissue to hold the pouch in place. I, on the other hand, did not so my pouch decided to have a little party in my abdomen, doing the twist all over the place.

Anyway, after my last hospital visit, my surgeon wanted to wait a little bit to see if things would essentially fix themselves so that we could avoid this surgery. Well a couple weeks later I was all twisted up again, so back in the hospital I went and this time surgery was a definite. Four days after being admitted to the hospital, surgery was on. When my doctor opened me up he found that my pouch had basically twisted around 360 degrees, pulling more intestine down with it underneath a fat pad that grows behind the intestines. I know, totally weird! So, my doc straightened me out, tacked down a piece of dissolvable mesh to my tailbone, and sewed my pouch in two different places to the mesh. The hope is that by the time the mesh dissolves, which takes about a year, enough scar tissue will grow in its place to hold my pouch in place. Keep your fingers crossed! While he was in there, my doc also revised the scar where my stoma was so that it's now a flatter straight line instead of an indented circle, which I am thrilled about. So once again, I have four incisions that need to heal, but all of them are incisions that were used in previous surgeries: Two laproscopic incisions, the stoma incision, and the bikini line incision from my second surgery.

I am now home recovering after 12 days in the hospital because my intestine decided to stay asleep longer than it should have and I'm hoping that this will be the last chapter in the J-pouch Saga. I've got some work ahead of me since from the time this mess started until now I've lost almost 15 pounds, so I have a lot of weight to gain, once again. I'm working my way up with food, hoping to try some plain pasta tonight and hoping to be eating some baby back ribs and french fries in a couple weeks!