Before the bathroom humor starts popping into your head, I want to say that I’m quite serious about this one. As a psychologist, over time, it is typical for people to feel quite comfortable telling me virtually anything that might be perceived as shameful, embarrassing, or humiliating. Confidentiality and acceptance are key to successful therapy, and creating an atmosphere that invites disclosure is important – if I don’t know what’s REALLY going on, how can I help you?
As a health and medical psychologist, I gather more than the usual amount of medical information from my clients. Many of them are dealing with PCOS, infertility, diabetes, and other endocrine conditions that can result in bowel irregularities. Anxiety often results in diarrhea, as do irritable bowel syndrome, Crohn’s disease, and related conditions. Thyroid disorders also alter bowel functioning. Cancer treatments affect regularity. And the list goes on and on.
What I usually hear is a client bringing up the issue by saying, “Um, you probably don’t want to really hear about this, but, um, I’m having this um, problem with, um, diarrhea… ” As they trail off, I reassure them that I’m used to hearing this stuff, and I actually want to hear it. Truly, I have heard it all in this department. This is an enormous relief to the client, who has often been too embarrassed to tell one of her doctors about it. Because I see the client weekly, there’s a much higher level of trust than with a doctor whom she seems every few months.
This information is helpful to me diagnostically, because I instantly know a great deal more about what’s driving stress and anxiety (if you’re prone to sudden loose stools, it can contribute to social anxiety and fear of leaving the house, for example). It helps me normalize certain behaviors or symptoms, and be alert to other things that might be troubling the client. Quite often, we are so used to having irregularities in our bodies – food cravings, random menstrual cycles and the like – that bowel irregularities get overlooked. When you can’t get pregnant, you’re generally not overly concerned with chronic constipation, right?
When a client is able to trust me with this type of information, I actually feel honored. I’m not a medical doctor; I can’t perform diagnostic procedures or prescribe medication to remedy the problem. But I truly do want to know every aspect of my clients, up to and including the quality and frequency of their bowel movements. I can make referrals to medical doctors who can help. And there are psychological treatments that are effective for bowel disorders, and of course for reducing stress and anxiety.
On a more interesting note, there’s a strong gut/bowel and brain connection. A significant percentage of our neuro-transmitters are produced in the gut – around 85% of the serotonin, for example. So, if you’re experiencing cramping, bloating, diarrhea, or constipation, not only may you have a medical disorder, but it may be contributing to depression, anxiety, or other psychological conditions. In a nutshell, that’s why I want the full scoop on your poop – so I can help you as comprehensively as possible!
Gretchen Kubacky, Psy.D. is a Health Psychologist in private practice in West Los Angeles, California. She specializes in counseling women and couples who are coping with infertility, PCOS, and related endocrine disorders and chronic illnesses.
If you would like to learn more about Dr. HOUSE or her practice, or obtain referrals in the Los Angeles area, please visit her website at www.drhousemd.com, or e-mail her at Gretchen@drhousemd.com. You can also follow her on Twitter @askdrhousemd.