Irritable bowel syndrome (IBS) poses some unique challenges to family relationships. I spoke with Drs. Mary-Joan and Charles D. Gerson about the research they have done in this area. Dr. Mary-Joan Gerson is a psychologist who is associated with New York University and Dr. Charles Gerson is a gastroenterologist at the Mount Sinai School of Medicine. They practice together at their Mind-Body Digestive Center in New York City. Here is what they had to say about the effect of IBS on family relationships.
Q. Why are family relationships important when talking about IBS?
We have long been interested in family systems medicine, a perspective that looks at the effect that family and other interpersonal relationships have on an individual's ability to cope with their illness. In our work, we have found that several family factors have an impact on a patient's ability to manage their IBS:
- The family's ability to find a healthy way to show concern for the patient without making the illness the primary focus of the relationship.
- The family's ability to emphasize the patient's strengths in coping with the illness.
- The family's beliefs and past experience in managing illness.
Q. Tell me about your research in this area.
We conducted a study which involved a survey of 240 IBS patients from eight different countries. We were interested in finding out if IBS symptoms were related to beliefs about the mind/body connection or affected by the quality of personal relationships. We also wondered if we would see different patterns depending on what country the patient resided in.
We had patients fill out a questionnaire called the Quality of Relationship Inventory (QRI). This questionnaire was designed to measure whether the patient's relationship with their significant other is characterized by support, depth or conflict. We also gave patients a Mind-Body IBS (MB/IBS) questionnaire to see if patients attributed their symptoms to physical or emotional factors. We then compared the results of these two measures with the severity of the patient's IBS symptoms.
Q. What were your findings?
In terms of interpersonal relationships, we found that when a patient's primary relationship was high in terms of support and depth, their symptoms tended to be milder. When a patient's primary relationship was marked by conflict, their symptoms tended to be more severe.
We also found that patients who attribute their IBS symptoms primarily to physical factors tended to experience symptoms that were more severe. Patients who attributed their symptoms to psychological factors, such as stress or anxiety, experienced lower levels of IBS distress.
Our findings were consistent no matter what country the patients resided in.
Q. In your practice, what issues have you seen when it comes to family members of IBS patients?
One pattern we have seen in our practice is family members who are over-involved in trying to help the patient. This approach can backfire as it stirs up the patient's anxiety which then exacerbates symptoms. We feel it is much better for the patient to be in control of managing their own illness. On the flip side, we often see patients who are hesitant to ask family members to make the changes that the patient needs in order to reduce their anxiety.
Another common problem is when family members blame the patient for being sick. This blaming can take the form of comments such as "it's the way you eat" or "just relax." The comments usually are coming from a place of concern, but generally lead to frustration from the patient who knows that there are not such easy answers to the problem.
Q. How can IBS patients enlist the help of the people in their life?
We believe that helping IBS patients to have healthy relationships with the people in their life is an important aspect of IBS treatment. We encourage our patients to:
- Directly address the areas of conflict in their relationships with others in order to reduce their overall stress level.
- Let the people in their life know what their special needs are in terms of dealing with IBS. It is important to be specific about what things the family member could do to be helpful and what things would be better left for the patient to handle.
- Educate the people in their life about the chronic course of IBS and that it takes trial and error to learn how to best manage the condition. Patients can ask that the people in their life offer support and encouragement.
- Understand that the people in their life care about the patient's well-being and that it is often anxiety that leads to be over-involvement and unwanted advice. It is a good idea to express gratitude for the concern of others, while educating them regarding the specific and unique nature of IBS.
For more information on the Gerson's research, see:
Gerson, et.al. "An international study of irritable bowel syndrome: Family relationships and mind-body attributions" Social Science & Medicine 2006 62:2838-2847.
DISCLAIMER: The information contained on this site is for educational purposes only and should not be used as a substitute for diagnosis or treatment rendered by a licensed physician. It is essential that you discuss with your doctor any symptoms or medical problems that you may be experiencing.