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I read over and over again that many people believe if a chronic health problem is considered psychological in origin, as some people believe IBS is, then they are being told their physical symptoms are in their head. I just want to clarify that these ideas are not mutually exclusive. Put another way, it is possible for emotional responses to cause physical symptoms. A classic example is when our cheeks get hot and turn red when we are embarrassed. For most of us, this is an uncontrollable reaction even though we are aware that it happens. The human brain is extremely complex. Our capacity for emotions is enormous and poorly understood at best. Some emotions we are aware of and others we are not. Our brain has the amazing ability to protect us from emotions that could be detrimental to our survival by repressing them into some dark corner where we can't really access them unless triggered somehow. We also learn how to repress our emotions by living in a culture where we are expected to cover up how we are really feeling. (Let's face it, if everyone said every thing they were thinking to each others faces, it wouldn't be very productive). Since we know that A) emotions can cause physical reactions in the body, and B. our mind is a complicated swirl of emotions known and unknown to us, and C) That our IBS symptoms are very, very real in our bodies - I think it's fair to be open to the possibility that physical problems in the body can be caused by emotional problems in the mind. Doctors do know that stress plays a very real role in increasing blood pressure in the body. Over time, high blood pressure is very damaging, leading to heart attacks, stokes, and aneurysms. That's not to say that every single person who has high blood pressure is extremely stressed out therefore causing their condition. It's to say that it is one possibility.And so I say the same for IBS (and many other chronic illnesses). One possible cause of IBS may be emotional in origin (as I believe is the case for myself, based on my personal history), but that doesn't mean that every person with IBS has the same origin, nor does it mean that people who have an emotional origin don't also experience real symptoms. I assure you I do. And just like I can't prevent myself from blushing even though I know what triggers it, I can't fully prevent my IBS flares by knowing it's cause is emotionally based. But being open to the possibility gives me more ways to approach treating it.
 

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"it is possible for emotional responses to cause physical symptoms.""Our brain has the amazing ability to protect us from emotions that could be detrimental to our survival""One possible cause of IBS may be emotional in origin...but that doesn't mean that every person with IBS has the same origin.."Spot on mate.I suffered severe stress several years ago, and 3 days after my problems were resolved I suffered IBS. But I got over my brain induced IBS within a few short days by talking to my brain. Refer to the "Tension Myositis Syndrome" website for a further insight.Jackmat
 

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My take.Every illness is made worse by certain emotional/mental states and/or behaviors, etc.Every illness has a psycho-social aspect to it and even emotionally healthy people who are mentally not stressed may have thoughts or behaviors that can make an illness worse, or easier to cope with. People with good social support and who are emotionally healthy do better after a heart attack than people who are depressed and lack social support. No one says you just pretended to have a heart attack and it wasn't real.The problem with "in your head" is it implies either their is no pain and no symptoms at all and you just think something is going on, or you would be healthy other than the fact you are making yourself sick because of some emotional or mental issue.I see it as everyone has some body part that is prone to symptoms for a physical reason. IBS is most commonly triggered by a GI infection, not just oh I had a bad day so I'm going to decide to be sick for the rest of my life. That being said severe trauma does seem to make it more likely a short term illness will trigger a long term health problems when you compare similar people with no trauma in their background. It seems to be that trauma, in general, seems to make it harder for the nervous system to re-regulate the body after a physical issue. My guess is because often during trauma people want to be anywhere but in their body at that moment going through that problem so I could see people tend to disconnect and then it is harder to connect back, or when you do it doesn't tend to calm things down as efficiently as it could.As I said, you don't need trauma or stress to have a chronic health problem happen, but neither one help make it better.
 

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Discussion Starter · #4 ·
I suffered severe stress several years ago, and 3 days after my problems were resolved I suffered IBS. But I got over my brain induced IBS within a few short days by talking to my brain. Refer to the "Tension Myositis Syndrome" website for a further insight.
Thanks for your response! I am familiar with Dr. Sarno's theories - I've read two of his books. While I strongly agree with what he says, talking to my brain hasn't solved my physical problems. My emotional issues are deeply buried, but going to therapy has made a significant difference in my overall health. I'm on the path. I'm glad that you had success in dealing with IBS.
 

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Discussion Starter · #5 ·
I see it as everyone has some body part that is prone to symptoms for a physical reason. IBS is most commonly triggered by a GI infection, not just oh I had a bad day so I'm going to decide to be sick for the rest of my life.
I feel that you are oversimplifying what I said. I don't believe chronic illness such as IBS is caused by one bad day, but a pattern of emotional response in dealing with life's difficulties. Also, I don't believe everyone has the same cause of IBS. Some people, as you pointed out, have IBS caused by GI infections. But that is not everyone. I've had IBS pretty much my entire life - starting with tummy aches when bad things happened as a child, getting worse after graduating college and coinciding with depression about the "real world". Also, people do not DECIDE to be sick with IBS. It happens automatically. Just as people don't decide to be sick with depression or anxiety, nor is it their fault. All I am saying is that if people are open to the possibility that their IBS is caused by emotional issues, it gives them more options for approaching treatment.
 

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I'm not saying stress isn't a trigger.Just something PHYSICAL happened which determines where your stress shows up in your body.If you had asthma it would be in your lungs, not your intestines.You didn't select which organ was going to be the weak link because you needed your stress to make you physically ill. However, any body part which has a weakness will be where the stress can show up in the body.You didn't decide one day to make your stress give you diarrhea rather than asthma or a sore back, or any other specific illness. Something was weak to start with for some reason (like you were one of the probably pretty darn near 100% of people that get some GI infection sometime in their life) and once that got set off stress makes it worse and the stress/symptom/stress/symptom cycle can be hard to break and part of that is dealing with the mental aspects and you do not need to be hysterically whatever to have symptoms.IBS is not a mental illness or a sign your brain is weak. However, stress and bad psychosocial situations will make it harder to deal with than if you were not stressed, etc. Much of what makes an illness get worse and worse rather than better and better are parts of NORMAL psychology. Often when using mind-body medicine to help break the stress/symptom/stress/symptom cycle it is the psychologically healthy that do well rather than those with depression or anxiety on top of whatever else is going on.I'm not saying do NOT persue mind/body work, but that your brain can't make your body break in specific physical way because for some reason you want to be sick and refuse to be healthy. (which is what "in your head" tends to mean to people, you could be well, but you prefer to torture yourself with an illness).Now there are people who imagine symptoms that are not happening, or who will do things to make themselves sick with poisons or other techniques because of a mental illness. IBS is not either of these, but saying it is "in your head" and there is no physical anything at all and you just picked the intestines for some reason rather than make yourself have a rash or asthma is what I don't agree with. Where the symptoms show up has to do with something real and physical, not something imagined.For any illness I think you have to deal with BOTH the physical weakness (why the symptoms show up there) as well as any emotional/stress/mental issues that can be a a block to getting better.Hey, I did CBT for my IBS and I do not believe I just imagined it or it was in my head. I had a clear infection that started the IBS but I couldn't get the right feedback to my intestines to help them heal up in a couple of weaks. Once I changed the feedback, they were able to heal and eventually I got off medications, but I also needed to treat the physical issue and do not believe just mind stuff would have been nearly as effective as doing both, and my CBT doctors ALL believe IBS is physical, not just a mental problem.I'm not really disagreeing with you or saying stress cannot be a problem or that mind/body approaches do not work. Just saying you didn't make it up and there is a physical reason why your stress triggers your GI tract rather than your lungs, skin, immune system, or any other body part. Why is that so wrong?
 

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Discussion Starter · #7 ·
Generally I agree with what you are saying Kathleen. I agree that there is an existing sensitivity in a specific part of the body, the gut, in the case of IBS, that allows symptoms to develop there. What that sensitivity is, is the unknown factor of course and I think it varies from person to person. I hear you saying you believe that since everyone has suffered from a GI infection in their lifetime, that could likely be the cause of IBS. That doesn't explain why some people don't develop IBS despite having multiple GI infections, nor why some people notice symptoms after said infection, and others (like myself) remember always having symptoms. (I suppose you could argue a GI infection set off IBS in me when I was so young I don't remember it - I'm not so sure about that - but who knows.)The fundamental issue we disagree on is the significant role the mind can have in developing symptoms in the body. I hear you saying that the mind-body relationship is important and that poor emotional health can make any illness worse but here's where I disagree:"I'm not saying do NOT persue mind/body work, but that your brain can't make your body break in specific physical way because for some reason you want to be sick and refuse to be healthy. (which is what "in your head" tends to mean to people, you could be well, but you prefer to torture yourself with an illness)."I actually do believe the mind can make the body break in a specific physical way - and it starts by exploiting an area that already weak. Why would the mind do that? Because it is an effective distraction from emotional trauma. One way this manifests for me is through something called the symptom imperative. Simply, I have physical symptoms 24/7. If my gut is feeling reasonable stable, then I develop a headache, or my stomach is acidy and upset, or I have an anxiety attack, or...? I believe that my mind is finding any way it can to distract me from my emotional issues (starting with childhood trauma) through the constant presence of discomfort in my body. My symptoms are real; my head really hurts, I really do have excess gas, bloating, alternating motility, etc. And they do effectively distract me. I only recently unburied some major issues through therapy that I had denied for many years. When I realized this, I started to wonder, what purpose does being physically ill serve me? And it turns out, there are a lot of things I get from being physically ill that are related to my emotional issues. Specifically, attention and caring from the people around me including my partner and my family. I also had the fear of being well because I was always waiting to feel bad again. So while on the surface, none of us want to feel physically sick and wouldn't wish these symptoms on our worst enemy, it can also serve a purpose for our emotional mind. I am not saying you are wrong. I think we've started a healthy debate about an issue that many IBSers are very sensitive about - the idea that their mind has a large role in their symptoms. I hope it's clear that I don't believe it's anyone's fault, nor that they are weak, nor have a 'mental illness' (which carries it's own stigma). We are all vulnerable to physical problems caused by emotional issues, in my opinion, because life is difficult and challenging. This is all based on my own observations, research, and opinions of course, and I know many people will reject this theory.Who knows - maybe in the future, doctors will finally understand the physical reason people have IBS and will know how to cure it. That would be fantastic. But my experience tells me that we all have a lot to deal with in our own heads and that our minds are more powerful than we know or are willing to admit.
 

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I do agree the mind is important and powerful and can be a big part of staying sick or getting well, but even if the doctors refuse to admit it, the researchers have found lots of physical things and there now is a medical test based on those physical things.GI infections are known to damage gut nerves and you see that damage if you look for it. Medical tests for IBD's and colon cancer and other things do not look for the physical damage you see in IBS. You are sure you never at any point in your life, not even as a baby ever had a GI illness of any kind. You never had food poisoning, or the "stomach flu". not even once in your life? Gosh, that would be nice, I usually get a stomach virus at least once every couple of years and I'm usually pretty careful.It isn't the complete mystery with absolutely no evidence of any physical issues that people like to think it is.
 

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Discussion Starter · #9 ·
I do agree the mind is important and powerful and can be a big part of staying sick or getting well, but even if the doctors refuse to admit it, the researchers have found lots of physical things and there now is a medical test based on those physical things.GI infections are known to damage gut nerves and you see that damage if you look for it. Medical tests for IBD's and colon cancer and other things do not look for the physical damage you see in IBS. You are sure you never at any point in your life, not even as a baby ever had a GI illness of any kind. You never had food poisoning, or the "stomach flu". not even once in your life? Gosh, that would be nice, I usually get a stomach virus at least once every couple of years and I'm usually pretty careful.It isn't the complete mystery with absolutely no evidence of any physical issues that people like to think it is.
I didn't say I've never had a GI infection - of course I have. I just said that I always remember having symptoms, that I can't pinpoint them to a specific time when they were switched on like some IBSers describe. Now my husband had a pretty severe intestinal infection and even after being on a heavy duty antibiotic, his GI symptoms of urgency, excess gas, and loose mucus-y stools lasted two more years. I would consider that PI-IBS. There was a clear delineation where he had a very strong stomach, then after the infection, as you say, the nerves in his gut weren't working correctly. It took a long, long time to heal. But now he's back to normal. That makes sense to me. But that's not the case for me. When I have had a GI infection, it sucks, but afterward my IBS has never been worse. I go back to feeling the same as always. What has made my IBS worse is having an extremely stressful job that ate away at me from the inside out, dealing with family issues, death and disease with people I love, moving, money trouble, job uncertainty, having a new puppy. My husband does NOT have GI issues when these things come up for him. He copes differently with stress and anxiety than I do. Frankly, he's much better at it. And he's healthier for it.I am genuinely interested to know more about the medical test you mention for IBS. When I went in for my colonoscopy, they told me my colon was super-healthy, as were all my blood tests. Absolutely no evidence of any physical problems (except for the daily mild to moderate symptoms of course). So if there are physical indicators of IBS, I am curious what they are and what we specifically need to ask our doctors to look for, since they don't seem to be up to date on the latest IBS research.
 

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The markers for IBS are not seen in routine blood tests looking for inflammation markers in the colon (as you don't get traditional inflammation) nor is the lining of the colon ulcerated or inflamed so the colonoscopy looks clean.Here is the test that includes blood markers for IBS as well as markers for celiac and IBD as if you have those that leads to a "not IBS" reading.http://www.ibsbloodtest.com/ I forget how many markers they screened through to find the ones for the test, but there were many more in the medical literature and they ran them in various combinations to find the subset that was good at predicting the diagnosis. So there are more biomarkers, but this was the best set for clinical testing.http://www.ncbi.nlm.nih.gov/pubmed/19811951 is a recent review of biomarkers for IBS. It is still an area that needs a lot more research, but there are a number of physical differences, they just don't show up in tests that were designed to find things that are not IBS.Most of the medical tests done for IBS are to rule other things out. Kinda like saying we don't know what causes malaria (to pick a random other disease) if all we do is test everyone for staph infections and if it isn't a staph infection then there can't possibly be anything physically wrong with you.There are also some other tests like anal manometry that are often abnormal in IBS (as 70% of IBSers have rectal hypersensitivity--they did this test for the CBT clinical study I was in and I was abnormal on this both before and after, but much more abnormal in the pre-CBT test). However it isn't diagnositic for IBS, and you can often tell if someone has this by symptoms, and they only really need to quantify how bad it is for things like clinical trials. If you have more pain right before a BM or a fart and the pain goes away once the rectum is emptied you have rectal hypersensitivity issues.
 

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Well the do anal manometry in clinical studies to check for dysfunction of the rectal nerves. They do PET scans of the brain where you can see how the bad signals change what happens in when they go up the system, but that is also for clinical trials.There are a couple of the markers in the ibsbloodtest that look at stuff nerves release to find abnormalities. Kinda like liver tests look at stuff livers release to see if you have a normal level or not.A lot of the research hasn't been developed into something that is useful for diagnostic work. For most of it you would need to be by a major research center and qualify for a clinical trial.http://www.centerwatch.com/clinical-trials/listings/studylist.aspx?CatID=90 would let you know some of the things in your area, and you'd have to find the right kind of trial.You might also check on the web for the University with a major GI clinic in the hospital doing research and see if they do any IBS studies. A lot of them have websites and have lists of the studies they need people for.
 

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There are some recent IBS papers out of Israel, so these two might be the ones I checked out. The last paper is co-authored by Drossman who is one of the leading researchers, so that might be the place I'd check first.J Neurogastroenterol Motil. 2010 Apr;16(2):113-9. Epub 2010 Apr 27.Irritable Bowel Syndrome and Co-morbid Gastrointestinal and Extra-gastrointestinal Functional Syndromes.Sperber AD, Dekel R.Department of Gastroenterology, Tel-Aviv Medical Center, Tel-Aviv, Israel.Neurogastroenterol Motil. 2009 Apr;21(4):351-60.The challenge of cross-cultural, multi-national research: potential benefits in the functional gastrointestinal disorders.Sperber AD.Department of Gastroenterology, Soroka Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel. Gastroenterology. 2008 Jan;134(1):75-84. Epub 2007 Oct 26.Development of abdominal pain and IBS following gynecological surgery: a prospective, controlled study.Sperber AD, Morris CB, Greemberg L, Bangdiwala SI, Goldstein D, Sheiner E, Rusabrov Y, Hu Y, Katz M, Freud T, Neville A, Drossman DA.Department of Gastroenterology, Soroka University Medical Center, and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
 

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I'm not saying stress isn't a trigger.Just something PHYSICAL happened which determines where your stress shows up in your body.If you had asthma it would be in your lungs, not your intestines.You didn't select which organ was going to be the weak link because you needed your stress to make you physically ill. However, any body part which has a weakness will be where the stress can show up in the body.You didn't decide one day to make your stress give you diarrhea rather than asthma or a sore back, or any other specific illness. Something was weak to start with for some reason (like you were one of the probably pretty darn near 100% of people that get some GI infection sometime in their life) and once that got set off stress makes it worse and the stress/symptom/stress/symptom cycle can be hard to break and part of that is dealing with the mental aspects and you do not need to be hysterically whatever to have symptoms.IBS is not a mental illness or a sign your brain is weak. However, stress and bad psychosocial situations will make it harder to deal with than if you were not stressed, etc. Much of what makes an illness get worse and worse rather than better and better are parts of NORMAL psychology. Often when using mind-body medicine to help break the stress/symptom/stress/symptom cycle it is the psychologically healthy that do well rather than those with depression or anxiety on top of whatever else is going on.I'm not saying do NOT persue mind/body work, but that your brain can't make your body break in specific physical way because for some reason you want to be sick and refuse to be healthy. (which is what "in your head" tends to mean to people, you could be well, but you prefer to torture yourself with an illness).Now there are people who imagine symptoms that are not happening, or who will do things to make themselves sick with poisons or other techniques because of a mental illness. IBS is not either of these, but saying it is "in your head" and there is no physical anything at all and you just picked the intestines for some reason rather than make yourself have a rash or asthma is what I don't agree with. Where the symptoms show up has to do with something real and physical, not something imagined.For any illness I think you have to deal with BOTH the physical weakness (why the symptoms show up there) as well as any emotional/stress/mental issues that can be a a block to getting better.Hey, I did CBT for my IBS and I do not believe I just imagined it or it was in my head. I had a clear infection that started the IBS but I couldn't get the right feedback to my intestines to help them heal up in a couple of weaks. Once I changed the feedback, they were able to heal and eventually I got off medications, but I also needed to treat the physical issue and do not believe just mind stuff would have been nearly as effective as doing both, and my CBT doctors ALL believe IBS is physical, not just a mental problem.I'm not really disagreeing with you or saying stress cannot be a problem or that mind/body approaches do not work. Just saying you didn't make it up and there is a physical reason why your stress triggers your GI tract rather than your lungs, skin, immune system, or any other body part. Why is that so wrong?
I want to concur with what you are saying Kathleen. It surprises me when people refer to mind-body that they consider this just something that is happening in their head. That is really not the case. There is a real physical occurance in the bowel, whatever it might be inflammation or damaged nerves or any number of other possibilities. And there is real mind- which is really brain participation. It doesnt mean that it is a mental problem at all. In fact much of the mind that I refer to is subconscious or in a lower brainstem function. Afterall who can directly control their bowel function? At best it is indirect with straining and breathing. We are not wired to have conscious control of the bowel. No doubt our mental state can indirectly affect bowel function through influencing these lower brain functions, but the dysfunction in IBS is more related directly to these lower brain structures and how they respond to the physical stimulus. Normally the brain not the "mind" directly influences the bowel function. Somehow that proper brain influence is lacking in IBS to normalize the physical function of the bowel. What people call the "mind" or their conscious behavior just influences these brain structures that control bowel function. So stress or whatever behavior can worsen the IBS or as you say CBT or even hypnosis can positively affect the brain structures which directly control the bowel. This is a mind-body disease in the sense that the brain is unable to correct the physical dysfunction that is occuring in the bowel which it normally should be able to do.
 

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Well, I know for sure it was in MY head.I suffered some stressful events a couple of years ago and I remember the onset of some loose motions. This should have come and gone but it didn't. It didn't because I feared that something bad was hanppening in my gut and this fear seemed to perpertuate the condition. And when my subconscious mind had taken note of my fears, it homed in on what it perceived to be a weakness in my body.When the doctors and specialists couldn't find any obvious disorders after numerous blood tests, faecal tests, scans etc, the diagnosis became IBS. In other words "We don't know whats wrong", so we are calling it IBS"I had this condition for months, but once I addresed the issues in my head, rapid recovery occurred within a week.And I am sure that there are SOME IBSérs out there who can resolve their issues by talking to their subconcious minds. I'm guessing that the vast majority of IBSérs have physical causes, but I refuse to believe that ALL of them do.If it is psychologically induced IBS, there is great hope.Jackmat
 

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This is an interesting discussion. Obviously, many specialists do prescribe antidepressants and anxiety meds in accordance with other meds to "treat" IBS. Many times when I eat, I think, "Oh no, this is really going to upset my stomach." That worry could be contributing greatly to whether or not I experience discomfort. The tricky thing is sometimes I think that and nothing happens, whereas sometimes I am not worried and have terrible IBS symptoms. Therefore, my worry is not causing it altogether, however, as you've said, it only makes it worse. I carry my stress all over my body - in my belly, my shoulders and back, jaws, headaches....I imagine any kind of stress relief for people with high anxiety would help, although would not "cure" IBS.
 

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This is an interesting discussion. Obviously, many specialists do prescribe antidepressants and anxiety meds in accordance with other meds to "treat" IBS. Many times when I eat, I think, "Oh no, this is really going to upset my stomach." That worry could be contributing greatly to whether or not I experience discomfort. The tricky thing is sometimes I think that and nothing happens, whereas sometimes I am not worried and have terrible IBS symptoms. Therefore, my worry is not causing it altogether, however, as you've said, it only makes it worse. I carry my stress all over my body - in my belly, my shoulders and back, jaws, headaches....I imagine any kind of stress relief for people with high anxiety would help, although would not "cure" IBS.
I think that is the key to this. The bowel definitely has a brain of its own. The physical function of the bowel is affected by the (subconscious)lower brain through its autonomic connections and hormonal actions. The autonomic brain functions are influenced by the mental state and emotions. It is not to say that the cause of the IBS for everyone is physical such as inflammation or mental such as stress or panic attacks. It is only to say that the lower brain is not able to normalize the bowel function for some reason. Either because it cannot overcome the physical dysfunction of the bowel due to some dysfunction or because of the mental state of the mind that impairs the function of the lower brain and which directly influences the bowel. It is not the necessarily the mental state of the mind but the state of lower brain which is dysfunctional. We know that drugs such as antidepressants, hypnosis and CBT all can help many people with IBS. This is not directly affecting the bowel function it must occur through the brain. We know that the brain can control bowel function (that is basic physiology) and I think even cure the IBS.
 

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If you are in the habit of putting lumbar support behind your back, you are "conditioning" your subconscious mind to perceive that there is a problem there.Similarly with the bowel, irrespective of whether one day is good and the other bad, the subconscious mind can still be "conditioned" to perceive that a problem exists with your stomach, simply by your actions to protect it.Being positive in my thoughts, telling myself that my stomach was normal, laughing each time I experienced stomach distress, telling myself that my problem was psychological not physical (particularly when my stomach was hurting) are some of the things that helped reverse this "conditioning" process. Jackmat
 
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