MyQOL Toolbox

Cognitive Behavioral Therapy (CBT)

CBT is a common type of talk therapy that people use to identify unhelpful thoughts or patterns of behaviors. It also teaches skills useful for replacing troubling thoughts or behaviors with helpful ones. Developed in the 1960s and 1970s to help patients with depression and anxiety, CBT has proved effective in treating symptoms in a wide variety of medical conditions, including GI disorders.

The first step in CBT is to become educated about your symptoms. In addition to the information given to you by MyGiHealth and MyQOL, you should ask your healthcare professional more about your particular condition. Next, you should begin monitoring your symptoms on this app – MyGiHealth can track your GI symptoms, and MyQOL can track your thoughts and feelings.

Finally, you will want to use some of the materials in this section. Something as simple as performing daily symptom monitoring may help with self-reflection and provide a sense of control and well-being. Once you have begun to identify your unhelpful thoughts and actions, you can use a CBT app (see below), or in-person therapy to help modify them. Therapy is not easy, but the results are worth the work!

Apps

The MyGIHealth team has reviewed a variety of apps, and has found that these apps may be useful for those who want learn some skills taught in CBT. Both of these apps are not free. The MyGIHealth team encourages their use, but does not provide technical support for these apps.

iCBT from Bonfire Development

iCBT helps you manage stress and anxiety, by allowing you to use CBT techniques to move past negative thinking. The app guides the user through a CBT thought record. Users can speak to the app or type, and email information to a therapist.

MoodKit from Thriveport, LLC.

This app has multiple tools that are aligned with CBT theory.

MoodKit Activities: these are goal driven statements along multiple domains (e.g. productivity, social, enjoyment, physical) which you can either commit to or continue to scroll through the various suggestions.

Thought Checker: this is the CBT core of the app. It gives you the opportunity to summarize a situation that was troublesome, rate the emotions that it stirred up, what thought distortions you had, then prompts you to write other ways in which you could have thought about the situation in a non distorted manner. Finally you re-rate their emotions. At the end you are provided a summary of the situation, the distortions, the modified thought and how their feelings/emotions have changed.

Mood Tracker: this allows you to rate your overall mood for the day and tracks it for you on a graph. Journal: This keeps track of your activity on the other tools as well as allowing you to journal other thoughts and has many templates such as: accomplishing goals, asserting yourself, evaluating predictions, food log, savoring experiences, shifting perspective.

It has 4.5 stars in the App Store. It was last updated on 6/13/15 and has been around since 2011. Has a lot of good press and reviews from publications and CBT authors. It is a little pricy at $4.99 but seems worth it.

Acceptance and Commitment Therapy (ACT) and Logotherapy

As you struggle to understand your GI symptoms, you may feel that the suffering, discomfort, or pain caused by symptoms is needless and without meaning. While your goal may be to eliminate suffering, total relief is not always possible, or may not be immediate. Experiencing prolonged illness can become emotionally and physically exhausting. Long-term symptoms can change your thoughts and actions. Rituals, fear, anxiety, and avoidance can run your life, and you may feel isolated because you cannot participate in life like you used to do. Ultimately, this prevents you from gaining meaning from life.

If you cannot change your GI symptoms, you must change how you view your symptoms. While it may be difficult, it is possible to restore meaning to your life, even in the face of suffering. Physical and mental pains are inevitable in life, but suffering is optional.

Logotherapy is based on European psychoanalysis, and directs people to find meaning in life, even in the most difficult situations. Acceptance and Commitment Therapy (ACT) is based on Eastern philosophy, and directs people to let go of what they cannot control, and to find meaning in what they can control. Both therapeutic methods encourage participants to engage in real-life experiences that allow them to see how unhelpful thoughts and behaviors interfere with life, and how to replace those with new activities that bring value, meaning, and purpose to life.

Setting Goals

When your GI symptoms flare up, they may capture your full attention. If you are only thinking about your symptoms and nothing else in life, then you are likely to experience fear, anxiety, and isolation. These thoughts and feelings are focused inward, trapping you in a cycle of physical pain and emotional suffering. Instead, focusing on life outside of your GI symptoms will allow you to reduce suffering. Your pain may persist, but it will not get in the way of achieving new goals, or creating new activities involving others, which helps to redirect your attention. The act of setting goals that involve others allows you to restore meaningful relationships with people and your environment.

Doing What You Fear

Often it seems like the symptom you fear will flare up just by thinking of it. For example, consider someone who suffers from abdominal pain. The person may be consumed by fear about when the pain might occur next, or think constantly about what foods or situations might bring it on. However, if that person tries to bring on the pain – by tightening their abdominal muscles – the person might discover that the symptoms and negative consequences do not appear. In fact, studies have shown that when people attempt to activate the very symptoms they fear, they gain improved symptom management and greater control over their GI illnesses. This is the distinction between pain and suffering. The pain is unavoidable, but the suffering is the mess surrounding the pain – the worry, the obsession, the fear. When you allow yourself to confront your pain, you may find that it is not as bad as expected, and you might actually regain control over the experience of having pain.

Share with Others

Even an action as simple as using this app is helping others with similar conditions. By entering data, you are allowing researchers to understand GI disorders better. The app also allows people with similar disorders to share helpful experiences and strategies.

Apps

The MyGIHealth team has reviewed a variety of apps, and has found that these apps may be useful for those who want regain control over their own lives. The app is not free. The MyGIHealth team encourages its use, but does not provide technical support for this app.

MoodKit from Thriveport, LLC.

This app has multiple tools that are aligned with CBT theory.

MoodKit Activities: these are goal driven statements along multiple domains (e.g. productivity, social, enjoyment, physical) which you can either commit to or continue to scroll through the various suggestions.

Thought Checker: this is the CBT core of the app. It gives you the opportunity to summarize a situation that was troublesome, rate the emotions that it stirred up, what thought distortions you had, then prompts you to write other ways in which you could have thought about the situation in a non distorted manner. Finally you re-rate their emotions. At the end you are provided a summary of the situation, the distortions, the modified thought and how their feelings/emotions have changed.

Mood Tracker: this allows you to rate your overall mood for the day and tracks it for you on a graph. Journal: This keeps track of your activity on the other tools as well as allowing you to journal other thoughts and has many templates such as: accomplishing goals, asserting yourself, evaluating predictions, food log, savoring experiences, shifting perspective.

It has 4.5 stars in the App Store. It was last updated on 6/13/15 and has been around since 2011. Has a lot of good press and reviews from publications and CBT authors. It is a little pricy at $4.99 but seems worth it.

Mindfulness and Meditation

Mindfulness is directing your thoughts, emotions, and sensations toward the present moment, intentionally, with acceptance, and without passing judgment. It is rooted in Eastern philosophy, but has been adapted for use in conjunction with Cognitive Behavioral Therapy and Acceptance and Commitment Therapy. Mindful meditation teaches you how to focus on your breathing, while observing and accepting the various thoughts and sensations that you experience. Through repeated practice (even as short as 5-10 minutes per day), you will gain more perspective on the connections between your thoughts and symptoms, while decreasing your overall stress and anxiety.

The simplest form of meditation is also the least expensive – breathe! Take a slow, deep breath through your nose that lasts for several seconds. Pause briefly, and then, slowly exhale through your mouth for several seconds. Pause briefly, and repeat as necessary.

Apps

The MyGIHealth team has reviewed a variety of apps, and has found that these apps may be useful for those who want to practice mindful meditation. Some of these apps are not free. The MyGIHealth team encourages their use, but does not provide technical support for these apps.

BellyBio Interactive Breathing (RelaxLine)

A free app that teaches you how to breathe deeply using your iPhone. It uses biofeedback and soothing music to promote deep abdominal breathing (not just your chest, but breathing down to your belly). When using the app, you will want to lie down or sit in a reclining chair to optimize deep breathing.

The Mindfulness App (MindApps)

This app helps you reduce stress and increase wellbeing. It guides you through meditation exercises from world experts on mindfulness, or allows you to meditate in silence. The app also tracks your meditation, and can prompt you to relax as needed.

Simply Being - Guided Meditation for Relaxation and Presence - Meditation Oasis (Meditation Oasis)

This app also guides you through meditation exercises, providing stress relief even without prior experience. You can different amounts of time to meditate, and listen to music or nature sounds during your meditation exercise.

MoodKit from Thriveport, LLC.

This app has multiple tools that are aligned with CBT theory.

MoodKit Activities: these are goal driven statements along multiple domains (e.g. productivity, social, enjoyment, physical) which you can either commit to or continue to scroll through the various suggestions.

Thought Checker: this is the CBT core of the app. It gives you the opportunity to summarize a situation that was troublesome, rate the emotions that it stirred up, what thought distortions you had, then prompts you to write other ways in which you could have thought about the situation in a non distorted manner. Finally you re-rate their emotions. At the end you are provided a summary of the situation, the distortions, the modified thought and how their feelings/emotions have changed.

Mood Tracker: this allows you to rate your overall mood for the day and tracks it for you on a graph. Journal: This keeps track of your activity on the other tools as well as allowing you to journal other thoughts and has many templates such as: accomplishing goals, asserting yourself, evaluating predictions, food log, savoring experiences, shifting perspective.

It has 4.5 stars in the App Store. It was last updated on 6/13/15 and has been around since 2011. Has a lot of good press and reviews from publications and CBT authors. It is a little pricy at $4.99 but seems worth it.

Mind-Body Connection

By answering questions about your GI symptoms and how they affect your life, we hope you are beginning to understand how your mind and body are connected together. If you are unhappy, you may feel physically unwell. Likewise, if you are injured, you are not likely to feel happy. We hope you review the reports generated by MyGIHealth, because these will show you which symptoms are reducing your quality of life the most. You can work with your doctor to change these symptoms, but you can also use the tools in the MyQOL Toolbox to make changes to how you think and feel about those symptoms. To learn more about how your mind and body are connected, check out Emeran Mayer’s article.