Week 1: Understanding irritable bowel syndrome

Week 4: Healthy thinking, healthy self

Week 5: Balancing activity and reclaiming your life

Week 6: Maintaining your gains and staying well

Mindfulness skills

As we mentioned, mindfulness practice involves bringing your attention to the present moment without judgement. Mindfulness is linked to many health benefits, including reduced anxiety and improvement in irritable bowel syndrome symptoms. When you practice mindfulness, you create space between yourself and your symptoms, making them feel less overwhelming. By helping you be in the here and now, mindfulness can help reduce your worry and uncertainty about future symptoms.  

There are many ways to practice mindfulness in your daily life. The simple formula for any mindfulness exercise is to 1) simply observe something in the present and 2) gently return your attention back to it whenever your mind wanders. In other words, you avoid judging or trying to change any thoughts that drift by. You simply learn to let them go. 

Your focus can be on anything, whether it be your body, an object, action, sound, or inner experience. It is common for mindfulness practices to focus on the breath, because it is an easily available ‘anchor’ to the present moment. Below, we discuss a few ways to practice mindfulness in more depth.  

Mindful breathing

You can easily bring mindfulness to the deep breathing exercise you learned above. The idea is that you focus your attention intently on your breathing as you perform the exercise. You become aware of its natural rhythm and the way it feels on each inhale and exhale. Mindful breathing can be a particularly helpful way to gain a sense of calm and bring yourself back to the present moment when you’re feeling stressed or overwhelmed. 

Here’s how you can do it: 

    • Find a comfortable position. Take a seat or lie down in a place where you feel calm. Try to find somewhere quiet where you won’t be interrupted. 
    • Set your time limit. We suggest starting with something relatively short, such as 5-10 minutes. You can set an alarm and build up gradually with practice. 
    • Notice your body. Observe any sensations, areas of comfort and tightness. Don’t try to change anything, simply notice. Avoid judging what you observe, allow it to simply be.  
    • Pay attention to your breath. Follow the sensation of your breath as you inhale and exhale. Notice the rise and fall of your body. Focus on taking some slow, deep breaths and notice the difference in how you feel.  
  • Notice when your mind has wandered. Whenever this happens, congratulate yourself on becoming aware and gently direct your attention back to the exercise.  

Practice this exercise regularly, at least once a day. If possible, practice several times throughout the day as a way to ground yourself to the present moment. 

Mindful movement

Mindful movement allows you to check in with your body and get moving in a way that can promote relaxation and lower stress. It can be a great way to practice mindfulness with the added physical benefits. When your body feels good, your mood often improves as well. Engaging in gentle movement can also improve energy and concentration. Mindful movement can involve walking, tai chi, stretching and yoga, and other forms of exercise. Here, we focus on walking and yoga/stretching.

Mindful walking can be a simple way to get started and explore mindful movement. The aim of mindful walking is to be present with the act of walking. Walk slowly as you try to focus on your experience. Notice your breath, how your legs move, the ground beneath your feet, and the repetitive motions that move you forward. Each time your mind wanders, bring it back to the sensations of walking.

Yoga and stretching is another great way to practice mindfulness. It also helps to reduce stress and tension and is good for the body. It involves simply being aware of your body as you move, rather than being carried away by distracting thoughts. The same principles apply, simply redirect your attention back to your body whenever your mind wanders. We spend a lot of time in sedentary positions that are not good for our bodies, minds, or digestive processes. If you’re constipated, gentle movement can be a good way to restore normal bowel function. 

Mindfulness of daily activities

Do you ever feel like you’re on autopilot, doing things without conscious awareness? Do you ever complete a task only to realise that you can’t remember doing it? These are signs that you are being mindless, rather than mindful. There are so many opportunities to practice mindfulness in our daily lives. For example, having a shower, washing the dishes, catching a bus or walking the dog. Throughout the day, look for opportunities to be more mindful.

Mindfulness of daily activities involves paying attention to the activity as you engage in it. It means tuning into your experience, noticing any sensations in your body, and being aware of everything you do. As you focus on the present, observe your thoughts and feelings without becoming attached to them. Just allow them to come and go naturally. If you get distracted by a thought, simply redirect your attention back to what you’re doing.     

For example, Nina uses her morning shower as an opportunity to practice mindfulness. She focuses on the sensation of the warm water as it trickles down her body. She hears the sound of running water. She feels the sensations of her hands on her head as she washes her hair. She takes in the pleasant smell of her soap. She notices a sense of calm as she fully participates in this activity. Of course, Nina’s mind wanders every now and then. Each time she notices this, she gently brings herself back to the present moment. 

Radical acceptance

Dropping the struggle with reality can help us accept things as they are and find a way forward. Instead of getting caught up in blame, self-criticism, and “why” or “what if” questions, radical acceptance helps us simply do what needs to be done. It can also lead to a sense of empowerment and freedom. Below, we discuss some simple steps to help you radically accept what can’t be changed. 

Here’s how you can start to practice radical acceptance: 

  • Notice when you are struggling with reality (“It shouldn’t be like this”)
  • Describe your reality, without judgment 
  • Remind yourself that reality can’t be changed (“It is how it is”)
  • Choose to accept your reality
  • Make a commitment to accept your reality wholeheartedly
  • Act as though you accept reality, even if you don’t 
  • Consider the pros and cons of accepting versus not accepting reality
  • Allow your emotions to be as they are, even if you don’t like them
  • Acknowledge that life is worth living, even with pain
  • Repeat the above steps each time you are faced with the choice to accept or reject reality 

As you engage in the above steps, try to adopt an open body posture. Relax your face and jaw muscles. Let the corners of your lips curl upwards slightly, as though you are softly smiling. Roll your shoulders back and away from your ears. Rest your hands, palms facing upwards, on your legs or by your side. Why do this? Our emotions are linked to our facial expressions and body posture. Research has found that if we take an open body posture, we are generally more open to ideas. Similarly, if we smile and relax the facial muscles, we tend to feel more accepting.

For example, Rahoul was in a constant struggle with his irritable bowel syndrome reality. Whenever he had symptoms, he would try to push them away or ignore them. As a result, he would often overdo it and suffer in the days following. During this period, Rahoul would miss out on hanging out with his friends. He would lie in bed feeling sad and wishing that his life was different. Rahoul was constantly hard on himself. He would say things like, “I’m so stupid, I shouldn’t have eaten that” or “I’m so weak, I should be able to cope better than this”.   

When Rahoul saw a psychologist, he started to practice radical acceptance. This helped him to acknowledge his symptoms, without trying to push them away. He still didn’t like them, but at least he was no longer in denial. This allowed Rahoul to take a more proactive approach to managing his irritable bowel syndrome. Instead of wishing his life was different, Rahoul started to accept his life as it was. He made the most of opportunities to hang out with his friends and he accepted the disappointment when he was unable to do this. 

Rahoul found this approach served him much better. Although his irritable bowel syndrome symptoms still got in the way sometimes, they no longer created longlasting suffering. Over time, Rahoul spent more time learning about his irritable bowel syndrome. His efforts paid off and he found some strategies that really helped. If Rahoul had remained in denial and continued to push himself to his limits, he would never have been open to these symptom management strategies. 

Other stress management tips

If you’re under pressure and feeling stressed, there are some other things you can do to manage effectively. The first step is to identify that you are feeling stressed and recognise when it is a problem. Try to recognise your warning signs or stress (e.g., tense muscles, headaches, fatigue) and make a plan to get on top of things early. Here are some other tips for good stress management:

  • Think about how you can relieve the pressure. Are there things that you can give up, leave until later or ask for help with? Can you prioritise your tasks, rather than trying to do everything at once? 
  • Access support. Talk to close friends and family about your situation and see if they can provide practical support and advice. If you don’t have people close by to offer support, consider taking steps to build a stronger social support network. 
  • Eat well and exercise. When we are stressed, we tend to let go of our self-care. However, maintaining a healthy diet and regular exercise is particularly important during times of stress. Making sure you get enough nutrients means that your risk of illness is reduced and you’ll have the energy to do what needs to be done. It’s also important to stay hydrated. Exercise is an effective way to manage the effects of stress and improve your mood.
  • Avoid unhelpful ways of coping. Times of stress are when we tend to turn to unhealthy ways of coping, like smoking and alcohol. In the short term, it can feel like these things relieve the pressure. However, in the long run, they tend to make things worse and increase feelings of stress and anxiety. 
  • Prioritise sleep. Stress often interferes with sleep. It can be hard to get a good night’s rest when you feel tense and overwhelmed by a mountain of worries. However, poor sleep makes us less able to cope with stress and keeps us trapped in a negative cycle. As such, it is important to find strategies for sleep that work for you. A simple online search for ‘sleep hygiene’ is a good place to start. 

Practice self-compassion. It is important to avoid self-criticism as much as possible. Frequently being harsh on yourself will just add to your stress and keep you feeling down. Try to keep things in perspective and don’t be too hard on yourself. Be kind and treat yourself like you would a close friend.