After gathering information and getting to know your symptoms a bit better, you are ready to look at how your symptoms, thoughts, emotions, and behaviours interact. Your symptoms often trigger you to think, feel or act in certain ways. Your thoughts, emotions, and behaviours also influence your symptoms, and interact with each other as well. As a result, we end up with a feedback loop that looks a bit like this:
As you can see, all the parts in the diagram interact with each other. Once a negative feedback loop starts, it is likely to continue unless you try to break it. For example, Ahmid experiences intense stomach pain, bloating, wind, and diarrhea. He has thoughts like “I can’t go out, what if I have an accident”, “I won’t be able to relax”, and “what if I can’t find a toilet?”. As a result, he stays home where possible. When forced to go out, he takes medication and skips meals to try and prevent his symptoms. As a result, he feels anxious, down and frustrated about his situation.
When you understand how your symptoms are being maintained by your thoughts, emotions and behaviours, you can take steps to intervene. For example, by using medication and skipping meals, Ahmed actually worsens his symptoms. These behaviours upset his body, he ends up eating more later, which triggers pain, bloating and diarrhea. If Ahmed changed this behaviour, perhaps he would experience some symptom relief. This would have flow on effects to the way he thinks and feels.
Similarly, by practicing relaxation techniques, Ahmed could reduce his anxiety and arousal. Instead of thinking negatively, Ahmed could be more balanced in the way he talks to himself. He could tell himself encouraging things like, “I’ve never actually had an accident”, “If I go along, I might have a good time”, and “If I get symptoms, I’ll cope. I’ve managed difficult situations before”. This may help Ahmed approach rather than avoid situations. It may also directly improve his symptoms by reducing his body’s stress response (fight-flight-freeze).