• Are you frustrated and confused by under-managed GI symptoms? Do you wish you could feel better physically, emotionally, and socially? 
• Are you looking for proven treatment options to supplement your GI care but don't know where to turn? 
• Would you like to feel understood and validated, hopeful, and empowered in your treatment? 

Disorders of Gut-Brain Interaction, or DGBI, are believed to arise when there is a pattern of miscommunication between the gut and the brain via the nervous system in both directions (from gut to brain and brain to gut). DGBIs include irritable bowel syndrome, reflux hypersensitivity, and functional dyspepsia. Approximately 10-20% of people in the United States suffer from these conditions. It is not uncommon for diagnostic testing of DGBIs to come back negative or inconclusive, which can be frustrating and discouraging and contribute to additional physical suffering.  

The Gut-Brain Axis and Your Health

Many chronic GI conditions are influenced by malfunctioning and miscommunicating between the brain and the gut. An illustration of the gut-brain axis (or pathway) is when you experience butterflies in your stomach when in a situation that makes you feel nervous. The gut-brain axis is formed as a fetus when the gut's nervous system (enteric nervous system) and brain are developing. 

With DGBIs, the experience of ongoing pain or ongoing stress can begin to wear out the nerves in the GI tract. This can result in situations where intermittent pain can become chronic pain. Other GI symptoms, such as nausea and vomiting, can also be influenced by the brain-gut axis.

Gut-Focused Psychotherapy Techniques 

My integrated approach includes evidence-based techniques from cognitive-behavioral therapy (CBT), mindfulness and relaxation-based therapies, stress management, and healthy lifestyle practices. I also have training in pain psychology and use this framework and treatment approach when GI-related pain is present. 

Cognitive-behavioral therapy can be used to treat pain and also potentially rewire the enteric nervous system over time. Therapy can also address anxiety and stress, which play a role in GI symptom presentation or arise as a result of the GI symptoms. ​These treatments not only have a direct benefit for GI symptoms, they also improve emotional well-being and quality of life.  ​

A Team-Based Approach to Care 

Research and practice recommend a team-based treatment approach for complex and chronic GI conditions. As an independent practicing psychologist, I prefer to coordinate care at the beginning and throughout the course of treatment with your gastroenterologist and other health care providers as needed.  Your permission for these treatment disclosures is requested; you are able to specify if there are concerns with respect to your privacy.

Frequently Asked Questions (FAQs)

Q: Will my insurance plan cover these services? 
A: I am in network with Aetna, United Healthcare, and Medicare and they will cover the cost of
     mental health services. I also accept private pay for patients who have other insurances or are
     uninsured. 
Q: How long does treatment take? 
A: Mental health interventions are typically short-term (between five to seven sessions) and are
    aimed at teaching patients coping skills that they can use to manage symptoms on their own. 
Q: Isn't psychotherapy for people who are anxious, depressed, or have "psychological issues"? If I
    talk to you, does that mean my gastroenterologist thinks I am crazy? 
A: Gut-focused psychotherapy/GI consultation is focused primarily on the management of your GI      symptoms and overall daily coping related to GI functioning. Your symptoms are real and are not
    just "in your head." I should mention that there are often underlying depression or anxiety
    symptoms that either contribute to the GI condition or are the result of the GI condition. 
   These depression and anxiety symptoms may or may not be a focus of treatment, depending on
​    your circumstances. We will discuss these concerns during intake.  
Q:  Do behavioral treatments really work? 
A: I utilize evidence-based interventions. Many of these treatments have proven effective in a
    number of clinical trials and are widely accepted as beneficial treatments for GI conditions. For
    example, studies have shown that up to 75 percent of patients with severe IBS achieve
​    significant symptom reduction after a course of gut-focused psychotherapy. 

This section includes content created by Dr. Sarah Kinsinger (2019) included in Psychogastroenterology with Adults: A Handbook for Mental Health Professionals. 

If you have any questions or would like to schedule an appointment, call or send me a note. I look forward to hearing from you ! ​​
- Dr. Melissa Soo Hoo