Episode 38 Don’t Hate your Guts! Holistic Treatment for Disorders of the Gut/Brain Interaction with Dr. Jennifer Franklin

[CHRIS McDONALD]

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Welcome to the Holistic Counseling Podcast, where you discover diverse wellness modalities, advice on growing your integrative practice, and grow confidence in being your unique self. I'm your host, Chris McDonald. I'm so glad you're here for the journey.

Welcome to today's episode of the Holistic Counseling Podcast. I'm Chris McDonald, your host, licensed therapist and expert in holistic counseling. Do you hate your guts? If you have some form of ongoing episodic or chronic digestive issues that disrupt your life, or if you have clients that do this episode is for you. Let me introduce you to today's guest. Her name is Dr. Jennifer Franklin. Dr. Jennifer Franklin is an experiential, relational, somatic and mindfulness based psychologist with about 20 years of psychotherapy experience and an educational background in mind, body holistic psychology, which makes her perfect for this podcast.

She worked at the UNC Center for Functional GI & Motility Disorders in Chapel Hill and specializes in healing, functional medical problems, especially disorders of gut brain interaction like IBS, along with issues associated with anxiety, panic, interpersonal relationships, attachment, and trauma. She helps clients to heal and find relief from ongoing digestive issues. In this episode will be talking about what are the disorders of the brain gut, how she treats them and about the mind body connection. Welcome to the podcast Dr. Jennifer.

[DR. JENNIFER FRANKLIN]

Hi.

[CHRIS]

We're so glad you're here. As I was telling you before we hit record, I didn't even know that this existed, that somebody is able to treat a lot of these mind, body issues that happen with the gut. I didn't even know that was a thing. As a holistic psychologist, I was like, this is so cool.

[DR. FRANKLIN]

I'm glad you know now, and I'm glad I reached out to you to let you know.

[CHRIS]

I'm sure so many listeners don't either that this is actually something we could refer to, or maybe even learn more about to put into treatment practice. This is just so exciting to find this other realm of psychology.

[DR. FRANKLIN]

I'm glad you're excited. I'm excited to be here and share more.

[CHRIS]

Let's get started with what kind of training did you undergo to become a holistic mind, body psychologist?

[DR. FRANKLIN]

Interestingly, I didn't actually set out to become a holistic mind, body psychologist. No, I just wanted to study psychology and by the time I applied to graduate school, I already understood that there was a powerful relationship between the mind and body from my own personal experience. So when I was applying to graduate school, this was in '98, it just didn't make sense to me to go to a traditional school for psychology that was not at all going to talk about the body. So that really narrowed the pool of choices and I ended up at a really small graduate school in Northern California that was talking about the body and was teaching psychology from a more mind, body perspective. So that's where my training began. My graduate program was also highly experiential so that everything we talked about as an approach, we practice on ourselves.

[CHRIS]

Isn't that great?

[DR. FRANKLIN]

It was so that we were doing a lot of our own work from the get go, just every step of the way. We had constant opportunities to work on ourselves and work on our relationships. Then lots of writing assignments included a component of self-inquiry and self-reflection. We were constantly being given opportunities to engage in our own different experiences from a place of curiosity. Mindfulness was a big part of, mindfulness in learning meditation, we were practicing meditation at the beginning of every class every day so mindfulness was a huge part of the philosophy and we were doing essentially learning to relate to each other mindfully.

Then part of the graduate program was physical disciplines like yoga and martial arts I did a year long yoga class, year long Aikido classes where there are interval parts of the program and the training. And it was taught in a different way than you would get at the yoga class. It was taught, they actually taught us the philosophy of these things as well. Then it was a lot of self-inquiry as we engaged in the experience of yoga and the experience of practicing Aikido art too. We had exposure to art therapy and a whole bunch of humanistic existential, phenomenological mindfulness space, experiential, and somatic approaches. So it was really a smorgasbord for me.

[CHRIS]

Sounds like it touches on so many parts of you holistically and it's so cool how it experiential, I think, is so important for learning.

[DR. FRANKLIN]

Yes. It was an entirely experiential learning program and it was, I don't know where I'd be if I hadn't gone to graduate school there. Honestly, I don't know that I would be, I don't think I would healed and recovered personally. I don't know that I would be specializing in what I specialize in.

[CHRIS]

And I've never heard of the martial arts as part of an integration. So that's even more using the body, isn't it?

[DR. FRANKLIN]

Yes. It was, I mean, a lot of those kinds of practices also have a contemplative component, so it's really mind, body spirit.

[CHRIS]

Exactly. Can you share your personal experience with recovering from chronic IBS?

[DR. FRANKLIN]

Sure. I'm happy to share some, and I just want to say that in sharing my story, I just want to acknowledge that healing is very specific to each person. So each person has his or her, their own healing journey that each of us needs to go through in order to get where we're trying to get. So my healing journey is not going to be somebody else's, but mine began back when I was 15 years old. That's when I started having really acute symptoms. Actually, I had symptoms even way before that I just thought were normal and they weren't really a problem, so to speak. When I was 15, I started having more acute symptoms and was referred to a gastroenterologist.

What I didn't know at that time was that my gastroenterologist was actually one of the more progressive gastroenterologists. He also had really excellent bedside manner. He was kind gentle and understanding. I met with him a few times over the course of a year. He ran some diagnostics and officially diagnosed with IBS. At that time I don't, they were really giving antidepressants to kids. I don't think they were doing, that they were really prescribing a lot of different medications to children for depression, anxiety, or I guess. So I was kind of left with muscle relaxants that I was told to take when I had an episode and for me it would start with pain.

I started using that when I needed to, but it didn't really stop the problem from happening. So that was it. Then the only other thing he said is he gave me the recommendation to start seeing a psychologist and he gave me a referral to one and I didn't like that suggestion. It did not make me feel comfortable. So I didn't do anything with that, but another year went by and I had really worsening symptoms and I was pretty debilitated at the end of that year. So I was so desperate and it was only in the desperation that I reached out to the psychologist he'd recommended.

I started weekly psychotherapy and after one year of weekly of therapy and no other changes to my life, my situation, no other additional treatments, I got about 50% better just from that. I wasn't even talking about my symptoms at all. I just talked about my life, my relationships, my thoughts, feelings, experiences. So just from doing that, I got about 50% better. It's hard to quantify but the bottom line is I went from being debilitated, like missing days and days at school, being in agonizing pain, having these episodes that kept me up all night to being able to go to school. I mean, I didn't have any of those really acute episodes after that.

[CHRIS]

That's pretty incredible.

[DR. FRANKLIN]

Yes. So it was a big difference, but I still was managing some, I'd say mild to medium IBS symptoms that would come and go. So it wasn't gone. Then the rest of my healing happened when I was in graduate school, because of that experience of having a year of psychotherapy makes such a profound difference in my physiological symptoms than when it came time to apply for graduate school. I just couldn't go to a school that wasn't going to talk about the body. So then I ended up at the school I ended up at and I wasn't trying to heal. I really wasn't. After I was functional again, after the year of psychotherapy, I was like, okay, I'm good.

I didn't expect to get any better than that because nobody ever gave me any reason to believe that I could heal or completely recover. So I just didn't even think it was possible. In graduate school, I was being exposed to all these things. I was learning all these things and I started tinkering with the things that I was learning with myself. Then there were aspects of my healing process that probably were not conscious. I just kind of was experiencing things more passively and those things really made a difference for my nervous system and my body. If you had asked me 15 years ago how did you recover, I would've said, oh, well, it's mindfulness. I started sitting in meditation and that did it for me. But now that I know everything that I know, I don't think that was it. It was a lot of different things.

[CHRIS]

I was going to say, isn't there multiple layers of things that you did?

[DR. FRANKLIN]

Yes, definitely. Some of them were more passive. Some of them were active. I mean, some of them, it was okay, I'm going to try this thing in this moment and see how that works and then I would get an effect that told me, oh, that made a really positive, that helped. That helped. Wow, that works. But that was a more active thing. There were many things that were than that and some of them were a longer process. Like sitting in meditation it didn't work instantly. It over time taught my nervous system how to do something different.

[CHRIS]

That's it, isn't it? Over time, you can't do it just once and be like, it doesn't work.

[DR. FRANKLIN]

Yes, yes. Healing from something like IBS or anxiety, that's been there a long time, lots of more chronic conditions, it's typically not overnight. It's a process. That doesn't mean it has to take as long as it took me to heal but that's part of why I do the work that I do is that I didn't have any kind of guide. I didn't have anybody like me to help me back then. So I was all on my own to figure this stuff out and one of the things I love about my work now is I get to make this process more expedient for people.

[CHRIS]

Yes, because you went through it. That's true. I never thought, I never heard that you could even recover from IBS. I thought that was chronic condition that you're stuck with the rest of your life.

[DR. FRANKLIN]

Yes, that's what most people hear. That's what most people believe. That's what most of the doctors convey, whether it's explicit or implicit.

[CHRIS]

Here's some medication and just deal.

[DR. FRANKLIN]

Yes, unfortunately. There's a huge gap between what medicine is teaching to physicians like Western medicine and that whole model and there's a big divide between that and more Eastern mind, body kinds of models.

[CHRIS]

I absolutely totally get that. I know when I was reading your website too, and you talk about DGBIs, I didn't know what that was. I didn't know that was a term. So Disorders of the Gut Brain Interaction. So can you share more of what that means?

[DR. FRANKLIN]

Yes. And don't feel bad about not having heard of that because ---

[CHRIS]

I'm like, how did I not know this?

[DR. FRANKLIN]

Because it's actually a new name for what used to be called Functional Gastrointestinal Disorders or FGIDs. Maybe you haven't heard that either, but it doesn't matter. Basically there's a large category of what we could say are mind, body kinds of illnesses or chronic problems or we could say, there's another term stress illnesses, but they have for many years been called functional medical problems, which refers to basically a whole host of physiological symptoms or conditions that are not caused by any kind of disease or organic dysfunction.

So if doctors don't find anything wrong with the body, then they might diagnose one of these other things. So functional gastrointestinal disorders was a cluster of digestive disorders that fell into that category of functional medical problems. But today they've changed the name from functional GI disorders to Disorders of the Gut Brain Interaction because they understand that these problems are more a function of the gut brain axis and the communication between the gut and brain not going so well.

[CHRIS]

Yes. That's very interesting. Why do you think, why does psychology matter in the treatment of the gut then? Why do you bring that into it?

[DR. FRANKLIN]

The gut brain access, which, we usually talk about the vagus nerve when we talk about the gut brain access. The vagus nerve is part of the nervous system that allows your brain and gut and actually your brain and other digestive organs as well to communicate. So there's constant by-directional, like in other words, from the gut to the brain and the brain to the gut, although most of the communication is from the gut to the brain or the digestive organs to the brain. So there's always this communication happening in our bodies.

here's a lot of information that's constantly being transmitted about what's happening in our bodies. So for talking specifically about DGBIs, then we need to focus on the communication between the gut and the digestive organs. And these messages primarily from the gut to the brain are essentially helping our brains to survive by maintaining homeostasis in the body and by coordinating digestion, given what's going on within the environment in the body and outside the body. That's how we're wired.

[CHRIS]

Yes. That's pretty complex.

[DR. FRANKLIN]

So our psychology, as you know affects us generally in so many ways. Our beliefs, attitudes, feelings, thoughts, perceptions, desires, wants, needs, impulses, urges, and behavior all have an effect on our every day, every moment functionality. How we feel, think, do, and relate both to ourselves, our bodies, our symptoms has a huge role, either helping us to feel better or helping us to feel worse. Is this the only factor at play? No, but it's a big factor. In my opinion, it's one of the most important factors involved in DGBIs because it's a variable, like a lot of these variables, these feelings, thoughts, perception, all of that, all of that stuff are variables that we can actually influence.

[CHRIS]

So who knew?

[DR. FRANKLIN]

Well, I did.

[CHRIS]

You did. Not everybody else. That's why you're here.

[DR. FRANKLIN]

Well, I mean, I think a lot of us realize that our thoughts are powerful and that, I mean, we can't just willy-nilly control some of these things and change these things. Some things we have more control over than others. Some things we have more influence over than others. We don't consciously control our digestion. So the idea that we control our digestive symptoms is hogwash. We don't control digestion. How are we going to control the symptoms that we're experiencing as a function of digestion?

So I try not to contribute to this whole idea of controlling our IBS symptoms. I'm not interested in helping somebody to control their symptoms because I don't believe that that's something that I can do. Because I don't think that that's something any of us can do, but we can influence our digestion by working with the parts of ourselves that we really do have more control over. That influence can be very powerful if we keep influencing it in the ways that are going to be helpful. So we don't just do it one time. We influence and then maybe we get a tiny little shift in the right direction and then we just keep influencing that. And that adds up to a big response over time.

[CHRIS]

So over and over that helps with healing.

[DR. FRANKLIN]

Lot of repetition, we try one little thing, one little shift, see how that works and if it works even a little bit, I mean there's a lot of different things here to this because you have to be able to track a shift. A lot of times the kinds of patients that I work with, they're not necessarily able to track things in a really subtle way. So we have to help bring that on board, the ability to actually see things clearly, to be able to notice the things that they're experiencing in their bodies so that they can track these little shifts that can occur.

[CHRIS]

So they're not as tuned to those signals?

[DR. FRANKLIN]

Right, because they're tuned off, oftentimes tuned into the signals of pain and distress and discomfort and the things that aren't making them feel good because guess what, that's what our brains do. When there's a stressor, when there's a threat in our environment, whether it's in our internal environment or our external environment, our brain zooms in on the threat to try to survive. And that threat are our symptoms. So then we get more focused. We get almost myopically focused on the symptoms that are not making us feel very good and then we feel helpless to stop them and then we feel out of control and then we feel frustrated and then it leads to a cascade of unpleasant, psychological and worse physiological symptoms. So we've got to move out of that whole stuck pattern and move out of that, honing in and zooming in on the unpleasant symptoms and focus on something else that's going to help us to feel better so that we can get our brains to not be under the grips of stress basically.

[CHRIS]

So it seems like there's a strong correlation too, with anxiety and trauma and depression. So they're all connected to gut health too, aren't they?

[DR. FRANKLIN]

Yes. I mean all, for some people gut symptoms show up when they're feeling anxious and some people, there's a huge correlation between anxiety, trauma, depression, and gut symptoms. What order that happens in is, it's a question of awareness really. For me personally, I like to use myself as an example, for me, if you had asked me when I had my most acute symptoms, are you feeling anxious, I would've said no, absolutely not. Because I was just generally anxious as a person. And I had always leaned on that anxious end of the continuum.

[CHRIS]

So was that your normal?

[DR. FRANKLIN]

That was my normal, exactly. It's not like that was a change for me. So it's hard to see something that you've been living with for so long or that creeps up on you so slowly you can't even really track it.

[DR. FRANKLIN]

So the first hint that something was going on with my body that needed my attention were the IBS symptoms. And this happens frequently. I see other patients that experience this as well, but if we really start to look at the whole picture, often there are precursors, often there is an uptick in anxiety or depression or digestive symptoms that were kind of low level and not really huge problems. This is part of what I mean by moving away from this very honed in perspective that's very focused on the threat at hand, which are the most acute symptoms that a person is living with, that they want to go away so that they can resume living their lives.

So part of my work is helping people to shift out of that way of thinking by helping their nervous systems to move out of this really stuck pattern of high level of stress. Because if we can shift out of that more stress fight or flight state or worse if it's freeze, if we can move out of that into a more regulated state where there is more ease, there is more flow, there's more capacity to, for relationship for connection, then people pretty readily feel better.

[CHRIS]

Yes, that's amazing.

[DR. FRANKLIN]

Then once they feel better and they can stay in that more regulated state, then their brain mindfulness starts come online, more faculties in the brain that were hijacked by stress start to come online. Those are the faculties that we want to come online because they bring a different perspective. They're a much more expansive perspective of being able to see whole picture, be able to settle, to be able to think more clearly and then there becomes the possibility of moving into a different way of relating to the symptoms and a different way of approaching things, a different conversation, basically.

[CHRIS]

As a holistic psychologist, so how do you treat these disorders? So how is it different than regular talk therapy?

[DR. FRANKLIN]

I don't know that it's always different from regular talk therapy. I guess to answer that question accurately, I think we have to make sure that we have the same definition for traditional talk therapy. How would you define traditional talk therapy, Chris?

[CHRIS]

It's more of a top down approach, isn't it, just using verbal skills, the frontal part of the brain, just using CBT. To me that's more talk therapy and not using the somatic experiencing. I know that you use some of that.

[DR. FRANKLIN]

Yes, but I think, yes, I would agree with what you're saying, with the definition you're offering. My backgrounds is such that, I don't know if I was ever really trained in just traditional talk therapy. I think I understand it more or less the way that you do that it's kind of, well, I guess the way that I would define it is that my experience is that it gives patients room to talk about what they want to talk about and often that ends up being kind of the problem de jure or the problem of the week.

[CHRIS]

The crisis of the week.

[DR. FRANKLIN]

Yes, exactly.

[CHRIS]

We call them cows

[DR. FRANKLIN]

Yes, exactly. Crisis of the week. And then the therapist kind of just supports working through that and listening empathically, but there's a lot of room given to them bringing in that problem of the week and or problem or crisis. I have not found that approach to be helpful. So my aim is to really think about big picture; where are we and what are we trying to accomplish and how are we going to get the there, and all of the things that I have to assess in order to help us get there.

So, yes, my training approach and orientation is fundamentally holistic and experiential. I'm really thinking in my mind at many moments what does this person as a unique individual in the world, in order for their body to feel better? What would make a profound difference in their life? What has this person not experienced ever, or had enough of in their life, such that if they were to have this experience, it would drastically change the trajectory of their interpersonal and interpersonal neuro biological experience?

[CHRIS]

Well, that's a great question though. What is it that they haven't had or what do they need more of?

[DR. FRANKLIN]

Right. What unmet needs are still waiting to be satisfied, such that impact their psychological and physiological experience? That's what I'm most focused on at all times, that question I'm constantly assessing for that. However, I'm not doing it by peppering people with a lot of questions, because depending on the level of awareness somebody comes in with, they're not necessarily going to be able to answer those questions for me it's a matter of kind of chipping away layer by layer and helping get to, it it's like there might be an obvious unmet need. They might come in and say, this is what I need and then once we satisfy that, then there's often more needs underneath that get revealed over time. So that's kind of the way that I think about it and the way that I'm working with people, which I think is a little bit different.

I should also mention, I think one of the biggest differences is that I learn to be really directive. That doesn't mean that I'm directive all the time or even every session. But I do tend to have a more directive approach because I'm not interested in helping somebody to perpetuate patterns in their life in any way that are not helpful and that are continuing to play out and not be helpful. As sooner I can help to disrupt those patterns and introduce something that might feel better, I'm going to do it.

[CHRIS]

Because I can see how traditional talk therapy that therapist might get stuck in that cycle of allowing the client to luminate and just get stuck in that pattern of thinking, oh, I have this pain in my gut and that's all I can think about and feeling depressed about it and just getting stuck and not getting anywhere.

[DR. FRANKLIN]

Yes, I'm not interested in contributing to that. So my goal is how do I not contribute to that? What needs to happen in order for us to do something different that's going to break that? That's going to be well tolerated. That's going to be well received. That's going to feel good. That's going to truly feel good to them where they go, even though I might be disrupting their process of talking or their narrative, I might even truly interrupt them. Even though I do that, what's going to help them to actually be on board with that? They're going to go, wow, I'm kind of, like on some level, I'm kind of glad you did that. I'm kind of kind of glad you interrupted me.

[CHRIS]

Exactly. I would think that's the only way to take them out of that, to lead towards that path to healing and find other ways that can help based on what they need.

[DR. FRANKLIN]

On some level, yes. I mean, that's my job, is to disrupt these patterns of communication between the brain and gut. Sometimes I'm more directive about it and sometimes it less. It just, I find myself doing very different things with different people because they're different. So I even use different language. I find myself using certain vernacular with some people and other vernacular with other people. I don't have to think about it. It just happens. So yes, it's very individualized and tailored.

[CHRIS]

I think it's a judgment call with clients too, kind of getting that feel for who they are and what might help them.

[DR. FRANKLIN]

Yes. At this point it's become much more intuitive. So I've been doing this long enough that sometimes I really don't have to think about it. I kind of just go, go. I just do

[CHRIS]

Okay, very good. So what's a takeaway you could share today that could help listeners that might be just starting their holistic journey?

[DR. FRANKLIN]

When you say holistic journey, do you mean their ---

[CHRIS]

Just learning about different holistic strategies.

[DR. FRANKLIN]

Got you. Okay, I don't know, I think that's a hard one for me. I think there's so many different modalities out there. So I think every practitioner has to do some exploration and figure out what has meaning for them and what feels authentic for them and what feels like a good, next thing to learn or try and just follow their own intuition, follow their gut, follow their interests.

[CHRIS]

Follow their gut really.

[DR. FRANKLIN]

Yes, see where it leads.

[CHRIS]

Absolutely, and I think just not jumping on the band and of the latest, everybody's doing EMDR. I'm going to do that, but really figuring out what is best for you. Just like you said, with clients, we're all individuals and what may work for someone else may not work for you, really looking at that. I think that's great to find something with meaning.

[DR. FRANKLIN]

Yes. As a therapist, I think it's really important that we model authenticity. I think that's what so many of our patients struggle with, is just being authentic in the world, being authentic with themselves, being authentic with other people. So if we're choosing a path for our learning and our training that feels authentic to us, it doesn't feel like we have to put on a hat or put on an act or play a role. If the more that we can settle into our seat in the room and to really be in our bodies and to be at ease in our bodies and to be at ease in our relationships with our patients or clients, whatever word you want to use, the more we model authenticity and truly being at ease.

[CHRIS]

I think that's what helps clients lead to healing too because they can sense it too, if you're not being authentic.

[DR. FRANKLIN]

Absolutely. And even if it's not being talked about explicitly, that's, what's playing out in the room, nervous system, the nervous system, and then yes, it gets in the way of healing for sure.

[CHRIS]

So what's the best way for listeners to find you and learn more about you?

[DR. FRANKLIN]

I have a website that's devoted to my specialty area. It's donthateyourguts.com.

[CHRIS]

That's why I started the intro with it. I just love that name. That is just the best.

[DR. FRANKLIN]

Thank you. Thank you so much. So I have a couple of webinars. I have a five-part webinar series for patients. Certainly therapists can take it, other practitioners can take it, if they excellent, want a more slowed down really solid learning experience. There's some repetition built in and it's kind of in digestible chunks, but I created that for patients and for therapists because a lot of therapists work with the kinds of patients I specialize in treating. And I'm not a one person so I'm not able to consult with more people than my schedule will allow.

So I created this webinar series so that therapists can have their patients watch the webinar series and then come into therapy with a greater sense of how to make therapy work for them so that they're less likely to engage in these kinds of patterns of talking about the problem de jure and being focused on some of the things that are not so helpful to focus on. So it's kind of my way of helping therapists to helping like translate what I do for other therapists and for patients so that they can get educated and then they can come into therapy with you and say, okay, this is what I really need to be focused on or I watched this webinar series and these things really spoke to me and I really want to focus on these things.

[CHRIS]

Yes, that's so helpful.

[DR. FRANKLIN]

I thought it would be helpful and I hope that it is. Then I also have a webinar, two-hour webinar for practitioners like you, Chris and other listeners, and they can get CE for it. It's two hours and it's kind of an easy, quick intro into how I work. So that could be helpful too.

[CHRIS]

Oh yes, absolutely. I want to thank you for coming on the podcast today.

[DR. FRANKLIN]

Thank you so much for having me, Chris.

[CHRIS]

This was so informational. I feel like we could talk for a long time. There's so many, like you said, so many different areas, avenues we can go down with this.

[DR. FRANKLIN]

Yes, it's a really big area. I really could talk for several days. And I kind of did in my webinar series, like tried to put some of into my webinar series and it was five hours of material and there's so much more. So I'm working on the next part right now actually. Hopefully that'll be out soon.

[CHRIS]

Excellent. I want to thank my listeners too, for continuing to support the show. And here's a friendly reminder, if you like today's episode, please subscribe, rate, and review wherever you get your podcast. Again, this is Chris McDonald sending each one of you much light and love. Until next time, take care and have a great day.

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