An article intended for practitioners of Chinese medicine:

I think it's important that we also get to know professions that are similar to ours and know in which cases they can provide a better solution than ours.

For example, a patient who wishes to seek treatment due to incontinence.

In a conversation with him, it becomes clear that since he experienced one incident of uncontrollable urination several years ago, he is afraid that it will happen again and has developed avoidance of many things (for example, he does not leave the house before he has emptied himself, even if it takes him hours).

During the conversation, I understand that he does not suffer from digestive problems on a daily basis and the only problem for him is the fear of losing control over his bowel movements again.

In such cases, I do not think acupuncture is necessary (the patient's problem is the fear of something that will happen, but not something that is happening right now), so I refer patients to CBT - cognitive behavioral therapy. For the benefit of those who are not familiar with the method, I am attaching here an explanation of CBT from Mafia Gil, a medical psychologist who specializes in gastroenterology:

"Cognitive behavioral therapy (CBT) is based on the idea that a major part of psychological distress stems from incorrect and irrational ways of thinking and the unhelpful behavioral patterns that accompany them. Once we know how to identify thinking distortions that create mental distress, we can cope with them better and feel better.

For example, a patient with irritable bowel syndrome may be invited to dinner at a friend's house. A thought that may arise from this event is, "I might have to go to the bathroom at their house." This thought may lead to feelings of embarrassment or anxiety, which may lead to stomach pain and ultimately to a decision to avoid visiting the friend's house or to fast that day so that they do not have to use the bathroom during the visit.

"CBT therapy will help the patient adopt more adaptive thinking patterns, think about additional alternatives, and thus reduce the mental distress associated with these thinking patterns."

In general, I really believe in combining different methods, which is why I work with therapists from different fields. I will occasionally bring you explanations from other therapists who specialize in gastroenterology, such as medical hypnosis, biofeedback, dietitians, and more.

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