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Surgery for colitis is a huge challenge. This woman can help you be strong
March 5, 2025 13:04
Some events are life-changing; living with a stoma is one of them. Ostomy surgery is an intrusive operation, with outcomes that can seriously impact daily life. It affects the individual not only physically, but also emotionally and psychologically. There are changes in bodily function, altered body image and personal-care needs. Self-image is distorted, and relationships with spouses, partners, children, close family, friends and work colleagues are transformed. While physical recovery rests with a surgical and medical team, the emotional and psychological recovery rests with a therapist. That is where I come in.
An ostomy involves a surgically created opening in the abdomen, diverting waste through a stoma (formed via the large or small intestine or urinary tract), into a disposable collection bag. This small hole, while essential, can cause significant emotional distress.
Ostomies (ileostomy, colostomy, urostomy) often follow physical challenges such as pain from obstructions caused by medical conditions such as cancer or an inflammatory bowel disease, as well as adhesions resulting from surgery, birth defects or injuries. Some ostomates experience feelings of inadequacy, shame, suicidal ideation, anxiety, depression, loneliness and diminished self-worth, as well as unacknowledged grief for the loss of a part of themselves.
Additionally, an ostomy is sometimes referred to as an unseen disability and, due to its discreet nature, it can lead to misunderstandings and lack of support, compounding the physical and emotional challenges.
Ostomate vulnerability is complex: physically (living with a stoma), emotionally (self-esteem) and socially (navigating an uncomprehending world). Creating a safe therapeutic space to explore these vulnerabilities is paramount, requiring compassion, empathy and genuine understanding to build resilience.
My personal journey began six months after my son was born, when I was diagnosed with severe ulcerative colitis. Though I hoped for a simple cure, my condition worsened, ultimately requiring a temporary ileostomy when I was 25. This news was devastating. I felt numb and terrified, realising quickly there was a lack of support and understanding for ostomates. Thereafter followed 17 further operations, multiple visits to A&E, life-threatening complications (almost dying twice) and constant anxiety. My final surgery, in 2023, resulted in a permanent stoma, which, considering the possible outcomes, was a good result. Pre-operatively, my consultant gave me three possible outcomes: I might die on the table due to the extensive operation (ten hours); I might be condemned to a permanent liquid diet, as I might not be left with enough functioning bowel; I might have a permanent stoma with a mixed diet of solids and liquids.
These experiences shaped my path to helping others, both ostomates and non-ostomates. Having lived with four stomas over 28 years, I understand and can empathise with those who go through the constant physical and emotional struggles of having a stoma and for those whom a stoma is advised.
Therapy offers many benefits. Taking charge of your mental wellbeing is empowering. Therapy can offer tools and support for this journey. It creates a safe space for self-discovery, emotional processing and working through challenges. This can lead to improved relationships, more self-awareness and greater resilience. While the path is personal, the destination offers greater happiness and life satisfaction. Seeking this support, though sometimes daunting, is a testament to strength and self-awareness.
My therapeutic approach is based on the principles of Gestalt psychotherapy, which focuses on enhancing self-awareness and understanding one’s experience in the world. It emphasises the present moment, recognising the importance of the past but addressing it through the lens of current feelings and emotions. This approach resonates deeply with the ostomy experience, a journey marked by significant physical and emotional adjustments.
I have worked with many clients to help them overcome the life-changing event of having a stoma. Whatever challenges you’re facing, help is available. My journey, though marked by struggle, has emboldened me to help individuals, the wider community and especially the ostomy community. Having navigated my own journey, I’m here to help others navigate theirs.
Carrie Helman is a psychotherapist and ostomate. Parasol Counselling: 07730 181210