Change is something that is asked a lot of patients with IBD, whether it be to have surgery, change medication or accept their diagnosis. This session address what changes are asked of people with IBD and considers how this impacts their emotional regulation systems. Three emotional regulation systems are discussed: the threat, drive and soothe systems. A compassion focused approach (Gilbert, 2009) would suggest that supporting patients to balance these 3 emotional regulation systems will support patients to make changes. Case examples are described to illustrate how this might work in practice.