In my long experience with pelvic pain, before it resolved for me, I had no idea how to stop my pain, it was there, I woke up with it every day, it didn’t go away, some things made it worse sometimes some things made it better or it just got a little better, but it never went away. For years I couldn’t see a way to resolve it. When it finally did resolve, the path of its resolution became clear to me.
We all understand that an intensive care unit in a hospital is a place in which patients who are dangerously ill are kept under constant observation to support their bodies to become well enough to remain alive and healthy without the need for such intensive support. Intensive care is needed to help someone recover their health. The true purpose of an intensive care unit is to support the body’s ability to become well. Let me say that again – the true purpose of an intensive care unit is to support the body’s innate natural ability to become well because the circumstances of someone’s life are jeopardizing and challenging the capacity of the body’s ability to do this.
An intensive care unit is aimed at supporting the body’s ability to heal so that it does not need extraordinary support to remain alive and healthy. Ultimately Intensive care leading to the recovery of someone’s health supports the natural, indigenous ability in the human body to be healthy and alive when it is compromised. We all intuitively understand that we don’t bring germs into an intensive care unit, we don’t play loud music, or we don’t do anything to stress the person who is there. We all understand that undue physical or psychological stress will impair the person’s ability to recover, will impair the body’s ability to restore health. We all understand that undue physical or psychological stress in an intensive care unit is forbidden for good reason. It’s touchy – the body’s ability to recover under certain circumstances, and in order for the body to heal, efforts that are intense and pointed are necessary to kickstart the healing mechanism of the body to be able to support the patients recovery to life and health.
None of us would be surprised in any way if there were a sign that said “quiet” outside an intensive care unit or even to require visitors to put gowns, masks, and gloves on, to not bring in any potential threat to the healing immune compromised person.
In another example, when an injured solder comes back from a war none of us are surprised at the long period of time it takes for the injured soldier to recover. None of us would be surprised that the soldier would be in the sanctuary of a hospital, that the soldier would not be expected to work or do normal duties of life that normally would not stress a healthy person, but would stress someone who is recovering from serious injury or compromise of their body.
When we get the flu most of us know that sleep, rest, liquids are essential to our recovery. We don’t go to work, often staying in the protected environment of bed and rest. What we are doing when we have a cold and take these measures in supporting our body is supporting our own natural healing mechanisms. It’s not the cold medicines that we buy at the pharmacy or the cold medicines that the doctor might give us that do the trick. It’s our body’s amazing ability to recover and heal. And that’s what we do when we protect ourselves in the way that we do when we have a bad flu for instance.
In the intensive care unit the case of an injured soldier who comes home from war or in the case of our battle with the bad flu, we may not recognize it explicitly but we honor and support and cooperate with the healing mechanism of the body to cure itself. In the age of modern medicine, we often forget this. We attribute all kinds of power to the drugs and healing devices that have been invented in modern times, but we forget that those are all just the servants of the healing mechanism of the body. This is what the important thing I’m saying here. Whatever we do in the intensive care unit or the hospital for an injured soldier, or for our own struggle with a bad flu, without the body being able to heal itself, none of our efforts would matter. We serve of the body’s ability to heal in the intensive care unit, the soldier’s hospital stay, or our attempts to heal ourselves of a bad flu.
Now pelvic pain doesn’t seem like a problem that requires healing in the same way as the examples that I’ve just discussed. I believe this is because pelvic pain is invisible, doctors can’t see it, friends can’t see it, doctors can’t find any abnormality either in the normal manual examination of a patient or in all the standard medical tests or standard visualizing tests used in contemporary medicine.
What is typically overlooked in understanding chronic pelvic pain is why the pelvic tissue is sore in the first place. What caused it? Why does it remain sore? It is accepted that chronic pelvic pain tissue is sore, it keeps being sore, and there isn’t much understanding about it.
If you pull a muscle or overdo exercise and your arm or hand or leg or back gets sore, you might baby it, not stress it, in other words, you would cooperate with the mechanism of the body that heals a sore arm, or neck, or back by mobilizing it, not stressing it, not using it so vigorously. You might not think that you are cooperating with the body’s capacity to heal sore, painful tissue, but in fact you are. A splint or brace or even a cast for a broken bone are all efforts to help the body’s natural healing mechanisms heal the problem. Most people don’t explicitly give a lot of credit to the body’s ability to heal but everyone goes to great lengths to support this ability of the body when they are injured or hurt even though they may not explicitly say “I am honoring the body’s ability to heal”.
It is peculiar that conventional thinking of chronic pelvic pain doesn’t recognize the need to support the body’s ability to heal itself. In the Wise Anderson Protocol, we train our patients to be servants of the body’s ability to heal the sore and irritated pelvic tissue. After all, when the sore and irritated pelvic tissue stops being sore and irritated, pelvic pain stops existing. Pelvic pain is essentially sore irritated pelvic tissue that hurts and that interferes with the normal functioning of urination and defecation and sexual activity and sitting and management of stress that otherwise it wouldn’t be affected by. What needs healing is the sore tissue that has occurred typically because chronic tension in the muscles of this tissue has made it sore and this process is invisible, it can’t be seen.
In our Protocol we support the healing of the body in pelvic pain by essentially training our patients in three methods: physical intervention; behavioral and mental intervention, which we call “extended paradoxical relaxation”. And, implicitly, we want to offer a new the viewpoint of what pelvic pain is, what needs to be done for it so that we help head off the normal catastrophizing and fear that people have about this very distressing disorder.
The problem with pelvic pain healing is that for a good part of a person’s day there are things that interfere with the healing up of this tissue, namely urination with some people, defecation with some people, sitting with many people, anxiety, which is a huge exacerbator of this problem. And sexual activity often exacerbates the condition. When somebody is anxious the tissue does not relax. The tissue remains tight and irritated. And the catastrophizing that occurs with many people like “they’re never going to get better, that no one understands, that the doctors can’t help, and woe is me, what am I going to do? What’s the matter with me”?
With some peoples continued activity like bodybuilding, bicycle riding, and other things that stress the pelvic floor are all things that normally don’t have any negative affect on the pelvis and in a pelvis that is not disordered like it is in pelvic floor dysfunction. But it can be a problem when you have pelvic floor tenderness and pain. So, the healing that is required for the sore pelvic floor is typically interrupted all day in the life of the person suffering from chronic pelvic pain. Imagine somebody in the ICU who is carefully monitored and supported in healing at 9:00 in the morning and at 9:00 in the morning has to deal with somebody coming in and saying “ok you have to go to work, get in a car, deal with all the stresses of life, and when you come back at 6:00 in the evening we can again support your healing in the ICU”. This would be a joke. The same would be true in our attempts to support the healing with a bad flu or a soldier recuperating from wounds, we wouldn’t think of doing this.
But in my view, this is what the pelvic pain patient is subject to. So, the two to four hours of self-treatment that we ask our patients to do, a huge requirement, which involves loosening the tightened tissue that needs to be loosened in order for it to heal and then reducing the inner turmoil triggered by an aroused nervous system continually stoked by catastrophizing, and the inherent arousal of the nervous system because of chronic pain, is a minimum time required for healing and this is why the healing takes so long. Because when you’re doing well, you’re moving ahead three steps and you’re moving back two steps in dealing with all of the stresses that continue to irritate the tissue during a normal day.
If you could put someone in an quiet environment protected from the stresses of normal life, supported them emotionally and physically, and this is a big if, I believe pelvic pain would heal up.
Because you can’t see what needs healing in the pelvic floor pain patient and because the pelvic pain patient can work and function, albeit, with a silent, very large cost to the patient, chronic pelvic pain remains chronic. In my view, supporting the healing of the body must be the ultimate focus of someone struggling with pelvic pain. And this is not a small matter. How do you calm a nervous system down and a tightened, painful pelvic floor in a person who has no experience in doing this.
Doing physical therapy to loosen the pelvic floor takes training and the right tool. Loosening the hypertonic pelvic floor has to be taught. You have to learn how to find the tissue, you have to insert a device inside the pelvic floor. It’s a challenge at first. you have to learn how to do it, but in our protocol, it is routinely done. You’re basically going into a sore area and releasing it. And you can’t do it too hard. And you can’t do it too softly. And practicing relaxation and getting very quiet is a life changing practice that requires training and support. It’s a commitment to peace. Many people are not ready to make that commitment. And then the nervous system has got to get used to being quiet, the nervous system used to be vigilant, will often rebel against being quiet, not anxious or fearful.
These are the real obstacles – the absence of an understanding and the creation of an environment – to heal the pain associated with diagnoses like prostatitis, CPPS, levator ani syndrome, and other chronic pelvic pain diagnoses. The healing of the sore and irritated pelvic floor — which is the common thread passing through all of these diagnoses —- requires making the body a regular healing environment. The healing of the painful pelvic floor involves loosening the pelvic floor tissue, releasing related trigger points inside and outside the body related to the pain and creating a healing chamber in which you regularly rest, a healing chamber that is quiet emotionally that peaceful, not guarded. It’s a major event in life to do this. This is why pelvic pain is a major event in life that in the most optimistic viewpoint provides us with the opportunity to be able to find peace inside to allow what is sore and irritate to heal.