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Treating Chronic Prostatitis and Chronic Pelvic Pain: The Meeting of Mind and Body in the Pelvic Floor

Treating chronic prostatitis and chronic pelvic pain: their relationship to mind and body

We are often asked whether the physical or behavioral parts of the Wise-Anderson Protocol for treating chronic prostatitis and chronic pelvic pain is more important for its connection to the relationship to the Mind and body. This is a major issue for patients, researchers and doctors alike because it determines the course of the prostatitis treatment and the outcome of treatment.

Over the years we have anecdotally noticed that a small group of our patients have significant improvement in their symptoms with what appears to be our physical treatment alone. On the other end of the spectrum, another small group of our patients appears to do very well with only the behavior component. The large majority of our patients, however, appear to require both the physical treatment which focuses on directly loosening the muscles of the pelvic floor and the behavioral treatment which focuses on helping patients reduce their anxiety daily in the service of releasing the chronic contraction of the muscles of the pelvic floor.

Those practitioners involved in treating chronic prostatitis and chronic pelvic pain rarely converse.

The health specialties in treating chronic prostatitis based on muscle dysfunction and related disorders are usually confined in their own relatively narrow orientations of focusing on either the physical or behavioral/psychological but not both. Historically the subspecialties like urology, colo-rectal surgery, gynecology, pain management, physical therapy, osteopathy on the one hand, and psychology and psychiatry on the other rarely talk to each other. Even when the physically-oriented practitioner recognizes the importance of the behavioral/psychological dimension, or vice-versa, rarely are the physical and behavioral/psychological treatments coordinated or specifically geared to the patient with a pelvic pain disorder. Psychologists and psychiatrists often have little training in the physical components nor do the physically oriented practitioners have training in the mind related dimension of the treatment of the problem.

Successfully treating chronic prostatitis and pelvic pain in terms of mind and body.

Mind and body meet in the pelvic floor in those who suffer from muscle-based chronic prostatitis and chronic pelvic pain. In our book, A Headache in the Pelvis, we discuss the centrality of the tension-anxiety-pain-protective guarding cycle and how this cycle takes on a life of its own no matter what triggers it. The large majority of our patients come to us with years of chronic pelvic contraction that is the way in which they have expressed their anxiety physically. Simply loosening and releasing the chronic contraction of the pelvic floor tends to be short-lived if this loosening is not done repetitively and accompanied by a daily program of relaxing the pelvis and calming down the arousal of the nervous system. All of this is not a small task and is usually undertaken only by those who are in great and ongoing suffering. Yet for those who understand the necessity of this mind and body treatment and diligently pursue it, they have the possibility of real help in a way that it has never been possible in the past.