By Lorraine Faehndrich
If you’re suffering with pelvic pain it’s very likely that you’ve spent a lot of time worrying and obsessing about your symptoms. Maybe you’ve spent hours online searching for answers, reading stories of others’ experiences with pelvic pain, or participating in “support” groups that leave you even more stressed, worried and fearful than you already were. Or maybe you can’t stop thinking that the pain will never go away, or that everything you do might trigger a flare.
If so, you’re not alone! Most (if not all) of my clients have struggled with worry, catastrophizing, and negatively obsessing about their symptoms. It’s just what happens when you’re dealing with something that is interfering with most aspects of your life, preventing you from doing what you love to do, and not going away.
While some amount of focus on your symptoms is helpful and necessary, excessive worry and negative focus not only makes you feel as if your symptoms have taken over your life, it can trigger the fight, flight, or freeze nervous system response in your body and signal danger to your brain, both of which lead to more pain.
Because of this, having strategies to help you overcome these negative thought patterns is an important part of an effective treatment plan. Learning ways to get your focus off worrying about your symptoms, can not only help relieve pain, but just as importantly help you reclaim a sense of yourself and your life as you do.
Which is why I want to share with you a few key concepts and strategies that I have found to be helpful for overcoming negative obsessive symptom focus.
- Spend Less Time Discussing Your Symptoms
Remove yourself from groups, forums, and relationships where the focus is primarily on sharing and discussing symptoms and diagnosis. This includes negative discussions of your symptoms with people in your life. Even if these discussions aren’t spiraling downward into worst case scenarios, spending a lot of time discussing your symptoms, or your worry about them, or listening to others do the same, can start to take over your life. While it is important to have emotional support, seek out connections that feel supportive, where the focus is on solutions, hope, and rebuilding a sense of strength, safety, and resiliency.
Last week a participant in my Healing Female Pain program shared her experience with discussing symptoms and diagnosis after she received a diagnosis of pudendal neuralgia. Here’s what she shared, “I became so addicted to the internet and the groups about it. I remember reading about it for the first time, my symptoms got worse as I read more about it. I would leave those groups after reading scary stories and being hopeless and then rejoin them…. My healing started when I got myself out of those groups. Stopped reading about pelvic pain stories, and stopped scaring the *@! out of myself. It’s been 6 month into this. Pain is better, depression is better and anxiety is a lot better.”
I hear stories like this repeatedly. While it’s natural to want to talk about what’s wrong, and find solutions, it’s important to make sure you’re not losing yourself by focusing too much on your symptoms. Focusing on things that feel good to you (and finding new things that feel good now if you aren’t yet able to do the things you enjoyed before your symptoms began) is important to maintain the sense of inner strength that is so important for healing.
- Come Back to Your Body
One of the reasons that it can be so difficult to stop worrying and obsessing about symptoms is that those stressful thoughts serve as a distraction from discomfort in your body. When you’re in your mind obsessing, and worrying about symptoms (or anything else) it decreases your awareness of other sensations in your body, including your emotions.
The best way to illustrate this is with an example. I’m going to tell you about one of my clients, who’s name I’ve changed to protect her privacy. When Kate and I began working together she was feeling scared and hopeless. She had been diagnosed with vulvodynia, and she was having severe anxiety about her symptoms. Kate was spending a lot of time online researching pelvic pain and reading in pain forums. Every time she read about a new diagnosis she became convinced that she had it or would get it, and she couldn’t stop thinking about it.
I taught Kate that when she was obsessing and worrying about her symptoms, her mind was distracting her from her body and her emotions. Basically, what was happening was she was spinning out of control in her mind, rather than stopping and breathing and feeling and being present in her body.
Over time Kate learned how to catch herself when she was worrying and obsessing, choose to set aside the thoughts, drop into her body, breathe and be present with whatever sensations were there, without trying to change them (including her symptoms). Each time she did this her anxiety reduced, and over time so did her pain.
Just like for Kate, the key to overcome obsessing and worrying about your symptoms is to first recognize that those thoughts are simply there to distract you from being present in your body. Imagine temporarily placing the thoughts in a bubble outside your head, and then turn your attention to your breath and the other sensations in your body. Breathe into your low belly. Feel your feet on the ground. If you’re having symptoms allow them to be there for the moment without trying to change them, and then scan your body and get curious about other sensations besides your symptoms. Breathe, be present and feel.
- Observe Your Mind in Writing
One of the most powerful tools you have at your disposal when it comes to shifting scary thinking is a paper and pen. Writing down scary obsessive thoughts while they are going through your mind gets them out of your head and onto paper where you have much more power to question them, and make decisions about how you want to use your mind.
Rather than instantly believing and reacting to your thoughts, if you can create a little space to observe them, you can decrease the fear and anxiety they cause. You don’t need to stop negative scary thoughts to calm your nervous system and signal your brain that you’re safe. You just need to learn how to respond to those thoughts in a new way. Writing helps you do that.
The next time you notice that you are worrying about your symptoms, making negative predictions about the future, or feeling like you want to hide under the covers – get out a piece of paper and start writing. Write down every thought you’re aware of that’s scaring you. Once you have the thoughts written down, read over them and notice how they make you feel. Scan your body from head to toe. Write down the sensations you notice. For instance, does your body feel tense or contracted anywhere? Are you having pain? Do you notice any other sensations like heaviness or stuck sensations?
When you’re done write the exact opposite of every thought you wrote down initially. For example, “You’re not going to relieve this pain.” Becomes “You are going to relieve this pain.”
“You can’t do it.” Becomes “You can do it!” and “There’s something wrong with you.” Becomes “There’s something RIGHT with you.”
When you’re finished. Read through these new thoughts. How do these opposite thoughts make you feel? Based on how the thoughts affect you, which do you think would be more helpful to think?
Thoughts are only thoughts. They can be changed. Overcoming worry and obsessing about symptoms can feel impossible at first, but with time and practice, these strategies can make it much easier to let go of the fearful thinking and choose thoughts that will support healing and relief.
Lorraine Faehndrich is a Women’s Mind Body Mentor, Pelvic Pain Relief Coach, and the founder of Radiant Life Design, a company dedicated to helping women relieve pelvic pain, heal their relationship with their body, and go on to live radiantly healthy joy-filled lives! If you’d like to learn more about Lorraine or how a mind body approach can help relieve pelvic pain, click here to download a free copy of her new e-book 7 Reasons You’re Still In Pain. To hear an interview with Lorraine and PHRC Cofounder Stephanie Prendergast please click here.
FAQ
What are pelvic floor muscles?
The pelvic floor muscles are a group of muscles that run from the coccyx to the pubic bone. They are part of the core, helping to support our entire body as well as providing support for the bowel, bladder and uterus. These muscles help us maintain bowel and bladder control and are involved in sexual pleasure and orgasm. The technical name of the pelvic floor muscles is the Levator Ani muscle group. The pudendal nerve, the levator ani nerve, and branches from the S2 – S4 nerve roots innervate the pelvic floor muscles. They are under voluntary and autonomic control, which is a unique feature only they possess compared to other muscle groups.
What is pelvic floor physical therapy?
Pelvic floor physical therapy is a specialized area of physical therapy. Currently, physical therapists need advanced post-graduate education to be able to help people with pelvic floor dysfunction because pelvic floor disorders are not yet being taught in standard physical therapy curricula. The Pelvic Health and Rehabilitation Center provides extensive training for our staff because we recognize the limitations of physical therapy education in this unique area.
What happens at pelvic floor therapy?
During an evaluation for pelvic floor dysfunction the physical therapist will take a detailed history. Following the history the physical therapist will leave the room to allow the patient to change and drape themselves. The physical therapist will return to the room and using gloved hands will perform an external and internal manual assessment of the pelvic floor and girdle muscles. The physical therapist will once again leave the room and allow the patient to dress. Following the manual examination there may also be an examination of strength, motor control, and overall biomechanics and neuromuscular control. The physical therapist will then communicate the findings to the patient and together with their patient they establish an assessment, short term and long term goals and a treatment plan. Typically people with pelvic floor dysfunction are seen one time per week for one hour for varying amounts of time based on the severity and chronicity of the disease. A home exercise program will be established and the physical therapist will help coordinate other providers on the treatment team. Typically patients are seen for 3 months to a year.
What is pudendal neuralgia and how is it treated?
Pudendal Neuralgia is a clinical diagnosis that means pain in the sensory distribution of the pudendal nerve. The pudendal nerve is a mixed nerve that exits the S2 – S4 sacral nerve roots, we have a right and left pudendal nerve and each side has three main trunks: the dorsal branch, the perineal branch, and the inferior rectal branch. The branches supply sensation to the clitoris/penis, labia/scrotum, perineum, anus, the distal ⅓ of the urethra and rectum, and the vulva and vestibule. The nerve branches also control the pelvic floor muscles. The pudendal nerve follows a tortuous path through the pelvic floor and girdle, leaving it vulnerable to compression and tension injuries at various points along its path.
Pudendal Neuralgia occurs when the nerve is unable to slide, glide and move normally and as a result, people experience pain in some or all of the above-mentioned areas. Pelvic floor physical therapy plays a crucial role in identifying the mechanical impairments that are affecting the nerve. The physical therapy treatment plan is designed to restore normal neural function. Patients with pudendal neuralgia require pelvic floor physical therapy and may also benefit from medical management that includes pharmaceuticals and procedures such as pudendal nerve blocks or botox injections.
What is interstitial cystitis and how is it treated?
Interstitial Cystitis is a clinical diagnosis characterized by irritative bladder symptoms such as urinary urgency, frequency, and hesitancy in the absence of infection. Research has shown the majority of patients who meet the clinical definition have pelvic floor dysfunction and myalgia. Therefore, the American Urologic Association recommends pelvic floor physical therapy as first-line treatment for Interstitial Cystitis. Patients will benefit from pelvic floor physical therapy and may also benefit from pharmacologic management or medical procedures such as bladder instillations.
Who is the Pelvic Health and Rehabilitation Team?
The Pelvic Health and Rehabilitation Center was founded by Elizabeth Akincilar and Stephanie Prendergast in 2006, they have been treating people with pelvic floor disorders since 2001. They were trained and mentored by a medical doctor and quickly became experts in treating pelvic floor disorders. They began creating courses and sharing their knowledge around the world. They expanded to 11 locations in the United States and developed a residency style training program for their employees with ongoing weekly mentoring. The physical therapists who work at PHRC have undergone more training than the majority of pelvic floor physical therapists and as a result offer efficient and high quality care.
How many years of experience do we have?
Stephanie and Liz have 24 years of experience and help each and every team member become an expert in the field through their training and mentoring program.
Why PHRC versus anyone else?
PHRC is unique because of the specific focus on pelvic floor disorders and the leadership at our company. We are constantly lecturing, teaching, and staying ahead of the curve with our connections to medical experts and emerging experts. As a result, we are able to efficiently and effectively help our patients restore their pelvic health.
Do we treat men for pelvic floor therapy?
The Pelvic Health and Rehabilitation Center is unique in that the Cofounders have always treated people of all genders and therefore have trained the team members and staff the same way. Many pelvic floor physical therapists focus solely on people with vulvas, this is not the case here.
Do I need pelvic floor therapy forever?
The majority of people with pelvic floor dysfunction will undergo pelvic floor physical therapy for a set amount of time based on their goals. Every 6 -8 weeks goals will be re-established based on the physical improvements and remaining physical impairments. Most patients will achieve their goals in 3 – 6 months. If there are complicating medical or untreated comorbidities some patients will be in therapy longer.
Comments
This article is very helpful. Thank you very much.
Thank you for that nice post.
I have had CPPS for years and have been treated prior to moving to Az. with a lot of success. I still have some flares but not like in the past.
Do you know of any men who treat this in the Phoenix Mesa area?
I have tried several PT’s in the ares but have been less that satisfied as these ladies I have four are not comfortable treating men and it is obvious.
As you know, it is difficult to find any PT is comfortable going there in men.
Thank you for any suggestions you may have.
Sincerely,
M
Hi Michael,
We recommend Desert Physical therapy (602)264-3369.
Regards,
Admin
You’re welcome Ruth. I’m glad you found it helpful. Thanks for reading.
Warmly,
Lorraine
Hi. Your website has been extremely helpful. Thank you.!!!! Could you recommend a similar practice in the NYC (Brooklyn) area?
Hi Joanne,
We recommend Beyond Basics Physical Therapy in NYC.
Regards,
Admin
That’s me right now. I am in Green Bay, WI and am having trouble finding a Dr. or PT who seems to be qualified to help. I am ready to travel to a Pelvic Pain Center. Do you have any suggestions?
Hello,
Please use the link below to find a pelvic floor physical therapist.
https://pelvicguru.com/2016/02/13/find-a-pelvic-health-professional/
Regards,
Admin