There is a deep insight in a book called the Course in Miracles that says: “ In my defenselessness my safety lies”.  This means that we only feel safe when we are not tightening up in self-defense and self-protection. Protective guarding typically reflects a state of fear, a state of not feeling safe.  Only after one is willing to trust that there is no threat and one let’s down one’s guard, anticipating nothing threatening, can we feel the relief of feeling safe. Only then can the muscles relax, the nervous system ease and the systems of the body can rest.

Most of us intuitively understand that there are groups of people who respond to stress in different parts of their body.  We all know people who under stress get headaches, or who suffer with gastrointestinal symptoms, have high blood pressure or non-cardiac chest pain among other physical reactions.   I am clear that there is a group of patients who can be called pelvic responders, people who have symptoms of pelvic floor pain. I know this group very well as I was a member of this group.  I have treated many people who are pelvic responders over the years as well.

Just like cars that respond to wear and tear in different places… some cars are known to variously have problems with the fuel system, charging system, electrical system, among others — all of these different problematic mechanisms, are brought about by the stresses and aging of a car.  So it is with people. In another podcast I have discussed pelvic pain as a local and systemic problem. It is local in that the local area of the pelvic floor becomes sore, irritated and contracted. It is systemic in that it is the stress on the car by virtue of simply driving it, that can trigger the various local reactions.

Understanding this, the reduction of stress and reduction in nervous arousal is helpful for many what could be called functional disorders.  There is a significant, published scientific literature documenting the relationship between the reduction of stress and the resolution of stress related disorders.  In the Wise-Anderson Protocol for pelvic floor pain, we treat both the local and systemic dysfunction. We train our patients to do all of their internal and external myofascial/trigger point release, which is the focus on the local component of the disorder.  In training our patients in Extended Paradoxical Relaxation, we train our patients in addressing the systemic aspect of pelvic floor related pain.

Just like it is recommended to change the oil the oil in a car every 3000 or 5000 miles allows the car to last much longer and to not break down, so the regular practice of reducing anxiety and autonomic arousal is critical in helping to heal a painful pelvis.  While what I am describing may feel like a huge and onerous burden, in fact it is one of the most pleasurable, soothing and healing of practices. While it takes several months of daily practice to begin to gain some skill in it, the practice of reducing anxiety and nervous arousal, in which the practitioner struggles to learn the method, once learned it is a life long practice of inestimable value.  It was a huge revelation to me that giving up my guarding was the only way I could finally feel safe.