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A video of a remarkable study demonstrating the relationship between anxiety and pain

In the following video clips below, you will witness a remarkable event. You will see an actual study being done by Sonya Banks, Ph.D. based on the work of David Hubbard, M.D. and Richard Gevirtz, Ph.D. You will see the actual rise in electrical activity in a trigger point of a woman that is brought about by anxiety. While we see this study focus on a trigger point in the upper back, we believe the exact same phenomenon occurs to the trigger points in the pelvic floor.

These clips can take a little while to download. The download is particularly slow with dial up internet service. We believe the material in these clips is important enough to take the time to download. As you click on each video clip below, a page will appear with a written description of what is going on the clip. As the clip downloads, read this written description to understand what is going on in the video.

*** Please note that these movies are in Quicktime format. If you do not have Quicktime installed on your machine we recommend you visit the Quicktime site to download and install prior to viewing the quicktime movies.

*** We also have Mpg versions of the movies available for viewing for those who do not wish to install Quicktime. The Mpg versions are approximately 12MB in size each.

Video Clip 1 (6.5MB - Quicktime movie)  |  Video Clip 1 (12MB - Mpg movie)
Video Clip 2 (6.5MB - Quicktime movie)  |  Video Clip 2 (12MB - Mpg movie)
Video Clip 3 (6.5MB - Quicktime movie)  |  Video Clip 3 (12MB - Mpg movie)


Anxiety as the gasoline fueling the fire of pelvic pain

In the conventional understanding and research over the past 50 years that informs the medical treatment of pelvic pain syndromes, the central role of anxiety in the perpetuation of pelvic pain has been missed. The old and new medical models of these disorders simply do not consider that anxiety has any role in the generation of dysfunction or pathology within the pelvic floor. In fact, as we demonstrate in the video clips below, and as we describe in our book A Headache in the Pelvis, anxiety plays a huge role in the generation of prostatitis and chronic pelvic pain disorders.

Many of the people who have called us in the last several months have reported that their pain and dysfunction substantially decreased after simply reading our book. These patients told us that our description of prostatitis and pelvic pain syndromes marked the first time that they felt that someone understood what was going on with them and offered an intuitively viable solution. Yet how could simply reading a book lower the level of pain and dysfunction that these people had?

Furthermore, when the doctors that you see for pelvic pain and dysfunction have no solutions for you and foresee no solutions, the psychological consequences are very deep and very painful.

Most clinicians rarely have the time or inclination to delve into the kinds of thinking that is common to people with pelvic pain. Typically, the person with prostatitis or other chronic pelvic pain syndromes lives in a dark world of negative thought. As we have discussed, in chapter three and four, each negative thought is taken to be real by the body as it contracts against the scary world created by the thought. These scary thoughts are like gasoline on the fire of the pelvic pain as they increase the electrical activity in the active painful trigger points and areas of chronic restriction within the pelvic floor. This increased pain leads to a reflexive and protective tightening of the muscles against the pain which then sets off a storm of more negative thinking. This cycle is cruel, self perpetuating, and takes on a life of its own.

The loneliness of having chronic pelvic pain has a number of sources. The seemingly insolvable and apparently real negative thinking that the sufferer lives in is one source. Another source, rarely discussed, is that no one seems to want to hear what the person with pelvic pain is thinking. The reason for this is that the person who hears these thoughts usually feels helpless around them. This is particularly true of doctors whom patients visit for treatment. The doctor is used to being able to solve the patient's problem. In the case of prostatitis and chronic pain syndromes, the doctor is left feeling helpless and ineffectual. It is no wonder that patients report their sense that doctors seem to rush through their visits giving the appearance of wanting to spend as little time with them as possible.

Our approach is very much interested in all of these dark and negative thoughts. Why? Each negative thought perpetuates the distress of the sufferer and is rarely true when subjected to thoughtful inquiry. The method that we share in chapter four, deriving from the work of Byron Katie and Frederick Perls, aims to take the sting out of these thoughts by exposing them to the light of inquiry regarding their validity. Our approach to dealing with the cognitive exacerbation of pelvic pain involves facing the demons of the scary and negative catastrophic thoughts. We do this by bringing the executive function of discrimination and evaluation to bear on the primitive early conditioning that usually gives rise to these thoughts. The methodology that we have developed is brief, direct and effective. Furthermore, we teach the patient to use this method on a daily basis at home.

We have found that in large part, the negative thinking of pelvic pain sufferers functions to defend them against the disappointment of getting their hopes up, only to find them dashed. Disappointment as a human suffering is not often discussed in the treatment of anxiety and depression related to pelvic pain. I have found aversion to disappointment to be one of the primary sources of contraction and catastrophic thinking. In the 5th edition of our book, we include the questions we use to help neutralize the frequency and impact of the negative thinking so endemic to and exacerbating of the conditions we discuss here.

 
National Center for Pelvic Pain Research, Box 54, Occidental, California 95465
Telephone: 707 874 2225 Fax: 707 874 2335
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