Time2be
Well known member
I had a email conversation with the urologist Dr. Eric Robins, Los Angeles. He sent me the following information on how he sees bladder pain syndrome/IC. He allowed me to share this with you. I think this could be interesting for many who have bladder issues.
"In my pretty vast experience, the non-ulcerative IC is not "incurable" at all. In the past, its been difficult to treat because 99% of urologists don't understand it. They don't understand that the pain is caused mainly by 2 things: nerve hypersensitivity, and pelvic floor muscular contraction/spasm. Both of these cause very real physical discomfort.
A lot of folks lately have written to me about Mind-Body Syndrome, about Sarno/Schubiner, etc. I partly agree with them, and partly differ. One of the biggest things I've noticed with chronic pain patients is that they will have uncomfortable sensations in their body. Then, in a millionth of a second, they will start thinking about them, trying to figure them out, pushing those sensations away. How they think ABOUT their uncomfortable sensations triggers a massive fight-flight response, stress hormones are released which sensitize the pain fibers and contribute to muscle tension and spasm and inflammation. How they think about their uncomfortable symptoms AMPLIFIES the pain in their brain and nervous system and musculature and then the pain does get worse.
The brilliance of the MBS approach is that, when it works, it does so because it gets patients to stop reacting so strongly, with so much anxiety, to their uncomfortable sensations. It is a cognitive approach that allows them to think about their sensations in such a way that they calm themselves, don't trigger a fight-flight reaction (because they realize that nothing serious is causing their symptoms), etc. Some of my worst chronic pain patients were those who had mildly uncomfortable sensations (one lady had a "slight throbbing pressure" in her vagina; one male had mild tingling on his penis). They both obsessed over the sensations, got themselves into an anxious panic, everything was amplified. It was only when they learned how to think about things differently that their pain got better. My goal with patients is not to necessarily make all of their pain or uncomfortable sensations go away. My goal is to allow them to tolerate uncomfortable sensations without freaking out about them, making themselves anxious about them, etc. We uncouple fear from raw sensation (to use the words of Peter Levine, the founder of Somatic Experiencing). The body then typically heals itself.
A great book that has an approach that has been highly successful in curing anxiety is called "DARE: The New Way to End Anxiety and Stop Panic Attacks", by Barry McDonagh. It has hundreds of great reviews on amazon from folks whose anxiety has been cured using his techniques (which involve learning to tolerate uncomfortable sensations in the body). I use similar cognitive principles in my practice. (...)
If I were seeing you in my office, I'd have you notice the raw physical sensations of the obturator muscle pulling. We'd allow the sensations to be there. I might have you pendulate, meaning notice the sensations of the obturator, then shift your attention to another part of your body that feels neutral or relaxed or safe. Then learn to shift your attention back and forth between the two (not with the idea of getting rid of the pain or sensations, just realizing that there are other parts of your body that feel okay right now, and learning to shift attention). I'd teach you the TRE's, which would likely help you to calm your nervous system, calm many of the anxious thoughts you might be having; and they'd likely help to relax areas of chronic tension and spasm in the obturator, psoas, and other muscles. They help to shift your physiology out of a chronic FFF state, and into a parasympathetic rest-and-digest state, where the body can heal itself better. "
TRE has been developed by Dr. David Berceli and there is an skype course by Alex Green that could be attended.
All in all very encouraging and uplifting information.
I hope some of you will benefit from this.
"In my pretty vast experience, the non-ulcerative IC is not "incurable" at all. In the past, its been difficult to treat because 99% of urologists don't understand it. They don't understand that the pain is caused mainly by 2 things: nerve hypersensitivity, and pelvic floor muscular contraction/spasm. Both of these cause very real physical discomfort.
A lot of folks lately have written to me about Mind-Body Syndrome, about Sarno/Schubiner, etc. I partly agree with them, and partly differ. One of the biggest things I've noticed with chronic pain patients is that they will have uncomfortable sensations in their body. Then, in a millionth of a second, they will start thinking about them, trying to figure them out, pushing those sensations away. How they think ABOUT their uncomfortable sensations triggers a massive fight-flight response, stress hormones are released which sensitize the pain fibers and contribute to muscle tension and spasm and inflammation. How they think about their uncomfortable symptoms AMPLIFIES the pain in their brain and nervous system and musculature and then the pain does get worse.
The brilliance of the MBS approach is that, when it works, it does so because it gets patients to stop reacting so strongly, with so much anxiety, to their uncomfortable sensations. It is a cognitive approach that allows them to think about their sensations in such a way that they calm themselves, don't trigger a fight-flight reaction (because they realize that nothing serious is causing their symptoms), etc. Some of my worst chronic pain patients were those who had mildly uncomfortable sensations (one lady had a "slight throbbing pressure" in her vagina; one male had mild tingling on his penis). They both obsessed over the sensations, got themselves into an anxious panic, everything was amplified. It was only when they learned how to think about things differently that their pain got better. My goal with patients is not to necessarily make all of their pain or uncomfortable sensations go away. My goal is to allow them to tolerate uncomfortable sensations without freaking out about them, making themselves anxious about them, etc. We uncouple fear from raw sensation (to use the words of Peter Levine, the founder of Somatic Experiencing). The body then typically heals itself.
A great book that has an approach that has been highly successful in curing anxiety is called "DARE: The New Way to End Anxiety and Stop Panic Attacks", by Barry McDonagh. It has hundreds of great reviews on amazon from folks whose anxiety has been cured using his techniques (which involve learning to tolerate uncomfortable sensations in the body). I use similar cognitive principles in my practice. (...)
If I were seeing you in my office, I'd have you notice the raw physical sensations of the obturator muscle pulling. We'd allow the sensations to be there. I might have you pendulate, meaning notice the sensations of the obturator, then shift your attention to another part of your body that feels neutral or relaxed or safe. Then learn to shift your attention back and forth between the two (not with the idea of getting rid of the pain or sensations, just realizing that there are other parts of your body that feel okay right now, and learning to shift attention). I'd teach you the TRE's, which would likely help you to calm your nervous system, calm many of the anxious thoughts you might be having; and they'd likely help to relax areas of chronic tension and spasm in the obturator, psoas, and other muscles. They help to shift your physiology out of a chronic FFF state, and into a parasympathetic rest-and-digest state, where the body can heal itself better. "
TRE has been developed by Dr. David Berceli and there is an skype course by Alex Green that could be attended.
All in all very encouraging and uplifting information.
I hope some of you will benefit from this.
