When I started off having pelvic pain I went to amazon and “headache in the pelvis” was one of the many books that was online, after reading the reviews I bought and read it, till then I had no idea what TMS was or who Dr.Sarno was but I made some notes from the book which were all pointing towards a psychological aspect of pelvic pain. I’m sharing some points from that book which now I feel were all pointing towards TMS. helping muscle-based pelvic pain heal means releasing the chronic pelvic contraction and calming down the aroused nervous system that feeds the contraction and interferes with the healing of the sore and irritated pelvic tissue. But for people who do have pelvic pain, whose way of expressing their anxiety is to tighten up the pelvis strongly and for a long time, or for people who have had some kind of injury and pain that has caused the pelvic muscles to reflexively tighten against the pain, the pelvic muscles don’t relax well after contraction. They stay in a tightened state or ongoing spasm, and when the pelvic muscles don’t relax, all kinds of weird symptoms occur. People who have pelvic pain syndromes tend to focus tension in the pelvic muscles as a response to stress, anxiety, trauma, or pain. Sore, painful, chronically contracted pelvic muscle tissue is the very center of muscle-based pelvic pain. Even though soreness and chronic contraction are not detected by modern imaging techniques, they are as real as a broken bone. If you approach it with anger, fear, resentment, impatience, or uncertainty, it will pick up your attitude and be more resistant to your help. Catastrophic thinking, doubt, and fear are usually the worst of the sufferings in dealing with pelvic pain. The nocebo effect—the effect of believing something harmless can hurt you—is relevant here. Theories on the Internet that paint your symptoms as hopeless, theories that are just words and ideas someone proposes—if believed, can be seen as a nocebo and can make your symptoms worse and hijack any quality of life. Many people with pelvic pain walk around miserable for years believing theories that paint a catastrophic picture about their symptoms because they believed things they read on the Internet or ignorant ideas of their doctor. Catastrophic thinking is almost always a defense against disappointment. This common process of catastrophizing pelvic pain and dysfunction can spin someone into an anxiety state in which the sore tissue–tension-anxiety-pain cycle makes the pain worse and adds misery to the already existing pain and dysfunction. Ironically, during the writing of this section of our book, we received a call from someone on the East Coast who was in the kind of anxiety state we have been describing. He described himself as “going crazy” as he read the accounts of sufferers of pelvic pain on the Internet who had not been helped and were wretched and desperate. He said his “pain was through the roof.” The day after we had an opportunity to discuss our protocol and understanding about the treatment for chronic pelvic pain syndromes, he not only reported that he was feeling relieved emotionally but also expressed his puzzlement because his pain had diminished substantially since our conversation with him. It wasn’t our book per se that helped his pain. It was the reassurance he felt in reading it. It is not uncommon for patients we have seen to report a reduction in pain simply from the reassurance they feel that perhaps something can be done to help their condition. The basic principles of Cognitive Therapy are found in an ancient document, the Dharmapada, which states that we create the world we see with our thoughts. If we think we are victims, we ruin our lives. “This is someone’s theory. There is no definitive proof for it. It offers nothing to help me or protect me, or it carries unacceptable risks. It creates fear and doubt in me. It is okay for me to disregard it as somebody’s unproven idea that I will consider if there emerges substantial evidence and/ or something to do about it. Therefore I can ignore it as simply someone’s unproven idea.” When you have faith, you have confidence that somehow everything is okay. When you have faith, even though you don’t know how things will turn out, you feel assured that you don’t have to know. You trust that things will simply turn out all right. Being willing to have a glimmer of faith that you will find your way can have a real impact on your symptoms. Faith is a frame that you hold up and through which you look at your life.