Amanda Lee Pelvic Health Physio demonstrating a lovely restorative position. Journaling that this restorative position helped your pelvic pain will remind you to repeat it regularly
Journaling helps improve pelvic pain
When you live with a persistent pain condition you may have sought help from multiple health professionals, tried many different remedies that have come recommended via friends and articles or be completely exhausted and incapable of contemplating anything new to try.
If you have anxiety as a new or old friend – fatigue, nausea, poor sleep and fuzzy thinking are constant companions which make life feel awful and unnecessarily complicated.
One of the strategies that can be invaluable with both these conditions is journaling – where you write down what makes your pain better, what makes it worse. When you make a note of any ideas, exercises, positions or thoughts that have contributed to improving your pain or your anxiety – you have a record that you can refer back to when you have a flare up. It becomes an invaluable learning experience for you. If something you have done has worsened your pain – then observing and recording that and analysing what caused that pain, can be as helpful as writing down what has helped lessen your pain.
Memories are funny things – the brain can run wild with memories of activities that have left you in pain. Painful intercourse (vulvodynia, vaginismus, endometriosis), painful feet (plantar fascitis), painful periods (monthly -why girls and women come to dread their ‘monthly’ – events coming up like the school dance, a first date, an elite sporting event ruined….again and again and then the anticipation of the upcoming activity can amplify the pain). So it is important to constantly work out ways to lay down new memories as your pain changes and improves, so these activities can be performed without fear and anxiety.
And that is where journaling helps improve pelvic pain.
Remember thoughts are chemical processes – if you experience an anxiety-producing thought, you may experience adrenaline and cortisol release which has the potential to upregulate your pain and your anxiety. If you think about a pleasurable experience, sensation or holiday or view a playlist of lovely photos of holidays, scenes, happy gifs that make you laugh, then serotonin, dopamine, oxytocin – the happy hormones – may flood your nervous system and contribute to down-regulation of your pain, anxiety, nervous system and future thoughts.
List as told to my husband by Paddy (age 5) about what he loves doing
Journaling can end up being a lot of lists – just like this list of happy experiences as told to my husband (AKA Pop) by my five year old grandson. I liked number 4 – Doing Lists. I like writing lists because they help to keep me organised as long as I can find the ‘said’ list – my family and staff will attest to many things on my lists not being achieved because I’ve mislaid the list.
But if you look at Paddy’s list – who doesn’t love some of the things on there? Birthday, Christmas and Easter? But what if there’s no one around to remember your birthday or Christmas is synonymous with the coming together of argumentative family members and ends up being an unpleasant experience? What if you pig out on chocolate at Easter and then feel guilty (another negative chemical process) or all the sugar which is inflammatory makes your pain worse?
So you need to use your lists that you journal to assess stressors and things that provoke danger messages to you (your brain) that may escalate any pain or anxiety and also work out things that promote feelings of safety for you and decrease your pain and anxiety. Once you have worked these Danger and Safety messages you need to make the time to regularly do those activities promoting safety.
Journaling can also become an exercise in expressive writing. This can be useful for people who have experienced life-changing and traumatic events where they may experience emotions such as shame if they have kept a traumatic event a secret. Constant rumination about these events may compromise your immune system functioning. Expressive writing has been found to be helpful with autoimmune conditions or immune dysregulation.
Writing down those negative emotions seems to blunt their effect on you. When your brain doesn’t have to work so hard at inhibiting those feelings anymore, there can be significant brain changes in the right prefrontal cortex and amygdala, as well as systemic changes such as decreased BP, heart rate and decreased sweating. When you write down these thoughts, it will help with ruminating, decrease fears and decrease health anxiety. If ruminating improves, then sleep can sometimes become easier, stress overall decreases and this allows for calmer thinking. (1, 2)
Journaling can also help with retraining your nervous system to not do the ‘same old, same old’. This particular method uses the idea of writing down the thoughts and then throwing them away to retrain your nervous system. Firstly through awareness – become aware of your repeating nerve pathways/circuits. Secondly what’s called detachment –take a step back to see what is really going on. By writing things down it makes it easier to step back and review. Thirdly try laying down new circuits or pathways (and thoughts) – new pathways (thoughts) can bypass troublesome older ones and quiet them down.
Sunshine National Park – my happy place
I am acutely aware of these recurring anxious thoughts at present due to the ongoing effect of COVID and other respiratory illnesses on staffing levels. I have actively tried to retrain my responses to texts early in the morning to stop my anxiety from spiralling out of control. I start the day with belly breathing before I pick up the phone to look at the messages.
On a recent drive to Dubbo for the weekend (to do some fun things with my pelvic health friends including Nat McConochie who has just set up her Dubbo Pelvic Health Clinic) Bob and I brainstormed (wrote a long list) of ways to decrease the workload in admin and have implemented many of those strategies.
I am regularly going to my happy places mentally by checking out my photos of the Sunshine National Park which always invokes peaceful and happy thoughts. Actively writing down some emergency plans and strategies and repelling intrusive negative thoughts have really made a difference over the last couple of weeks. And of course there’s dance – making sure I attend my Wednesday dance class via Zoom each week).
Remember Journaling helps improve pelvic pain so grab a small journal – it can be a pretty thing or a kids exercise book from Officeworks.
And start writing.
Start paying attention.
To what feels better.
What did you do that made that happen?
And always remember to come back to The Breath.
Let you tummy go, Sit like a Man, Belly Breathe 8 times a day for a minute.
Walk through the day.
Listen to music.
Look at the trees and the birds.
Take time to observe.
If pervasive thoughts become intrusive write them down and unburden your brain.
And don’t forget to seek counsel with your psychologist or GP if you are distressed with your thoughts.
One thing for sure that I know is that Paddy is getting a drum kit (see No 9 on the list) for Xmas from us (but I do understand that may provoke some danger signals for his parents and their neighbours).
References:
- Carolyn Vandyken: Biopsychosocial Reframed: Creating a Psychologically Informed Practice Course, undertaken in 2020.
- Dr James Pennebaker, Dr Joshua Smyth. Opening up by Writing it Down 3rd Edition
- David Hanscom, M.D. Writing and Journaling to Help Manage Chronic Pain Swedish Pain Services
