Episode 37: Transforming pain by listening to the nervous system
A quick note: We recorded this at our practitioner event, so we're talking clinician-to-clinician in parts. But if you're navigating pelvic pain yourself, you might find it really validating to hear how we think about symptoms, nervous system states, and what actually drives lasting change.
If you're a practitioner working with pain, you've probably felt the pressure to fix, the complexity of trauma and chronic symptoms, and the frustration of treatments that don't create lasting change.
In this episode, we share the foundations of the Vera Wellness approach to pelvic pain – an evidence-informed, nervous-system-led framework that shifts care away from symptom whack-a-mole and toward genuine transformation.
Recorded live at our online practitioner event on 30 October 2025, this conversation includes practical tools, a powerful case study, and a clear reframe that changes everything: pain isn't the problem to eliminate – it's information.
And the nervous system is the foundation of both patient outcomes and practitioner sustainability.
If you're craving a more grounded, embodied approach to pelvic pain care – one that supports your patients without burning you out – this episode is for you.
In this episode, we explore:
Why the nervous system is the foundation of pelvic pain care (and clinician wellbeing)
A real patient case study – and what changed when care shifted from "fixing" to listening
The Vera philosophy: no one is broken, and no one needs to be fixed
Pain as information – and what happens when we replace fear with curiosity
Polyvagal theory: nervous system states and what they look like in the consult room
The "alarm vs fire" reframe: why conventional care often tries to silence symptoms while the deeper drivers remain
Catastrophising, overprotection and central sensitisation – and why these matter clinically
Co-regulation: how your tone, pace and presence shape patient safety and outcomes
Guided regulation practices you can use immediately (including pelvic and self-compassion-based tools)
Why paradigm-shifting care requires paradigm-shifting ways of working
For practitioners:
If today's conversation resonates, you may be feeling the same shift we're seeing across women's health – a desire for care that is more embodied, integrative and nervous-system-led.
In 2026, Dr Peta Wright, Dr Thea Bowler and holistic physiotherapist Paula Hindle are hosting Transformational Medicine: Alchemising Pain into Power with two pathways:
4-day in-person immersive retreat (17–20 April 2026)
12-week online program (starts 4 May 2026)
Explore the program here: https://www.verawellness.com.au/practitioner-program-intensive
Episode transcript
E37: Transforming pelvic pain by listening to the nervous system
[00:00:00] Welcome to Women of the Well. This is a podcast to help you heal, learn, and feel empowered to take back your body and your healthcare. Hosted by Gynecologists, Dr. Peta Wright, Dr. Thea Bowler, and holistic counselor, Sam Lindsay German. This is for women who want to remember the magic, beauty, and power in their bodies to live a healthy life that's true to themselves.
This podcast is for information and educational purposes only, and is not intended as a substitute for medical advice. Diagnosis or treatment. Before we start today's episode, we would like to acknowledge and show our deep respect to the Jinibara people as the traditional custodians of the beautiful land we are recording this on.
We pay respect to their elders past, present, and across time, and extend that respect to all Aboriginal and Torres Strait Islander peoples today. Now it's time to replenish yourself by the [00:01:00] well.
Paula Hindle: Okay, welcome everyone to our transforming pelvic pain, the Vera Wellness approach. We're so excited to have you here, and we'd just like to start by acknowledging the traditional custodians of the country throughout Australia and their connections to land, sea, and community. We acknowledge the Jinibara people whose land our clinic sits on, who've lived here long before us and have much to teach us about traditional wisdom and how connection to the natural world affects our bodies, our minds, and our souls.
We pay respect to the elders past and present, and extend that respect to Aboriginal and Torres Strait Islanders. We would like to start today by acknowledging that you may have been with patients all day long, just like we have, and we would like to give you the [00:02:00] opportunity to maybe discharge some of the stress hormone in your body by doing a tool that we like to use here, which is shaking.
So I would like to invite you all to stand up wherever you are. Or you can do this sitting down. I'd love you to just shake your arms. Shake your arms really hard, almost like you've got honey on your fingers and you're trying to shake that off. If you're standing, you might wanna shake your legs, kick your legs around, maybe throw your arms from side to side, having a big slap.
Notice how that feels in your body. And now just stop, sit back down wherever you are and just notice your body. Maybe take a deep, full breath in and sigh out.
And now I invite you to just start by closing your eyes down. If you feel comfortable doing that, or simply just soften your gaze [00:03:00] and start by just checking in and asking yourself, how do I feel? How do I feel right now in this moment? Let's notice what comes up and then start to feel the connection that your body is making to the earth.
Maybe the couch, the bed, the chair you're sitting on, and feel that sense of being supported by the chair underneath you. Maybe you can feel the connection that your feet are making to the earth,
and now start to listen to the most distant sounds that you can hear.
Maybe listening to the sounds that are in the room around you, just noticing,
and then bring [00:04:00] awareness to your breath
without changing anything. Just notice the breath moving in and out.
Notice which breath is longer. Is the inhale longer or is the exhale longer? Remembering that all of this is just information,
and then very gently start to bring the inhale and the exhale into an even rhythm. That might mean slightly lengthening your inhale or slightly lengthening the exhale. Just notice into your own body what you need to do to bring the breath into an even rhythm. Maybe it's an inhale for four or five.
Maybe it's an exhale for four or five. Make [00:05:00] the breath as easeful as you can. Slowly sipping the breath in, but you are sipping in through a straw and let the breath leave your body.
Notice the inhale being slightly enlivening and the exhale, a drawing back in and grounding
as you continue that, even breathing, even breath in, and an even breath out. Just notice how that feels in your body. How does it feel in the physical body and how does the mind feel?
[00:06:00] And then when you're ready. Slowly open your eyes.
So let's get started. And I would love to introduce myself first. My name's Paula Hindle. I'm one of the physiotherapists here at Vera Wellness.
And of course we have the beautiful Dr. Peta Wright, gynecologist and founder of Vera Wellness. And Dr. Thea Bowler gynecologist here at Vera Wellness. Over to you ladies.
Dr Peta Wright: Thank you, Paula. I wish, I think everybody should have a Paula moment. What a wonderful thing.
It is, very good to have a Paula here to regulate your nervous system while you're about to do something that you care about and do a talk that you're, you know, a bit anxious about.
So anyway, thank you very much for attending and also give yourselves a big thank you for showing up after a really long day to hopefully give back to yourself and learn some things that will make a difference to your life going forward and your patients' lives. [00:07:00]
Dr Thea Bowler: So we're really grateful that you're all here, and tonight we want to give you a really broad idea about, I guess the way we approach helping our patients with pelvic pain here at Vera, a lot of which starts with ourselves. And so what we're going to talk about is a quick case study and then really about why the nervous system is the foundation of both looking after ourselves and also managing patients who have complex pain.
Talking about co-regulation, which is the way that our nervous systems talk to each other, um, which is a really valuable tool that we all have as part of our own physiology that we can put to really good use. And then practical ways to support your own nervous system and thereby be able to co-regulate with your patients and help them support their nervous systems.
And then we're going to talk to you about a course that we have available, which will enable you, to do a really big deep dive into all of this, both from a learning but also experiential lens.
Dr Peta Wright: So I guess our [00:08:00] philosophy at Vera is that no one is broken or needs to be fixed. And that's huge because then that takes a huge amount of pressure off the person, us, the healer, the practitioner because when, we'll talk about this a little bit later on, when we are attached to the idea of fixing somebody, often that doesn't work as we probably have experienced in our own practices. And, um, we, uh, we keep people stuck in a bit of a victim rescuer triangle, which actually doesn't help people to really move forward. We believe that chronic pain and symptoms are a sign of a dysregulated nervous system, so they're messages.
There is not a mind and body, there is only a mind, body, soul ecosystem, and it's in continuum. So we're all one and everything is talking to each other. And we think that much of the chronic pain and the symptoms that we [00:09:00] see in our patients comes from our profound disconnection to ourselves as nature and to our inner truth.
And when we come from this lens we are really turning towards these symptoms, the suffering, the pain that people are coming to us with, and we are addressing it on a much deeper level. And just because just dealing with it like whack-a-mole, uh, means that we never actually get to that, those deeper layers and people remain stuck.
So we'll very quickly touch on a case that is one of our patients here at Vera, but I'm sure something that everyone is unfortunately very, very familiar with, we often have these patients who have essentially been through the ringer, with multiple kind of invasive treatments aimed at reducing pain.
And, you know, that ranges from hormonal treatments to neuromodulators to to pain devices like spinal cord stimulators and vagus nerve stimulators and [00:10:00] stoic ganglion blocks and all of the things. And we're constantly, as Peta said, we're just trying to play whack-a-mole with all of these symptoms.
And ultimately, as we all have experienced, it's incredibly frustrating both for the patient who winds up feeling that their body is their enemy, that, that they are in some way broken and unfixable, but also really frustrating for us as clinicians who only wanna help our patients. We only wanna see all of our patients get better and lead full lives.
But this paradigm of constantly focusing on the body does not serve either our patients or the way that we would ideally practice medicine.
As Thea said, Jess is a real person at Vera, name is changed of course. The last picture was just a. A picture from the internet. This is a picture with her permission she has wanted me to share. So I probably met, probably met her maybe four or five years ago after all of those laparoscopies, all of those procedures. [00:11:00] I haven't not done a laparoscopy, I haven't done any procedures. I haven't done pelvic floor Botox. I haven't done any of those things. I don't even, I think we took her off a lot of her neuro modulating medications.
But what we did was like, really went back to the start with her how join the dots with how did she arrive at the place she was in. And I think it always starts with seeing our clients in, the full, that full 360 view. So starting with her childhood, what kind of family did she come into talking about?
All the things that have happened to her up until this point when she's sitting in front of me. She is an incredibly intelligent young woman, but constantly worried about pleasing others. She wasn't living authentically and openly. She was kind of really living a double life and hiding a lot about the things that she wanted to do from the people that she loved the most.
She was kind of in a constant state of nervous system dysregulation. She'd had [00:12:00] a lot of pain education, and this is something that I think is really valid, is that. Often we learn that, you know, pain education is important and it can change pain and experience for people by itself, but it's not enough.
She'd had all of that. She'd been to the, to the, the pain education clinics, but she didn't really understand how her nervous system was winding up her pain pathways, and she didn't realize how her nervous system state was contr, how sorry, how living out of alignment was contributing to her carrying this extra load and extra stress in her nervous system that was then keeping her stuck in those survival states.
Where the danger in her brain was turned up and where pain was more likely. So instead of, you know, thinking about all the ways we could fix, take away the pain, we really focused on it being a message to be listened to. So she'd had physio before, but she hadn't had how kind of physio, which is more nervous system informed physio.
She engaged in [00:13:00] symptomatic psychotherapy. We didn't reinforce anything. I didn't reinforce that anything needed to be physically fixed, but we worked together to support her, to bring her back to herself, to live a life that was more in alignment. We were able to let go of a lot of the labels and the diagnoses that she had gathered over the years 'cause they hadn't really helped her.
And the treatments for those things hadn't really helped her. But we worked kind of together to normalize the fears and doubts and that she was having and her feelings, and taught her how to feel safe even when she had scary feelings. So now she hasn't, as I said, no further surgeries. I see her sometimes for, you know, occasional little things, but we never talk about pain anymore.
She left a really stressful job that was keeping her stuck, that was, took a lot of courage to do. She now has actually started her own business as a photographer. Dance teacher. She takes really sexy [00:14:00] photos of women and actually does practices embodiment with them and teaches them dance and all of the nervous system stuff that we've learned together over the last few years.
She's in a happy, long-term relationship, which she hasn't been in for a long time, and she's living more in alignment with her soul's purpose. So she actually shared with me, um, some words about how she's felt over the last few years, and maybe that would be helpful. So she has said it's been an absolute physical and mental transformation, a lot of slow but strong growth.
I've really learned the meaning of patience and I've learned how to feel rather than suppress, which helps me, me express creatively and also helps me work through my big emotions instead of holding them in my mind and body. The biggest helps have been mindset shifts and seeing that there are lots of options.
And of course, you guys showing me how much power resides in me, a reconnection to myself, to the collective womanhood community, [00:15:00] and to nature. And I think that's amazing that she was able to, to feel or, um, as she said, feel rather than suppressed. And I think a lot of our kind of current paradigm is really focused on suppressing the symptoms, suppressing the feelings, like it's too dangerous to feel them.
So this is I guess a way that we can think about how we conceptualize healing rather than the whack a mole situation. This is like the Inana archetype. Inana was a Sumerian goddess, so she was a goddess that was worshiped before Jesus, like thousands of years ago.
And she's probably the template for lots of other goddesses, like Demeter, Persephone, a whole lot of different archetypes. But basically, one of the most famous stories about her was she had to go down and enter the underworld, and there she confronted like her darkness.
Before she went, she talked to her, [00:16:00] her best priestess friend, and said, if I don't return in three days, you need to help, help me go and get help. Go to my father. He can help me to find my way out of the underworld. And as she went down these seven, through these seven doors, she had to remove a layer of her beautiful adornments, her crown, her earrings, her bracelets, her necklaces.
It was a whole shedding of all of the things that she had attached to or had identified with, it was like an a letting go of the old to, I guess metaphorically die, face the darkness and so that she could then rise again with support from people that she loved. So it's a metaphor and it's a way of viewing suffering as it as instead of being just meaningless pain that we just have to squash so that we all feel numb and nothing.
It's viewing these things, as we said, as messages that then become a catalyst for transformation. If they're [00:17:00] telling us something about the way we are living our lives about a pain or a darkness or a trauma that hasn't been processed or even felt there is meaning to feel those things and there's meaning on the other side of that, but by going through that darkness and then, um, ascending.
So it's the, the metaphor talks to us about confronting the dark self. So it's looking at the pain, looking at the symptoms rather than trying to squash it down. And we know through pain, neuroscience that when we do that, um, that often makes things worse because it reinforces to our brain that, um, this symptom is dangerous.
And hence like all of our alarm bells and and our dials in our brain for pain and danger go up. It talks about sacrifice, letting go of things that are no longer serving us, the role of compassion and support so that we can't do this alone. We're all in this life together. The cyclical nature of life and death.
So the cyclical nature of our lives, which is particularly [00:18:00] poignant as with with women and the cycles that we go through with the menstrual cycle and the return or the ascension isn't an end point. It's just that lesson and throughout our life as we go ahead, we will confront many a lesson. So I really like this sort of metaphor for the way we view healing.
Almost like any symptom that then crops up is an opportunity Yeah. To go through that process again. And, and almost we can start to see pa particularly pain, but any chronic symptom as that opportunity to enter that portal to figure out what exactly is driving it, to then have more growth.
It's always the, we always talk about the pain is a portal. The menopause symptoms are a portal. The pmms symptoms are a portal. It's all an opportunity Yeah. To feel our lives more deeply and find that meaning. Mm. And so, yes, really what we see as our role as the clinician is not to fix our [00:19:00] patients, but to be able to sit with them, to be able to walk beside them and hold their discomfort and acknowledge their discomfort, and really encourage our patients to almost turn towards their pain and to start to be curious about their pain.
What, what are these symptoms here to teach you? And this is really where, number one, we start to realize the things that might be driving a lot of the symptoms we're experiencing, but also we're then teaching our brain that if we're turning towards our symptoms with without fear, but with curiosity, then that reduces all of the pain amplification that goes on that contributes to chronic pain.
And so we really feel that pain is a, is a meaningful message from our body, and our nervous system is not making a mistake. Our nervous system is actually telling us, giving us clues as to what might be going on in our lives [00:20:00] historically or currently that might be driving up those symptoms. And so really it's our systems saying to us the level of danger.
Being felt is too high. And so then can we start to think, okay, well what might these messages be? And can we really sit with our patients and say, what is, what do you think your body's trying to tell you? And it's amazing when you ask them those questions they often come up with exactly what the problem is.
Mm-hmm. And it might be any of these things or none of those things. But really I think just getting curious and really seeing our bodies as wise, our patients' bodies as wise and being able to turn towards the discomfort rather than try and constantly be getting rid of it, which is a lot to do with our own, um, inability to sit with suffering.
So the, another way of thinking about it is there, is the material, the physical body that we, I think in Western medicine are very fixated [00:21:00] on you know, often doing lots of surgeries, lots of uh, medications, looking even, even with functional medicine. Like there's a, still a very big focus on, biochemical pathways and specific nutrients.
We all know patients who are already in heightened states who, um, go down even like a more alternative route. And then they're very fixated on eating exactly the right diet and doing exactly the right thing. And then the still the body isn't, isn't, um. Isn't functioning as they would like it. So we believe that we are looking at the physical body, but then, and then the nervous system, which we've spoken about and we'll speak more about today, but just the body and just the nervous system isn't enough.
Because if we're just focusing on the nervous system and nervous system practices, which can help to ease suffering in the moment, it can help us to get clearer. So we can make better decisions retain information, all of that. But then we need to get to the why is the nervous system feeling dysregulated [00:22:00] in the first place?
And that can be, uh, we, I think that it's related to our connection to our spirit, our soul, to source energy bodies. And that might be things that we don't even, it might be related to things that have happened to us in our past as a child where we are storing energetic trauma. It might be related to ancestral trauma that is still stored in our past and can, and especially when we think about women and the, the conditioning and the, the collective trauma of women.
Um, I think we all as women, still carry a lot of that. And then there is how to... It's not just thinking about mind, body, have the right diet, do the right nervous [00:23:00] system practices. That's really on the superficial level. It's about how can we help to connect you to that soul level and to that to the environment and to all of the energies that are still stored in and around our body.
This is what we really believe to be a big part of of getting to the bottom of healing. And I think the way Western medicine, or the way that we have all been taught to practice is that we see the symptoms we get as the problem, but really it's the state of the nervous system. And going back even further, the experiences we have, the connection, the life that we are living, the stress we're experiencing, the trauma that might have, um, happened in our, in our patient's past.
That's really the fire and the symptoms are just the alarm bell. But Western medicine focuses all its energy on trying to [00:24:00] stop the alarm. The fire keeps going. And that's why we see, with all of the very kind of reductionist treatments that we have, which focus on organ systems and cutting things out and injecting things, that's really focusing on the alarm.
The pain is the alarm and the nervous system dysregulation. And what is driving that is the fire. And that's what we need to be focusing on. And often focusing on the alarm means that the fire burns even more out of control and people become even more traumatized and the problem becomes even bigger. So we know if you're here at this, if you're even attending this, you know that the that fixing the tissue alone often misses the mark.
And we have come to this conclusion through our practice and from sitting with hundreds and hundreds and probably thousands of women at this point. But just to clarify some of the evidence there is limited evidence that surgery for endo reduces pain. That's a general statement.
Obviously, it depends on what pot potentially, what kind of [00:25:00] endometriosis. Um, but particularly when, when we are talking about chronic pain, it's probably very limited. And we're, we're talking about multiple operations. There's probably not a role for multiple operations with chronic pain. And I would always argue the first operation is something to be very, to think very hard about as well.
Especially if there is sign of underlying nervous system regulation. We know that the presence and absence of endometriosis and extent of the disease is not well correlated to pain. We know that women who have high central sensitization scores have either no improvement or worse pain after surgery.
So if you're a gynecologist or somebody that is considering who to choose for surgery, doing a central sensitization inventory, um, with that person is always a good idea if they score more than 40 on that. A big study that was done a year or a couple of years ago had shown that people yeah, did not to do better after surgery.
So that's a really good thing too. You can counsel patients [00:26:00] about doing surgery, um, women with chronic pelvic pain. In a recent study by Karen Joseph showed that it had no effect on ED presentations either with endometriosis being removed or if there was no endometriosis. Um, we know that hormones are a great tool to have and they can definitely decrease pain that's related to inflammation.
But it's not, again it doesn't fix, um, it doesn't fix the problem in many, many women and often side effects are really intolerable. So it's not sufficient for these women that we're seeing. And I guess just the major point is that despite more laparoscopy, more awareness, more pushing for early diagnosis pain is actually increasing and one in five women in Australia suffer with chronic pelvic pain.
So this is why we have come to a different point of view. Something's not working. No. And yes, so when we think about the nervous system, there's lots and [00:27:00] lots of studies looking at I guess the things that differentiate all the things that really tell us about whether or not pain is likely to become chronic.
And there's many studies that report on catastrophizing, but that all show that really in patients with pelvic pain, endometriosis doesn't make a huge difference to patients reports of pain. But what is across multiple studies, what is shown to be really significant is the degree to which patients catastrophize.
And so that's that intense fear, rumination, worry about their pain. And that is really the thing that's been shown to drive pain to the greatest degree. Leading to overprotection. So I guess how it becomes persistent and how dysregulate nervous system dysregulation perpetuates it. So I think about it like setting the stage.
So every woman, um, when she gets her first period, it's like the period's coming onto a stage. I think about it like the nervous system [00:28:00] stage, and if that woman or, or that young girl has had early childhood trauma, attachment things, chronic stress with school, with all the stuff that's in our lifestyle with, in our life at the moment, or stress at the time, that period or that inflammatory event, that potential, a potentially painful thing is coming onto a stage with a nervous system that's already dialed to danger.
And so when that pain event happens, that pain event is likely to be more intense. And then as time goes by, and especially obviously with menstrual pain, it's, it's unique because it's, you know, it's month after month. And then if that nervous system is already heightened and then the nervous system responds by trying to protect us even further with fear protection with the pelvic floor muscles, avoiding doing things that further disregulates the nervous system.
And that's how we get central sensitization, pelvic floor dysfunction and chronic pain. So it's so crucial to [00:29:00] have a nervous system focus when we're dealing with pelvic pain. And I think also, like one thing we would do with all of our patients is actually do a timeline. Mm-hmm. Like this, you know, and actually go right back to the beginning and think about what was like, like for you when you got your first period, what was going on.
And it can be really helpful for them to see that sequence of events. Which also includes things that have happened to them later in life. Yeah. And we know what's happened. We, we have a big intake form. Many of you will have that with your patients or clients, but often we ask quite detailed questions about childhood, adolescence you know, every stage of life and things that have gone well and not gone so, so well.
And often in the writing of that, the answers will be there before we even see the patient. And so a really helpful way to understand our own nervous systems, but to help our patients understand their nervous systems and perhaps the things that are really contributing to their symptoms is, um, is a theory called Polyvagal theory, which was [00:30:00] developed by a neonatologist actually called Steven Forges.
And he talked about the three different the three different states that the nervous system can be in from ventral vagal, which is our parasympathetic nervous system where we feel calm, grounded, safe, connected, and we can do all of the things that, bring joy to our lives. And our physiology is working as it should.
So inflammation is low. Gut peristalsis is working. Hormone secretion is, is working immune function is working, and we're not having we are not having increased, um, nervous system sensitivity in the form of pain amplification syndromes. And as we move into survival states, which obviously are a necessary part of our physiology we can start to see as we move into our parasympathetic nervous system, that we get changes in our emotional state.
So we can start to feel that panic, fear, worry, anxiety, overprotection, catastrophization and start to feel. Changes [00:31:00] in, in the body, in our own physiology in terms of how pain is pain is being felt, how our physiology is working. And then when we experience a danger that is inescapable or, or prolonged, we move into shut down, freeze, dissociate.
It's all too scary and hard, and this is where, um, people can feel depression, numbness, disconnection. And so I think it's very helpful for patients. We often show them this slide to think, well, where do you spend most of your time? Where would you say your nervous system tends to reside? And I would say the majority of patients would be either in, fight or flight or in, um, shutdown and, or, or yes, or flicking between the two.
But certainly not spending a lot of time in their parasympathetic nervous system. And then we know that, you know, if a patient's really sympathetically driven, they're going to have more of that overprotection, that fear, that anxiety that we know then drives up pain or complete dissociation from their body if they're in shutdown, which [00:32:00] is very common as well.
So it's a very useful way of visualizing the nervous system and. Thinking about your own nervous system, where might you be sitting like in the day, you know, where, where do you sit when you're consulting with patients? But also really as a good graphic for for patients to start to understand where their nervous system is at.
And it's such a good one for helping people to understand as you, I sometimes have patients come and they say, my greatest fear is you'll tell me. This is all in my head. And I love this concept because it shows them how the mind, the nervous system and the body are connected and it tells them that our thoughts and our experiences can actually change our physiology.
And if the phy, if that is the bit that they need, the validation over, um, I know we're off in the soul and the, and all of that, but that, that there is a direct correlation and it can really help them to understand and feel really validated. Well, yeah, it really helps to make that link between the environment [00:33:00] body does it, that there is, there is no separation.
Essentially. It's all one system responding to each other. Um, and so yeah, this is how we kind of see it, that the nervous system becomes dysregulated. It affects our hormones, it disrupts our gut microbiome. It, which can then increase gut per hyperpermeability, increases immune system dysregulation, which can lead to more inflammation with or without endometriosis.
So that can lead to that neural inflammation, which is really common. And typical of chronic pain syndromes. Um, and that pain system hypersensitivity or central sensitization that we see, pelvic floor muscle spasm and then like mood anxiety, depression, that loss of meaning, that disconnection. And for me, and I guess how we think about it, those things are the things that are causing the endo symptoms.
So like when patients come in with bloating and all over body pain and fatigue, it's not an endo lesion, it's all of that nervous [00:34:00] system dysregulation and the endometriosis. Yes, it may be more likely if you have a dysregulated nervous system and immune system that you could potentially have endometriosis, but it's, um, not the cause of the whole picture.
So again, helping patients to understand their nervous system. We think about the window of regulation very often, which is basically our nervous system's capacity to hold stress and in a regulated nervous system, um, we should be able to hold most of the events of daily life without needing to flick into hyper arousal or a sympathetic response or dropping into dissociation.
And so really, if we've got a good wide window of regulation, we can contain most of the things that go on in the day without being stuck in one of these survival states. Um, which then will serve to, um, alter pain signaling within the body. [00:35:00] But what happens is, as our bodies are, we said really well designed to handle stress, but we are designed to handle it and come back down to homeostasis or baseline.
And that would be that ventral vagal point. Um, it's our set point. But when we are living with chronically repeated stressful stimulus, which you know, can be trauma and I guess that means that someone's already starting, starting with a high l of static load. But it's also the way we're all living essentially.
Um, it's technology. It's not moving enough. It's poor diet. It's disconnection from our bodies. It's the, it's the excessive work. No play, no fun, no rest. Mm-hmm. And then what happens is we don't, we don't ever come back down to that homeostasis. So we develop this allostatic load and this new set point.
Um, and then what happens is when we are then continually living in those chronically dysregulated states Yes. Then our nervous system basically has to function in order to function, moves in, has to [00:36:00] move into survival states for more time. And so if we're in a chronically stressed state, we're often having to mobilize that sympathetic energy, that hyper arousal in order to function throughout the day.
And so that window where we can actually tolerate. The stress laws of life starts to narrow and we start to spend more and more time in survival states of our nervous system. And as we've discussed, the more we're in a survival state, the more we start to have that anxiety, fear, overprotection, catastrophization, fear and mobilization, which all serves to drive up pain.
And then people will often protect with behaviors like immobilizing curling up in a ball the, uh, contraction of our pelvic floor muscles and all of the muscles in the body, and all of those thoughts. And then that keeps us further stuck and shrinks that window even more. Or trying to cope with social media or drinking or other things, or shutting down that's going into that hyper arousal.
But really it's [00:37:00] narrowing that window of regulation. And we know that these things, theory mobilization and overprotection, or catastrophization, but overprotection is probably a better word, they are actually in the literature associated with increased pain, increased pelvic pain. So we can then kind of broaden this to think about the nervous system as a driving factor in many different chronic conditions.
So it's not just pain, but it's PMDD. It's PMS, it's, it's the intensity of menopause symptoms. Um, hypothalamic am amenorrhea, which is often due to, um, not eating well enough. Exercising, too much depression. Um. Anxiety, other mind body things like fibromyalgia, other nervous system states like MAS, pots, IBS, migraines.
So often, again, you're probably seeing patient patients with all of these things and they have this big, sounds like a complex history with all these diagnoses, but it's really just the same thing being, uh, [00:38:00] manifested in different ways that we call different syndromes. And I always, we put in the environment because it's not just the person's nervous system going haywire for no reason.
Um, of course some people can develop these symptoms after they've had a virus or something like that can make it worse or really precipitate things. But the things in our environment our society, the biological reductionism we've talked about, that loss of connection to our sacred selves is a huge part of what makes our nervous system respond in this way in the first place.
And so I think as the clinician, we often can get stuck in this in this triad where the patient is the victim, the disease, often endometriosis for our patients is the persecutor. And we have to be the rescuer. But the problem with that is that if we see ourselves as the rescuer, as the person who has to come in and fix the problem, then we are making the patient the [00:39:00] victim.
We are making their source of power lie outside of themselves. We are making them have to look for solutions that don't lie within their own self. And we are perpetuating them, staying stuck in that victim role. So really starting to see the patient as the wise guide the patient who knows what they need in order to become well.
And we are the person who just holds the space for them and walks alongside them while they move along their healing journey, that they are able to, with the right support that they're able to elucidate for themselves. And as we move out of rescuer. Um, mode. It prevents us from getting burnout, which is got so many practitioners suffer.
Yeah. And people move around the triangle. 'cause when you're really, really in burnout and you're the rescuer, the patient becomes the perfect leader. And like, it's, it's this triangle that there's probably, you [00:40:00] could apply this just so many places in our, in our life and in society. But it really keeps people stuck.
And there's so much research that people who do have chronic pain conditions if they have that external locus of control that's more associated with persistent pain states too. Mm-hmm. So this is why we need to shift, um, this paradigm. So the key to bringing our nervous system back into regulation is really trying to support our patients to find safety, to sense safety.
And I think it's important to understand that safety and threat are different for all of us based on all of our past experiences. So the first step is being really familiar with your own nervous system state. So understanding what it feels like for you and your mind and your body when you're in hyper arousal, that sympathetic state, what it feels like when we drop down into that [00:41:00] low hypo aous state.
Also what takes us there? Is it the way we're working? Is it our family life? What is it that's doing that? Because when we're sitting across from patients who are dysregulated, if we're dysregulated as well, we are co-regulating. Where in fact we know that something that's so potent as a practitioner is to be able to connect and to co-regulate with our patients.
So the first step is becoming aware of our own nervous system state so that we can develop tools to be able to anchor into regulation throughout our workday. So we are going to be teaching a lot of different tools that can help with that. And you would've noticed the practice that I started with actually used quite a few different tools in that practice.
So one of them was X ception, which is simply using our five outward facing senses. So when I was asking you to be aware of the sounds that you can hear, [00:42:00] that's X stereo, ception feeling the connection that your body was making with the chair. So that's touch. It's bringing awareness to our touch. You can use sight, you can use taste.
Any of those things can very quickly bring us back into a regulated state. Breathing. You can see in that beautiful picture there, Thea has taken one of her teen patients outside, which is. Just incredible medicine being out in nature and using nature as a co-reg to anchor back into regulation. And Dante our dog.
Dante our dog. Yeah. Yeah. He's very powerful. And as we've said, we know that when we're anchoring our patients into regulation and where in regulation, that's when our body's innate wisdom to heal is happening naturally. So that's what we wanna be doing. We wanna be guiding our patients towards finding safety, identifying what their threats are, [00:43:00] and then working out what tools support them, because that's also different as well.
So a tool that might help me is gonna be totally different to a tool that's gonna help a patient in front of us. And the other thing to say is, when we are thinking about nervous system education and pain science, education and all these things that we know are helpful, they're not helpful if someone doesn't feel safe.
Mm-hmm. If someone is in fight, flight, or freeze, they're not gonna be taking anything in that you're saying. So this is why this is like the most important thing first. Yeah, which is why we started with the nervous system practice.
So we're going to go into another practice now where I would love to start to support you towards connecting with your own sacred pelvis, because as women, we are already coming from a place where this part of our body is often shamed.
So even if there is [00:44:00] no trauma, that in itself is a bit of a trauma we've been taught to cover up and don't touch that part of our body. But this is our sacred space, this place of creation and creativity. So I think it's so important as a practitioner working in this field that we develop a beautiful relationship with this part of our body.
So we're gonna do that. It might feel challenging, but I would really love for you to become aware if this feels hard or confronting and challenge yourself to trying it and just seeing how it feels. And then we're gonna move into a self-compassion practice called containment. So it would be amazing if you're able to stand up actually to start with.
And we're going to start with just some pelvic movement. You're gonna do this with me, I hope we're not over camera here, but give it a go. You might just be getting picture about that's our pelvis is close up of our pelvis is so if it [00:45:00] feels good in your body, because of course choice is a really important factor to think about when we're connecting with our patients.
But if it feels good for you, I would love for you to have your hands just on your sacred pelvis, nice and low, maybe fingertips touching your pubic bone, palms of the hands on the belly, and just draw some really big circles with the pelvis. You might wanna close your eyes down or just soften your gaze.
And again, if it feels comfortable, just bring your awareness inward towards this part of your body. Maybe start to take some beautiful, grounded, even breaths in and out, and just drawing really big circles, really letting your body move. Letting your body sway. Can you release any rigidity? Soften around the butt muscles, soften the belly.
Let your beautiful belly relax, and just notice how that feels in your body. Might wanna rock your pelvis back and forth, [00:46:00] tucking the tailbone under, and a little arch of the lower back, and just feel into that beautiful, full range of movement. As you're doing that, soften the jaw down. Allow your tongue to widen in your mouth.
Release the jaw, soften the space between the brow, and then if you are standing up, just take a seat wherever you are. And if no one's around, I would love to offer you the chance to do a vulva hold. So just with both hands, place your hands over your vulva, and again, either close your eyes down, soften your gaze, and just start by noticing how that feels.
What is your relationship with this part of your body? Does this feel like a really simple thing to do, or does this feel a little awkward? [00:47:00] Just notice without any judgment, it's just information coming up. And start by feeling the connection of your hands on this beautiful part of your body. Feel the warmth of your hands holding your vulva.
And the yoga tradition, we talk about the arms and the hands being an extension of the heart. Our hands often are placed on friends or loved ones when they are feeling suffering or pain. And now you're extending that same love, compassion, reverence into this incredible part of your body.
And now just start by taking some slow breaths in, traveling down the spine all the way to the sacred pelvis and vulva. Exhale and allow your body to soften. Take a slow, deep breath in. Sense [00:48:00] that breath, that energy, traveling all the way down your body, feeling your sacred pelvis. You might even wanna give the breath, the energy of color, maybe breathing in a golden light, a shimmery golden light into your body, traveling down the spine, feeling the pelvis, filling the vulva, lighting up the sacred cervix.
Exhale, whole body softens. Just notice how that feels to speak to this part of your body. What messages are coming up here? What are you feeling? This is all information. Maybe this is the first time you've connected with this part of the body. Just notice how that feels.
And now keeping your right hand over your vulvas, place, your left hand over your [00:49:00] heart. It's connecting the heart center with the sacred pelvis. Breathing in that golden light to the heart. To the pelvis, to the vulva, cervix. Exhale it, everything soften. Feeling the warmth of the hands over the heart, over the vulva.
Let everything soften the jaw, shoulders, belly, pelvic floor melting down butt muscles releasing, just connecting and revering this incredible part of your body.
And then from here, keep the left hand on your heart and bring the right hand and wrap it around. So you're giving your body a hug. The right hand will reach around to the left shoulder. Just [00:50:00] notice how that feels to embrace your body. In a hug. You might wanna let your body sway gently side to side. It might be really small movements, or maybe they're flowy big movements.
And start to notice what feels good in your body.
And then from here, release the right hand and place it onto the side of your face, the right side. Let your head fall into your hand almost like you are cradling your own head, left hand on the heart, right hand, holding your face, almost like you'd hold a baby with love, compassion, keep the breath moving in and out.
Continuing to rock if that feels [00:51:00] good, or just coming into stillness, noticing what feels good in your body.
And then remove the left hand from your heart and place that left hand into the base of your skull at the back, and let your head fall back into that hand and still resting into the right hand, feeling that your whole head is supported. Notice how that feels. Holding your body, is holding your own body, your mind, your soul, supporting your own body with whatever's coming up for you. And now, remove your right hand and place it on the forehead, one hand on the front, one hand on the back. How does that shift feel for you?[00:52:00]
Breath moving in. Breath moving out.
Now start to think about which one of those felt best for you. Where did you feel most supported? Can have a hand on the heart. Can have a hand on your cheek, front of the bare head, back of the head, can give your body a bear hug. You can even hold your own hand. Holding yourself with whatever is coming up.
Come back to noticing how this is feeling. How has everything you've heard so far tonight feeling for you? And can you [00:53:00] hold yourself with compassion through whatever's coming up?
And then just let your arms drop down into your lap and slowly start to open your eyes.
Thank you. Thank you, Paula, again. It's so funny. I was just thinking how. Like we've done a lot, we've done a lot of work and a lot of stuff in the last, like five years, but the thought of doing a vulva, hold on, live on a Zoom meeting with lots of people five years ago would've absolutely terrified me, which is also really interesting because we are gynecologists, so we are dealing with women's like we are dealing with women's bodies and mm-hmm.
And this part of our body and the disconnection that I certainly have [00:54:00] felt is really telling because how can we help our patients to connect to themselves if we are so disconnected? And I've found that sort of practice with many clients who might have, you know, vulvodynia, so painful vulva stuff. Things like Lichen Sclerosis who just won't even look at their v they're so disconnected, the words that they use. And I've had, um, we have another beautiful physio here called Brooke Dobo, and she uses the mirror. And I've had patients who would never in a million years have thought that doing a, like looking gazing mirror, gazing vulva practice would be anything that they would ever do.
Like it was so cringe, it was so confronting who have found it to be unbelievably transformational in their healing. So I think it's just, yeah. Really beautiful. Thank you for taking us through that. Yes, thank you Paula. And I think it's so important for us to explore those things ourselves, and even notice, like in that practice [00:55:00] was that hard for me.
And you can feel when a practitioner is not comfortable, and I think you're less likely to or not think, you are less likely to open up and share what your fears are, what brings you into safety, what's going on in your body, what your darkest thoughts are. So we need to be comfortable with all of these things, particularly for that part of the body, to take the shame away.
Yeah. Why should we be shaming this part? Mm mm Yeah.
So thinking about ourselves and really thinking about it through the lens of looking after ourselves so that we don't feel frustrated and burnt out looking after our patients with complex pain, but also to optimize our ability to co-regulate with our patients. Because co-regulation is essentially the way that our nervous systems read each other.
And on a subconscious level, our [00:56:00] bodies and our nervous systems are constantly reading the posture, the eye contact, the face facial expression, the tone of voice, the speed of language that people we're interacting with are using. And really our brain, which is a survival machine, is constantly reading to work out is this person safe or is this person dangerous?
And if we are getting signals from another person that's calm, that's grounded, that's not distressed by the things we're telling them, then we're much more likely in another sort of nervous system, um, survival technique to start to mirror that, that we mirror what we see in other individuals. And if what we're seeing is calm groundedness, then we start to reflect that in our own nervous system, which basically says that it's of ultimate importance to first.
And so we are really starting to have that self-inquiry. Are we operating within our window of regulation at work? Are we [00:57:00] actually feeling that we're in a hyper arousal most of the day, feeling angry, feeling frustrated, feeling like the victim? Have we got things in our past that might be pushing our nervous system, um, into a dysregulated state?
And have we looked at those? Have we dealt with them? What else in our life might be causing stress for us? And that might be simple things like the kids have too much sport on and you need to actually scale things back a bit. Or it might be bigger things. What self care practices do we regularly engage in?
And are there people in our, you know, work community that we can talk to about our frustrations? Certainly in the mental health care space, you guys have lots of supervision, but it's not really something we have a great deal of in medicine. So seeking out those people that you can talk to. Mm. And then on prac, on a practical level, thinking about how you work.
You know, do you need to see as many patients as you see? Can you factor in some break time? Can you have a bit of a longer lunch break? Um, and will [00:58:00] all of these things help you to then feel more grounded in your own nervous system so that you can pass that onto your patients? And really thinking about is the life I'm living one that I love?
You know, am I, am I having moments of, of joy and aliveness? Am I doing things that make my soul sing? Mm-hmm. You know, and, um. There are lots of little practices you can do from things that Paula has taught us to bookending your day. You know, having a, having a short practice at the beginning and the end of the day or things at the start and end of the day that that really bring you into a state of regulation, which might be as simple as like really consciously having your coffee in the sun and just meditating on that sensation of having your coffee in the sun.
We do meditation every morning, so get up and do yoga and meditation every morning. Having an exercise routine that you really enjoy and that makes you feel alive. That's not punishing your body or trying to achieve some aesthetic goal, but making you feel really joyful. Just really [00:59:00] thinking about all of these things because to really hold space for other people, we have to start with ourselves.
And it's kind of like our responsibility when we're seeing patients who, where the greatest medicine is that co-regulation that we are, we have to make sure we are showing up in a regulated way so that we can provide safety number one, and then provide all the other things or, and be that, that guide we can't really help to help to find the way, to help someone else find their, their soul's purpose if we are completely miserable and hate our job.
And like counting down the, and bitter and resentful and in burnout. I liked this quote that I saw, but it was like I shared it to these guys and it's like, perhaps it's a controversial opinion, but I don't think we are paying healing practitioners for an hour of their time. I think we're paying them for whatever they need to do to tend to their own nervous system so that they can really show up for that hour and take care of themselves after too.
So I guess what we know [01:00:00] to be true is that holding space for real healing takes time and energy. That's why we have longer appointments and we probably see fewer patients. We've made, we'll talk about it at length, um, in the future, but we make, we have our, we know what our values are and writing your values down is really, really helpful.
But we will prioritize those things. So for me, it's my family. So I, and like my care of my child. So I don't work long hours. I don't work early mornings and late nights generally. Um, although my little bedtime alarm just went off that so I can get up early to, to do, um, meditation anyway. But we need to be in touch with what makes our own soul thing.
We need to be connected to the parts of our body that collectively we might feel shame about because that, like, that's the most basic thing we need to do to help shift that for other people. Um, we know that, you know, we've talked a lot about the old paradigm is not working. It's not just in pelvic pain.
It's with lots of chronic conditions. [01:01:00] We know that paradigm shifting care requires new ways of working. We need to, to help our patients begin to listen to their bodies. We need to be able to listen to our own. We can't just push through or ignore it or just be numbed out. We know that facilitating healing in another always starts with us.
And creating change in systems always starts with us. There's no point. And we've all been there like complaining about the system. Why isn't it a different way? The system is made up of people and people are us. So it starts with us.
So we are super, super, super excited because we have been where we've been burnt out. It's taken many years to come to the way that we work with patients, and we think that really the biggest, well, I think the, really the biggest gift that I've had over the past five years is being able to face my discomfort and pain and all of my hidden dark stuff so [01:02:00] that I could feel stuff.
I think that in general, we don't feel very well, like, there's a lot of fear around that. If you're a medical person or a helper or a healer especially Western Medical trained, there's a lot of feeling isn't really prioritized and I certainly felt really disconnected. But we're really excited to let you know about this new program called Alchemizing Pain Into Power.
It's transformational medicine. It's totally different to what we've been taught, but it begins with your own embodiment and regulation, which is gonna help you in your own life. But also to dramatically improve your outcomes for your patients. So we're so excited to be able to introduce you to this, and you're the first people who are finding out about it.
And we have got two options to deliver this program or for you to receive this work from April in, of next year. So there's an online 12 week program, and then there is, or a four day [01:03:00] intensive retreat. And, but you also get access to all of the course content.
And so the first part of the program will be all, the foundation is all about your own embodiment and self practice. So it's about mastering your own nervous system. It's about facing the darkness and then rising out. It's about learning all of these tools and in intimately getting to know your own nervous system in yourself so that you can start to bring this into your clinical practice.
And the second part will be all about patient care. So how we talk about the neuroscience of, of chronic pain with that, those deeper levels of mind. Body, spirit environment. Um, we'll be giving you information about how to how to educate patients, lots of resources so you don't have to replicate all of this.
You'll have it all. And so like we have on our desks, we just have this flip folder of all the things that we go through with our [01:04:00] patients and you'll be able to have that. And so, so you'll have this framework for you with your own clients, and then there'll be an integration and assessment. So we will do live practice and role play so you can practice what you've learned.
And we'll have peer feedback and support, and then you can bring all of your cases and we can discuss them all. So you can find out more about this. If you wanna just check out, you can QR code this, or Sophia I think is in the, in the chat and she'll send you the link.
But we would just like to thank you for taking this time for yourself and in the coming days or week, if anybody does have any questions or anything pops up, then please reach out and you can email us at Vera.
I hope that if nothing else you've opened up just some like internal reflections or space for you to you know, question if there are maybe different ways that you could practice that might serve you better mm-hmm.
That might bring [01:05:00] you more into alignment with your soul. Yeah. And we would really, really love for you to join us on the course next year. Okay. Thank you. Thank you.
Thank you for joining us for this episode of Women of the Well. If you enjoyed it, please subscribe or follow the podcast and leave a glowing review so more women like you can find us and get access to empowering and holistic wellness information. If you'd like to continue the conversation or connect with our online community, visit@verawellness.com au on Instagram.
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DISCLAIMER:
This podcast is for information and educational purposes only and is not intended as a substitute for medical advice, diagnosis, or treatment.
