09 Mar Pelvic pain: keys to successful intervention through yoga
I was invited to speak at King Edward Memorial Hospital about how yoga can help women with pelvic pain. While there are demonstrated physiological benefits to yoga, such as reducing cortisol, enhancing internal body awareness and improving digestion, I’d like to write about some of the educative components Finding Yoga would consider in the design of a specific pelvic pain program.
1. Absence of pain does not guarantee wellness
When asked to name their clients’ biggest challenges, practitioners at KEMH listed everyday living, having fulfilling roles, finding pleasure and acceptance. You’ll note that none are specifically about the physiological sensation of pain. They all relate to mental concepts of the experience of pain.
We have found clients retain the benefits gained in Yoga for Pain only if they have a purpose for living and a perception of how to enable that. In the absence of meaningful employment, social connections and joyful activities, the experience of pain soon returns. Design of a yoga for pelvic pain program would therefore analyse physical, social and psychological aspects to wellness to individual wellbeing alongside the common medical goal of reducing pain.
2. Health is a resource for life, not an outcome
The Ottawa Charter for Health Promotion, laid out by the World Health Organisation in 1986, reminds us that health is a resource for every day life, not the objective of living. Any medical approach to reduce pain should be accompanied by an inquiry into “why”: how will this intervention help this person with living?
Bronnie Thompson, occupational therapist, writes extensively about the importance of understanding why someone is presenting for care. Someone presenting with symptoms of pelvic pain may really be saying “I cannot care for my family” or “Pain in my vulva means I can’t make love to my partner and I’m worried he’ll have an affair”. To be truly effective, any treatment for pain must also have provision to help the woman to feel a valued member of her family, or ensure that she has support to maintain an honest and sexually satisfying relationship with her partner.
3. Health is found outside the therapy room
Marie-Andree Baillon, head of University of Lille’s University Diploma in Yogic Education, talks about a global approach to health care that considers the whole of the person’s life experience and potential (paper in French). As well as the complex internal workings of the person in pain’s body and experiences, the outer ecology of the client includes a home life and social milieu. How does a home practice fit within a busy schedule and untidy house? What financial commitment is appropriate? Can mindfulness be implemented immediately up on leaving the clinic, to ensure the drive to pick up kids from school is safe? Can body awareness instantaneously help with a more loving, physical relationship?
4. What’s good for the client must be good for the practitioner
In 1994 hospital researchers interviewed medical practitioners at a hospital in Germany about the future of health care. The negative response from physicians led the hospital to launch a seven-year initiative to re-design the system. When they asked practitioners and patients about what was needed, they found that both groups wanted the same things. The changes they implemented as a result of the dialogue not only saved a lot of money but left clients more satisfied.
The collaborative pain unit seems to be a successful new model for pain care. But while results are good, challenges are still the same: long wait lists, insufficient resources, and very caring practitioners who want to be able to do more with the diverse and individual clients who come their way. In this context, it would be a shame to design a fabulous Yoga for Pelvic Pain that doesn’t also help reduce the load for the hospital system.
5. We must always begin with inquiry
While Yoga for Pelvic Pain for women in the western suburbs of Perth in 2015 may be structurally similar to Yoga for Pelvic Pain in rural Queensland in 2020, each may be vastly different in terms of ideal venue, social factors and desired outcomes. We always begin by asking “What is the ecology of health we want to support, and what is required, now?”
To roll out a Yoga for Pelvic Pain program in your organisation please get in touch.