Hello,
And welcome.
My name is Yaesha Bryan.
I'm a psychiatric physician associate,
Trauma-informed yoga teacher,
And chronic pain coach.
If you're here listening,
There's a very good chance you know how deeply chronic pelvic pain can affect your life,
Physically,
Emotionally,
And in relationship.
I say this not just as a clinician,
But as someone who lives with it too.
And that's part of why I care so deeply about helping people understand the full picture of what drives pelvic pain and what can help.
Today,
I will share with you a way of thinking about chronic pelvic pain that I've found incredibly helpful for myself,
For patients,
And for clients.
It's a whole-body,
Four-bucket model.
Each of the buckets contributes to pain in a different way,
But they all influence one another.
Understanding them is a powerful first step on your path.
So,
The first bucket is,
What has the brain learned?
This bucket is all about pain pathways that the brain has learned over time.
We often refer to this as neuroplastic pain.
You may have also heard it referred to as nociplastic pain,
Or a neural circuit disorder.
I go deeper into the science of this in my other talk,
Chronic Pain Explained,
But here's the basic idea.
The brain can generate real pain even in the absence of ongoing injury or tissue damage.
One of the biggest risk factors for developing neuroplastic pain is increased activity in the brain's emotion and learning centers.
Who tends to have the most activation here?
This probably won't come as a surprise,
But people with anxiety,
Hypervigilance,
Stress,
Or trauma histories,
Which is many of us with chronic pain.
These pain pathways can become deeply,
Deeply ingrained,
But here's the empowering part.
Because this type of pain is learned,
It can also be unlearned through approaches like pain reprocessing,
Somatic work,
And other mind-body tools,
We can teach the brain to respond differently and reduce or even resolve pain over time.
But first,
It helps to gently challenge the assumption that pain always means damage.
In neuroplastic pain,
The danger isn't in the body,
It's in the brain's interpretation,
And that is something we can change.
The second bucket is what is the state of the nervous system?
And this bucket is very closely connected to the first.
When we live in a state of ongoing stress,
Fear,
Or hypervigilance,
It changes the way our nervous system processes and interprets information,
Especially signals from the body itself.
In fact,
One powerful study used brain scans alone to predict,
With 85 percent accuracy,
Who would go on to develop chronic pain after injury.
What were the key predictors?
Having an increased amount of activity in the emotional processing regions of the brain before the pain became chronic.
This tells us that the more emotionally activated or threatened the brain feels,
The more likely it is to create and maintain pain pathways.
So in order to retrain these pain pathways,
We need to help the brain and body feel safe.
This means reducing fear of the pain itself and learning how to regulate stress and anxiety.
This is why nervous system regulation tools like breathwork,
Grounding,
And co-regulation are not just helpful,
They're absolutely essential.
The third bucket is the pelvic floor itself.
So of course we can't talk about pelvic pain without mentioning the pelvic floor.
These muscles support our pelvic organs and play key roles in posture,
Digestion,
Alignment,
And even emotional holding.
Sometimes the pelvic floor becomes chronically contracted or hyperactive,
Often in response to an old injury or even ongoing stress.
The body tries to protect itself by closing in and tightening,
But over time this constant guarding becomes part of the problem.
Tight pelvic muscles can compress nerves,
Misalign the pelvis,
And interfere with bowel movements,
Urination,
And even intimacy.
And yes,
Just like the jaw and the shoulders,
Many of us subconsciously hold stress in our pelvic floor.
This is why pelvic floor therapy can be helpful,
But also why it's not always enough on its own.
If your nervous system is still in a high alert state,
Those muscles may not be able to fully soften and relax.
Pelvic breathing is one example of a simple yet powerful practice that can support multiple buckets at once,
Addressing both the body and the nervous system simultaneously.
The last bucket is what are you holding on to?
This is the most tender and often the most overlooked piece.
Many people with chronic pain have a history of emotional repression,
Trauma,
Or simply never having had the space to feel,
Process,
And integrate their emotions.
Research shows that unfelt emotions can contribute to pain and sometimes are even held physically in the body.
In one striking study,
People with chronic pain were asked to write about deep emotional experiences for just 20 minutes on three separate occasions.
Four months later,
Those who did this kind of expressive writing had less pain,
Less fatigue,
And improved well-being compared to groups.
Whether through writing,
Movement,
Breath,
Or simply learning to feel your feelings in small safe doses,
This kind of work can create real physical change.
So bringing it all together,
When it comes to chronic pelvic pain,
No single intervention is a silver bullet.
Not medication or surgery alone,
Not meditation alone.
Because this pain doesn't live in just one place,
It's shaped by the brain,
Nervous system,
Muscles,
Fascia,
And the emotional body.
True healing must be multidimensional too.
When we meet ourselves with curiosity,
Compassion,
And a whole person approach,
Change becomes possible.
Not just relief from the pain,
But deep meaningful transformation.
As someone who walks this path too,
I want you to know your pain is real and so is your capacity to heal.
Thank you so much for spending this time with me.
I really appreciate your presence here and I hope this framework offers a new way of understanding your pain and perhaps just a little more hope for what is possible.
