My Reflections on the Bladder, the Brain and Learning Pain following Episode 2

Urgency, urgently thinking, or thinking away the urge: Is chronic UTI psychological?

What if the thing keeping your bladder symptoms going isn't just the infection, it's also what your brain is doing with the threat of it? And what if that doesn’t mean that your symptoms aren’t real? That it instead is reflective of your body being a highly interconnected system that needs some further understanding. That is what this conversation with Dr Laura Katz and Melissa Kramer explores.  Dr Laura Katz is a clinical health and rehabilitation psychologist whose research has focused specifically on how women cope with bladder pain and interstitial cystitis including landmark work on emotion regulation, fear of pain, and helplessness as predictors of long-term outcomes. Melissa Kramer is the founder and CEO of Live UTI Free, a PhD researcher at the University of Reading, and someone with five years of her own chronic UTI experience. Between them, they bring rigorous science and deep lived understanding to a conversation that I think fills a real gap. For a lot of people navigating bladder and pelvic conditions, the moment anyone mentions psychology or thinking, it feels like another version of being told it's all in your head. We address that directly, clarifying terms, science and the neurobiology of thoughts.  What this episode covers: * Why thoughts are not fluffy or separate from physical experience -they are part of the neurobiology of your nervous system, and they have measurable effects on pain * What Laura's research shows about emotion regulation as a predictor of quality of life in women with bladder pain- and why this is not about blame or willpower * The word catastrophising: why both guests take issue with it, what the research actually measures, and why fear of pain is a normal, human, adaptive response - not an overreaction * How fear of pain can longitudinally predict more pain -the chicken and egg, and what it means practically * What helplessness does to outcomes over time, and how perfectionism and self-blame can quietly compound a flare * Why validation must come before acceptance and what goes wrong clinically when it doesn't * What actually helps: forward motion, community used wisely, self-transcendence, and what happened when one of my own patients tried being kinder to herself mid-flare * Why clinicians should share the neuroscience directly with patients and how psychoeducation alone can shift fear Whether you're living with bladder symptoms, supporting someone who is, or you're a clinician working in this space  I hope this leaves you with something that genuinely reframes things. Show notes, references and resources: https://www.howwereallyfeel.com/episode-6-urgency-urgently-thinking-thinking-away-the-urge [https://www.howwereallyfeel.com/episode-6-urgency-urgently-thinking-thinking-away-the-urge] This podcast is supported by Convatec Continence Care and their Me+ programme, which supports people using intermittent catheters with both practical guidance and emotional wellbeing resources. Find out more at www.howwereallyfeel.com/in-partnership-with-convatec [http://www.howwereallyfeel.com/in-partnership-with-convatec]

My reflections on pelvic pain, being believed and what's possible following episode 5

There are images from conversations that stay with you. Carla, 21 years old, crawling across the floor to the bathroom, still being told she would grow out of it. Sheren's black diary, found years later, full of red scrawl - I can't go on like this - pain rated nine and ten, page after page. In this short solo reflection I sit with what that conversation stirred up clinically, and as someone who works with people navigating exactly this kind of pain every day. We talk a lot in health psychology about the mind-body connection. This episode is an attempt to make that concrete. What does it actually mean for your physiology when your pain isn't believed? Why does the world start to shrink around your symptoms? And when someone says that working with the emotional or psychological side of things might help - does that mean the pain isn't real? It doesn't. And I want to talk about why that matters. This reflection follows episode 5 of How We Really Feel. If you haven't listened yet, I'd recommend starting there - it goes much deeper, and I think it will stay with you. This episode is supported by Convatec and the me+ Emotional Wellbeing Programme - a free holistic support programme for intermittent catheter users. Visit www.howwereallyfeel.com/in-partnership-with-convatec [http://www.howwereallyfeel.com/in-partnership-with-convatec] 🎧 Full episode 5 — with Carla Cressy OBE and Sheren Gaulbert: 👉 https://pod.link/1895564493/episode/NTc5NWY5MjEtNmM5NS00NTIyLTg2YTgtNTgyMmM0YWM0OTY1?view=apps&sort=popularity [https://pod.link/1895564493/episode/NTc5NWY5MjEtNmM5NS00NTIyLTg2YTgtNTgyMmM0YWM0OTY1?view=apps&sort=popularity] 📚 Show notes, references and resources: 👉 www.howwereallyfeel.com/episode-five [http://www.howwereallyfeel.com/episode-five] 🔗 Find the guests from the full episode: Carla Cressy OBE - theendometriosisfoundation.org [http://theendometriosisfoundation.org] Sheren Gaulbert - the-ultimate-you.com [http://the-ultimate-you.com] 📩 Newsletter: www.healthpsychologist.co.uk/subscribe [http://www.healthpsychologist.co.uk/subscribe] 📱 Instagram: @the_health_psychologist_ 🎧 Spotify | Apple Podcasts | Amazon Music | [https://pod.link/1895564493/episode/NTc5NWY5MjEtNmM5NS00NTIyLTg2YTgtNTgyMmM0YWM0OTY1?view=apps&sort=popularity] This episode is supported by Convatec and the me+ Emotional Wellbeing Programme - a free holistic support programme for intermittent catheter users. Visit www.howwereallyfeel.com/in-partnership-with-convatec [http://www.howwereallyfeel.com/in-partnership-with-convatec] ⬇️ If this landed for you, please share it with someone who needs to hear it!

Pain in my pelvis - Recovering from chronic pelvic pain

What does it feel like to crawl across the floor to reach the bathroom? To carry a cushion everywhere because every chair in every restaurant has become a threat? To have a decade of your life measured in pain scores scrawled in a black diary? This episode starts in the reality of what severe, unrelenting pelvic pain actually looks like. A reality that does not seem to be readily apparent or appreciated in lots of healthcare consults, to the detriment of many patients.  Dr Sula is joined by two guests who have both lived this from the inside, and now work to change it from the outside. Carla Cressy OBE is the founder and CEO of The Endometriosis Foundation, diagnosed at 25 after years of being dismissed, and now one of the most important voices in UK women's health advocacy. Sheren Gaulbert is a cognitive hypnotherapist, pain and trauma therapist, and Trustee of the Vulval Pain Society, who spent a decade living with vulvodynia before finding a way through and training to provide support for many others going through these health experiences.  Together, they explore the territory that sits beneath the diagnosis: why the nervous system stays stuck in threat long after the immediate crisis passes, how the unpredictability of conditions like endometriosis keeps the body braced for impact, and what happens when pain becomes so total that it stops feeling like something you have and starts feeling like something you are. This conversation covers the science of why pelvic pain is particularly entangled with the nervous system, what cognitive hypnotherapy actually is (and isn't), why generic pain management approaches can actively make things worse for people with complex pelvic conditions, and how identity can begin to be rebuilt when pain has taken up the space where a sense of self used to be. There are also honest reflections on what it means to be told "nothing's wrong"  and the very specific kind of anger, shame, and helplessness that follows. What you'll take from this episode: * Why the brain's predictive processing can keep pain patterns alive and how that changes the body * How the pelvic floor holds emotional as well as physical tension, and what that means for treatment * Why the word "catastrophising" is doing more harm than good in clinical practice * What it means to rebuild identity when chronic illness has consumed it  and a practical way to start * Why "find your community" is Carla's first recommendation, and what good community actually offers that online forums often can't Whether you're living with endometriosis, vulvodynia, pelvic pain, or a condition that has never quite had the right name -or you're a clinician working alongside people who are - this conversation is for you. Show notes and resources: www.howwereallyfeel.com/episode-5 [http://www.howwereallyfeel.com/episode-5] This conversation connects closely with the work I'm doing with Convatec Continence Care and their Me+ programme, which supports people using intermittent catheters with both practical guidance and emotional wellbeing resources. Find out more at www.howwereallyfeel.com/in-partnership-with-convatec [http://twww.howwereallyfeel.com/in-partnership-with-convatec] 📩 Mind body science mail: www.healthpsychologist.co.uk/subscribe [http://www.healthpsychologist.co.uk/subscribe] 📱 Instagram: @the_health_psychologist_ 🎧 Spotify | Apple Podcasts | Amazon Music | All major platforms

My reflections on owning your body when it works differently - following episode 4

Sometimes the most useful thing you can hear is someone else's honest account of how they got through something you're convinced you couldn't. In this short solo reflection, I'm thinking through the conversation I just had with Steve Kearley and Niall McCann. Two men who experienced spinal cord injuries and navigated their way, in very different ways and at very different paces, towards lives they find genuinely meaningful. If you haven't heard that episode yet, I'd encourage you to start there. What I keep coming back to from that conversation is how much it challenges the story we tell ourselves about coping- that we either have it or we don't, that struggling means failing, that a body that works differently is a body to fight. Here's some of what I reflect on: * Why the adjustment process after illness or injury is rarely linear, and why moving back into crisis doesn't mean you're not making progress * What the research actually says about harsh self-talk and why the inner critic tends to hold us back rather than drive us forward * The quiet but significant shift that happens when you stop treating your body as the enemy * How confidence after illness or injury builds. Why starting small isn't giving up, it's strategy * The power of naming the things we don't usually talk about: continence, intimacy, the hidden losses that come with a changed body * Why social connection isn't just nice to have when you're navigating a health journey and the small, specific things the people around you can do that genuinely matter This connects closely with the work I'm doing with Convatec Continence Care and their Me+ programme, which supports people using intermittent catheters with both practical guidance and emotional wellbeing resources. Find out more at www.howwereallyfeel.com/in-partnership-with-convatec [http://www.howwereallyfeel.com/in-partnership-with-convatec] Show notes, resources and links at https://www.howwereallyfeel.com/episode-four-owning-your-body [https://www.howwereallyfeel.com/episode-four-owning-your-body]

Owning your body when it works differently: Spinal injury, identity & learning to befriend yourself

Have you ever thought: if that happened to me, I couldn't cope? Or perhaps something has happened and you find yourself caught in a battle with your body, with no clear picture of how to move forward? This episode might just shift something for you. Dr Sula is joined by Dr Niall McCann, biologist, National Geographic Explorer, mountain rescuer, and Spinal Injuries Association ambassador, who sustained a serious spinal cord injury in a paragliding accident. With him is Steve Kearle, two-time wheelchair rugby World medalist, featured in the Oscar-nominated documentary Murderball, patient advocate, and coach who mentors people navigating life after spinal injury. Together, they have a conversation that is rare in its honesty: about the parts of disability that don't get talked about. The hidden adjustments. The internal monologue that can either hold you back or become your most powerful ally. The parts of yourself- identity, sexuality, bladder and bowel management- that nobody prepares you for. And the surprising, hard-won discoveries about what it actually means to live fully in a changed body. Here's some of what you'll take away: * The three phases of adjustment after injury or illness: Crisis, coping, and adaptation. Why moving through them isn't linear, and what that actually looks like in real life * Why your inner monologue matters more than almost anything else in recovery, and how both Niall and Steve learned to shift from self-criticism to something that helped them do hard and remarkable things * The things nobody considers in injury and illness: bowel and bladder changes, sexual function, catheterisation, and how to find your way to openness rather than shame * What partners, friends and healthcare professionals can actually do and what tends to get in the way * Why 'just be you' is the most powerful advice for anyone who loves someone navigating serious illness or injury * Small, honest steps towards re-engaging with life, community, and a sense of possibility, even when that feels a long way off Whether you are navigating a health challenge yourself, supporting someone who is, or working clinically with people in these circumstances, this episode is full of wisdom, warmth, and a kind of grounded hope that is genuinely hard to come by. You can access references and resources discussed in this episode, fact checked and collated by our show researcher and trainee health psychologist, here: [https://www.howwereallyfeel.com/episode-four [https://www.howwereallyfeel.com/episode-four]]