When your bladder holds your trauma: emotion, the nervous system, and bladder health

When your bladder holds your trauma: emotion, the nervous system, and bladder health

When your bladder holds your trauma: emotion, the nervous system, and bladder health You know your body is telling you something. But when every test comes back clear, it becomes very hard to trust what you're feeling or to understand why it won't get better. In this episode, I'm joined by Dr Lindsey McKernan, PhD, Associate Professor of Psychiatry and Urology at Vanderbilt University Medical Center and pioneer of uro-psychology, and Saoirse Nash, women's health coach and Director of Live UTI Free. Together we explore something that doesn't get nearly enough airtime: what happens to the bladder and pelvis when the nervous system has been under sustained stress, or when trauma has never fully been processed. Saoirse shares her own journey from recurring acute UTIs in her teens to chronic symptoms that no one could explain, including the link she made between her mother’s passing and the way her body responded. Lindsey brings the science: why childhood adversity and trauma change the way the nervous system processes pain, how the stress response directly affects bladder function, and what uro-psychology, the field she has spent her career building, offers to people who haven't found answers in standard care. This conversation covers: * Why emotional history can show up as physical symptoms in the bladder and pelvis and what that actually means for treatment * What PTSD looks like in a urology clinic, and why it's more common than most clinicians realise * How sustained stress keeps the nervous system in a state of threat and what that does to pelvic muscles and pain processing * The research behind psychological interventions for interstitial cystitis, and why outcomes can improve even after 14 years of chronic pain * What it means to move from being at war with your body to working with it This episode will resonate deeply with anyone who has long suspected that it is their bladder or pelvis holding the score. It is also essential listening for clinicians looking for a more integrated framework for supporting people with bladder and pelvic pain. 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 urgency, urgently thinking, or thinking away the urge - following episode 6

There's a moment of significance in so many health journeys that rarely gets explored. The moment when you go from believing the healthcare system will help you, to realising it won't. I call this a belief flip. In this short solo reflection on my conversation with Melissa Kramer and Dr Laura Katz on the subject of the role of thoughts and beliefs in bladder conditions, I want to sit with what that actually does to a person, and why it matters so much for how we then talk about the role of thoughts in bladder and pelvic conditions. Because here's the thing. If your beliefs have been flipped, if you've gone from feeling safe and supported to feeling alone and dismissed, then someone exploring the psychological side of your symptoms is almost certainly going to feel like another version of being told it's all in your head. And that response makes complete sense. A threatened brain doesn't have much room for nuance. What I wanted to unpack here is the nuance that I think is so worth having. Thoughts are not fluffy or incidental. They are biologically mediated. They have downstream effects on the nervous system, on pain processing, on how your body responds. That is not the same as saying you caused this, or that you're doing something wrong. You are not in control of the thousands of thoughts your brain generates every day. But once you can see some of those patterns -the threat forecasting, the perfectionist tracking spiral, the self-blame that follows a flare -there is something you can do with that awareness. I also reflect on what Laura said about validation -that you cannot ask someone to explore the psychological dimensions of their condition until they feel genuinely believed. Not just in words. In practice. That means biology and psychology together, not one instead of the other. This one is a bit more thinking out loud than usual. I hope it adds something after episode 6. 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]

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