Balancing the Scales of Pain and Pleasure

Many years ago, before I heard the term “neuroplastic pain,” I was bowed in front of a shaman, begging him to separate pain from pleasure in my body. He sang his “Icaros” song to me, willing these two sensations to become independent of one another. 

“Please allow me to feel pleasure without pain,” I pleaded through tears. Oh, the stories we accumulate as we travel along our pain recovery journey.

It’s a common experience for those with chronic pelvic pain to feel pain before, during, or after orgasm, or with self-pleasure or penetration, which can lead to thoughts like:

“Please relieve me of the pain, and leave me with the pleasure.”

What I’m discovering, is that pain and pleasure are deeply intertwined. The brain circuits that process pain and pleasure are not opposites living in separate parts of the brain; they are deeply interconnected. Some of the pathways that carry pain signals overlap with — or run very close to — the pathways involved in pleasure.

When we experience severe pain, built-in pain inhibitory mechanisms stimulate brain regions that release internal opioids to decrease the experience of pain. When we orgasm, opioids are released as well — substances that both make us feel good and relieve pain.

When pain has been amplified for a long time, it can affect our ability to experience pleasure. Conversely, positive, pleasurable, and safe experiences can help shift the nervous system away from a persistent pain state.

It’s less about eradicating pain in order to experience pleasure, but instead creating balance within the pain/pleasure system. (Many of these concepts are explored beautifully in Nan Wise’s book, Why Good Sex Matters.)

In Pain Reprocessing Therapy, or PRT, we talk about “positive affect induction” — a fancy term for intentionally inviting in feelings of pleasure, joy, lightness. When we summon a positive sensation or memory while experiencing pain, the brain begins to receive new information: maybe the pain sensation isn’t as threatening as we once believed. We’re creating a new pairing — linking pain with something the brain interprets as safe. Over time, this can begin to change the way the painful sensation itself is experienced.

When we allow pleasurable sensations to be present, even alongside pain, the brain learns: “Oh, this painful sensation must not be so threatening if my person is also feeling lightness, joy, or ease.”

When I work with clients, I often ask them to engage in something pleasurable every day. Taking a walk. Pausing to feel the sun on their skin. Savoring a cup of coffee.

When we live in constant pain, one of the first things we neglect is pleasure. But pleasure is one of the most powerful tools we have to show our systems we are safe, and prioritizing pleasure is essential in rebalancing the pain/pleasure system.

Don't worry if pleasurable actions don't feel pleasurable at first. In depression research, we know that people often don’t feel motivated or uplifted before they act — they act first, and with repetition, the nervous system begins to respond.

The same is true with pleasure. We don’t always feel pleasure before engaging in something pleasurable. But with repetition, the system begins to relearn it.

When our brains associate the pelvis primarily with painful experiences, generating pleasure within the pelvis can be especially powerful. Here are some ideas to explore (take what resonates, leave what doesn't): 

Make it about pleasure, rather than pressure. 

• Vaginal steaming (Not while you're bleeding though)

• Gentle hip stretches

• Pelvic breath, inviting in softness and arousal if accessible (maybe while taking a bath, or while vaginal steaming)

• Self-touch

• Dancing. Anything from twerking to your favorite hip-hop song, to slow, sensual hip circlesSelf-massage with body oil
  

These don't have to be huge acts. Maybe 30 seconds to listen to the birds and feel the sun on your skin. Or shake your hips to one 3 minute song. 

If you're experiencing chronic pelvic pain, pain with sex, or related symptoms and want support, you can learn more about me here You can also schedule a free consult here