Chronic Pelvic Pain: How to Transform and Heal
Authored by Dr. Maryssa Steffen, PT, DPT, Board-Certified Pelvic Health Clinical Specialist
“Mindfulness is defined as present-moment, nonjudgmental awareness. By reducing self-criticism, and depression, and increasing self-compassion, attention, and interoceptive awareness, mindfulness has been found across a variety of systematic reviews and meta-analyses to significantly improve sexual desire, sexual pain, and sex-related distress.” (Mindfulness and Management of Low Desire and Vulvovaginal Pain)
How Can Somatic Practices Help Those Living With Pain?
Somatic pelvic therapy and somatic movement therapy offer a way of relating to pain that honors the intelligence of your body.
By playing with the somatic principles of interoception, exteroception, and proprioception, you can develop awareness, enhance pleasure, and gently modulate sensations, emotions, and nervous system responses that are often bound up with pain.
Somatic practices invite you into relationship with your senses and can support self-management of symptoms through curiosity, choice, and expanded movement options—rather than force or pushing through.
Turning Your Micro-Attention Inward
You might begin by asking:
What do I need in order to safely turn my attention inward?
How does my environment support or inhibit that inward attention?
What options are available to me that may increase my capacity to listen to my body?
As attention turns inward, many people notice a shift in curiosity and creativity around movement. With repetition, somatic approaches improve body awareness, expand options for self-regulation, and offer new ways to explore both fear and pleasure in movement.
Social and relational environments matter, too. Pain does not exist in isolation—it is shaped by context.
Interoception and Resourcing
Interoception—your awareness of internal bodily sensations—plays a powerful role in grounding and resourcing practices. It supports your nervous system’s flexibility and resilience in response to stress.
“Interoception is bound up with awareness of and modulating chronic pain experiences on multiple levels, often providing prompts for action such as discomfort or tiredness as cues for changing activity.”
In trauma-informed pelvic therapy, interoception is never forced. It is invited, paced, and supported.
How Somatic Movement Therapy Modulates Pain
At the foundation of somatic movement therapy is attention to breath.
When you breathe:
How do you know you are breathing?
What sensations tell you about the quality of your breath?
Where do you feel movement, and where might it feel restricted?
Breath directly influences your autonomic nervous system. Somatic approaches enrich breathing by inviting awareness into skin, bones, muscles, and visceral organs—supporting relaxation without overriding protective responses.
Somatic pelvic therapy encourages personal movement research, where you become an active participant in understanding how your body responds to stress, safety, and choice.
You are not broken.
You are adaptable.
Habitual Responses to Pain
Your sensory-motor system is always responding—to daily stress, past trauma, and perceived threat.
These responses often show up as:
unconscious muscle contraction
rapid protective patterns
tension that persists long after the original stimulus
These habits are efficient and loyal. They once protected you. Over time, however, they may contribute to pain.
Trauma-informed physical therapy works with these patterns—not against them.
When Interoception Feels Like Too Much
Yes—interoceptive attention can sometimes heighten symptoms.
This is why consistent, gentle practice over time, matters.
Rather than asking whether to attend inward, the more useful question may be:
How and when is it supportive to attend inward?
Consider:
Are you resourced today?
Are you rested?
Do you feel safe and do you have privacy?
Do you have emotional, social, or professional support?
Working with a trauma-sensitive pelvic pain specialist—such as Dr. Maryssa Steffen, PT, DPT—can help you navigate these layers with care, pacing, and consent.
What Is Pain, Really?
The International Association for the Study of Pain (IASP) defines pain as:
“An unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage.”
Key truths from this definition:
Pain is always personal
Pain is shaped by biological, psychological, and social factors
Pain can exist without tissue damage
A person’s experience of pain must be honored
Chronic pain—pain lasting longer than three months—is not a failure of your body. It reflects adaptation.
The Good News: Neuroplasticity
Your nervous system changes throughout your life.
Pain is often the most dedicated expression of neuroplasticity—your system learned to respond quickly in order to protect you.
From a somatic perspective, people living with chronic pain are not medical mysteries. They are active meaning-makers. Their bodies are holding information that deserves attunement.
Somatic movement therapy offers validation and a shared language.
Embodied Inquiry as Healing
Rather than simply saying, “I am in pain,” you might explore:
textures
weights
temperatures
emotions
images
impulses
meanings
colors
energies
Pause.
Notice what shifts when you inquire this way.
This is somatic authority.
This is process-oriented change.
An Example: Body-Mind Centering®
Body-Mind Centering®—developed by Bonnie Bainbridge Cohen—is a researched, curriculum-based somatic movement therapy that explores anatomy through lived experience.
In this work, you may:
sense the movement and tone of muscles
explore the weight and motility of organs
revisit early developmental movement patterns
interrupt pain loops by offering new sensory input to change perception and responses
These practices do not bypass pain—they expand your relationship to it.
Chronic Pain and Body Awareness
Persistent pain can alter perception:
touch may feel unclear
body boundaries may blur
balance and spatial awareness may change
hypervigilance may increase sensitivity to sound, smell, and movement
Avoiding movement may feel protective, but over time it can reinforce pain.
Somatic pelvic therapy gently invites movement back—with the practice of compassionate curiousity.
Working With Fear Avoidance Through Somatic Movement Therapy
You might explore:
how you orient to your environment
which positions feel supportive
where strength lives in your body
what movements feel tolerable—even pleasurable
Micromovements count.
Imagined movement counts.
Breath counts.
Confidence grows through a practiced flow.
You Are the Expert of Your Body
You have agency.
You have choice.
What is your body saying?
Somatic movement therapy supports you in identifying what aligns with your values, needs, and lived experience.
Ready to Explore Somatic Pelvic Therapy?
If you are living with chronic pelvic pain and are curious about trauma-informed pelvic therapy, Dr. Maryssa Steffen, pelvic pain specialist, offers a grounded, somatic approach.
If you are in the state of California, you can book a discovery call to learn more about pelvic floor physical therapy.
Telehealth and in-person visits are available at our Oakland, CA office.
Your body has not abandoned you.
It has been protecting you.
Reference:
Meehan E and Carter B (2021) Moving With Pain: What Principles From Somatic Practices Can Offer to People Living With Chronic Pain. Front. Psychol. 11:620381. Doi: 10.3389/fpsyg.2020.620381
