Letter from H

• The enterocele sac is formed in front by the posterior wall of the cervix and in back by the front wall of the rectum. When the cervix drops, the sac becomes a bit deeper, because the cervix brings the front wall of the sac down with it, but a “garden variety” rectocele should have no bearing on an enterocele. Surgeons have created a lot of confusion around this issue, but I like the way urogynecologist Linda Brubaker straightens it out:

“The vast majority of rectoceles are ‘low’, that is, at the perineal body. The literature commonly refers to ‘mid’ and ‘high’ rectoceles, but we have only seen such defects in patients with unsuccessful prior posterior colporrhaphy.”

hello H. Is this the quote you are referring to? My understanding is that the term "garden variety" was used to describe a rectocele that appears low in the posterior vaginal wall. This is what most of us women with rectocele have- The more serious type of rectocele is much higher-and are not really seen in women who have not had pop surgery.

How is your SPD? I am going a round right now with my pubic symphasis- I recently birthed an OP baby - with sticky shoulders and my pelvis is a little unstable. It is very painful if I move "the wrong way" or stand on one foot for more than a few seconds. I am using ice to bring down the inflammation- as well as some other topical sorts of things- arnica etc... at some point soon I will start back appointments with a body worker which I know will be of great help.
If your SPD is still present 16 months later you have some work to do. Have you considered chiropractic care- or even better would be a doctor of osteopathy.

Sounds like you are in the "why me I did everything right" phase of dealing with your prolapse. I suspect your prolapse started with your first birth- tearing your perineum is not a great way to avoid a rectocele- and then I imagine cutting through many supportive structures during your c-section sealed the deal. I can only speculate of course-

What is interesting is that pelvic floor strength has just about nothing to do with prolapse- Many of us here have amazing pelvic floor strength and have always had amazing pelvic floor strength.

alright- my little guy is wanting to nurse so let me finish up quickly- I am sure you will get more action......re: the vaginal wind- you can control this- since you are interested in yoga check out NAULI- you may find this breathing exercise helps you learn how to control the vacuum effect of air pulling in-
re: bowl movements- if you could use the search engine here you could get a ton of help with this- but the best advice I can give you is to keep everything in good shape with a special dietary approach- combined with proper positioning and a few tricks- like splinting, twisting to the right- etc.....
and NEVER strain- go with an enema if you must- but do not strain.

Glad you have the book- and sounds like you would like the DVD and yes I think it is compatible. Also look into the blog post about yoga- you may find some of the positions you have been using are not particularly great for prolapse.

This prolapse thing is amazingly small once you get it under control- sounds like the pain you are feeling comes from a wonky alignment in your pelvis and possibly scar tissue and adhesions. Start working on these things and you may find you get great relief.

I'll probably not come even close to answering what you want answered, but your post compelled me to write something. I too had wondered, why me? I was a professional ballerina for over a decade, and ballet is touted as a prolapse helpmate! I did Bikram yoga three times a week and twice on Sundays. I grew up on brown rice and fresh produce. While other families went to the movies on the weekend, mine did 6 mile Volksmarches (set course walks). I had an extremely gentle home water birth with but a small 2nd degree perineal tear. And I have a cystocele! What the H***? My best guess is that yoga and occasionally ballet promotes the tucked tum 'n' bum that in turn promotes prolapse. In my case, a little of that over many, many years along with the high impact nature of ballet performance may have set me up. Enough drops of water on rock, and eventually the rock yields. Who knows? I'm trying to move past the why and onto the how (how to feel better).

As far as this work goes, I don't think it is a "some" kind of thing in order to see results. (that may not be what you meant, but I'll throw my humble opinion in anyhow :-) I think it has to be thoroughly incorporated into one's life. It is body sculpting, and like any other form of this, it takes a lot of hard work and dedication. Think of weight lifting -- it takes a lot of workouts to get one to where one could compete in a bodybuilding competition! Or, as you know from yoga, it takes months, if not years, of daily dedicated practice in order to reach the advanced versions of the postures. (again, this may not apply to you and you may be already totally immersed in WW posture and exercises. I just know that this viewpoint has helped wrap my dancer's mind around adopting this work). Can you see yourself being able to try this for a year? It just may be the good option you are looking for. Read some old posts on here -- specifically those by alemama, louiseds, and granolamom. They all feel normal and empowered. It IS distressing, this situation. I know. We all know. So many of your worries and feelings are our worries and feelings. You are not alone. And we are all here for you to "talk" to.

Best Wishes

Hi H

It sounds like you are feeling that everything you have worked towards is unravelling. No wonder you are feeling so very distressed.

The discovery and confirmation of POP is initially perceived as a very great loss in the life of a woman, whether she feels that she has done nothing to deserve this, or else she feels betrayed by the giving of her body to bear and birth her dear children and been rewarded with a permanent injury and debilitation.

I don't even know how long you have been reading these Forums. I can only reiterate what the other women have said about perservering with Wholewoman techniques until you can see what is possible, even if it is only fleetingly at first.

I do agree that it sounds like there are some other physical imbalances or maladjustments happening and it is important to address these, which may be exacerbating your POPs.

From the sounds of your letter to Christine, you are not in a good headspace at the moment, which is quite understandable. It is tempting to reach for the surgical quick fix which, as you have perceived, is not what it seems. To go for surgical repair now would be an act of impatient desperation, not a carefully balanced decision, based on rational eveluation.

You have only just started this work, from what I can gather, and will need time and effort on your part to move through this acute grief that you are feeling, and find your way as we all have, along the road that leads to true healing, with healing of underlying physical problems, improvement of POP symptoms, adjustment of your lifestyle and healing of your soul. None of us has a perfect body, but you don't need a perfect body to be the best person you can be. Nor do you need a perfect body to live the life that you want to live.

Please let us help you along the rocky path.

Cheers

Louise

HI H,

It is such a hard place to be in--we know! The why's, the what if's, the how do i live with this now and forever... But the good news if that you are amongst a group of women who are finding ways to move through this, emotionally and physically.
btw...I have to run in a sec as i need to go to work, but wanted to write quickly!

I too had symphesis pubis. Mine hasn't resolved 100%, but nothing like you describe. I agree with the others--there is something out of line, and an osteopath might really help. It kept me walking during pregnancy, and helped realign things after.

Re the healing...i've been amazed at the changes since starting christine's work. i'm sure some of it would have happened in that natural post partum state, but nothing like what i ahve experienced. i've just started the DVD and already feel things getting even better! i do have bad days, and the toilet thing is a pain--i completely sympathise. but i know how to manage it now, and if it is bad it's usually because i indulged on something i can no longer eat. when this started i could barely walk my POP's were so bad. now i play with the kids outside, go hike, climb through soft plays, and just started dancing again.

DVD--I'm in the UK but our DVD plays any DVD.
Please feel free to email me if you want ideas on seeing if yours can (click on my name and it lets you email me).

gotta run now but please stick around here--and have faith, a lot can change...
Kiki

'This prolapse thing is amazingly small once you get it under control' Hhhhm bring it on alemama! It's a continuing comfort to read of all you superfit woman who have also come to this place. Helps me with the 'if onlyies' I tend to be vey obsessive anyway and hope to be able to shift my fanatical dedication to daily pracitce to the exercises Christine has identified as most helpful. Went to a traditional yoga class yesterday and it's definately not for me anymore. I'm in the UK too H and have sent for the DVD.
Sally

I had the pubic bone pain for a while after my son was born too. I went to pt and she told me to push my hips together with my hands to help get it to go back together. It actually did help a lot with the pain too. For me, the pain went away completely. I can't remember how long it actually lasted, but it did go away. And, I nursed my son for a long time too. For me, the prolapse yuck feeling is not noticeable anymore. My only problem right now is stool getting stuck. But, I have cut dairy out and am finding it so much easier. (still annoying though!)

Christine,

You did not betray my privacy I have just been in a very dark place and felt I had to stop surfing the net trying to find a solution to fix me. I really appreciate some of the responses I have had and will reply to them. I have come to realise that I have two options either surgery and a hysterectomy and suffer the possible consequences - also how will I look after two children if I can never lift my son again, he is only 17 months old, or trying to deal with this holistically. I want to be the person I was before and don't know how to come to terms with the fact that I won't be ever again. I feel my body has totally failed me despite my best efforts to look after it properly. I feel unattractive, unfeminine and full of grief and anxiety. I can't remember the last time I had a decent nights sleep since all this began and am so depressed and upset.

I want to get out of this hole but I just don't know how, I have two beautiful children a lovely house and a good husband, I should be able to be happy and enjoy myself yet I'm totally pre-occupied with how I feel, i.e. that everything is going to fall out and I have some very uncomfortable vaginal pain. I used to be so physical and since my pregnancy with my son when I developed severe symphisis pubis pain at 8 weeks pregnant and pretty much ended up in a wheel chair and shuffling about my house I have not been the active person I feel I am. The pubic pain has diminished but I have had several really bad flare ups the last one leading me to where I am now. The physio therapist and osteopath who have been treating me feel that my prolapse has been hindering my recovery and so I went to see the gynaecologist. She then told me what I could feel was happening already, that my rectocele is moderate to severe and that my uterus is dropping and so is my bladder, the only positive thing in that is that at least I don't have any incontincence issues, more the difficulty with bowel movements.

I have yet to order your book and dvd but will do so and hope that it can give me some relief from my symptoms. I don't particularly mind having prolapses if they are not symptomatic but feeling the way I feel at the moment stops me from even wanting to stand up. I am on holiday with my family at the moment and my husband is trying to be supportive but doesn't understand why I am being so hopeless and don't want to be active with my children.

I am seeing the gynae again on my 37th birthday, oh joy, to be fitted with a pessary with the hope it can relive some of my symptoms and then maybe I can learn to live like this.

I was in that dark place too. this is grief. it is a process that cant be skipped over or rushed along, but you will come out the other side feeling a whole lot better than you do now.
I don't have much time now, but please know that you do not have to learn to live like this because it is very likely that once you get the book & dvd and start the program, things will begin to change.
I remember not wanting to stand up and feeling unable (uninterested) in being active with my family. and now, a few years later, I do anything I want to do. anything I used to do before I found the prolapse. I feel a bit bulgy occasionally, usually around ovulation or right before menstruation, but that's it for symptoms.

also, in my opinion, it is not the prolapse hindering the recovery from the symphisis pubis pain, but the other way around.

Hi H

Yeah, dark places are called dark places because they reduce what you can see. There are monsters hiding in every shadow, and you cannot find your way out. They prevent you from seeing reality as it is with the light on, rather than as a threatening, negative, hopeless, dark mess. However, you do sound a little more optimistic now.

That can only get better with knowledge as you learn more about what your body is doing, both POP and SP-wise. It is so hard when you feel that you *should* be feeling this or that, or doing this or that, or being a better wife and mother, when all about you are people, both big and little, who do not understand the dark place. *Should* is a useless word, isn't it? It just produces guilt and shame. OK, it does also stop us from doing things that are not good, but ...

Take Kiki and Mom30's words as true. They can be beacons in your darkness. Take baby steps. POP and SP may indeed be aggravating each other. Pain can do terrible things to a person's way of thinking. When you read the book you will understand better why and how WW posture works for POP, and I bet you will feel more confident of making some progress with the POP over the next few months.

Keep posting, and may your darkness lighten.

Louise

Thank you all you lovely ladies for your words of support. I have not got the second book yet (ordered it and hope it will be at home when I return from my holiday) although I did read the first one after my daughter was born, my prolapse didn't go away then but it never bothered me apart from embarassing vaginal wind when doing yoga and I think it was quite small compared to how it all feels now. However I used to wear a tampon and that helped. Now I can't wear a tampon as it is just too uncomfortable, feels like it is sticking into something - bowels maybe? I am finding the toileting thing very difficult to come to terms with, having been someone who goes regular as clock work without even thinking about it this is very distresssing and also to be able to feel what is in my bowel in my vagina is just horrid. My diet is good, I eat muesli for breakfast with grated apple and some juice over it- lots of salad etc. I do eat cheese occasionally and have cut out red meat. Tricky to do in Spain where I am now! I feel I need something to bulk my stools up a bit. Does anyone use physillium succesfully? I am worried about becoming reliant on methods to make me go.

My sp pain is not so bad at the moment. I have been doing some yoga and trying to do some massage around my c-section scar although physio did not seem to think that I have an adhesions that she can feel. Sp pain caused by the right side of my pelvis rotating forwards no matter all the work I have done to try and stabilise it it still happens. I saw a medical osteopath and they suggested that prolotherapy into sacro iliac joints might work also suggested a cortisone injection into the joint - I cancelled that appointment as I have deep seated mistrust of steroids.

Question I read somewhere on this site that bridge is not good posture to do but I seem to remember it being in Christine's first book as one of the exercises. Also what about warrior? I find this helps me relieve tension in the front of my hip flexors but will it aggravate my prolapses?

I guess I feel I have lost faith, I used to always believe in positive outcomes and think only the best can happen but the last two years have challenged me beyond belief. all this physical stuff having a new baby and losing my Dad phew I'm amazed I'm not a total basket case or severely depressed. So much grief to deal with in such a short space of time.

It's hard to balance out what you read on this site and what the gynae said, she seems to think I am worrying about nothing and when I asked her if she was me and would have the surgery she said yes she felt it would improve her quality of life and that the majority of women come out of it the other side very happy.

I had sex last night for the first time in ages, feel need to try and re-connect with my husband a bit. Is painful to lie on my back but okay if I am on top. I don't think he found it very satisifying though. Feels like I can barely feel anything so how must it be for him? Can the whole woman thing help this?

Sorry for such long post but feel I need to air my thoughts some how and this seems a safe place to do it.

H

Hi H

We are all on uncertain ground, including the most positive of us. Wholewoman techniques have only been developed over the last 12(?) years. I am 56, formally diagnosed about 4 1/2 years ago, and still having the occasional period. I have experienced some worsening of POP over the last 6 or so years, but I have learned how to minimise my symptoms, and now feel assured that I am doing the right thing. I have not had any worsening for the last two years.

I really do not know what will happen over the next 20 or 30 years, though I am hopeful that as long as I can physically maintain good posture, as long as I have some control over what I eat, so long as I am physically able to do appropriate, whole body exercise, as long as I can choose what I wear, as long as I can choose where and how I sit, stand and move, I will be able to maintain the lack of symptoms. I do not know whether bad posture causes hunching over that we see in elderly people, or whether the hunching over is a natural part of ageing that the person cannot do anything about. With hunching over, postural support of the pelvic organs is severerly compromised. I only know that I see very old people with good posture, and that the elderly are the same species as I am. Therefore I should be able to have good posture into my 80's and 90's too. But I am not sure of that. Only time and practice will tell.

Your gyno obviously has not experienced her pelvic organs descending. She has obviously also not thought about the possibility that the unlucky ones who suffer problems after repair surgery are really compromised. It is all very well saying that, eg 7 out of 10 women experience no problems. What about the other 3???? If I can manage it myself I don't have to worry about being one of the 3! She sounds pretty flippant to me, and has obviously not thought about the prospect of suffering from worsened problems toileting, sexual dysfunction and pain, nerve damage etc from a personal point of view. She is obviously not going to tell you about the risks and possible complications unless you ask her (that's if she knows!). To volunteer that information would demonstrate to you that life post-surgery is not necessarily the bed of roses she says it would be. Then she would have contradicted herself quite seriously, which would not do her professional cred any good!

You have used some pretty negative adjectives in describing your symptoms. I don't blame you for that. Some of POP is really confronting and can be pretty yukky. Having a body that would obey our every request would indeed be very pleasant, and much more convenient, but that is not the reality that you or I experience. Getting used to it, and developing your own personal ways of dealing with the realities of POP without recoiling in horror, seems to be the way to a happy life with POP.

Splinting with bowel movements is better than dealing with a colostomy bag. Using lubricant for sex and day to day is better than no sex at all. Having a positive attitude towards the acceptability and desirability of my body is better than choosing celibacy (so I don't have to share my lack of perfectness with a man). Well-fitted garments in quality fabrics which fall loose over my belly look and feel better than ill-fitting trousers made for a different body shape, that push my pelvic organs south. Whole foods with plenty of fibre are better for my whole body than a more refined diet. Sitting around eating chocolate and drinking sherry is more comfortable than getting out and using my body physically, but it aint doin' my body (my vehicle through this life) any good.

It is just matter of adjusting your *attitude*, so that you are more comfortable with your body, as much as manipulating what you do with your body to minimise POP symptoms. I think we can be a bit prudish about body functions. They are all natural. They are all good. We just have to manage them as friends, instead of enemies. This takes time and knowledge.

Re "Only the best can happen", I think you have just debunked one of life's great myths. Sorry to say it, but it is a myth. The worst sometimes does happen, but not very often. It is more the *fear* of the worst happening that upsets us. We see horrible things happening to others and hope it doesn't happen to us. Then we speak to these people and find that they have real spunk, and really positive attitudes to life. It really doesn't matter what happens to a person's body. It is ultimately their attitude and their adaptability that determines the quality of their life and their relationships.

Be gentle with yourself.

Cheers

Louise

Hi h
i've been so moved by your account. you've had a hell of a lot to deal with in addition to the challenges of living with a nasty rectocele (my post-partum problem too) and you're being hugely brave about it all - well done for holding on there.

I've started a reply to you on the emotional side of things but it got a bit long, so I thought I should spare the rest of the WW community my ramblings and email you off-line, which I will do shortly.

Meantime, though, I just wanted to say that like you I have always had a good diet (and regular as clockwork in the past) so I was a bit "where next to make this easier?"
but after a couple of months of experimenting post rectocele, I now find that bulking things out with physillium is key to having enough 'momentum' and volume to move things regularly. I take mine twice a day in the form of Fybogel drink (that's the UK brand, I think it's metucil in the US, and not sure what it is in spain). It's not exactly nice to drink but I'm used to it now. Warning: the first 2-3 weeks I was very windy lol, but that has really settled now. GP says it's safe to take regularly and doesn't make your gut/bowels lazy. I also have a tablespoon of soaked flax seeds on my porridge. not sure if that's helping but it's not making it worse. though is there any food less pleasant to eat than soaked flaxseed? It's like grit encased in frogspawn...

having read through some old posts, I gather a product called Fybresmart (from renewlife) is a good alternative so I'm going to try in due course. Incidentally, in hopes of mega-ease of BMs, I tried stool softener (lactulose) and magnesium tablets but found that I was getting too soft - almost diarrohea territory - to go. And diarrohea when you can't actually expel it really isn't fun.

Also, you might like to know you've been a bit of an inspiration to me that I should stop avoiding sex with my husband and get on with it. anything to 'normalise' this has got to be a good thing (also, I gather men can rarely feel any difference with prolapse even if we do - there's lots of old postings on this site about that)

wishing you lots of hope and improvement too!

Mumtogirls London

I grind my flax, pumpkin and sunflower seeds in a coffee grinder before mixing with my porrage. Takes away the frog-spawn-ness.
Sally

As mumstogirls posted, is also key for me. I also have had a healthy veg diet but now need a little more help to prevent any straining. I use the ground flax in cooked oatmeal and avoid most dairy, and use fiber daily. If I have yogurt or cheese I have it at lunch, that seems to work best for me, and a lot of water through the day.
I had eliminated coffee but some mornings it's just the help I need, and I use it medicinally now for its purgative effects. (It also has a spirit lifting side effect that I sometimes miss!)
Experimenting will help you find what works for you and your body. The food section here has some more helpful posts.
Best of luck-

Hey, watch out for the Fybogel in Spain. It is probably chilly flavoured. ;-)

You don't have to buy those expensive, processed forms. You can buy pure psyllium husks at health food stores, no sweeteners, no colourings etc, and put them in whatever food you want to. They will thicken any food you put them in. That's the gel absorbing and holding water, which is what it does in your gut. However you take it, you will need more water in your diet, otherwise it will just absorb what is in your other food. Nett result, zero.

Yay, here's to good coffee, in moderation.

Probably a mug of hot water would have the same effect if you really don't want caffeine or don't like coffee. Probably better actually, cos coffee is a diuretic. It causes the kidneys to excrete more water, and it will absorb it from anywhere it can to do this. This is why they serve iced water with coffee at good cafes. It makes you thirsty.

Cheers

Louise

Hello Ladies,

No chilly flavoured fibrogel no fibrogel at all so far but have found some fiber tablets and an enema kit is an enema kit so the pharmacist was able to understand me. Thankfully no little old spanish ladies or Giri's - the villagers here call us tourist that - to have to try and explain in front of.

I'm struggling with my mental state of mind. It's like my brain is stuck and keeps going round round and round, surgery all horrid risks, not surgery feel like my insides are falling out and I can't pooh. The net result of this is that I am in a high state of anxiety constantly and can't sleep. So I go to bed exhuasted and then the old record just keeps turning and I don't know how to stop it and at 2am I'm still awake I finally fall asleep and then wake up about six needing to go to toilet and then get anxious about that. This is not a good place to be - tiredness and anxiety exacerbate all symptoms but I just can't seem to turn my brain off. I know I need to give myself a break and try and accept where I am now until I calm down enough to see the way forward but how do you do it when you feel so wound up? My breathing practises don't seem to help and I have been trying to do a bit of yoga every day. My husband is getting upset at my being so upset and then I am distant and pre-occupied in the day because all I am aware of are my symptoms and obsessing about whether my womb has dropped any further.

Louise you are an inspiration and I need some of what you've got! Any ideas?

H

Hopefully you've gone back and re-read the posts in response to your original letter, as there's a lot of validation about the anxiety and despair you're experiencing. Sometimes the feelings can get the best of us, and especially at night when there are few distractions.
So here's my two cents- I've only been dealing with this a few weeks but I've had my share of rough nights. I use visualisation- on a raft, totally relaxed, sun on face, rocked by the waves, breathing. Think Shavasana. I tell myself things a good friend would say, like this feeling isn't going to last forever, this too shall pass. How great that you don't have a life-threatening illness like pancreatic or ovarian cancer, Parkinson's or MS. This doesn't change your ability to love or be loved.
Not to minimize this in any way but sometimes all I can come up with is how much worse a diagnosis I could have and that calms my brain. I started a corny gratefulness journal. I also send health and healing to my organs instead of fear and worry, and this stops the crazy out of control thinking.
And speaking of control, see how we all enjoyed giving advice about fiber? We have control over what we eat and see that it has an effect on our bodies. So many things out of our control and sometimes the little things I'm in control of make all the difference. Keep reading the posts here- much good advice an encouragement for just what you're going through. OK, just wanted you to have a response to your post.
Keep going- CL

Hi H

Sympathies. Not a good mental place to be. When I was caught in that high anxiety spiral I found writing things down really helped. Just stream of consciousness splurgng of whatever was in my head. I was quite strict with myself (or tried to be). 'No, you are not allowed to ruminate on (whatever) 24/7. You can write about it as often as you have to, hourly if necessary, but in between times you must leave it alone.' It helped me discipline and distract myself. Not a quick fix, if I could get peace of mind for literally a few seconds at a time I thought I was doing well. But the seconds gradually increased.

I still write when I feel I need it and am keeping a prolpase management diary at the moment. (You'll notice its done nothing for my spelling!) Pleased to say I am no longer in a state of high anxiety. Hang on in there.
Sally

Hi H
I've been thinking of you lots since seeing your post above - I hope you're feeling a bit brighter now.

I don't know if helps to know that seemingly all of us newbies - whatever our age, stage in this work, or cause of prolapse - are experiencing that kind of despair some, most or all of the time. I've emailed you offline, but meantime, TinyShinyThing's advice on trying to keep the 'worry time' to specified slots etc is good stuff I reckon. (I've also heard of this being recommended as part of cognitive behavioural therapy). Like TST, I'm also keeping a prolapse journal about symptoms, and to try and track what makes it worse and better (psychologically and emotionally). This weekend's annoying discovery is that my dad's famous prawn curry tastes great at the time but causes merry hell the next morning. I haven't broken it to him yet - it's his culinary magnum opus and it'll break his heart..!)

I just wondered, though, if you'd seen the post from Stella today ('words of hope' I think the title is)? She seems to have undergone a really impressive improvement despite her prolapse not being an immediate postpartum one (her youngest is 7yrs). Bit of encouragement for all of us in our long dark prolapse nights but perhaps especially because it can't be put down to early postpartum discovery.

With massive hugs

Mumtogirls London

Hi H

What I have got is probably what you have got, but I discovered my POPs at a time after I recovered from depression. Emotionally, during my depression, there were other things that kept me awake at night (now it is just menopause!) and kept me in a state of paralysing anxiety and inaction. The only difference between you and me is probably our ages. I probably have a bit more life experience to call on.

I finally realised that the way I was thinking was my main problem, not the horror of the world, or my difficult kids, nor my messy house or chaotic life, or unhappy married state.

Until I could unscramble my brain and get some reins onto it and tame it a bit I had no hope of moving past my then 'hopelessness' and anxiety. It was Cognitive Behaviour Therapy (CBT) that enabled me to debunk some of the statements I made about myself (mainly in my head). It also enabled me to make sense of the unsatisfactory interactions I had with people who were 'being difficult'. Once I started to understand my unrecognised emotions and hidden thoughts and where they came from, I was able to challenge them, and either affirm my reaction as being rational (which was a pat on the back for me) or debunk them as irrational reflections of previous situations which had no relevance in the current situation. (This is called Self-Monitoring. I still do it on an irregular, or as needs, basis. I think you really need to learn it with the help of a professional.) Eventually, after the same negative thoughts kept coming up, I just learned I could ignore them as irrational (because I could understand where they came from) and made friends with the rational thoughts.

BTW, it turned out that it wasn't always my fault when my interactions and relationships with others went wrong.

The other two important lessons I learned were:-

1 My response to any situation in my life is the *only thing in this world* that I have any control over.

2 My future is determined by *how I respond* to any situation, ie what comes next will be determined by the response I make in any situation.

3 (I think the concept of Worry Time is potentially quite useful, but as processing time only. I think it might only useful to me if I respond to it positively afterwards. Worry time should be programmed outside of sleeping hours!)

I was under the care of a psychiatrist at the time, and taking SSRI medication. I changed my medication at that point and have not looked back.

Circular thoughts after the lights are out, or at 3 in the morning, are a different thing altogether. I also suffered from sleeplessness in my teens, probably related to perimenarche, but also depression-related. I trained myself to simply cut these thoughts off, like when the late night TV test pattern used to go off and be replaced by a monotone sound and a blank black screen with a tiny white dot in the centre. Every time I become aware that the circular thought, or a different thought, tries to come back into my head I wilfully turn it off again and replacing it with a monotone and a black screen. I just keep turning it off until I wake up in the morning and realise that I did finally get off to sleep again using this technique. Using an imaginary, constant, single frequency sound and a blank screen to replace the circular thought seems to prevent my brain from actually processing any thoughts. It calms.

The rest of the POP healing stuff happens over a number of months and years, and it all starts with Baby Steps. You don't think you are getting anywhere. A baby just keeps practising, and learns new techniques, some of them consciously, some unconsciously. Eventually, perhaps 30 years later, she wins a marathon.

Periodically you realise that something has changed positively. There are setbacks. There is recovery from setbacks. There is a reduction in symptoms, but the really powerful healing happens in your brain when you realise how much is possible, and in your heart when you begin to trust your body again, and accept that a changed body is not necessarily the end of the world.

Now, it is over to you.

What tiny, baby step will you take first, today? It might be the decision to take your recovery and healing into your own hands, and be responsible for your own healing? It might be the decision to stop *a single circular thought* tonight if you wake in the middle of the night? It might be seeking out professional help for depression treatment? It might be telling your husband how much you are suffering and how much you want to get better?

Cheers

Louise