Why Your Nervous System Is Not Overreacting, It's Doing Exactly What It Learned To Do

If you have ever been told that your pain is psychological or that stress is making it worse, like that should be simple to fix, this episode offers a more honest and useful explanation of what is actually happening.

The nervous system and chronic pain are not separate conversations. They are the same one.

What Happens in the Body When You Feel Dismissed

Sheren Gaulbert explains the neurobiology in a way that is both accessible and genuinely clarifying. When the threat response fires (whether that threat is physical pain, an invalidating clinical appointment, or simply the anticipation of a difficult situation) adrenaline and cortisol flood the system. These are inflammatory biochemicals. And the first place the body responds is the pelvic floor.

"As soon as adrenaline hits the system, the pelvic floor muscles are the first to tense up, followed by the jaw. This is not great for pelvic pain." ~ Sheren Gaulbert

Now think about what happens across a ten-year period of being dismissed by clinicians. Of attending appointments where your pain is minimised, misattributed or met with a standard protocol that doesn't fit your experience. Each of those moments adds to the load. More adrenaline. More tension. Less serotonin and oxytocin, the biochemicals that actually help.

Chronic pelvic pain and mental health are inseparable here, not because pain is "in the mind," but because mind and body are running the same operating system.

The Prediction Problem

One of the most practically useful parts of this episode is the exploration of how the brain predicts pain before it arrives. Based on everything it has learned from past experience, the nervous system builds a picture of what a situation is likely to feel like. It does this automatically, unconsciously, and with impressive efficiency.

The problem is that for someone with a long history of pain, that picture tends to be accurate in the worst possible direction.

Sheren uses seating as an example, something most people never think about. For someone with endometriosis or vulvodynia, walking past a row of restaurants and clocking that the chairs are metal is not a small thing. It's a split-second threat assessment. And before anyone has even sat down, the adrenaline has already started, the pelvic floor has already responded, and the pain experience is already being shaped.

"If we're already predicting that this may not go very well, then we've got that adrenaline, we've got the tension there already." ~ Sheren Gaulbert

This is not catastrophising. This is the nervous system doing its job based on genuinely painful past experience. Understanding that distinction matters, both for the people living with it and for the clinicians trying to support them.

Why Words Do Physical Damage

Something Sheren names that doesn't get nearly enough attention is the measurable harm that can be done by a clinician's words. Being told "this is your life now" by someone you're consulting in a position of expertise doesn't just feel bad. It strengthens the neural pathway that perpetuates pain. It adds to the threat response. It makes the whole thing harder to shift.

The nervous system and chronic pain exist in a loop. The good news (and this episode makes a genuinely compelling case for it) is that the loop can be interrupted. But that requires understanding what's actually driving it, not just treating the symptom in isolation.

Listen to the full episode with Sheren Gaulbert and Carla Cressey to understand how that interruption works and what becomes possible when it does.

Resources and research discussed here