How To Reduce Nervous System Windup

With the now clear understanding that IC/BPS is not a bladder disease but rather a chronic pelvic pain condition (AUA 2022 IC/BPS Guidelines), treatment has expanded beyond the bladder to the nervous system and reducing the chronic “fight or flight” which has been found in patients struggling with multiple pain conditions. What can we do to calm our nervous system and break out of “fight or flight”? We encourage you to participate in classes and/or courses in your community and, ideally, to work with a therapist who specializes in anxiety and stress management. Here are some techniques that you can do at home.


Developed by Scott Musgrave, Reflexercise® can calm the vagal nerve response. It’s simple to do and basically reminds your body, through its position, to leave the fight or flight response. When standing:

  1. Curl your toes into the ground, as if you are gripping the surface. You are not running away, you are anchored to the ground.
  2. Open your arms to the side, with palms facing forward. Your hands are not clenched, but relaxed and open. The front of your body is open and receptive, not hunched over or hidden by your arms
  3. Turn your head from one side to the other, gently loosening your neck.
  4. Close your eyes.
  5. Put your tongue between your teeth.
  6. Take three deep breaths and, at the end, think about something that you love.

The Power Pose

Remind your body what it feels like to be in control. Amy Cuddy gave a fabulous TED talk about how body posture influences your attitude, brain and nervous system. Stand tall, legs spread, chin up and with your arms on your hips. (i.e. the wonder woman pose) Make yourself big. Hold the position for two minutes. This position increases testosterone (and courage), while decreasing cortisol. It can help reverse adrenal fatigue and will increase your sense of confidence. Even if you’d don’t feel powerful, fake it. Anytime you have to walk into a situation where you might feel powerless, do a power pose before hand.

Diaphragmatic breathing

Taking a minute or two to take some deep, diaphragmatic (belly) breaths will calm the nervous system. The exhalation should be longer than the inhalation. Better yet, sing along to the radio or your favorite song. Singing encourages slowing down the breath and increases your exhalation on.


Lay on the floor and put your legs on a couch or wall. This creates a nice increase of blood flow to the brain and lymphatic system which can also improve anxiety and depression if held for 15 minutes a day. You must make sure that it is ok with your doctor to this, particularly if you struggle with blood pressure issues.

Healing the Nervous System

When a physician suggests that a patient get “therapy”, it’s infuriating to the patient. Of course, any suggestion that implies that our pain is the result of mental illness is met with anger, fear, frustration and, in some cases, rage. The problem is that they don’t tell you why it’s important. Programs that can calm the nervous system and ease anxiety can and will help with pain processing. They aren’t suggesting that you are mentally ill. They are suggesting something which has been proven to help calm the nervous system.

Emotional Freedom Technique (Tapping)

Dr. Milspaw swears by the use of EFT, a form of psychological acu- pressure that actually helps turn off the amygdala and stress response. EFT uses fingertip tapping at meridian points (energy hot spots) to balance energy by sending signals to the part of the brain that controls stress. It can and should be used when you are feeling anxious, stressed or would like to address a specific issue. It has been studied with veterans struggling with PTSD and within one month, these patients had significantly reduced their stress and some no longer struggled with PTSD.

EFT should be used on one problem at a time.

Step 1: Identify the issue. What pain or fear would you like to work on. This will be your focus while your tapping. (i.e. I have bladder and pelvic pain).

Step 2: Rate your initial fear on a scale of one to ten, with ten being the most difficult. If, at the end of tapping, your fear intensity has dropped to a 5, that’s a 50% improvement.

Step 3: Pick a phrase that explains what you are trying to address and that you accept yourself despite the problem. “Even though I have bladder pain, I deeply and com- pletely accept myself.”

Step 4: Tap each meridian point seven times as you repeat your statement. As you tap on the meridien, it signals a signal to the amygdala to turn itself off.

  • Start at the karate chop point on the side of your hand. Tap 7 times, while repeating your phrase. You can do one or both hands. Repeat this sequence three times.
  • Move to your eyebrows, just where the hair begins above your nose. Tap 5 to 7 times and say “Even though