There is an historic building on the Atlantic coastline of Florida in Martin County known as the House of Refuge. Built in 1876, the purpose of this home was to rescue sailors who were lucky enough to live through being washed ashore from shipwrecks. One Keeper stayed in the House of Refuge and his job was to look out upon a watchtower for sailors who had survived storms at sea. The Keeper also walked for miles in the hot sand after a storm and took a wheelbarrow, so that any sailor found could be transported back to the House of Refuge. The sailor would then be fed, clothed and provided with rest while recovering from a storm at sea.
How the House of Refuge is related to pelvic floor dysfunction:
There were once a dozen such Houses of Refuge and the one in Florida is the only one left in existence. In visiting it, I was reminded of some parallels between what the house and Keeper provided for the weary ocean sailors and how this relates to having pelvic floor dysfunction. You see, I am a pelvic floor physical therapist who has had pelvic floor dysfunction, and I also treat such conditions in patients. The pelvic floor muscles are located in the saddle region of the body. They control the activities of peeing, bowel movements, and sexual function. Any change in your pelvic floor muscles, however seemingly slight, can alter these very necessary bodily functions and cause a great deal of distress to individuals who experience such problems. So why, you may be asking, is the story about an old house by the sea analogous to having pelvic floor dysfunction in today's world?
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Having pelvic floor dysfunction is isolating:
The Keeper of the House of Refuge was alone for months at a time, with his only other human contact being a shipwrecked sailor who needed to be nursed back to health. Loneliness can worsen symptoms of pain and deepen depression. For people living with pelvic floor dysfunction today, the sense of loneliness and isolation can be profound. When something is happening to your urinary stream, or you have pain with bowel movements or sex, it is common to feel alone. It is harder to discuss pelvic floor dysfunction with your friends and family than it is to talk about an upcoming rotator cuff repair of the shoulder. Dealing with urinary or bowel issues can also confine a person to their home where proximity to a bathroom is often essential. Being a Keeper of the House of Refuge in 1876 must have felt very similar to living within the hollow silence of pelvic floor dysfunction.
Having pelvic floor dysfunction leads to hypervigilance:
The Keeper of the House of Refuge climbed up onto the watchtower to look out at sea after a storm, eyes scanning the horizon for another human being. The Keeper also walked the beach up to 20 miles in search of shipwrecked sailors. A person with pelvic floor dysfunction will also feel on high alert for the next symptom or problem that must be managed. Someone with chronic constipation may develop secondary urinary incontinence, and it is troubling when the problem of one system (in this case a bowel disorder), can then impact another bodily system (the genitourinary system). Hypervigilance becomes the norm with pelvic floor dysfunction, and this peaks nervous system activity and anxiety. Like the Keeper of the house who must stay on watch, those with pelvic floor dysfunction can feel on high alert at all times.
Having pelvic floor dysfunction requires self-rescue:
While the job of the Keeper of the House of Refuge was to save shipwrecked sailors, the task of a person with pelvic floor dysfunction is to save themselves. I find it helpful to imagine that your Keeper is your soul observing all that you endure in this world. The Keeper must look out for the sailor tossed about at sea. The shipwrecked sailor is the bodily shell of the person with pelvic floor dysfunction: dehydrated, struggling to stay afloat, unable to swim to shore, bone tired, weary and wondering if he or she will ever return to safety again.
The role of the Keeper in the rescue:
When you are in the throes of a flare-up of pelvic floor dysfunction, you might feel lost at sea. You may wonder if help will ever come, and you might even give up on ever getting rescued. In times of a pelvic flare, you are a shipwrecked sailor, and you may feel as though you are completely alone. But this is where the Keeper steps up to care for the sailor. The Keeper within you is your higher self. The Keeper looks out on the horizon after the storm and walks the beach, ready to collect the weakened body of the sailor who has lived through something catastrophic.
Finding compassion for your inner sailor:
Any person with a chronic health condition can attest to a certain level of self-blame when it comes to how we talk to ourselves. It becomes so easy to succumb to saying really nasty things about how we have arrived in the broken state we feel trapped within. We rail against the world and our own bodies for perceived failure and our inability to escape the situation depletes us even further.
Instead of feeling angry with ourselves for having been caught in a storm at sea, what if we gave ourselves compassion for our very difficult journeys? Rather than choking on salt water and flailing our arms in frustration, what if we took care of ourselves like one should a shipwrecked sailor, one who needs nourishing food and attention and deep rest? Lastly, what if we bathed the sailor with kindness, much as a Keeper would do after lifting the skinny limbs of the sailor out of the ocean?
Returning to peace and safety on land:
Because I have had pelvic floor dysfunction and now help others to overcome it, I found new appreciation for the House of Refuge. The Keeper’s job was to rescue complete strangers and bring them back to good health. The sailor’s job was to relinquish control and allow themselves to be healed within the safety of this house by the sea. Our job as people with pelvic floor dysfunction is to rescue the beleaguered sailor when he or she needs rescuing, to get in touch with the Keeper who will climb that watchtower as the storms tear through the ocean, and to unite both of these identities to heal. We can rescue ourselves and find our own House of Refuge.
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