How are you doing now, OP?
I just wanted to chime in because I went through something very, very similar. I think it might be interesting for you to read my story.
I have created an account specifically for this purpose because I've been where you are.
Sorry this is such an enormous post; skip to the part where I start putting stuff in bold font if you don't wanna read it all. That's when I do the combat-stare and get real serious.
In 2011 (I was about 30) I also developed an anal wound (probably a hemorrhoid or some kind of small fissure) of some kind: I woke up with a grueling rectal pain that worried me to shreds. I got some cream, and was told to just sit (..) it out.
I did not deal with this medical situation well at all: I became completely obsessed by it. It started to eat me instantly. Almost without any distraction I was thinking about, worrying about, or googling about my malady. Weeks later the pain had still not subsided, although the fissure was already confirmed completely healed by doctors.
A month later I was still ball and shackle with my pain, my discomfort and pain sitting and lying down, the rectal pain, rectal fullness, tailbone pain, pain in the perineum, under the ballsack, lower back, etc. Pain was my jailer. It kept me jailed while it taught me extensively about pelvic anatomy. It was a terrible school.
My days consisted mostly of trying to describe what I was feeling (is it pain, is it tension, is it hypertonicity?), where exactly the pain was hanging out at that moment, and how bad it was on a scale to 10 (usually really close to 10).
This ignited a series of visits to an army of medical professionals, I'm not gonna name them all but trust me, you name it I've done it. And, you know it's coming... they all declared me 100% healthy. There was nothing wrong with me.
(One doctor actually had the wits to diagnose me with pelvic tension but that didn't help much, more about that at the end of my post.)
It felt like my life had made a drastic turn for the worse. I was now a diseased man, imprisoned by a mysterious malady. The pain was only absent right after I woke up. From there it would build. Unfortunately, since we do it so often, pooping really propelled things into orbit and was a fast way to drive the pain up to overwhelming levels and it would hang out with me all day, except when I was moving around. I oddly usually only felt this pain when I was sitting or laying down, but I've come to find it manifests differently for everyone. But in the end it's all the same thing.
Booze or downers took care of it really well too, and believe me that I've done my fair share of it to mitigate the panic and desperation that was bestowed upon me by this terrible syndrome. Next day it'd be worse, though.
Fast forward, I hope I'm not hijacking your thread TOO much with my personal misadventures but I have a point to make so bear with me, 2 years: I met my now wife while travelling and I had a pain free month for the first time. But only until the moment that I realized that I had been painfree for a month: the pain woke up and came back immediately.
Fast foward another 2 years, with the pain slightly waxing and waning during those years, but being there 80% of the time, through one of my extensive googling bonanza's, I discovered TMS and this .. kind of.. made things click for me. It wasn't a big a-ha moment but I had already intuitively felt that the only way to alleviate symptoms was to ignore them completely, to live with them, to let go, but this was EXTREMELY hard and my mind was constantly fighting back and trying to tell me there was something 'else' going on.
The urge to intellectualize and medicalize my pain was unbelievably strong. My obsession with this pain was some sort of twisted addiction.
So, I was still ball & shackle a lot of the time, but after investigating TMS back in 2015 things changed.
I am now 10 years past my initial medical 'event' (like you had), and the past years my symptoms were pretty much gone for 95%, bare a few short flareups here and there that luckily never really managed to imprison or obsess me. (What did happen is that I developed other replacement pain (abdominal, dental, knee, all that good stuff)).
I've just had a bad flare-up in the ol' pelvic/rectal area that mimics the pain I felt in 2011 after my fissure. This flare-up, the past few days, made me remember all of the extensive reading I had already done on TMS in 2015, and FORGOT about.
That's right, I think learning about the mindbody connection that created my pelvic pain made me succesfully forget about it all together, even including my self-diagnosis of TMS. I'm not sure that was Sarno's point all along, probably not, but I honestly didn't know I already owned books about it. I now have Sarno's book twice. (And I'm not a typically forgetful person or having a benzo habit or something.)
This flare-up was triggered by a stressful period (sure seems you've had your share this year, I'm so sorry about it) and.. accidentally opening my 10 year old diaries on a google drive where I logged and rated my pelvic pain in a meticulously formatted excel-document. Boom, pain back.
To me, this is all the proof I need that this pain is conditioning, that this pain is TMS.
It is ridiculous that I'm feeling the EXACT pain of this hemorrhoid or fissure from july 2011, all the way in august 2021. It has actually genuinely made me laugh how absurd it is.
Today I've been brushing up a lot on Ozanich's book and other TMS related texts and the pain that has been plaguing me for 2 weeks now has already gone from an 8 to a 2 or 3, in just 1 day. Who knows it'll be a 9 again later tonight, but I know enough.
The past 2 weeks I've fallen victim to all my old mistakes of 'medicalization'. Overzealous stretching, thinking about getting back in touch for treatment by pelvic PT's, electric massagers, heatpads, coldpads, general mental obsessing, feeling like I could not enjoy life until this pain was gone.
I was already daydreaming about anal probes providing bio-feedback readouts on fancy equipment. Maybe I could sign up for some pelvic camp somewhere, and think and talk about it and have it investigated for 4 days straight (those exist!). I was physically and mentally bracing again, everytime I got ready to sit on a chair or couch: my mind-body succesfully rekindled my fear of sitting, exactly as it has done for 10 years.
For my mind, giving in to pelvic pain is like learning how to ride a bike: it has learned how to do it and will get back to it effortlessly, no matter how long the pauses in between.
It seems you have a clean bill of health from your doctor so finally here's my take, do with it what you want:
In my opinion, and I get no pleasure out of saying there's 10 years of experience to base that opinion on, every thought or action spent on this pelvic pain garbage is one too much. This harshness is not directed at the sufferer of course, but at this terrible syndrome itself. It's BS, forget about it. There's nothing wrong with you.
Please, don't be me, don't obsess over rectal pain on and off for 10 years. That's a hell of a lot of time I've spent thinking my life was over or at least in shambles, that I could have spent on something fun.
The only periods that I didn't have any pain was when I arrived at rock bottom and miserably accepted that my life from now on was to suck and I was going to have painful spasms sitting and lying down forever. Looking back, taking that defeat always led into symptom-free phases. Because it is TMS.
I'm absolutely not an expert on TMS so I can not speak to the do's and don'ts of combining TMS with PT and stretching from a theoretical perspective, but intuivitely I'm feeling a very strong No.
PT's mean well (even the ones that stick needles up your ass, I've had them do it, I've been known to really brag about those sessions during get-togethers) but the problem is that they will keep reinforcing your thoughts about your symptoms, thus keeping the tension alive. Even if it temporarily helps.
I guess stretching might be fine but don't do it to fix the pain. Do it because it feels nice to have stretched limbs. And because it might help you to move around more smoothly.
"A headache in the pelvis" is a well thought out and elaborate book, I've read it twice, but it won't take your mind off of your pelvis unless you become ninja-like at the paradoxical relaxation and meditation part. The sheer amount of information kind of frightened me to be honest and definitely did not make me feel un-sicker.
Also something about them selling their 'home treatment program' including a kindle tablet (?) for $3250 doesn't sit right with me and to me fits right in with the claims made in Ozanich' book about medical professionals having a horse in this race: mon$y, and feeding you the conviction that you need them to get rid of your chronic pain.
The only healthy place for anyone to go vent or learn about this condition going through this, imo, is in TMS based literature or a TMS forum. Skip the support groups and ignore the good doctors that hide out on a website called Reddit all day.
For me, all of this stuff keeps the vicious circle alive.
These are just my thoughts and I hope they resonate with you. I sure as hell wished someone would have told me this back in 2011 when I developed my symptoms. I could have started to break the horse that is this syndrome way earlier.
I'm no longer fearful of the pain and everytime I feel & dismiss it, I see it as a victory over it and a step towards healing and breaking it.
If we are sure there's nothing else that is causing this, just trust that it's TMS. What do you have to lose? You're in pain anyway. Go for it 100% and you will heal.
All the best.