Episode Synopsis

In this episode I interview Dr. Rebecca Patton of Patton Pelvic Health. We dive into reconnecting to the body after physical trauma with curiosity, common things she sees in the body after someone experiences trauma and how physical therapy helps a clients' sexual health journey as they heal from trauma. In this conversation, there are so many cross overs from the mental health world and the physical health world, which highlights the need for holistic care. Join us as we talk about how it all intersects and how this path to healing can help.

Guest Bio

Dr. Rebecca Patton is a pelvic physical therapist supporting patients of all genders and identities with a trauma-informed and inclusive approach. After working several years in a rushed and protocol-based healthcare system, she observed care that was not prioritizing individuals and contributing to traumatic healthcare experiences. She recognized that there was an opportunity and need for better care that was personalized, safe, and healing. So she started Patton Pelvic Health with a vision and mission to bring that personalized and safe care to life. She strives to de-stigmatize sexual health and pelvic health concerns across the gender and sexual identity spectrum and believes everyone should have the chance to feel secure in managing their bowel and bladder health and have pain-free sex. She is passionate about creating a space to empower patients in their medical care and when working with her you can expect a warm, calm, and open space where your concerns will be heard. 

Timestamps

[01:48] - Intro

[02:50] - Getting to Know the Provider

[13:45] - Topic of the Week: Reconnecting to the Body After Trauma

[49:14] - Providers Aren't Robots

[56:38] - Trauma Tip of the Week

[59:43] - Final Fast Five

[67:10] - Container and Calm State Change Exercises

Topics Covered in this Episode

• Physical symptoms of trauma
• Importance of addressing breathing and muscle guarding
• Assessment of muscle guarding in different areas of the body
• Recognizing trauma responses in patients
• Importance of listening to the body's signals and prioritizing patient comfort
• Understanding pain that moves around the body
• Trauma Tips
• Importance of body awareness in sexual health
• Effective use of pelvic floor physical therapy to reconnect with the body
• Pelvic pain and how the Rebecca's practice helps people find treatment
• The container and calm state change place exercises

Relevant links mentioned

Rebecca's Instagram and Handle

https://www.instagram.com/drpatton_pelvicpt/

@drpatton_pelvicpt

Rebecca's Website

https://www.pattonpelvichealth.com/

Find a Pelvic Rehab Practitioner Near You

https://pelvicrehab.com/

or

https://pelvicguru.com/directory/

Connect for a consultation

https://soulmission-emdrtherapy.com/contact

Sign up for our Newsletter and get your Trauma Informed Mindfulness Workbook

https://soulmission-emdrtherapy.com/podcast

Leave us a review on PodChaser.com

https://www.podchaser.com/podcasts/moving-out-of-trauma-5172742

Kandace's Instagram

https://www.instagram.com/soulmission_emdrtherapy/

Kandace's Facebook

https://www.facebook.com/soulmissionmentalhealthandyoga

Join Us Next Time

Join us in two weeks for a conversation about how writing circles can facilitate healing for sexual abuse survivors as I talk with Kaite Tiffany, LPC here in Arizona!

Hello and welcome to Moving Out of Trauma, a podcast made to support trauma survivors with actionable steps and resources so they can start moving out of trauma and into the life that they're craving. I'm the host, Candace Leader, gerber, EMDR, therapist, yoga teacher, first time mom and dog enthusiast here in Phoenix, Arizona. And I am so excited about today's episode with Rebecca Patton. She is a pelvic physical therapist supporting patients of all genders and identities with a traumainformed and inclusive approach, working to destigmatize sexual health and pelvic health concerns across the gender and sexual identity spectrum. But before we dive into today's episode of Moving Out of Trauma, I want to give you a reminder that if you're looking to practice more mindfulness and incorporate grounding skills in your daily life while also getting monthly updates about new content, head over to Soulmissionemdrtherapy.com podcast to sign up for our newsletter. You'll get a free workbook there with actionable steps you can use today with a traumainformed lens to feel more grounded and more present in life. Again, that link is Soulmissionemdrtherapy.com Podcast, and that link will be in the show. Notes let's get started with Rebecca. This is a quick disclaimer that this podcast is meant to educate and inspire and is not a replacement for therapy. It does not constitute therapy services, advice or guidance in the form of therapy or medical help to treat any condition. So please consult a therapist, your physician, or use the resources we provide in the episodes to find a provider near you.

All right, so I'm so excited to have Rebecca here on Moving Out of Trauma today. And Rebecca is a pelvic floor therapist supporting patients of all genders and identities with trauma informed approach. And we're going to talk a little bit about the pelvic floor today, just reconnecting to the body after physical trauma and all these other wonderful pieces. So. Hello, Rebecca.

Hello, Candace.

Welcome.

How's it going?

It is good. I'm excited to dive into this topic and just hear all of the wisdom and the great stuff that you offer from your field because obviously, coming from a therapist perspective, it's very different. And so I'm just excited to learn today and give learning and wisdom to others. So, yeah, let's dive in.

I'm very excited I could talk about this topic and anything with the pelvis pretty much all day.

That's awesome. That's how you know it's a good provider, right? They're passionate about their work. Love it. All right, cool. So I'd like to start with this section of the show as getting to know you as a provider. And so I heard this quote, and I wish I could find who it was from, but I couldn't find it. And it was just an anonymous quote. So the quote was, knowing a person is like music. What attracts us to them is their melody, and as we get to know them, we learn their lyrics. And so I really fell in love with that. And I just want to kind of learn a little bit more about you as a provider and just get to know a little bit more of your music.

I love that quote.

So beautiful, right? Yeah. So the first question I have is just asking why are you passionate about this work?

So many reasons, but I think the most obvious one now to me is like, everyone has a pelvic floor. I've never met anyone without one. I've never met anyone that doesn't poop and pee in some way, even if it's modified or is not the average way that everyone else does. So managing those symptoms, sexual health gets really and then the last thing that pelvic floor physical therapy really talks about is sexual health. And sexual health gets left out of the health conversation more times than not. And I don't think providers are really trained, even generally screening questions, but then resources and referrals and patients don't feel like they have space within their health care to talk about that. Like it's an extra.

Right.

And it's actually very integral to who we are and how we see ourselves, how we connect with other people. And we have a very narrow, limited view of what sex is. And so when it doesn't look like we expect it to or it has how it has in the past for us, then we think something's wrong, something's broken, and it's unfixable. And there's really not many people that you're comfortable talking about that with. So those are my reasons for really saying this applies to so many people and so many people also don't want to talk about any of these things.

Yeah, absolutely. So I'm going to ask this, and you can say we'll get to that later if it's something that's kind of like part of the piece that we'll talk about more of. But do you feel like it's because of the stigma around talking about it, like this discomfort that we have, or is there more to it in your experience?

I think it's layered just like any other topic where it's layered with race, it's layered with gender, it's layered with cultural expectations, it's layered with sexual orientation. And when you add in all of these additional notes of how people identify and who they are and what speaks to them as a person, they're all going to have different goals and they're going to have a different relationship with their body with all of these layers. And so I think there's so much more than just the stigmatization of it. It's health care providers too, not being educated and have being able to have these conversations. But the stigma is, of course, a big part.

Yeah. I almost feel like on the surface level, seeing that stigma is just like, oh, no. Almost like the taboo, I guess. Oh no, we don't talk about that kind of thing. But yeah, as you kind of got into more of that description of all of the different pieces that impact how we see that. And then on top of that, the providers that we're going to that oftentimes, we're like putting all of the trust and all of the stuff in their court aren't bringing up the conversation and maybe not even are very educated on the topic.

Yeah, definitely. I think in relation to sexual health, people don't know exactly what type of provider they're always looking for either. And I think along like a gender binary, CIS men tend to seek out medication and CIS women tend to seek out therapy. And what we know is that probably a combination of both or like really just letting people know all of their options is really important.

Yeah, absolutely. Yeah. I mean, information is power, right? Knowledge is power because then we can start making the right choices for ourselves.

Yeah, for sure.

Okay, cool. Anything else to add with that piece? That question?

Oh, no, that one's heavy. We could talk about that all day.

I know, it's such a good one. I love it.

The why.

I know the why behind it all. How does your personality show up in the room with your clients?

I think mostly I've changed as a clinician over the years. And one of the things that has been different is I have a lot of confidence in my knowledge and my expertise now. Whereas before I was trying to prove myself as like a younger clinician. So there was a lot of the energy of the way I feel like I had been trained or my perception of my education was prove to the client they need to do these exercises, make sure that they're compliant with their exercises. And I approach physical therapy a lot different now. One of those ways is just making sure that I'm asking the patient, hey, if I had you do this, does this feel realistic this week? Does it feel realistic to do this thing this often? And then there's not an expectation of compliance ever. There is an expectation of communication. So if this thing didn't work out for you, that's fine, but why didn't it work out? Let's figure out why it didn't work out. So either we navigate the barriers or we figure out that we're going to take away that thing for now and then maybe we add it back in later. But I think in the way that my personality shows up is really just giving people space to be a part of their care plan now and not letting myself be the dictator of the protocol anymore. That's beautiful.

Yeah. And I feel like that's not again something that we're really, I guess, taught maybe. I don't know if it's the right word, but as patients in a setting like that, we are kind of taught, I think at least maybe in this culture of like, you're the person with the power. I'm coming and you tell me what to do, I go home and maybe I do it.

But.

This position but really just being in that space with that person and meeting them where they are as the person they are, that's beautiful.

Yeah. And I think when people are having so much pain, they really do want answers and they sometimes want a protocol. And I'm happy saying, like, hey, this is the thing I have imagined for you, and here's how I hope it goes. And then also there's flexibility to change this plan.

That's beautiful. Yeah, I really enjoyed that. What is the top thing, number one thing you wish every single person in the world would know about? Pelvic floor therapy.

I was so excited for this question. Pelvic floor physical therapy is not only for pregnancy, it is not only for CIS women. Okay. Everyone deserves physical therapy during pregnancy, after pregnancy, not just like six weeks, which we don't have. And also, I see so many people outside of those categories. When we talk about pelvic floor dysfunction and we talk about pelvic pain, we're also talking about constipation, urinary issues, sexual health concerns. We're talking about chronic back pain, GI symptoms, IBS. We're talking about so many vast categories of things that it's weird. I think that pelvic floor kind of got like, cinched down to this niche.

Yeah.

My education, at least, I think that, again, things are changing slowly, but my education for the first few years only focused on CIS women, vulvas, vaginas, and that's really important. And also, we're missing a lot of people. Now, what I tell when I do lectures and I am talking to future healthcare professionals that want to get into pelvic floor physical therapy, I kind of say only treating these two things is kind of like saying that you're going to be a sports medicine specialist and you just treat patello femoral pain. Like, you just treat the pain in the kneecap. You just treat this one local knee pain, which is cool. It's great.

Yeah.

Right?

And there's so much more to it.

Yeah. And imagine if that's where you're limited to treat.

Yeah.

So much smaller than the actual population and the people that need things. Right?

Yeah. So I just like to share with people. You can specialize in anything and you can have your favorite thing to treat, and that is okay. And also know that you can get into this work and treat more than just that, too. That's awesome. Yeah.

I mean, speaking for myself, prior to, and I think I've told you this before, but prior to maybe a couple of months before I got pregnant, I learned about pelvic floor therapy. And I just thought it was for pregnant women. That's what I understood as like, this is the thing you do. And I didn't know anything beyond that. That was where my education stopped.

For a long time also. Same.

Yeah. All right, so let's dive into this topic today of physical trauma in the body and reconnecting to the body and sexual health and all of those wonderful pieces. Yeah. Where would you like to start in this juicy topic?

I liked your first question when you asked about the common things that you see in the body after trauma. There's so many things and there's so many ways and some are really easy and obvious and the other ones you pick up the longer that you've been treating people that have had these experiences. But the first thing that I see in the body is changes in breathing. Not being aware of when people are holding their breath throughout the day, holding their breath for really long periods of time and then feeling like they have to gasp for air changes. And this can kind of appear in the session as like changes in the fluidity of their speech, like needing to take big breaths or getting out of breath when they're talking. Of course this can happen for many reasons, not just trauma. So I just like to say breathing is a really integral part of our nervous system and our diaphragm. And the way that our diaphragm and our pelvic floor work together is going to be one of the foundational things that we work on first before we get to a bunch of other things. And so breathing is just an indicator for me of like that's somewhere we're starting pretty foundationally. Another thing I see in the body is muscle guarding. Muscle guarding, as in a muscle not being able to move flexibly through its full range of motion. And we can see this really easily in muscles that influence a very specific joint. For example, like our elbow. We know exactly when our elbow is not able to do what it needs to do because we can tell every day if it can't bend all the way, it can't straighten all the way. But unfortunately for our diaphragm, our pelvic floor, our abdominal muscles, it's less obvious when we're not using these muscles to the fullest length or range of motion or they're restricted because our body then gets just used to that restriction and just works around it. Rather than holding tension in the abdomen, sucking in their stomach all the time, back, not having as much range of motion, flexibility. The pelvic floor is tense, the jaw can be tense and then the inner thighs, like squeezing your legs together or clenching your butt. I mean, again, everybody is different. But just tuning into some of these things and assessing the muscles and the range of motion is a really, again, foundational piece of just getting someone to say like oh, I didn't even register that as guarding my muscle. Because we can't see a lot of these things, they're kind of in our core or inside of us and especially the pelvic floor, you have to go off of feeling and that's really hard.

Yeah, well, and I would imagine, too, when you're talking with people, but yeah, sometimes it's just kind of like a surprise of like, oh, I've been doing this for years. I didn't even know this was abnormal. This is just what my body does.

Yeah, definitely. I hear that a lot with the pelvic floor, and muscles can be tense and not painful. So I try to emphasize, like, not everything shows up as pain in our body, especially with the pelvic floor. Sometimes tension shows up as having to pee more often. Sometimes tension in your pelvic floor shows up as being constipated. Sometimes tension in your pelvic floor shows up as holding your breath. So there's a lot of these overlapping things. The good news is when we start to work on one muscle group and being aware of it, there's kind of this cascade effect of like, oh, now I notice this. Oh, now I notice this. Oh, now I notice this. So you don't have to be perfect at every single muscle. You just have to get the ball rolling and get started with connecting with your body. And then usually the body is like, cool, this is like some new information.

Breathe.

Like, what? I don't have to work so hard?

Yeah, sure. Well, yeah, I heard a lot of kind of mindfulness speak in that of allowing the body to just be and to be mindful of it and to just be in that. And the other thought that I had when you were explaining the back pain, the core pieces and what else the holding the breast piece almost echoed this fight, flight, or freeze mode of if we're in freeze mode, we're holding the things, we're holding our breath. We're pinching every single muscle we got so it can be completely frozen. And even with the rapid speech, I guess, could probably be fight or flight, but just this interesting parallel of our nervous system really showing up and just echoing the trauma.

Yes, there's a lot of overlap here with mental health therapists, and I got to be honest, I learned so much from mental health therapists that carry over into Pelvic. Health and that's helped me be a better practitioner rather than only looking to Pelvic. Health resources.

Yeah, because it encompasses the whole person that you're treating in front of you, rather than just kind of like what you're saying with that sports analogy, right, of like, you're only treating this one thing.

And then I have a couple more things that happen in the body. One is decreased interoception, and interoception is I'm sure most people are familiar in the mental health world, but the awareness of what is going on inside your body, and that is kind of like when are you hungry, when are you full? When are you thirsty, when are you cold, when are you hot? When do you have to pee? When do you have to poop? When is your bladder actually full? Versus when is your bladder irritated. And that is really hard and challenging piece of the puzzle to reconnect with. I had one patient in particular who had a long history of sexual trauma and got out of that situation and living her fantastic life mostly still kind of dissociated from her body. And as we started pelvic floor physical therapy, she really started to notice, oh, I have pain here, but in a way where she was like, oh, my body's talking to me again. This is really cool. Like, not pain and like, oh, that sucks. Kind of like pain and like, oh my goodness, I have a sensation. And her bladder, she would have to sit down on the toilet and just work so hard to pee and strain and push just to pee. And peeing should be really easy and just kind of like a let go. And she finally got this really strong bladder urge when she was driving on a trip, and she had not felt that in so long. And so unfortunately, she ended up peeing her pants. But she goes, But I felt my bladder.

Yeah.

So it kind of like the pendulum went from one direction of not talking at all to really loud screaming, which happens, and now we just have to get the pendulum a little bit more narrow and it's swinging. But that's really great to work with and recognize like, this is a step. But honestly, she was so excited to say this is a step in the right direction for me, and it is a step in the right direction for the body. But when you can know how to interpret things, even things that kind of suck to deal with in the moment, you can at least say, like, okay, I get why my body did that thing.

Yeah, absolutely. I feel like that same kind of theme happens in therapy, too, of this. No, I'm going to push it down. I'm going to push it down. I'm not in pain. I'm fine. Everything's fine. Right? And then once you start really pulling things up to the surface, then it's like, oh, wow, okay, I'm really not fine. And everything is screaming. And so hopefully trying again, balance that out and finding that stability and that grounding. But yeah, that's so cool for me as a therapist to hear. As our body echoes the things that are happening in the mind.

So much overlap yes. With emotion. I think there's so much overlap, too with the motions that we have to purge and let out and take out of the box with same thing with our body. And I think, unfortunately, just as people step into your office and start to talk about things they have really never talked about before, and that might open some of those boxes. When my patients step into pelvic floor and we do a pelvic exam, that's kind of like opening a box sometimes. And that box sometimes is really tough and difficult and sometimes we need to add in more people to the puzzle. Like going into therapy too.

Yeah, absolutely.

It reminds me of that analogy of cleaning the wound.

Right.

If you don't clean a wound, it's just going to fester and get icky. But we have to kind of go in and put the peroxide or put whatever on it to clean it so that way it can heal. And so this is the method of allowing the body and the mind and the soul and everything to the whole person to heal.

Yeah, absolutely. The last thing I had well, I kind of have two more, but that pain smudges or it moves. And what I see a lot when people are coming in after experiencing trauma or anything that's affected and sat in their physical body pain gets really confusing. And smudging is like when you might have like a local area of your body hurt initially, but then the nerves around that start to say, oh, we need to talk to or something isn't being addressed. So then the body kind of makes this spread out sensation. So instead of just maybe you have pain in your pelvic floor, it radiates to your tailbone and it radiates to your back and it radiates to your hips and then it gets louder and louder or I see pain that moves a whole bunch and people can't keep up with it. Like it goes from the left hip to the right hip to the back to the pubic bone to the abdomen and it's just jumping around and people are like, I can't know what this pain is. I can't expect it, I can't anticipate it. And I think when the nervous system is involved, it's a lot less tissue specific. It doesn't let us say, oh, here's your pain. Let me tap on it right here. Because the whole body is involved and the whole nervous system is involved, sometimes we just have to help the whole system first. And then as pain starts to become more steady and localized and informative, then we get to do more with that information.

Yeah, really. Again, like tapping into the whole body and helping the whole system. Yeah.

And then the last thing is you already alluded to this like fight, flight, freeze, fawn trauma responses. And the biggest one, I don't know. I think this experience is different for everybody, but as a practitioner, I think fight, Flight and freeze for me were the easiest to see and acknowledge when they were happening. Although I will say freeze. I think people think freezing is like also never talking or answering a question. And I will say that people in a freeze state can sometimes still answer questions. They're just kind of not really there and not really connected. So those are sometimes subtle things. But the fawning response is the one that I sometimes see as a pelvic practitioner that gives me the most caution. And what that fawning response can kind of look like is, well, you recognize the power dynamic. And sometimes a patient feels the need to say, yes, of course you can do a pelvic exam. Of course we're going to do this thing. And sometimes they're verbally saying something like, yes, and their body is saying, please stop, like their legs are clenching, their toes are curling, their butt is squeezed, they're not able to breathe and talk. And so sometimes I just take a moment to say, like, I hear you that you want to go farther and your body is giving us some different information. And I'm just going to default to listening to that for right now. Because if you feel great after this session, then we know that we have some room for flexibility. But if you feel really crappy leaving here and you have a pain flare up later, then we have to navigate that. And I'd rather you feel better than not.

Yeah, that gives me chills almost. Just this really, again, listening to the body and for someone that has been through trauma, I feel like so much of the time, trauma survivors are taught to suppress what their body needs. Suppress what they need. And so in that moment, even if the actual person in their conscious level can't recognize, okay, they're listening to me. Right. You're listening to the body and what the body needs in that moment and respecting it.

Right.

Like respecting the boundaries it's setting of saying like, yep, no, stop, please. Right. And honoring that. I think that's that's such a beautiful, beautiful connection.

Yeah. So those are the main things I see. And those are probably foundational things that in order to recognize them, then you get to say, okay, we're going to start here and then we can build on all of that. Perfect.

How you seen PT impact clients sexual health journey as they heal from trauma.

Yeah, we can go into that one too.

Yeah.

I will say that this is something that as a newer Pelvic PT years ago, I wasn't as good at navigating sexual health in the way that I am now. Pelvic floor therapy education does a really good job of teaching you about the pelvic floor muscles, teaching you about bowel and bladder, teaching about the musculoskeletal system of the hip and the back and the pelvis. But sexual health is extra education to navigate. And you have to do separate education from your pelvic health musculoskeletal things to really help people, I think, with sexual health in a way that is not just about your patient in that moment, but also how to get their partner involved or their partners involved or how to set them up for success, like, not just now, but in the future.

But the education for themselves so they can walk away with more information but how to operate within those realms and be able to advocate for themselves. It sounds like, yes.

So one of the things that I'm working towards is a sex counseling certification, of course. And it just is my way of trying. And sex counseling I want to specify is under my physical therapy license is an extension of it. So at Foundation, I'm still doing interventions and education for short term goals, but I am not a mental health provider. And I just think that distinction is really important because I use sex counseling as like, okay, this is a bridge, but we still probably might have to go to somebody who does more or does more mental health therapy. But hey, we have some things that we can work on in the short term that can give you some autonomy and some feeling of control again, but anyways, in the realm of physical therapy impacting clients sexual health journey, the first thing usually is like body awareness. It's like improving someone's awareness for how their breathing system coordinates their muscle range of motion and their flexibility. It's more difficult to train pelvic floor muscles and the diaphragm because they're inside of our body. And so feeling that thing move, you don't get to do by just looking at it throughout the day. You don't get to like the way you engage your quadricep muscle. You kick your knee out and you see that muscle right in front of you. Tighten. The pelvic floor is kind of tucked under there, under the pelvis. And it's so small. And getting people to say, oh, that's moving. Oh, I can control it, is so exciting. And that's one of my favorite pieces of the puzzle because if we can get over the hump of like, oh, I feel a muscle, it's moving. Oh my gosh. My diaphragm helps my pelvic floor move. The way I breathe helps my pelvic floor. It's like yeah.

So being in charge of what's happening in your body.

Yes, exactly.

That's so big.

That's a huge thing on a Foundational level, even imagining like, the way we treat a panic attack. Right. Like learning to recognize those signs of when you're in it and how your breathing coordinates with that is really similar to when my patient is having like a bladder spasm and a bladder urgency sensation of like, oh my gosh, I have to go to the bathroom right now. I call it like a bladder panic attack.

Yeah, no, well, recognizing again, I mean, I know I keep saying this, but the knowledge is power. And to have the body awareness and just the overall oh, gosh, what am I trying to say? Presence. The ability to be present in the body rather than, again, like that pushing off, like, no, we're not going to connect to that feeling. That's what I hear anyway. I don't know if there's something else there.

Yeah, I love that. Yeah. When we're talking about pain, pain takes up so much energy from our life. Thinking about pain, thinking how not to have. Pain that hyper vigilance I think you were alluding to earlier. And hyper vigilance and pain are just their best friends because people are constantly trying to be hyper vigilant about how to get themselves out of pain. And that just takes up so much energy. And so one of the things like when we start to improve muscle flexibility, breathing mechanics, that also helps with pain. It helps with that dial switch of pain. And so when people are in less pain, they get to spend their energy thinking about other things. And from physical therapy standpoint, when people get a relief and a break from feeling the intensity of pain that they do or the pain is less frequent, then they suddenly get a little bit of quality of life back. Oh, I get to go on a hike today. Oh, I get to walk my dog. Oh, I'm not afraid of picking this thing up.

Yeah, to be really fully present and just enjoying the life that's in front of them rather than being consumed by like this thing hurts, this stuff hurts.

What was it that I was just.

Thinking too, that you.

I hope it.

Comes back to me. It was something I wanted to ask you off of that and it flew away.

It'll come back pain and hang out with your kids, right? A lot of people want to be present and present parents and that's really challenging when you're thinking like I don't know if my kid can jump my back or I don't know if I can help them pick up play with their toys on the floor.

Yeah, that being present piece. Well, with that you had shared learning how to work that muscle, right? And that being a big part of autonomy and just figuring what that feels like here in the body the same way. And that at first when clients come in and I'm working with them, a lot of it is just working on being here in the moment. Because so much of what I see is like, I'm either in the past, right, and I'm like reliving all of this crap or I'm launched into the future and I'm like anxious AF and that kind of piece. And so really just learning how to dial that back and be in the present. And I'm curious if that's kind of what you see as you teach them how to re encounter their body and really be present and figure out this is what this muscle feels like and this is how that all intertwines. Because I know I saw your face light up of like I'm imagining what your clients must feel and their faces and expressions and the happiness behind just being present in their body. So I don't know, tell me a.

Little bit about that. Yeah, that is definitely something I encourage and I have to learn. Not everyone is at the same place and not to force be present because sometimes we just need to talk about something or someone wants to talk while we're working on body stuff. Even if I can get someone to notice one new thing, that's a pretty good session. And some people have sessions that are like, oh my gosh, I don't think I've spent that time with my body in so long. So there's a big variation of what someone gets out of any given session, which is why the length of treatment and just things vary so much with each person in plan of care. But I see what you're talking about a lot with focusing on a lot of things I see with pain and pelvic pain is, am I going to have this forever? Am I broken forever? Am I never going to have sex again with my partner? I don't even want to masturbate right now. I don't even want to have sex. Is that always going to be like that now? Right?

Yeah. When I hear too, what you're saying about kind of the balance of meeting that person where they are, of like, I do, or I don't want to talk about it, and I don't know if this was connected to that piece, but of just maybe giving that information to them, like, this isn't forever. There's hope in these pieces.

That's a lot of what people want to hear when they come in for pelvic pain. It's a terrible place in your body. First of all, to have pain. People have, I say, like, you are a resilient person, just what you've described to me. You've had knee pain before you've had ankle pain, and those weren't such a big deal for you. You navigated those really well. But our body responds to the pelvis much differently. Think about having pain in your genitals or being constipated all the time, or always feeling like your guts or like your stomach is kind of twisted in knots, or just like there's always pressure on your back. Those are the ways that people are describing to me their pain. And I think it's really hard to sometimes imagine the body not being in that way or that condition when you've been feeling it. But also our body is going to protect that space more and we're going to interpret pain in those spaces a lot more intensely too, than like, oh yeah, my ankle is kind of bothering me, but there's no organs there or my heart's not there, so my bladder is not there. So I always usually mention to people, like, yeah, things feel really intense in this space in our body, and luckily there's treatment for it. This is what I do every day. I built a whole practice around pain on this kind of pain. So it's really important to be able to let people see this is entirely what my job is to focus on. So if you can just let a little bit of the burden off of you to figure out every piece of that puzzle. That's what I'm here to help you do.

Yeah. I love that you help them normalize. This is what's happening and you're here. That's okay, we're here to work on this together rather than like, okay, I just have to continue figuring this out on my own.

That's the worst feeling, right? When you're trying to navigate something really difficult and you feel like you're by yourself and you also feel like, okay, so if your ankle hurts, you're going to probably chat with your friends about it. Not such a big deal. You could talk to your boss maybe about it like, yeah, I'm having trouble walking on my ankle. Okay. That is a visual obvious injury most of the time. And pelvic pain is not. And people do not want to talk about that with people they don't want to talk about with their friends. Sometimes they don't want to talk about it even with their partners, sometimes they don't want to talk. They just can't mention it to anybody. When my patients are doing getting time off work, they usually say something about their hip or their back, to be honest.

Yeah. Such an intimate part of yourself.

Yeah. So a lot more people are dealing with these things than you think. They're just probably not talking about it because they don't feel safe enough to.

I'm glad practitioners like you exist.

Well, we always become the things that we needed, right?

Yes, amen to that.

And I think a couple of other things that I see people getting is just learning to trust their body's intuition again. Like, yes, I do need to stop right now having sex or, oh, this isn't really that comfortable for me, let me switch positions, or that intuition of, am I going to exercise today? How am I going to exercise today? What is that exercise going to look like? Does it have to be hurt myself? Exercise, like exercise to the point where I'm just so exhausted and tired I can't do anything else. Or am I going to have a form of exercise that's a little bit more looking like joy, joyful movement or playful movement? And so just trying to give people a broader definition of body intuition and the way that it can look and it doesn't have to be so rigid.

Yeah, I love that because I think in our society we often very rigidly. Look at those things of like, this is what I'm supposed to do. I'm supposed to go work out, I'm supposed to do this and whatever thing, and this is the box I have to fit in. This is the mold that I'm supposed to be, when really that's not it. We're allowed to be people like the exact person that we are and we're supposed to be, and to be able to tap into that intuition in that body and say, like, I say, no, this is a boundary I'm setting. This is where I enjoy this or, you know, however that looks. It's so important.

Yeah. It's really exciting. I think when someone comes in not with that information and skill set, to have that body awareness and then to see how their confidence grows, and when they've made those boundaries and said, like, oh, yeah, I hated this, and I finally realized I hated this thing, so.

I stopped doing this thing.

Yeah.

I said no. I said I didn't want to do this. That's so freaking great. Yeah. Gosh. I see so many parallels to therapy. This is right.

I know in the early again, this is just something I've learned over time. A lot of the marketing, right. When pelvic peaches are, like, market to other professionals, like interdisciplinary plan of care, a lot of that is to gynecologist urologists uro gynecologists. Right. And my biggest resource is, by far, mental health care professionals. And once I finally made that connection of, like, oh, this is the overlap.

Yeah. That's so beautiful.

Yeah.

Because I see a lot of similarities in the therapeutic relationship and how the work is done, but the work is done more, like up here. I'm pointing in my head, but yeah, up in the mind, whatever. And taking those things and acting them out in our life versus in the body. We scratch the surface on that. So it's so cool that you get to really dive into that with people and offer them the same therapeutic care that they need right. Like, to encompass their whole person.

And I think it's really important to note that there's not a perfect order in which to take care of your body, like mental health and then physical therapy. Or physical therapy and then mental health, or both at the same time. But sometimes I do get people who have come in with pelvic pain and we do an exam, and it is absolutely terribly overwhelming for them. They have a lot of intrusive thoughts. And as we're trying to work together, we realize, oh, we got to step back, and we have to make sure that the mental health therapy is focused on first and that you have strategies, and then you can come back into this space with just, like, a lot less overwhelmed sensation. A lot of more things are in your control.

Yeah. Which is I mean, the whole thing about trauma is that it's outside of our control. So regaining that control and autonomy and those pieces where we get to say no, we get to express ourselves, is so vital to, I think, the healing process. So I think that's really cool that you're able to work within that.

We have the best jobs. We do. Okay, wait, actually, I take that back. There's goat yoga, and I'm pretty sure.

That might be I've done goat yoga ones. It was pretty cool.

Was it? I would love to.

I mean, there are baby goats, and so they're little, tiny, cute things that were just hanging out. I didn't do very much yoga that day, but I mean, it was adorable.

But it was so great for the nervous system, wasn't it?

It was so many giggles and laughs.

I loved it. See, I think you got more than enough out of it.

Yeah, I definitely advocate for that. All right, so that was a really cool conversation and we will take a quick break here so I can share some additional resources with you and we'll be back in just a moment. All right, so I hope you are.

Enjoying this episode so far and I just want to take a quick pause to share with you a few resources.

So if you are looking for more.

Ways to feel grounded and more ways.

To practice mindfulness in your daily life.

With real actionable steps, I've developed a workbook that will walk you through developing this skill. It comes from a trauma informed lens.

So if you've tried mindfulness before and you maybe felt like it's been more triggering than useful, that could be because you were actively dealing with a trauma response. So this workbook is designed for trauma.

Survivors, and more than that, it gives.

You those actionable steps and is really.

Just packed with information. Whether your schedule is a stay at.

Home caregiver or someone that works a.

Nine to five or something else entirely.

This workbook has something in it.

So head over to Soulmissionemdrtherapy.com podcast. You can subscribe to our newsletter where you'll get reminders once a month about new content and an email with your free workbook that you can download as many times as you want and have access to that link as I update it with new information. So again, that link is Soulmissionemdrthertherapy.com podcast and you can also find that link.

In the Show Notes.

If you are enjoying this episode so far, which I really hope that you are, because I'm enjoying this conversation and you think it might be useful for someone else to hear, please consider leaving us a review either on your favorite podcast platform that you listen to or on podchaser.com. And lastly, if you'd like to work with me and you either live in Arizona or Florida, I now have openings for EMDR intensive sessions. So EMDR intensive sessions are longer than your standard 50 minutes therapy session and can really help people reach a place of grounding and healing from past trauma quicker than the standard talk therapy session once per week. So if you want to find more about this, I invite you to set up a free 15 minutes consultation. We can chat about if this is the type of work that's right for you, and if it's not, I really would love to refer you to someone else that maybe is the right fit for you. So to do that, you can go to soulmission. Emdrthertherapycontact, which will also be in the Show Notes. All right, let's go back to this.

Episode all right, so we are back. So with this next section of the show, I want us to talk about the fact that providers are robots. Which can seem a little silly, I guess, when I say it, but really, honestly and truly, we already talked. About a bit about it, of this kind of power dynamic that happens a lot in the job of people come in and think we have all of this control. And so I just want us to kind of show our humanness a little bit and kind of break that perfect instagram bubble that people think we live in a lot of the times. Kind of share a little bit of that. So I didn't know if you had an example you wanted to share. If you do not, I have an example to share. Or we could both share.

Can I let you go first and be vulnerable first? Okay, great.

Yeah, 100%. So my example actually happened a few weeks ago, but it was one of those really hilarious moments that I just felt like I need this to be in here because it was such a good example of like, hey, I'm a human too, so I take care of.

My one year old.

And we went to this little gym class where he gets to run around and jump on things and do one year old things, so that way maybe he won't do that on the couch when we get home. So we're at one of these little parts in the program that they do, and we're singing this song and doing whatever, and I reach into my back pocket thinking, I'm going to grab my cell phone and instead of my cell phone, I reach and I grab a baby monitor and had no cell phone. And I know that's like a really small, silly thing, but it just felt like this is hashtag parenting brain. This is what this looks like. And the guy that leads the class, he looked over at me as I pulled the baby monitor out of my pocket and I'm like, what? For a second, I'm just like, I'm not at my house, my kid's not sleeping. Why is this in my hand?

You can even process it.

Yeah, no, it was just like one of those things where it's like, this one of these things is not like the other. What is happening? And I had to laugh about it. I was a little mad that I didn't have my phone, but hey, it is what it is, right? But yeah, I was trying to figure out what time it was because I didn't have my watch either, so I was just completely disconnected from all electronics, which is probably a good thing, right? I need more of that. But yeah, so that is just my little silly thing of like, I'm a human too. I have these weird moments where my brain just doesn't work. Like, we were talking about before the recording started. I parenting brain 101.

I am so much better at showing up in all my flaws than I was before. So I let people know when I am just like, I guess thinking like, oh, I forgot this thing. I'm not afraid of hiding that as much as trying to be perfect because I've learned to work with one, how amazing my brain is. I can really hyper focus on something. And when I have patients, I am there, I am focused, I am here for them. But in so many ways, my day is different every day. I can't even think as like one example, I cannot think of like five a day.

But hard to do when you aren't like, acting. I mean, like, literally, I had to make my brain remember this incident because I knew otherwise it would be a blend in to one of the millions of things that just makes my day my day.

One time when I was especially in the early days of starting my practice, I was always like, switching my vehicle with my partner for different reasons. And I kept forgetting to copy the key for the office. And of course, one of those times they ended up forgetting my keys to the office because they were on the wrong key fob. So I had to call somebody and cancel because I'm like, oh, my partner is already at work. They're on the other side of Phoenix. I'm never going to get my keys in time. And they probably, in retrospect, could have had someone let me in, gotten called maintenance. But I just remember being like, dang it, who messes this up? Who as a business owner makes that mistake? Yeah, I think as a business owner, that's when I feel like my mistakes stood out more to me because I felt more responsible for everything and I didn't want to let anybody down. So, yeah, I think those instances sit a little heavier with me because I'm like, oh, I hate to ruin someone's day and not let them get the treatment that they planned on getting. But once you do something wrong, the good thing is you probably are going to be more motivated to prevent that thing from happening again. So I can guarantee you that night.

I got the keys, you solved that problem, right? Yeah.

So sometimes our life is just telling us, like, hey, if you don't deal with this problem, we'll convince you to.

We will keep coming back.

Yeah. I forget what else I was going to say. Go ahead. Oh, I'm sorry, I don't remember.

Okay. I was just going to say, I mean, I definitely feel like as business owners, there can be a lot of pressure and I think maybe the pressure that we put on ourselves sometimes and it's a lot sometimes to carry all of that by ourselves.

Yeah. And so my patients are human when they come in and I just try to give them the most energy and the most time I have and the most intention. And I think if I can come away having done that, then other little things like, it's okay if we're not perfect.

Yeah, absolutely. And I think in those moments that I am not perfect, like, hey, I e, my kid crying in the background. Those moments are the things that, again, make my life what it is. And sometimes I'd say make therapy even that much more richer because I'm able to just come as my full self. Like, this is who I am.

Yes. And isn't it so nice? Can't you tell when patients, too, feel like, oh, they can be themselves, like an exhale? They didn't have to come in perfect. You didn't have to have your makeup on to come in. You didn't have to shave to come in. You didn't have to wear fancy clothes.

That's right.

Yeah. Absolutely love it.

Okay, well, let's move on to the trauma tip of the week. I know that you have two little tips for us, and I would love for you to just share whichever one that you'd like to first with all the information and the juicy details.

Cool. My first trauma tip for anybody is please let your belly relax. Doesn't need to be tense all day. You don't have to be sucking in your stomach all day. And if you are going to do things that you feel like you're in an environment where you need to do that, just be mindful when you come out of that environment to let it go and breathe. Let your pelvic floor relax. So if you're not sure how to do any of those things, then you have some great resources now. And then. My other tip is, for sexual health, a good lubricant does wonders, and I kind of go off on some tangents, and you can reach out on my instagram. There's a link to get a lubricant guide, but the most important thing about lubricants is that if you're using a water based lubricant, that you're using one that has a matching PH to the vagina or the rectum and an osmolality number that is, like, pretty low. So osmolality is just the concentration of the lubricant, and you also have an osmolality number in the lining of the mucosa and the vagina and the rectum. And that's what maintains that great microbiome, the thing that is self cleaning and keeps things just, like, happy and healthy. That also keeps things really stretchable and flexible. And unfortunately, not all lubricants are good lubricants. So my favorite water based brands are Ah. Yes. Ah, Y-E-S and Good Clean Love, because they have great ones that match, like, the vaginal microbiome. But there's other fantastic lubricants out there, and I have a whole guide about it. But a good lubricant goes a long way, and also a bad lubricant doesn't do good.

Yeah.

Okay.

So best to get a better one.

Yes.

Sorry, go ahead.

There's just some that you need to be thrown in the trash always.

Yeah, sorry. Don't buy them in the first place.

And I would say about lubricants, one thing that frustrates me is they use marketing really tools really well, which is like saying like natural. And people will literally put food in lubricants. I've seen yam lubricants and I just want to be like, those are not digestive systems and if it's not going in your mouth, it doesn't need to be food. That's my rant.

Yeah, no, I think that's good information to have and to hold. And you said you have the links. I'll get all the links and include them in the show notes.

Great.

People can find that. And you said it on your Instagram, is that right?

Yeah.

Okay, perfect. Just making a little note too. All right, so for the last part of our show here, it's the final fast and sometimes funny questions that we just want to wrap our show up with. So first one, where would you go if you could visit any place on Earth?

I would go literally anywhere.

Anywhere?

I know that sounds great. Well, I'm not going to say anywhere, I'm just going to say I didn't do enough. I haven't done enough traveling in the last three years and that was something I used to be really attached to. So if I could get to Europe or Asia or Australia or literally Antarctica, I would go and explore. I love it.

And yeah, I think many people could say the same. The last three years travel has been at the bottom of the list.

Yes.

Should pineapple be on pizza?

I think I am weird in that I can go either way. Sorry, I'm just not that attached. If it's pizza, I will probably eat it.

Fair enough.

I'm not like super excited about pineapple, but if it's on there and there's pizza in front of me, I will eat the pineapple.

Like, hey, it's pizza.

I'm not going to peel it off just to avoid pineapple.

Okay, fair enough.

How about you?

I love pineapple and pizza. In loving it, I meet a lot of people that are like, oh, that's gross. Yeah, I get a really gross face when I share that. And so I just imagine that most people have strong opinions. So it's really interesting that you either.

Way, I feel like I need to have a strong opinion because so many people have strong opinions.

They do. I love it. I think it's great. I think it's wonderful.

That's so good.

What makes you inspired or motivated to do the work that you love?

Just when someone tells me something that's awesome that they were like, this is so cool, I couldn't do it before. People tell me about their Poops a lot, so I'll get like Poop emails, poop messages on my portal, like approved today. Oh my gosh, your poop is so great because if you have a whole bunch of patients that are constipated, they're probably going to be really excited and they don't have anyone else to share it with.

So I am super.

Also, my friends have started to tell me when they had a great poop, and I got to say, I'm excited for you each and every time. Never stop telling me. I have people that will have not been my patients in a long time, and they'll message me and they'll be like, I just want to let you know that I taught my friend how to sit on the toilet and breathe while they were going to the bathroom, and they also had a great poop. And I'm like, this is so amazing.

Right? Oh, my gosh. Do you sometimes wish that there were different poop emojis? That people could send you, like, varying colors or something? I figured, oh, totally.

And my niece, she's nine, and we always text poop emojis all the time, so it's pretty fun. And then the other thing I get really excited about what inspired me, I just get really motivated when someone tells me, like, I had sex and it was great and it wasn't painful, and we did it in this position, and I felt like, I just love people. What they're really saying is I have to connect with my body and my partner, and I'm not ashamed of it, and I'm super excited about it. The work that it takes behind that one thing is months and months, years. So to get to that point is a lot of work.

Yeah. Them sharing their victories with you, their celebrations of like, hey, this work that we did paid off.

Those are very exciting.

Yeah.

I also get excited even if someone says something like, I set a boundary and it was great.

Yeah. I said no to this work that you're doing.

Yeah, I said no to this thing. I realized I don't want to be with this person I was having sex with. I realized we didn't have the same goals. That's fantastic. So they don't have to be such exciting things. They could just be like, I'm really confident in the decision that I made.

Yeah. It's seeing the work pay off. I agree. That's a good one. All right. What is one thing that people are generally surprised to find out about you?

I really should have. I was like, I'm just going to wing these answers.

Only answer what you're comfortable with.

What is one thing? I was a baton twirler, and I baton twirled, like, in pageants, and I went to a world competition twice in high school for team, like, baton twirling. So I still baton twirl occasionally in my spare time just as, like an ADHD kind of thing. It's just like, twist twirling between fingers and stuff. It just helps me, I don't know, move around and do something.

Yeah. Can I ask you. Probably a silly question.

Yeah, go for it.

My thought, were you ever afraid about it falling on your head? Because that's the fear I would have.

Afraid it happened every practice, so yeah, you get really resilient to that. And also, I can't say that I've ever had a concussion from a baton, like, hitting me in the head. Like, it's hurt pretty bad, but it's not like falling on your head.

Okay. All right, fair enough.

Yeah, you get pretty adapted to that. Okay.

What does a simple moment of pure.

Joy look like for you? I love this question. Probably my most consistent pure joy moment on a regular basis, like, in the morning, is if my partner brings me coffee, and then we just have an extra few moments of cuddles before the day gets started. That's my favorite.

Yeah.

That's beautiful.

Just having that connection before you kind of enter the world and all of the things that go with it.

Yeah, it's really funny. What we'll do now is we both get up and then get coffee and then sit on the couch again, sit on the couch again for a few more minutes, and we're just, like, drinking our coffee and cuddles, and then we can get our day started a lot easier.

That's beautiful. That's such a beautiful frame of perspective to start your day in, because you're like, you start from a good place.

It is much easier. Our lives fit that schedule now, and I've always wished I had a life that fit that schedule, and now that I have it, I'm like, this is so amazing, because I was always getting up for work really early, or we had different work schedules, so that wasn't always accessible to us.

Yeah, but now that you're your own business owner right. You can do that.

That's wonderful.

Yeah, that's what we do. All right, well, thank you so much for joining me today. I'm so excited that we got to have this conversation and just dive into all of this. So thank you.

Thank you. You ask great questions, and I'm really excited to have you close by as a resource.

Yeah, thank you.

All right. Thank you so much for joining me today on Moving Out of Trauma. If you like today's episode or you think it might be useful for someone else, please consider leaving us a review on your favorite podcast platform or on podchaser.com. And if you have any questions at all, I'd love to hear from you. You can find me over on Instagram at Soulmissionemdrthertherapy, and over on Facebook at soulmissionemdrtherapy. Stay tuned for the calm State change place as well as the container exercise if you would like them. Remember, you didn't choose Trauma, and you can choose your path towards healing. So I just want to invite you to find a comfortable position and to make sure that you're doing this exercise somewhere safe, somewhere where you feel that you can take a few moments for yourself and definitely not while you're driving. So we're going to start with the container activity and then move into the calm seat place. So it's good to have a secure place where you can store memories and issues and things that may need still some work, but also maybe you don't need to focus on them right at this point. So if you think about it almost like cleaning up the files on your desktop computer so you can just feel a little bit less overwhelmed and focus a little bit more efficiently. Files are in a safe place, you can access them next time that you need to. So to start creating this container, I'd like you to imagine some kind of container or storage system that can securely hold as much as you need it to, for as long as you need it to, until you're ready to work on it again. So this container can be something you imagine, it could be something that's real. We just want to make sure that this container has a lid or some type of secure closure. So that way there's a way to take things out only when you want to. Now it's important to note we don't want to put people in containers, but we can put memories and feelings and any kind of situation. So take a moment and really think about what that container might look like. Notice how the container feels, notice how it feels that it's there for you should you choose to use it or when you choose to use it. Now, if you need to use that container, I want you to picture allowing whatever needs to go in there to take its place in there. This can happen slowly, this can happen quickly. However it needs to happen, it's okay. Just allow the pieces, the memories, the thoughts, the feelings, the situation, whatever it is, to just slowly take its place into that container. Now, once you feel like the things that need to be in the container are in there, I want you to close that container. Some people like to imagine that there's a lock there or some kind of secured closure beyond just a lid. So if you like, you can go ahead and lock that and then just imagine it kind of taking its place back into wherever it needs to be. So this could be a place that you think of in your home, this could be an imaginary place wherever it is, just someplace that we know that it's there when we need it. And now we're going to transition to that calm state change place. So this is a really good activity to develop a couple of ways to feel more calm and secure without really needing to rely on something or someone external than us. So one way we can do this to create this type of place that you can visit internally whenever you want. Kind of like having an instant mini vacation on demand. So see if you can think of a place where you might feel a sense of calm or a sense of well being. You can imagine a place that's similar to one that you've experienced or heard about or read about. It's best not to use a specific memory with people, though, from your own history. So some people like to think of the beach or the woods, mountains, maybe someplace they feel cozy. So just notice this place. Notice what you hear, notice what you smell. Look around. What do you see? What do you feel? Maybe either the temperature, the time of day, even down to how you feel in your body as you imagine yourself in this place. Really just allowing yourself to soak up every single positive part of this place. The way it looks, the things that you hear, the things that you smell, the things that you might be able to touch, any textures or temperatures, and really encapsulating what you feel in your body as you're in this place, as long as it feels good and calm in a place of centeredness. Now, knowing that this place is always available to you because it is within you, it's a place of your very own making. Place that you can return anytime you need. Whether it's for quick, deep breaths, returning the center, or maybe even winding down for the evening. This place is always here for you.

You.

So this recording is going to finish, but if you'd like to stay in this place a while longer, you're certainly more than welcome to do so. And I hope that you'll join me next time on Moving Out of Trauma.