The Pelvic Floor Project
Embarrassing symptoms deserve better conversations.
Whether you're dealing with bladder leaks, prolapse, pelvic pain, painful sex, erectile dysfunction, constipation, pregnancy, postpartum recovery, or simply wondering if what you're experiencing is normal—you're not alone.
Hosted by pelvic floor physiotherapist Melissa Dessaulles, this podcast helps you understand how your body works and why symptoms happen. Through conversations with leading researchers, physicians, surgeons, sex therapists, midwives, psychologists, and other experts, we translate the latest evidence into practical information you can actually use.
No myths. No shame. No confusing medical jargon.
Just honest conversations that connect the dots—so you can feel informed, confident, and empowered to make decisions about your health.
The Pelvic Floor Project
132. How personality traits, past experiences and beliefs influence physical symptoms with clinical counsellor, Cory Arthurs.
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In this episode I discuss with registered clinical counsellor, Cory Arthurs:
- How personality traits like perfectionism, people-pleasing, anxiety, or being highly driven can influence recovery and coping?
- How messages like "no pain go gain" or "listen to your body” can be interpreted differently by people
- How previous life experiences, messages we received as kids or beliefs can influence our physical symptoms
- How stress influences our nervous system and contributes to healing/recovery
- Pelvic health conditions are often associated with shame, embarrassment, and stigma. How can those emotions affect symptoms and recovery?
- Physical symptoms often have emotional influence but that doesn’t mean “it’s in your head”
Originally from Calgary, AB, Cory completed her undergrad degree in Addiction Counselling from the University of Lethbridge, and worked for many years with individuals struggling with substance use and related issues. She later moved to Vancouver, where she completed her Masters of Counselling degree at City University of Seattle, and expanded her work into working with trauma and altered state integration. She uses both Sensorimotor Psychotherapy and EMDR in her work with PTSD, both nervous system based approaches to treating trauma. Using these trauma therapy modalities, she helps clients reduce the impact of trauma by working directly with the nervous system and body, not just thoughts and memories. This means slowing down, tracking what’s happening somatically in the moment, and supporting the kind of regulation that makes lasting change possible. Her work with clients over the years has taught her many lessons of the innate wisdom we all carry, and capacity for healing. When not working or learning, Cory can be found in one of the many forests of the Okanagan, or out on a paddle board.
HOW TO CONTACT CORY
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Welcome to episode 132. As a physiotherapist, I see people day in and day out, and I'm telling you, it's fascinating how unique each person is. You can take several people who have seemingly had a similar experience. 10 women who give birth, five men who have a vasectomy, seven people who injure their back. On paper, there are similarities. But then you add in personality, beliefs, past experiences, messages from her upbringing, and out comes something completely different every time. A few of my clients actually inspired this episode. One was working through persistent pain after a sacral fracture. Over time, it became clear that part of her recovery involved learning to slow down and actually listen to the signals her body was giving her. She shared that growing up, she had learned to just keep going. Put your head down, push through. It had been a survival mechanism for her, and ignoring what her body was telling her had become second nature. Another client, a man experiencing significant pelvic pain and testicular pressure, reflected on something similar. He had never really allowed himself to recover after an inguinal hernia repair or a vasectomy because he had always been taught to suck it up, be a man. Both had learned for very different reasons to ignore signals from their body. But I also see the opposite. People who become hyper-focused on every sensation or who stop moving because pain has created fear around what might be happening in their body. That got me thinking. How much of the way we experience and respond to our bodies is shaped by what we've learned through our lives. Joining me today to unpack this is Corey Arthur's, a Kelowna-based registered clinical counselor. We're talking about the messages we receive growing up, personality and coping patterns, how those experiences can shape our relationship with pain and physical symptoms, and how we can start recognizing when those patterns are no longer serving us. It's a fascinating conversation. Let's get into it. I'll be right back with Corey. Hey practitioners, you know that feeling when you're looking at a complex pelvic health case and there's no one down the hall to bounce ideas off? You've learnt the material in courses, but having a hard time applying it. That's what Embody a year of mentorship is built for. It's a full year with world-renowned physiotherapist Carolyn Van Dyken and a roster of international pelvic health instructors built around a biopsychosocial, trauma-informed approach, plus a mentorship partner and a community that sticks around after the year is done. Seats are limited. Check the show notes for everything you need to know, including how to register. 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Their team can help you choose the right garment and fit for your stage of pregnancy or recovery. Click on the link in the show notes and you'll automatically receive 10% off site-wide. Okay, I'm looking forward to this discussion with you, Corey. And just before I get you to introduce yourself, I'll just kind of explain how this came to be. So as a physio, people come to see me all the time for physical issues. Um, they have they have pain. I think about people that have pain in their pelvis. Like um, I'm thinking about an example of a gentleman that is like, I have a lot of pain in my testicles and in my penis, and I've seen so many people, and they told me to come to a pelvic floor physio. And you can just see that they're like, I don't know why I'm here, but I'm here. Um, I can think of other people that maybe have like significant tailbone pain that they've had for a long time. Um, I think about post-surgical patients, and when they cut they come to see me for their physical symptoms, but then as practitioners, we have to be kind of detective-like and figure out why are they having these symptoms? What are all the reasons? And I always say it is fascinating to me that you can take like five people that have the same surgery, like a hysterectomy, and then you throw in a personality or belief or a way that we perceive pain and outspits some very interesting things. Or um, you know, someone has an injury and you take uh a belief system, an individualized belief system, and outspits a very different outcome. And so I thought I would love to talk to someone about the emotional or the psycho psychological piece of this to help people understand why their physical symptoms are related to something so much bigger. And and so we have a patient in common that as I was working with her and just noticing like I was, it takes a while to get to know your patient sometimes. And as I got to know her more, I was kind of thinking, like, I feel like she just blows through her pain signals all the time. Like it's almost like she's creating like a tantrum in her body, like that we're we have to back this up a little bit. And and um, she needs to learn how to kind of like diffuse this. Um, and as we started talking more, she would use language, she's like, Okay, here's the notes that I got from my therapist. And I thought, I love these person's notes. Like it's kind of neat how I like how she explained that. And and so she, you know, in in my version of the story here, she would have notes that kind of you would use things like that. You need to be mindful, you need to be present in your in your body so that you can recognize some of these signals because she just wasn't present at all. So she would blow past a lot of what I would call a threshold, anyways. Long story short, Corey, she gave me her name and said this is the therapist I'm working with. And I thought, oh, I'm gonna ask her if she'll talk about this with me on the podcast. And so here we are. We made it happen. And before we I start asking you some more questions and we get into this, will you kindly introduce to the listeners a little bit about yourself?
SPEAKER_02Yeah, absolutely. Thanks for having me here. It's very exciting. Uh so my name's Corey Arthurs, and I'm a registered clinical counselor and I work in a couple of capacities. So I work part-time for a mental health clinic called the Newly Institute, in which we work with trauma and pain. Uh, and then I also work in private practice, seeing folks with all sorts of presenting issues and life experiences. I've been doing this for a long time now, and I have specialized training in sensory motor psychotherapy, which is a body-based way of working with trauma. It really focuses on the nervous system and the nervous system's role in our experience, um, how trauma is stored in the nervous system and expressed through the nervous system, how our beliefs are stored in our nervous system and in our body, and then show up in our day-to-day, how that influences relationships, our sense of self, our relationship with pain, all of these sorts of things. Uh, and so that work has really given me a wonderful foundation to connect the people and better understanding and slowing things down to get into their self in a safe way, uh, or to even just discover that they have a body uh and the impacts of that on our emotional self.
SPEAKER_00I think it's fascinating how some people are they almost can't feel things in their body because they're so like cerebral or in their head, like they're they're thinking so much they can't feel. Whereas I find there's some people are the complete opposite where where they actually like they're so in tune with what they feel that they almost don't think about it.
SPEAKER_02For sure. Yeah. I talked to so many clients about like we are not just floating heads because a lot of people are moving through the world as though they're a floating head. Uh it's something that's rewarded in our world a lot of times, right? It's the pushing through, it's the thinking about, figuring it out, being a problem solver, um, being a good thinker and are completely dissociated from what happens neck down. Uh, and that has its own set of challenges. But yes, the kind of people who are so in tuned and so oriented towards what's happening inside, but that comes with its own uh emotional impacts and challenges as well, where they're just so kind of consumed by body sensation.
SPEAKER_00Can we talk a little bit about, and I don't know if these would necessarily be called like personality traits or what you would call these, but let me just let's just use like a fictitious example here. But let's say someone um um has um like a hysterectomy. I mean, use the example of a hysterectomy. So they have a hysterectomy, um, and then I I think about how some people will, they seem to be kind of um avoiders or they're nervous about pain. So I think about those are the people that are like, I'm not even gonna try it because I might have pain. Um, I'm just gonna avoid. Um, I find that there's people that are um more like, oh, I didn't even recognize. I just grew up with this kind of like no pain, no gain. You just push through. Pain is a sign of weakness. I think about the people that are um what I would call almost like perfectionists or like very high hyper-vigilant in that, like, is this right? Is this right? Is this right? Am I doing this right? Um, I need to do it perfect. I want exactly how many repetitions of this exercise should I do? Um, or the people that are just like, whatever you want me to do, I'll do. Like, what do you mean what I want you to do? Wait, the people like more the people pleasers. Can you talk a little bit about um like can you describe the differences? Like, how much is this just related to who we are when we're born, or how much is this is related to like the the people around us that influence us, like our parents?
SPEAKER_02Yeah, I mean, I think it can be a bit of both. I guess it's probably that age-old meat or nurture thing that there's gonna be part of us that are just yeah, personality traits and what's in our DNA, but how we are raised in the messages that are given to us about pain, about our body, about our place in this world, about ourself in relation to other people, um, definitely lays a blueprint for things all down the road. So, you know, those perfectionists who are just pushing and everything has to be perfect and done in a certain way might be very dissociated from their body because that hasn't been helpful for them to get what they need. That strategy, like of knowing what's happening in their body and responding to it, hasn't gotten them where they wanted, or maybe was punished growing up, um, or at least wasn't valued. They were maybe not taught that their whole self has value. It may have just been the performance or how they think, uh, or yeah, getting it right in order to be accepted or receive love. Um, similar with people pleasing, um, may have not really been shown that them taking up space in this world is actually valuable. So it's all about other people, it's all very external focused, and we lose a connection with our embodied self. Uh, and then we have injury or surgery, like hysterectomy, and we don't even know what's happening in the body because that was never shown to us, and we've spent potentially decades just in the head thinking um, or intentionally moving away from it, or those signals from the body feeling threatening because that meant something's bad or wrong with me.
SPEAKER_00Definitely something I find that comes up in my line of work because I would I introduce myself sometimes as a physio for embarrassing things. Like people come to see me for bodily function, let's call call them issues, and this is not an area we learn much about. So I feel that already I know, well, I expect that the majority of people entering the room have limited knowledge. And I think that limited knowledge just creates so much more fear and unknown and shame. And and so that's what that's what one of the reasons like why I record this podcast is because I think with the more that you start to know, kind of like, first of all, anatomically, this is what all the areas or that area looks like. These are the organs, these are the muscles, this is how it typically functions. Now, let me give you some reasons of some of the things that might make it not function normally. And this is where, um, for example, if I say, like, can you imagine if you um, you know, don't move your body after this injury, or let's pretend it was a knee and you had a knee surgery instead of this embarrassing place, if you had a knee surgery and didn't move your knee after, what do you think would happen? Oh, and they can say I would stiffen up or I would have less ability to walk. Okay, do you see how it happens in this area? Yeah, but I'm scared to move. Exactly. So kind of like, what's the fear? Is it is it that I've always been scared to move? Like, is that is are you bringing up something that is kind of something that you see all the time in your life, or is it more just a lack of understanding? And that's where I think this where where this episode will come in is where when they're like, okay, I understand it, but I can see there's something deep to this. Like, this is the story of my life. I am always avoiding things, or I never listen to signals in my body. Yeah, it's an fascinating.
SPEAKER_02Very much so. And that like brings to mind me like how people will brace internally, right? And I'm sure you see that lots as physio of like the physical bracing, and um, and that translates into the work that I do as well, that you know, different beliefs and ways of moving through the world or fear creates a bracing, which translates into the nervous system, and then our whole life gets organized around this bracing and our belief systems are integrated into this bracing. And it's hard to feel safe in this world when we are in a tense place and just compressed or contorted in some way with this bracing. Um, our worldview changes. And if we're not feeling safe in this world, we might not be feeling safe inside. And so noticing how the depth of some of these things that can happen with injury and fears around moving or fears around pain, yeah, it's it's the the whole system of the person, it's not just physical, it's all of the embodiment too.
SPEAKER_00This this one gentleman comes to mind when you talk about this bracing, like he had all this um, he had had some previous surgeries of vasectomy and an and and a um hernia repair, and kind of acknowledged that he's like, I didn't take the time to recover after them because I don't do that. I kind of keep going, and that's my personality. And I said, So again, like using different body part, like if you didn't rest the knee, what do you think would happen? Pain, swelling, muscle tension. Do you see how the same thing could happen in your in your pelvic, you know, genitalia and your muscles? And he's like, Yeah, that makes sense. And so, you know, starts learning how to kind of relax those muscles, give them exercises to be more present. And what does it feel like to relax? And then he stands up and he's like, Yeah, I always hold tension, like at all times I hold. Okay, why? Well, aren't you supposed to? Like, if I just let it go, is that okay? I'm like, Yes. He's like, Really? Right? And I think that's where you sometimes that whole belief system unravels in front of them. They're like, Really? So people don't, not everybody walks around like this. Isn't that yeah? Um and I think of um another lady today. This is all stuff that comes up in your day all the time, that um because her surgeon told her, essentially, kind of like, this is bad about your prolapse, and this is bad about your bladder, and you know, these are all negative things, these are all reasons you have to have surgery, but you shouldn't have surgery because it's the outcomes aren't good. Of course, she's holding all the time, right?
SPEAKER_02Yeah, absolutely. Those messages that we're given from the outside world, and if we don't have trust in ourselves or a sense of being an expert in our own experience, then everything that comes at us becomes true, or at least maybe likely to be true. And there's a response to that. And now that kind of furthers the dissociation from our experience because, well, obviously, I don't know myself because what they're saying must be right. They they know what they're saying and they know what they're talking about, and I just have to do what everyone else says because I can't trust myself. And that can also go back a very long time and probably shows up in relationships all over the place for them and just how they take care of themselves.
SPEAKER_00And this is why there's probably so much discrepancy in how people interpret the term listen to your body, right? I'm curious to know kind of like thoughts that you have about all the different ways people interpret that or have a hard time interpreting that.
SPEAKER_02Yeah, I think so often it's like, what does that even mean? Listen to my body. Um, or they think of it from a really basic place of like, well, yeah, I know if I'm hungry or if I need to go to the bathroom or if I'm cold. And it's like, yes, that is definitely one way of listening to our body, and we can build from that. Um, but starting to support people in like understanding that their body communicates in other ways through you know fatigue, through bracing, through pulling in. And part of the work that I do with people, especially as we're looking at like nervous system pieces or resolving trauma, is to really notice some of those internal senses that they have, like when they're talking about something, feeling like they're pulling back, or I can observe it oftentimes. They're like really pulled back in the session, or they're turned away, or they're not able to engage with eye contact, or they're like look like they're halfway out the door. Um, and that is, you know, I can see what's going on, but they have no idea that their body is doing this. And so supporting them and recognizing listening to your body is not just those instinctual cues of like, oh, I'm hungry or I'm really thirsty, which even that I think people can mix up or override or dismiss, but also I am feeling disconnected or I'm feeling scared, um how emotions are showing up in our body, that that's a way that uh we can listen to our body is being able to acknowledge that emotions don't just show up in our head, they also show up in our body. Um, so try to support people and really building from that kind of more accessible place of like, well, let's notice temperature or let's notice sensation that you can create in your body to notice that you're listening to it. Or if I bring up this, even if it's like, let's talk about ice cream, what do you notice happens uh in your body? Oh, I really want that, or I start salivating. It's like, cool. Now we're discovering, like, yeah, you can listen to your body for that. But that also means, do you notice when you're tired? Do you notice when you've reached limits? Um, do you have a sense of when you have energy or are ready for something? Uh and a lot of times people just kind of going through the motions of their day or functioning from a real autopilot dissociated place of this is just what I do, this is what I'm supposed to do, this is what I'm expected to do, without realizing, oh, I'm actually very tired or my pain has gone up and I need to take a step back. Pacing is a challenge for so many folks in lots of different ways because they're not noticing the cues that their body has beyond, oh, I need to get up and go to the bathroom, or maybe I need a snack. So it's a lot of slowing down to discover the body has more information.
SPEAKER_00Which is hard this day in this day and age to slow down. I find that's for a lot of people there. I can tell um a lot of the people that I see, good majority of people will leave with what I would call like, I just want you to be mindful of. And and so I might teach them like this is what it feels like to tighten your pelvic floor, this is what it feels like to relax your pelvic floor, and I want you to pay attention to signals from your bladder or signals that there's poop in your rectum. I want you to walk to the toilet and I want you to notice what you do, like or or and and things like that. And I can tell people are looking at me like, are you serious? I wanted exercises. I'm like, I know. Trust me, just trust me, because I need more information first. Like, I just want you to go home and because I don't know exactly all the reasons you're having these symptoms yet, but I I want you to go home and tell me more when you come in. And I'm can't believe how many people take away some pretty basic things to be able to say, okay, I can tell you more about why I'm having a peeing problem, or I can tell you a bit more about why I have hemorrhoids because I get to the toilet and I start pushing. I didn't notice that I was doing that. I'm not waiting for the signal from the poop or what have you, right? And I think a lot of this stuff that's the cool thing about our nervous system is it's smart and it just keeps going, but it can get stuck in unhelpful patterns, right? That might be giving you your symptoms. Yeah. Yeah. Can you because of course you're not going to do the exact same thing with every person and and um there's there's so many variables to determine what kinds of things you do in your sessions. But if I use the example of let's say the the person that I mentioned that, oh wow, like what? I have this tension all the time. Like what? Some people let go of that. And he would reflect at times and share things like, Oh, yeah, I grew up in a house where it was kind of like you keep going, you know, like and and especially as a male, you know, you don't share your feelings, you suck that up and you keep going and you Power through. What kinds of things like would someone like that expect? Like, where would you start? Like, what kinds of things do you start with? With people that are just like, oh my gosh, I never pay attention to feelings or sensations.
SPEAKER_02Yeah, I first normalize that that makes sense that they probably didn't, and that this is something that has been happening unconsciously and as their normal for so long. Um, I generally will start with curiosity around what is without expecting anything to change. So really being able to land with that tension and become curious about it and really study it as their embodied experience. Like, what does it feel like? Where is it? Does it move in any way? Um, they can even, sometimes people are quite visual and can assign like a color to it or a shape, maybe has texture. What happens when we pay attention to it? Does it change in any way for some people? When we start to pay attention to it, it kind of goes away or dissociates. Other times it gets really big and really loud. So just being curious about what the tension is and understanding that organization of their experience and how they're relating to it. And with that is being able to hold that and then notice like what else is happening? Are they maybe they're feeling emotions arise, maybe sensation or tension is showing up elsewhere. Uh, maybe beliefs are starting to pop up or a memory might show up as we're really studying that tension. And then we kind of go with what the body is showing us and what the nervous system is showing us, but very gently and very carefully because we don't want to overwhelm the nervous system or jump in too deep too soon. Um, being able to provide a framework of like their nervous system and the functions of their nervous system and what, and then becoming curious, like what's the function of this tension? What would it mean about them to not have this tension? Um, and just it's it's a lot of curiosity and it's a lot of them becoming curious about their experience. And that's part of them discovering how to listen to their body, is just becoming curious about, oh, this is happening and it's happening in me, and I didn't even realize it. Now I'm present to it. Uh, and encouraging them to notice if that tension changes in any way through their day or through the the week or weeks before I see them again. Uh, and then we can start also doing some experiments on intentionally shifting the tension so that we can resource the body to feel that differently if that's necessary, so that they can have a break from it or discover what it's like to have a moment without tension and then really steep in that of like, okay, cool, that shifted. Let's let's notice that, let's slow down in it. Um, and then we pull those threads back into the beliefs or the memories that might be attached and start to do some of that deeper therapeutic work to unwind that so the body doesn't have to hold the tension anymore.
SPEAKER_00I'm thinking that that must require, like, like you said, like time to kind of think and feel. And I always find that I'm a eye closer, like intuitively I just close my eyes right away to like listen to my body. But what about I always feel like there's always those people that are like, nope, I feel so uncomfortable when I stop, or I do not like taking the time to be in my body, it is too uncomfortable. Like, can you just give me an idea? Because there'll be people listening to this that are very interested in, like, oh, that sounds so interesting to do that stuff with Corey. Whereas there'll be other people that are like, that sounds uncomfortable.
SPEAKER_02So for sure.
SPEAKER_00What obviously there's other things that you'd suggest. Like, can you kind of give a message to those people?
SPEAKER_02Yeah, I mean, it's so common to be like, I don't think I want to do that. Yeah. Um, lots of discomfort with being in our body. And I can that makes sense. We're not gonna force it if it doesn't feel okay. So I tend to start in like what might be very um like peripheral sort of things, like stuff that's maybe more external, so we can start to just notice senses. And that's a way of becoming more mindful. It's a way of slowing down, it's a way of discovering our experience as it's happening without having to be deep in our body. So just becoming aware of what we're seeing, hearing, smelling, tasting, sensing all of those things. And that can be pretty accessible to a lot of people without there being judgment or expectation on where it goes. It's just building it as a skill, um, using what they already know about their body, like points of contact on the seat while they're sitting talking to me. Like, can they notice that? What happens when they notice that? Um, noticing temperature in the room or creating sensation. Maybe they have I always have like a stuffed animal or a blanket or a pillow or something or fidget, so people can be holding things and we can describe stuff that is external to us, but still uses our body to interact with it. And that can be a way of just discovering, like, oh, I can do this and that's okay. And that's also it's not about evaluating what's wrong. Uh, and that can be part of the discomfort of going into the body is you're gonna tell me something's wrong with me, or I'm gonna discover something's wrong with me. Um, so really trying to come at it from a place of we can just be really neutral. In fact, it might be important to notice what is neutral so we don't feel like we have to go inside and find out what's wrong or what isn't going right or what's uncomfortable, but we can actually notice what is comfortable or what's really neutral. Um, so that can be a bit of a an easier way towards that and what they already know about themselves. If they experience anxiety, that tends to be very physically based. They can probably describe to me what anxiety feels like in their body. It's like, okay, cool. So we can start there. We know what that feels like. What if we started to shift or find something that helps that feel different? And that for a lot of people are like, I want to feel different when I'm anxious. I don't want that overwhelming agitation in my body. So yes, help me feel that differently. And that can be an avenue to relate to ourselves as well.
SPEAKER_00So it sounds like kind of for this, it's kind of helping people be more present in their body or their surroundings, like just helping them meet them where they're at, but find that presence. What about the people that I would say are getting so much stimulation? Like, um, I think about people that are um they're almost just kind of like, but then I feel this and then I feel this and then I feel this, and I can't even get them to kind of like stop and be in one place. Like, what about those people? Any thoughts for that?
SPEAKER_02Yeah, so challenging when it's like so much information is coming at them. Um, and I kind of see that through the lens of like that's like a hyper arousal sort of state, like a really ramped up things are coming too fast. So finding a way to bring that down, whether that is shifting focus out of their body into something more external, like, okay, so let's look outside, notice what you're seeing outside, and let's just like, or being outside and thinking them so that they can feel something or see something and engage in something that's more external. Sometimes we have to help people come out of their body because it's just so wound up. Um, being able to use again, really neutral or comforting things, because I find that if in the really hyper-vigilant, hyper-aroused, everything's I'm feeling everything, it's usually from a place of discomfort or pain or, you know, again, assessing for what's wrong. It's not feeling safe inside. So starting to transition to if you could notice one place in your body that feels completely neutral, where would that be? And see if they can land their attention even just for a second on that more neutral place and try to expand and build on that so that they're reducing that tendency to constantly assess and essentially orient towards what's dangerous, what's not safe, what's not right, and find uh something pretty neutral and basic to land on and give themselves a break. And once they discover, oh, I can do that, and they can build some mastery in that of like, oh, this is something I can do, even if it's just for a minute, maybe it's only for a second, to give the nervous system a bit of a break in that there can still be a lot of power and it can be a thread to pull on and build on. Like, okay, I don't just have to be in all of this, I can actually find something completely different.
SPEAKER_00And I think I probably should have asked you this at the beginning of the discussion, but sometimes I think that people need to hear the word enough before they ask the question. Like I find I use the word nervous system a lot, and then I don't I don't explain it enough. Like I don't think I take the time to ask them, what do you like, what do you think the nervous system is? When people ask you, like let's say you're using that terminology and they say, What's the nervous system? How do you explain it to them?
SPEAKER_02Yeah, so I generally will start early on in sessions talking about the window of tolerance as a framework and a concept for them to lean on when it comes to nervous system work and let them know that we in our nervous system, we have the part of it in which we feel like our best self, we feel we can make good decisions, we can make memories, we can learn stuff, we feel okay. We still have feelings when we're in our window of tolerance, but this is our most regulated state where we're able to function in what feels like the most okay place, even if we're having some feelings. Um, then we have the part of our nervous system which is really ramped up, and that is that fight or flight. Most people are pretty familiar with the fight or flight phrasing. Um, and I say, you know, that's a hyper-aroused place where everything that we can imagine is jacked up. And when we're in that place, we're not making good decisions. We can't integrate information or memories very well. Um, we're not able to even sometimes access words. Uh, and that's where our experience is really dialed up. And I give examples of, you know, everything in us turns up, heart rate goes up, breathing changes, temperature goes up, body tension goes up. Um, a lot of people are pretty familiar with that as I describe it. They're like, oh yeah, that's where I am most of the time. I'm like, yep. And then I let them know we also have the part of our nervous system that is that kind of checked out, um, dissociated, depressed place where there's no energy in the system. Uh, and again, we can't make good decisions, we're not taking good care of ourselves, we're not integrating information very well when we're in that place. We've got nothing to give. And that's not just being tired, it's being completely checked out. And that that is also a survival strategy. So I remind people that, like outside of our nervous or in our nervous system, outside of our window of tolerance is the survival strategies. It's all the things that our wonderful, smart nervous system has in it to make sure that we survive, but it's really difficult to live life in those places. We want to be in our window of tolerance, which is our regulated nervous system, and allows us to feel like we're as okay as possible.
SPEAKER_00And so obviously, like different things will happen to us that kind of push us outside of our window of tolerance. Um, like, for example, an injury, maybe, or pain, for example. But can you talk about how like can you talk about how things like stress influence that? Because I think this is where what people sometimes have a hard time connecting is when like they come in with an injury, like that's very seems very tangible to them, but then they can't necessarily understand why I'm asking about things like stress or why I why perhaps maybe we're curious about what their day-to-day life looks like. Can you just explain a little bit about how yeah, I think external stresses influence like how our injury will present?
SPEAKER_02Yeah, I let people know that things will compress our window of tolerance and stress makes uh that bandwidth much more narrow. Lack of sleep, not have eating well, like all these things will press in on that window of tolerance and means we have very little space to be okay before we are starting to feel really overwhelmed or dysregulated, which means that pain can be really dialed up, um, we can also be really dissociated from pain if we tend to drop out the bottom into the hypo aroused place, uh, and that everything is perceived as threatening when we have very little bandwidth in our window of tolerance. So it's important on a day-to-day basis to be doing things that create a bit more space in that window of tolerance. And then if I also know for someone that they have a long history of trauma or that the injury was through a traumatic means, whether it was accident or I mean, sometimes surgery can also be perceived and experienced as traumatic for a lot of folks, um, then I'm also holding that in mind of like the nervous system has felt under threat, uh, and it's possible that that is contributing to how intense they're experiencing things or how dissociated they are from experience.
SPEAKER_00And I think this is where sometimes physiotherapy feels confusing to people because I think that people associate physio with like exercise. And exercise can can also be calming. And I think when I find that um it can be a lot of work to describe to people, like I'll I'll describe in your analogy that people might come in with a very narrow window window of tolerance in their symptoms, and so the exercise I'm giving them might have to do with more, like I said, mindfulness or maybe breathing or noticing things more. And I I do find sometimes they're like, Well, that's not what I thought I'd get from physio. I thought I would get strength I thought I was weak and I do strengthening exercises. Whereas based on their presentation, I might be like, I think that's gonna compress your window more because it's gonna either push you up into that more fight or fight or make more tension, perhaps, or if and if those exercises are making pain, and I think that's where a lot of times people don't understand is that I can give an exercise again to 10 different people, the same exercise, but it's gonna land very different depending on what they believe about the exercise, how they are doing the exercise, what they feel in the exercise, right? And you know, I'm getting off on a tangent here, but that's very relevant. The social media is terrible for this right now because people will see, oh, I have hip pain. I'm supposed to do like social media told me I'm supposed to do these clamshells, but it's making me worse, so something must be wrong, right? And I think that's where it's like, well, no, you just can't assume that everybody with hip pain needs that um want to exercise. I find that social media is making all of this very hard for people.
SPEAKER_01Yeah. Same in the therapy world.
SPEAKER_02Yes. Yeah, a lot of stuff that's very like generalized. Um, yeah, not taking into consideration the nuances of it, or just languaging that has been applied incorrectly and now is part of like pop culture um conversations, including trauma, right? Like trauma, everyone talks about well, that was traumatic or this is trauma. It's like trauma also actually has a very specific definition uh and is meant to, you know, describe and pertain to specific things. It's not everybody's got trauma. I mean, probably all do, but the way that it's being used um is so generalized, which can be harmful as well. Um, but I think, you know, it's kind of comes back to what you were talking about before, and that we were talking about with the bracing of like if somebody's window of tolerance is really narrow and they're trying to do these things to move through injury or trying to apply these things, and their body is just bracing and clamping down more around it, like that is gonna feel more threatening in the nervous system and they're gonna compress that window of tolerance or be on the edges or outside of their window of tolerance if it's feeling threatening enough. Um, and then there's that like, well, I'm just not doing it right, or I must be a failure, I have to go harder, or you know, something's wrong with me. And now all the beliefs get in that further kind of brace the body and the nervous system. And now we have like layer upon layer of um, you know, the nervous system doing exactly what it thinks it's supposed to be doing to protect us, uh, but it's actually now such a barrier to recovery.
SPEAKER_00And it's interesting because um, like if someone says to me, Should I do this exercise? Often I would say, I don't know, do it. Tell me how it feels. And they look at me like I have two heads, and like, well, I don't know to I don't know if you should do that or not until you give me feedback. Okay. And I it's interesting how some people, like I said, let's just use the example of cat cow. Okay. I'm just picturing someone on this yoga mat doing cat cow. And I can picture this one woman who, as soon as she does it, and I can see her, as soon as she feels something, she quickly comes out of the movement. And I say, What makes you stop? I don't know, like I feel nervous to do this. Like it was it's kind of like a um like her mind is telling her not to do it, right? Like her mind is like, I feel nervous about this, and this is why I feel nervous. Um, social media told me I shouldn't do this, right? Whereas someone else, they're maybe moving so fast, and like, how could you possibly feel anything in this movement, right? Like they're they're almost just going through the motions. You told me to do 10, I'm gonna do 10 as fast as I can, right? Whereas someone else is kind of like, is this right? Is this right? Is this right? And and that's why I sometimes like, well, why do you like what would be the point of doing the exercise? What are you wanting to get out of this? And it's interesting how some people, yeah, some people know exactly this is what I want to get out of it. And other people are like, I don't know. You tell me.
SPEAKER_02Yeah, you're the expert, you're supposed to know. And again, there's that like if we've never been taught to trust ourselves or to know that I know my experience best and that that is okay, and it's okay for me to take up space in this world, and it's okay to me for me to express my experience to someone, then yeah, we're just looking to the outside world to validate us, whether it's in how we're doing physio exercises or you know, how we feel about ourselves or what I'm supposed to eat for dinner.
SPEAKER_00Yeah. That's funny. That's often something I say to people like, especially the pregnant and postpartum woman right now is just inundated with information. And I find myself saying, like, go in before you go out, go in before you go out. Like, just ask yourself first, do I want to do this exercise? Or should I do this with my child? Like, go in before out. And because they're inundated with the outside information, it's it's really hard right now.
SPEAKER_02Yeah, no kidding, so much. And yeah, then we become more dissociated and disconnected from ourselves because I'm just going through what other people are telling me to do, and we maybe even lose the the skill of noticing how we are responding inside. Like sometimes I do the exercise with clients of like something that's totally unrelated to their experience, but I'll be like, Okay, I'm gonna offer you two things imaginally, and I want you to just tell me your preference. I'll be like, you know, do you want chocolate ice cream or vanilla ice cream? And I'll be like, oh, vanilla. Oh, okay, cool. What told you that you wanted that? What did you notice? And then we can study that and be curious about it. And then I can be like, okay, so you want vanilla ice cream. Um, and what if I told you that I'm gonna serve it to you with apple pie? And they're like, oh yeah. I'm like, okay, so you still want vanilla or would you change it to chocolate? Oh no, I don't want chocolate ice cream with apple pie. I'm like, okay, so what tells you that? How do you notice that? Just to help people go in and check in with themselves of like, right, you do know yourself, and let's notice how you know that and begin that practice and building that confidence back or rediscovering it if they've really never been able to connect with it because of the messaging from so many different places, whether it was from childhood or other relationships.
SPEAKER_00Okay, so I feel like my job and like doing having this kind of conversations like makes me overthink parenting because I'm always like, How do I make sure I teach them? Like, or how do I have good influence? Because I see all day people that I'm like, that's unfortunate that you got that message, or that's unfortunate that you had that experience. It makes me overthink parenting. Can you ease my mind? Can you can you speak to um yeah, like parents listening? Like, how can we? Because obviously we cannot do anything perfect and we are who we are, and our kids have to pull things from so many different directions, but uh I think what you're gonna say is help teach our kids to like listen to their own messages. I just want to hear you talk. Give me some give me some information.
SPEAKER_02Well, all parents are gonna get it wrong at some point. Yes, all of us grow up needing therapy because of what happened when you were growing up. That's just to be expected. Um, the important piece is being like the good enough parent and being able to also, when there is a rupture, to be able to also repair. That is so important for the nervous systems, even as adults. Um, but like in little people in our world, it's like you're gonna mess up, you're gonna say something wrong, or offer the incorrect messaging, or wish you'd said something different. It's the repair that we make afterwards and coming back into connection, coming back into trust and um and safety with each other that is so important for nervous systems uh and creating a sense of safety or helping little people understand what safe in their body means and what safe around them means. Like that sense of being safe or safe enough is so important. Um being able to permit comfort, uh, whether that's offering it or making sure that they're accessing it in different ways. We need comfort, um, being the safe enough adult around because you know, as adults, we are the external nervous system of the little ones in our world because theirs isn't yet fully developed and they're still discovering. So yeah, that's a big task and a big responsibility as adults in their world. And it's okay that we don't get it right all the time, but we can attune to each other. We're a nervous system, their nervous system coming into connection and attunement, even if we don't understand what is happening, we can also learn from them. Like maybe they know some of what's going on for them. They might not have all the languaging that we have or all of the ways of expressing what's going on for them, but just slowing down with them so that they can be present and that we can be present with them. Kids are wonderful examples of mindfulness and being present because they only function in the here and now. So just meeting them in that place and letting that be okay and creating personal. permission to notice and be the expert in their little body um while still being you know the guiding light for them.
SPEAKER_00Totally. So I mean you've kind of answered this in a roundabout way, but I think about how um and again people are already coming to you knowing that kind of like their emotional well-being or or their their brain and their nervous system are what they're coming to talk to you about. But I wonder if you could give for the the physical health practitioners like massage therapist physios like how do we some creative ways for us let's say and I think about this all the time in my practice like when people tell me their symptoms I can like I can infer pretty quickly that like I have to think about a belief system I have to think about previous experiences like I have to think about so many things. So now creative ways to let them know that their symptoms um aren't are be they have an emotional component or a history and like how do I make them think that this is not in their head or that you know like how creative ways for us if we're like oh there's something more to this and this person might benefit from working with a counselor or something like that. Like how do we bring that up without them feeling like we're saying like you're just this is in your head it's delicate and not everyone's going to hear it the way that is maybe intended.
SPEAKER_02They might still hear it through that lens of oh you're saying I'm crazy. But I always let people know that they are a full system. They are a whole experience they're not just a physical body they're also not just emotions and they're not just thoughts but that we're a lot of different pieces and attending to all of them together can really support the whole picture and being able to move forward in recovery and being able to feel best in themselves, best like physically in themselves and best towards themselves. And I think being able to suggest that as we were working through the physical piece, we might have feelings about the physical experience. Or sometimes as we're working through the physical recovery, feelings might show up that we didn't expect and or we might discover stuff about ourself that feels confusing or feels like a bit of an obstacle and we're not sure why we keep getting in our own way and it's okay to talk about these things kind of alongside the the physical treatments. But that you know our whole system including our pain system takes place in our body but it also takes place in our brain and it's can be so helpful to do both alongside and I always remind people like it's it's tentative. It's like it could be helpful for you not like you have to do this but um but it could be supportive or try it out and see what you discover about um these other parts of yourself.
SPEAKER_00I would say like I always I find people are quite often open to exploring it but some people be like I don't want to go to a talk therapist um can you give some ideas like uh maybe they're kind of like ready to scratch the surface or they're ready to think about it but they just don't a lot of people I don't want to talk about it. And even though we're like I think that might be helpful down the road what are some baby steps?
SPEAKER_02Baby steps may even just be it could be finding a podcast or a book or a website that speaks to it so they can get more understanding or other people's experiences. Like oh okay maybe or even just starting the process of looking at who's available like going on psychology today or the BCACC or finding like just looking through people's profiles as part of the like who would I want to work with if I was going to do this. People's profiles say a lot about different ways of working and that might speak to them of like oh this person says they don't really do talk therapy at all. It's something totally different or oh equine therapy how interesting that might be or it could even be stepping in towards something like first this isn't going to fit for everyone but for some it's like doing maybe yoga or something that is still like allows them to be with themselves and start that experience of like being in a room with other people being reflective potentially or finding out that they're not at all or discovering how uncomfortable that is to be like oh maybe I could work through this. But yeah there's lots of like really gentle ways to just be curious. Hearing from other people's experiences is probably one of the the easiest most accessible ways for people to be like oh maybe I could consider it.
SPEAKER_00That's what I find is like I think like people will come in and um I'm gonna use the topic of abortion for a second because people will come in and maybe say like I had an abortion this long ago and I think okay I have a kind of an idea of some of the things that maybe are going to come up but I wouldn't say like do you feel this and so sometimes I find that that's how I I'm just using that example to say like I might bring up some other okay I've had a couple other people imagine I have had a couple other people that come in and um these are some things that came up and I find that they're like oh my God that's me.
SPEAKER_02Like I find that I do find that such a helpful way of just like oh yeah you know does this sound familiar because I think it just feels less accusing right definitely yeah and that sense of like oh it's not just me it's not like I'm not wrong or bad. There's other people that maybe have yeah something like this.
SPEAKER_00Yes. And I think it's easier to see that in other people like no wonder they feel like that. Like no wonder that other girl that had an abortion feels like that.
SPEAKER_02Oh wait that's me right exactly um Corey what what other things do you feel are relevant to this conversation that I haven't asked you if if anything um I think we touched on so many really important things just yeah that the person's internal organization of experience like how they perceive themselves in the world I think probably translates so much into what you're seeing because you're seeing and experiencing and hearing from the symptom place of like how they're braced or how they're contorted or how they're compressed, um, how they lack breath or lack movement and how their whole body has responded to their life experience and being able to tease out that this is not just the injury that happened but it's like the whole life that is in this body that this is occurring in is yeah it's it's it's not what people expect, right? People think it's just about the injury. And so I think it's so important to encourage them to loosen that up a bit of like what else could this be or what else could be um considered or how could they relate to themselves through this process. And yeah the the physical piece and the therapy piece are so well aligned. So I think that's important.
SPEAKER_00I think that one of the takeaways that I had is because I think um it would be very typical that I would help someone kind of like oh do you see how that okay you came in for the symptom but yeah you're bringing up this brace as you say um in and let's notice that but I find that really quickly I'm moving to let's try to change that. And I think this is where probably some resistance may come up and that might be where that's where they start to put two and two together like I think I got to go work on this with somebody right I think one thing I could definitely do better is not try to change it right away or not suggest they change it right away, but just like notice that.
SPEAKER_02Yeah it's all the slowing down and discovering like I see it as so much curiosity and just learning to notice and observe a lot imagine a lot of people that you see well one they're expecting you to change that and they want they're there like please change this so getting people to understand like it's okay to slow down and just be in this place so that we can get the lay of the land and gather the information it sounds like you do a great job of like getting people to like discover what's happening, try things out and gather information before just making the change but this I think the skill of slowing down and actually noticing our own experience is hugely absent in our current world but is foundational to the work probably that both of you and I are doing.
SPEAKER_00Well and at the end of the day I don't want them to have to come back and that's where like I could probably work on whatever that brace is making tension in. I could probably mobilize that and work on that but bet you it'll come back if we don't figure out why you're bracing. And so I think that like that's where the manual therapy can come in is kind of like oh do you feel the difference when I give this manual therapy um I you can feel the difference now what are we going to do to make that not come back right or if they say I find if they come back and sometimes I felt so much better and it's creeping back. Okay let's figure out why you know and so I do think that sometimes there's a a misconception too about physio is that we can take it away but I I've heard of from a few instructors before kind of like there's no you can't take out any tension only the nervous system can. And so um I think that's what a lot of people don't understand either is that it's bigger than what we can do. Right?
SPEAKER_02For sure. Yeah I feel like we're both in the world of like discovering the function of that tension. Yeah doing something we're just coming at it from different perspectives but with the same intention of like what's the function of it.
SPEAKER_00Yeah exactly and that's why I think if I go full circle to kind of how you can take a different injury or sorry the same injury or the same surgery and you add it to a different person it spits out very different things because because the belief systems, the previous experiences, the things we do with our stress, the places we hold our stress, the activities we do is what kind of um expresses it right yeah absolutely well I appreciate your time and I appreciate your wisdom and we'll I I will make sure in the show notes I have where people can contact you. Okay. Do you do a combination of virtual and in-person work?
SPEAKER_02Yes I do yeah yeah so I can work with anybody in BC uh virtually and then in person at my clinic and that's a wrap.
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