Serving Men in Pelvic Health With Confidence with Dr. Susie Gronski

Show Notes
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Dr. Susie's Book:  "Pelvic Pain The Ultimate Cock Block"

How to find Dr. Susie Gronski on social media:

• Susie's Website
• Susie on YouTube 
• Pelvic Pain Relief Program for Men 

Other Resources
University of Michigan Sexual Health Cert

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Pelvic OTPs United - Lindsey's off-line interactive community for $39 a month!
Inside Pelvic OTPs United you'll find:​

• Weekly group mentoring calls with Lindsey. She's doing this exclusively inside this community. These aren't your boring old Zoom calls where she is a talking head. We interact, we coach, we learn from each other.
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• Highly curated forums. The worst is when you post a question on FB just to have it drowned out with 10 other questions that follow it. So, she's got dedicated forums on different populations, different diagnosis, different topics (including business). Hop it, post your specific question, and get the expert advice you need.

More info here. Lindsey would love support you in this quiet corner off social media!

Transcript

Lindsey Vestal What a fabulous conversation I had today with Dr. Susie Gronski, who specializes in men's pelvic and sexual health for over a decade. She's a licensed doctor of physical therapy, a certified pelvic rehab practitioner and a certified sexuality educator and sexuality counselor, an international teacher and author of Pelvic Pain The Ultimate Cock Block. She's the owner of an exclusive pelvic and sexual health clinic for men in Asheville, North Carolina. And she's about to hire her first occupational therapist in her private practice. We talk about so many under-discussed aspects of treating male clients. I can't wait for you to hear today's episode. New and seasoned OTs are finding their calling in Pelvic health. After all, what's more adult than sex? Peeing and poop. Now, here's the question. What does it take to become a successful, fulfilled and thriving O.T. in Pelvic health? How do you go from beginner to seasons and everything in between? Those are the questions and this podcast will give you the answers. We are inspired, OTs. We are out of the box, OTs. We are Pelvic health OTs. I'm your host, Lindsey Vestal, and welcome to the OTs and Pelvic health Podcast. Susie. I am thrilled. I am excited. I'm honored. I'm just beside myself to welcome you to the Autism Pelvic health podcast. Thank you for being here. 

Dr. Susie Gronski Thank you for having me. 

Lindsey Vestal I am so inspired by you. Of course, I've read your book. I love your in In Your Pants podcast. You have such, such an incredible sense of humor and you also serve such an incredibly important community that we can all learn from. And so I'm really excited to talk with you today. I just want to dive right in with something that's on my mind, which is how how can pelvic floor therapists, both OTs and Petits alike, support men? What's our role there? 

Dr. Susie Gronski That's a really great question. And I believe pelvic floor therapists such as OTs and Petey's like ourselves, can support men by creating a safe therapeutic container where men can feel heard, seen, validated without shame or embarrassment around their pelvic and sexual health concerns. Men need to know that they can trust us as their provider when they're sharing sensitive and often very vulnerable topics and parts of their body, really in a therapeutic encounter such as this. And I also feel that it's crucial that therapist acknowledge their own feelings around sexual ambiguity within this particular therapeutic. Container. So those all of those, I think, are really what is going to help support men in these therapeutic spaces and not just in the physical space, but also having recognizing that there's trust being established right from the beginning and all touchpoints. And what I mean by touch points is Internet. You know, if you're on social media, your website, you know, are you truly speaking to this person? Do you truly get them and understand them? And are you really welcoming them wholeheartedly with everything that they may or may not bring to the table? So I think that's how we can really best support men in this space. 

Lindsey Vestal I was listening to your podcast recently, and one of the things I heard you talk about were and that goes very much along with what you just said, Suzy is thinking about maybe, you know, a pretty a pretty typical pelvic floor therapy office where you walk in and maybe you see pictures of pregnant people, female bodies. And one of the things you were talking about was like, okay, think think about that from from the men's perspective. Giving them that chance to know they're in the right place right from the moment they walk in. And that really resonated with me because, again, it's sort of this container conversation where we're thinking about all aspects of care that mean from the moment they walk in the door, we thought about them. 

Dr. Susie Gronski Exactly. And then includes front staff answering, you know, how are you answering the phone? If they have particular questions, you know, are they being misconstrued in any way? You know, are you truly, really nondiscriminatory and and welcoming men or male identified people into into your space without, again, shame or embarrassment as far as what they're what they're reaching out for. Because I will say, you know, for this population and maybe people know this, maybe people don't, but it takes tremendous amount of courage and bravery to reach out to a provider like ourselves and to say, I'm really struggling with a very vulnerable part of my body physically and emotionally and with men. That's not an easy thing to do for several reasons. For example, the psychosocial factors, social cultural factors around men and their identity and quote unquote expectations and roles. There are a lot of stereotypes. There are a lot of biases. There are a lot of gaps within. Accessible medical health care for them. And and really, I think I can't stress that enough. It does take a lot of courage to just reach out, make that call. And often I do hear several times in the week it took me about a year to reach out to to make this initial connection. So that trust factor and building that trust is crucial. 

Lindsey Vestal Many of the therapists that I teach through my online courses have shared with me. And I have to admit I felt that way in the past as well. Sort of a cautiousness around supporting men for a variety of reasons. What would you say, Suzy, to a therapist that is on the fence but isn't quite sure? 

Dr. Susie Gronski Another wonderful question. So in my opinion, I feel that many therapists are cautious about supporting men because of two reasons. One being the gap in knowledge and skill, treating pelvic and sexual health conditions in men, and the second being sexual ambiguity around the therapeutic relationship. Both therapists and patients need to establish trust in this particular relationship's relationship, which includes having clear boundaries. So so these two things, I believe, are all why certain therapists are cautious about supporting men in the space which many of the therapists are female. Female identified? Yes. And it really comes down to one's comfort level, one's own experiences, skill, knowledge, etc. and really just owning that space, owning where you are at as a practitioner, what you're comfortable with, what you're not comfortable with. And if if treating this population for whatever reason is not within the cards for you and stable for you right now, that's okay. But knowing who to refer to. Yeah, that they do get the support and care that they that they need and that they're looking for. 

Lindsey Vestal I have some super exciting news for you. O.T. Pioneers Intro to Pelvic Floor Therapy. Is opening for enrollment January 13th through the 17th 2025. This is your chance to dive into a 100% online course with lifetime access. You'll get five group mentoring calls with me and two free months inside our off social media private community Pelvic OTP's United. Plus, we're hosting an optional in-person lab in Cleveland on February 21st and 22nd. Please come join over 1500 other OTs who have already taken the leap. I can't wait to see you inside OT Pioneers Enrollment January 13th through 17th 2025. So let's let's actually tackle those two huge buckets that you just said. I think you nailed it. A gap in knowledge and then sexual ambiguity around the therapeutic relationship. How what, Suzy, what are two ways we can what are ways that we can solve those two issues? 

Dr. Susie Gronski So the gap in knowledge and skill treating pelvic and sexual health conditions in men really comes down to the availability of resources for therapists. So one of the reasons why I actually created one of my own courses was because there is just a lack of availability in continuing education courses and training for working with men in particular, having hands on practice, working with a male model or male, you know, male body, right? So when when we often do, at least I'm going to speak from my own experience getting into Pelvic health we practice at each other, right? I'm a vagina vulva owner with another vagina vulva owner, and that's how we learned, you know, how we learned how we practiced. When I started doing this work, there were really there was nothing really available as far as resources for men. So I noticed the gap, recognize that and decided to do my own research and work with the brave individuals who had penises, who reached out and said, Can you please help me? And and really establish this filled the gap, really. And I'm not the only person to do that. I know there are way a lot more individuals today filling in these spaces and helping to support men more in the therapy space. But still, it's it's lagging behind quite a bit, quite a bit. So it's the accessibility to having continuing education courses and training and mentorship around pelvic and sexual health for men. And then the second part of this is the sexual ambiguity, which is a big one. Sexual and dignity around therapeutic relationships are often because of our own. I mean, to speak for my own, our own discomfort or my own discomfort perhaps around working with a person who has a penis. And it really shouldn't, in my opinion, it really should make no difference, to be honest. You know, if I'm assessing someone's vulva or doing an internal exam vaginally or rectally it, as my one patient said, it should be treated like any other part of my body, like my nose, my elbow, my foot. The more comfortable that the practitioner is with an individual, the more that person is at ease because that energy permeates and that therapeutic relationship. And I recognize that we all have our own experiences and we need to honor those experiences as well. Since recognizing where the discomfort is coming from, working with our own feelings around sexual ambiguity or uncertainty, but really also from a space of not shaming or embarrassing the individual that you're working with. So you there might be a perception of an engagement that really makes you feel uncomfortable. For example, the person having an erection. Okay, while you're by you're doing some manual therapy, maybe while you're doing an exam, it's recognizing what comes up for you in that particular situation. If that's the first time that that has ever occurred to you, and also knowing the knowledge around that, that spontaneous erections or spontaneous emission aka ejaculation can occur in these situations because these are physiological bodily reactions. You know, that doesn't necessarily mean that the person is sexually aroused mentally. So it's understanding that and not shaming the person and really just being curious. So if you do suspect that there's perhaps a different intention than what you yourself are establishing within that therapeutic relationship or you that you feel your boundaries are being crossed, it's acknowledging those feelings, sitting with them, and also having an open and honest conversation with the person in front of you. Certainly again, from the space of not shaming them, not judging them, but us from a space of curiosity. So that's what I have to say about those two things. 

Lindsey Vestal I love that. And that's such that such rich, valuable wisdom. And I have just a question like in a more concrete way, what do you recommend if let's say, well, let me back up for a second. Do you ever talk ahead of time with your clients about the possibility? Like, is that is that one or do you wait until it might happen? So just kind of thinking about logistics or day to day or even some of the questions that some of my pioneer students have had as they're thinking ahead about what these experiences may be? And I love your emphasis around, you know, sitting, sitting and what your response will be so that you're holding the most therapeutic space in a non shaming way. But in terms of like logistics and boundaries. So taking that one step further, you know, is this a conversation you have ahead of time? Is this a conversation you have if you notice it's happening, What do you recommend there? 

Dr. Susie Gronski Yes. So the practical stuff, I encourage folks to have a therapeutic relationship agreement, which is something that isn't often talked about in the OTP spaces. Therapeutic relationship agreement. Is your expectations concerning the professional relationship between you and the person that you're treating so that the work that you do together takes place in a consensual and safe therapeutic space? So establishing a new relationship agreement is going to name what your boundaries are. Within reason, of course, because it's not just one sided. You know, if you if we have a relationship agreement that's completely muting the other person from being themselves or sharing something that might be, you know, not your cup of tea sexually or otherwise, you know, can you still hold space for other people's experiences and what they want to share with you? Certainly being relevant to that that relationship. So my therapeutic relationship agreement is, is basically states that I will not participate in or be witness to behaviors like masturbation. I would, of course, intercourse, hand sex, mouth, sex, etc. I will not be witness to sensual, erotic sexual talk or behaviors or gestures towards me. Any any invitations beyond. The professional relationship space. So going out for lunch, going out for dinner, can I send you some pictures, etc. that that is not going that invitation will not be welcomed if there's any nonconsensual touching beyond the the touching that occurs within that therapeutic space. And I'm emphasizing therapeutic space because that's the language that I use with my patients. Any sexually explicit visual audio written material. And then, you know, certainly around language of disrespectful, aggressive or hateful language, which includes all the isms, right, sexism, homophobia, gender based aggression, etc.. I also, in my therapeutic relationship agreement, emphasize that the the the topic of sexualized transference or erotic transference and sexualized transference occurs when a person develops romantic or sexual feelings, thoughts, fantasies or attraction toward their provider. And it could be other vice versa too. I mean, if we're really honest, we all have thoughts and feelings about the people that we work with. So sexualized transference may develop within a therapeutic relationship for many different reasons. And again, we don't shame the individual, we don't shame ourselves. But we acknowledge that if we recognize any incident instances of sexualized transference and and engage in a discussion about a past, the possible impacts on treatment. And if it continues or hinders the treatment, then it is up to the provider or you to determine whether it's wise to continue the therapeutic relationship. So you know the meaning that you hold strictly to these boundaries to protect both them and you as the provider. So this agreement is to protect both of you. Not just you, but both of you. And then certainly, if if behaviors if there's if there any behaviors in your therapeutic relationship agreement that continue to become persistent and reoccurring that you have. That you have the permission and the power to end treatment and discharge that person. And that you don't have an obligation to refer to another individual at that point, that you're not obligated to do that. However, you may suggest that they may benefit from working with a mental health therapist. So that that kind of gives you a little bit of a framework for what is in my therapeutic relationship agreement. And I encourage providers to think about this for themselves. You know, what am I okay with? What am I not okay with all this? Am I not okay with particular discussions because of my own discomfort around that? Or is it truly violating a boundary here of a therapeutic relationship? And that really does take a lot of just sitting with yourself, sitting with your own sexual ambiguity, your own your your previous experiences. And, you know, maybe if you do have a mental health professional that you work with yourself. And in my situation, when I wrote this agreement, I was working with a psychologist. You know, I came up with this with her. So I kind of had a coach who would walk me through certain situations, certain boundaries for me that that have been maybe crossed in the in the past. You know, how do I prevent this from happening again and how do I just have clear, concise, direct communication that protects both myself and the person? 

Lindsey Vestal I love that. That's that's so beautiful. And, you know, I if do you mind sharing, Suzy, a difficult situation that you were in that perhaps kind of led you to developing that therapeutic relationship agreement? 

Dr. Susie Gronski Yeah. So I have I have had, you know, several instances where, again, it really was more reflective of my own discomfort in that process. But one one in particular is, for example, you have a consultation, a virtual consultation online, and this is a new person that you've never seen before. It's just an introductory call and the individual chooses to show up in a robe and exposes themselves to you. That for me was certainly a boundary that was crossed or unexpected. Right? So I be, you know, in that situation because I had never happened to me before. I had a lot of my own sympathetic protective responses come up, very defensive. And certainly in that situation, we do the best we can to say, you know, I understand that you're feeling very comfortable with me to to come as you are wholly and you felt very comfortable with your body. But for the privacy of this call, it's not necessary for you to be naked. So please put on your robe and we can have a discussion about what concerns you're having. You know, and so, again, not shaming the person because for whatever reason, you know, maybe that's what if they had, you know, pain and that's all they could wear was a robe. I mean, I don't know. But, you know, particularly speaking, maybe I'm exaggerating that. But, you know, we just don't know what that person's intention is. What I know is that that was something that didn't feel right for me. And having worked that scenario out and then establishing this therapeutic relationship agreement helps to mitigate some of those instances. A second one that comes to mind is, again, more in the online space, which is interesting. I had a person who was who decided who chose to participate in an online call, and I didn't see the act itself. So are we clear here? I didn't I didn't see him masturbating, but it was it was implied because of the other contextual factors in that situation that I was put in. So the person was undressed from the waist down. I did not know about this until the very end of the call where it was clear that that was deliberately that that behavior was deliberate to to to make it known that he was naked. And then once I started to unpack the experience after the call, I recognized the signs before then. So I was like, okay. There is a reason why the phone was so awkwardly positioned, you know, so that, you know, the person is looking down at their phone and all of these, you know, nuances to that experience. But again, so those are those are situations of clearly violated my trust. And they were not consensual by any means and they were not there. They were not therapeutic by any means. So again, in those situations. Things that helped me to mitigate that behavior is to have this therapeutic relationship agreement and also to make my consultations paid for services. 

Lindsey Vestal Yeah. 

Dr. Susie Gronski That's that's what really helped me. So those are two instances that I can, I can share, you know, that are that really maybe you could tell, but they, they still bring up some feelings for me where I'm like, wow, you know, But again, I don't want folks, you know, I don't want people listening to this to, you know, get turned off or deterred from doing this work. I mean, it really, really does happen. But it those experiences were beautiful learning experiences for me to really hone in on boundaries, clear communication, and really not to shame that person or and how do I become less flustered? How do I become more assertive, you know, assertive and direct and separate the behavior from the person, you know? So. 

Lindsey Vestal Yeah, I really I really appreciate you sharing that with us. And, you know, sort of my intention for for having these candid conversations with you is that I think a lot of people aren't even sure what they're unsure about. And when we talk directly about experiences that we've had, it it helps us break it down and then maybe even come to this decision of like, well, my gosh, I love this idea of a therapeutic relationship agreement and what would I want to put in there? What are some of the things that could happen that I can anticipate and and right in there. And then, of course, as you said, it's a learning experience because there's things that maybe we're not going to be able to anticipate or experience or know until we experience it. And what a what a gift to learn and to be able to put that in there and to have that assertiveness and to step into those boundaries, which helps us really get out there and continue to serve these clients because I'm sure it's a rare occurrence that things happen that are that are what you describe. But to be able to serve all the people that need us, we need to be able to think through what it is we're concerned about, what it is that maybe we are on the fence about. So thank you so much for for sharing those concrete examples with us because it does help us start to wrap our head around, you know, the discomfort that we may be having. And we're not even sure what it is. 

Dr. Susie Gronski Right. Exactly. And I would like to also just mention that this isn't just a one sided, you know, male identified therapeutic relationship agreement. Okay. If I'm working with a male, this is what they got. This agreement goes to everyone because I've had experience. Yeah. I have also had experiences where I had female identified people also crossed boundaries. And it's just it's just important not to discriminate based on someone's gender. This is like a 400 acre relationship agreement and it should go to everyone. 

Lindsey Vestal I love that. Thank you for thank you for anticipating that was were exactly to my head. I still love that, Susie. I love that. So how how did you prepare for specializing with this community? Kind of like what what let you down this road. That is a very clear passion for you. 

Dr. Susie Gronski So it really is. It was the observation of the health care gap and treating the male identified population with pelvic and sexual health concerns. So I started my practice several years ago in Illinois, and it was a very general practice, you know, seeing all folks, but really mostly women's health at the time, because that's kind of how I started it was women's health, which I think a lot of us also have that experience. And as I said earlier in our conversation, men would reach out to me saying that they have some of these similar symptoms and concerns. Would I be willing to see them and treat them? And that's how it all started, really is is through their work, their bravery, their courage to step into these spaces, to ask to reach out. And then I started to do my own market research. So using the information and the experiences that I had with my patients and then doing my own market research and then evolving through that process as well, Right. Learning where, you know, men are, what spaces are they living in, where are they getting their health information, What are the health behavior habits that that again, quote unquote, I don't want to stereotype all penis owners, but what are the general health behavior habits when you compare that to women, etc.? So so that was where I really honed in on my message and my my language to really be able to relate to this population because I don't have a penis. So that was another thing that I really had to work hard at. No pun intended. Yeah, I really. A lot of effort. I really had to put a lot of effort to building the trust and the relationship with this population because I am female identified, I don't have a penis and I cannot possibly say that I know what it's like or what the experience is like to be a male with pelvic pain or erectile difficulty, etc.. I don't have those firsthand experiences, but what I do have is the experience, the shared experience in working with this population and doing the research and getting to understand them at a higher level. Yet that's when the trust really just, you know, they they get it. They're like, You speak my language, you know, you're speaking to me. I feel like, you know, some of them would say like your website or your book, I felt like you were talking to me. So so it really did take a lot of cultivating and enriching that therapeutic relationship over time so that they can can really trust and feel comfortable enough to reach out and get help sooner than later. 

Lindsey Vestal How beautiful. I love that. So I, I, I'm very passionate about the biopsychosocial model and strongly lean into that to support pretty much my entire framework for pelvic health. And I. I've listened to your podcasts enough to know that you are also a really big supporter of this approach. Can you share with us, Suzy, a little bit about how you use this in your practice and maybe even a story that gives us a sense of its importance in the way you treat? 

Dr. Susie Gronski Yeah. So the bio psychosocial approach, you know, I tell folks, it's not a treatment modality, it's just a framework or a model by which I work with individuals. And for some people that bio is more important than the psychosocial factors. But essentially what how I use the bio psychosocial model is to approach therapy and and support by looking at this person or the person that I'm working with as a unified human being, that they're not just a body part. We're not I'm not compartmentalizing them. And even this could be something that and I fall in fallen into this trap too, of using the bio psychosocial model as compartmentalizing people. So and it's really not it's not about putting them into bubbles and compartmentalizing their their issues or their concerns, but really it's about helping both the patient and the clinician understand the multifactorial aspects to that person's experience and what might be driving some of these in internal models, their beliefs, their feelings, which ultimately result in, you know, motor commands and all sorts of physiological processes, etc.. So I use it in such a way where I get to know that person. So the interview or the subjective is is treatment for me, it's very important. Actually, a lot of my diagnosis for my my assessment, you know, curating an assessment tailored to that individual comes from their story. And I allow ample time for them to be able to share their story in the way that they want to express themselves. Because not only is it maybe perhaps the first time that they're able to share all these vulnerabilities with you, and you're probably the first one that are going is going to hear these their story in this way. But you can use that to develop trust and to also then curate a an exam that that models what's most important for that individual and perhaps use it as a learning opportunity as well for that person to perhaps reflect or see their situation in a different way. So it's a collaborative approach that I take using the bio psychosocial model and in again, knowing, you know, what part of that model is, is maybe the most important or maybe the driving factor for that individual and then supporting them as well. So I'm not a psychologist, but if I'm going through their their story and listening to their story and recognizing that they're really struggling with coping skills and being able to feel like they feel in control or that they've got a good handle on the situation, then I'm certainly going to suggest a mental health professional and I'm going to bring it up. Up in a very gentle way and compassionate way. Letting them know that I'm recognizing how challenging and how difficult it has been for them to cope with such a situation. Have you have you considered talking to someone about this? You know, so that's that's that's the way that I would do it. An example that exemplifies this model is a story that I had with, gosh, a male patient who came from another state. I'm trying to eliminate any identifiers here. So we're going to be very slow in trying to like not let it slip, you know, be so, so, so, so he came with his parents flat in the back seat, Couldn't sit, couldn't sit at all, lay down the back seat for 4 or 5 hours to completely debilitated. Completely debilitated. Had hip surgery had gone through so many providers and therapists. Pelvic, you know, pelvic pain, penile pain, hip pain, etc., So afraid to move. And in my you know, again, I acknowledge the bravery for him and his family to to come down to to have this, quote intensive or several sessions with me. And I you know, I start that off by saying, you know, you're so persistent, you're so determined, you're so committed to your health. You know, I admire that. You know, so from that situation, really a beautiful transformation had happened because this individual was told to stop doing the things he loves for fear that he's going to keep hurting himself, or that if it hurts, don't do it. You know, all these misguided and misinformation around the old views of pain that were really limiting him. I mean, he was in his 20s. So I literally heard a story. And at the crux of it was I have lost my entire life and I feel like I can't do anything. And so by gently sharing some pain, you know, just trickling in some some pain education, but not just talking to him and saying like, here's the education. Do with you what you want with it. It's it was actually then saying, how can I help? You have an experience in your body that's other than what you're used to right now. And that involved a little bit of a little bit of a, how do I say a theatrical performance? Because you had to kind of take him down an experience where he was actually doing the things he was afraid to do. But did it know he was actually doing them and it didn't hurt. So it was around maybe a lunch. I can't remember. It was so long ago, but it was around doing some positions at the time. I think I had more of a yoga emphasis, so I had him kind of explore his body in different ways and then point out, Hey look, did you know that you just did that? And he was like, No, I thought I was going to really that was going to really hurt. And I was like, Well, did it? And he's like, my gosh. So then I, you know, giving him permission to say, Hey, what would it be like if you went with your parents to have lunch and you just sat in whatever chair there was available? I wonder what that would be like knowing that you're not hurting or harming yourself, that all this is just a sense of protection and you don't want In that week that he was with me, sat with his parents at lunch, no problem. And even at towards the end was able to go kayaking. He could not believe that he was able to do that immediately. It shifted. So for him, it wasn't the manual therapy, it wasn't the exercise, it was the permission to move and the optimism around his situation and filling in the knowledge gaps because he thought, you know, I had the surgery, I'm never going to be able to do these things again. And understanding like, well, where is this belief coming from? Where did you learn this? What were you told? All of those factors for particularly the fear, the grappling fear that this person had was really debilitating him. And now he met with a practitioner who said, wait a second, you can do these things. Let's try them out. Let's be curious and have fun, You know, for the music, I like to I like to ask patients what music they like to listen to, what's on their playlist these days because music and and and sounds and smells and the atmosphere in the environment can really make a big difference as far as safety versus threat cues. So I really like that. You know that. That experience with this particular person was truly eye opening for me and for. For him, because he was empowered to know like, wow, I do have more control than I think I can recover. Not just manage but recover. And look how quickly my body adapts. It's it was just a beautiful experience to be to to be a part of and to share with him. 

Lindsey Vestal That's so powerful. I love that. I love that. I love so many aspects of the way you supported him. And that was just a really, really clear example. So thank you for sharing that. I noticed that you are an ASX certified sexuality educator and sexuality counselor. For anyone listening today who is curious about how pursuing that certification really helps you in the day to day. What would you say to them? 

Dr. Susie Gronski Yeah, so Aspect is one of the top names in sexuality educators, counselors and therapists. It's an American association. It's Asec stands for American Association of Sexuality Educators, Counselors and Therapist. And I did a yearlong program with the University of Michigan for their sexuality health certificate program. And in becoming a counselor, an educator, it was the best experience I've ever had. Really, if there's anything that I suggest to any of the therapists, those who are working in Pelvic health, the sexuality, education and training is, I think, crucial to what we do, because how could we not open up the conversation with our patients talking about sex, asking all those questions that are difficult to roll off our tongues, you know, saying the words, we could read them, but saying them is another thing. You know, it's getting it's doing the process. And as I went through the certification process myself, I learned a lot about my own sexuality. And that's something that was that has really helped me in my practice to work with those discomforts, to work with in a space that again, is supported and to have other other students and really practitioners, I should say, because this is a cohort that is psychotherapists and other allied health professionals, medical doctors, etc., that you're all sharing in this space and each each person brings it to their to the table or to this, to the group, their own experiences and, and modeling of a type of behavior and interaction with their clients. I think this is so beautiful to see and I learned so much from my cohort that I'm so grateful. And for the program itself and all the professors and speakers. But it really opened up my eyes to what I was, what I was, what I was already doing, but not taking it even further because I just felt like I didn't have the the skill set or the practice or the experience. And so through this certificate certification process, it really helped me hone in my skills to better help support individuals that are outside of the traditional box of occupational physical therapy. So, you know, sexual specific exercises, you know, masturbation, talking about toys, talking about pleasure and all of that can be a form of sensory integration. But it's a it's a sexual health twist. And not being afraid of that to share sexual exercise, to talk about sexual resources, to to guide someone, maybe through a visual imagery exercise that helps to connect with their sexuality and reduce fear, etc.. I just think that that is such a important and crucial aspect to the work that we do as therapists. And if we if we bring in this element of sexuality counseling and education, it really does make for a very robust ability to help someone who has sexual pain or sexual dysfunction, for example. So, yeah, it's beautiful. And and in order to get certified through a sect, you have to have a certain number of hours supervision hours. So it's not that you just, you know, go through the program and you get your certificate and you can. But if you want to be certified through exact, they do. They have very rigorous guidelines around who can be certified and the number of hour hours that you have clinically and with supervision. So you have a supervisor, sexuality counselor, supervisor, a sexuality educator, supervisor, where you are, you're being mentored, I own cases and curricula, etc.. So it's a beautiful it's a beautiful process. At least it was for me. 

Lindsey Vestal Incredible. Incredible. Suzy, what's next for you? What are you looking ahead down the road? What do you hope to accomplish in the next 3 or 5 years? 

Dr. Susie Gronski Gosh, I'm a person that's like day by day. I'm like 3 to 5 years from now. Know I'm not sure. So, Well, I know right now, maybe I'll speak to what's happening right now and why I hope for things to be as far as my practice is in inter-disciplinary practice. And right now we kind of have that established. I have a occupational therapist who is joining my team in June. I have a nutrition nutrition therapist who is with my practice as well, and I'm hoping to have a professional mental health therapist as well too. And all of us, where we just share the same language and approach As far as the bio psychosocial approach and understanding the contemporary views on pain science to support individuals throughout their process. Because really, you know, I've gone through doing everything myself, trying to be everything for everyone or yeah, exactly like doing it all. And I realize that that is not helpful at all. In fact, you know, you're going to be overwhelmed, tired, and just completely deflated. It's not sustainable. And so to bring people on board who are can do a better job of all these things, I think is is the best thing for my practice moving forward. So really creating this support system where an individual has permission to work with any of us throughout their their journey. And that's kind of where I hope my practice in North Carolina is going to to be is this interdisciplinary practice approach. 

Lindsey Vestal I am I am very passionate about the interdisciplinary approach and I am nodding and clapping and I think I have a couple arms over the head moment. Thank you for for embracing that, living that and recognizing that importance. And I think that's incredibly that inclusivity, recognizing how much we can learn from each other and how much our clients gain from partnering together is beautiful. And I appreciate that nod to, to this idea of as an entrepreneur wanting to do it all and, and then recognizing at that point and maybe maybe it's before reach burnout, maybe it's after but recognizing that there's is so much strength on collaborating. 

Dr. Susie Gronski Absolutely. 

Lindsey Vestal Susie, I'm so. 

Lindsey Vestal I'm so grateful for your time today. I'm going to put links to where people can find you on IG, your YouTube page, even a link to your pelvic pain relief program for men in my show notes. And I'm really, really appreciative of your time and your wisdom. Thank you for joining me today. 

Dr. Susie Gronski Thank you for having me. Lindsey It was a pleasure. 

Lindsey Vestal Thanks for listening to another episode of OTs and Pelvic health. If you haven't already, hop on to Facebook and join my group OTs for Pelvic health, where we have thousands of OTs at all stages of their Pelvic health career journey. This is such an incredibly supportive community where I go live each and every week. If you love this episode, please take a screenshot of this episode on your phone and posted to IG Facebook or wherever you post your stuff and be sure to tag me and let me know why you like this episode. This will help me to create in the future what you want to hear more of. Thanks again for listening to the OTs and Pelvic health podcast.