Real Healing Starts When We Stop Following The Script

• Learn more about Level 1 Functional Pelvic Health Practitioner program
• Get certified in pelvic health from the OT lens here
• Grab your free AOTA approved Pelvic Health CEU course here.

____________________________________________________________________________________________
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.
  ​
• 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

Let’s dive into a topic I find foundational—not just for pelvic health, but for how we show up as occupational therapists. When you’re sitting across from a client and you're unsure which direction to go, when multiple treatment paths are possible, or when you feel stuck in “analysis mode,” this is where having a solid framework makes all the difference.

For me, that framework has two core components:

1. We operate as facilitators, not fixers.
2. We embrace a whole-person, biopsychosocial perspective.

Of course, there’s more complexity under each of those, but today isn’t about theory overload—it’s about grounding ourselves in practical, repeatable ways to center our work. And yes, while OTs are who I’m speaking to specifically, this approach isn’t exclusive. Many PTs share this same perspective too. I just happen to be an OT who has spent most of her career as the underdog, and I’m here to champion this profession and the big-picture, client-centered lens we bring.

Let’s start with a reflection. Think about your role with your clients. If you had to describe it—how would you frame it? I’ll give you three options to choose from. No pressure—it’s not a test. But it is a gut check.

A. I carry my clients up the mountain.
B. I lead the way and they follow.
C. I walk beside them.

Let’s unpack what each of those means in practice.

Option A: Carrying the client.

When we carry someone, we’re doing the heavy lifting. We’re assuming they can’t do it themselves. We’re accomplishing the goal—sure—but at what cost? They arrive at the top of that mountain without having climbed it. There’s no skill-building, no awareness of how they got there, and no self-efficacy built along the way.

This model positions the therapist as the authority and the client as passive. The message becomes: “I know best, I’ll take it from here.” And often, that leads to interventions that feel more like procedures being done to someone—rather than a co-created process.

The client may leave feeling like something was “done to them,” but not necessarily “built within them.” And if we’re honest, we’ve all experienced this dynamic in some healthcare setting. It doesn’t feel empowering—it feels like being on the receiving end of someone else’s plan.

Option B: Leading from the front.

This model often feels like progress. The client is walking. They’re active. They’re doing the work—but we’re out front, showing the path. We’re still the expert, determining the direction. And while this model can produce results, it often lacks flexibility.

I spent a good portion of my career here. I gave great education, I assigned home programs, I explained the “why.” But I didn’t always stop to ask whether the plan made sense for them. I assumed motivation equaled availability, that if they wanted to feel better, they’d just follow the path I mapped out. I didn’t always pause to ask: “Does this actually fit your life?”

This approach is organized, effective—but it can be rigid. It doesn’t leave much room for the client’s insight, or their lived experience, or their wisdom about their own body.

Option C: Walking side by side.

This is the model I’ve worked hard to embrace. It’s collaborative. It’s fluid. It’s built on mutual respect, curiosity, and responsiveness. Here, the client is not just active—they’re equal.

We ask, “What’s most important to you right now?”
We wonder, “What would success look like to you?”
We negotiate: “Do you think 10 minutes a day feels manageable? Would mornings feel better? Evenings?”

This is about partnership. About seeing our clients not just as recipients of care, but as co-creators of it. When we walk beside them, we trust that they know themselves—and we support them in reconnecting to that knowledge.

We also stay open to feedback. We ask how therapy is feeling for them. We adjust. We take cues from their nervous system, their preferences, and their pace. And the beautiful thing is, when we show up this way, our clients often reveal exactly what they need. We just have to be listening.

This approach means noticing not just symptoms, but personality traits, motivations, belief systems, and cultural backgrounds. We tailor our care—not just the content of therapy, but the tone, the rhythm, and the relationship.

And it starts with the little things. Saying “Sit wherever you feel comfortable” instead of “Sit over here.” Knocking before entering. Being mindful of touch and space and tone.

These small moments build a sense of safety. And safety is the foundation of any healing process.

Let’s talk about the “fixer” mindset.

This is one I’ve had to unlearn. Because when we see ourselves as fixers, we see our clients as broken. And that’s simply not true.

When we act as if we’re solely responsible for healing someone, we take on a burden that was never ours to carry. It’s unsustainable. And it’s disempowering—for both therapist and client.

Instead, we can reframe healing as a shared process. We can be guides, not mechanics. We can help people reconnect with their own capacity to heal, rather than positioning ourselves as the only source of that healing.

Ask yourself: If it’s not my job to fix this person, how would I show up differently?

This is where the trauma-informed lens becomes essential.

Trauma-informed care isn’t about asking for someone’s trauma history. It’s about assuming that trauma may be present—and making sure our care doesn’t re-traumatize.

It’s about choice. Collaboration. Transparency. It’s about informed consent that goes beyond, “May I do this?” and into, “Here’s what I’d like to do, here’s why, and here’s what it might feel like.” It’s about using language that invites, not commands.

And it’s about creating physical spaces where people feel safe—private rooms, no interruptions, respectful touch, and clear communication about where we are in the space and what we’re doing.

We also have to remember that trauma is layered. There’s often the original wound, and then there are the secondary ones—like being dismissed, ignored, or misdiagnosed. Even something like an injury that removes a coping strategy—say, a runner who can’t run anymore—can create a feedback loop of stress and dysregulation.

Which is why we don’t ask, “What happened?” so much as, “What are you feeling right now?”

The nervous system is central to everything.

Are they in fight or flight? Are they frozen? Are they able to down-regulate? These are the questions we start with—not just because they help us treat pain, but because they help us treat people.

And that’s the heart of the biopsychosocial model. Yes, we look at physical tissues. But we also look at beliefs, emotions, social context, identity, and meaning. We treat the person, not the diagnosis. And this can begin the moment they walk in the door.

At my clinic, we start with intake forms that say explicitly: “We take a whole-person approach.” That language matters. It sets the tone. And often we hear clients say, “This is the first time I feel seen.”

That’s not about the form—it’s about the mindset behind it.

So what does this mean for us as OTs?

It means we’re uniquely positioned to take this integrative approach. We have the training to analyze tasks, the language to build rapport, and the scope to address both function and meaning.

It means we screen for emotional distress, fear-avoidance, low self-efficacy—not just tissue status. Because pain is as much a human condition as it is a biological one.

And it means we lean into our roots. The BPS model isn’t a trendy addition—it’s a return to what OT has always been about: supporting the whole person, in the context of their real life.

Let’s stop minimizing that. Let’s lead with it.

We don’t need to be cookie-cutter pelvic health providers. In fact, we can’t be. There’s too much nuance, too much individuality, too much humanity.

Our clients feel that when we walk beside them. They feel it in our presence, our questions, our pauses, our responsiveness.

So if you’re just starting to shift into this mindset, give yourself time. You don’t have to get it perfect. Start with how you think. Let your thoughts shape your language. Let your language shape your actions.

Even one small shift in one session is a powerful start.

Because when we empower our clients, we’re not just helping them heal—we’re helping them remember that they were never broken in the first place.