From Pressure to Presence: Trauma-Informed Pelvic Health in Real Practice

• Learn more about Level 1 Functional Pelvic Health Practitioner program
• Get certified in pelvic health from the OT lens here
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Learn more about my guest

Kaitlyn Ellis is an occupational therapist with over two decades of clinical experience and eight years dedicated to pelvic health. She co-founded Twin Root Wellness to bridge pelvic floor rehabilitation with trauma-informed care and nervous system regulation strategies. Her approach centers on restoring safety in the body while empowering women to return to strength and performance.

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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
 Thank you so much, Kaitlyn, for being a guest on the OTs for Pelvic Health podcast. We're also joined by Lara Desrosier, and I gotta tell you, both of us are so incredibly excited to have this chat with you today.


 Kaitlyn
 Thank you. I'm really excited to be here.


 Lindsey Vestal
 Amazing. And Lara, let's hear a quick welcome from you just so folks can hear the difference in our voices. When we have three people, it can be challenging to keep track of it of all.


Lara Desrosiers
Yes. Hi, everybody. I'm Lara. I am an OT practicing in Ontario, Canada, and partner with Lindsay to deliver the Trauma-Informed Pelvic Health Certifications.

 Lindsey Vestal
 Amazing, amazing. And Kaitlyn has graduated from the level two trauma-informed public health certification and just absolutely blew us away through not only throughout the program, but really, you know, the program culminates in a case study. And so the focus of today is actually really sharing the brilliance that unfolded during that case study. And so I think it would make a lot of sense, Kaitlyn, if you could just start off by talking a little bit about yourself, about your practice, and then we'll go from there.


Kaitlyn
Sure. name is Kaitlyn. I've been an occupational therapist for over 20 years now, which is crazy that more than half my life has been a therapist now but most of my career has been in neuromuscular reeducation and rehab in the in patient setting. But after I had my son, my interests really started to shift based on my own experiences to pelvic health. 

I've been working in the pelvic health arena for about eight years now. with the last four being full-time outpatient for Hartford HealthCare. care And what's kind of great about that is we accept all and insurances.

I see all walks of life, 17 years and older, Medicare and Medic aid. So any given day, I can see a variety of clients from a young athlete struggling with pelvic pain to a 70-year-old female with incontinence to neuromuscular issues with their bladder to trauma.


Kaitlyn
So you never know what the day is going to bring. And so I love that. And then on top of that, I am the co-founder of Twin Root Wellness with my twin sister, Megan, who is an LICSW specializing in trauma, which so much of what we've done with that is because we saw the need for not just the physical rehabilitation after pregnancy, postpartum, menopause, that type of stuff, but the need for that look at like, why what are these forces driving me?

How am I grieving? the changes in my body. And so we were constantly picking each other's brain. I use her all the time in my own work. And so the fact that this course came up just kind of was a beautiful step towards continuing my work in the pelvic floor arena.


Lara Desrosiers
Amazing. I want to pick your brain so much about the work that you're doing with your sister. Can you tell us a little bit more about um some of the things that you're doing together?


Kaitlyn
Yeah. well we've been working together formally for two years now. It started as pregnancy and postpartum athleticism work because of our own personal experiences, knowing in my head what to do and how to tell people to do things or collaborate with them, of course, Is one thing.

But then the why? Why is it hard for me to take this? Why is it hard for me to take a step back as a new mom and honor my pelvic floor in my body? And there was so much more to it than just the athletic modifications and that became huge like if we ignored that athlete brain that our clients have we were not doing our work justice so we started with just kind of the basics of after you've had a baby what's happening with our body the why between why we're really incorporating their occupation which is sport into that 

And then Megan will kind of sit on with us during our calls and really make note of the phrasing, the nonverbal communication. And she it's so helpful because she'll stop and just say, like, I've noticed that, you know, you're sitting like this or you're saying I should. and where is that coming from? And it really is so helpful just to sit there and like listen because I'm like, oh, gosh, yeah, I think I do that, too.

And so we found it really helpful and beneficial just to marry the mind and the body, which is why I love occupational therapy in general. But we're finding that we're just really empowering our clients to not just feel and regain the trust in their body.

But also really embrace this not so comfortable things that we're feeling, especially now we've kind of moved into doing a lot of perimenopause and menopause, and there's so much grief in that.

Our kids are getting older, we're taking care of parents. There's so many life shifts that are happening and really honoring that aspect has just been the piece that I think has been missing in a lot of like athletic rehabilitation.


 Lara Desrosiers
 That's such beautiful work that you're doing and what a great partnership. It's so cool to have that.


Kaitlyn
It’s so interesting. So we're twin sisters, obviously, and we don't know if we're identical or not. My mom didn't realize she was pregnant until I already came out. So we don't we've never tested.

We've never done anything. But we we do look similar. Even some people that have known Megan and then see me in this arena and vice versa are like, You guys are so different It's not even funny.

She's so much more poised and put together and I'm known as just the unfiltered version of her So if like you're thinking it I'm probably saying it and she's not and horrified.

So when we do our calls together, it's just so, It’s so interesting.

Lara Desrosiers
Kaitlyn, I want to ask in that in that work that you're doing with your sister, but also the work, you're seeing such a diverse clientele, I'm curious what drew you to the Trauma-Informed Pelvic Health Program. What made you want to take it?

Kaitlyn
Well, I've always been interested in it, you know especially, of course, like collaborating with my sister, but I've noticed probably, oh gosh, definitely since COVID being in the medical setting, that there are just more and more instances of loss and grief and trauma. And not just, I think with pelvic health, a lot of times we think of sexual trauma, which is absolutely a huge aspect of it, but just medical trauma and other things.

And clients have been disclosing so much more to me and I just didn't feel really confident in my ability to manage it the way that I wanted to. I felt really comfortable in my tools physically with clients, but I was really finding that so many more really sensitive and beautiful things were being shared with me. And I just wanted to make sure that I could give my clients back the same response that they deserve for sharing such intimate things with me. And so I've done some other trauma-informed classes that were really helpful, but I think was kind of just mirroring, glossing the surface of it, kind of what to look for, how to make sure their clients are safe and can leave our facility safe. But I think that just like looking at the curriculum of your class, it's just getting down to so much more of the depth that we can use and help our clients give the tools, not to just to make sure that they're safe in that moment, but also to move confidently forward. And so like, which is so huge is how can we also use this work on o ourselves so we can be the best version of ourselves for our clients? 

Because, when you're taking, we're all so passionate about what we do, and which is why I've been like so drawn to Lindsey's work and everything. It's more so much more than that physical, these are the muscles, but like there is a human behind this. And, just having the tools, especially in such an intimate and vulnerable setting.

I just think everybody, it should be, like I love that you're like making this part of your whole you know, in order to kind of get to this certification, you need to have this. Every single medical provider should be mandated to take this class.

Kaitlyn
It's just, I don't even know. I just digressed, but I don't know. It's just so important. So when I looked at your curriculum, I knew that this was going to be more than just your standard use of pronouns and things like that.


Lindsey Vestal
Thank you. Thank you so much. That means so much to us. The integrity that you bring to your work, everything that we've been able to witness, it just, as Lara said, like the amount that you're seeing in a typical day Kaitlyn, like it it's just so incredibly comprehensive and to switch between the needs of the client, right? So you're not just seeing postpartum, you're not just seeing, you know, pediatric, like you're really having to switch parts of your brain and be incredibly present. And I think that one of the reasons why your case study blew us away is because we did see that integration. We did see sort of that holistic that you're talking about. Like it's clear that was your beacon. You were really drawn towards, towards not only learning more about that, but actually like deeply diving in.

And, and we're so grateful for that. It was, it was such a pleasure, such a pleasure to support you. Would you mind for the folks that weren't on the graduation call and and weren't able to, to hear your case study? Can you, can you share it with us about it


Kaitlyn
Yeah, sure. And you know there were so many cases that I was debating between doing. And on the surface, this one doesn't look like too deep. right And so I really wanted to show how we really have to utilize that lens of trauma-informed care with everybody that we're meeting and addressing. So my client was postpartum about five to eight weeks postpartum.


 She was having some issues with her urinary incontinence following the birth of her baby. She had received pelvic floor physical therapy in the past during pregnancy due to pain.

And in the chart review, she had made it clear to her provider that she did not want to return to that specific therapist. so kind of going in, that knew that I wanted to know what made her previous experience with pelvic floor therapy not a positive one for her because yes, we're going to talk about muscle coordination and recovery, but also what was it that didn't make her comfortable so I could make her feel comfortable and present in that moment.


So her her background, again, she had had some back pain in pregnancy, some um pubic symphysis discomfort, Delivery was fairly traumatic and long, um had a hard time recovering, just sitting tolerance over energy. And then her was having stress incontinence as well. Some your urge incontinence initially, but that had resolved by, I think it was like the eight week mark when I saw her.

But even when I met her and she just, we get people from the waiting room, they come down the long hallway. You can always see them panicking because there's a large gym and they're like, oh my God, am I going to have to go in there?

So then bring her around the corner.

And usually once we turn the corner and they realize they're going down in a private room, they start to settle. And I'm just looking at, you know, from the get-go, eye contact, body posturing. Also, of course, from that functional mobility standpoint, how are they weight shifting? How are they walking? That kind of thing. And we I was noticing a very just like contracted posture, just kind of pulled in looking at the ground, legs crossed, arms crossed, um and just very quiet, short word responses to, you know, what brought her here. Yeah.

And so one of the first things I said is just to kind of address the elephant in the room is that I saw from your medical record that you've gone to pelvic therapy in the past. Can you tell me a little bit about that?

What happened, you know, during pregnancy, we're having pain. So I kind of left it open-ended to see what she was comfortable disclosing. And she just started out with, she didn't believe me.

She said, I'm pregnant. What do you expect from my pain? Like, Typical, unfortunately, of what we hear from providers.

So I said, well, tell me about your pain. Tell me about what we were feeling during pregnancy. And she was just like, well, it hurt to stand up. And I'm like, OK. Then just asking with curiosity.

Tell me a little bit more about that.

Was it Did it last for a couple steps? Did it resolve? And she was still looking at the ground, giving short answers, but she would start to look up at me a little bit more. And so I started just to push my computer off to the side, face her a little bit more. But I also crossed my legs and leaned back to just look like I'm just, comfortable in talking. And then her she started to expand and you could see her getting a little bit more comfortable with telling me the story of not just what was going on with her pain, but I said, you know, what

what did you learn from pelvic floor therapy? And she just said nothing. I learned nothing. I learned to that I shouldn't be having this pain.

I shouldn't, you know, I'm pregnant. What do I expect? And just felt very invalidated. and then I kind of asked to her to tell me about her birth. And she's like, oh, it wasn't a big deal. I only had a grade one laceration.

And I think that's a big thing that we hear too is it's only a one. It was only that has nothing to do with the pain that we've had, the amount of pushing the circumstances.

 So i was like, well, grade one can mean a lot. it has nothing to do with what you're feeling for pain. It just is a degree of like how big the laceration is or how, you know, there's nothing else than that.

And she started to breathe. And I was like, don't tell me about your birth. Did you have a fast one? Did you have to push? And she just started opening up more, but still was quite guarded. And she just said the last exam was really invasive for me, Kaitlyn, just kind of in the middle of the question. Like she just needed to get that out there. This this was really invasive for me.

And I said, well, we have so many ways. And like, that's what I, again, having the tools and building from the OT pioneers to where we are now is there's so many different ways that we can look at your body and there's no right or wrong way. It's the way that you're the most comfortable with, because if you are guarded and hesitant, that's not going to give me the full picture of what your pelvic floor is,

And has the capability of doing. And just like, she's like oh yeah, well how? And so she just started asking so many more questions and curiosity. And I love explaining to people, especially postpartum, oh gosh, I love all of but pelvic, but like what is really going on with our bodies when we have a baby and we deliver? Because no one tells us that. 

And you're like, I should feel better by now, right? No. So just like validating her, like girl, like you had all this stretching, loss of abdominal sore, your pelvic floor muscles stretch over 250%. You've had trauma. Even if you don't tear, you've got swelling, bruising, all of this. And then you have to go take care of a baby. It's not like you get to put your feet up and rest. And so it's like, like, come on.

We're like, oh, we should be like running a marathon now, right? No.

So she's like, oh yeah, I have been doing a lot. 

So... and then I'm like, you know, just add the communication in our pelvic floor and our core work as a team. And when they get stretched and dramatized, they stop talking to each other.

And our pressure is not being distributed evenly, which is what's happening here. So I'm like, we can look at your core. We can look at your grit and just explaining all of it. And I'm like, we could do it lying down. We can do it standing.

Is there something you prefer? And she chose to do it in standing first. And she didn't want to face away from me. She wanted to look at me the whole time. So even just like it if I'm positioned here, is that okay?

I'm going to place my hands on your rib cage because I want to. And she was just like, okay. And then she was into it. And then she's like, oh, what are you feeling? So you could just see her getting more and more into it and then kind of shifting to doing some things lying on her back.

And it was just – looking at her pelvis, looking at her hips, looking at the muscles and the bones in between it, looking at her core. And she was just like so excited. she like what did you see next? What did you see? And so I said, like, we've already seen so much that explains why you're feeling and what is happening to you. So validation, validation, validation. And I was like, this is how we can move forward. It seems like you're pretty busy during your day. And that's what i ask people. like Again, we're doing that occupational profile always. And sometimes it's structured and sometimes it's more casual, depending on the vibe.

What is your day like? like How busy are you? like I don't want to overwhelm you. So really just incorporating, again, the functional pelvic tilt into how she can hold her baby, how she can lift, how she can start to get the team working together again, just to give her some immediate takeaways versus, especially with 45-minute sessions, I do never, ever do an internal on the first session because i can I don't have time to process it with them. I'm not giving them actually a strategy that they can use.

It's not worth it. like it's so And we can get so much more data just by looking at the whole person anyway. So she left excited and curious. And she has these tools to take in. And so every time she came back, and I ended up only needing to see her twice. wait I don't even think I ever did an internal on her. It just wasn't needed. She wasn't having pain. Her symptoms had resolved.

She felt confident. She was able, she had initially been avoiding going out with friends because she was nervous about incontinence. And now she's got she's going out with her friends. She's not avoiding anything else that she was previously. And that's really our main goal. Like it's not so much if their pelvic floor strength changes from a three to a four, but are you happy and comfortable in the body that we have now?


Lara Desrosiers
Oh, amazing. Oh, there's so much gold in there, Kaitlyn. And I, yeah the things that I, there are new things that are standing out for me every time you share this case study. I know right off the hop when I first read it over, what struck me was the attunement, like how detailed your descriptions were of your clients' language and body language as they moved through that care with you.

And also so value how you model curiosity for them. I think we heard and I know I experienced when I'm able to stay in that curiosity place, then it helps to bring the client into that place alongside us and get really excited and interested in the information. And as you said, like this was It wasn't a huge like red flag on the surface, this is trauma, but the qualities of being trauma-informed weaved into your work, it sounds like it helped you to have an impact quite a bit quicker.

The new thing that stood out for me that I didn't register the first couple times I heard about your case study was, It sounds like how much better the education was received when you supported your client with getting

Into that curious mindset alongside you when you were at tuned with her, when you could kind of read how she was receiving the different information, the pieces that that you were giving her, what kind of got her excited, just being able to deliver that in education when we're attuned and reading it versus the dump, right?

Like the, I want to share everything with you because I'm so excited about this, but not kind of reading how it's being received by the that struck me as you shared today. So thank you for that.

 Kaitlyn
 Yeah. So it's, it's so easy because you're, we just get so excited about it.

And that's been one of the things that, you know, you meet someone for the first time. I only have, you know, have this amount of time and you have to kind of guess their personality really quickly and kind of alter the way that I present myself based on them.

Still being true to myself, but what language do I use? like should therapeutic use of self really necessary in this case? Or you know what analogies am I going to use to help describe this?

 And so it's something that, sometimes goes really well and sometimes it doesn't. But you but learning those subtle cues and I think you know presenting that and how we learned it here in the course has just been able to fine tune and pick up those subtleties to get more of a meshed session.

Lara Desrosiers
Yeah. I'm wondering, because I just heard in your description, the value it held so much for the client. And One of the things we ask folks to reflect on too is in taking this approach and taking a trauma-informed approach with your clients, what impact do you notice for yourself when you take that approach?


Kaitlyn
It almost takes the pressure off me. And that is the most surprising outcome. I think I wasn't expecting that at all. I'm the the arena I'm working is those 45 minutes sessions. And so there's, for me, is a lot of pressure to make it worth their while and get something out of that. 

And I think reflectively there's still that am i doing this the right way because i know i'm doing it different than what a lot of other people do even where i work is one of they have embraced pelvic floor ot in a way that no other giant organization does but i'm still seeing you know you're you're working with pts and and and OTs. And so our approaches are so different that you do doubt yourself.

Not as much as I used to, but that ah I saw that that was still there.

So I felt so much pressure in those 45 minutes to get all these stuff, get all this stuff done, give them all these exercises and things. So this class kind of gave me the permission that I don't have to do as much. And by not doing as much,

They're actually getting more out of it. So it's, it doesn't have to be a rush, rush, rush. It, by being present, by being curious, by listening, we're getting so much out of our clients and, and giving them the tools and the concepts versus an exercise. How can I, how do you see this working during your day to day? And what maybe a roadblock to getting that done. 

And that's okay too. So let's problem solve this together. So that has really taken the pressure off of me so I can get my sessions done. I feel like I've done a good job with them for the most part.

And then I can kind of have that moment to take that breath so that I'm in a better, I'm more centered with my next person coming in.

Lindsey Vestal
I am blown away at what you're sharing right now. I am, first of all, so happy that it's taken the pressure off of you. You have no idea how much that means to us, you know, because we hear a lot about burnout, right?

Andmthe healthcare care system, especially large ones, the demands are ever increasing. the document Not just documentation, but every amount they can they can squeeze out of us.

It's just just the way of the world, right? Corporations, hospital systems, you name it. And I love that it's taken the pressure off of you. That means so much to us. And I also hear you talking about a sense of expansiveness that it has given you along with taking the pressure off.

To then step into the OT lens even more. And thank you for being vulnerable and sharing what most of us feel, which is we don't want to be in OT and PT's clothing.

You know And in those larger organizations, that can be a challenge. So thank you for also paving way and showing them and helping them be a part of embracing the OT lens and then giving the confidence to step into that even more.

It's just a self-fulfilling prophecy.

And I love this program helps scaffold you to do that. And then I also want to mention the way you described how it helps the client. You're really describing helping them be the expert of their own body saying, you know, where does this fit into your day?

That occupational profile, you know, like I just think that is, that is pelvic health at its finest. Literally, if only people heard the last three minutes of what you said in this episode, like It is truly a shining light of how well pelvic health can be practiced and how beautiful it is to feel like we belong in this space.

I'm blown away. I feel like we can end the episode there, but I do, we do have more questions for you. Kaitlyn, what would you describe is some of the most, I guess, like impactful shifts that you've been able to consistently weave into your day-to-day practice since taking the program?

Kaitlyn
I would say that I think that I went into this, especially when you started talking about the different grounding practices and we would follow along with the different scripts and such.

I definitely came in biased about them. And I was just automatically had thought to myself, these aren't going to work for me. It's not going to work in the setting that I'm in. It's not going to work. And so I kind of poo-pooed them and I went through them, but um kind half-assed.

And don't know. I don't know.

But then we had done one of them. I think it was the Quadrant Wake Up during one of the live classes. And I had just come back from EMDR for myself. And it was such a different experience for me.

It was so helpful. It was really what I needed in that moment. And it kind of like a light bulb switched and it's like the same thing I've been talking about this whole time. But then I just, you know, you just don't make that connection to yourself of like, we're OTs. We can make this space our own. And so we can make this grounding work our own. I don't have to poo-poo it just because I don't have time to sit and do this whole session with my client for it. But I can still provide aspects of it or like tiny little like snacks of it within the session, depending on their interest

And make it their own, make it my own and just kind of use that. So I've been using so many of the grounding practices. The sensory checklist is just become part of the tools that I give all my clients. Just how can we utilize this? How can we use this to our advantage when we maybe need to pick up the answers might be different than when we need our body to kind of regulate and calm down. 

So, I definitely of you know use explicit consent and pacing and all of that. But I feel of the grounding tools, shockingly, I use all the time, but in my own way, which is great. And that's what I'll say to people, because again, i get all walks of life. like You don't have to be a yogi.

You don't have to believe in this. to have it work just by doing these things anatomically, this is what happens to it. So kind of getting that rationale for my very like clinical brain can help people carry over like I'm going to take two big breaths every time I wash my hands and that's going to help me do this.

You can make it your own if you want to do 10 minutes of breath work at night. Great. If not, we can still make that work for you. So it's just kind of taking these tools. And I was kind of like dove into the why anatomically this is happening, what's going on with our vagal nerve and all that stuff and kind of packaging it up in a way that resonated more for me versus just that automatic dismissal.


 Lara Desrosiers
 I remember when you brought that up in our support call. And it's so funny that you say that was like the moment of switch.

Because it brought up such a good conversation in that support call about even meeting ourselves where we're at, right?

And I think what you're, what you're saying, Kaitlyn is so important. A huge part of trauma informed care is meeting our clients where they are. And so, I love that you kind of took that experience and ran with, your creativity and leaning into your creativity. And, in our, in the program, we

We, Introduce some of these concepts like the neuroscience behind some of these practices using springboard scripts. But we call them springboard scripts because it's so valuable to take them and make it your own so that you're comfortable with it, but also to help us meet our clients where they are knowing getting to know them, their personalities, do they really crave the science or are they craving that 20 minute guided practice?

Like there's, there's just so many different personalities. So having that creativity is just so valuable.

Kaitlyn
Like the engineers, you could they're like, yeah I'm not going to do that.

But then when I'm like, okay, this is how our core system works. It's like a piston. And if we're neglecting this part, what's going to happen with the pressure? And they're like, oh my God, so I can wrap myself around that one.

So it's just finding that language to make them like connect with it. Yeah.

Lara Desrosiers
It's so funny that it was that moment because one of the things Lindsey and I say throughout the program is you will get out of this what you put into it.

Right. And and you are someone, Kaitlyn, who throughout this the workbook, like we really saw you lean into that and take it's so much from it in terms of the work that you're doing and you described with your clients, but also in terms of that self-reflection piece.

And how could I even take some of these tools and these concepts and support my own nervous system, whether it's like life balance or setting boundaries where I need boundaries.

And so I'm wondering if you could tell us a little bit more about shifts outside the clinic room that that you have seen or made for yourself.

Kaitlyn
Yeah, I think boundaries was a big one There aren't enough of us in the pelvic space, as we know. And so the more the merrier, but especially with taking insurance and being part of a large organization, there's always a need. And I feel so much pressure to try to see everyone and fix and solve every problem.

And that's just not realistic. And so I was really getting burnout and feeling like I wasn't able to be as present, not just with my clients, but also when I got home, not having as much patience. just kind of getting home and being so fatigued. I couldn't engage into my meaningful occupations because I was just in like a state of freeze. So by setting those boundaries and saying no, or saying like this day looks pretty, my caseload looks pretty heavy as far as the intensity of clients I have versus the numbers of clients I have.

I need a break in order somewhere in this day so that I can be present and, and, give my clients what they need and what I need so that I can continue working here. Also looking at resources that we can continue to grow so that our clients have those support has kind of taken the pressure off me. But especially just the tools, like I have a lot of anxiety. i have very neurodivergent. So just having those, like taking those

Like snack size bites of the grounding tools have really helped me stay present where I might be off mentally in a thousand different places. So I just feel like I'm just more present and I cannot always thinking like a thousand miles of what I should be doing.

What else could I be doing? That type of stuff. And that's just like, there's no, I don't know how to say it. Like, Those are just such an amazing, that's such an amazing gift, you know, like to be able to be present is just something that I never realized I wasn't doing. But when I have now experienced it, it's like, oh, where have I been for a while?

Lara Desrosiers
Yeah, that's a beautiful description. And it's, it sounds so simple, but it's actually, it's so challenging in the world that we live in to find.

I'm so happy to hear that you've been able to find a little bit more presence. Yeah.

Kaitlyn
And I think too that like one of the springboard scripts or the grounding practices was the like the creating space or I forget what that one was.

And that resonated so much as well because I've always used kind of the metaphor of needing space in my pelvic practice. The bladder needs the space to fill so that it can hold its true capacity. Our diaphragm needs to be able to move up and down. If we're gripping our rib cage, if we're holding onto this tension, if we're contracting into that small posture and not taking space, our body isn't able to work the way we need to.

But in that same regard, I feel like so many of our clients are afraid of taking up space, like hence that posture, hence that just like glossing over, making, wrapping up like their story in like this neat little package.

That just being present and asking those questions kind of gives them that validation that it's okay for you to take up space here. Like that's safe, you're welcome here.

And I need to also embrace that because I think that it's something that we often feel like, oh, I don't I don't want to be too much. I'm that weird you know pelvic floor therapist. But we're we're allowed to take up space. And we take up that space emotionally, then that is literally going to help us be able to take that deeper breath and help our body work in the way that it really needs to. 

So both like physically and emotionally, there's just such a connection there that It's just, you know, just to see that. And that's what it's just like, just to take that time to ask a very simple question and help someone feel heard is such a small thing, but can have literally the biggest impact on somebody's life. 

And so, I don't, so many people who are training in pelvic health are like, I just don't think I know enough. And I'm like, but you care and you listen and you don't have to be the best at grading muscles or knowing if it's the obturator or the levator, like who cares?

Like if you are listening and validating and supporting people with this, you are doing a thousand times more than most people are.

Lara Desrosiers
Yes, what a beautiful description. I actually, I was going to ask you another question, but I think you answered it beautifully. There was a quote in your case study that like just really stood out for me, which was trauma-informed care isn't about avoiding discomfort, it's about creating space for connection.

And I am going to ask you to tell us more, but you just did. Like that's this space and the way that you described it.

So powerful in terms of the impact it can have for our clients. And on that note, actually, you sent me a message recently, Kaitlyn, and I just mentioning Another case that you had recently where creating that space made such a huge difference for your client.

I wonder if you would mind telling us a little bit more about

Kaitlyn
Sure, I have a young client, very young, that came in with the diagnosis of urinary retention. And I didn't see, it wasn't much in the chart as a young person technically doesn't have any. I didn't see any urodynamic testing. I didn't see anything. I just saw urinary retention.

And she came in and is such a beautiful soul and has had the worst year ever as far as just like recurrent UTIs and now having to catheterize herself and going from one doctor to the next and also not being able to eat. So in addition to everything that's happening, she's been vomiting. She cannot keep down food. She hasn't been able to keep down anything since October.

All testing has come back normal for a GI system. Follow up with neuro GI is July. This was in December.

She felt so unheard. She felt that catheterizing as a 22 year old, especially with a trauma history is Awful.

And the way that she was treated by not just one, but a multitude of medical providers is something that I'm working on addressing. But she came in and she just seemed more withdrawn than typically she would very much cover with sarcasm and humor and things like that.

And I just stopped and said, you just seem like you're a little bit more down today. What can I do for you? And she's like, it doesn't matter. No one can help me. like, I'm here.

What can we do? And she was just like, can you turn off the lights? And I have warm lights in my room in addition to wait awful fluorescence. So we turn the lights off and she's like, I just want to lie down and I don't want to do anything right now.

Okay. And I'm like, I'm just going to sit here. Why don't you just, you know, you don't have to talk, but I'm just here. And she's like, it doesn't matter because you're not, everybody gets tired of me. Like everyone's sick of me. Everyone's tired of me.

And so I had to ask, like, I followed up with some safety questions and was able to, she confided a lot about me and we were able to get some resources in place for her so that she was safe.

And not only that, but like advocate, I was able to advocate and get her the care that she needed a lot sooner than what she needed than in July.

My initial response, I think prior to this class would have been I would have noticed that she was in that space. Oh, also during this, she passed out and had to call 911.

 Lara Desrosiers
 Oh my gosh.

Kaitlyn
But her blood pressure was super low. And all the doctors who said she was fine, she wasn't and had a massive, she was out for over 20 minutes. So we were able to get help in place, which needat should have been done anyway. But that was able to kind of move things along. And I just was so grateful that one, I knew she hadn't been doing well earlier in the week when she was capping. And I said, like, why don't you come back so that I can check on you?

Even if this is an available session, i i just need to have eyes on you.

And just having the tools to be comfortable in silence when she was needed that silence and knowing sensory wise, because we had kind of built off of that sensory checklist to begin with. I knew like the darker stuff was better. She likes, I have fidget toys in my room, kind of giving her those tools to help at least somewhat get her the volume kind of turned down a little bit so we could start to articulate and know what kind of resources that were needed to help her out.

Prior, I think I would have noticed it, addressed it, but maybe not had her come back or maybe not been comfortable enough to really just say that it's okay for me to sit here in silence with you. I don't have to do

A rib mobilization or something like it's enough just to be here and be present with you. I'm not going anywhere. You're here. You're safe. That kind of stuff versus I have to do something. Just being OK, being there is is is enough.


Lara Desrosiers
Yeah. Sitting with discomfort, it's such a hard thing, right? Like it's, we all have that tension we feel to really jump in and want to fix, want to resolve.


And so I so appreciate that reflection because it comes back to your quote, Kaitlyn, like there's so much value in really noticing our own, that's like our own urges to jump in and be that container, create that space that our clients might need in a moment when they're holding a lot of really hard, hard experiences.

Kaitlyn

Yeah. And I think that overall all experience really shown the light and I've been seeing it again more, but there needs to be more.

Patient advocacy. There needs to be a liaison to help clients navigate the waters of situations like this so that a young person, not even a young person, but nobody should have to navigate all these different providers and specialists. And, you know, we have urologists and urogynecologists and gynecologists and GI, but colorectal, there's so many different providers.

It's so confusing and they're getting passed from one person to the next and they're just get more and more hopeless. And so it really highlighted the need for that to happen, at least within, well, everywhere it should happen, but within our organization. And, so hopefully some steps are being taken to help,

And I think is the pelvic population is is really special and unique. We have like physiatrists that very much oversee the care of some of our neuro and ortho patients, but they're not as comfortable. I mean, I've tried to utilize them, but they're not as comfortable with the population that we see. So it hasn't been as effective. 

It'll take a while, but I think it at least got the conversation going. People are listening. And so one step at a time.

Lindsey Vestal

That's exactly it. And I think this has been so special because we got to start off with a call that that, excuse me, a case that you shared during our cohort together. And then we got to catch up with you real time.


And hear just how much more you're really leaning into this. And oh my goodness, I just can't believe what a difference you made in her life. So thank you for all the work that you do day in and day out.

It has been, we've known each other a long time, Kaitlyn.

 It has been such an, I like a proud mama bear moment right now.


We're just thinking all, just listening and really reflecting on your incredible journey. And I just know it's going to continue to to grow exponentially. So Thank you for leading the way in our field and for being exactly who you are it was such a privilege to to support you.


Kaitlyn

Oh, thank you. Yeah, and I think that, I've learned so much from both of you and that it's okay to be who we are. And I think pelvic space is so beautiful because, you know, at the summit and everything, like everyone has the best energy and everyone just sees and loves each provider for who they are. And you don't have to have that imposter syndrome, but you just feel like you found your place. And yeah, it's such a great, so great. I love it.