OTs In Pelvic Health

Trauma Informed Pelvic Floor Therapy: Centering Through Interoception

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--Transcript--
We are going to be talking about getting centered through interoception today. I love this topic because it really highlights our strengths as OTs and as holistic thinkers. This type of perspective helps the nervous system feel supported, and the longer I am a pelvic floor therapist, the longer I see the benefit of starting with this.

We are going to kick off this topic with discussing permission vs informed consent – Permission is simply, may I touch you? Can I do an internal exam now? They reply yes or no. Informed consent is a bit different – its  sharing with them what you are going to do, and where you will touch them so that they are fully aware of what they are agreeing to. 

Everything is an invitation – this is what creates a feeling of being empowered – we can do this right from the beginning—starting with where they have to be in your space – such as saying “make yourself comfortable” sit wherever you’d like. Instead of “you can sit right there.” Even the physical space can create a feeling of safety – we can do tangible things like this to encourage them to connect to their nerv system – by responding to you and the environment. And just by walking in, and choosing where to sit, they  already feel empowered. They start their experience this way. Many of our clients have had too many experiences of being disempowered. And that stops with us. Practice in a way that fosters a sense of ownership of their own body – empower through choice by using the language of invitation and cuing.

Here are few other examples of how Safety begins with the phy envt – we always ensuring clients are not on display, they are in a private space both so they aren’t seen but also aren’t overheard talking and sharing their story with you, also ensuring no one will interrupt the tx while in progress. Consider things like Do you answer the door during tx? Esp while the client is laying face down.

We should be Mindful of our fascial expressions and the position of our body. This is even more impt with covid and us all wearing masks. We need to be mindful of our eyes and they convey safety and trust.

Also, Let the indiv know where you are in the room. If you are moving around (esp if they are lying prone, or if approach from behind). Think about this in assessment and treatment.  Especially if they can’t see you.

Another important aspect that’s imprtamt, especially with masks is our Tone of voice – how you are saying (not just what saying)

As pelvic floor therapists, we are all trauma therapists ––  The intention often determines the approach. Why you do something will inform how you do it. It’s about the Mental and emo and physical – this is a very multifaceted approach. And there are layers of trauma. There could have been the original trauma that resulted in a secondary trauma.  For ex, my client Runs for stress relief- but she injured herself – she can no longer run – her stress levels increase more. This is simple example of the Physical affecting the mental aspects and demonstrates the layers of trauma. 

The response and experience the person has is more important than the event.  For ex, take two War veterans -one who returns w/ ptsd and the other doesn’t. Their History, wiring, learned behavior, coping mech, what strategies do they have to reg a dysregulated nervous system? All of this has an effect on their response.

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