Trauma Queen
"The Trauma Within" is a weekly podcast hosted by Jimanekia, a Trauma and Sexual Assault expert, queer media consultant, and comprehensive sex educator. Join us as we normalize conversations about life's most challenging experiences, from sexual assault to mental health and beyond. Discover stories of resilience, expert insights, and a safe space for discussing some of life's most complex topics. Support this podcast: https://podcasters.spotify.com/pod/show/traumaqueen/support
Trauma Queen
The Trauma Within Redefining Identity and Embracing Vulnerability W/ Nicoletta Hedger
Do you have any questions, any comments about the episode? Jimanekia would love to hear from you!
Can redefining our identities lead to a more fulfilling life? Join us as we engage with Nicoletta Hedger, a licensed marriage and family therapist and award-nominated sexologist, who courageously shares her journey beyond her career titles. Nicoletta offers a raw and honest look into the societal pressures of self-definition by our professional achievements, challenging us to embrace vulnerability and discover our true selves. Her personal experiences with health challenges and her multifaceted roles as a partner, daughter, and friend serve as a powerful reminder that our identities are complex and deserving of exploration.
We then unravel the intricate world of sex therapy, guided by Nicoletta's insights into the often-taboo topic of sexuality. Her passion for advocating around issues like pelvic pain and medical trauma shines through, offering a glimpse into the systemic challenges that many face. Nicoletta introduces tools like the Erotic Blueprint Test and emphasizes the importance of self-advocacy, aiming to reshape how individuals understand and communicate their desires. By addressing the misconceptions and societal norms around sexual pain, we learn how trauma-informed care and specialized medical attention are crucial for healing and empowerment.
As we conclude, we take a closer look at the broader implications of pelvic health, including the myths and systemic biases that can marginalize individuals within healthcare. Nicoletta candidly discusses the fear and mistrust faced by marginalized communities, highlighting the need for a compassionate and informed approach to medical care. The vital role of social media in raising awareness, despite the challenges it presents, is also examined, leaving listeners with valuable perspectives on empowerment and healing. This conversation is a must for anyone seeking a deeper understanding of sexual health, trauma, and the courage it takes to advocate for oneself in a complex world.
Thank you all for listening. Set a boundary with yourself this week, set a boundary with someone else. If someone else does not respect that boundary. LET THEM LOOSE YOU! Stay hydrated internally and externally. We do not have an ashy family.
IG: @The_Trauma_Within
Youtube: https://www.youtube.com/@thetraumawithin
Jimanekia Ig: @Jimanekia
Nicoletta Hedger is a licensed marriage and family therapist and award-nominated sexologist practicing in Los Angeles, california. She specializes in sex therapy for diverse populations, as well as equine assisted psychotherapy. When not seeing clients, nicoletta creates weekly content via her award nominated show Sluts and Scholars a sex positive, shame-free, educational podcast for professionals, professionals who prioritize pleasure Y'all. We got Nicoletta Fabulous. I'm looking forward to this question and I know that there's a lot of folks that probably have questions. A lot of folks struggle with what we're talking about today, so I'm excited for this talk. But before we get into the talk, they've heard the bio. They do all the things, but my guests know and if not, you're going to learn. I like to know directly who are you?
Speaker 1:Thank you for asking. You know I'm trying to come up with a better response to it because I'm really tired of answering. Who are you with what I do? Because in our culture.
Speaker 1:we're just like taught that. So I feel like my prepared answer is what I do, but I just want to say that it's a work in progress, because I think who I am is is more than that. Who I am is like someone who's struggling with her own health stuff and someone who's trying to figure it out, and a partner and a daughter and a friend, and and someone who's a little burnt out. Um, what I do is, uh, also a part of who I am, but I'm a licensed marriage and family therapist and I specialize in sex therapy. Uh, and I also host a podcast, which you have been on and will return to, called sluts and scholars, and, um, yeah, I, my goal is to, you know, help people experience more people experience more shame-free pleasure in their life and find ways to better connect with themselves. And I also work with animals as an equine-assisted psychotherapist, meaning we work with horses to assist people in their therapy journey and, hopefully, to assist the horses in that as well.
Speaker 2:So that's who I am. I love that. I think that is so true. We instantly go to how do we make money, how do we survive? Versus like this is who I am. Vulnerability is scary for people.
Speaker 1:Yeah, well, it's just in capitalism, right? It's all about like, well, what are you doing? What are you producing? What are you doing?
Speaker 2:Status yeah, are you worth talking to?
Speaker 1:Exactly that's literally the question Are you worth talking to? Absolutely, and I've been guilty of it too when I ask people that. So I'm trying to shift that and I've been starting to ask people how do you like to spend your time?
Speaker 2:But I don't know if that's. I'm still working on it. It is a question. And also, when you answer honestly, people ask like how are you? I'm like, eh, today's kind of rough. They're like I don't know what to do with this. You're supposed to say I'm fine.
Speaker 1:How about you yeah?
Speaker 2:I'm like, nah, it's kind of rough and they're going. I'm sorry, I don't know. Yeah, yeah, it's hard. That's funny it is. It is really hard. How did we meet?
Speaker 1:Oh my gosh, I want to say we met when you used to do the um survivor like cabaret, oh yes, back in the day. Um, I think, yeah, I think we we met that way. Um, so it was a, it was a really fun thing, but just through a lot of different colleagues and peers and friends and the overlaps have continued as we've known each other. But dang, I mean, it's been like 10 years, we're old, I feel old.
Speaker 2:Let me tell you I'm so thankful.
Speaker 1:My knee hurts my back hurts, my body hurts, I feel I am in it.
Speaker 2:What does trauma mean to you?
Speaker 1:For me, the way I describe it to clients and to myself is really anything that overwhelms the nervous system, that affects our ability to move through states the way that ideally, our body needs to so to be able to move in and out of different states, including survival states, but also relational grounded states, all those things. So really I define it broadly as anything that overwhelms the nervous system that affects our quality of life. So obviously there's a lot of people who want to create a hierarchy of, like, big trauma, little trauma, one instance versus, uh, ongoing relational attachment trauma, uh, but I see it affecting people a lot in the same ways.
Speaker 2:um, so yeah, anything that overwhelms the system and affects your, your quality of of life and connection yeah, I love asking people that because I think there's so many different definitions depending on who you are, and I think that people assume well, if it doesn't look like this, then it's not trauma and it's like that's not how it works.
Speaker 1:Yeah, and you know, I mean I see this with my clients all the time, where they'll list out all these things that like I mean, look, it's not necessarily up to me to be like, yes, that's trauma and it's affecting you as PTSD. But I often will give education to help people get there and understand it. But people will list out these things that I'm like that's trauma and they're telling me how it's affecting their body and I'm like that's trauma response and we, I educate them and then and then they'll still go back to like, well, no, but this didn't happen to me and this didn't happen to me and I wasn't in war and nobody raped me, and I'm like, but still, here you are in therapy, having these feelings and these experiences and these struggles, and so, yeah, it's such a wide experience for people who either are threatened, have perceived threat and and are living in that state more than they need to be.
Speaker 2:Which most of us fucking are, especially now. But I digress, do that all day. So, getting to this work that you do and part of the purpose that I want to have this conversation with my friends. I want to have these talks with my friends. I want to have these talks with my friends because I get to learn more about them as well, thanks for being my friend, you're welcome.
Speaker 2:But I think there's also the parts that people like don't know about the people I'm talking to. Like you didn't just wake up a sex therapist who was younger Nicoletta, because she was a time um like how did you get here? How did you like what was teenage you like? Let's just start there. What a teenage you look like young, wild and freya oh my gosh.
Speaker 1:Um, you know I'm lucky to have some uh views back into that because this is a whole nother story, but I actually did like a reality show when I was younger that never got aired, so I have we'll have to watch it I have some video, uh, evidence and old my spaces and things like that to look back and I I look back and I'm just like oh my gosh, what is going on with her?
Speaker 1:Um, but I would say, you know, I didn't want to be a poser, right, I was like really into trying to be like alternative and not like the other posers, which probably made me a poser. So I really liked, you know, I was into alternative music, I liked shopping at Hot Topic, but then I also had this other side that really wanted to fit in. So I had my juicy track suit and, you know, my Von Dutch hat or whatever. People who are of my era will understand what I mean. But you know, it was this kind of push pull between like wanting to be liked, wanting to fit in, but also like wanting to be cool and alternative, and had this kind of fuck you attitude, which I think is something that helped.
Speaker 1:Yeah, it's something that helped me get into sex therapy, because I've always been interested in the taboo, the things that we're not supposed to maybe like or talk about, and so I definitely had some luck growing up and having some supportive parents and people around me who encouraged my sexual and relational knowledge and education to an extent more than other folks, and so, yeah, starting in high school, I became interested in talking about sexuality and my siblings had a babysitter at the time who taught me that she would never hook up with anyone unless they went and got tested together and this was like such a novel idea for my you know, 16 year old self.
Speaker 1:And then I started doing that in late high school and through college and it became a way for me to start having safer sex conversations, before I even really knew what that was. And it became like emotional safety as well, like is this person willing to chat with me about my needs and my comforts and our um, our health status? Um. Then, by the time I got to college, I worked at the sexual health resource center and um had a column in the newspaper uh called sex talks with the tree. I was the mascot of my college, which was a tree, um pause.
Speaker 2:What do you mean? It's a tree, so I went to Stanford.
Speaker 1:Their technical mascot is a color which is really stupid the Stanford Cardinal, which is a like a reddish color, but the unofficial university mascot is a tree. And so at all the games, all the football games, basketball games, volleyball games, t-shirts, it's the tree. And so that was me, my senior year, and I used my tree, my arboreal platform, to teach people about sex ed weekly in the newspaper.
Speaker 2:I love this.
Speaker 1:teach people about sex ed weekly in the newspaper. I love this. But the other thing that that helped me is I had my own therapist growing up. That my mother kind of forced me to go to at 12, but I'm so glad she did and that really led me on the on the path I would say.
Speaker 2:That's wild. To like one the tree y'all. Let's sit with the tree for a moment.
Speaker 1:Cause what I think we.
Speaker 2:That's wild to like one the tree y'all. Let's sit with the tree for a moment, because what I think we have similarities in the sense that our families let us be ourselves and now we get to be these fun weirdos that people pay us to be. I love that Totally. Did you always know you wanted to do sex therapy, or was it just therapy?
Speaker 1:I think it probably started as just therapy, but I do think later in high school the sexuality stuff was always an interest. So when I started in college I was always looking for classes around that topic and working at the sex health resource center. So I think I knew pretty early on that that was like the path. Um, both personally and professionally, interested me, um, and so I just kind of became the person that people would often talk to about that stuff or have conversations with that they wouldn't normally have. And I think that, mixed with that sort of attraction to the taboo um, kept me interested. Because the more I went through the process, the more I realized people didn't want to talk about it and people struggle to talk about it and explore their bodies, their pleasure, communicate about these things. So the more I saw that there was pushback, the more I wanted to do it.
Speaker 2:Yeah, Still on brand for you. Still on brand. Okay, We'll get there, have you? So? So I don't know if you've listened to me talk, but you know me in life, so you know there's going to be a lot of side side combos happening. Um, have you ever taken the erotic blueprint test?
Speaker 1:I have. I use it a lot Shout out to Ms Jaya and um, I use it a lot with clients. I have found it to be so helpful to help partners better understand each other and kind of diminish this assumption around like high libido, low libido. So I love it. What do you think mine is?
Speaker 2:I think it's. I think it's like kinky a kinky sexual.
Speaker 1:So I'm like a kinky sensual, I would say.
Speaker 2:Okay Okay, I was. It was there Cause I was like this bitch also likes cute little soft, woo things. But totally Okay, okay I was. It was there Cause I was like this bitch also likes cute little soft, woo things.
Speaker 1:But totally the other side. Um yeah.
Speaker 2:I took it. I took it again today.
Speaker 1:You did.
Speaker 2:I'm so kinky I said yeah is that a surprise? I was like nope, I was like still me.
Speaker 1:Absolutely, and I think the blueprint can can often show up with who we are in our life. So I'm the kinky blueprint which again is around that you know sort of what's taboo, what's shameful, what's kind of novel in that way, and I feel sensual as well because I can get anxious, I can get in my head and I do like kind of the artistry of an experience and the slowness and my nervous system really likes to create an experience and it does like sort of a slow approach for most things.
Speaker 2:Sure, that was just the first side, just because I wanted to know. So today we're really going to talk a bit more about pelvic pain and medical trauma and I like to ask my guests what do you want to talk about? I don't want people to be happy here, consent, why did you want to talk about this today?
Speaker 1:been going through myself. That has been a big struggle, but it's also kind of become something that I've started to specialize in with clients and it was sort of I don't want to say by accident. I mean, I was aware of it, I learned about this, but I ended up, you know, working with a lot of people who are sexual medicine specialists and pelvic floor therapists and I just kept getting referrals for this and a lot of the people I see with vulvas and vaginas though it can affect all pelvises and all genitals. That's just who I see a lot of.
Speaker 1:So many people have pain I think it's like one in four people with vaginas experience pelvic pain, but the number is probably a lot higher or pain with sex, because a lot of people think it's normal, so the number is probably higher. So I wanted to talk about it because I'm seeing so much of it. It's such a systemic issue as well, just in our medical system and also because I'm kind of living through it and I'm feeling passionate about it and helping people learn to advocate for themselves. And just a topic people still aren't talking about. Most health providers don't have any training on it. So as many places as I can talk about it. I'm going to talk about it.
Speaker 2:Fabulous, let's talk about it. Great. When folks do come to you, are they because you are a sex therapist?
Speaker 1:And.
Speaker 2:And so do they. Do they say, hey, I'm having these pains, or does it come through in conversations about them actually having sex? Yeah, and not even understanding the bigger issues.
Speaker 1:You know it's been a mix. I think, now that I have worked with a lot of folks like this, I do get referrals from people who already know they're having pain and they've been referred to me by their pelvic floor therapist, their gynecologist, some specialist. But the other half, I would say, come in and they don't even know they're having pain. And so they come in and they're telling me I have low libido or I don't want to have sex with my partner, and I ask a lot of questions. But one of the first questions I ask is well, do you experience, have you experienced any pain with sex? And they're like oh yeah, it really hurts, like when they first put it in, but like that's normal, right.
Speaker 1:And so a lot of times, um, I think because especially people with vaginas in our culture are taught that being a woman or being a person with vagina is just normal to be in pain and have discomfort and to not really be heard and believed around that. And so a lot of folks that come in have just been grinning and bearing a significant amount of pain and discomfort and just thinking it's normal, or they've talked to their OBGYN about it and they've been like, oh, have you tried lube and that's kind of it. And then the more it happens, the more traumatic it becomes, because their body's tensing in waiting for the pain to happen, which creates more pain, to the point where some of their desire libido is just like shut off. And so a lot of people will come in and haven't even been asked the question, and then when we get into it, they're like oh my gosh, I'm having pain and it's like a light bulb, which is wild to me.
Speaker 2:Yeah, that is such a thing Like we're taught like the first time you have sex it's probably going to hurt.
Speaker 1:Yeah, your period is supposed to be really painful and just cripple you for a week.
Speaker 2:It's just like sets you up to be like.
Speaker 1:this is going to suck Everything about my future sucks and sex should only hurt unless you're kinky like me and Jim and you want it to. So you know it should only hurt if you want it to and if it's planned and if you're experiencing you know pain with it there might be something going on, and even with your first time it doesn't have to hurt your first time, but most of us don't have the knowledge to have it not hurt.
Speaker 2:Yeah, let me take it back. So did you start having your own navigation of your body before you started working with these individuals, or did you take your own experience to really want you to work more with these individuals? I mean not want to, but they, they're finding you for a reason.
Speaker 1:Yeah, you know it wasn't something that I knew I was experiencing before. I don't think I was experiencing it. Um, it just kind of ended up being something that I was able to really work with people on. I think too, uh, because of some of my other interests and specializations just around advocacy work and healthcare and like holistic mind, body, spirit, you know, biopsychosocial wellness, and so my pain and stuff didn't happen until this last year or two. So I was familiar with all the stuff because of the work that I had done, but now I experience it myself After 30,.
Speaker 2:my body started being like hey, have you felt this before? Figure it out.
Speaker 1:You're like what I know and it's all happening at once and it's oh yeah, our medical system is really really tough in navigating some of these chronic conditions.
Speaker 2:Yeah, when folks do come to you and you know when they do come to you and they know what the struggle is as a sex therapist, because you're not, you're not touching them. I'm assuming you are not, you're not touching. Let's be clear everyone. There's no touching here in that support. And there are PT folks that do do that. How do you support these individuals as a therapist?
Speaker 1:Yeah, I mean I would say first. First, we're doing a lot of like resourcing, like I want to know what their current tools are, if any. I want to know, like how their nervous system is doing. You know, I really want to approach it as much as I can from a trauma informed space to just kind of know, to get to know their nervous system. What are we working with? Where are things at right now?
Speaker 1:Then I would say it's a lot of psychoeducation, so education around the psychology of pain, around painful sex and pelvic pain. And then it's a lot of me working with other practitioners too, because obviously I can only really help with the psychological piece. I can provide education and some referrals. So usually then my first step if I hear pain is I will refer them to a sexual medicine specialist. So this is someone who's usually a urologist or a gynecologist who has specialized sexual medicine training, because most health practitioners do not have specialized training in this.
Speaker 1:And the group Tight Lipped, which is a great advocacy group around pelvic pain that y'all should check out.
Speaker 1:I think they did a study that said, on average, people with pelvic pain see about 15 doctors first before they get a diagnosis and get the care that they need, which is so inaccessible for most people, cost-wise and otherwise.
Speaker 1:So my first step is to send them to a specialist so we can really know what's physically going on, so that I know how I can best support them. So sometimes it's helping with helping them find their voice so that they can advocate for themselves and have tools and resources to take care of their nervous system before, during and after doctor's appointments, especially if their doctor is not collaborative with them. So it's a lot of that. It's a lot of finding creative new ways to experience pleasure and it's a lot of re-narrating around, helping people feel pleasure-able now and feeling into the new story that pleasure is something that is, I believe, like a human right but also a medicine and a tool for healing, as opposed to only something that we get to have when we're all healed up. So you know, different clients are going to do different things, but I would say these are kind of the main themes of where we start.
Speaker 2:You know, it's so interesting that for a long time I didn't even know there were pelvic therapists. Right, most people don't. These aren't the things that we're taught, right. And like I was visiting my friend Hunter in New Mexico and I was like listen, tmi, and I started like laughing and like peeing at myself recently.
Speaker 1:And I was like that's another fun over 30 thing too, huh.
Speaker 2:Excuse me, laughing and like peeing on myself recently and I was like, excuse me, and so my friend is a PT, and she was like, do you mind? I said, sure, don't, let me get up on this table, okay. Have a look, Looped up with some gloves. She felt around. She said oh, you're doing too many Kegels.
Speaker 1:Yes, which I think.
Speaker 2:So then it's then it's more tight than it needs to be, but it's also weak Too tight, Too tight and weak which I think is a conversation we can have, is we're taught like well, here's this thing.
Speaker 1:Yeah, you want to have a tight vagina. Do some kegels.
Speaker 2:But there can be too much. Yes and I think that's the conversation that we can also engage in is like you can overdo it with trying to do everything, like when you're trying to fix things. Have you met individuals that are like I've done this and this and this and this and this thing. You're like what?
Speaker 1:Yeah, well, and most of the time, what they're doing is sort of a one size fits all thing that has to do with, like a cultural norm that they've been told, such as doing kegels. Some people absolutely do need to work their PT muscles, their muscles in their pelvis, but it's not something that everybody needs or should be doing, and so that's something that you can figure out with a pelvic floor therapist, with a sexual medicine specialist, to tell you what your body actually needs, and so, yeah, I see people sometimes doing a lot of things, but they haven't necessarily gone to a doctor or a healthcare provider who's taken the time to actually see them as a whole unique, integrated individual, to help them figure out what is best for them, as opposed to you know, just this.
Speaker 2:Yeah, this one size fits all thing, yeah you kind of brought it up, and this is something that I talk about a lot, a lot with trauma survivors and that is medical trauma.
Speaker 1:Yes.
Speaker 2:The idea of going to the doctors is so scary for a lot of people, especially those of us that have vulvas and vaginas or identify as women, because we're often not believed. What do you? Can you explain what medical trauma is, just so folks can understand, and maybe some of the things that you know? You have had to work with clients around when even just going to the doctors, yeah.
Speaker 1:I mean again, I want to maybe describe it broadly because I think there's so many things that it can be. So I think first there are folks who are part, of, you know, minority or marginalized populations who just have systemic trauma and fear around the medical system, whether that's folks of color who know that their ancestors were non-consensually tested upon and they don't trust the system, or people who just know that maybe the system was not created for them, people who just know that maybe the system was not created for them. Then we're looking at people who have had negative experiences themselves. So I see a lot of folks again in marginalized populations queer folks, other LGBT folks, trans folks who have gone to doctors where they have been misgendered, where they have not been treated well, where they have been misgendered, where they have not been treated well, where they have been asked questions that you know didn't feel right for them and you know the healthcare practitioners just weren't informed about how to work with non-monogamous, queer, whatever population, and so they stopped going because they weren't happy or comfortable with the care they were getting. So that could be trauma.
Speaker 1:And then I think we have folks who have, you know, if they're experiencing pain. So for pelvic pain in particular, the most common one that I see, in addition to all those intersections I just listed before, is folks who have gone to a OBGYN and look, obgyns are great, they do an amazing service. Not everyone can learn all the specializations in all the things, but it's a real problem in our whole country that there's not a better pain education and trauma-informed care. And so what I see happening a lot is folks will go to non-trauma or pain-informed providers. Those providers will forcibly use a speculum for someone who's already experiencing pain to do a pelvic exam, or they will use some kind of ultrasound and the person is in excruciating pain. They're not firstly asked, there's not really consent and explanation of what they're doing or expectation of what it's going to hurt. Or they might say, oh, you'll feel slight pressure and the person's in big pain.
Speaker 1:And then we have this power dynamic where, especially if you're in trauma response.
Speaker 1:But for anybody even myself I'm in this field it is fucking hard to speak to a doctor who's in this power position and say no, that's not right, or that doesn't feel right for me, or, um, I have some questions and you know they're like maybe don't have the time or don't know how to answer, or just are like I'm the doctor, I'm right, um and so that can be traumatic, dismissive, so people can go into appeasement at any of the survival responses and so then they're having this ongoing thing where they're not feeling listened to, they're not feeling heard, they're experiencing pain, they're not getting their questions answered and it's traumatic.
Speaker 1:So then they start dreading going to the doctor. The other layer I see for folks with chronic pain is they're just fucking tired of going to the goddamn doctor, like, even if they're getting great care, to be poked and prodded and clinical and be a patient. It's exhausting and to try to imagine that this body is capable of pleasure when, like, the majority of what you're experiencing is doctor's appointments and clinical medical stuff. The majority of what you're experiencing is doctor's appointments and clinical medical stuff that can feel traumatic too.
Speaker 2:So long answer to say that there's so many layers, and I see this a lot. Yeah, it is a thing that really does have a lot of layers and shouldn't right Like why is this so hard all the time? Like it should be more collaborative. It doesn't feel like you're even led into your own medical care?
Speaker 2:often, when you do work with folks, are there certain diagnosis that they are given, that they can finally go, that they can latch onto? I know a lot of us are that are in pain, which I'm a human in pain. Quite often we spend so much time and energy, like you said, trying to figure out what the fuck is going on and to finally get a name for it. How has that been working with individuals?
Speaker 1:Yeah, like what kind of diagnoses I'm seeing. So I think first I'll say if someone's going to someone that's maybe not, you know, pelvic pain informed, they might not get one, they might just get the. Have you drank? Have you had a glass of wine? Try some wine, maybe some lube? Are you relaxed? You know, just try relaxing. And I think we all know when you tell someone to relax, that makes me want to relax quickly and be fine. Quickly and be fine. That's actually. I only need one session with every client, I see, because I just say have you tried not being upset? And then that's all they need. It's a wonder. Yeah, it's wild, you know I just churn them in and out.
Speaker 1:Um, so, you know they often won't get a diagnosis, but when they finally do, probably and again, I know we're talking about people with vulvas and vaginas, but there's pain that can happen for all kinds of folks, all kinds of genitals, and so for people with penises, common ones can be also, you know, a tight pelvic floor, people carrying a lot of tension in their pelvic floor which can affect ejaculation erection. It can also be indicative of like a cardiovascular thing going on or something called Peyronie's, which is like a fibroid, fibrosis issue of the penis, of the tissue. So there's some there. Obviously, for folks who are trans, non-binary, if they've had any sort of affirming surgeries, there can be, you know, medical trauma as well as scar tissue and things going on there. If they haven't had, you know, affirming surgeries, it could be the tension they're carrying in their pelvis because of not feeling aligned with their genitals and their gender.
Speaker 1:For people with vulvas and vaginas, endometriosis is a big one that I see this is a very oversimplifying definition but basically when tissue in the pelvic area is growing outside of where it should be. But it can also happen all over the body, so it's like tissue growing where it's not supposed to causing pain. Another big one is this a mouthful hormone mediated vestibulodynia. This basically basically means yeah, it's not as not sexy as it sounds. It basically means hormones are causing pain at the vestibule. The vestibule is the entrance of the vagina. This is often caused by some kind of hormonal thing going on, which I see a lot for folks who have been on long-term hormonal birth control. So that affects that's probably the biggest one that I see for people that I work with.
Speaker 1:There are other things that can go on with the tissue with the nerves. Some people have like neuralgia going on, like a compression or issue in the sensitivity of the nerves. Some people have stuff going on with their microbiome that's affecting consistent infections. So it can really be a variety of things. So get yourself evaluated to figure out what's going on for you. And the thing with pain is, even if it starts as like a physical diagnosis, it's often maintained by psychological and sociocultural stuff. So you know, even once the physical is treated, cultural stuff. So you know, even once the physical is treated, ideally the treatment team consists of a physical therapist, a sex medicine specialist and a therapist, so we can get the whole person and the whole human healing, which is not accessible for everybody and a lot of times insurances won't cover what's needed or or those specialists won't take insurance won't cover what's needed or those specialists won't take insurance, isn't that?
Speaker 2:great. Yeah, such a fun fuck. It's so fun, but there are-. You fight to get insurance and it doesn't work. You're like cute, I love it. Thank you so much for taking my money for nothing.
Speaker 1:I know and all the people that I, for me, end up seeing are oftentimes people out of pocket, because they're the ones who have the time to spend time with you and hear about what's going on, which is this is a systemic issue. Luckily, there are groups like Tightlipped and others that are fighting for advocacy and trying to change some of these things, but dang, it is frustrating.
Speaker 2:Yeah, I want to ask one question that I kind of want to ask. Let's talk through some myths. Is all pain bad?
Speaker 1:No Period. That's it Complete sentence.
Speaker 1:Thank you, yeah that's it, we're all done. I'd love to hear your answer on this too. I would say, in short, no. What I mean by no is that I think not I think, but I know that pain can be a really important indicator and barometer, like a warning light to tell us when something isn't right. And so I think I read it a long time ago, but I think my therapist a long time ago told me to read the Gift of Fear or something like that.
Speaker 1:I had mixed feelings about it, but I think it was all to say that sometimes our bodies have a lot to tell us and we need to listen to them. Sure, sometimes the messages are coming from maybe an old trauma place, but other times it's giving us an indication. So pain could be telling you that something's going too fast, that something's not right, that you need support. It could be something that you do intentionally because you like the way it feels. It could be. I don't think that feelings and sensations are good or bad. I think that they are sensations that can give us information and to be curious about. So certainly, if you're experiencing pain that is unwanted, I would get it checked out. And that doesn't mean that pain doesn't have a message or a purpose or something to tell us.
Speaker 2:What do you think? How did you get to? I agree with you but before I forget this question how did you get to not thinking things are good or bad? I mean, I don't think that's like a thing. We all think where it has to be one or the other.
Speaker 1:I think, in all transparency, I'm still working on with myself and the trainings I've done to support my clients. It's just been an ongoing thing to get curious and to give us, to give us information, and so I don't know if I am there, even within myself. I think it's something I'm still practicing. But I think trying to detach yourself from the story can be really helpful. But in order to shift our story, we have to change our state.
Speaker 1:And so I think it was Deb Dana, like a trauma specialist, who said story follows state, which means like whatever state we're in is going to affect the meaning and the story of something that we're experiencing. And so, for me, I think, when I'm in a certain state that's able like a rest and digest, a socially engaged state, I'm able to be like oh, I'm having a sensation that's interesting, I'm going to be curious about it. Versus, if I'm in like fight or flight, or stressed, and I have a feeling I'm probably going to be like it's bad, it's all bad, it's all bad, we're all going to die, you know so, and it could be the same sensation. So I would say for me, me once a week.
Speaker 1:I mean, yeah, that's what I'm saying. I'm working on it myself, but if I can, as I've been trying to shift my internal states, it's affected the way I can look at those things when I'm not in a survival, fight or flight space.
Speaker 2:Yeah, I love that. I am a curious human. That's why I asked. But I agree with you. I don't think that all pain is bad. I think that we are fed that pain is all bad in somewhat of a controlling way. I don't, I can't, I don't have the energy to flush that out, but I feel like I'm a liar.
Speaker 2:Here we go, I feel like as those of us that you know were, you know identify as women have vaginas, have vulvas, like we are set up to, like think that being us is so hard and painful, like there's no joy in all of these things Right, which I think is kind of really shitty that we're set up to just be like. You're getting your period, are you okay? Like that's like the start of it. It just gets downhill from oh no, you're getting little breasts. People's tones change, the way that we are held, the way that we are held, the way that we're talked to. It's like a fucked up, weird start.
Speaker 1:Yeah well, yeah, and then and then the way that people emphasize the no pain, no gain. So there is this also like thing in our culture that's like, oh, you can only find, you know, strength and healing and growth if you go through pain right, or like just just grin and bear it, you know, just white knuckle it, like pain builds character. So I think our culture can also go to the other extreme, where then we're dealing with immense amounts of pain and thinking it's normal. So I don't know, I've seen it swing both ways, where it's like sure, yeah, it's either like a really good thing that builds character or like something that is bad.
Speaker 2:And also those conversations when I really pull back are very gendered.
Speaker 1:Yeah, the no pain, no gain is more for men, cis men, right? Mm-hmm, mm-hmm.
Speaker 2:And then I'm like, because we were taught, oh, it's gonna be so sad you, you better get up like the energy right.
Speaker 1:A whole, nother, whole, nother convo yeah, but go into, but there is a gendered piece here, absolutely yeah, yeah, even even as the myth the myths.
Speaker 2:Let's get into some this. I pulled some up on different websites um myth. You can tell me your thought on them. You could tell me true, you can say false, however you want to respond. Okay, we're open.
Speaker 1:Oh, I just got anxious. What is it?
Speaker 2:It's just different questions, like people have said. No, I know.
Speaker 1:Just like I'm noticing that I got into, like my test body, which is like I saw it you did I need extended time?
Speaker 2:I have ADHD. What is going to happen? See, this is real time. Y'all this is real life Myth Men don't have pelvic floor muscles.
Speaker 1:It's a myth that they don't. So they do have pelvic floor muscles. Yes, yes, people with all genitals have a lot. Again, this is a little bit out of my scope so I can't do it justice, but there are a lot of muscle groups that are part of our pelvic bowl, our pelvic floor, that all genders have and that deserve care just like any other muscles.
Speaker 2:And maybe a little bit more, because I just told y'all I'm a happy person. I was laughing and tinkling at the same time, so I don't know yeah, which is? It says something's going on yeah, which is my next myth pelvic floor issues only affect older individuals. False, that's not true, not true.
Speaker 1:Well, I mean, we are old, untrue. We are older individuals. I not older, I feel like an older individual. No, it can affect people of all ages and there's lots of traumas that can happen to that part of the body at any age pelvic floor is normal, is a normal part of aging um, like our pelvic floor is a normal part of aging. Pelvic pain, oh pelvic pain.
Speaker 2:Maybe I say again maybe I didn't fully read it it's also a fall. Okay, pelvic pain is a normal part of aging.
Speaker 1:Um, yes, no, and so I would say um, people definitely can experience more pain as the tissues thin, as the tissues change as we age, they can need more care. That does not mean that you have to tolerate it without support and intervention.
Speaker 2:Sure. And last one pelvic floor support only matters after giving birth tissue connected to so many things in your body.
Speaker 1:That deserves care and knowledgeable intervention at all stages in life. And I wish it was required to have pelvic floor, which again is physical therapy for the pelvic region, to have pelvic floor therapy before and after birth. And a lot of people don't know that, a lot of people don't get it, and then they have pelvic floor dysfunction and are like what's going on? Why am I laughing and peeing? Why am I, you know, feeling, um, uh, a shift in my experience with pleasure during penetration, um, all these kinds of things. So scar tissue if you have a C-section, um, so please do yourself a favor and do it now, even if there's not an issue. See how things are going, how you can be preventative, proactive, and also, if you're planning to have some kind of a birth process, consider it before and after that is such a thing that they don't really focus on.
Speaker 2:I feel like often those that have children like it's focused on the children and not on the care of the person that the little human grew inside. So, having that information, I really do wish that more folks knew about it. I do think that because of our good girlfriend's social media, which is where we're going here, I want to break up. There's a lot more. You know same. She and I have had a rough time. I think I'm being suppressed again on the internet, but that's fine. That means I'm doing my job With social media, with our good girlfriend TikTok and Instagram and Twitter. Because we're not calling it that letter. There's a lot of people Instagram and Twitter because we're not calling it that letter. There's a lot of people that have a lot of opinions and thoughts. Do you think social media is helpful?
Speaker 1:or harmful. I think it can be both. I guess it's sort of the way I view anything is that depends on how you use it. I do think it has given people access to a lot of things and information that they maybe wouldn't otherwise. To help them find community, to help them feel normal, to help them learn about things they may not otherwise. And then, on the flip side, I think it's really hard for the consumer and the young people who aren't taught comprehensive sex education or mental health education to decipher, maybe how it's impacting them, what's maybe feeling harmful, what's causing more body image issues, more isolation. I think a lot of us use it in a dissociative way.
Speaker 1:That's not super intentional, and I think there's a lot of people out there who are calling themselves experts that maybe don't have the knowledge, the experience, to be calling themselves that and are just preaching their opinions, which, um, you know you can share your opinion, but for people who don't have a discerning lens or a broader knowledge, I think it can be dangerous and harmful. Um, I definitely think it's been harmful for people in like comparison culture and being present with like what life actually is and looking at sort of like a false reality. So I think I've seen it have a lot of support and I've also seen it be detrimental. So it depends.
Speaker 2:Why do you want to break up with her?
Speaker 1:Because I'm feeling that push pull as well. Why do you want to break up with her? Because I'm feeling that push pull as well. I'm feeling I've been trying to like stop doing things that I don't feel excited about, and I definitely don't feel excited about it.
Speaker 1:Certainly, you can try to bring in people to help, but it's it gets costly, um, and I think, yeah, it just doesn't feel quite real. It feels, um, like I'm just having to, I don't know. It almost feels like an abusive relationship a little bit, where there's like this entity, this Mark Zuckerberg entity, that like I need them to survive. I don't feel like I can leave them because I'm supposed to be doing this and they can just like take, they can just like pull the rug out from under me at any time. Um, if we were talking about like a relationship like that, that does not sound like a healthy, fulfilling relationship to me. So when I think about it relationally, it is not. It doesn't feel very good, but again it feels stuck Like well, what else, you know? Are there other ways? But for me, I'm really trying to spend some more time focusing on my own health and all the stuff we talked about in this episode. I'm starting to wonder if it's important to me anymore.
Speaker 2:Yeah, yeah, it is a weird thing, like everyone's like you should do TikTok, you should do this. Let me tell everyone, and I like to remind folks I fucking hate unsolicited advice.
Speaker 1:Leave me alone, I'm tired she does, she does leave me alone don't tell her to call it x I hate it, I do that same thing, that's my little picky, the fuck you attitude. It's like I will not thank you for your suggestion.
Speaker 2:Yeah, also, our birthdays are very close. We're a lot of the same. There are a lot of individuals and I'm glad you hit that little nail on the head. Everyone's a fucking expert on the internet. I don't even like being called an expert. They've done it so much. I have the ick and I've been studying psychology since I was 16. Ew, I hate the word.
Speaker 1:Yeah, it's a little bit like beware the Buddha on the road or whatever.
Speaker 2:Have you found, though, good information around, like pelvic floor stuff that you do refer clients to, or practices, or anything like that?
Speaker 1:Uh, lipped, I think you found them on the internet. I think I found them through colleagues and maybe a client. So again, their advocacy education group. They also do support groups, get togethers, meetups, podcasts, so I really like referring to them. Around some of the pelvic pain stuff. There's definitely some other physical therapists I can't think of them right now but I can give a list to folks if they want. But there certainly are some really wonderful ones out there.
Speaker 2:Yeah, how would you tell folks as someone that does sometimes get into the scroll things like how are there any tips to decipher if the person actually knows what the fuck they're talking about?
Speaker 1:Good question, Gosh. I don't know if I know how to answer that.
Speaker 2:That's okay, that's an answer.
Speaker 1:I think my answer is to get a few different inputs of information and, you know, be curious about where this person just got their training and, again, I know people who have gotten great training and I would not send people to them. So also that that's hard. I think it's having some kind of check and balance and I do, like you said, like people who aren't just like expert expert but seem to be continuing to learn, continuing to offer updated versions of things but get a couple different inputs so that it's not just like one one input. Yeah, but that's a hard one, I don't know. What do you think?
Speaker 2:I also. I'm listen. I love to use my good girlfriend, google, because she's free, and I'm like who is this? Let me go and look them up. Even people that work with me. I'm always like look me up, you should know who you're working with. You should know whose advice you're taking, because there is a lot of people that have advice and not expertise and not knowledge. Yeah, so I would say, sure, if you like what they're saying and it connects with you, I think that's also a start, feeling that aha moment of like, oh shit, I've never heard it in a way that maybe it's digestible for me to understand. But then I would also go and do whatever research I can. You already have a computer in your hand. Just do that extra step for yourself.
Speaker 1:Yeah, I mean this is sort of a harder answer and a longer process. But I do work a lot with people with helping them what we call like find their yes and their no, to help them sort of trust their body messages right, like what is my body telling me, and to trust that feeling that we get around people that maybe give us the yes or give us the no and to slow down enough to really feel into those and figure out those sensations. So that's sort of a longer answer is to maybe get some therapy support to help you build a better trusting relationship with your body's responses so that if and when you have you're checking out a new person, to take the time to sit back and be like how do I actually feel listening or looking at this person's stuff? Is it giving me yes, vibes? Is it giving me no? Is it giving me?
Speaker 1:I'm not sure I need more information, vibes. Is it giving me no? Is it giving me? I'm not sure I need more information. So I'd say that's another one. But that's a, that's a longer, lifelong process of kind of getting to know the communications of our body which are sometimes in conflict with our brain. So it's a, that's a that's a process, but one that I would invite people to be curious and inquire about people to be curious and inquire about.
Speaker 2:Yeah, how is your mental health as you navigate all these things? We always talk about other individuals as providers. I'm always like how's your brain, how's your heart? What's happening over there? Because we're not asked enough. People are always putting things on us and forgetting that we're also humans. It's so wild.
Speaker 1:I saw a funny little clip on TikTok or something the other day. That was like two mental health providers like trying to catch up and ask each other about their lives, and it was just this ping pong of like, no, no, no, how are you doing? Like, how are things feeling for you? Yeah, how are you doing? Because we're like, yeah, it can be hard to flip the script, man, I'm a work in progress, I am doing a lot of my own therapy, I'm doing a lot of my own care stuff and it is hard to be a human.
Speaker 1:You know, I I certainly don't use my therapy sessions with my clients as my personal therapy, but I do get real with clients, like being no, don't do that, but I am, you know, more transparent than the old Freudian. You know blank slate approach of like, yeah, being a human is hard, like oh, yeah, that's something I've struggled with and here's some of the things that I've been doing to work through that like when it is helpful for the client. I will self disclose, not in too much detail, but I'll be a real, a real human with them. So, like I'm doing okay, like I have a lot of the tools and resources, it is hard to make the time to do all the things.
Speaker 1:Some of the it feels like a full-time job. It is a full-time job so sometimes I would love the opportunity to just have my health and wellness be my full-time job, get paid to do it, which it like half is, but, you know, not quite. So work in progress, trying to find better balance and time management, which is hard for a ADHD person like me that wants to do all the things. As you know, it can be hard to, you know, find the time to do all the stuff I want to do and make sure that I'm prioritizing taking care of myself. So I'm really working on it for myself and to model that for my clients. But it is a work in progress and it is hard when we're up against so many systemic societal things that are not set up to prioritize a life that prioritizes that kind of wellbeing.
Speaker 2:Yeah, this was fun. I people, people are always like you have such hard comments. I'm like they're so fun.
Speaker 1:That's the kinky in us. We're like let's talk about the shadow. Give me trauma.
Speaker 2:It's so good? I also think because we're very comfortable in the uncomfortable, even if it makes us squirmy, because we're so inquisitive humans. This is why we get along.
Speaker 1:It's like this is weird, but have you thought about this? This is weird, but can you look at my vagina?
Speaker 2:Why not? We got gloves. Can I use your lube? Thanks, that is interesting something. Before we wrap up here, um, I'd love for you to speak to a little bit about like safety. Um, you know, for a lot of folks you know going to the doctors it's. It's also like a safety feeling. You know navigating pelvic pain. It it might be because of sexual harm or whatever, or just because whatever, but there's a lot of safety that comes to my brain. As we've had this conversation externally and internally, which is the way that I kind of look at it, does that come up in sessions for you? Have you had to navigate through any of that for yourself as well?
Speaker 1:Absolutely. I would say a big part of the work is helping people find. People who have experienced a lot don't feel safe, feeling safe. So what I mean by that is, if you've experienced a lot of stuff, your body has learned that it should be on guard, waiting for the next thing. That isn't safe isn't safe. And so a lot of the work that I do is, you know, trying to help people or giving people resources to feel safe again in being safe, which is why I've been trying to do a lot more you know, trauma, trauma trainings to really help with that for myself and with clients. But yeah, safety is huge and that's kind of the one of the first things that I have to do with clients is how do we build a sense of safety with each other in this relationship by having consistent care so we can do the work.
Speaker 2:Yeah, I just wanted to touch on that Cause I know a lot of folks that have had, you know, different types of trauma. They're like I don't trust anyone, so no, thank you.
Speaker 1:Yeah, yeah, which, which, for them, has probably kept them safe when it needed to, but it might not be working anymore. What the body needs?
Speaker 2:Sure, and I think there's. You know, when you say like it's not working anymore, things change. Like you evolve the things that maybe you needed before you, you don't need as much or you're able to navigate easier. Right, Exactly. Okay, We've gotten to the last question, which is my favorite question because nosy.
Speaker 1:Okay.
Speaker 2:What is the wildest thing? That someone has texted or DMG in the last two weeks?
Speaker 1:Oh, gosh, it's hard to think of the last two weeks, but I'll give you a good one that comes to my mind from my, from the archives and okay. So luckily it's been better since I'm like licensed and have learned you know better boundaries, but you know, when I first and again, nothing's really crazy to me anymore because I'm like I see people peopling all the time, so I'm not like shocked and you know whatever. But back in the day I used to get what I would call creepy callers, which was people who weren't really looking for therapy, who wanted to push the boundaries of how they talked about sex, which can be hard because sometimes people call a therapist and they're going to talk about some explicit stuff and it's like part of why they're coming to see you. But I had this one person who got creepy afterwards and got a little stalkery, which was scary.
Speaker 1:But the funny part was it that basically they first called me and they said they were struggling because they realized that they liked the smell of public bathrooms after people would poop in them and I was like, okay, that's a thing Like tell me what. Like you know, are you doing it ethically? Are you doing it consensually, cause that doesn't have to be a problem, like you know find some people to let's let's figure that out for you Um, and turned into them actually wanting to come to session with me so I could fart in the room with them so that they could see if they liked the way that I smelled and part of me was like, well, I fart every day. Like how much?
Speaker 2:You're like well, well, let me, yeah, lights, I like.
Speaker 1:Right, can't do that as a therapist. But you know, I was like, I think I think, because of how non shaming I am and how sex positive I am, it wasn't the reaction they wanted from me. I think they wanted me to be like upset and bothered and shocked, but instead I was like well, look, I don't do that. But you know, let me refer you to some of my colleagues who will happily fart in your mouth, fart in your face, fart in a jar, like what kind of farts are you looking for, you know? So I'm giving a whole list of farters. Um, so I think they didn't want that. You know, they wanted me to be part of this shaming cycle of like no, so mad.
Speaker 1:So shout out to the fart lovers out there. That was a. That's a good one. That comes to my mind. Uh, thank you for that gift. Yeah, um, and just, ps, don't send me unsolicited dick pics. Luckily I don't get much of those anymore, but now and then I don't either. Yeah, I got one guy who sent me one, with him next to a pringle can, and just was like oh I think that photo too, yeah.
Speaker 2:Um, because everyone's not pulled out, pringle cancel yeah oh man, I get some. We get some of those, but have you ever gotten a vulva, because I've gotten a vulva before no, I haven't yeah, I sure did. I said who coaches this?
Speaker 1:yeah, yeah, I've only gotten it once though oh, man, man, it makes me want to bring up my they're all in the hidden files.
Speaker 2:You're gonna be like. I was just kidding, I actually got 50 over here.
Speaker 1:I know I'm like there's so many, oh shoot, okay, well, next time, but now now I'm just now they're just funny at some point, still, doesn't them?
Speaker 2:no, thank you Now they're just funny at some point. Still don't send them. No, thank you, I was going to say something. We're going to stop because I was going to say something wild and that's not for your ears, it's just for hers. Before you go, where can he, they, them, she, they, zee, them, zee, zay, anybody? Where can they find you? Where can they find out what you're doing? Keep up with you, listen to things, give us your info.
Speaker 1:Thank you. Y'all can find me at my website. I'll give it to you to put in the show notes nicolettavheideggercom. Please do join my newsletter. I don't send a lot of stuff and spam, mostly just events I'm doing, but I would say that'd be the best way in case me and social media do have a pause at some point. But for now I'm also on social media at Sluts and Scholars, which is the name of my podcast. You can also find that at slutsandscholarscom or anywhere you get your podcasts, or at Therapy with Nicoletta. You can find all my links in my bios there. Thank you for having me.
Speaker 2:Yes, this was so fun. Take what feels good for you. Go do some research. If we talked about something that you are inquisitive about, go use your good girlfriend Google. She's free, but we're not, neither is our time. So we will talk to you later, and until next time, thank you.
