Things You Learn in Therapy
Things You Learn in Therapy
Ep 108: Unpacking Chronic Illness and Medical Trauma: Insights from Victoria Rodriguez
What happens when our favorite TV shows influence our understanding of real-life medical experiences? Today on "Things You Learn in Therapy," we welcome back Victoria Rodriguez to unpack this question. Victoria shares her personal journey with chronic illnesses and the impact of shows like Grey's Anatomy on public perception. We examine the concept of complex medical PTSD and debunk common myths surrounding chronic health issues, while uncovering the persistent stress that patients endure.
Navigating chronic health issues often feels like a never-ending odyssey, especially when it comes to elusive diagnoses. Victoria and I discuss how societal norms can lead individuals to downplay their symptoms, causing emotional distress and self-doubt. We highlight the significance of validating these experiences and the bittersweet emotions that come with finally receiving a diagnosis. The conversation underscores the importance of addressing the emotional toll and maintaining hope throughout the treatment process.
Chronic illnesses do not just affect the body; they take a significant toll on mental health too. Stress, particularly, can exacerbate conditions like autoimmune disorders. Victoria and I reflect on the lessons learned, emphasizing the need for mental health support in chronic health management. We also delve into the essential role of caregivers and how therapists can offer compassionate support. By fostering empathy and understanding, we can improve the quality of care for those battling chronic illnesses. Tune in for a compelling discussion that offers practical advice and heartfelt insights into the world of chronic illness and medical trauma.
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www.bethtrammell.com
Hello listener, welcome back. I'm your host, dr Beth Trammell. I am a licensed psychologist and an associate professor of psychology at Indiana University East, where I'm also the director of the Master's in Mental Health Counseling Program. And this is Things you Learn in Therapy and I am very excited that my guest is coming back. Before we started recording, I fangirling with Victoria today on her last episode. That was so meaningful to me and so powerful when we talked about kind of radical comfort and how we have to take sort of radical acts to engage in self-care practices that include physical comfort, and I just found so much meaning in that, and so I'm so grateful that Victoria is coming back today to talk about all things kind of chronic illness, and we might dig into a little bit of medical trauma, maybe some PTSD. We're going to just sort of see where things go. But I think your expertise I'm just so grateful you said yes. So Victoria Rodriguez is here. Tell us a little bit about you and one fun thing about you.
Speaker 2:Absolutely. Thank you so much for having me on, beth. I am so excited today to get into treating chronic illness. What it's like to live with a chronic illness, what it's like to be a therapist with chronic illnesses. One fun thing about me is right now I had just finished up doing a presentation actually on Grey's Anatomy and General Hospital for the Therapeutic Applied Geek and Gaming Conference and I am just about finished with Grey's Anatomy all season. So I'm caught up. So that's one fun thing about me is I am now trying to learn about what medical trauma looks like in television shows that we grew up with. So that is what I am working on at the moment and I'll let you know how that goes once I finish all like 100 seasons of it or something.
Speaker 1:It really is. You know, I think my teenage daughter started watching Grey's and she was like naming all these characters that I was like, oh yeah, they're, they're goners, they're. They're not in the show anymore. They were like you know seasons and seasons and seasons ago.
Speaker 2:Talk about medical trauma. Absolutely. There's so much to unpack there.
Speaker 1:Although I love this idea because I think about where people get information from about medical conditions or like their health, and it probably is shows like Grey's Anatomy or med shows or whatever right.
Speaker 2:Yeah, there's research that actually that people are far more likely to have medical anxiety about basic surgical procedures because of Grey's Anatomy and that everything seems to go wrong, like there's plane crashes and bombs and all kinds of traumas that happen at the hospital. But actually it has very real life implications where people will consider routine procedures to be much, much more dangerous than they actually are. So that's kind of an interesting fact that I learned this month.
Speaker 1:It's like. Probably most people are like yeah, I know this isn't real, I know it's a show, but it does like what your eyes believe, what they see, and it sends that message to your brain that says this is true, even though your brain, if you don't like, pause enough to say like this isn't true. Brain, your brain that says this is true, even though your brain, if you don't like, pause enough to say like this isn't true brain, your brain just soaks it in, believes it to be true, and then that impacts you when you engage in other experiences in life.
Speaker 2:Yeah, so when we talk about chronic illness too, I think about all of these myths, both television, in movies, in the media that we surround ourselves with, and also messaging that we receive from our families, from our culture, around chronic health issues and health in general.
Speaker 1:I couldn't agree more and I shared a little bit with you before we started recording. I'll probably share more that. I had a lot of those in my own life around chronic illness. I had a lot of those in my own life around chronic illness. I believed a lot of myths. I had a lot of messages from being from younger. I mean I can't think of what the messages were, I just know that I developed this sense of like, oh, this is what chronic illness is and oh, this situation that I'm in is not that. And so maybe if we start with sort of how you would define chronic illness and maybe if there's a myth that you know is around that we can just kind of float those in as we're having this conversation, but let's help educate folks on what chronic illness actually is.
Speaker 2:Sure. So chronic illness can refer to any sort of health issue that is long-term and most of the times these illnesses cannot be cured but they can be managed through lifestyle medication, et cetera. The way that I conceptualize chronic illness as a therapist this isn't for every client, but when I think about a medical trauma, it typically refers to one event, like medical PTSD. There might be one procedure or accident or surgery, etc. A stay in the ICU, for example that can be traumatizing. When I think of a chronic illness, I conceptualize it more as complex medical PTSD and that means that there's not necessarily one event that we can say, yes, right. So the stress pathways being used over and over again. That can include managing an illness with doctor's visits, even going on what we call the medical odyssey, and that's the journey that a patient goes on to even find out what is happening in their bodies what chronic illnesses are occurring, what health issues are occurring, and so that can be traumatizing in and of itself, like not having an answer to these health issues, additionally having to take medication.
Speaker 2:So I see a lot of teens that are working with chronic health issues and there can be a lot of shame and isolation and embarrassment even having to take medication or having to excuse themselves from class or having to miss school as just a couple of examples. So chronic illness I conceptualize it as kind of that complex PTSD where it's these events happening over and over again versus just this one major event.
Speaker 1:And so some examples of chronic illness might include what kinds of things are like yeah, this is what people usually think chronic illness is, but then this might also be chronic illness.
Speaker 2:That's a really good question. So if anything comes up for you I know I swim in this place a lot so it's hard to even think of the myths around it. So I would say with my clients that I see if they receive a definitive diagnosis from a doctor. So I'm thinking things like dysautonomia, pot, ehlers-danlos. I see a lot of hypermobility that would be in their minds that's an immediate chronic.
Speaker 2:I have had this chronic illness. I have struggled with it. For some reason I find chronic pain to not be recognized as part of this chronic illness category. So that can include fibromyalgia, that can include, again, joint pains associated with hypermobility but maybe they don't have an official diagnosis and headaches as well, or migraines. So I see a lot of people, especially people who are socialized as women, who don't recognize their migraines as a chronic health issue, even pain associated with menstrual cycles. They don't recognize that as a chronic health issue, even though it will frankly take them out for, you know, two weeks out of the month where they just cannot function or they're dealing with like other symptoms on top of that. So when I think of my own clients, it's really just these health issues that occur but are maybe not recognized as a chronic health issue. So I find especially pain is not associated as being a chronic health issue.
Speaker 1:Yeah, I feel like I kind of agree. I don't do as much work as you do in kind of chronic illness, but I think in conversations both with clients and non-clients, yeah, I don't think that folks put chronic pain in that same category as those chronic illnesses and it's almost like chronic pain is a less severe. Is severe the right way to say it, victoria, it's like chronic pain is kind of less than a chronic illness. Yeah, yeah.
Speaker 2:I think that's the messaging we were seeing. Is that a chronic illness? Yeah, yeah, I think that's the messaging we received. Is that, well, everybody experiences pain, right, and everybody might experience, will experience pain at some point in their life, right, yeah, however, for a chronic, a person who has experiences chronic pain, either as a primary or secondary symptom or issue that has the ability to mess with their functioning in life, and it's long term and it can vary in intensity, but might not even vary in its ability to disrupt their functioning right, so they might still be able to go to work, they might still be able to take care of their family, they might still be able to perform all the necessary care tasks, like showering or brushing their teeth, except when the pain gets to be too much, and yet it's still not recognized as a chronic health issue. I also find sleep disorders are maybe not recognized as a chronic health issue.
Speaker 2:So again, I'm thinking of my clients in particular who have had a lot of sleep issues and then they just work through it, or they are chronically tired and I think that's really normalized for them, either through messaging they've received, again through their culture or their family, or just from messages from media that they've consumed, that yeah, they're supposed to be chronically tired, you're supposed to feel this tired all the time, but they're not. And then they go for it. We have conversations of you know, do you feel like it's time for a sleep study, since you're telling me that you're experiencing all of these sleep issues and that you're fatigued all of the time? And then they come back and they'll be diagnosed with some sort of sleep disorder, sleep apnea, you know, etc. And so I think sleep disorders, too, are just really normalized. When I think of chronic health issues that are not as recognized, I try to think of the ones that are really normalized. That will all of us experience that, but maybe not to that severity or intensity or longevity that somebody with a chronic health issue experiences.
Speaker 1:Okay. So I'm thinking about unpacking this medical odyssey that you mentioned. I can I mean, I can resonate with this idea. Personally, I had never heard of this term medical odyssey but it makes sense to me and I've encountered a lot of folks who gosh. It just adds such an emotional struggle to the already physical struggle. So how do people like how have you been able to help folks stay hopeful or maybe hope isn't the thing that you try to encourage them, but you know, how do they manage the emotional part of this medical odyssey when they can't figure out what's going on?
Speaker 2:So I want to come back to that word, hope too, as well. So with my clients that are going on this medical odyssey, right, A lot of the work that we do is even just normalizing that something is wrong, that they are in pain or that they are experiencing these symptoms. Because when you go for decades and years of not having an official diagnosis, you can almost start to gaslight yourself into believing that you're not having a flare up. Or I have clients that say, well, everybody hurts this much or everybody experiences this. Maybe I'm just making this up in my head or making excuses, or this is a big one that comes up, Maybe I'm just lazy, I don't want to do this task enough.
Speaker 2:And so a lot of the work that we do is even normalizing, first exploring what messages have you received around productivity and health, and then how have you kind of normalized this emotional state, this physical state, to be something that's just not as serious for you, even though it really is serious and really again disrupts your life, disrupts your functioning.
Speaker 2:And when I think about that word hope, it's really difficult to balance. I should say it's difficult work to balance between finding hope through this medical odyssey, like continuing to work towards finding answers and finding accommodations and finding potential solutions and not partaking in this kind of what maybe pop psychology would call like toxic positivity. Right, you just have to stay hopeful you will find an answer to this, and allowing them to really experience the grief over having a lot of unanswered questions about their body right. So I think there's a fine balance between exploring ways in which they do have hope so exceptions to times where they do have hope and ensuring that I'm not kind of preceding this message that they might have received from family members or co-workers or just those in their circle of well, you just have to keep trying. You just have to have hope. It's exhausting and you're allowed to feel exhausted and you're allowed to feel grief and, yes, you are allowed to feel hopeless. That is a valid emotion to feel through this process.
Speaker 1:That's so good and hard, you know, I think about the word odyssey is so. So, on point, you know, like I think folks who experience chronic illness, it's not just like they've gone to one provider and then they they saw they got a second opinion. I mean we're talking like years, multiple doctors, multiple specialists. I mean you had talked about sort of managing doctor's appointments and then explaining to your work or to your partner that, hey, we're going to drive an hour and a half to go to this specialist because we still don't know what's going on.
Speaker 1:Man, there is a lot that goes into this just figuring out what's wrong, and gosh, we haven't even started treatment this part of the in-between and managing your emotional responses of hope and hopelessness. And you said grief, and I think there's so much power in recognizing grief through all of this. But again, I don't think that's what people think naturally, I don't think that they make that connection naturally. And so I love that you're encouraging us to consider these pathways, whether we're a clinician, or even if we're just we're not a clinician and we're somebody who's just listening in today. Man, there's a lot that goes into it and grief, grief, maybe one of them.
Speaker 2:Yeah. So I think there's a joke in the the Spoonie community and the chronic illness community that once you have this answer for a chronic illness, you've received this diagnosis, there can be this relief. And so there's this joke that we're the only ones that feel relief when you finally have this like life altering diagnosis. But it's really that you finally have an answer and can start looking at the second half of this right of, of potential treatment and management of this chronic health issue for sure. And then I think to there, this chronic health issue for sure.
Speaker 2:And then I think too, with my clients and even myself, there can be a lot of self-blame that comes up when you're having a flare-up right or when you are trying to find answers to this managing a chronic health issue.
Speaker 2:So I know, for my clients and even for myself, there can sometimes be this thought of what did I do to cause this flare-up? How could I be so and again, I'm not saying that this is what's happening, but this is just some messaging I receive of how could I be so stupid to stay up late or to go out partying or to not drink enough water during the day. You know, all of this blame that comes up when we experience a chronic health flare-up and what I find is that when I'm blaming myself, so I'm pretty intense chronic migraines that can again take me out for hours or a day of work, and I find that I can experience this self blame of like how could I not see this coming? How could I not manage this better? Even though we know there's a lot of variables and factors that go into managing chronic pain, what I find is it can give this false sense of control.
Speaker 1:So with my clients.
Speaker 2:There's this idea of if I had just done this, if I was able to manage this better, what's really going on is? There's this idea of oh, I had some level of control over this it was within my power to control this pain or control this flare up, even when the reality is it was potentially or probably out of your control, and so it can give us this real false sense that we have control over our bodies, over disability, over this situation.
Speaker 1:You know it's interesting. I have been the last eight years I think I have shared on other episodes I have had a kind of chronic skin condition that causes itchiness, just horrible, horrible, horrible itchiness every night. And I have still been on the Odyssey and no one can seem to know what's happening. And even as a psychologist and so I know for you as a psychologist also it's like I know that I shouldn't feel this way. I know I shouldn't have the messages of well, if I just don't scratch and if I can just have more self-control, and if I could just do this right, if I could just do these things, then I won't have this condition anymore.
Speaker 1:And then, when it comes to like gosh, I don't have enough self-control and now I feel shame, and now I'm in this cyclical pattern and now I kind of feel bad. I'm in a terrible mood and I'm a parent and I am trying to engage with my kids or my spouse, but really my body is just feels like it's eating itself alive. And so how do I engage with my family? And like nothing's wrong, or I can complain every day, and then that's no fun for eight years. You know, I'm sharing this to say like as a person who's in this field and who knows this is part of the process and I shouldn't engage in these sort of like shame spirals or kind of self-hatred moments. It can get really hard day after day to feel like, hmm, I'm going to face this one again.
Speaker 2:Yeah, thank you so much for sharing that. I feel the same way. So even just yesterday I'll share a story of my own. I had to take off the morning, I think until 1pm, with a migraine. And again, I know there are lots of people that suffer different types of chronic pain, who can't work at all. So I do want to acknowledge that.
Speaker 1:Yeah, for sure.
Speaker 2:But even there's so much shame associated with not having this like super productive morning, having to take time off to kind of manage this pain, even though I could just stay up later to finish the work Like it didn't. I only share that story to say it didn't even make logical sense for this self-blame and I really think that has to do with messages I'm sure you've received, I'm sure that your listeners have received, about how we have to be productive even through pain or even through a chronic health flare up, and so I always think about the social model of disability too.
Speaker 2:You know I'm a theory based girl, so I love to talk about a theory. It helps me with some of that self-blame.
Speaker 2:And so this model is the idea that it's the environment itself that's disabling. So, for example, I work from home. I have an all telehealth practice. I don't have to move around a lot to do my work. If I were to go out of the home I would just be able to function a lot less. So it's not that I don't have these chronic health issues, versus when I always have them, but working from home can in some ways accommodate that and hide that, even though those health issues are still there. So it's the environment itself that becomes disabling, if that makes sense. So it just reminds me of that story that you even shared of like it's the self blame environment that we're swimming around in psychologically that can also become disabling.
Speaker 1:No, I love that because I, as we were talking before, I was thinking about how the comparison causes all of that psychological and emotional distress, because I am, like you know, for eight years I've just been like, well, it's really just itchiness, you know, like my body is doing okay and at least I don't have fill in the blank right, at least I don't have something worse right. And so we have this comparison thing that we do. That then sort of minimizes the kind of lived experience. But to what you're saying, there is some. It is sort of hard to get out of that because I am like I am grateful that I still can do the things I have to do, and so I think it's this conundrum with chronic illness, that is just this added layer for people to be aware of, that really is impactful to just sort of your overall well-being, as you are sort of having these thoughts and these emotions that come with these thoughts around around the physical nature of the chronic illness as well.
Speaker 2:Yeah, and we also know so many chronic health issues, especially with the autoimmune system, is really impacted by stress.
Speaker 2:We know that and we have known that for a long time. And so, even though, again, logically, so many of us know, so many of our clients know that stress impacts their chronic health issues, and yet we still engage in this cycle of blame when this comes up. And so I think that's where therapy can be really impactful if you have a chronic health issue, and why I truly believe that psychologists, counselors, social workers, mental health professionals should be involved in your chronic health team, right In your health team, because stress we know, have known for a long time impacts that pathway and vice versa. So when I'm feeling physically unwell, it's really, really hard to have self confidence. It impacts my self esteem, it impacts our ability to socialize just all of these mental health parts of us as well, that mental health wellness. So I do think it's it's such a one on one relationship between physical health and mental health, and so that's why I think it's important that mental health professionals be part of that conversation around chronic health issues as well.
Speaker 1:I agree wholeheartedly and I think, gosh, it's so critical to have somebody who can walk you through the countless messages in your mind around all the things.
Speaker 1:One thing that I think COVID taught us is that we're not great at sort of chronic things. We could sit at home for a day or two or a week or two and then, as that drags on for months, it's like the chronic nature I think is so against what we are kind of primed to always be doing. When will I get relief? Because I could do pain, I can do emotional turmoil, I can do hard things for a day or two. But if we're going on months or years or decades of this chronic illness, like that level of fatigue, both physically and emotionally, goodness, if you are in that, if you're in that space and you don't have a therapist friend, let us both encourage you today to find a person who can walk alongside you in this journey, because that is so much to carry walk alongside you in this journey, because that is so much to carry and we're not meant to carry that alone.
Speaker 2:You know we really do require a lot of emotional support as well as just logistical support.
Speaker 2:So if you're somebody who requires assistance getting to doctor's appointments or even just like physically getting there or having somebody sit with you in those appointments to take notes or to just even emotionally help you through that, you know I really don't think we're meant to go through this journey alone.
Speaker 2:And yet it can be really isolating, even when we work with people or go to school with people who have other chronic health conditions. And I think that's what's so important about talking about chronic health conditions that we experience, that our clients experience, because it normalizes that not everybody is healthy. You know we have this bias that we are going to be healthy. We always assume health is the norm and that's just not the reality for a good amount of the population all over the world, right, and so I think when we have these conversations, even just saying that at a basic level for a good amount of the population all over the world, right, and so I think when we have these conversations, even just saying that at a basic level. Chronic illness is a thing and it doesn't look like just one type of diagnosis. It helps to help that person who feels like they're isolated and feels like they're alone dealing with this chronic health issue or going on this medical odyssey.
Speaker 1:And something you said before we started recording is chronic illness is probably not an if scenario, it's a when scenario that as we age the likelihood of kind of chronic illness is getting to be greater, right that eventually there might be something that kind of sticks around for us, and so I don't know, like, as you think about that, what comes to mind.
Speaker 2:Yeah, I think about some of that bias right, that internalized ableism, where we just assume we're going to be healthy, when the truth is that we're always one issue or accident or something going wrong, away from being disabled or being chronically ill. And so I think about when I talk to therapists about this right, when I give trainings about chronic health issues, I always ask well, what is your specialty? And I get a lot of eating disorder therapists, I get a lot of perinatal therapists, so those that work through the birthing process. I always know, you know, all of our clients have a body, all of our clients have a physical body and things can go wrong in that body. So, no matter what your specialty is or no matter what line of work you're in, you can always potentially work with a client who ends up having a chronic health issue or ends up having a health issue.
Speaker 2:And I think that goes for us as well. Right, like it's not a question of if we're going to deal with some level of disability as we age. It's a question of when and what accommodations we're going to need as we age. And so, again, it's really important to have these conversations, not only as individual therapists but also as we build community and have conversations in our community about how we support all of us as we age, as the population in the United States ages. You know that's a whole separate topic, but I really could go on and on where I think it's so important. It's not a question of if it really is a question of what type of support we're going to need.
Speaker 1:There's a lot to unpack there. We, you know, as our, as our population ages and, I think, society, I think there are certain things around mental health that are gaining traction, but I'm not sure if this is one of the spaces where we're gaining a lot of traction around, around like messages and around chronic illness. Right, I mean?
Speaker 2:I really thought that that would change after too, because there were a lot of conversations right About health, about bodies, about illness at that time.
Speaker 2:And yet, you know, when I see a lot of, for example and this is neither negative or positive, but just something that I noticed about you know this idea of like returning to work for office, which again works great for certain personalities but maybe is not so accommodating to others who need accommodations working from home, and so I think this conversation needs to continue around accommodations for chronic health issues and how we are probably working with a lot more disabled people than we think that we are, or we might be disabled and not even recognize that.
Speaker 2:So I call that as well. When we have chronic flare-ups, we might also be able to categorize that as like a dynamic disability, meaning that one day, you can be at this level of functioning, or I should say, like have this level of support needs right, and so it can look like you are not disabled on certain days or have these chronic health issues on certain days. But with a dynamic disability, it's really that it's changing hormones, with seasons of life, with different levels of treatment. So I think that's also important to keep in mind too is with the dynamic disability. It can change from day to day or even year to year.
Speaker 1:Okay, so I've been listening to you and I'm thinking, okay, I really want to talk about medical trauma, but I think we need a whole nother episode on medical trauma. And because the thing that I want for you to share is how do we love people, well, who have chronic illness? And so I'm thinking of the scenario that I think many people can relate to, that, let's say, I love someone who has a chronic illness and some days they're great to what you're just describing, right, like, some days this dynamic shifts and so they can go out and they can do the things they have to do, or they can go to work or whatever, right? And then the very next day, they can't or won't. Here we go, you ready for this. They can't or won't get out of bed.
Speaker 1:And so I would love for your thoughts on, like, how do we love people who you know, when, in the back of our mind, it's like well, are they, can they actually do it, or are they just like choosing to just sort of like succumb to these symptoms and do nothing? Is it a can't or a won't issue? And so I'm thinking about, like, people we love, or even our kids, right, like, how do we nudge them. What if there's comorbid depression and we know that they're in a depressed episode and what's best for them is if they can just sort of take a couple of steps toward wellness, a wellness choice in this moment? But they're not, and whether it's a can't or a won't, like, how can we love people?
Speaker 2:well, that is so much to unpack. Yeah, Thank you so much for bringing that up. So you know, I always say that my job as a therapist and what I try to teach parents is my job is not to assess for Melling Green, not a lawyer right, Not an insurance company. I am your therapist and so my job is to support you with the symptoms that you are telling me. And if those symptoms turn out to be highly accurate at one point and maybe not so accurate at another, not interested in that, my job is to support you with the symptoms that you are reporting. And so if you're telling me that you're experiencing pain or your child is telling you that they just can't you know our job is to get curious about that.
Speaker 2:So, rather than assessing or evaluating. From there, I want to ask more questions. I want to get curious about tell me about how your pain is affecting you today. How can, how can we know when your pain is affecting you? Tell me more about that, and I think I just take the bias of of believing them when they tell me that. So I think I have a very easy job as a therapist and that my bias is to believe you right. So we always say that therapy is meant to be super objective and unbiased. But when job is not to evaluate whether or not you are feeling those things, that's why I refer you to your doctor to rule out possible medical causes and so that I'm not sure if that answers your question. But when I, when I think about parents trying to work with maybe their teens who are experiencing that, you know I always say one we can't control the teen. All we can do is control ourselves, and so what we can do is we can reframe our job as evaluator into our job as an explorer.
Speaker 2:And we can approach it with curiosity and something I know we're coming up on time, and so something that I always lead with as well is that you know when your body is your first home and something goes wrong in that home and you can't return home to that body that you knew that was functioning at a certain level or needed a lower level of support, that's when the medical trauma can happen. You know, your body is your first home, and my job as your therapist is to help you feel safe there as possible.
Speaker 1:I'm writing all this down because that's so good. You know one thing that you kind of talked about in helping parents or loved ones it's getting curious explore, don't evaluate. And I think about just that. Pause to remember that while, for example, if it's chronic back pain right secondary to you know an injury you know years. Example, if it's chronic back pain right secondary to an injury years ago, whatever today, it may not be that their back is hurting at like a level 10. It may be that their back is hurting a level four, but their emotional pain of I don't want to do this one more day maybe at a 10. And if I can pause to get curious about how that would feel and maybe show empathy and compassion first before evaluation, first before evaluation, like I could see myself kind of getting behind that idea in that tiny moment. There is so much more going on here than just their back pain right, there is the fatigue of this and maybe reminding myself of that might be helpful in that moment.
Speaker 2:So I'll say this if you are a therapist that sees a client like this, or you, maybe you are this client and you're experiencing this judgment towards this person who has chronic back pain thank you for the concrete example, right, and you're saying why do they deserve all this attention? They're just seeking attention or they're just looking to get out of this work?
Speaker 1:right.
Speaker 2:I would encourage you to look at yourself and say what are they getting that I need, Because when I find that I'm jealous of somebody, and again so I have not experienced this in a long time, but we all have some form of like internalized ableism, right Of like certainly you could just do this thing right. Like certainly you don't have to take this day off, is there? I would just get curious for myself. Is there a part of me that also needs more compassion and needs more empathy and might be and I say jealousy is a neutral term might be experiencing this need or this want or this jealousy of getting needs met? So I and again, this isn't for everybody, but I would just start there with getting curious if those thoughts of those judgmental thoughts and that internalized ableism is coming up for me.
Speaker 1:Oh my goodness, this is like classic therapist client drop the like mic drop at the very end of it.
Speaker 2:Got to save the best for last. I think we have a demon club.
Speaker 1:I literally just got chills all over that question. What a game changer If you can pause and actually say, and really have a moment with yourself to say what are they getting that I need?
Speaker 2:Wow, I mean caretaker is hard when you're that, when you're a caretaker in the household, I mean again, that's its own type of. It can be secondary medical trauma, it can be vicarious medical trauma. We, we really live in a system right now that doesn't provide like a communal level of support, and so it might be on that one caretaker to provide all the emotional support, all the logistical support, the financial support, et cetera. And so this is a concrete piece of advice that I give to clients who are caretakers is can you spread out that support? Can you receive support from other areas? Can you ask for this level of support from family members? Can you use medical transportation? Can you ask about home health, you know? So I always encourage you to spread out that support, because it is not meant to be on one person. That's just not how we're meant to operate.
Speaker 1:I want to keep talking.
Speaker 1:I'm going to say one more thing.
Speaker 1:I know we're past, we've got to end, but I had a client in the past who was the mother of a child, a young child, who had chronic medical issues and this issue of like she felt she was carrying all of the information from every doctor, every specialist, every person from the school, from you know, the neighbors, from her partner, from every doctor, every specialist, every therapy you know, and she was the holder of all the information.
Speaker 1:And so even just the load of that and I was thinking about this earlier and we probably would spend time unpacking this that I don't think we have a great well, I know in Indiana we don't. I mean, maybe there are other places and other parts of the country that are better at. Maybe there are other places and other parts of the country that are better at coordinating care, particularly during this medical odyssey of one person which is supposed to be your GP but may not always be. They may not always get all the information of case manager-y kind of positions with the medical background or the medical expertise to help integrate. So anyway, I know that's a lot to unpack and you know I still want people to know how they can find you.
Speaker 2:So, yeah, I'm going to share how to find me. And I'm going to share one last piece of advice. I love it Do it Case management. Ask your doctor about a peer advocate or a medical advocate. Those are oftentimes mental health professionals, medical social workers. You know, there there are advocacy options in place. It's not great in my state, it's not great in a lot of other states, but those are those options. If you are looking for I'll share my information. So again, my name is Dr Victoria Rodriguez. If you are looking for individual support, I am licensed in Louisiana and hopefully Florida soon, my home state. So you can visit me at wwwvictoriarodrigueztherapycom super creative name. There I also provide trainings and consultations to therapists or hospital systems as well. But thank you so much again, beth, for having me on today. Dr Drell, this was, as always, just so meaningful and impactful and I really hope your audience is able to get something out of today.
Speaker 1:I just can't imagine they didn't because of the today. I just can't imagine they didn't because of the long list of notes that I wrote down they. I'm sure we're gathering information from you. So I'm so grateful for you and the work that you're doing, and I hope that people can find you and look up the resources you have, cause I know you have. You offer a lot of resources as well, and so just thank you, thank you.
Speaker 2:Absolutely. Thank you so much.
Speaker 1:It's amazing. All right, y'all. Thanks for listening. Until next time, stay safe and stay well.
