Ep 19: Navigating Complex Medical Trauma within the School System: Insights from Victoria Rodriguez
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This is a rough transcript created with Artificial Intelligence technology. Any misspellings and sentence errors are a result of imperfect Al.
In this episode, Victoria Rodriguez will be discussing the impact of complex medical trauma within the school system for people with chronic illnesses from childhood.
We're taught to control our bodies in extremely common but abnormal ways, which negatively impacts everyone but it's especially harmful to those of us with chronic health conditions. Victoria is a licensed professional counselor and certified clinical trauma professional in Louisiana.
She provides telehealth counseling to support teens and adults with health, anxiety, chronic illness, and medical trauma so that they can feel fully connected to their bodies and their needs. Victoria's passionate about creating resources for clients and clinicians to close the gaps in treatment for medical trauma.
You can find more of Victoria's resources on medical trauma@www.revivepractice.com. That's R E V I V E practice.com or on social media at revive practice. Hi Victoria, thanks for being here.
Hi, Destiny. I'm so excited to talk a little bit today about, you know, what medical trauma can look like, you know, within the school system.
So I just really wanna say thank you for providing a space on your podcast. Um, maybe it be for your listeners to process some of that trauma that they went through, or now for parents, you know, processing that medical trauma, um, with their children as well, going through school system.
Yeah, absolutely.
Hopefully this will be, if it's just helpful to one person, that's all I ever want. So, um, thank you for spending your time here too. Uh, can you tell us a little bit about where you practice, you know, what kind of setting you're in and um, Yeah, what, what kind of work you're doing Most right.
Sure. So I am in New Orleans, Louisiana, and I do an all telehealth, um, private practice.
So that really fits my own health needs. It fits my clients, um, you know, who are mostly dealing with their own chronic illnesses, so it can be really flexible around their needs. Um, also for healthcare professionals. So I was a home health professional before this. I did community mental health where I would see clients, you know, in the home.
So, Think even taking the lessons that I learned from that and applying it to my own practice. Now, one of my top priorities that I always tell my clients is that, you know, my top priority is your comfort. We can do that with telehealth, we can do that through other interventions. But that is my, my hope for you when you leave counseling is that you learn how to prioritize your comfort as well.
Um, so in addition to that, I'm also a PhD student, so I, um, do research on home based counseling. I do research on medical trauma and have a couple of exciting. Coming out on that. So I'm really, um, I'm really excited to talk about that aspect as well of
wellness. . Awesome. Yeah. Are there anything, do you wanna talk about any of those projects?
Tell us a little bit about what you've got going on there.
Sure. And I can share at the end. So right now I am updating my website. It's called My Car as My Office, and it's specifically for home health professionals who might be, um, experiencing burnout or maybe looking to recover from their own chronic illness in a way that's sustainable for them.
So for those of your listeners, you know, who. Done in homework or have visited, um, clients, or patients in their homes might be able to relate to that. So similar into a way that visiting clients at school can be traumatic or navigating that system and can be traumatic. Um, home health can also be traumatic, you know, for, for those of us living with chronic illnesses, you know, who are trying to navigate those systems.
So I guess that's the through line Destiny is, um, is, I specialize in navigating systems or the trauma of navigating those systems, medical or educational or other.
No, that makes perfect sense. Yeah, that's, you know, that is fascinating to me. Um, I never did work home health, but that was always something that I thought I wanted to do.
Uh, and then I realized all that went into it. So, um, you know, the travel time and the extra pieces that go along with that, and with my own chronic illness, it didn't seem feasible. So, can you tell me a little bit, do you, do you help people more? Move out of that sphere, or are you helping people figure out how to navigate and stay there?
Uh, obviously, you know, with it being their choice, but what do you find yourself working with more? I think that
goes back to the theme that you always talk about on the show too, about like acceptance versus accommodation. Um, so I try to help those who are still doing home health, you know, kind of, um, ex, I'm even curious about using that word, but like, accept the situation they're in, move through that situation and do the best possible job that they can.
You know, um, protecting their own health, protecting their own wellness. And we also talk about what it looks like to transition maybe out of that system and create a whole new system that works for them. Um, but I, I think as we're gonna talk about in the podcast, who so many of those messages that we receive about, you know, working through a system about pushing through, even when our bodies are telling us this might not be the best choice.
So young. So even with my home health professionals that I work with now, um, or medical professionals in this setting, the messages that they received, um, from their parents, from caretakers, from schools about pushing through maybe a chronic illness or just health issues in general, um, really sets the stage for those messages being played out later on in
life for how they end up showing up at work and what we're pushing through.
Yeah. As adults stems from c. Yeah. Yeah. Can you give some specific examples of what that looks like, either in the school system or at home? Like what does it look like to, uh, be pushed into a certain outcome? Um, yeah, that isn't quite working, but we have to do it anyway.
Right. So I, I guess when I think of the school system in general and what my teams go through and what I went through in, in the school system as well, um, in the United States is, you know, so it's really not created for individual care, individual accommodation, and can be a really, um, Hmm.
Threatening environment for students with chronic illnesses. So I always think of the example and I'm, I'm wondering if you had to do the same, but we had these little books that we had to get filled out. Um, and many of my teens still have to do the same two day, where you have to get a book filled out if you have to use the restroom.
So I, I talk a lot about decision fatigue. With my clients, with my teens, and all the decisions that lead into making that decision of whether or not you're gonna ask to use the rescue. You know, something that might seem simple to the rest of us, but, um, for my clients who have stomach issues or digestive issues, or just chronic illness in general, that's a.
For them, what feels like a life or death situation in those moments and making the decision, you know, well, do I raise my hand to ask to go, Do I feel well enough to even be at school right now? Do I feel well enough to even go to school in the first place? Do I ask the teacher, Do I wait until recess? So I think it's really important to realize.
That we are asking some of the youngest most vulnerable populations to make so many decisions about their health, um, in an environment that can be just really, really hostile
towards wellness. Yeah. I even when you get accommodations and you know, your school and your teachers know the kids around, you aren't asking to go to the bathroom, especially again with GI issues.
Um, you might have to go 10 times in a. And then that might end up leading towards, you know, just missing that whole class. Or again, going back to the decisions. Do you just stay in the bathroom all class? Do you come back and do you go back out? Um, and no one around you is asking those questions. So even if your teacher knows the environment and the culture is not set up in a way.
It's always still kinda like hidden in taboo and like we don't talk about our accommodations and we don't like, That's so taboo, right? What? Go ahead. I'm sorry. No, yeah. Well, I was just gonna say like, even though, so yeah, we wanna respect their privacy, right? If that's what they want. But it also sets up this culture of don't ask, don't tell, and then therefore people don't understand when I do need what
I.
Yeah, exactly. So I was, I was thinking along the same lines of, even when you're saying that out loud, it's like it creates this environment where you just don't talk about these issues. And even if you have accommodations, you might not. Use them. You might not use them or you might not be in an environment.
I mean, I've heard so many examples of, of teachers or other staff asking, you know, even a student with accommodations, do you really need to go right now? Or, you know, we just had recess. Um, so maybe some education for these systems as well of, you know, what does it, what does an actual accommodation look like?
What questions are appropriate, not appropriate? Um, but I also get a lot of teens that, you know, just talk about feeling embarrassed. So I, I use using the restroom cuz that's probably the one that my student. Teens with GI issues talk about the most is being like one of the more traumatic decisions they have to make in a day.
Right. Or 10 times in a class like you said. But even, um, eating. So eating has become very, um, ritualized and very uh, According to the clock. So, you know, we're always hearing stories about how later in the day and later in the day, you know, teens, children are asked, you know, to eat lunch or they're not allowed to eat lunch, you know, in the classroom, and they're not allowed to snack in between the classroom or drink when they need to.
Um, so I even think that sets the stage for we're, we're giving these messages to kids with chronic illnesses. You know, it's your responsibility to take care of your body. You know, this is on you now to make sure that your body is working properly. , even though a lot of it might be out of your control or out of their control, and yet they're also receiving messages that you can't prioritize your wellness at this time, or your wellness is not as important as you being on time for this class or you following, you know, what these instructors are instructing you to do.
So I think there's just a lot of conflicting messages for children around caring for their health. If that makes sense.
Oh, a hundred percent. Yeah. And just makes me think about the nervous system and how everyone is trying to create order everywhere. But what we're doing is like boxing in these very natural and normal needs, and your nervous system is just going haywire inside.
But you learn how to put on a face and you learn how to say, Okay, I'm gonna fall in line. Meanwhile, your body is like screaming from the inside, creating that trauma, you know, that the body holds onto.
Yeah, so that reminds me of, you know, it, I identify it as complex medical trauma because really what it is, is you, it's not necessarily the trauma.
It can be related to the trauma of a one time event, right? Like something happening at school. But more so what I see is just the everyday trauma. of putting your body through these stressful situations and then teaching yourself how to ignore your body's cues. And then we wonder why children grow up, um, you know, who are in these environments and they develop eating disorders because they're not able to tell when they're hungry or when they're not hungry or their GI issues get worse because they've tuned out so much of what their body is trying to tell them what they need.
So, you know, we identify that as, um, as part of a trauma
response. Absolutely. Yeah. And for people who might listen to this and think, Well, what are we supposed to do? Like we need order in the classroom, how would you respond to that? Hmm, that's a really good
question. So I have a partner in my practice who does, um, trainings for teachers specifically on burnouts, so that that's specifically for educators in K through 12 settings.
And what we always talk about is that when, when the entire system is burned out, . It really becomes at that point a game of self-advocacy because if you, if you, so, you know, if we're putting, if we're putting your listeners, you know, in, in the mind of like a child or a teen trying to navigate these systems, we cannot expect them to navigate this and study for a math test.
We can't expect them to handle this type of trauma. and succeed in extracurricular activities. So I think at that point it really becomes identifying who's going to be on your self-advocacy team, um, for that child. And then what's kind of your plan for, for advocacy. So I can't necessarily speak to a systemic, um, gosh, I wish I could a systemic solution.
Right. But I think when it comes down,
Go ahead. No, I was gonna say, it makes me think of Montessori. So within a Montessori system, now there's different, um, from what I'm learning recently, there are different like levels of how legitimate or how, um, how a Montessori schools run. Uh, so there's, so it can be mis some misperceptions about what that means and what that looks like.
But what they do really value is this individualized approach. And these kids end up thriving. Now, not all of 'em, of course, but not of, not all of our kids in the traditional school system are thriving either because of the issues that we're talking about here and, um, So my thinking too is like you mentioned, burnout with teachers and how much easier it would be to give your class the option to just go to the bathroom when they needed to go to the bathroom and not have this pass or this book and, and not get into a power struggle because you think a child is trying to get out of a lesson.
The other thing that comes up with around this for me is like, When we are in levels of stress, so if the lesson is really hard, it's harder than a, a child can can grasp in that moment. We do need to escape for a moment, and if we can escape and come back to it, if we have teachers who are willing to look at it in that way, like, An escape is okay when we can then come back to the problem, um, and we can then work together on it rather than, Nope, you can't escape because that means you're always gonna wanna escape.
And that means, you know, we go down this spiral of like, we have to have order and control. And I just wonder if we had a, a little bit more freedom and we, we, there is a way to make that work. The teachers might be a little less burnt out. Yeah, it's an
entirely systemic issue, right, of, you know, when you're burned out.
I'm wondering how much are you able to help your students that are burned out to your students, specifically with chronic illness? You know, how can we expect them to individualize care? In that way, or individualized education really, because they're, they're not caretakers. That's not what their role is in a school, and we're asking them to play so many roles.
So that's really unfair for me to even ask a teacher, you know, um, can you take all of these roles? Can you become their caretaker when, um, we are severely underpaying them? And again, asking them to take on so many of, of these roles. So, so I get it, You know, it's a, it's a real balancing act. It's a really difficult questions that I think we're talking about today.
Um, That maybe don't have an answer besides overhauling the entire
system. Right? Yeah. Yeah. Um, and, and just to kind of go back to the, so people don't get the wrong idea, cuz Montessori can be inaccessible, inexpensive. Um, maybe though we can look to other systems, whether it's Montessori or something different.
That are working, right? Yeah. That, that are, that is an As and I, I don't know. I don't know what that answer is, but I'm sure there are people who do do this research and do know what systems are working, whether it's in our country or other countries, and let's look to them and not try to recreate the wheel.
Yeah, absolutely. You know, um, schools are notorious for not looking at the research, so even when it comes to, to that decision fatigue, it's like so many of these decisions that even, it's almost like a dual process where so many decisions that my teens are having to make, schools are almost having to make.
The same amount of decisions in a day. And it's almost like this system is causing you to make more decisions than you really should have to make in a day, or that any human can make in a day. Um, so I think when I'm working individually with teens and their families specifically, you know, I, I think it's important to recognize that if you're not advocating for your teen or, you know, we don't have a plan for advocacy, nobody else.
You know, and that, I think that's just, um, That's just the truth of it. Or rather, we can't rely on these systems to protect them, to advocate for them. And so we need to have maybe some outside systems in place to, to help us, you know, create an environment that, um, that can
help them thrive. Yeah, absolutely.
And then for those of us who, you know, where this is not even close to a reality and we're already kind of into adulthood and we've had all these years. Constantly being denied just bodily, you know, autonomy in that way. Um, what are some of the things that you start to do to help clients come back to safety in their body or learn how to listen to their body?
So, yeah, I think first and foremost, it goes back to connecting you to your pews because if you. Grew up in a school system or you, or you went through a school system or education system where you were taught, you have to ignore your body's cues just to survive.
Like, just to get through the day. Or even if you're in pain, you're gonna have to go through this gym class because, um, everybody else is doing it. And understandably, you wanna survive in school and you don't wanna be othered and you wanna just kind of, you know, perform to the best of your ability through these systems.
So I think a lot of that comes with just connecting to your body. So one of the first things we do, As we, um, we, we use Ms. Brown's, um, the sensations emotions wheel. So I'll talk about, you know, where is that, where is that emotion coming up for you? But even further, like what sensation is that bringing out in your body so you know, when you're feeling hungry.
Does that, does that feel like rumbling in your tummy? Does that, does that feel tingly? Like, do you feel hot? Do you feel cold when trying to make a decision? So we, I really start to explore with them. How feelings show up as sensations in the body. Because I think for those of us who are adults, you know, who again went through the system, it can be such a, a disconnection between your body's cues and between you just trying to survive to get through the day.
And I think we can see that even, um, even in the workforce, right, of like, so I always use the example when I'm working with an. For example, teachers are, are asked to stand, you know, for, for eight hours a day. They're in America. They're not allowed to sit down and teach a lesson, um, without extensive letters from doctors or accommodations.
We ask cashiers to stand for the entirety of their shift, even though that is not a practice done. All over the world. So I think we really need to ask ourselves why do we prioritize discomfort even for adults? And where is that line where it starts in childhood and how does it ended up? How has it ended up in the workforce?
Right. So I think with my adults, it really starts with unlearning maybe some of the messages that they've received, whether that's just generic, you know, chronic illness of you need to push through this or you need to rest, versus like just listening to their body's cues of what they need in that moment.
And also, Mean some of the more systemic messages that they received of like, Okay, can you, can you not use the restroom until you get through this next piece, this next piece of work? Or can you, you know, put off eating until 4:00 PM in the afternoon? I mean, we're really asking for some disordered behavior if we continue with those thought processes.
Yeah. Even in my individual sessions with clients, um, sometimes they'll. Mention like having not eaten lunch yet, or like something small and simple and they just kind of like, and I'm like, You can eat during our session. Like you don't have to sit here in front of a screen for 50 minutes ignoring all your bodily cues, because that's what we're taught to do and I make sure to take care of myself in a way that I can.
I can be on screen for 50 minutes at a time and, you know, all of those things. But, um, that's because this is my job and I like, I've figured out how to make that work for me. Um, and another thing that I do, I tell my clients that you're allowed to look from away from the screen. Like this is not a natural way of, of interacting with the world.
Um, and when you narrow in on your screen, your eyes, like it literally sends your body into a bit of fight or flight. If you think about being out in the wild or going in, like think I, if you think about like, um, Being in a fight or like, you know, fighting for your, like, you're super focused and lasered in on what is happening.
And so when you, when you're looking at a screen, your body is saying, We're lasered in, we're focused, we're ready for a fight. Mm-hmm. . And so even though it's not that dramatic in our thoughts and like we're also used to it, we can sit here still, , we can be still for, for 50 minutes. Um, Your nervous system is taking that all in as like, we're like, we're, we're fighting all day.
Um, so those are just some examples that, just small ways to kind of do the same thing what you're saying, letting clients know you are allowed to listen to what's happening in here. Yeah. . Yeah.
You know, even as you're saying that out loud, it's making me think about my neuro divergent clients. So like my ADHD clients, my autistic clients.
And it's important to talk about that too, because when you know, when you are considering neurodiversity, um, and your neuro divergent, you might not be able to tell your body's cues as easily as neurotypical people. So we call that interceptive awareness. It means I have no idea what's going on with my stomach right now.
Like, am I hungry? Am I not hungry? Like it's very d. Tell. So I think that needs to be taken into account as well as, you know, what? Almost like we're modeling for them what it looks like to just prioritize your comfort and that you don't have to behave or mask a certain way just because you've been taught that, you know, whether in school or another system that that's the acceptable way to behave.
So I think even just in therapy, we can model for clients. We can teach them outright that it's okay to. Be yourself and like do with your what your body needs right now. And when we practice that in therapy, my hope is that they're able to practice that outside of therapy and start figuring out what they need in that moment.
Yeah,
and it's not to dismiss that there are very real consequences when we decide to go against the norm and, you know, not mask or not do things the way that everybody expects us to do. But at a certain point, as an adult, we start to be able to have these conversations around what you can control and what you can't control and what you're willing to.
Lose in a sense if it's, if it's gonna bring a lot of gain. Whereas I feel like, and maybe you can challenge this a little bit, but I feel like with children, a lot of times there's just so much less op opportunity for choice. You know, there's what my parents want, what my teachers want, and what I'm told I have to do.
And, and it doesn't feel like I do have a choice. So, you know, we still wanna work within a framework of empowering them, but, um, Yeah, it just feels like there's a lot less opportunity there.
It's so ironic, even as we're talking about decision fatigue, to really come down to it and ask them, how much power do you really feel you have over your decisions?
Because sometimes, I mean, especially for, for developing minds, it can feel very binary, but also they're receiving messages that it's very binary. You either sit in class and you deal with your chronic pain. Or you leave class and there's an entire system to take care of you. So, and both options feel very, very extreme and can be extreme.
I think it's important to remember that, that when you're a kid, that's your, that's your life. It's not just school. That's where you spend, you know, six, eight hours a day out of your life. Um, so I think. One exercise that I like to do, especially with my teens who are maybe, um, a bit older, but even for, for my children, you know, we'll do an activity we'll.
We will just divide a sheet of paper things totally within my control, things kind of within my control and things that are completely out of my control. So with my younger kids, we might like cut up sheets of paper, you know, all through. Telehealth, you know, or do it on a whiteboard and well place where do you feel like this belongs?
Or where do you feel like this decision belongs? And from there, it might be really surprising what they think they have power over what they don't think they have power over. But I also think it comes down to even me as a, the, I'm, I'm really being careful about the words that I choose, right? , even me as a therapist, modeling for them what it looks like to advocate for them.
So even if that's with parents who are really, really curious about what their team is talking about in counseling, you know, my job is to even model to them. Hey, you know, we talked about these expectations. You know, that I cannot share with you what your teen talked about unless it's a safety issue. Um, I'm, you know, I'm wondering how we move forward from this, or, or maybe we don't even have that discussion.
And that's, that's the boundary and that's the end of it. And you know, even for that teen, it could be so empowering just to see another adult that is saying you. You get to decide what I tell your parent. You get to decide what we talk about and what we do in therapy. And I think for, for other therapists who might be in, you know, um, your listeners, it's important to remember that you might be the one adult.
In their life, who provides that space where they can make their own decisions. And that might take a long time to build that rapport because of that reason. And it might take a long time to see some progress in treatment because again, you might be the one space in their entire life where they get, you know, 99% of the decision making.
Yeah, absolutely. Um, and, and it reminds me too that, you know, even if, uh, children have less autonomy over certain decisions, it's not so much about how much you can control, it's about learning to, to constantly redirect our attention back to what, what we are able to control. So we're building that muscle of.
Helpfulness like the opposite of helplessness. . Mm-hmm. , um, yeah, the, that learned helplessness where like, I have no control over anything. As we get older and older, we do have more and more control and so the paper exercise you mentioned just makes me think like there might only be one thing right now, you know, that is on that side of things you can control.
How does that make you feel when you're in control, when you're doing that thing? And can we tap into that feeling a little bit more and more as we move throughout life? Um, so just teaching them how to find that, even if they don't have it right now, is what came up for me as you were talking.
Yeah, and I would even say, um, to adults who might be listening, I, I love that phrase, learned helpfulness to yourself.
So I would even challenge the adults or teens that are listening to you. When you think about maybe those few things that you feel are in that column that are completely within your control, let's explore those more. I'm curious about that. How did you get control over that? What does it feel like in your body in those moments where you have control over those items and are.
In the ones that you kind of have control over, what would you need to have more control over in that moment? I think it's also, I wanna put a caveat to that. For adults who maybe have not even had a lot of control over their body, you know, over, over what their body does, you know, throughout the day, that can be really uncomfortable.
That can be a really uncomfortable conversation to say, Well, how do you gain more control? Because if they haven't practiced getting more control, it's going to feel really uncomfortable to. You know, to finally say, I have control over when I can use the restroom. I have control over when I can eat. That can be overwhelming.
Yeah, absolutely. It makes perfect sense. This conversation is, it's one that is always difficult because when you're talking about systemic change, there's, it often feels like there's so little that we can control. But yeah, I, I wanna make the caveat that, when we talk about focusing on what you can control, it doesn't mean that we then don't feel hurt or upset over the things that we can't control.
And we're supposed to just focus on that and just focus on the positive, Like the things that we can control, help give us enough empowerment in our own bodies so that we can handle the grief of whatever we can't. Yeah, that's a really
good caveat, to say, cuz I think sometimes it almost gets into that like toxic positivity, you know, that that's kind of thrown around of um, well what, what's within your control and can you focus on that without really going through the grief of like, Oh, I went through a school that did not allow me to.
Eat when I was hungry and what does that mean now? And am I practicing intermittent fasting accidentally, Uh, because I never learned, like when I was hungry or when I needed to take care of my body in that way. You know, we have so many adults that we have to even tell the message over and over again, Hey, did you drink the amount of water that your body needs today?
Which is, that's insane to me, you know, to say, Did you drink? For your body. So the fact that we have to do so much of this messaging and so much of this work, you know, I think comes with like natural grief over these systems and things that we weren't able to control growing up. So I think that's a lot of, um, I would even categorize it maybe as like childhood trauma depending on the client that I'm working with of the, the, again, that complex trauma of just, wow, you know, there, there might be a lot of stuff that you're grieving over the lack of control that you had in your life.
Yeah, and for those who are, you know, worried about the term trauma, really the, the newest and best definition that we have is anything that overwhelms your nervous. So if you have a chronic illness and you're constantly not able to go to the bathroom or eat when you need to or any of these things, then that is an overwhelm to your nervous system.
And we also know that we can heal the, the, um, trauma responses. That's kind of what we're talking about here too, is that if this is how you were raised, we can work on now overriding and unlearning some of these lessons. Um, so I think in the past when you talked about trauma, it would be like, I have trauma, that means I'm like broken and ill and, and unfixable.
And so as therapists we know now so much better. And so, uh, I often forget to give that disclaimer of like, if you hear the word trauma, it doesn't mean you're broken. Never did. That was just. A narrative that unfortunately was happening in our field. Um, and we know how to work with things like hyper vigilance and flashbacks and, um, ruminating thoughts and all of the things that come along with trauma.
So there's just a message for people who, who maybe, you know, have some, uh, unspoken, uh, biases about the word trauma.
That's a good point. Yeah. So when I think of trauma, that's more so for me to help conceptualize it. If there's another word that you use for what you went through, we're gonna use that word, I might explore with you, like, Hey, have you ever thought that this might be trauma?
And I will say, So this and destiny, you might define it differently because it's not in the DSM complex trauma. Like we don't, we don't talk about grief in the dsm or, or rather, it's not, It's not insured, you know, so we don't get reimbursements from insurance for grief. So that's maybe why our language might look a little bit different.
But I define specifically, Trauma as maybe one event that happened to you versus I define complex trauma as maybe a series of events that happened to you or an environment that you had to be in. So that's why I call moving through these education systems, through these medical systems with a chronic illness.
I identify more that more as a complex trauma. So I'm curious for you, you know, do you see any difference between that or is that, you know, kind of how you define
it? Well, yeah, it's really interesting because, and I agree with you, um, but what's interesting is like complex trauma, it sounds. It sounds so much more severe and well, in a sense, it it's more chronic and it's more long term, and it's more, I think, impactful, um, in the sense that it's gonna take your nervous system a lot longer to undo some of these lessons that were so insidious and so subtle.
Like not being able to go to the bathroom. And you think like, that's just normal because no one's allowed to, right? Mm-hmm. , um, or even waking. In the morning when you're melatonin, your, your cortisol, that's supposed to be the stress hormone that actually wakes you up, doesn't, doesn't rise in your body until, you know, let's say for you specifically it's 10 or 11, and yet you're forced to get up when you're melatonin as at its peak like 7:00 AM.
So that alone is a, is a, that, uh, contributes to complex trauma. I, I would define it very similarly to you, and I just think it. It's important to note, like it's not about something being more severe or more or worse than the other, um, but it's a little bit harder to grasp and harder to understand when it's these small, repetitive things that happen over a long period of time.
Everybody understands why you're waking up with nightmares after a horrendous assault or car accident, or your house caught on fire. Like no one questions that. Lots of people don't understand when our small little experiences throughout life cause us to be super jumpy all the time. Or, um, argumentative, ready to kind of be fight or flight like constantly, you know, it's like, whatever happened to you, why are you so angry?
And you can't even put it into words because even you don't quite cognitively understand it. Um, so I don't know if that quite answers your question and there's no definition in there, but that's kind of how I, how I conceptualize. Complex trauma.
Well, no, and it's actually making me think like even when you say the word subtle, I did not even think about that.
Like I didn't even identify that. So I'm rethinking Yeah, waking up at 7:00 AM Okay. Not even seven because I swear the, the kids in our neighborhood get on the bus at like 5:00 AM or 6:00 AM or something insane. And I'm thinking, okay, we know this is like what we know from the research that teens need more sleep.
Almost any other population, um, any other age, you will need the most sleep in your life as a teen. And yet we are asking teen, we're not asking, we're requiring teens legally that you have to be at school for seven 30. And taking, I always use math test because again, that's a trauma for me, . But um, you
know, maybe for you it's like, you know,
you're having to take a test first thing in the morning, or you're having to go to PE first thing in the morning and put your body through that stress and then maybe.
School. You have band or you have rehearsal or you have a sport. And um, again, it's just like we're asking them to continuously ignore what does your body need while they're telling you that their body needs sleep? Well, we're telling you. Put that on the back burner. Don't pay attention to that. Drink coffee, take melatonin night, do whatever you need to do so that you're in the state to kind of keep that, that system running.
And I'm, I'm really happy. Well, I'm really jealous that a lot of systems are now moving towards starting school later for students at like 10:00 AM 9:00 AM you know, to, to more so adapt to those needs that we know the sleep needs that they, we know that they have from the research. So I am excited for that as kind of a, a systemic change.
Yeah, I think that's really good. Um, we also know that teens start producing. They're melatonin later at night. And so even within our field, we try so hard to help them with behavior modification of turn your screens off and lower the lights at night. All of those things are important, don't get me wrong.
Um, but, uh, teens still produce melatonin later at night, and yet we're then blaming them for not being able to churn off these devices that are all over our world anyway. And you cannot live without them. Um, so that just, I think, contributes to this conversation. Complex trauma. It's like so many mixed messages for such young minds that don't have, even for adults, like, it's so hard to grasp a lot of this stuff and to understand how like all the layers that go into it.
Yeah. You know, and
I think, um, I think in some ways it relates back to, okay, are you asking the teens or the children in your life to. Things that are also extremely difficult for us to ask adults to do. So, for example, you know, the not sleeping with your screen, the amount of behavior modification I had to do on myself to get to that space.
And it was only because, you know, I, I'm at a stage in my life where I wanna prioritize sleep. It's an act of rebellion for me to say that like I want. Wanna prioritize sleep at this point in my life, you know, even running a business, even in a PhD program, nothing is going to come between me and sleep because I know that's when I function and feel my best.
Right. And I think it's so funny where we ask, you know, for example, teens, okay, you know, all electronics need to be out. And yet so many adults are having the same issue with these devices, if, you know, um, staying up late, seeing that blue light, um, late into the night. So I think it's really important to ask our.
and this might be a question, you know, your listeners can even start to explore or even journal about of, you know, what am I asking myself to do that I might not be asking a teen to do who has even less decision making power than I have in this moment?
Yeah, absolutely. I have a seven month old and she like reaches for my phone and can literally scroll her hand on the phone like she's seven months old and it's just insane to me.
But, These, they learn from us. Like they see, she sees me on the phone. And you know, as much as I, as much as you can still, you try to prioritize your work. Everything, like everything we do is on our phone. And so, um, She sees that. And even with like my plate, you know, I think we think like kids just, Oh, they just want what you have.
No, like it's not so much that they want what, what you have, it's that they learn through modeling. Mm-hmm. . And so if they see that you are scrolling on a phone or they see you are using a ceramic plate instead of their plastic plate, they think that is what they're supposed to. And it, you know, it, that's how they learn.
And so some of the things we're doing in my house are, are starting with ceramic plates. And I mean, it's not like she's unsupervised anyway when she's eating. So there's really no hardship on me to have a ceramic plate for her than it is to have a, you know, a bamboo plate or a plastic plate, But, I think we really have to have, um, proper expectations of, of these kids.
And again, if you are not even able to curb a certain behavior, then how do you expect your child to curb that behavior? Yeah. And you know,
I, I promise this, it's all gonna segue back together, but we also know from the research that even for, even for babies or even for toddlers, it's really important to start that play with like heavy coloring, like heavy plates.
Because otherwise they, they don't learn like, okay, if you're using a plastic plate for the majority of, you know, your five years, and then all of a sudden you. Okay. You need to sit quietly in a restaurant and use these things you've never used to. Totally. How can we expect them to know how much weight something has?
But I will also use the example and kind of segue back to what we were talking about in terms of school where like, uh, so I even remember in my elementary school, we were not allowed to bring our own food unless we had a note from a doctor, and then all of a sudden we're expected, you know, in a very quick transition to make that decision of, okay, now you need to start like packing.
Your food for high school, you need to be in charge of now feeding yourself. And that's a big transition. Or how we ask teens. Okay, you were in high school where you know you're not allowed to leave campus during the day. You're not allowed, you know, to, um, you're on a very tight, strict schedule 10 now all of a sudden you're in college and you are having, we're expecting you to kind of have the, the cognitive ability to organize your day, to make it to class on time when you don't have somebody, you know, Helping you do that.
So, you know, I always get the question from parents, well, how, how involved do I need to be in their life in these therapy goals that we have? And I always answer, you know, it depends on the team. Of course, you know, that's our famous answer for everything. It depends on the client. But I, I try to stress that like, it's really important for your teen to test out these coping skills without you there, because my.
And our goal together is for your team to be able to use those coping tools without anybody prompting them too. So it's important for them to test it out. It's important for them to fail and see what works and doesn't work, and it's important for them to use that ceramic plate, um, cognitively speaking.
Um, yeah. So yeah, I love that we're having that conversation.
Yeah, I mean there's, it's the concept of frustration and tolerance. Um, even like, we just don't, we, it's interesting, we expect so much of these kids, but I think we also do a lot of things for them that they're capable of. So a baby grabbing for something, you know, you might always.
Be quick to like give it to them instead of them coming to it and grabbing it themselves. Or if something's hard for them, you, you maneuver it or change it so that then they can like do it. And what they learn is that you're always gonna come and fix the problem and that any, any level of frustration is dangerous.
Yeah, and then simultaneously putting them in these boxes all day, that cause a ton of frustration because you're not allowed to listen to your body. But then there's all these consequences if they don't listen to it. So it's like two very and extremes.
Yeah. And I especially think with, with, again, teens with chronic illness, so I use the word teens, but I mean children too.
I see only, um, teens in my practice right now. I think especially when we're looking at teens with chronic illness, it's really important to explore within these conflicting messages because they might be receiving the message at home that like, You are like, literally the message, you are fragile or you need this level of protection, and then they're going to school and it's like, good luck out there.
Like, like, you know, you're on your own figuring this out. So I think it's really important to like, validate that feeling of like, well, yeah, no wonder you don't know if you have to use the bathroom or not because you, you're receiving all of these different messages from different areas. So I think that's important for teens to explore in, in therapy as.
Yeah.
Yeah. The, the dichotomy there is really interesting and an important part of the conversation. Yeah, absolutely.
So, you know, even, even when we're talking about what it's like to navigate these systems with chronic illness, I, I would just put out less reminder to. When, when we're helping teens, you know, make that transition into adulthood.
You know, I don't, I, I feel like I have so many caveats today, but I don't want it to sound that like, well, you just have to figure out what works for you and you have to push through it cuz like, it's just harder with the chronic illness. And I think that's where the grief comes in of, you know, no, you might not have the energy.
That somebody else has. Or maybe you're neuro divergent and your mind works differently than somebody else, or you just have differing needs than other people. Or you're disabled and you've maybe internalized a lot of that ableism. And I think it's really important, again, to, to recognize that this level of grief still has to come of, you know, figuring out that, Oh, maybe I wasn't allowed to test out my limits and testing out my limits.
Now, in addition to all of these new responsibilities, is just a really, really hard. Situation and moment in my life.
Yeah, absolutely. Yeah. I'm thinking about like when you are deciding to use real plates with children instead of, um, like bamboo or plastic, it's. Some plates are gonna get broken. That's like literally just a part of the process is to allow them to understand what, how does something break, What does it mean to drink criminal open cup and get water all over you?
Um, like what did I do? What movements in my body lead to that? You know? And so same, same thing as what we're talking about in on the chronic illness level. Like if I'm allowed to listen to my body and I overdo it, Then now I have data and information for what that looks like. And then if I have enough flexibility in my life to make changes, now I can actually feel empowered after something like pushing past my limits.
Whereas if I push past my limits, but there's no way for me to make a change that's trauma. Yes. Yes.
And again, that trauma goes back to that bodily safety of does your body feel safe when you're pushing it through, or does it feel threatened even by you? So I, I think that's a really important point to differentiate between, you know, does this feel, and it's so simple, right?
Of like, does this feel good for my body? No. And a, again, so much of my work with young adults is figuring out, okay, like does my stomach hurt or is this anxiety because they never learned how to tell in school cuz they were just never given that option to explore what that boundary or what that limit looked like for
them.
Yeah, yeah, absolutely. A lot of my clients actually have just persistent stomach ache and I think it's like when you shut down your responses, uh, That means any sensation you feel in your stomach is going to feel dangerous. And so it's gonna come across as nausea 24 7, when really it's like, maybe this is like the start of hunger or having to go to the bathroom or, um, this is anxiety cuz that that causes feelings in our stomach or excitement even.
Um, our stomach has so many receptors and can feel so much, and when you're taught to shut down all of the analysis of what's happening in your body, then it all feels dangerous.
Yeah. You know, the, the ancient Greeks thought, I know we're getting a little nerdy here, but like the ancient Greeks thought that like emotions were stored in the stomach or like, essentially your decision making, your brain essentially was in your stomach.
But if we really think about that in terms of chronic illness, like that really makes sense. Because so many of our emotions are felt in our stomach. And for those of us with, um, with gastrointestinal issues or digestive issues, that may really hard to differentiate. You know, again, like, okay, every time I'm anxious my stomach hurts.
But did the anxiety start first or am I anxious because my stomach is hurting and I'm in school and I can't leave and I don't have a parent that's gonna pick me up or the school won't let me leave? So there's so many, again, that decision fatigue of like, They first and foremost have to decide. Is my stomach, am I actually in pain right now, or is my stomach actually hurting?
I mean, that is the first decision you have to make in that situation, and that's a big difficult decision to make.
Yeah, When you have had no modeling or mentorship or education around how to even make that decision. .
Yeah. And then so many I've, I've heard so many adults in their lives just say, you know, well if it's a stomach issue, just take medication or just leave.
And I don't think a lot of people realize the amount of decisions that have to go through. So, you know, we'll, we'll do even like a little brain exercise. You know, if I have a teen that's coming in that's saying I have a lot of anxiety around, you know, my stomach issues at school, well, okay, let's look at the decisions that you have to make and we're gonna break down every single one of.
Decisions. So you have to decide whether it's anxiety or it's a stomach ache. Like that's kind of the first decision you have to make. You have to make that decision. If you're gonna raise your hand and ask to leave, you have to, even before that, you have to make the decision, Okay, well if I asked to leave, like, who's gonna pick me up?
Am I feeling well enough to drive myself? Do I even have access to transportation home? Do I need to go to the doctor after? Or is this something that I just need to write out? So there's all of those decisions. Then you have to decide. If I ask to use the restroom, do I stay in the restroom until next period, just in case like I'm not feeling well enough to go back, Or do I just try to quickly go back to please as many people and make sure like I'm not embarrassed, you know, with um, with people talking about me while I'm gone.
Um, do I go talk to the nurse who then tells me to go through all these steps? You know what? What are they going to tell me? Do I talk to the school staff about calling, um, a caretaker or a parent at home? So those are, I think those are just a few of the decisions that like you have to make as a teen when deciding whether or not how to handle that situation at school.
Yeah, absolutely. And another thing that comes up for me is when, And this, I get it. Look, I get it from a parent, from a parent perspective. A lot of my parents of the teens that I work with or the young adults that I work with, have a really hard time with understanding. How their pain increases during stressful situations, and then three hours later they can be fine in time to go over their friend's house.
And I really try hard to do a lot of education around that. And so I think it's important, important to note here that one, when we're feeling stressed, our pain does physically exacerbate. Like that's not, you're not making that up. That is a, our, our sci, our science now shows us how much. Fear and difficult emotions exacerbates our pain.
It does not mean your pain's not real. It means your pain is worse because you're stressed and you cannot control, Like, you can't just not be stressed over something that someone tells you, Oh, well don't be stressed about that. That doesn't work. So yes, that is why they can have a stomach ache and wanna leave school and then be able to go to a friend's house three hours later.
And the correct way to maneuver that is not by. Never letting them do any of the fun stuff. In fact, it's, it's more of like this body, body awareness and being able to ask for what you need and get accommodations in the way that you need them so that you can manage what you can manage and then have grace where, where it's something that's just beyond, beyond their, their capacity at this time.
Hmm. You know, I did a presentation this weekend, um, with TPN for anybody who wants to watch that on medical trauma. And a lot of the questions that I got that I was kind of surprised at because I hang out in a lot of, um, chronic illness spaces, you know, where people are kind of just used to that of like, Oh yeah, well, three hours you might be feeling better.
Like, that's another decision of like, Okay, well this. Like, am I, you know, do I decide to leave school? And then it turns out to be nothing, right? So like, you're probably not the only one. If you're the parent, you're probably not the only one freaking out about that decision, right? Like, I promise you, your team is also freaking out about that decision.
Um, but then on top of that, I got a lot of questions around mal lingering of like, well, how do I tell if a client is really in pain or really not in pain? And I. Everybody's answer. Every therapist's answer might be different, but I practice from a feminist lens, which means no matter what that client in comes in telling me, my job is not to investigate that.
Like my job is to explore that with them, believe them, and validate those experiences. . So I really am not exploring with the teen, you know, whether or not that pain was real at the time. No. Um, because they're, they're communicating something with it no matter what. They're communicating something with it, and that's just not within my role.
To figure, to figure that out. So I think that's also really important for therapists to hear that maybe it's really a good time for you to explore whether or not it's your role to decide if one of your teen clients is, is mal lingering?
I could not agree more. Yeah. I practice from the same lens. It, it doesn't matter.
It literally doesn't matter if they are quote, making it up or not because exactly like you said, um, there's a reason for. So maybe they don't have the language for what they're trying to accomplish, but their body is going. That goes back to me reminding people that it is real regardless. Like their body will come up with a way to say, I, this is too much for me.
Hmm. You know, it's, and it does physiologically stress, physiologically changes your body, your brain, your nervous system. It, physiologically it's not, I like don't know how to explain any clearer to people that your mind and your body are connected and that when you are stressed, you can see it. Like you have higher cortisol, you have, you know, different.
Like, that's just probably the easiest example. Higher cortisol. We know that. And so chronic high cortisol in your body leads to X, Y, and Z. Physical pain and inability to think straight. All of this. And so, ah, I'm, I, It makes me so mad that people are still asking that question, but that's why I do this podcast is so like, hopefully more people hear this lesson.
And I, my, my anger I hope comes across at just how important. This is, it does not matter if you think someone is faking the pain or not, because I promise you, if they are faking it, if they're like, let's just say they're, they're exaggerating it, they're trying to get a desired result. It could be, it could be attention in this in the sense that you're human.
Hello, we all need attention. And this has been the way historically that they have fit found to get that attention. And if you actually give attention to that, it decreases the problem. It doesn't increase it the way that people like to think. Um, so it, you know, when we, when we are in connection with, with other humans, our pain physically decreases.
We know. From the science, so mm-hmm. , it's, it's when you're investigating whether it's your role to decide if a client is telling the truth or not, I would encourage therapists to also investigate the science of pain and, and what it means to be in cooperation with one another. Your heart rate variability evens out and your pain receptors actually decrease in the body, and we can be more on, uh, in cooperation with one another.
You know, I, I hate
that phrase, um, that a lot of my ous clients hear of like, Well, is it in your head? And I wanna ask them, is your head not? Where do you think pain comes from? Like, where is it not a part of your body where that's coming? Like, I get a lot of parents that ask that, and I'm like, I, I can't tell whether she's feeling her stomach.
Pain in her stomach or her head. It's the same. That's where her stomach's getting it from. So I think that's, and, and I get angry too. And so I have to stop myself and I have to ask, like, when I'm feeling angry, that usually indicates that a boundary of mine has been crossed and like something has really, um, just really crossed a boundary that I've set up for myself.
So I think for other therapists, you know, when, when you are angry about, you know, someone questioning your, you know, when you are angry, when you think of client's. Smelling green or I, I'm on a podcast, I'm doing quote hands, but if you, if you are concerned about why your client is Mel Green, that probably has more to do with your needs than it does with your client's needs.
So I think that's something
to explore. Yeah, and typically, I mean, this goes back to systems. Typically it's even in the realm of like, well I have to create this treatment plan. I have to create this treatment goal and my job is to like help them get back to work. And if their pain is not quote real, then we can do that.
But if it's real, then I don't know. Cause I feel just as hopeless as they do. And you know, that's where a lot of acceptance and commitment therapy comes in. And it's like, But did you know that pain is in a death sentence? And did you know that chronic illness is not a death sentence and you can still live a life that is just as big and meaningful and purposeful.
Anyone else, because if you know that and you believe that, we don't need to fix your pain.
Yeah. I think that all goes back to like just that ableism that they receive in school too, of like, you know, these parents asking. Well, is the, is the pain bad enough, you know, for them to be considered disabled? And we have to almost ask the question, not to minimize disabled people, but like, So what?
Yeah. Like what does the, what? That's more about your fear than it is about your teen's experience or, Or for people in the school systems, you know, adults in the school system. That is more about your. And I get it, like the directions that you've been given to like keep, maintain control in the classroom, then it is about that student's needs.
So I start to get really curious about what need is being met when you are telling me all your fears around the fact that you might have a disabled teen.
Yeah, I don't think a lot of us are ready for that conversation. . Yeah.
And I mean, I hear that internalized a lot too with my clients of like, Oh, that's the, this is the worst thing that could possibly happen to me.
And of course we grieve that, but I think it's also important to explore. Well, where have you seen examples of chronic illness? Like, tell me about the television that you're watching. Tell me about the books that you're reading. Tell me about the examples that you've seen. That were either overly inspirational or just, you know, the most tragic lifetime movie you've ever seen of somebody with IBS at school.
Right. So I think that, again, it goes back to messaging. Like that's a big part of my practice. So where have you received those messages? Either in school or from media or even, you know, your own family?
Yeah. Oh, Victoria. I really, I really loved this conversation. It was really good to just, yeah, get a lot of this out.
It's everything I'm passionate about and it's clear how passionate you are too. So, um, we talked a little bit in the beginning about where people can find you. Do you have anything else going on that you wanna share before we get off today?
Um, so I am releasing on my website, I have a guideline, the seven, what is it?
Seven, Coping skills for pre-surgery anxiety. So maybe for some of your listeners or your clients who have to go through regular surgery or maybe even going through surgery for the first time. Um, These are just some really helpful coping skills that they can use, you know, to prepare for surgery. I love an anti-anxiety box, so something physical that they can pack and bring with them.
So again, you can find that, um, at www.revivepractice.com on my website or again, you can find me on social media at revive
practice. Oh, that's so good. I'm really glad you have that resource available. So I'll link that in the show notes and thank you so much for being on the show.
Yeah, thank you so much for having me.
Destiny.
Episode Summary and Notes
Meet Victoria Rodriguez: Victoria Rodriguez is a dedicated licensed professional counselor and certified clinical trauma professional based in Louisiana.
Victoria's commitment to supporting teens and adults through telehealth counseling, addressing health-related anxiety, chronic illnesses, and medical trauma, has been instrumental in guiding her clients toward a more profound connection with their bodies and needs. Her unwavering dedication extends to bridging the gaps in medical trauma treatment, benefiting both clients and clinicians alike. Victoria's expertise shines as she introduces us to the world of medical trauma within educational settings. The discussion unveils the unspoken challenges faced by individuals with chronic health conditions as they navigate the intricacies of school systems.
Acceptance Versus Accommodation: A Central Theme
The conversation takes a thought-provoking turn as we explore the theme of acceptance versus accommodation, a recurring topic on the show. Victoria shares her unique perspective as she assists home health professionals in accepting their circumstances while prioritizing their well-being. This nuanced approach fosters an environment where individuals can excel while safeguarding their health, ultimately leading to better outcomes.
The School System: A Breeding Ground for Trauma
The podcast provides a platform to discuss the hidden struggles faced by students coping with chronic health conditions. The expectation to conform to rigid systems can create a hostile environment, leaving students with chronic illnesses to navigate complex decisions about their health within an unsupportive framework. Despite having access to accommodations, students may still face challenges due to a lack of understanding and a culture of silence surrounding chronic illnesses.
A Pathway to Thriving Through Individualized Education:
The emphasis on individualized approaches has paved the way for many students to thrive, challenging the conventional norms of the traditional school system. Victoria's insights prompt us to explore and learn from the successes of other systems that prioritize personalized education. She shares her perspective on the potential benefits of allowing students to temporarily "escape" from overwhelming situations, only to return with a refreshed mindset. This approach challenges the notion of absolute control and opens the door to more compassionate and effective teaching methods that acknowledge the human need for respite.
Empowering Body Awareness and Healing from Complex Trauma:
Victoria skillfully guides us through an exploration of how to foster empowerment and agency in children and teens, despite the often limited control they have over their circumstances. She introduces a powerful exercise involving categorizing decisions as within one's control, somewhat within one's control, or entirely beyond one's control. It's okay to prioritize comfort and well-being, even in the face of societal expectations. This modeling of self-care can empower clients to make choices aligned with their own needs, creating a ripple effect of positive change in their lives.
Transitioning from Childhood to Adulthood:
Victoria emphasizes the significance of preparing teens for these transitions, both practically and emotionally. She sheds light on the cognitive adjustments required and the coping skills that must be developed to handle newfound responsibilities.
Bridging the Gap Between School and Chronic Illness:
Victoria addresses the frustration and tolerance levels that teens with chronic illnesses must manage, both physically and emotionally. She discusses the significance of teaching these teens to listen to their bodies, make informed decisions, and seek accommodations without feeling guilty. Victoria emphasizes that accommodating their health needs doesn't mean giving up on pursuing a fulfilling and meaningful life.
She encourages therapists to explore their own biases and fears around chronic illness and acknowledges the importance of acknowledging pain, embracing uncertainty, and fostering connection.
Conclusion:
In conclusion, the conversation shed light on the complex journey of young individuals living with chronic illness and pain. By promoting cognitive empowerment, validating experiences, and addressing ableism, we can create a more supportive environment for these individuals to thrive. Victoria's insights underscore the importance of a compassionate and understanding approach in therapy and beyond.
Stay connected with Victoria Rodriguez's invaluable insights and resources related to medical trauma at www.revivepractice.com and on social media by following @revivepractice.
Listen now for the complete episode! 🎙️