Ep 35: Nadia Clontz: A Journey into Healing and Understanding Chronic Pain and Medical Trauma
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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.
Nadia Clontz is a licensed professional counselor who earned her masters of science and clinical counseling psychology from Brunel university. She's been providing individual therapy at empower counseling center in Swanee, Georgia. Since her transition to private practice in February of 2020. She meets with her clients virtually for safe, effective treatment from comfortable spaces and welcomes company of all furry friends. Nadia provides trauma focused care via EMDR and somatic approaches to help clients cope with navigating life. With chronic health concerns, pain and complex trauma.
She is LGBTQ plus affirming and pledges with the gender affirming letter access project, where she offers free assessments and letters of support for those seeking gender affirming surgeries and navigating potential barriers to care. She's passionate about helping clients learn to practice self advocacy skills and find comfort and living in their lives, unapologetically and authentically.
As a fellow spoonie, Nadia has personal experience in navigating the ongoing grieving process associated with chronic illness and pain. She finds existing comes easiest by balancing life with a healthy dose of dark humor self-compassion and acceptance along with her helpful sidekick service dog Kodak.
Additionally, she feels passionate about her activism with her profession and aiding other professionals in building cultural awareness and sensitivity to break down implicit biases and covert ableism within the healthcare field.
Well, thank you for being here. I appreciate you being here. Why don't you start by telling us a little bit about where you practice and who you work with and things like that.
Sure. So I work at a private practice in Suwanee, Georgia called Empower Counseling Center. I am a licensed professional counselor.
I specialize in chronic pain chronic illness, complex trauma specifically passionate about medical trauma. I utilize EMDR for trauma as well as some like somatic pieces and. Good. All mindfulness and some D B T thrown in there as well.
Awesome. And today, I know we really wanna start off, I really wanna start off by talking about the pain scale.
This is a, this is something that all of us have experienced multiple, multiple times. A doctor, even therapists, even your friend, your mom, your partner, like, oh well, like, what's your pain level today? What is your, what are your thoughts on the pan scale?
I am not a fan. Simply because of how subjective the pain scale is you know, the, the zero to 10 pain scale, it's like, well, who, who's zero, who's 10?
Mine are yours? How do I classify that pain? How do I describe it in any scale is developed for research purposes. And how do you, how do you research something so subjective? And I find I hear a lot from people within the community that anytime they say, you know, off the scale a nurse or a Dr.
May reply well, the scale only goes to 10, and then, you know, the way that can impact the patient being embarrassed or feel shamed and stuff like that. How do, how do you quantify something as subjective this pain?
Yeah. Or even just the fact that if your doctor's asking you like, well, what's your pain scale? Well, why? Like, why are, what are you trying to determine through a number on a scale that is completely arbitrary? Can you just ask me what I need instead or have a different conversation with me?
You know, if the question is like, oh, you're in a level 10 pain, that means I'm giving you X medication, or that means maybe that's even a way for you to think, oh, you're exaggerating cuz you can't possibly, I mean, I have, well I have a few different clients with kidney issues and I don't, I'm realizing that there is a theme with kidney issues and doctors and pain.
It's Just Terri. It's terrible. Like they have told my clients like, there's no way you can be feeling this pain. There's, you know, so what does this scale like? It's about informed consent too. Again, if you're asking me what my number is on a scale, you should probably be telling me why you're asking that too.
Yeah. And for that reason I tend to prefer When we're talking about pain specifically focusing on how it impacts someone's functioning, I feel like that is much more inclusive of the total picture versus, oh, my pain is such and such number because everybody's definition is different. So if we're looking at how it impacts your functioning and how it impacts your life, I feel like.
That sets you up for better treatment and management of symptoms.
Yeah, that makes perfect sense. What are some other issues with the pain scale that, that you can verbalize for us?
It's it's difficult cause
I feel like as a whole it's, it's also problematic because of implicit biases and how we as humans tend to interpret what we're hearing based on what we're seeing. So if someone's non-verbal communication or cues or whatever it might be, doesn't match what. The provider feels like should go with said number that can set the stage for gaslighting.
And then medical trauma as a whole tends to come, come along with that as well.
How do you feel like that makes people respond in response to knowing, to knowing that? I need to look a certain way in order for you to believe me. What does that often lead to?
Well, I think it leads to chasing our own assumptions. So for example There's, there's really no way to win because you have some providers that say, oh, if you're not crying, your number cannot be that high. While others may see those tears and be like, oh, you're just seeking medication. So it's just, it just
thing depends on the, on the provider really, which puts us in a whole nother position where we are, which.
When you live with trauma, when you live with chronic illness, you're constantly trying to guess what other people are thinking. Assume in order to keep yourself safe. And it, it's like this is one more area where we have to do that. I have to guess or predict what my doctor, what kind of person my doctor is, and if they're the type that will think that my tears are exaggerating.
If that's the case, then I can't show my true tears in this very emotional situation or. Say, I'm not really even wanting to cry, but I feel like I have to make myself show a little bit more so that you'll believe me. And it just puts us in such a, it's such a game.
Yeah. And you know, we live in a culture where, We're supposed to seem fully able, so we develop these like really great skills of masking and sometimes going into the doctor is so anxiety inducing that we do throw on that mask.
So if we pull down the mask and we allow those emotions to come out, sometimes it's harder to Shove those emotions to the side later, which can result in exacerbation of physical pain or other medical symptoms. So it's, it's such a complex issue when it comes to how we cope on the day to day.
What are some of your go-to kind of, it is complex and it is situation dependent. So this might be, this is a very vague question, but like what are some of your go-to coping skills for managing, I guess we could make it more specific. What are some coping skills for getting in tune with your body? And I this, I'm asking this because we're talking about the pain scale and usually it's like, what's your pain level one through 10?
And it's so arbitrary and so vague and it doesn't mean anything. So what, how do you work with clients in getting them to be a little more in tune with what's happening inside?
So, It's, it's funny you asked because one of the EMDR training that I've had is somatic and attachment focus. So it does go into quite a bit of really going through examining like what you're feeling in your body.
So there's something called a body scan where you go from head to toe identifying areas of discomfort. Or pain identifying what kind of pain it is. Is it sharp? Is it stabbing? Is it, does it throb is it dull, is it achy? Et cetera, et cetera. So that would be the start is just kind of going through and scanning your body and kind of like picking up on those discomfort or pain points or whatever it might be would be.
Probably the easiest first step.
Yeah. And how does that help people? How does it help people emotionally, physically? What is the benefit of doing
Well when it comes to trauma? Trauma is often expressed physically. So by doing that you can pair. You can develop some insight on what emotions you're feeling and how that connects with these various bodi bodily sensations.
So, for example, if someone is anxious, I might have them see where their breathing starts and stops. It often is either in the chest or even in the throat. And then you kind of move into, okay, well I want you to connect with a. Happy experience. So you can connect with those positive emotions and then see where your breath shifts.
I think a lot of times also when we're, our breath is not going all the way down to our diagram where it needs to be, that also coincides with a lot of like muscle tension, especially like shoulders, neck and all of that. So really kind of aiding in the. Awareness that breathing also kind of connects with different types of pain and like muscle tension and that kind of stuff.
Yeah. And, and what would you say, like, so bringing awareness to these different areas and, and even awareness to, like what, what do you feel when you're actually in a moment of joy or a moment of happiness? What is the. What is the main reason we're trying to do that with clients? Like what are we helping them accomplish by tapping into that?
Well when you think about mindfulness and grounding and connecting with those things you can also identify the types of circumstances or situations which help those positive emotions. Kind of be tapped into. And so by identifying these positive experiences or situations or coping mechanisms that you find, you feel that kind of piece in and kind of tracking that connection that can help them limit their exposure to those types of stimuli that create the opposite of the desired effect.
By identifying the negative experiences they can then choose, make the active choice to stay away from those things and start to really focus on living their life in a positive type as, as, as positive as possible type of way.
Yeah, I think it's so important because right, like usually when people think about therapy or just even like any kind of self-help, like book or, it's always about like ch a lot of times it's like choosing, making this choice and, and it only talks about your thoughts, like what are your maladaptive thoughts or what are your core beliefs?
And it's like one, a lot of times we don't even really know, they're so unconscious. And then two. I mean, I think everything is bidirectional, but I think a lot of times our thoughts are created after a sensation happens in our body. So there's, especially if you go back to childhood, like there are certain things that happened in your bo like in your environment that would create either attention or, and these are all very normal things that like happen in our bodies.
It's either tension or expansion or hot or cold, or. And you know, as a young kid, you start to make these associations where it's like, oh, tension and tension only means fear. So then you grow. You know, you have these experiences where it's like, okay, every time I'm tense now my brain gives me a story of like why I'm scared.
Even though there maybe there was nothing to be scared of. And it's like literally just maybe like the wind blew too cold on you and your body tensed up, but now your anxiety kicks in because it only knows that tension equals fear. So I like the way you explained it cuz it's like, I don't remember exactly how you said it now, but yeah.
We're paying attention to our body so that we can then become aware of what's actually happening and then we get to make an informed choice rather than just tension, fear, react.
Yeah. And people with chronic pain and chronic illness become, So unfortunately skilled at enduring suffering that a lot of times it just becomes second nature for us to.
Like, yeah, okay. I'm uncomfortable, but this is my expectation in this situation. I have to do chores around the house instead of take a break because I don't wanna be a burden. I have to go into work because I don't wanna burden my coworkers. Or you know, with therapists we hate canceling. So it's like, I find that that fear of being seen as a burden often pushes us past our limits, and we ignore those bodily sensations in order to meet whatever expectations we feel are put on us.
Yeah, I mean, it starts, we've definitely talked about this in the podcast before, so I won't repeat too much, but it No, no. It stems back to school. School age. You have to raise your hand to go to the bathroom, and then you still might even be told no, like the doctor, the, the teacher might be like, no, it's time.
You have to wait. Like, it's not bathroom time yet. It's like bathroom time. Like my body doesn't know that at 12 o'clock it's time for the bathroom. We just we're taught so early to ignore, ignore what our bodies need and to push through. Which again, going back to the pain scale, And how subjective it is.
It's like, yeah, if I'm used to constantly shoving things down, I might, I might come in and tell you I'm at a level three, but like I can barely get out of bed every day.
A hundred percent agree. We are raised from a very young age to saying like, Being fully able and having no issues and being a cog in the capitalist system you know, this society was not built with people with disabilities in mind.
Yeah, no, absolutely. And I know maybe we can get a little bit more into gender differences. I have some thoughts around not only like was it not designed for.
People with, with any type of disability, but it also was not designed for women with fluctuating hormone cycles and bodily needs. So yeah, maybe we can talk a little bit just about implicit biases that we have about pain and, and some of the gender differences.
Mm-hmm.
So for example studies show women are more likely to be dismissed and labeled as emotional, less likely to receive opiate pain management than men. And women, women may be more likely to be referred to mental healthcare instead. Can we, can you give us some of your thoughts on that?
Yeah. It, it goes back to medical education and the history of research.
So kind of like a workday, you know that nine to five is built around a man's 24 hour hormone cycle. Medical studies and medical research has heavily been done on men. And we know that every, not only is everybody different, but women having are afab people having these organs, these reproductive organs that can come with a lot of issues and hormones can also impact.
Just any kind of illness or pain experience on a, a daily basis. It's so often the assumptions made by medical providers are made off of the research that's been done on men versus women, which then leads to poor treatment or poor understanding or those. Assumptions. Well, it's like, well this doesn't show in the research of medical history.
So I don't see how this could be due to X, Y, Z. It's gotta be in their head. Hello Medical gaslighting. You know, in the history of the, the hysteria diagnosis and all of that. And it's like, sure, emotions can absolutely. Express in a somatic way, but it's a chicken or the egg, which came first. How do you know you need to do thorough testing?
Refer out to other medical providers and specialists versus just sending them off to see a therapist or a psychiatrist?
Yeah,
absolutely. It's, it's, I mean, I mentioned bidirectional earlier and. The chicken or the egg question? Yeah. Is it, I, I honestly, I have clients coming to me all the time recently, as of recent, like, I think because there's a lot more talk right now about a lot of like somatic therapies and, and even like talk of like curing chronic pain and things like this, and people are hearing this stuff and people are actually much more willing, I'm finding these days to come to me saying like, actually it is all in my head, like, can you help me?
Mm-hmm.
And I'm like, it's not, it's not all like, it's not all in your head. It's like there's an experience that you're having and then there are all these emotions that can exacerbate physical symptoms, which is very, very real like, We know that stress increases cortisol. Why? Why is it so hard to accept that stress or emotions would increase pain receptors in your body without then saying like, that means it's quote in your head.
So, mm-hmm. It's just a little, a little bit like a lot of education lately and, and it's difficult because I just don't think we have all of the, we do have a lot of pain science, but there's still a lot of division even within the pain science world and. There's, and also like we're talking about emotions exacerbating certain different things.
Different things are true for different people, so there's different theories and different techniques, and some people might feel like they're broken if one, one didn't work for them, you know, Ugh, this is clearly like my issue. And it's like, no, like we're all so individual. There's no way every technique is gonna work.
It's not gonna work for every person. So, Another problem. I guess back to the pain skills, just how subjective this experience is, which, which we've been talking about. But again you know, for women too, like obviously I think you grow up hearing or for when you mentioned Afab earlier, so I just wanted to find that for the audience assigned female at birth.
And we grew, I, I dunno about you, but I grew up hearing like, oh, literally like. Are you on? The rag was always how it was said, like, oh, are you on the rag? It's so, it's just so like, and the, the way it's said is so demeaning and so like, ugh. You're like, what's wrong with you? You're like, and yeah, I'm sorry I'm being a human.
My body is like going through a process here. We're physically are a, muscles are physically and tendons are physically weaker when we are menstruating, so, It would only make sense that you'd be more fatigued, have less, you know strength. But instead we kind of, yeah, we wanna push through and act like there's nothing off.
And every day is just this consistency, which was what we were talking about earlier with. Assigned male at birth is you have a 24 hour clock. And it's not to say that men, men are the same every day. Like they obviously have their own fluctuations, but they still have this hormonal, it's one less fluctuation that they have to deal with versus what all of the different fluctuations that we have to deal with.
We have four different phases in our cycle, so it's a lot of change in one month every month.
Yeah. And not to mention that, Our inflammation is also more likely to be at an elevated level when we are menstruating as well. Bodies are complex and going back to the pain scale, it's like how do, how do you fit all of these factors that could be impacting it into this one number I'm supposed to give you it.
Life is complex. Why can pain? Be expected to be placed on a, like a, a 10 point scale.
Yeah. And you know, we were talking about
research and, and women are, are historically not even research at all. But even like lately there's been a, a shift to include more women in the studies, but now there's They're, so they're doing that, but yet there there's no where are you in your menstruation cycle?
There's no, in your menstrual cycle, there's no talk of like where we're at hormonally. And it's because it's complicated. So they're trying to make it less complicated, but in doing so, they're making it a lot less precise. But yeah, research has done a lot of good.
But I think sometimes we can just put it on this like gold pedestal and it's like, well, the research says this, so therefore your experience is meaningless.
Yeah, and I think also another thing is when you are an A five individual the expectation is you were, you were born with these female reproductive organs.
You were born with these organs needed for childbirth. Therefore, you're, you're expected to be in more pain, which I think can also mess with like how we're believed when we do give a rating on a pain scale. Whether it's they think that it's just emotions or they think like, oh, this patient is clearly lying because they're presenting as a woman.
Women withstand pain better, or something like that.
That's awful.
Awful. And the same thing for African Americans. They literally were
taught in med school that they
don't feel pain. And that's just, it's
brutally awful. I don't even know how to describe
how
awful that is. And, and black women I believe, yeah, four.
They're black women are 400% more likely to die in childbirth. Or as a result of birth complications,
Do you wanna expand any, any thoughts on that and, and kind of what you can, or we can, it's totally up to you, but what are some of the contributing factors or what, just what could be changed?
I think that something that really needs to be. Focused more on when it comes to medical research and stuff like that is intersectionality.
So there's so many reasons why non-white patients could be treated differently but also, Looking at the likelihood of developing some sort of disability as a result of having an intersected identity and being enforced poverty or not having access to good healthcare because you don't have access to the education needed for these higher income jobs that come with health benefits and all of those things.
Or you don't have access to the, the dietary needs that you know are required for good health, depending on your condition. Yeah, absolutely.
Just, which a lot of times starts in childhood. Even just, did you get enough calcium and vitamin C? Like simple, simple things that can be really incredibly difficult to make sure your kid is getting given your situation.
Mm-hmm. Yeah, I think too so like recognizing intersectionality and then also just, which I, I think is an ongoing conversation all the time in our country. But making sure there's more representation of, of everyone in each profession. I, I think often I, I learned this from Malcolm Gladwell's podcast.
Years ago. But you know, I don't think a lot of people realize, like when segregation, when we were desegregated as a country, like basically black teachers were just fired and black kids were transferred into white schools and labeled as all of these, they're the troublemakers, or they're all from implicit and explicit biases, not because the kids were actually making trouble.
And when you're not around people who look like you and talk like you and act like you, You feel like an other, and it's harder to learn and it's harder to live. So we just need more people who are represented in every, per every profession.
Yeah. And, and desegregation and Jim Crow and all of that was not that long ago.
I, I think people tend to forget it was not that long ago.
No. You can still see the effects of it today. And yeah, it's. It really, I think, like you said, 400 times more likely to die on childbirth. I think that's a pretty, that's, that's not, that's not 12%, that's not, like, that is a substantial number, the substantial number.
Mm-hmm. I mean, any, any number above the average for, for white people is unacceptable. I agree.
I agree. Yeah, and I think that, you know, it's interesting too, like all of the research, I think I've mentioned this on the podcast too, but research for therapists, for medical doctors, for all types of professions.
There's pro, there are, there's research done on the efficacy of treatments, and it always comes down to the relationship between the provider. And the patient. So it's not just therapy that that's relevant for it's medical doctors, it's physical therapists. Like if you don't have a relationship with the person, and we don't these days for an array of reasons.
Managed care insurance high turnover rates in large group practices that aren't paying their doctors as much as they should. Making huge profit margins, all these things. Lead to why we don't have a relationship with our provider, so that this way when we do say my pain is at a level five or a level 10, if we have a relationship with our provider, they know us.
They know what that means without us fully having to explain it. But now the onus is on us to make sure we are very articulate and are saying things exactly as we quote should and it's stressful. Mm-hmm. Unnecessarily so.
It's a guessing game too. Yeah. And it's self-advocacy is so important, but so exhausting and like having the awareness that you can file fire a medical provider if they are not meeting your needs, it's not something commonly known.
Yeah. Or if you do know it, it's also like, ugh, the, like I don't wanna go find another one. Like, I'm just gonna stick it out here.
The next one may be just as bad. Yeah. Yeah.
Yeah. And I think that is a theme on the podcast of like, when I ask people what has helped them most you know, in their own journey is a lot of.
People who have been interviewed on this podcast are like, it's just keep trying, like keep going from doctor to doctor, which in and of itself, again, it takes time, takes energy, it takes emotional energy. And so it's not easy, but it is, it is how we all get that is the way we get through it. Like we have to find providers who are willing to listen
and, and then of course, sadly Afab that people are more likely to be listened when they bring a male presenting partner or family member with them.
Yeah, I hear that a lot too, and I don't know the reason for that other than obviously implicit biases, but I don't know. Yeah. It's, it's hard too. I mean, learning to, I think for me, learning to be assertive has helped me in a lot of ways. But again, that's like, why did I have to learn that? Because men are, are historically more assertive than women, and so therefore, being assertive helps me but be believed.
And I, I think also as counselors and as therapists or social workers, we recognize that the client is the expert and we help people. You know, own their powers. So it, it puts us at a unique position to be able to advocate for ourselves because we have the education that not everyone has. We understand that you believe the person the first time.
Which then, you know, it just sets us up to, to have more success at advocating for ourselves as a whole,
ideally. No, I agree. Every time I start to think about like when I'm working with clients, I'm being assertive or speaking up what, for what they need. Like, I do really recognize like I'm, I've been trained in this, this is my entire training is like how to talk and how to, you know, articulate what I'm feeling.
And so it just, for people listening, like it does, it takes time. And I probably learned it faster than anybody who is not going to school for this to be a therapist. Or to communicate, you know, in some, some way journalism would probably help you too, or something like that. But teaching. Teaching, yeah.
Yeah. But yeah it is a, it is a skill that is worth learning. It just takes time. Mm-hmm.
And it is heavily influenced by trauma as well. Mm-hmm. Especially when we're talking like emotional neglect in childhood, it, you know, you may be more likely to just be like, oh, okay, well this, this is what it is, but you know, I'm not gonna fight the doctor on it.
I'm not going. It's because I know what it's like to have bad outcomes because of my experience in childhood. Right. Right.
Or even if you lean more towards the, the fighter side of things, maybe you fight a little too quickly and you, you know, now your doctor's like not on your side anymore. It, it, it really does come down.
This is why therapy with people with chronic illness is so important and why it's so closely tied to your childhood experiences. It's not that, you know, I mean, we, we know from ACEs that. Early childhood experiences such, so much increases our risk of having a chronic illness. But again, it's not that the trauma is like at fault and then therefore you're going to a therapist cause it's all in your head and now you're trying to reverse that.
It's just more so like, there are so many maladaptive coping mechanisms that we formed that continue to hurt us as adults. They made us safe as kids and they harm us as adults, so, mm-hmm. That's what a lot of my work looks like in session.
Yeah. And that's, that's the approach with the e emdr that I was trained in as well, is, you know, you develop these, you overdevelop certain skills and then as a result have underdeveloped other skills which get you where you need to go and then start causing problems right when you are an adult on your own and all of that good stuff.
Yeah, definitely. Does anything else feel important about this conversation that you wanna share today?
Oh age. Hmm. So oftentimes for AAP afab individuals, like, for example, autoimmune diseases, love to show up early twenties, childbearing ages. When you're the picture perfect idea of good health. And I think that that also goes into being believed and taken seriously by, by doctors. And then let's being comorbidities.
I think that's also important is people with history of substance use concerns are often less likely to be taken seriously labeled as drug seekers. When their pain is just as important. Their struggle is just as important, and they deserve pain management in whatever way. Despite having substance use history, That's also a, another big one.
I think it's such a tricky conversation. Because yeah, I mean, even to think about, well, why is someone, why is someone seeking out drugs who, like, especially for we, we've just, we've learned in this, I think in this country that everything needs to be like fixed with a quick pill. Mm-hmm. And so, The idea of social support and being cared for and having community and all of these things that we know are really, really healing, that's just not even an option for a lot of people.
So when we go to the doctor and that's, and then that, that's the only tool that you've been given as a doctor. It's just like, we've been set up in this system, we're just, we're just set up. Mm-hmm.
Yeah. Any last thoughts that you wanna leave people with today? Any words of advice or hope or just like something that kind of keeps you going?
So, one thing I think is important when we're talking about implicit biases is my, my favorite recommendation for people. Who have relationships with someone with chronic pain as well as like healthcare providers is when someone tells you what their pain level is, believe them. Even if. The presentation challenges your own perceptions. They are the only ones that know how they feel. It's better often, if not always, to believe them, to get them the right treatment than to just say, oh, go see this mental health counselor.
Oh, it's just emotions or. You know, whatever it may be, it's, it's so important to just believe them when they tell you what their experience is because only they
know, not to mention, if you're showing them that you believe them, they don't need to exaggerate anything or dramatize anything to, they just, they know you're going to provide for them when they tell you the truth.
So it's a really good precedent to, to
make. Yeah. And a, and a great resource to kind of identify where you may have implicit biases is the implicit bias testing on the Harvard website for free for all types of marginalizations including people with disabilities, age, sex, race, et cetera. Yeah, thanks for sharing that resource.
I'll put a link to that in the show notes.
Any, anything else come to mind before we hop off for today?
Just I would say for people out there that may be listening that struggle with chronic pain and chronic illness your experience matters just as much as the next person. You deserve to be listened to. You deserve to be cared for. You deserve proper treatment. And it's okay to,
that's so cheesy. It's okay to not be okay. Like it's okay to take a rest. There's no such thing as laziness. The laziness lie is something that is also a great read. The term laziness was it, it's always been used to oppress people. Yeah. And you don't deserve that. Rest is just as productive as doing the dishes.
It really is. And it's not just something we're saying cuz it sounds good. It it's literally
true. Mm-hmm. Yeah. Absolutely.
Well, thank you so much for all of that. It, it was really helpful and I'm looking forward to, to publishing this.
Cool.
https://implicit.harvard.edu/implicit/
Episode Summary and Notes
Meet Nadia Clontz, a licensed professional counselor dedicated to helping individuals navigate the complex and often misunderstood world of chronic pain, chronic illness, and medical trauma. With her background in clinical counseling psychology, Nadia brings a unique perspective to her practice, Empower Counseling Center, in Suwanee, Georgia. She offers trauma-focused care using EMDR and somatic approaches to help clients cope with life's challenges, including chronic health concerns, pain, and complex trauma.
A Transition to Empowerment
Nadia's journey into private practice at Empower Counseling Center in February 2020 marked a significant shift in her career. It was the beginning of her mission to provide individuals with safe and effective treatment from the comfort of their own spaces. Embracing the benefits of virtual sessions, Nadia invites clients to join her, and their furry companions if they wish, on a journey toward healing and understanding.
A Holistic Approach to Healing
Nadia specializes in chronic pain, chronic illness, and complex trauma, with a particular passion for addressing medical trauma. Her therapeutic toolkit includes EMDR for trauma, somatic approaches, mindfulness, and dialectical behavior therapy (DBT). These techniques are essential components of her holistic approach to healing, recognizing that emotional and physical well-being are deeply interconnected.
LGBTQ+ Affirming and Gender Affirming Advocate
Nadia proudly affirms her support for the LGBTQ+ community and is a part of the Gender Affirming Letter Access Project. As a part of this initiative, she offers free assessments and letters of support to individuals seeking gender-affirming surgeries. Her commitment to breaking down barriers and promoting access to care demonstrates her dedication to helping clients live unapologetically and authentically.
Living with Chronic Illness and Pain
Nadia understands the ongoing grieving process associated with chronic illness and pain firsthand. As a fellow "spoonie," she navigates the challenges with a blend of dark humor, self-compassion, and acceptance. Alongside her trusty service dog, Kodak, she embodies resilience, and her personal experience informs her professional practice.
Cultural Awareness and Sensitivity
Beyond her work with clients, Nadia is passionate about advocating for her profession and aiding other professionals in building cultural awareness and sensitivity. She strives to break down implicit biases and covert ableism within the healthcare field, ensuring that everyone receives the respect, understanding, and care they deserve.
In this candid conversation, Nadia shares insights about the pain scale, gender differences in healthcare, and the importance of tuning into your body's signals. She emphasizes the need for a more holistic, patient-centered approach to care that transcends numbers and embraces the unique experiences of individuals.
Subjectivity of the Pain Scale
Nadia addresses the challenges of the pain scale, a tool that aims to quantify an intensely subjective experience. She emphasizes that the pain scale cannot fully capture the complexity of pain, as it's unique to each individual. The emotional and physiological aspects of pain are often intertwined, making it impossible to neatly categorize on a 10-point scale.
Emotions and Physical Symptoms
Nadia highlights the profound connection between emotions and physical symptoms. She explains that emotions can exacerbate physical symptoms, citing the well-known stress response that increases cortisol levels, which, in turn, can heighten pain perception. Despite this scientific understanding, society sometimes struggles to accept that emotional states can impact pain without reducing the experience to being "in your head.”
Gender Differences in Healthcare
Nadia sheds light on gender disparities in healthcare. She points out that women and individuals assigned female at birth (AFAB) are often dismissed, labeled as emotional, and less likely to receive appropriate pain management. The biases stemming from the historical lack of research on women's health are pervasive and harmful.
Intersectionality and Racial Bias
The conversation expands to intersectionality, emphasizing the importance of considering multiple layers of identity, including race and socioeconomic factors, when assessing healthcare outcomes. Racial disparities in healthcare persist, contributing to unequal access to quality care and increased risks for marginalized communities.
The Need for Representation
Both hosts discuss the significance of representation in professions and healthcare. They note that a lack of diverse representation can lead to feelings of "otherness" and hinder individuals' access to quality care. Professionals and providers must reflect the diversity of the populations they serve.
The Power of Patient-Provider Relationships
Nadia underscores the essential role of patient-provider relationships in healthcare. The absence of meaningful relationships between patients and providers can lead to miscommunication and mistrust. In contrast, a strong patient-provider relationship can facilitate more accurate assessments of pain and ensure that the patient's unique experience is understood and valued.
Conclusion: The conversation closes with a powerful message: when a patient describes their pain level, it is essential to believe them. Regardless of the clinician's or observer's perception, the patient knows their own experience best. Believing the patient is vital for providing the right treatment and fostering a trusting relationship.