This is a fun conversation about a not fun topic, healing from chronic pelvic pain. Rachel and I are mindbody besties, our work is deeply rooted in learning and teaching these skills of body trust and always believing the recovery is available for everyone in any body. I hope you listen with wide open ears, catching any themes that might resonate for you. And with any of my interviews, I invite you to imagine applying these concepts to you in your life. How can you start to view your symptoms and your life differently? To me, Rachel is a hero of self determination, someone willing to step through fear, pain, discomfort and trauma with such passion and self compassion. It's not an easy path as you will discover, but she and I share the sentiment that once you understand neuroplastic pain it's hard to view our human experience through a different lens. Rachel is a Doctor of Physical Therapy and pelvic pain coach who specializes in guiding women with chronic pelvic pain to heal through a holistic mind-body approach. Her own journey of healing from chronic pelvic pain inspired her to pursue this work, and she now dedicates her career to guiding and supporting others through their own paths to recovery. With years of experience in both clinical practice and coaching, Rachel empowers her clients to not only heal their pain but also to create full and empowered lives rooted in connection and intention as they heal. Her unique approach combines expert knowledge with compassionate coaching, providing women with the tools to feel safe in their bodies, live freely, and foster deeper, more meaningful connections with themselves and others as they heal.
This is a fun conversation about a not fun topic, healing from chronic pelvic pain. Rachel and I are mindbody besties, our work is deeply rooted in learning and teaching these skills of body trust and always believing the recovery is available for everyone in any body. I hope you listen with wide open ears, catching any themes that might resonate for you. And with any of my interviews, I invite you to imagine applying these concepts to you in your life. How can you start to view your symptoms and your life differently?
To me, Rachel is a hero of self determination, someone willing to step through fear, pain, discomfort and trauma with such passion and self compassion. It's not an easy path as you will discover, but she and I share the sentiment that once you understand neuroplastic pain it's hard to view our human experience through a different lens.
Rachel is a Doctor of Physical Therapy and pelvic pain coach who specializes in guiding women with chronic pelvic pain to heal through a holistic mind-body approach. Her own journey of healing from chronic pelvic pain inspired her to pursue this work, and she now dedicates her career to guiding and supporting others through their own paths to recovery. With years of experience in both clinical practice and coaching, Rachel empowers her clients to not only heal their pain but also to create full and empowered lives rooted in connection and intention as they heal. Her unique approach combines expert knowledge with compassionate coaching, providing women with the tools to feel safe in their bodies, live freely, and foster deeper, more meaningful connections with themselves and others as they heal.
If you’re ready to start healing TODAY and want a clear, flexible roadmap, Beyond Chronic Pelvic Pain: The Self-Paced Course is the place to begin. You’ll learn the core mind-body and nervous system tools she used to heal—and have helped dozens of clients do the same.
Click the link below to learn more! https://thepelvicpaincoach.com/course
https://thepelvicpaincoach.com/
https://www.instagram.com/thepelvicpaincoach/
TCCEP52
[00:00:00] Welcome to the Curiosity Cure podcast. I'm your host, Deb Malkin, master certified life coach, body worker hypnotist, trained in pain reprocessing by the pain psychology center, queer elder. Fat human on planet Earth. Here to help you evoke the power of simple neuroplasticity techniques rooted in shame free curiosity, so you can feel more, better, more of the time in the body you have today, and build the rich full life that you want to live.
[00:00:39] A quick disclaimer, this podcast is not a replacement for medical care. I am here to provide insights and techniques that can compliment your healthcare journey. But always consult with your healthcare provider for personalized advice.
[00:00:58] Deb: So I wanna talk about the physical body, the emotional body, the social body. Those are the three categories that I like to touch upon. So inside of those three things as much or as little as you wanna tell your story.
[00:01:12] Rachel: Mm-hmm.
[00:01:13] Deb: 'Cause I know you have such a compelling story
[00:01:16] Rachel: when you say emotional body.
[00:01:18] Deb: Yeah.
[00:01:18] Rachel: I'm curious about that. Like what are you kind of
[00:01:22] Deb: So emotional body can be like the way that doing emotion work helps recovery. Oh, so that could be like nothing. Or it could be like, oh yeah, I realized I was repressing all of my anger.
[00:01:34] Yeah,
[00:01:35] Rachel: no, I just suppressed every part of me. What do you mean?
[00:01:37] Deb: Yeah. So that kind of thing because we are trained to think about emotions separate from physical. Right. And
[00:01:44] Rachel: yeah. To me, I'm like at this point. They're one and the same, but that was not the case for a long time. Yeah, right.
[00:01:49] Deb: Exactly. So I think lots of people can really relate to that. And I separate them so we can bring them back together because we are not trained to have a holistic view Yeah. Of the body. Even when we say mind, body, people are still thinking about it in these very separate ways.
[00:02:06] Rachel: And they also often are like, either that means it's just in my head. Right. Or that it's like stress related, but like it's because we also are tense, because I'm stressed and that's it. It's like nuance and like complexity to all of this, right?
[00:02:20] Deb: Mm-hmm. Yeah and I think because we can't disconnect anger, accessing healthy anger from the social body.
[00:02:29] Rachel: Yeah.
[00:02:30] Deb: Right? Yeah. The social body is everything that we are told that we are supposed to be, or the way that the systems interact with our individual selves. We're constantly having things that we need to be responding to, and some of those are socially sanctioned.
[00:02:46] Rachel: Yeah. And for like, good reasons, safety reasons, all of that. We'll get into it, like in the actual discussion.
[00:02:51] Deb: Absolutely. I think that sounds great. Okay. Hello my feelers and healers and welcome to the Curiosity Cure podcast. I am Deb, and I am so beyond excited to be here with one of my, oh my God, I'm gonna say mind body besties. That was the thought that came up out of my body because this is how we connected and now I think of you as a friend and when we first met I was like, I really want Rachel to be my friend. And I feel like it's true. We've traveled together, we're creating new conversations around MINDBODY healing, with and for people. So I am excited. Rachel Goffman is here, the pelvic pain coach. And, we're gonna talk about her recovery from pelvic pain.
[00:03:42] And we're gonna talk about different themes, the physical body, the emotional body, the social body. 'cause all of these things are connected. All of these things are triggers for pain and understanding them is how we can unwire our brains and change our pain experience and navigate this thing that we call recovery.
[00:04:04] So Rachel, would you please introduce yourself, who you are, what you do, how you help people?
[00:04:11] Rachel: Absolutely. Thank you Deb for that intro and absolutely mind body besties for life. So my name is Rachel Goffman. I am a doctor of physical therapy and pelvic pain coach, and I help women with chronic pelvic pain heal through a mind body approach and return to living full and empowered lives in the process.
[00:04:31] I do this work because it saved my life. That's truly, like I always say, it chose me. I had my own experience with chronic pelvic pain and a whole myriad of other symptoms prior to pelvic pain that I didn't know were all connected until I actually healed pelvic pain through a mind body approach.
[00:04:48] But really what I'll say is my social, emotional, physical bodies were not connected until I did this work. I didn't even know that there was anything beyond just the physical body. And this work really required me to do the merging, as you've so eloquently described. I'd love to talk about that process for me. And hopefully it helps your listeners make some connections for themselves.
[00:05:16] Deb: I love that. One of my favorite things about this field is how practitioners bring their full and complex and very human selves to it with a lot of transparency and love and compassion. And it really, for me, feels like it's healing this message that I've always received about my body, that there's something wrong with it. That there's something wrong with me. Being in a larger body means that I have some kind of disease or disorder or just problem. I am a problem and I need fixing. And then when I arrive at whatever fixing looks like, usually it means being smaller, then all of those things will go away. And what this work has just blown out of the water, the fact that one, that's just a whole mythology that keeps us in this fear, pain, fear cycle, but also what you were saying about empowerment and being able to live your full and amazing life, we can just do that now.
[00:06:18] Rachel: Yeah, absolutely. And also feel less pain
[00:06:21] in the process. Right? Yeah. I so resonate with what you described as far as growing up. Being in a bigger body and the messages of you are doing it wrong, you are wrong, your body is wrong, you're messing this up. I was always in a bigger body since I was a child.
[00:06:38] I was both gaining weight much faster than my siblings. I'm a triplet, by the way. Fun fact. I was always in a bigger body than my siblings. And I was always sick from a very young age. I always got sick. So I was the sick kid and the fat kid, right? And the messaging from doctors was like, well, what's wrong with you?
[00:06:59] Your siblings are fine. What are you doing wrong? And that messaging I didn't understand, of course at the time, how deeply damaging that was and how that messaging pervaded my entire life. But really this idea of my body is wrong and it's not built for living in the way that everyone else's is.
[00:07:21] And I kept trying to figure out like, what's wrong with me? What's wrong with me? Because of course, when you're sick as a, even as a kid in a fat body, a doctor tells you if you just lost weight, you'd be healthier. And by the way, we're talking about tonsillitis, strep throat, sinus infections, ear infections.
[00:07:38] What the fuck does that have to do with her weight? Right. But that was literally the messaging I was getting since I was like, you know, six years old. It is really, really hard and it was really, really hard to shift that narrative from what's wrong with you?
[00:07:53] To how can I support you?
[00:07:55] Deb: That was what I was just thinking. I was imagining young Rachel who wasn't feeling well and I just wanted to scoop her up. And I was just imagining like those doctors, like pointing fingers and that feeling of like looking down on you and especially, oh my God, like being one of three.
[00:08:15] Rachel: I was the problem child and you, right? Like my, my siblings were not sick. I was always sick and fat. Right? And so I really internalized, and my parents weren't explicitly saying this to me, right? But like society, teachers, physicians, like that was the messaging I was getting. I really internalized this idea of I'm doing something wrong. I must be doing something wrong.
[00:08:37] My first TMS Mind body neuroplastic symptom was chronic back pain. Years before the pelvic pain was back pain was sciatica. I was 20. It started after a traumatic event.
[00:08:46] I, at the time had no idea that the mind affected the body, by the way. So it took me a couple of years to find healing back pain and Sarno's work and really make any connection with trauma and my pain. I remember the pervasive message I was sending myself in those two years of absolute suffering was what is wrong with you?
[00:09:08] What is wrong with you? That was the thought, like, what is wrong with you? I did the same thing by the way, of course when pelvic pain started, but I had to do that actual work to unlearn that patterning. But it's such a, understandable perspective, if that's what you were growing up with, the thought what is wrong with you?
[00:09:25] Deb: Our entire Western medical system often leads with that. The overemphasis on the personal responsibility of health without any knowledge of bio-psychosocial factors of health and wellbeing. But even just the blame culture that we live in, and not even understanding how shame feels, how it lands on the body.
[00:09:49] It is so heavy. It is like the heaviest, heaviest cloak, it's not like a lovely weighted blanket. It's like, a, a cloak of rocks.
[00:10:01] Rachel: That's the perfect imagery, hypnotist over here? It's funny 'cause I didn't name it as shame at the time. And now I so clearly see I think the primary emotion that I really couldn't even, even name that I was experiencing was shame.
[00:10:19] Deb: Yeah.
[00:10:20] Rachel: And actually like, turning towards it and seeing what was under there and lifting the cloak and sitting with it and asking like what, what is your experience? Right. Why are you here? What's the message? Right. It took me so long to understand that was even possible because the overarching belief was, I am wrong.
[00:10:39] Deb: Mm-hmm.
[00:10:40] Rachel: Intrinsically, like I just am wrong. And so what's the point in investigating and figuring it out? 'cause like I'm the problem.
[00:10:47] And so if that's the belief, there's no work to do there, right? There's no possibility of repair. Right. And I just realized I never, ever, ever had self-trust before going through my healing journey.
[00:11:00] Mm-hmm. I outsourced, I think all expertise to everybody around me, whether it was physicians or teachers or books or dieticians or naturopaths or whomever, as experts on what's best for me and what I need to do to be okay. And one of the biggest lessons I learned throughout my healing journey is that literally nobody can know what's best for me, more than I can.
[00:11:27] Hmm. Which I could not have ever even thought that before. I went through this whole mind body healing experience. I. Oh, and just so your audience knows, 'cause you probably don't know very much about me. I'm totally chronic, pain-free. I have no symptoms I'm healed. But I think it's just important to know that the lessons that we learn in the process of healing, I'll speak for myself, make my life so much better than it ever was.
[00:11:52] I didn't know what I didn't know before. I thought I was like living like everyone else, which I now realize is with the rules of other people and like trying to do it right and like meet someone else's standards. But I was self abandoning literally at every turn. I was making my body wrong, my thoughts wrong, my feelings.
[00:12:12] Well, I didn't know I had feelings to be very clear. I had no connection to my emotional world. Okay, so I studied neuroscience in undergrad, and the reason I studied neuroscience instead of psych is because I wanted to cognitively understand why emotions don't matter.
[00:12:29] Deb: I'm sorry. I love that.
[00:12:31] Rachel: I'm dead serious. I was like, I want proof that like we are just a machine. We're squidgy brain matter and nerves and therefore the gushy mushy thoughts and feelings BS don't matter. That's when I went into neurosciences to confirm for myself and like I learned the opposite.
[00:12:55] Deb: That's amazing. I feel like we can write a doctoral thesis unpacking the patriarchal influence on that, how science is about the machinery of the body and emotions are unnecessary. Ugh.
[00:13:12] Rachel: Yes. And I wanted to like, scientifically reason my way out of having to ever allow a feeling.
[00:13:19] Isn't that wild? Like, I like went to university to do that.
[00:13:24] Deb: I love that determined you. You're like, I am gonna organize my entire life to prove that feelings are unnecessary for me to have.
[00:13:33] Rachel: It's also so emblematic of the way my brain, was committed to not feeling right. Again, all up here, right? All in my brain, all education, all cognitive, all thinking to prove feeling is bullshit.
[00:13:45] Deb: Well, because you were taught that your body was wrong and broken. Yeah. And it only, had these negative associations. So why would you wanna spend any time in your body?
[00:13:56] Rachel: Yeah. Feelings were inconvenient.
[00:13:57] My body was not a safe place to live. I did not want to spend any time in there. And so if I just hung out in the brain thinking about things, it was safer. Right? Until it wasn't.
[00:14:11] Until we're like, oh, it's a great thesis and it doesn't work.
[00:14:16] Well, it's funny because like there's that phrase, I'm gonna get this totally wrong, but it's like, either you go or you're dragged, right?
[00:14:22] It's like you decide to go or you're dragged. I was dragged, unfortunately, I wish I just decided to go, but I was dragged down the path of having to connect with my inner world to my emotional world, and to my truth, which I didn't even have any access to. It's crazy because I thought intuition was like literal, like dog shit.
[00:14:46] Like I thought all of it was complete crap. This is such an internalized, like misogyny, patriarchy, like all that stuff about how like we just need to think and have structure and have reason, and that's the only way to do anything. I think I so badly wanted to belong in this society that, that says that. I think back and I have so much compassion for the past version of me who just wanted to fucking fit in. And I never literally fit in because I was fat.
[00:15:14] Deb: Oh my God. The layers and the layers, it's like the most delicious flaky pastry of a journey. There's like never ending layers. There's so much here that's absolutely resonating for me that deep desire to want to fit in, to connect, to feel welcome, to not be abandoned, like the pressure to self abandon in order to fit in, in order to not be abandoned is so loud and is such a part of growing up.
[00:15:48] Rachel: Mm-hmm.
[00:15:48] Deb: In a lot of ways we're really trained in, designed for that versus this kind of deepening into a sense of self and a sense of empowerment.
[00:15:57] I'm gonna bring us back. Because people know I love Dr. Who and I get very timey wimey on these interviews and we bounce around everywhere. So I'm gonna try to be linear in a non-linear healing journey. To tell a story of your process and experience. Here's what I think is so amazing and fascinating.
[00:16:18] You got your doctorate of physical therapy, which is a very body-based field. Now that's changing, right? We have people like you and Charlie Merrill and other people who understand this information of integration and the brain. But I'm sure you didn't learn that in school.
[00:16:41] So there's you studying things and then you having your own physical and emotional experiences, and then you're putting the pieces together for your own healing. So can you tell that story in whatever way?
[00:16:59] Rachel: Yes. I'll do my very best. I always struggle to tell the story in any logical, linear fashion because of course, right.
[00:17:07] It took a long time. And my memories from those periods of time are not as solid as I'd like them to be because, you know, trauma. Okay. So starting with I'll call it like my first official that I figured out TMS symptom, which was back pain. When I was 20 years old, I had an assault experience, which I immediately suppressed.
[00:17:34] The event had occurred and I remember in real time saying, if I don't think about it, it didn't happen.
[00:17:39] Deb: Whoa, wait, I just wanna slow that down. Because there's this part of you that's so on your side, right? You are assaulted and then your brain is like, or yourself or whatever. This part of you that's like, I know the answer.
[00:17:55] If you don't think about it, it never happened.
[00:17:59] Rachel: Which goes back to the part of me that's like gonna say neuroscience to not feel feelings like one and the same. And so I had that experience and then within a week I started feeling what I thought was a hamstring strain or pull, some achiness tension down the back of my leg.
[00:18:18] And I was like, well that's weird, but I'm just gonna walk it off, see if it gets better. I didn't do anything. I was like, it must be just something weird. Across the span of a week to two weeks, it's just getting worse. And I was like, oh shit. So I go to my orthopedic sports med doctor and he like, moves my leg around, has me bend, do all this stuff.
[00:18:37] And he goes, it's not your leg, it's your back. And that moment I was like, oh shit. Like back felt so much scarier than leg. I was like, oh my God. He's like, okay. I get an MRI, I got an MRI, I had a herniated disc. At L5, S1 bulging discs above, like I'm looking at this MRI and it looks like my spine is collapsing and I'm basically being told my spine is collapsing at the ripe old age of 20.
[00:19:03] And I'm like, oh my God, my life is literally over And he's like, well, I can have you meet with an orthopedic surgeon and discuss surgery. And I was like, can we do some PT first? And he's like, sure. Give it a try.
[00:19:15] Deb: Give it a try, give it a try. Some ringing endorsement. Yeah. You can hear between the lines where he is kind of like, yeah, good luck with that.
[00:19:24] Rachel: Yeah. He is like, well, look at your freaking MRI like, good luck.
[00:19:27] Right. And listen, it looked like a pretty big herniation, whatever. So I didn't know any better. I'm gonna listen to the doctor. So I go to pt, I basically end up in PT on and off for two years and like four to six month bouts with a couple of cortisone injections peppered in there.
[00:19:46] Honestly, in that time. I was pretty disabled. I really couldn't walk very well. I couldn't stand for very long. Sitting was like impossible. I walked around my campus with a little tush kush, and I would slide into those auditorium chairs so I could sit in class. I was not okay all that time. And then one day I was home for school break.
[00:20:08] And my father, who's like the least woo person you'll ever meet, was like, Hey, I was listening to the Howard Stern Show, and he mentioned this book, I think you should read it. And I was like, okay, I can read a fricking book, like what's that gonna do? But sure, I'll read anything. I want help.
[00:20:26] And so I read this book and it was Healing Back Pain by John Sarno. And I read it in one night and bawled my eyes out because what I gleaned from that book was, what what happened to me emotionally also happened to me physically. And that created very real debilitating physical pain. And even though yes, my spine looked wild on an MRI, that was not the cause of my pain.
[00:20:48] Now, I wasn't like a hundred percent okay, I feel safe that my spine is totally fine. But I was so much more open to believing there was possibility for improvement. Mm-hmm. And I recognized that I actually had to process my trauma, which sucked. I really didn't wanna do it, but I was like, I will only do it if that means that I can no longer have this crazy pain.
[00:21:12] So I went to EMDR therapy. And then within six-ish months of doing therapy and getting back to movement and like being less afraid of my back and my body and just deciding to believe that like my spine could look crazy and like I could still be okay.
[00:21:26] Um, I eventually became totally back pain free, no sciatica, all bang, bang, boom, like finally good. Um, so it's not like a book cure, book cure, but it was kind of a book cure, right? Yeah. And I was like, okay, so that's behind me. Perfect. Love that. Never thinking about that again. Cool, cool, cool. Moving on.
[00:21:47] Deb: I wanna pause here and just talk about one, I feel like Howard Stern really deserves a lot of credit. I have a lot of thoughts and feelings about him and his legacy, but I also really just am like, Howard, you have done so many people a solid.
[00:22:04] Yes by sharing Dr. Sarno's work publicly.
[00:22:09] Rachel: Mm-hmm.
[00:22:09] Deb: And the power of it. So Thank you Howard. Yes. And I also wanna be like, and maybe you're also responsible for some pelvic pain sex women are treated. I don't know. I don't like, I don't know how Howard of today, right. Yeah. So I can't really reflect on that. But, I would call that a book cure in the sense that the origin, right. What you attribute your pain to changed because of the book. Yes. So that to me is a book cure. Yes. We went from believing that the herniated disc and the disc bulges and the shape of your 20-year-old spine mm-hmm. Was the cause of your pain.
[00:22:55] And now. You went and processed your trauma and of course we're not just like, oh, I'm gonna do this for the rest of my life. You're like, I feel better and I'm gonna orient myself towards that. And that book was the doorway by which you walked through that experience. That's a tremendously powerful journey in and of itself.
[00:23:16] Rachel: Yes. Yes. It didn't feel that fast, but it was much faster than the next one.
[00:23:23] Deb: Yeah. And when you're 20, in your twenties, six months kind of is a long time. Yeah. I haven't been an adult for very long. Right, right. Yeah. It's only been like two years of being an adult or something. So six months out of that is like a significant amount of time.
[00:23:38] Yes. That's where this chronicity piece that I often work with clients on. Mm-hmm. It's like, yes, you want to be not suffering today, but also we can't put a timeline urgency on it. And also it will go by faster than you think and also, right? Yes, yes, yes. Exactly. Okay, so now we're moving into the next piece.
[00:24:02] Rachel: Yes. Phase of my TMS neuroplastic symptoms. So I had a really solid year off. I second, it's a year off, but it wasn't, I had chronic migraines, I had palpitations, I had a whole lot of other stuff that just didn't feel as disabling for me.
[00:24:18] Deb: Yeah.
[00:24:19] Rachel: And so I often say it's a year off, but it was just like a different flavor that didn't demand that I look at my life the way the next symptom did.
[00:24:27] So I had, I'll call it my year off. I had my year off. And then I had a sexually triggering incident. And then within a week I developed what I thought was maybe a yeast infection or bv. I went to the doctor and I got tested and everything was totally clear and I said, well, that's impossible because I feel really terrible, so please test me again.
[00:24:49] Tested me again. She's like, there's nothing there, but maybe just take this yeast medication because like maybe it's subclinical yeast. That became an insidious thought.
[00:25:00] Deb: So yes, subclinical, yep. Is the worst thing that you can tell somebody. Yep.
[00:25:07] Rachel: And so I did the medication. Nothing got better.
[00:25:12] Went to the doctor, I said, nothing is better. Test me again. I think I got tested from the same doctor maybe seven or eight times, at which point she's like, I have nothing more to give you. I don't really know what to tell you. So I went to see several other gynecologists who all did some very similar things. Then a transvaginal ultrasound. And then I saw a neurologist who did a pelvic MRI. And in this process, it was a process of probably six months of getting all this testing done and I was given a ton of antibiotics and yeast medication with no positive testing.
[00:25:49] Just like try it, maybe it'll help. By this point my symptoms have gotten exponentially worse and have spread. I ended up having constant vulvar burning and clitoral pain. And then, sprinkled in was what felt like chronic u uti I symptoms like my urethra was burning. And at this point I'm absolutely terrified.
[00:26:10] The only, you know, quote unquote solutions I was being offered were medications, like amitriptyline, like gabapentin, things that weren't going to cure my pain. It might mask it temporarily, but that's not a cure. They were offering a Botox injections and trigger point injections and nerve blocks and all of these things, but they couldn't tell me why I was having this pain.
[00:26:33] This pelvic pain felt monumentally different from the back pain in that, with back pain, you could talk about it. You could say, I'm having a bad day, my back hurts, or I can't do this because my back hurts. Or people could understand back pain. I I didn't tell anybody about my pelvic pain. It took me a long time until my best friend and then like a couple of family members and like I told almost nobody.
[00:26:58] And this all happened about six months before I started PT school. I went into PT school with these 10, outta 10, all day every day symptoms that fluctuated maybe between like an 7, 8, 9, on a good day. But it was very loud and all the time. And so I'm sitting there in class trying to learn, and my internal awareness is just simply scanning inside, right? I'm just constantly monitoring and catastrophizing and I thought my life was over. Like I remember walking down the street, I lived in the city at the time, New York City, and I'd see couples like walking down the street and I would be like, oh God, I'm never gonna like ever have that.
[00:27:40] And I was like, grieving the future. I thought I would never have. I get emotional every time I talk about this.
[00:27:46] Deb: I, I feel emotional. What was going on in my mind was, oh, I wanna talk to you about, about sex and Yeah. Like your thoughts, was that something you're like, oh, I'm never gonna have that.
[00:27:59] Rachel: Yeah. It's just never gonna happen. I was like, that's off the table. Like never again. I also had the belief that if any pain was present, it was a like absolute no.
[00:28:09] Deb: Yeah.
[00:28:10] Rachel: Right. I had very black and white thinking, but of course I was terrified. I didn't know what was happening. I really did develop this kind of OCD, compulsive thoughts about subclinical infections. Right, because doctors had mentioned maybe it's subclinical yeast, subclinical bv, subclinical U uti, I embedded UTI, right?
[00:28:27] All of these like really terrifying ideas. I'm like, what if there's like a subclinical STI, they haven't discovered yet. Like my brain really tried to find a reason why I was having these very real physical symptoms and I wasn't getting an answer. So my brain did the creative appropriate thing of trying to find one.
[00:28:47] Deb: Your brain, the thing that you have relied on for so long, which was the part of you that is like saving you from having feelings, being scared, living in that oh, I don't know what's gonna happen. Your brain is trying to show up and do you a solid and be like, here's a bunch of reasons and that are backed with these words from these doctors.
[00:29:11] So like, of course they know better. You can Google them. People are talking about embedded infections on the internet all the time, which I, if I could like do anything, it's like press some button that just deletes all of that. Or redirects people to the ATNS website or to your website and be like, can we just do a global redirect? Anytime somebody searches for that, they just like go over here to where the real healing lives. Because otherwise it's just fear. And then people are in these online communities talking about their very real symptoms. I'm not dismissing or diminishing the fact that these symptoms are very real, but they're talking about them in these incredibly fearful ways.
[00:29:56] And you show up thinking I'm gonna get some answers. And then what you really get is the Godzilla of fear and catastrophizing.
[00:30:05] Rachel: Oh yes. And I was on those message boards, right? I was reading the stories and trying to find answers. What you get is exactly what you're describing, right?
[00:30:13] People who are living lives of absolute devastation and terror for decades. So what I learned later and had to figure out as I was working to accept this neuroplastic diagnosis, is the idea of an embedded infection. I don't really care what it is, right? A embedded or a subclinical infection.
[00:30:30] Same thing effectively. 'cause you can't freaking test for it. It's a trap. There's no way out because you can't test for it and you can't really effectively treat it. So if that's a diagnosis you're choosing to accept, it's really hard to shift because there's no obvious solution and no way to confirm diagnosis.
[00:30:51] And I see people all the time who are committed, I have so much compassion, like I so understand why they feel that this is the answer for them. Also, right? If a doctor is saying, just take this antibiotics for six to 12 months or whatever, they're like, oh, that seems fine. I can do that. If at the end I end up pain free, I have never heard from anybody.
[00:31:12] Well, to be fair, I have a skewed example because I hear people who haven't healed, but like I have not run across anybody who has had long-term symptom resolution from treating an embedded infection or a subclinical infection. I just wanna offer if anyone's stuck in that place, please question where that ends up for you.
[00:31:33] Where, what is the end game here? What is possible for you if that's the direction you're going, because I got stuck there for a really long time, and even as I was healing through a MINDBODY approach, I I would have these intrusive thoughts. And I like, but what if it is an infection? I had two intrusive thoughts.
[00:31:50] Primarily. The two primary ones, I would come back and ping me back into a medical model. Mm-hmm. Which is one, sub clinical infection or two, compressed pudendal nerve. Okay. And those are pretty common fears from people that I hear in the pelvic pain space. Again, they're both kind of in the same spot, which is like, what is the solution?
[00:32:10] Like, where do we end up when we're trying to heal and think about a decompression of pudendal nerve, which people people can get. You can get the procedure to decompress the penal nerve. Most of the time pain comes back.
[00:32:24] Gotcha.
[00:32:25] Rachel: And so I'm not here to tell anyone to do with their care. I was looking at my options and was like, I'm unwilling to do exploratory surgery and and there's no actual evidence of infection that anyone can tell me how to treat. So now what?
[00:32:38] Deb: I just wanna pause here and say two things. One, in hypnosis, we call that a double bind. Mm-hmm. People create double binds on purpose to break people out of that rumination. That cycle of subconscious thinking that kind of goes on its own journey.
[00:33:02] It's almost like once you can see it, this is a double bind. Then we can be like, we're gonna set that aside. Right? There is a cognitive awareness piece that can come when you notice that you're ruminating when you notice that these thoughts are cycling, that we can witness that and even experience the physicality of it, right?
[00:33:23] Because there, it has a certain kind of quality to it. Uh, and you can see like the words that you use, this is a trap. It's like, okay, yeah, I learned a lot when I was a kid. 'cause I'm a Gen X. We thought quicksand was gonna be like more of a thing in our lives. And like we watch the Brady Bunch and quicksand, and then you're like, oh, you just stand up.
[00:33:44] Yes. I love that. I love that. This is how you break yourself out of it. You're like, oh, I'm in quicksand. I just stand up.
[00:33:53] Rachel: Yeah.
[00:33:54] Deb: Like, like if I flail around. I am going to drown.
[00:33:59] Rachel: And I've done that. I've done the flailing. I did it a gazillion times. I was in that process for so long. Yeah. Until I was able to zoom out and be like, oh, there's the quicksand.
[00:34:11] Yeah. You decide. You can flail if you want to or you can stand up.
[00:34:16] Deb: Yeah. And I love how you say it like you decide. So it's not like, oh, here's just another authority telling you what it is or isn't. It's you decide. And I think that is one of the pathways out. And here's the second thing that I wanted to say, which is TMS recovery.
[00:34:34] TMS is the colloquial term for neuroplastic symptoms that was coined by Dr. Sarno. But, this is the medical model. Symptom recovery using these methods is a medical model. I didn't say that to argue with you, but as you said that I was like, but this is science backed, we have studies, we have evidence. This is a science backed process of recovery. So this is a medical model in my point of view.
[00:35:06] I just feel like that's so important to say even if it's not in every doctor's office.
[00:35:12] Rachel: I so agree. Actually the other day I was talking to a client and she was comparing our work together to a visit with a previous very famous pelvic pt. And she's like, yeah, I mean this is so different. Her work was so much more clinical and I was like, interesting. I find our work to be very clinical. Yes, the way that we're doing the work may feel different than you'd expect to find in a clinic. Yes. But I think it's very clinical.
[00:35:41] Deb: I agree with you. And maybe that is a conversation for another day, but I wanted to intervene there because I think we do ourselves a disservice when we are like.
[00:35:53] Even I said the Western medical system or whatever, and I kind of put that over there and I put us over here in a different area, but I was like, hmm, no,
[00:36:03] Rachel: it's not adversarial in the way that we often write. And I say the same thing, right? I have a whole email about why western medicine is doing it wrong.
[00:36:11] For the most part, the systems that have been there for a long time are harming people and not updated with the modern pain neuroscience that we're discussing here. This is science. Yes. It's just not been implemented in the way that it should be in the majority of the Western medical system.
[00:36:29] Deb: Absolutely, because the system isn't just based on science, it's also based on commerce. It's based on a lot of things. It is a slow moving, it's the ship that gets stuck in the Panama Canal or whatever. It moves slowly. So many conversations we can have about that.
[00:36:43] I know. We can just talk forever. Okay. Wait, lemme go back, Rachel, but let's go back to, yeah.
[00:36:48] Rachel: Finish my story. Your story. Segue back. I think I was talking about I had all the testing done and doctors were like, nothing is wrong with basically not, nothing is wrong with you. You have these three diagnoses.
[00:37:00] These were the diagnoses I was given. I didn't mention that I was given three diagnoses throughout my testing, which were unprovoked vulvadynia, pudendal neuralgia, and interstitial cystitis. At the time, those were the most devastating things I could have heard because, they were incurable. Right?
[00:37:18] There's no cure for these diagnoses. What I didn't understand at the time was those were diagnoses of exclusion, meaning they're describing where the pain is and that you've had it for more than three months, not what the cause is. And so I, if I had that knowledge back then, I think I would've had a very different experience to those diagnoses.
[00:37:40] But I was absolutely devastated. Like, I genuinely thought my life was over and I was like, how do we get three of these at once? That's crazy. You're overachiever. Yeah.
[00:37:52] So I had diagnoses and I kind of was done with seeing Western medical doctors. I was like, the things that you're offering me, I'm not interested in.
[00:37:59] You can't tell me why this is happening. And you're giving me expensive, invasive, and temporary treatments that I do not want to try because they don't feel like a solution to me. And so I was like, okay, back to drawing board. And gosh, I never quite know exactly what my next step was because I really genuinely don't remember.
[00:38:18] There's a couple of factors that happened around the same time. One was, I heard a podcast from Nicole Sachs, not her podcast, she was a guest on someone's pod. Oh, that's so retrograde. That was the podcast. Some random like astrology podcast. And Nicole was on there talking about T and I was like, oh my God.
[00:38:41] Is. Is this, it can't be, is it? Right? And she wasn't talking about pelvic pain specifically, but she was talking about all this and she's like, basically any symptom, like it can be anywhere. And I was like, what the pill is? I don't know. And part of my fight for it being biomedical was like, but I have real signs.
[00:39:00] Like I had tissue redness, on urine culture I had trace blood in my urine. I had signs of something happening in my body. And I was really fighting for that as proof that it's not just TMS it's not neuroplastic. And then so with Nicole's like back of my mind being like, okay, she said this, but like, I'm not quite sure.
[00:39:23] I went looking for TMS books and MINDBODY healing books and I found Dr. Ners unlearn Your pain. I, my stubborn aspirin. I really need to hear it from a doctor. Really needed air from a doctor. And he specifically talked about a couple things that were really important for me. One, he mentioned pelvic pain specifically as a commonplace that mind body symptoms present.
[00:39:49] That was really important for me. And he talked about the actual neuroscience brain areas, like speak in my fricking scientifically minded language. And I was like, okay, damn it with me. And I was really honestly like upset. I was like, how am I here again? I thought I healed before. How am I here again?
[00:40:17] I realized that in this time, awareness, knowledge, understanding was not gonna be sufficient. A couple of things. One, I found pelvic pain much harder to navigate from a symptom perspective because you could always have an infection. Mm-hmm. You could always have a true UTI. You could always have true BV or yeast.
[00:40:37] Now I can count on one hand how many times I actually had a true infection. But the thought and fear of what if I'm missing something dangerous? And the symptom actually is indicating true tissue pathology was really hard for me to work through and shake.
[00:40:53] And the other was I had so much fear and shame around the physical sensations themselves. I hadn't heard enough stories yet about people healing from symptoms like mine. But thank goodness Nicole has a podcast, which is fantastic and I found a couple of healing stories on there mostly IC, Interstitial Cystitis but that was enough to be like, okay, there was a handful of stories.
[00:41:19] I then found this podcast called the V Hive, which Nicole also used to guest on quite a bit. And there was like healing stories on there and I was like accumulating this evidence that women have these symptoms and they are mind, body, and they heal. Mm-hmm. And I really needed to know that because that really needed to know.
[00:41:37] It's funny because like now I'm like, oh, symptoms ultimately it doesn't really matter where they are. It's all effectively the same process, but it didn't feel that way at the time. It felt really important that my same symptoms and I didn't find anybody who had exactly the same trifecta. But I found pieces of it that were enough for me to be like, okay. I'm ready to freaking try this because literally, what else am I gonna do? I'd effectively run out of options in any other domain that I was willing to investigate.
[00:42:07] Deb: Like kind of thank goodness. Yes. That you ran out of options.
[00:42:11] Rachel: Absolutely at the time devastated. Right. But retrospectively, I'm so grateful and it's funny, it's hard, like we often talk about how the people who get the worst care in Western medicine are those with no money or a lot of money, because no money Makes sense. We can skip over that. You can't afford services and you get terrible care. It's awful. A lot of money. You can keep getting endless treatments. You can get a million botox injections, trigger point injections, nerve blocks, forever. You can see the pelvic pain specialists a gazillion times get every medication, like do that whole route forever.
[00:42:50] Mm-hmm. I didn't have money. So for me, going down that road, which I looked into, okay, I could maybe spend max 2K, I mean on credit card, right? That's like my possibility for care. And none of that was gonna be 2K. It was ongoing like six K increments at a time with no real hope of resolution.
[00:43:11] In some way feeling financially constrained was a gift that really forced me to be like, okay, that's literally not an option for a whole lot of reasons. How do I help myself now?
[00:43:25] Deb: Okay, so you have some desperation and you have some buy-in and you have some willingness. What was that next step for you?
[00:43:32] Yeah,
[00:43:32] Rachel: so what I recognized in reading everyone's stuff, reading Schubiner's book, and eventually The Way Out came out a little bit later and Nicole's work, and everyone's kind of saying for my purposes the same thing, which is, you need to find authentic safety in the nervous system.
[00:43:48] Long story short. And I was oh, well that's not gonna happen. Because I was chronically unsafe in every way, right? Like, everything felt like danger. My body felt like danger. Other humans felt like danger. My future felt like danger. Like everything, right? And so I missed this part of my story.
[00:44:09] This is such a long story. I'm sorry.
[00:44:12] Deb: Fine. We all have long stories.
[00:44:17] Rachel: So one piece I think is important to mention is I, as many of us do, especially we've had disordered eating histories and try to live in smaller bodies our whole life tried to diet my way out of these symptoms.
[00:44:28] And I had gotten a really restrictive, em frankly embarrassing, diet from the medical medium, which please don't look that up. Which is essentially required that I eat in this really, really tightly controlled way where almost all foods were dangerous. No gluten, no dairy, no soy, no peanuts, no meats. It was like you could eat basically some vegetables and like a, occasionally a bean.
[00:44:56] I think I realized I had made like literally everything a threat. So I had to first name that and say, okay, Rachel, we can't keep living like this. And so I recognized the categories of my life that would have to shift, and they were kind of all of them. But the biggest overarching messaging is I had to learn to trust myself in every way.
[00:45:20] How I feed myself, how I move my body, how I relate to others, how I can protect myself like I was a people pleasing boundaryless perfectionist, as so many of us are, right and so this patterning, pervaded everything that I did. My system was living in chronic unsafety because I was literally self abandoning at every turn and being very hard on myself with every result.
[00:45:43] And so I had to consistently work to shift that patterning. That took time and that took repetition, and that took practice.
[00:45:53] Deb: That's neuroplasticity. Oh my God. I just said these words to a client this week and I said, it's time, it's repetition, it's practice. Because we have been subconsciously practicing, as you said, this lack of safety our whole times.
[00:46:10] Not on purpose, but because of this kind of existential misunderstanding, right? Of what creates the idea of safety, which is like barricading ourselves, a away and then ruminating, fixating
[00:46:25] Rachel: Yeah.
[00:46:26] Deb: On this idea of safety rather than cultivating a felt sense of it, which means coming in contact with a lot of, not feeling that like a lot of feeling the feelings we don't wanna be feeling.
[00:46:40] Rachel: Yeah. Such a big one. I really had to go through a process of befriending my body and not hating it. And not pathologizing it. And not restricting it. And part of that was healing my disordered eating and eating disorders. I had to stop the behaviors of constant fixing and restricting.
[00:47:00] And that took me a really long time to accept because the thought of getting fatter felt impossible to accept. That was a piece of work I had to do in order to heal. And I resisted that for a long time.
[00:47:15] I had to learn to set boundaries in dating. That was a really big thing for me. 'Cause I literally did not know how to say no to people. And it got me into literally dangerous situations and my nervous system demanded that I learned to use my voice or my body would set the boundaries for me. This would happen in so many parts of my life where I recognized, we say this phrase pain is protection, but I deeply had to understand that and partner with it in order for it to shift.
[00:47:44] And that's building a relationship. That requires building of trust. And relating to pain can feel impossible in the beginning because you just want it to go away That's how human of us Right.
[00:47:58] Deb: Number one greatest wish
[00:48:00] Rachel: to not feel pain.
[00:48:02] Yeah.
[00:48:02] And what I, I realized like, I listen, I try to not feel it. I, we all try that, right?
[00:48:07] It doesn't work. And so again, I am very stubborn and I don't like, like giving up or quote unquote surrendering. And so the work to learn surrender and acceptance and compassion and all of that was the hardest work of my life and the most important work of my life.
[00:48:25] I don't like the phrase when people say, I understand why they say it. And they're like, I'm so grateful for my pain. I'm not grateful for having pain, it stucked. It was awful. I wouldn't wish it on anyone. But I am grateful who I became in the process of healing. And that's rooted in myself. Which would've been impossible with who I was before.
[00:48:46] Deb: That's so powerful. And you have achieved the end result that you were wanting. Which is no longer having chronic symptoms. You're still chronically human.
[00:48:59] Rachel: Human. Yeah. It's funny too, 'cause I always say one of the biggest gifts of this journey is literally not being afraid of pain anymore because like human bodies feel pain sometimes.
[00:49:10] That's just literally human and normal. But what makes pain chronic is our fear, worry focus. The worry that it's going to last forever and, and once you understand neuroplastic pain in the process of how it becomes, if something comes on like a headache or a little bit of like an ache here or there, I'm like, oh, hello, what's going on?
[00:49:32] Deb: Seriously, I have had this slight nausea the last two days and I could feel, I had like two brain responses. The one brain response was like, oh my God, I can't believe this is happening. What does it mean? Oh, I can't, I don't want it to be this thing or become something. And then the other part was like, oh, hi.
[00:49:51] Rachel: Yes,
[00:49:52] Deb: yes. What do ya need? I love you. It's not my favorite feeling, but clearly there's some attending, attuning.
[00:50:02] Rachel: Mm-hmm.
[00:50:03] Deb: And I, and as soon as I was like, oh, you need a little bit of attunement. I was like, yeah, of course I do.
[00:50:10] Rachel: Yeah. So good. So good. It's like a turning toward
[00:50:15] Deb: Yeah,
[00:50:15] Rachel: right.
[00:50:16] Rather than a running away. And that goes into every part of our lives, right? Like a turning toward instead of running away. I am deeply grateful for that.
[00:50:24] Deb: Yeah. And now we're speeding through because we could talk about this forever. I know. But being on this side now where you help people, can you say a little bit more about, 'cause I know that you work with people one-on-one, but you also have Yes. Like different ways that you, you help them. Yeah. Yeah,
[00:50:43] Rachel: so I love supporting people in all of the ways I do, work with clients one-to-one. I have a course that just came out about a month ago, leading people through the process that I really guide clients through, but like in a structured way where they can watch the videos, do practices, and support themselves with the journey.
[00:50:59] And I also have a group coaching offer that launches about twice a year. I love working with women in really every context, but I like that one-to-one is like the individualized guidance, support, and attention, right?
[00:51:11] Like everyone's journeys are so unique and I think feeling really seen and heard and validated and really affirming that you are not uniquely broken. What's happening for you is so real. And so individual. And so, in need of being validated, right? And I see you and you can do this too.
[00:51:30] Then in a group, what I like is, gosh, the community there is so much loneliness and shame and hiding that happens so often with chronic pelvic pain. And as you mentioned before, the the, the spaces where people are talking about it, not optimistic, not supportive, not accurate, really.
[00:51:50] Right? And so I love bringing women together who are trying to do this work together and seeing like they are not alone. I think that's such an important thing that I wish that I had experienced in my own journey. And yeah, the course I just came out, I'm really excited about it. I really wanted to find a way to make this information more accessible and really allow people to understand pain, befriend their body, reclaim pleasure, re-engage in life.
[00:52:17] And really walk them through how to do that for themselves.
[00:52:21] Deb: Oh my God, I can't believe we didn't talk about pleasure. I
[00:52:25] Rachel: know. Another, another opposite.
[00:52:26] Deb: Another opposite. I know. Seriously. It's, , it's, oh, how do I even describe it? In a lot of different recovery processes, right?
[00:52:36] Like recovering from eating disorder. Even in like PRT, right? We have like positive affect induction, right? The way that pleasure is both an innately part of our human experience. Yes. But also how we can use it as a tool. To both amplify, self connection, connection with others. Maybe we need to have a, like a whole conversation like diving deep into pleasure, because also like in my own reclamation of my, sex and sexuality as a postmenopausal mm-hmm. Like, I've had to change my relationship to pleasure. Pleasure has been like a, oh, I just used to be there all the time.
[00:53:15] And now I'm like, oh, where'd you go? Hey hormones. What the hell is happening? And, yeah, it's different. It changes over the course of our lifetime, it's so important in this work.
[00:53:27] Rachel: Yes, absolutely. And even expanding it right to rest and play and joy and like the states of the nervous system that signal safety.
[00:53:38] Deb: Oh my god. Nailed it. Even expanding, because I do think that's important when we talk about pleasure, not just to have it be siloed in sex and sexuality.
[00:53:48] 'cause then that's makes it easy for people to be like, well that's not for me,
[00:53:51] Rachel: not possible for me. Or either I don't want it or it's not possible for me.
[00:53:55] Deb: Right.
[00:53:56] Rachel: And it's like, let's, like, let's make a menu of options of how we can include pleasure into your life while you're healing.
[00:54:03] Deb: Yeah. We will put a pin in that. We will have that conversation. 'cause I think that's, definitely part two. In the show notes, there'll be the link to all of your stuff, all of the different ways that people, can work with you.
[00:54:18] One thing I didn't mention is Rachel and I, along with some other people, have a weight stigma and neuroplastic pain working group. And we are going to be presenting at the A TNS conference, which is the Association for Treatment of neuroplastic symptoms, and we are going to be talking about weight stigma and how it factors into symptoms and how understanding weight stigma factors into recovery and sharing that world with this community. And then hopefully we're just gonna continue to grow it.
[00:54:54] Rachel: We are having this working group and we're very excited about it and really opening the conversation in both sides of the aisle, right? In the neuroplastic world and in the weight stigma world we're talking about neuroplastic symptoms.
[00:55:06] So like making sure everyone knows about each other and how to best support people who need this work. Yeah.
[00:55:15] Deb: Recovery is possible. There is this kind of subtle messaging for people in larger bodies that somehow your body is so uniquely different than anybody else's, that you can't possibly use these techniques to feel better. So from that point of view, from like always giving people the message, the hope and the belief and the knowledge that they can recover from their symptoms, what do you wanna tell people so that they can hear that and like tuck it away in their brain? Wherever they are, there's a little Rachel message that they can come back to when feeling confused or overwhelmed.
[00:55:59] Rachel: I wanna say this kind of in two ways. One, for people in larger bodies who are afraid that their weight is the reason they can't heal.
[00:56:05] I healed in a fatter body then I started, I actually gained weight in the process of healing. And that's because that's what my nervous system needed to create safety is to recover from disordered eating. So the weight was never the problem, I thought it was before, but actually the problem was I was feeling chronically unsafe.
[00:56:26] And so body size in and of itself is not the problem. The beliefs around your body size are often a much bigger factor in the experience of pain and the internalized weight stigma, which I had to work through as well. For those for whom weight stigma is not part of their current experience as far as they know, healing is possible for you.
[00:56:50] If you have a human brain, you can heal your neuroplastic pain. It's just a matter of finding what does your nervous system need to feel safe and just moving towards that one baby step at a time. It doesn't have to be big leaps and bounds and have to be any major huge life change, but moving towards self-honesty and self-trust and really just self-support one little baby step at a time and best you can releasing the timeline.
[00:57:22] Everyone hates that. Everyone wants to know when exactly. And I'll do this for X amount of time, only if I get X result by that time. And I played that game for a long time and it made me feel awful and want to quit. So I just wanna offer, it is very human to want to know when it's very human, to want it to be fast. And best you can working to release urgency is the fastest way forward. I'm rooting for you always. I know you can do this.
[00:57:50] Deb: Chef kiss. Beautiful. I think that, that's it. Thank you so much.
[00:57:55] Thank you for having me. You so generous. I really appreciate it. I love the way that you conceptualize and communicate all of this and it's rooted in so much love and grounded in humor and, it's still hard to share these deeply personal stories. But thank you so much. 'cause they help so many people.
[00:58:16] Rachel: Thank you for creating a safe space for me to share. And I feel same about you. You're like my favorite brain. Always a pleasure speaking Deb. We always have the best convos and happy to have this one recorded.
[00:58:26] Deb: That's so great. Everybody's so lucky that we are here having this conversation.
[00:58:31] Bye.
[00:58:32] Rachel: Bye.