Holly Tanner Short Interview Series - Episode 3 featuring Lauren Mansell

Lauren Mansell shares, "We're never ready to do this work. We're never ready to be perfect." Her course, Trauma Awareness for the Pelvic Therapist, is for all practitioners, not just physical therapists. Anyone licensed who works with patients can benefit from this topic. However, it can be offputting to put ourselves into a vulnerable position by registering for a course on this topic. Lauren understands this and comes prepared to teach other practitioners about trauma-informed care in the gentlest way possible.

Lauren Mansell, DPT, CLT, PRPC, CYT curated and instructs this course. Lauren worked in counseling and advocacy for sexual assault survivors before becoming a physical therapist. She also brings her experience as a 2017 Fellow of the Chicago Trauma Collective to teach trauma-informed care to medical providers. Trauma-informed care is especially important as the field of pelvic rehabilitation becomes more inclusive.

Pelvic rehabilitation and pelvic therapists really do treat the whole patient. Patients can present with pain, long-term issues, and undisclosed trauma that can be compounded when it includes sex, bladder, or bowel issues. Trauma Awareness for the Pelvic Therapist addresses several topics under this umbrella and spends time on each of the following:

• Explaining and describing compassion fatigue, trauma-informed care as well as anatomy, neurobiology, physiology of trauma, and the polyvagal autonomic nervous system
• Identifying risk factors and Adverse Childhood Experiences (ACEs)
• Formulating techniques for reducing compassion fatigue, secondary trauma, and retraumatization

To learn more about trauma-informed care join H&W this weekend at Trauma Awareness for the Pelvic Therapist this September 25-26, 2021. The course will be offered again in 2022 if you are not available this weekend!

When looking through past blogs from The Pelvic Rehab Report, I ran across this gem submitted by Lauren Mansell explaining Trauma-Informed Approach and her course Trauma Awareness for the Pelvic Therapist. While it is not policy to recycle past articles, this was too good not to share again. Lauren succinctly explains the Trauma-Informed Approach that is instructed in her remote course, Trauma Awareness for the Pelvic Therapist, and it is as pertinent today as it was when first published in 2018.

[as written by Lauren Mansell]…

In my experience, trauma creates the trauma, and the body responds in characteristically uncharacteristic ways.

People in distress/trauma-affected do not respond rationally or characteristically, so I have learned to respond to distress/trauma in a rational, ethical, legal, and caring manner. Always. Every time. To the best of my ability, and without shame or blame.

Let’s talk briefly about Trauma-Informed Approach. This is a (person), program, institution, or system that:

• Realizes the widespread impact of trauma and understands potential paths for recovery
• Recognizes the signs and symptoms of trauma in clients, families, staff, and others affected
• Responds by fully integrating knowledge about trauma into policies, procedures, and practices
• Seeks to actively resist retraumatization

The tenets of Trauma-Informed Approach are:

• Safety
• Trustworthiness and transparency
• Peer support
• Collaboration and mutuality
• Empowerment, voice, and choice
• Cultural, historical, and gender issues

Trauma specific interventions:

• Survivors need to be respected, informed, supported, connected, and hopeful- in their recovery
• Interrelation between trauma and symptoms of trauma such as substance abuse, eating disorders, depression, anxiety, musculoskeletal presentation, and acute crisis- including suicidal/homicidal ideations (coordination with other service providers)
• Work in a collaborative way with survivors, families, and friends of the survivor, and other service providers in a way that will empower survivors.

Types of trauma are varied, but I usually treat survivors of emotional, verbal, sexual, and medical trauma. I have even treated patients who felt traumatized by other pelvic floor physical therapists (again, no judgment). Since most of my clinical experience includes sexual and medical trauma survivorship, I try to reframe these experiences as potential post-traumatic growth, especially when working with my oncology patients. For my pelvic patients who divulge sexual trauma, I don’t dictate or name anything. I allow the survivor to make the rules and definitions. Survivors of sexual trauma need extra care when treating pelvic floor dysfunction.

First, when treating survivors of sexual trauma: expect ‘characteristically uncharacteristic’ events to occur. These include the psychological/somatic effects of passing out, flashbacks, seizures, tremors, dissociation, and other mechanisms of coping with the trauma. Have a plan ready for these patients.

Triaging the survivor to assess their needs, when trauma has been verbalized/disclosed:

• Are you safe right now?
• Do you need medical treatment right now?
• What do you need to feel in control of (PT session/immediately after disclosure of trauma)?
• You have choices in your treatment and in your response to trauma.
• I believe you.
• Lastly, is this a situation for mandated reporting?

After assisting the survivor in their journey towards healing, it is imperative that you take care of yourself. Make healthy boundaries (with patients and others) and take time to decompress, create healthy ritualistic behaviors, mindfulness/relaxation, and somatic release (like yoga, massage, or working out). These are crucial to successfully treating patients who have experienced trauma and who have shared that trauma experience with you.

Because I use gentle yoga for both my trauma survivors’ treatment and for my own self-care, my course implements evidenced-based trauma-sensitive yoga. Additionally, modifications for manual therapy are explored. The class is designed to be informative and experiential while integrating the Trauma-Informed Approaches of Safety, trustworthiness and transparency, peer support, collaboration and mutuality, empowerment, voice and choice and cultural, historical and gender issues.

Join Lauren Mansell and H&W to learn more in the remote course Trauma Awareness for the Pelvic Therapist, scheduled for September 25-26, 2021.