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The Missing Piece for Vocal and Pelvic Floor Dysfunction

25 minute listen
pelvic floor dysfunction


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About the Episode:

It’s time we came to terms with the fight or flight response. We must learn to keep it for life threatening emergencies only. As women in our society, who are constantly stuck in this fight or flight response. We find ourselves getting stuck. Stuck in an unhelpful stress response that most of us don’t know how to get out of.

All of this wreaks havoc on our voice and our pelvic floors.  This constant high stress puts a vice grip on your voice, neck, pelvic floor, and even your diaphragm. And it’s absolutely impossible to thrive in this kind of state.

So what do you do about it? It starts with knowing your triggers. From there…so much can change, for the better!

Check out this podcast episode to learn more!


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Quotes/Highlights from the Episode:

  • “What does stress feel like in your voice to pelvic floor connection? Because that is the first step in being able to tell your body that fight or flight, or freeze or fawn.”
  • “If you’re having any of those pain situations, it actually could be manifesting itself just from your stress response alone, not from anything you did wrong in the back or the pelvic floor, right?”
  • “Telling your body, look, fight or flight is for life and death situations, not for answering this email, not for answering this phone call or text. Sometimes just saying that gives you enough self-compassion and actually humor in the situation to go, look, it’s just an email. It’s just a text.”

References

  1. Season 3 – Episode 5 (Part 1 of Stress and Meditation)
  2. YouTube Voice to Pelvic Floor Playlist

Want to work with Dr. Ginger?

  • Work with her directly through Garner Pelvic Health – she offers exclusive Intensive Care treatments if you are out of state/country and has limited openings. First consult is free.
  • Get our on WAITLIST for Dr. Ginger’s V2PF (Voice to Pelvic Floor) membership program PLUS when you sign up you will get the Learn to Breathe Guide as a thank you for signing up!

Transcript for the Episode

Hello everyone and welcome back to the Living Well podcast. I’m your host Ginger Garner. Okay. What I really want to say is, okay y ‘all, I have a question, a question that we have maybe not asked in this way, but we have asked ourselves this again and again and again. 

And the question is, how do I tell my body that fight or flight is for life and death situations and not for answering email or your phone. And although it seems funny, It’s like a funny not funny, right? Because it’s true. 

This is part two of meditation for stress management. And I want you to think about it as kind of A:  what does stress on mindfulness look like? When you’re mindful, stress does begin to dissipate. But as I said in previous episodes, it does not mean that the goal is elimination of stress. That would leave us like a little, just a puddle on the floor because it would leave us incapable of having any healthy coping mechanisms because if you never have stress, how do you develop coping mechanisms, right? 

But on the flip side, if all you ever are introduced to is stress, right? Then you could develop coping habits, habits that are not sustainable. Where you stay stuck in fight, flight, freeze or fawn. Where you’re afraid of conflict. And so you just people please, people please all the time to avoid conflict.

Or you could be on the flip side, you know, a person that avoids conflict and then just blames it on everybody else. But you usually bump up against barriers in your life that will let you know that that’s happening. Because you can’t exist in the world and have colleagues and friends and relationships and romance and stuff like that if you’re just blame shifting all the time, right?

So that’s where we check ourselves, right? That’s where we check ourselves and go, ooh, am I the problem? Or is this genuinely something that I can step out of because it isn’t my problem? And it’s useless to spend your energy on a situation that you can’t control.

So our stress on mindfulness requires us to ask that question, is this something that I can control or am I trying to control other people’s emotions or responses? It’s not that you’re trying to control the situation, but you’re putting yourself in the shoes of being responsible for how they respond. And then you’re like, when they respond poorly, you feel responsible. You need to go fix it. You need to explain it the right way. You need to…

buy a gift, you need to do something, you need to continue to try and resolve the situation. When honestly, that situation and the way that other person can, you know, the situation rolled out was you were never in control of that to begin with. You were never in control of or responsible for their emotional response essentially.

So now that requires us to ask a little bit deeper of a question. In part one of this, so you can go back and listen to the previous episode if you didn’t catch it, part one of the meditation for stress management. 

In part one, we went over the vice grip relationship on how the voice and pelvic floor are connected. And then I walked you through kind of a three diaphragm approach to just experiencing somatically what’s going on. 

But what we didn’t talk about and what we’re going to do now to dive deeper is what are your triggers for voice grip and pelvic grip? So if you have a voice grip, you’re going to have a vice grip on the neck and the orofacial area, which might mean you have jaw issues or headaches or neck pain or not great vocal quality, or you can speak but not for long before you lose your voice.

So we need to ask, what are your triggers for voice grip and pelvic grip? Now between the voice and the pelvic floor, you do have the respiratory diaphragm. So you could throw in there, you know, diaphragm grip as well. But I think you get my point, right?

So what situations trigger that voice grip? Is it speaking up? Is it sexual health? Is it work stress? Is it personal relationship stress?

What is it? You need to write it down or at least reflect on it. Because unless you know what those triggers are, you won’t be able to change your response to them when they happen. So what are your triggers for voice grip and pelvic grip?

Now keep in mind, from a body experience situation, it could be related to the senses. It could be a sound. It could be a certain song. It could be a smell. It could be a taste.

So you kind of have to peruse your senses, your five senses to determine if it is one of those senses that’s triggering. The other thing that it could be is the memory because we have an unlimited capacity to store those memories and to hang on to that trauma.

 Now we briefly touched on epigenetics before, but it’s a real phenomenon. And we have to harness the science of it to practice two things. Self-compassion and awareness, self -awareness. So if, epigenetically, you look back and you’re looking for triggers, right? We’re still looking for triggers. If you look back in your family history, is there anything that happened to your parents, your mom, your dad, your grandparents,their parents?

Is there anything that happened to them that could really weigh heavily or manifest itself in your modern life? For example, my grandmother. Well, really all my grandparents. But I’m thinking of a specific scenario that led to a particular behavioral pattern for my grandmother that it arose from the fact that she grew up during the Great Depression.

So that made her choose things and maybe do things that weren’t always super healthy, right?

So if you think about that, like my grandfather was in World War II for four years, you know, then they grew up in the Great Depression, that’s a lot of stuff happening. Then you begin to understand why some things trigger you that don’t trigger other people and it’s okay.

That’s where self -compassion comes in. You’re building awareness, enough awareness to know that things have happened to your family members that will manifest itself in you.

I remember a particular trigger and let’s define trigger for a second. A trigger is something that will elicit a response in you that puts you into fight, flight, freeze or fawn. But it doesn’t do that to other people, right? Because it wouldn’t be a trigger. Let’s just say if it was a trauma that would be shocking to anyone. 

So if someone was treated poorly or if they were in a car accident or if they lost someone or they lost their job or whatever, that’s not a trigger. That’s traumatizing for everyone, right? So we need to accurately define trigger first because people, I think, overuse the word. So a trigger is something that happens to you, puts you in a stress response you don’t like, but it’s okay with other people.

Okay, so going back to your triggers, you’re building awareness by being aware that epigenetics, that your genetics basically can manifest itself in you in a way that’s not positive, in a way that’s negative. And that’s where you begin to then say, okay, what are the resources that I need to seek out in order to help me not be triggered by that?

And to choose a pattern, a habit, a lifestyle choice, whatever it is, that helps me manage it until the trigger isn’t a trigger anymore, because that’s the goal, right? Separate that out from being traumatized, from experiencing trauma, which is something that would be hard for anyone, losing their job, losing a marriage, a relationship, losing a loved one, right? Going through a natural disaster or hurricane, for example.

Many of those I’ve been through, that’s why that popped up in my own subconscious. That those things would be hard for anyone and although you may end up working through them in a similar way. You tend to have more compassion on yourself and for yourself when it’s something that you know would bother anyone, like being in a car accident, for example. 

And then somehow when these triggers come up, we tend to not be self-compassionate and we tend to really give ourselves a hard time. So I would like to invite you to shift that thinking a little. Shift the thinking and know that, okay, I’m in flight mode. I just want to run away, right? I just want it to all go away. Or freeze mode, where you have analysis paralysis and you just can’t take the next step. It feels so hard.

Or you’re in the scenario, you stay in that scenario, and then you choose to fawn or people please. And then the one that’s the most exhausting, well, I won’t say it’s the most exhausting. I think it’s the most acutely exhausting is trying to fight it out. Fight back constantly. 

Now I want you to ask yourself another question. If you know which one of those four patterns, those four stress patterns, fight, flight, freeze, or fawn that you go into most often with the most bothersome trigger. I just want you to pick that out, the most bothersome trigger right now, what do you tend to go into?

So you may need to take a few breaths, close your eyes if it feels appropriate, and think about the wicked problem you’re having right now. What’s the biggest issue? It could be a trigger, it could be a combination of trauma and a trigger.

When you have it in your mind and you take another big breath. What mode do you go into? Fight, flight, freeze, or fawn?

And you may say, well, Ginger, it’s actually more than one. I start out trying to manage it and just stay in it and people please. And then when I get absolutely frustrated or exhausted, I can’t take anymore. I go into freeze mode and I just stop responding. I become kind of robotic because I’ve already exhausted the fight and the flight. And that’s an honest answer and that might be your answer and that’s fine.

But now I want to ask you a deeper question. It’s okay to have more than one stress response to a trigger, to your wicked problem that you’re thinking about right now. But now let’s go a level deeper. You’ve given yourself compassion. It’s okay to be in freeze one day and then fawn the next. You might vacillate between two coping mechanisms that aren’t necessarily sustainable.

When you’re in those coping mechanisms, what does it feel like (this is the next question) in your voice and pelvic floor?

In your voice, it just may feel like speaking less. You’ve exhausted the fight and now you’re just accepting it, which is not a bad thing. You could be in the middle of thinking through how you’re going to respond next. And so you’re just not putting any more energy into using your voice in a scenario where it’s not yielding any change. 

That’s practicing enormous, incredible, amazing self-compassion and that’s not something to beat yourself up about. It’s something to feel good about because you have recognized with self-awareness that speaking up hasn’t done any good. It’s actually exhausted you, fatigued you, maybe cost you, maybe even very costly. And now it’s just time to sit, have self-compassion and go, what’s the boundary that I need to set next in order to take me to the next level? Right? Digging out of the hole, right? 

Telling your body, look, fight or flight is for life and death situations, not for answering this email, not for answering this phone call or text. Sometimes just saying that gives you enough self-compassion and actually humor in the situation to go, look, it’s just an email. It’s just a text.

I know this person or this situation is trying to get at me again and I’m just not going to let it. I’m not gonna give them the power to do that to me, right? You’re not gonna give up your power. But that’s in the voice, right? In answering, you might feel some of that tension in the voice. The voice, you may literally lose your voice or use it less or speak up less.

What about in the pelvic floor and the core? What does stress feel like in the core and pelvic floor? I’ll tell you what it looks like when I see it in patient care.

When I am taking care of the lovely people that are entrusting me with their mind and body. I will use imaging and practice to literally look with ultrasound imaging and see, visualize where they’re holding that stress. And it usually is somewhere in the voice, in the core, the respiratory diaphragm, or the pelvic floor. 

Now, in the pelvic floor and the respiratory diaphragm, the little connecting point between them from a muscular and fascial perspective is something called the psoas or the hip flexors. I like to call it the snarky psoas. So if your hip flexors get tight, then maybe that’s where you hold that fight or flight tension, right? Intimately connected to the pelvic floor. Maybe it is the pelvic floor. What does that feel like?

Well, what it feels like is back pain, sacroiliac joint pain. If you’re female, difficulty trying to like insert a tampon or having anything inserted at all. So painful intercourse, which is called dyspareunia, it could be that. It could be hip pain. It could be even what you think is a hamstring strain or a groin pull or strain.

And it actually turns out to be pelvic floor. I’ve even had people come in thinking they had a knee problem and it was actually one of the deep hip muscles connected to the pelvic floor, which is called the obturator internus.

So you know your body better than anyone else. If you’re having any of those pain situations, it actually could be manifesting itself just from your stress response alone, not from anything you did wrong in the back or the pelvic floor, right?

So it gives you hope, right? It gives one hope. It gives me hope that, of course, I know when I feel a particular muscle in my pelvic girdle, I know what it is, that’s what I do for a living. As a pelvic ortho PT and like, yep, that’s just my quadratus femoris or that’s just my pectineus or iliacus or whatever. So that might be the point where you go, I feel it in my pelvic floor, I’ve got this back pain and this hip pain, Ginger described, but I don’t know what to do with it.

Your next step would be, well, how do you mitigate that? It could be, and often is, that breath work is your first step. So in the show notes, I’m going to put a link to my free guide to breathing. And the next level up from that would be, of course, paid guidance towards functional integrative lifestyle medicine and all the things that you can do to self-treat.

And then the third tier level of that would be, well, gosh, maybe I need to actually seek out a voice to pelvic floor expert and start really working on this because it does take a holistic approach. 

It’s not just about. Definitely not just about doing a Kegel or stretching the pelvic floor, that kind of thing. If only it was that easy. The care that you deserve should be trauma informed for the voice to pelvic floor connection, for changing your stress response, right? So my take home message for you is in part two of this meditation for stress management is that get used to feeling what stress and tension is like in your voice to pelvic floor. 

So this part two of meditation for stress management is less of a meditation, although it is mindfulness practice. It’s less of a meditation and it’s more of a question. What does stress feel like in your voice to pelvic floor connection? 

Because that is the first step in being able to tell your body that fight or flight, or freeze or fawn is for life and death situations and not answering a simple email or a phone call or text.

It lands heavy with me as the person sharing this with you because it applies to me, right? I’m applying this stuff to me. I haven’t somehow elevated, you know, to some sage wisdom status. It’s talking to myself, it’s talking to you. It’s realizing that every day we call these kleshas  or obstructions to practice in yoga philosophy.

And in yoga philosophy, one of the things you’ll learn is that these obstructions to practice, 

Ignorance
Claiming to things that are temporary, right? 
Valuing the temporary body too much or materialistic things. 
Being averse to something that may actually be good for you.

Those are the four aversions. And they’re never conquered. As long as we live on this planet, we are not going to conquer all four of those obstructions at all times. They’re going to be present in some way. 

But the worst one of all would be avidya, ignorance. Of pretending like there isn’t a problem. Or pretending like there’s no more growth, right? There’s nothing that you can do to change things. Or pretending like, or telling yourself that…you’ve already learned everything you need to know, right? 

I think maybe a shared core value of a wise person or wise people would be curiosity and a love for making things better, for being better. And that could just be described by being curious. So I want you to just be curious. This is your mindfulness practice. Be curious. 

When you’re stressed, where do you feel it in the voice?

Where do you feel it in the pelvic floor?

And then determine how you’re going to mitigate it. Will it be free resources on my YouTube channel? I have several playlists for it. You can go to my voice to pelvic floor playlist to get started. Will it be seeking out care from one of the paid programs that I have? Will it be seeking out a voice to pelvic floor expert in your area?

I don’t know, I can’t tell you that. But I do know that you’re going to experience next level transformation once you are able to fully understand what tension feels like, what the stress response feels like in your voice to pelvic floor. And that’s the beginning of some fantastic living. So I encourage you to get out there, feel all the feelings. 

And the next time your body wants to go into fight or flight, when there’s an email to answer or a phone call to pick up, take a breath. Notice how your voice to pelvic floor is feeling. Maybe just send a message to them. It’s okay.

And that may be the very first step and the only thing, the biggest thing, the most important thing you need to do to turn your stress response around.

Until then, until next time, keep living well.


Dr. Ginger Garner, DPT
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ABOUT THE AUTHOR

Dr. Garner is a passionate, unapologetic advocate of improving access to pelvic physical therapy, a mother to 3 sons, & a 25+ year veteran in Functional, Integrative, & Lifestyle Medicine-based physical therapy. She is the author of Medical Therapeutic Yoga, Integrative & Lifestyle Medicine in PT, founder & CEO of Living Well Institute, owner of Garner Pelvic Health, and loves making music and adventure seeking outdoors as often as possible.

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