Lauren Mansell, DPT, CLT, PRPC is the author and instructor of Trauma Awareness for the Pelvic Therapist, a course now available remotely. Lauren's next offering of her course is coming up this May 1-2, 2021

Working with survivors of sexual violence has been the most challenging and rewarding aspect of my pelvic rehabilitative work. I am fortunate to have been trained as a legal and medical advocate for sexual assault survivors and worked within mental health prior to becoming a physical therapist. I hope to give everything I know about being a patient centered trauma aware practitioner. Can we talk about how common sexual violence is within our society and within our work? I can spout the statistics: 1 in 3 females and 1 in 7 males report unwanted sexual attention; 1 in 6 females and 1 in 33 males experience sexual assault.* But in our rooms, sexual violence is pandemic.

Please feel empowered to provide appropriate, trauma-informed support to these patients. It starts with our wellness and self-care. We cannot empower others if we have not empowered ourselves. We don’t have to be perfect. Practice self-forgiveness. Know your triggers. Commit to impeccable self-care. Be well. Keep ourselves safe by practicing empowered choice. If you have empowered choice, you can provide and teach empowered choice to your patients. What is empowered choice? Empowered choice is saying: we don’t do anything you don’t want to do or I don’t do anything I don’t want to do. Ever. Give your patient the power of directing their healing while providing extensive physiology and anatomy education with trauma-focused, patient-centered care. With information, patients choose what they want treated when. And with empowered choice, they tend to choose higher level treatment quicker. Additionally, they may show up to more appointments and, from my experience, they get better faster. I know we all do this with informed consent, but I have found success with being immensely purposeful in repeatedly telling the patient that they are in control of the treatment. Patients are completely in control of the treatment, not to be confused with being in control of me.

Last week- on May 6 amid a pandemic- the Department of Education released changes to Title IX. Title IX is a 1972 Civil Rights Act that bans sexual discrimination within the educational system. Sadly, the new provisions within the 2,033 page document include the following changes:

• Narrows the definition of sexual harassment
• Reduces options to survivors of sexual assault, dating violence and stalking
• Reduces liability of colleges and universities
• Reduces mandated reporting of sexual violence
• Deregulates federal guidelines to protect sexual violence survivors
• Changes the ‘standard of proof’ from ‘preponderance’ to ‘clear and convincing’
• Bolsters protections for perpetrators
• Allows for live hearings and cross examinations of the assault survivor
• Only investigates if assault reported to ‘certain people’

23% of undergraduates and 11% of graduate students report having experienced sexual violence, AND we know survivors under-report assaults. We talk extensively about medical and legal considerations for sexual violence survivors in my "Empowering the Sexual Assault Survivor" course. Participants who took my course will need to know those protections we discussed just a few days ago are slated to be rolled back. Today, in my remote course "Trauma Informed Care", we lay the physiological and neurobiological framework for empowering the sexual assault survivor. Following that, in addition to how to continue empowering for survivors, we elaborated on the legal changes listed above.

Outrageously, these Title IX deregulating provisions are to go into effect August 14, 2020 while schools are struggling to keep students safe amid coronavirus pandemic.  Again, let us look at these percentages (23% of undergraduates, and 11% of graduate students) and think about who needs safety and protection.

It’s OK to be feeling (insert feeling) right now. (maybe: sad, fearful, angry, denial, numb, anxious, avoidant, bored?)

It’s OK to acknowledge those feelings.

It’s also OK to create a plan and direction about what we may do about our feelings, thoughts, and actions.

I work at University of Chicago and we are in the throes of preparing for a (big T) Trauma Center. But I am physical therapist who works with (little t) traumatized patients- as I treat only pelvic or oncology patients (and usually both).

From the online dictionary: Trauma is 1. A deeply distressing or disturbing experience (little t trauma) or 2. Physical injury (injury, damage, wound) yes- big T Trauma. In my experience, the Trauma creates the trauma and the body responds in characteristically uncharacteristic ways (more on this later).

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.