Case Study: When Symptoms Do Not Change
I love sharing interesting case studies with you as they can provide a different perspective on working with clients. Here is a perfect example that demonstrates when the physical releases donāt get you anywhere with your clients and symptoms remain unchanged, you need to dive deeper.
Client History and Birth Story
This was the client’s third time coming in to see me in 5 years. She came in for her first treatment session in 2019 when her baby was 4 months old. She complained of C/S scar pain, and that she couldnāt wear jeans as her whole lower belly was tender to the touch. She had a history of painful intercourse even prior to becoming pregnant.
The client’s birth story began at 41 weeks when she was induced due to baby being late. During the induction, her babyās heart decelerated, and she had to have an emergency Cesarean. During the surgery, they couldnāt get the baby out, so they used suction to remove the baby from the pelvis. The cord was wrapped around the babyās neck. The baby had to spend 2 days in the NICU.
Assessment and Treatment Sessions
When I saw this client for her first visit in 2019, her nervous system was very elevated. Her scar tissue from the Cesarean was restricted and tender. There was a lot of trauma being held in her system, and it seemed to me that her body didnāt know her baby was okay – that it had survived birth. In that first session, I believe about 80% of her tissues released, but there was still something holding on that we were unable to access in that session.
In 2024, this client came back because she was trying to get pregnant again, and she still had similar symptoms as she did before. She complained of continuing to have deep penetration pain with intercourse, and she was still having some pain in her Cesarean scar tissue. In this session, I did more physical release work with her on her scar tissue. I also did internal work on the tissue addressing her cervical mobility and pelvic floor muscles.
Four months later in 2024, the client returned saying her symptoms had not improved. She is still complaining of deep penetrative pain. In addition, she had gotten into a car accident in the timeframe between her 2024 visits and was experiencing low back and neck pain. She had been seeking treatment for the back and neck pain with a chiropractor and was feeling some relief in those areas. She, also, reported that her sacrum hurt when she was lying down.
When the last session with a client does not change the pain in any way, this is my red flag warning to myself. When the pain does not change or returns almost immediately after I have approached the body physically, it is my indicator that I am not going to continue to work with the same approach. I need to dive deeper.
Diving Deeper With The Client
As part of a deeper dive, I tune into the body in other ways besides just assessing physical function of the tissues. I began my deeper dive with this client by scanning her trunk to feel for changes in the temperature of her skin. I could feel that above her Cesarean scar was warm and below it was cold. When there are temperature changes like this, it is an indication of an energetic block in her body. Something is causing the body to hold in that place.
To treat this block, I placed my hand right on the area of change in temperature and asked the client to tune into this area of her body. Her first response was, āIām mad at my uterus!ā. She felt her uterus had failed her in the birth of her baby. Giving her womb some attention, she came to realize that it had not. In thinking back to her birth, she said she could tell something was wrong, and realized that her uterus was trying to help her. During this acknowledgement, the client’s skin temperature changed and warmth returned to her lower belly.
There was still a lot of trauma from the birth that we processed. In this processing, the client shared that her baby did die during the birth but was brought back to life. Her body didnāt realize that the baby was safe and was still stuck in the shock that the baby had died. When the client shifted this limiting belief that the baby was dead, her entire pelvic area softened. She reported immediate relief in her sacrum and that the sacral pain was gone. Her scar tissue became less tender and stopped hurting as well. She stood up and felt much lighter in her pelvic space. I still donāt know about her pain with intercourse, but I do feel weāll be able to go there much easier in her next session. Iāll let the body guide me.
Listening at a Deeper Level
I had approached the death of her baby with her in her first session, but sometimes, when a traumatic event is very recent, the body is not fully able to let go of all the trauma. It needs time to process things and let go of the shock from that experience. In this most recent session, we also addressed the feeling of her dying, which may have been the key to a better resolution; it’s hard to say.
In the client’s first session, we couldn’t fully release everything that was there, but that is because we have to listen to where our clients are in their experience and processing. When dealing with trauma, we have to go at a slower pace. Just as we cannot force a release in the tissues, we cannot force clients to process pieces they are not yet ready for. We have to listen to the body and our clients in multiple ways.
In her last session, the client seemed to have greater resolution, as the tissues really let go and the pain resolved. Iāll know more next time I see her and will do my best to write a follow-up to this study.
Taking Your Practice to a Deeper Level
I hope this case study helps you realize that what is held in the body, whether it is pain or tension, is not always from a physical cause. Getting curious with the tissues and knowing how to dialogue and help a person discover what truly is being held in their tissues is possible and a skill you can learn. The Birth Healing Intensive program is designed to help you do so in case you want to dive deeper with your practice.
About the Author: Lynn Schulte is a Pelvic Health Therapist and the founder of the Institute for Birth Healing, a pelvic health continuing education organization that specializes in prenatal and postpartum care. For more information, go to https://instituteforbirthhealing.com