Welcome to Hotness, the podcast that brings you practical tools to balance your hormones and rekindle connection, confidence, and desire in midlife and beyond.

I'm your host, Dr. Liz Lister. Hotners is a safe space for honest conversations about menopause, sex, identity, love, loss, reinvention, and desire, because you can embrace your hotness at every age.

Hello, Hot Ones. Welcome to Hotness, the podcast where hormones, confidence, and desire come back online. And I am so delighted to have my friend and colleague, Dr.

Karen Sponholtz join us. Karin, welcome to the show. Thank you so much for having me, Liz. I'm really excited about this. Your expertise in your therapy practice specifically with trauma really interests me.

And what I've noticed in my work with women is that when trauma lives in the body, and it can be from obviously so many different things, that, when women heal that trauma and they begin to feel safe in their bodies, That's when desire not just first not to sexual desire but libido is about life energy in general Starts to come back online.

So can you please tell us what's happening in the nervous system? What is going on when women are experiencing the trauma and then when they heal the Trauma and we'll talk about ways and tools for that in a little while But first just tell what is happening.

What's going right? In general, when someone has trauma or chronic trauma, the sympathetic nervous system is activated, and it's activated ongoing. So the system's never able to relax or settle down.

because there's the sense of danger and they don't feel safe. So when they start to feel saved, the parasympathetic system comes online, which then allows for all that energy that's going towards protection, threat assessment, to finally be utilized in a way that people want it to be utilised.

right where we can actually make conscious choices. I'll share really quickly, I'm not even sure if you know this story, but I will be talking more about my dating in other episodes.

But I dated someone for a stretch of time and the way it ended was she just dropped all contact, basically ghosting after several months of dating, which was, oh, we'll talk about that another time in more detail.

It was really interesting, Karen, because I developed a little tremor in my hand. Which, as you can see, I've been doing a lot of work and I don't have that tremor now, but no question that was like sympathetic activation and it was really from a lack of completion.

Can you say a little bit about that? What's happening when people don' t have the opportunity to complete a loss or a trauma? Right. The full completion happens in the body.

A lot of people mistake understanding their trauma, this cognitive understanding of how they got to where they are and what happened, and they feel like that that should be enough to correct their system.

And yes, it's important to have a logical understanding, of what happen, but it is really in the body where we find that full completion. Because trauma sits in a body and it a different kind of process.

And is it different for different individuals or are there themes? Do people have things stored in different areas of the body? What do you think about that?

It depends on if people are all different. Some people a little more self-aware, which helps. They're more aware of their body. A lot of people with trauma, especially in childhood, have disconnected from their bodies, so that there's no body awareness.

So that takes time to reconnect with your body, to re-attune to your bodies. But then there is a misunderstanding of what the signals are, right? Oh, that means this, or that mean that.

So it's then also understanding what your body is saying to you and to really listen and not misinterpret it and then give the body what it needs. Yeah, so it's a lengthy process, you know.

Right, and you're also, to me, reminding me of the limitations of talk therapy. Yes, yes, exactly. Because talk-therapy occurs up here, right? Exactly.

What other methods do you use with your clients that help get into the cell level Thankfully, the field is moving towards including the body because it was just talk therapy.

It was in the mind. A lot of times when I do therapy, I also ground in my body. I slow people down and really let them connect with, where do you feel that in your body?

What's happening for you right now? Instead of just staying in mind, which is easier to do for a lot people. They don't want to go into the Because again, the mind is so much faster in understanding what happened to them.

The body is much slower. So there's a lot of frustration of like, I understand that I'm anxious, but why am I still feeling that jitteriness in my hand?

That's so helpful. Yeah, that's like helpful to me personally. That is really interesting. Yes, That's fascinating. And women in particular, I think, and maybe even more in midlife and beyond, we maybe our relationship with our body, our bodies change, obviously, but also our relationships with their body.

Maybe we'd lose some confidence. We lose trust. Yeah. Our body it does things without our permission. In mid life. Yes. Right. And so that's very interesting that that is part of rebuilding trust with our own bodies.

Exactly. I'm glad you brought that up because oftentimes people who have trauma from their childhood mistrust their body. Maybe they responded in a way they didn't want to respond to a particular trauma or challenge or abuse.

So there's already early on that imprint, you know, early on where we didn't really have a choice either. And so then when we get to adulthood, there's this idea that I should be able to decide.

that I'm not going to be anxious or I should decide that, well, I shouldn't feel this way. And then, you know, unfortunately we, we can't decide those things.

If we could, then my profession probably wouldn't exist. We could just decide, that we're going feel peace. I feel better now. But it's really developing a compassion for the body.

and the pace of the body. I love that. Now, of course, I deal with hormonal changes for women in midlife. That's what my practice is basically focused on.

But you also know about this. So whatever level you're willing to share on, personal level or with your clients, with the hormonals changes, what do you think are some specific connections between the hormone changes of mid-life and mental health?

Yeah, you know, I was reflecting on this before, we started talking because when I Was growing up, hormones was a bad word, right? Especially for women, especially for girls, it was seen as an excuse.

Yeah. If you mention hormones, that means you're weak or it was not taken seriously. Yeah. And unfortunately, it should be taken serious because a lot of maybe our responses are maybe do more to hormonal and not psychological.

Or a a of the struggles that people have, especially in midlife when the body starts to change, you know, they're anxious or this or have trouble sleeping, it actually might be hormonal, you now, versus them being somehow broken or not able to do this, or that there's lack of willpower, which then, can be very frustrating for people.

Yes. And then it does that vicious cycle of women being upset with themselves, upset, with their bodies. Exactly. Tell me if your clientele is like this, but definitely, I would say, most of the women that I work with, definitely they're busy, they are professionals, or they have full-time work, whether it's in the home or not.

They're used to being in control. If they want to feel in, control and then, of course, midlife body changes. They kind of shake that up, right? Yes. And that's the message that you have a choice in this, and that is unfortunate.

No, you don't have control. You can't just choose or will yourself into a certain state. And again, that messaging of somehow I'm not doing enough or I need to do more really can drive people into a state that is fortunate and could be easily solved in some ways with hormones.

And I wish doctors growing up were more amenable to asking about not only your childhood, but also your hormones. For girls and women, especially in midlife, about testosterone, it's all about estrogen and progesterone.

But what about these gendered hormones, which is, we all have them. We all of them, exactly, just in different amounts. Exactly. What are some of the tools?

I love to share tools on this show. That's my purpose for it to be really practical for women in particular. But of course, you know, we're all human women, men, whatever gender that that doesn't matter.

but specifically, what are Some tools that you do with your clients that You can share now and you can take us through one or two of things that people do.

Sure. You mean related to trauma? To calming down the sympathetic nervous system, letting the parasympathetic take back over, addressing, we might, if you want to start with like ways to, when people say, okay, I know I've had trauma in my life, but I'm not sure exactly what is your feeling about how to initiate that.

First of all, I always say, let's look at the symptoms, because oftentimes people may come into my office and say my childhood was great. But then they have 20 symptoms of these habits that are wreaking havoc in their life.

So you didn't get that from nowhere, right? So it's looking at what are the systems, maybe the habit of perfectionism or the habits of jumping to conclusions, for instance.

So I usually start with just noticing that. Just notice when you start to do that, because it starts to create a sense of separation between what's habitual to recognizing like, oh, in this moment, then maybe, actually, maybe I have a choice.

Maybe I don't have to make assumptions. So it's interrupting the habits that maybe we're unconscious of until now. And then it is practicing the grounding.

Because when you have trauma, what happens is that there's a part of us that still feels like we are back in time. Much like the veteran who, you know, there's a plane flying over them and they know logically that that's an United commercial airline.

Their body is still responding as if they were on the battlefield, right? And there is no convincing them that, that is a United plane. The body's still going to respond.

So it's, one, being compassionate with yourself and patient with the body, but then it is also grounding yourself in the moment, in that present time of, you know, that's a commercial flight, and being very kind to yourself, slowing down and always connecting with your breath.

That's the first thing I say. If you can't trust anything, trust the breath, just take a moment to breathe in and out and really feel your lungs filling.

So that usually is the initial grounding that I do with them. Okay. The other thing I'd do is similar to what happens when people have a panic attack.

I have them stop and turn their head very slowly to the left and to their right. And really start naming out loud what they see. It's the reason why I say outloud because it's hard to think and speak at the same time.

Okay. You can't be in your head when you're talking. Okay, great. Got it. So it's, you know, lamp, door, jacket. And in that moment, even if it was just for five seconds, they're able to ground themselves in the present.

That's already a start. Then it is to keep that habit going. It's about a commitment to making changes. And it's little changes. We don't want to make a big jump and say, oh, you got to love yourself, which is, people may not even understand what love is.

Let's like yourself first before we go into the love. Right. That's such a good comment and suggestion because same with other people. We're sometimes looking for love in relationships, but we forget to say, do we like this person?

Exactly. You know, women go on dates and it's like, oh, does it? Do they like me? Well, how about do you like that person, you know? Why don't you ask, let's start with that question.

I love it. That's amazing. What about ketamine? Do you think it's a good tool? Does it help in the trauma scenario? Yes. Ketamine can be very helpful, but I would recommend it in this way, meaning having somebody sit for somebody who's doing ketamine.

Oftentimes, some clinics have a patient you know, do like a ketamine drip, right? They get a dosage of the ketamin, but they're left in the room by themselves with maybe some music, But there's no one guiding.

There's not one really helping them. And I would recommend that somebody sit for them, ideally somebody who's a clinician or even their own therapist, because it's really about that immediate feedback that will help, you in in this session, in ketamines session.

But the key with ketamine or other medicines that people might use, it's the integration. It's really what happens afterwards. And it is really taking advantage of the neuroplasticity that happens after these ketamines sessions to really take advantage and make changes.

So I always say, operationalize what you want. If they say I want more peace in my life, Okay, you know, but let's operationalize that so that you can practice every day versus it being this concept.

Right. Got it. So that's really great. That's adding to my understanding of why and how ketamine can be helpful. I only have one knowledge bit related to ketamines.

We used it as a very brief anesthetic in my OB residency. We had to do something very quick, like after a baby was born and there was a retained placenta and we had just get that placent out.

And so ketamine would just be very short acting. But that was long time ago. That was decades ago and I'm not even sure it's used in that context. There's probably better agents for that.

So that's really great to know. Can I add something about ketamines? Yes, absolutely. The reason why ketamine is so helpful for a lot of people, especially people who are over thinkers, is that ketamine tends to, you know, this is not a scientific explanation, but it puts the mind, thinking mind on the shelf.

And so then people can access other information, whether it's from their body, from emotions, and have the mind out of the way, so to speak. Cool. I love that.

Boy, that's really something. We strive for that, right, in a lot of modalities. How about EMDR? What's happening in the nervous system? Why is EM DR helpful?

Because it's the bilateral stimulation of EMDR, meaning like it is triggering both the left side and the right side of the mind, of brain. What often happens is with trauma, it sits on the one side the brain, right?

Again, this is not a scientific explanation, but just for the sake of- Sure, that's okay. discussion, you know, they tend to sit in the right side of the brain where things are more imagery, emotions, feelings, exactly.

And what's not left out is the rational side, right? See that with the veteran, rationally they understand that that's a plane, but it's the trauma is still sitting on the right side of the brain.

So what EMDR does, because of bilateral stimulation, it basically connects the left and right brain, sort of stretches that trauma to both sides. There's this understanding now, rational understanding.

from the mind that, oh, wait, okay, that is a united plane, you know, and it helps the nervous system almost deactivate, if you will. Beautiful. At least the sympathetic, right?

The sympathetic nervous unlatch and then allow the person to better work their parasympathetic nervous system with breathing and lots of other techniques, which I think we should do another episode just focused entirely on just the techniques.

But I really think that we've covered a lot of variety and of course we'll do an episode another time. We'll both think of topics afterwards. about this, that, and the other.

And as always to anyone watching or listening, if you have any questions, please submit them because I will absolutely have guests back on, answer questions.

I want it to be interactive as much as possible. Karen, if people want to reach you and learn more about your practice, about what you do, what's the best way for them to do that?

They can reach me by phone. They call or text 650-704-0709 or they can go to my website and I'll send you the link. If they Google Kaleile Collective, they will be able to find me.

Beautiful. We'll make sure all that's in the show notes for sure. Yes. Okay, great. And I ask all my guests a closing question here. So I'm going to now ask you, and I didn't give this one to you ahead of time.

What is something that you do to experience your own hotness? Oh, I make that I tend to my body and really set myself up for success, right, with vitamins, supplements, hormones, sleep, water, because mental health is not just in the mind.

Mental health lives in your body as well. And so when you feel that alignment and that balance, the hotness, that feeling of like, wow, I'm really, you know, singing, then then that's taking care of your whole system.

I love that. That's yummy. It's what I'm here for as well, right? To help my patients that I work with too. So that's wonderful. I loved that, thank you so much.

And I am quite sure that besides the fact that we will see each other again, that will do more of this on another occasion so that can keep sharing your wisdom with both of our audiences.

Thank you for being here. Thanks for listening to Hotness. Help more women find these practical tools by liking, sharing, and following the show, as well as leaving a review.

As a gift for listing, go to drlizmd.com forward slash hotness for your free midlife guide filled with powerful support for you mind, body, soul, because you can embrace your hotnes at every age.

Karin Sponholz, MSW, PhD

Your Mind Moved On… Your Body Didn’t