Dr. Jessica Rabon is a licensed clinical psychologist specializing in pediatric psychology. She splits her time evenly between inpatient care at a children’s hospital, where she covers general pediatrics, the ICU, the epilepsy monitoring unit, and an outpatient adolescent medicine clinic. Her clinical interests include depression, anxiety, chronic medical illness, LGBTQ+ health, and eating disorders. She has published peer-reviewed research and a book on topics like suicide, self-compassion, gratitude, and forgiveness. She also hosts the podcast Psych Talk, where I was a guest before she came on mine.
I invited Jess on to talk about working with children with chronic illness in a hospital, because so much of this show covers the long outpatient road of mystery symptoms and medical gaslighting. We did talk about that, but the conversation kept circling back to something bigger: what happens when the tests come back normal, why coordinated care looks so different from fragmented care, and how often “noncompliant” describes a system rather than a person.
What a Psychologist Does on a Pediatric Inpatient Team
Jess has been doing this work for eight years. She was the first inpatient psychologist at her hospital, so she remembers when families wondered why a psychologist was walking into their room at all. She sees everything from new diagnoses to kids admitted with pain no one can explain, and she introduces herself as support for the stress of the hospitalization, names what she’s heard from the team (“I’ve heard you’ve been vomiting for six months and we don’t have answers”), and normalizes how much those symptoms affect mental health. The theme she hears most is, “We just want answers. Even if the answer is one we don’t wanna hear, having an answer means we can have a treatment plan.”
What struck me is how flexible she keeps the role. She might teach coping skills or carry a family’s concern back to the team, and sometimes she’s simply “a sounding board.” As she put it, “I would not have a job in the hospital if our physical health and mental health were not interconnected.” So if you’ve ever bristled when a psychologist showed up at your bedside, a good one is there to support you through the stay, not to decide whether your symptoms are psychological or physical.
When Every Test Comes Back Normal: “Your Symptoms Are Real”
I asked Jess what happens when a team decides a problem might be psychological. She was honest that early on she heard physicians say, “This is in your head, so we’re gonna have the psychologist come in,” and she has spent years teaching them better language for her role. One diagnosis she mentioned that can come up after normal GI testing is rumination syndrome, which causes effortless regurgitation after eating, without the nausea or retching of vomiting. The Cleveland Clinic classifies it as both a GI disorder and an eating disorder, and its main treatment is behavioral, often diaphragmatic breathing. I mention it because it’s a real, physical, diagnosable disorder, and a behavioral treatment doesn’t make the symptoms any less real.
When a kid’s upper GI, lower GI, and endoscopy all come back normal, she leads with “your symptoms, your pain, everything you’re feeling, is real,” and holds what she calls the both/and: the symptoms are real, there isn’t a medical explanation right now, and skills like activity pacing can help whether or not a diagnosis ever comes. And when families want a second, third, or fourth opinion, Jess tells them to go get it, because she has seen physicians be wrong.
I shared that I lean even further toward continuing to search, because conditions like endometriosis can take years to diagnose. A ten-country study found an average of 6.7 years between the start of symptoms and a surgical diagnosis of endometriosis (Nnoaham et al., Fertility and Sterility, 2011). And honestly, I see much longer delays than that in my own therapy pracrice. So even the kindest version of “we believe your pain, there’s nothing more we can do, so go do CBT” can leave someone without a next step and feeling incredibly dismissed. Their labs might say nothing is wrong, but their body is telling them something is, and a normal result is information about that test, not a verdict on the person.
Why Kids Sometimes Get Diagnosed Faster in the Hospital
In my intro I mentioned people who finally got answers in the emergency room, and Jess sees a version of this in pediatrics. A child admitted with vomiting, fever, and diarrhea sees the hospitalist team, infectious disease, and GI, who might land on Crohn’s, all in one place. Outpatient, that same child gets antibiotics, a return visit, a referral to GI with a six to twelve month waitlist, a stool sample taken home, and another appointment for the next test. “It could still be a year to get the same diagnosis that a hospital stay does,” she said.
She was careful to add that you have to be very sick to be admitted and that hospitalization “can be traumatizing within itself,” but the mechanism matters: specialists talk to each other, tests happen days apart instead of months apart, and a biopsy can happen while you’re already under for another procedure. So if you’ve spent years bouncing between referrals, much of that delay is built into how scheduling works, not evidence that you haven’t tried hard enough.
Disjointed Care and the Myth of the “Noncompliant” Patient
Jess described a week where she, GI, nursing, the hospitalist team, child life, and nutrition were all on one paging thread, updating each other in real time. If you haven’t met a child life specialist, they help hospitalized kids keep life as normal as possible by explaining procedures in words a child can understand, comforting and distracting them during those procedures, and supporting parents and siblings (Cleveland Clinic). Outpatient, even inside the same health system, she gets a reply in 24 hours if she’s lucky, and patients end up hearing that “physician A said this, physician B said this, physician C said this, and none of it aligns.” Add referrals no one explained, medications stuck waiting on a pre-authorization, and missed appointments for referrals patients didn’t know about, and those patients get labeled noncompliant. This isn’t a new problem. Back in 2003, the World Health Organization reported that people with chronic illnesses in developed countries follow their prescribed treatments only about 50% of the time on average, and said patients are “too often blamed” for this when providers and health systems shape it so heavily.
This is a big part of my own role as a private practice therapist specializing in chronic illness. I get releases early and keep a booking calendar just for my clients’ doctors, and then I might tell two specialists that their conflicting guidance “is contributing to a sense of anxiety,” rather than letting anxiety become the explanation for why a client isn’t following the plan. I see it when functional medicine providers here in Atlanta diagnose EDS, POTS, or MCAS in direct contradiction to a client’s cardiologist, and that uncertainty costs precious energy, time, and money. For clinicians, when a client isn’t following a plan, it’s worth asking whether the plan was ever clear and consistent to begin with.
Second Opinions, Distance, and the Structural Barriers to Care
Jess told me about a family on their third admission who felt like they were repeating the same steps without getting new answers. They were willing to travel for a second opinion, but the next closest children’s hospital was three hours away. In Jess’s experience, a referral to another hospital usually happens because the family asks for it, not because the team suggests it. Even then, the family has to work out transportation, insurance coverage, and time off work. A parent might have other kids at home, or might not have been at their job long enough to qualify for FMLA leave.
In my opinion, this is structural silencing, because so many structures sit between a patient and their ability to advocate for themselves. Philosophers Ian James Kidd and Havi Carel describe something related as epistemic injustice: ill people are given less credibility when they describe their own experience, and they often lack shared language for what they’re going through, and both are reinforced by the way modern healthcare is structured (Kidd & Carel, Journal of Applied Philosophy, 2016). Physician Rageshri Dhairyawan has also written about how people with conditions that have few objective diagnostic markers, like fibromyalgia and ME/CFS, are routinely dismissed (Dhairyawan, PLOS Global Public Health, 2024). And I wish physicians had more training for the moment they feel frustrated that they can’t help, so that instead of getting defensive they could say, “We’ve done all we can here, and we suggest going to Children’s next.” If you’ve had to push for that referral yourself, we see you. Justice is not served when we have to fight this hard just to hear bad news.
How to Tell Your Doctor About Medical Trauma
The National Child Traumatic Stress Network defines pediatric medical traumatic stress as “a set of psychological and physiological responses of children and their families to pain, injury, serious illness, medical procedures, and invasive or frightening treatment experiences,” and notes it can follow a single medical event or many. Near the end, Jess shared that when a patient discloses medical trauma, she tells the medical team how it might show up, and she encourages patients who feel able to name it with new providers. Otherwise a chart might simply say “patient presented as anxious,” when the real story is a past provider who dismissed them or a medication reaction that left them terrified. “It’s not that they’re noncompliant,” she said. “It’s they had this horrible adverse experience.”
I added the piece I coach clients on, which is the follow-up. “I’m really scared” can leave a doctor unsure whether you’re saying yes or no, so I encourage something like, “If I have an allergic reaction to the MRI contrast, what’s the plan for that? If I know that, then I can go along with this treatment plan.” Jess does similar work before anesthesia, helping kids write down their questions. Naming what you need hands your physician a clear path, and if they can’t meet it, you can ask for a referral to someone who can.
You Deserve Care for Your Mind, Too
Whenever a psychologist is introduced, it doesn’t always mean “it’s all in your head.” Jessica put it this way: she wouldn’t have a job in the hospital if physical and mental health weren’t connected. Having a mental health professional on your team, if you have access and want one, is part of caring for your whole self.
Her closing message was for anyone with symptoms but no official diagnosis. What you’re going through is real, even if a doctor has told you otherwise. You deserve answers, treatment, and the fullest life you can have. Find a therapist who specializes in chronic illness if you can, find a team that listens, and don’t give up.
Where to Find Dr. Jessica Rabon
You can find Jess on social media at @JessicaLeighPhD and on her podcast, Psych Talk. Her parting words were for anyone living with symptoms, diagnosed or not: “Your symptoms and your lived experience are real, and you deserve answers, you deserve treatment, you deserve to live the fullest life that you can.”
If you’re looking for a therapist who understands chronic illness, my directory is at thechronicillnesstherapist.com/find-a-therapist, and my workbook includes worksheets on building and trusting your medical team.
If you need a place to start, the directory on my website, thechronicillnesstherapist.com, lists therapists with lived or professional experience in chronic illness. No gaslighting allowed.
Disclaimer: Everything we discuss here is just meant to be general education and information. It's not intended as personal mental health or medical advice. If you have any questions related to your unique circumstances, please contact a licensed therapist or medical professional in your state of residence.
Destiny Davis, LPC CRC, is solely responsible for the content of this article. The views expressed herein may or may not necessarily reflect the opinions of the guest.
The content in this blog post comes directly from a real, human interview between Destiny and her guest on The Chronic Illness Therapist Podcast. This written version was formatted using AI. Listen to the full episode to hear the actual conversation.
Listen to my full conversation with Dr. Jessica Rabon on Ep 130: When Your Doctor Brings Up a Psychologist and You Hear “It’s All in Your Head”
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Episode transcribed with AI and may contain errors that are not representative of the actual word or meaning of the sentence.
Destiny Davis LPC CRC: [00:00:00] Therapists, the Chronic Illness Therapist Collective is live, And it's basically a culmination of all of my work for the last six years or so
We meet every first Friday for a business consultation group, every third Friday for clinical consultation group, and every first and third Wednesday for skills class. The skills classes are recorded if you can't make them live. The consultation groups, you know, for sake of privacy, obviously, are not recorded, but we do hope that you can make them.
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There's also ongoing CEs throughout the year that are specific to chronic illness. Everything we do is very specific to chronic illness. So if you are a therapist who works with chronic illness clients, or you are a therapist who has a chronic illness, either way, you're [00:01:00] welcome here, And we are really leading the way in chronic illness education and consultation.
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So without further ado, today we are talking about J the hospital and what it's like to work with children with chronic illnesses in a hospital setting
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Destiny Davis LPC CRC: Jessica Rabon
a licensed clinical psychologist specializing in pediatric psychology. Her clinical interests include depression, anxiety, chronic medical illness, LGBTQ+ [00:04:00] health, and eating disorders. She has published a number of peer-reviewed research papers and a book on topics such as suicide, depression, anxiety, self-compassion, gratitude, and forgiveness.
Additionally, Jess creates mental health content on social media and hosts a podcast, Psych Talk, which I've been on, and with the goal of making mental health more accessible and relatable and de-stigmatizing. Well, thank you so much, Jess, for being here. I'm really looking forward to our talk today, um, because you actually work in a hospital setting, and you see that, that side of medical, uh, illness every single day.
Jessica Rabon: Mm-hmm.
Destiny Davis LPC CRC: of times we're, on this podcast we're talking about more of the, um, like, um, long chronic journey of mystery symptoms that get medically gaslit until, you know, 15 years down the road finally they get a diagnosis.
But when you're in the ICU or in a, um, you know, in a hospital setting, yeah, there's w- I will, I'm very much looking forward to hearing [00:05:00] from you what that work is like. Um, but I think sometimes I even hear from people that when they went to the emergency room for something kind of unrelated, that's when they even got answers.
Like, it's almost sometimes, like, the emergency room, they can get answers faster. Um, that's not always true, but that's just one of the things that I've, I've heard, um, and observed. So yeah, please tell me a little bit about yourself, not only where you work, like, what kind of work you do, but also maybe the, the content that you create on- online and what the purpose of all of that is.
Jessica Rabon: Absolutely. Well, first of all, thank you so much for having me on. I loved our conversation on my podcast, so I'm excited to be on
Destiny Davis LPC CRC: Yes
Jessica Rabon: But yeah, so as you said, I work in a children's hospital, so I split my time 50% medical inpatient and 50% outpatient. I'll start outpatient 'cause that's probably gonna be a shorter conversation. So I work in our adolescent medicine clinic, and that is more traditional hour-long therapy sessions where I primarily [00:06:00] see depression, anxiety, eating disorders, LGBTQ+ health. But a lot of my patients there do also have comorbid chronic medical issues just because within a hospital system. then the other 50% of my time is spent medical inpatient, um, in the children's hospital.
So I cover general pediatrics, our ICU, and our EMU, so, um, unit. And then sometimes I will work with hematology oncology, but they also have their own psychologist, so it just depends on was the kid in the ICU first and I got to know them, switched over to hematology oncology. Um, so I've been doing this work for eight years.
I've been at the hospital I'm at, um, I did my fellowship there and then I got hired on and I've stayed there, uh, yeah, since 'cause I love it so much and I'm happy to answer any specific [00:07:00] questions my work. But inpatient I see a variety of things. So I see new diagnoses of chronic illness. Um, I see people that are admitted for complications due to their chronic illness. I see traumas, so car accidents, gunshot wounds, uh, things like that, disorders. I see a lot of pain, so, uh, kids that are admitted with pain disorders or unknown causes of pain. Um, and then I also see a lot of just, hey, there's medical stuff going on, we don't know what the diagnosis is. The kid's stressed, the family's stressed, they've been here a while or it's gonna be a while or this is their third admission because we can't figure out what's going on type things. Um, outside of my job, like you said, I, I create content on social media and have my own podcast and Really, that is a mixed bag [00:08:00] of stuff that I create. I think it's much more generalist. Um, I like to stick with the things I know well. So, um, my research throughout graduate school was on suicide, so I, I post a lot of information about suicide, eating disorders, depression, anxiety.
Um, I also like to talk a lot about, like, ethics and social media as therapists. Um, don't know. What else do I talk about? I also like to take, like, what's going on, whether it's politically or if there's things in the media that people are talking about related to mental health, I like to talk about that. And really the goal with, um, my platform there is just to make mental health information more accessible, um, especially evidence-based, uh, accurate mental health information, 'cause we know there's so much misinformation out there online or wherever it might be. And, um, it started as [00:09:00] I was bored during the pandemic. And that's when my podcast started as well, and I've just continued it over the years, and I've connected with other great therapists like yourself through it. So I doing it
Destiny Davis LPC CRC: I love that. That's, yeah, I also, I mean, definitely started thinking in the pan- uh, in, during the pandemic about my podcast, and then I launched it right when my first baby was born. So it was kinda like I knew I was taking time off from work, and that I was probably gonna be bored even with a newborn.
Jessica Rabon: Mm-hmm.
Destiny Davis LPC CRC: yeah, that was when I, when I launched mine.
Um, but yeah, I would love to hear a little bit more about, um, when you were talking about your work in the hospital, you mentioned that sometimes you're seeing families who've been there three times, doctors don't really know what's going on. What do some of your conversations sound like with families that are going through that?
Jessica Rabon: Yeah, that's a great question. So, a lot of times, especially if a family's been [00:10:00] admitted like two, three times and I'm only getting involved in third admission, 'cause a lot of times they're like, "Oh gosh, why is a psychologist We haven't met her before." Um, so usually initial conversation when I'm like just first going in introducing myself, I introduce myself, my role, and I say, "The medical team told me that you've been going through a rough time.
I know that this is your third admission. You have a lot of symptoms." And then obviously depending on what it is, I'll say like, heard you've been vomiting for six months and we don't have answers," or, "I've heard that you've had this chronic pain and we don't know where it's coming from, and the team wanted me to check in on you to see how I can best support you during your hop- hospitalization and while we're navigating all the medical procedures," things like that. And then, you know, my first assessment is similar to a general mental health assessment that any of us would do, like [00:11:00] biopsychosocial, what's going on, but obviously I have more questions about like the medical illness and really how their physical symptoms have impacted their mental health. And I always normalize, 'cause I work with kids and teens primarily, that, you know, I would expect that your mental health has been negatively impacted by in physical pain, by having these symptoms without answers. A lot of conversations we talk about how the unknown is really scary. It's really frustrating. Um, a common theme I hear from kids and parents a lot is like, "We just want answers. Even if the answer is one we don't wanna hear, having an answer means we can have a treatment plan. Right now, we don't have any information."
Um, a lot of times it's creating space to just have them like vent their frustrations validate frustrations. Um, [00:12:00] also kind of play a role of a middleman in the sense of- People feel more comfortable, I f- feel like if they're open to mental health help, open to a psychologist, like, sh- sharing their frustrations about maybe, uh, what a physician did or said, or they're like, "I don't really agree with what they're doing, but I felt like I couldn't say that."
And I'm like, "If you want, I can bring that up to the team. I am happy to facilitate that conversation with them." say, like, "This is what we were talking about. These concerns got brought up. Can you go explain to them why you're thinking about this? Or have you all considered this And one of the reasons I love working in a hospital so much is because there are so many players involved in a patient's care at the same time.
So, you know, we have the primary hospitalist team. Um, we have any specialists, so we might have our pain team, we might have GI, we might have [00:13:00] cardiology, we might have neurology. Um, then obviously myself, we have child life. We have physical therapy, speech therapy, occupational therapy, if those are needed, nursing.
And I think, you know, having a team-based approach, like some families or some individuals are more comfortable sharing concerns, worries, frustrations with certain team members, and then that can get back to the people that may be ordering the tests or the exams. And so I know I kind of just got off track
Destiny Davis LPC CRC: No, that's great
Jessica Rabon: you know, a lot of the conversations are really about, like, what has been done?
How do you feel like the hospitalization's going? What can I do to support you? Whether that's teaching you coping skills, if you want that, whether that's just providing a safe space to talk about your frustrations, whether it's being, like I said, kind of that facilitator of conversation. Is it brainstorming, you know, we [00:14:00] can do to make the hospitalization more enjoyable?
That's why we have these wonderful child life specialists that can
Destiny Davis LPC CRC: Yeah
Jessica Rabon: Is it talking about anxiety before procedures? Is it, you know, helping you find the language to communicate with your physician? So the conversations can look so many different ways. Um, but I will say generally they start very similarly from the standpoint of, I really try to just introduce myself as a source of support to help with the stress related to the hospitalization or what brought them into the hospital.
Destiny Davis LPC CRC: Yeah. Can you tell me what it looks like when somebody is deemed maybe this is, is a psychological problem? Is that, how do you, how are you navigating those conversations, and what are even maybe some of your beliefs around that? Um, is that something that happens, or is, I mean, yeah, or like is it always something [00:15:00] physical that's just maybe being missed?
Or yeah, where do you stand on that?
Jessica Rabon: Yeah. So I, I will say, I think I'm very lucky with where I work, and I've worked very hard to provide psychoeducation to a lot of our physicians about, like, the role of psychologists and, like, the language to use. Um, so I've definitely, like, I can think back, you know, when I first started, 'cause I, there was not a psychologist in the hospital before me, like, on the inpatient side before me, so it was an adjustment for a lot
Destiny Davis LPC CRC: Everyone, yeah
Jessica Rabon: But I absolutely recall conversations with physicians that they were like, "Hey, this is in your head, so we're gonna have the psychologist come in." I'm like, "That's not the way to approach it. Please. Please." And even if physicians have gotten better at being like, "Hey, we think, you know, there may be a psychological component to so we're gonna have the psychologist come in," some people are still gonna hear it as they think it's all in
Destiny Davis LPC CRC: Yeah
Jessica Rabon: So I mean, [00:16:00] I think part of that is, you know, navigating with the patient. Like, no, they're not saying it's all in your head, unless I did hear them say that, and then I'll be like, "I'll
Destiny Davis LPC CRC: Right.
Jessica Rabon: physician about how to better
Destiny Davis LPC CRC: Yeah.
Jessica Rabon: that." Now, what I will
Destiny Davis LPC CRC: That's, that's what ac- that's what I'm curious about too, if, yeah, is like also how, how is it determined actually when it is determined to be that way? Which I don't,
Jessica Rabon: it
Destiny Davis LPC CRC: I don't operate... Yeah, I don't operate under that kind of in a... I, but I also don't assess for that. I just, in an outpatient private practice, I believe everything my client is telling me about what their experience is without, you know.
But I, I know when it comes to doctors and hospital settings, that there actually does have to be a little bit more of an assessment because you're deciding what to treat, right?
Jessica Rabon: Correct. Yeah. So a lot of times in my experience, um, th- I will, I will say the, the f- hospitalists do get [00:17:00] me involved earlier. They don't wait till like, "Hey, we've run every single test ever, and there's nothing. Now can you get involved?"
Destiny Davis LPC CRC: Yeah
Jessica Rabon: didn't used to be the case, and I think that's important because I'm already involved, so if they're running literally every te- And I'm gonna use GI as an example because I see so many kids with, like, pain or vomiting.
Destiny Davis LPC CRC: Yeah
Jessica Rabon: and they will run, like, an upper GI, a lower GI, like an endoscopy, like all of these tests, and if everything is coming back normal, that's usually
Destiny Davis LPC CRC: Right
Jessica Rabon: "Hey, we don't have answers. We can still treat your symptoms, but there may be a psychological component to it," or like, "Hey, this is looking like rumination disorder."
So for, if your listeners aren't like it's a vomiting disorder that's considered more mental health. Um, but the way I try to approach those conversations, like if the doctors [00:18:00] are saying like, "All our medical tests are coming back, like there's nothing going on," is emphasizing like your symptoms, your pain, your whatever it is, is real. Like, nobody is trying to tell you like your pain is not real or
Destiny Davis LPC CRC: Yeah
Jessica Rabon: is not real or, your dizziness or your fainting spells aren't
Destiny Davis LPC CRC: Yeah
Jessica Rabon: there may be a psychological component that is making those symptoms So the stress of being in pain all the time, the anxiety about vomiting is
Destiny Davis LPC CRC: Right
Jessica Rabon: um, and that can trigger the vomiting So I really try to emphasize, and I will say like most families that I work with that. I've
Destiny Davis LPC CRC: Hmm.
Jessica Rabon: some that are like, "Absolutely not. We want a second opinion," and that's fine. Like, go get a second, third, fourth opinion. And [00:19:00] like there have been times that physicians have definitely been wrong and then subsequently been wrong 'cause I only have the information from the
Destiny Davis LPC CRC: Right
Jessica Rabon: that tests, um,
Destiny Davis LPC CRC: Yeah. You're not a medical doctor and so you can't, you can't interpret these medical labs, but you, yeah.
Jessica Rabon: No,
Destiny Davis LPC CRC: Yeah
Jessica Rabon: But, um, a lot of my conversation is like the both/and. Like, these symptoms are real, and right now we don't have a medical reason, so
Destiny Davis LPC CRC: Yeah.
Jessica Rabon: to s- like reduce the anxiety, stress, overwhelm around it, or do more behavioral interventions. Like activity pacing is one I do which can be beneficial whether you have a chronic illness diagnosis or not. Um, like, but, but I mean like official diagnosis. Like
Destiny Davis LPC CRC: Yeah
Jessica Rabon: is so important whether you
Destiny Davis LPC CRC: Yeah
Jessica Rabon: label or you don't, and so teaching those skills[00:20:00]
Destiny Davis LPC CRC: Yep
Jessica Rabon: if that helps the symptoms. If it doesn't, can see if there's more tests be
Destiny Davis LPC CRC: Yeah
Jessica Rabon: but let's... no harm in starting to teach these skills ahead of time while we're still trying to figure out answers,
Destiny Davis LPC CRC: side of things, yeah.
Jessica Rabon: that answer your question? I hope
Destiny Davis LPC CRC: Yeah, yeah, yeah. It's, it, it's, it's a tricky, it's a hard conversation to have because I think so many people do go years before they get a proper diagnosis. And so it's like, you know, was it missed 15 years ago when I was at this hospital? And, um, you know, it was like, "Hey, go do some CBT to, like, help the anxiety."
Or even in the best of presentation of it, like, "We believe your pain. We, you know, and there's nothing more we can do, so go do CBT." And it's hard. It's really hard 'cause, yeah... And so I think that's where I also, so I pr- I practice very much in a way of, like, [00:21:00] I, it's hard when you're dealing with, um, it's tricky when you're dealing with, like, health anxiety or,
Jessica Rabon: Mm-hmm.
Destiny Davis LPC CRC: OCD to, to encourage clients to keep searching for answers,
Jessica Rabon: Mm-hmm.
Destiny Davis LPC CRC: that tends to be where I lean.
I tend to lean into continuing to search for answers because we just know. I mean, endometriosis, like, it's such a severe disorder, and it takes how long to get diagnosed? I mean,
Jessica Rabon: Mm-hmm.
Destiny Davis LPC CRC: uh, 10, 15 years before that surgery is done to even confirm that it's there. Um, if at all. So it's like, yeah, I'm, like, always, I lean on the side of always continuing to search for answers while trying to navigate that really tricky intersection of OCD and, you know, illness anxiety disorder, which is literally like you're anxious about something without any real evidence.
But again, I don't, mo- all of my clients have evidence there's something. You know, like,
Jessica Rabon: Yeah
Destiny Davis LPC CRC: their labs might say nothing's wrong, but their body is not, and [00:22:00] so it's, yeah, it's tricky
Jessica Rabon: Yeah. Well, and I mean, you know, and I absolutely know physicians are wrong, and so I don't wanna sound like I'm just, like, defending physicians, but,
Destiny Davis LPC CRC: Yeah, I don't know
Jessica Rabon: with... And my, my perspective also might be different 'cause I'm in pediatrics, and I feel like
Destiny Davis LPC CRC: Yeah
Jessica Rabon: pediatricians and, um, physicians that go into pediatrics probably have, like, I don't know, a different personality type than
Destiny Davis LPC CRC: Definitely.
Jessica Rabon: doctors.
Destiny Davis LPC CRC: Yes
Jessica Rabon: from conversations, like, it's also frustrating for them. Like, "Hey, we see this child is sick. We've run all of these tests. It's coming back normal." you know, you're saying, like, yes, there's anxiety, but also something... Like, it, it's not, doesn't seem to be just this. But they're like, "We don't, like, know how to help them."
And I wanna go
Destiny Davis LPC CRC: Yeah
Jessica Rabon: something you said in the introduction about, like, sometimes getting answers quicker,
Destiny Davis LPC CRC: Hmm
Jessica Rabon: that. And once again, my [00:23:00] perspective's pediatrics, and I don't know if, like, they're more willing to do things because it's a child or a teenager compared to, like, a 30-year-old woman walking in, but I have seen, like- Kids and teens get diagnoses a lot quicker in the hospital than they would've done outpatient simply because you have access to all the resources in one place. Now, it's at a, it's a very expensive way to get a
Destiny Davis LPC CRC: Right.
Jessica Rabon: because nobody wants to be in the hospital. But, like, if you, like, if a kid comes in and they're, you know, vomiting, fever, diarrhea, like, all these symptoms, admitted to the hospital. So first they're gonna see the hospitalist team. The hospitalist is gonna run maybe tests, get infectious disease involved to make sure it's no, like, infection.
Destiny Davis LPC CRC: Yeah
Jessica Rabon: might get GI involved. GI runs [00:24:00] some tests like, "Ooh, this might look like or something." They can get a Crohn's diagnosis. Depending on the severity of that, surgery might get involved to talk about... Like, you have access to all of these subspecialists in one place, that you wouldn't have on the outpatient side.
Because if you take that same situation, the kid goes to their pediatrician, the pediatrician's like, "Here's some antibiotics. Come back if it doesn't get better." back, it doesn't get better. They're like, "Okay, you said there's blood in your stool. Let's refer you to GI." Okay, GI now has a six to 12-month wait list.
Destiny Davis LPC CRC: Exactly.
Jessica Rabon: go in
Destiny Davis LPC CRC: Yep
Jessica Rabon: months for the initial assessment. "Okay, cool. We're gonna run some tests, but you have to take the stool sample home." Okay, whatever. They turn it back. The test comes back. "Oh, there's elevated levels. Now we need to have you come back to do this other test." And, like, and I'm giving an [00:25:00] example that is a lot quicker than that, like, 10 to 15 years, but it could still be a year
Destiny Davis LPC CRC: Yeah
Jessica Rabon: to get the same diagnosis that a hospital stay does.
But once again, you have to be so sick
Destiny Davis LPC CRC: Yeah, exact-
Jessica Rabon: And, and who's not saying that these symptoms weren't going on for, like, six months before, but then get the test. Or even just, like, I was talking about GI earlier, like, upper GI, lower GI endosc- endos- endoscopy. I can never say that word. Y- on the outpatient side, you're not getting all those, like, a day apart a couple days apart. You're having to set up these appointments. So it makes sense why so many people literally go because they're having to wait to get in with specialists. They need the referral, then they need to, like, do all these tests at different times.
Or a biopsy where if you're in the hospital, they're like, "Hey, we're gonna go in, we're gonna do this test, but since you're already under, we're gonna do this bi-," like,
Destiny Davis LPC CRC: Yeah
Jessica Rabon: at the same [00:26:00] time,
Destiny Davis LPC CRC: they're all talking to each other, so even when you're doing all that outpatient stuff, no one's talking to each other. It is truly infuriating.
Jessica Rabon: Yeah. I, I love that you brought that up, because that's something we could o- obviously talk about as well. Because, yeah, you're talking to each other and you're all working with the patient and family at the same time. So, like, I can give a perfect... Just from this week, I've had a lot of GI kids this week. Um, so I was talking to GI, I was talking to the nurses, I was talking to, um, the hospitalist team. I'm talking to child life. I'm talking to nutrition. Then we also have our paging system where all of us are in a thread together we can provide real time updates. Like, "Hey, just met with this patient. X, Y, and Z were their concerns." Okay, then GI comes back, "Yeah, I was about to see them. Thanks for letting me know." And then the, like, hospitalist team can come in and be like, "Hey, they had a question about nutrition," and the nutritionist can come in. [00:27:00] And it's happening all at once versus even, like, as somebody that works in a hospital system, like on the outpatient side, if I need to contact, unless it's a physician in my office, then I just walk to their office.
But like, say their psychiatrist or the patient is also seeing, like, developmental peds or endo and I need to like message them, I have to send them a staff message in our system. If I'm lucky, I get a response within 24
Destiny Davis LPC CRC: Yeah.
Jessica Rabon: And I don't mean that in a negative way. Like,
Destiny Davis LPC CRC: No
Jessica Rabon: respond to my messages in 24 hours because we're a hospital system.
We're, like,
Destiny Davis LPC CRC: How much of this?
Jessica Rabon: stuff, and it's, like,
Destiny Davis LPC CRC: Yeah
Jessica Rabon: as in-depth or live updates because it's like I need to get all of my thoughts in, like, one paragraph walking around a hospital and being able to be like, "Hey, hey." And we also, on the inpatient side, we will hold, like, what we call, like, MDTs, like multidisciplinary team meetings.
If we have a patient that is complex, or the family's really frustrated, or there's a lot of questions or a [00:28:00] lot of players, we'll be like, "Hey, we need to set up an MDT 2:00 on this day where all of us can get in a room together," or Zoom, but ideally in a room together like, "Hey, we need to come up with a plan." all need to be on the same page to communicate, 'cause I think that's another issue, um, and this might go down a different rabbit hole, but I'm sure you've experienced this, where, like, you as a therapist are saying one thing, and then one physician is saying another thing, and then the psychiatrist might be saying another thing, and then this other specialist is saying another thing, and the client's getting, like, mixed messages or not on the same page.
Or like, this one doctor prescribed this, but then the other doctor said I can't be on that because of this, and it's like,
Destiny Davis LPC CRC: no one's talking. Yeah
Jessica Rabon: knowing... And it's disjointed care, and all it's doing is hurting the
Destiny Davis LPC CRC: The client. That is something that I take as a part of my role, um, is a little bit, a little bit [00:29:00] of, not case management, but just in, in an effort to help clients advocate for themselves, um, and teach them that self-advocacy. I do also sometimes model that. So I often, you know, good practice is to get a release of information and talk to their primary care, like pretty much right away, um, when, when relevant, but my entire caseload is chronic illness, so it's almost always relevant for me.
Um, but then also any specialist that they have. So I have a booking calendar that's specific for these clinicians, um, these doctors and, and other people on their team. So when I call, um, their office or I send them an email, it's easy for them to book with me, and hopefully we can get on the phone right away.
And so then I might say something like that, you know, "My client is pretty distressed over the two conflicting, you know, things that have been said. Can you two talk to each other? Or can you give a, a clearer answer that doesn't contradict what this person over here is saying? 'Cause it's very-- That is contributing to a sense of anxiety," rather [00:30:00] than anxiety is the reason why they're not following their treatment plan.
Jessica Rabon: Yeah.
Destiny Davis LPC CRC: So
Jessica Rabon: Oh, yeah. Well, and you just brought up case management, like another benefit of working in a hospital, we have case management and social work. We have t- like two separate... And I mean, sometimes their roles overlap,
Destiny Davis LPC CRC: Mm-hmm.
Jessica Rabon: our case management does more of like, um, if somebody has to go home on a pump for like a feeding tube, they'll do
Destiny Davis LPC CRC: Right.
Jessica Rabon: and,
Destiny Davis LPC CRC: Yeah
Jessica Rabon: the walker or wheelchair, things like that, and social work more of like resource connection. Um, yeah, exactly like you said, like that's a whole nother If people are getting mixed messages or you, um, oh, what did you say? You said something a few moments ago that I was like, "Ah, yeah." Oh, the treatment plan. Like, if the treatment plan is not clear, that's another thing, like a benefit of being hospitalized, which I don't wanna make it sound like, "Yay, go to the
Destiny Davis LPC CRC: No
Jessica Rabon: it's also can be traumatizing within itself.
I wanna acknowledge
Destiny Davis LPC CRC: [00:31:00] Yeah.
Jessica Rabon: we can make a clear treatment plan. "Okay, these are the specialists you're seeing. These are your next appointments.
Destiny Davis LPC CRC: Yep
Jessica Rabon: This per, you know, cardiology, this is what you're following. And on the same piece of paper, per endocrinology, per..." Like, you know, here is what it is, and here are numbers to call when you don't have it.
But like if somebody is outpatient and, say, their specialist is rushed, or I could go on a whole thing about AI documentation that
Destiny Davis LPC CRC: Yeah.
Jessica Rabon: as clear anymore, and they leave the appointment and they're like, "Okay, I think I got it," and then they are like, "I don't remember," refer to whatever
Destiny Davis LPC CRC: Mm-hmm.
Jessica Rabon: they got, and they're like, "I don't remember talking about this."
Or like their medication doesn't get filled,
Destiny Davis LPC CRC: Yes
Jessica Rabon: trying to refill it because there needs to be a pre-authorization and nobody's picking up, or it's Satur- Like, there's so many to care for everybody, but especially those with chronic illness [00:32:00] that, exactly to your point, a lot of people will look at, "Oh, they didn't refill their medication," or, um, "They're not following the treatment plan.
They're being noncompliant." It's like actually there are so many barriers in place. Or they're overwhelmed because physician A said this, physician B said this,
Destiny Davis LPC CRC: Yep
Jessica Rabon: physician C said this, and none of it aligns.
Destiny Davis LPC CRC: Exactly. That's what I see the most, yeah. And then it, you know, and then there's, um, functional medicine, which is becoming more and more popular, and I will say I even, I work with a couple of functional medicine practitioners here in Atlanta 'cause they are the ones who are diagnosing things like EDS and POTS and MCAS and, um, all of that.
And so, and they have different treatments that seem to be, uh, helping. So anyway, my, I'm getting on a little bit of a tangent there. I think it can be useful, and also it's almost always at a direct odds with their cardiologist or their traditional kind of, um, [00:33:00] hospital-based care,
Jessica Rabon: Mm-hmm.
Destiny Davis LPC CRC: is confusing and causes a lot of, um, uh, delay in actually getting their, doing their treatment, whether that's from a prescription standpoint or a physical therapy standpoint or, you know, something that they're supposed to be doing.
It's very hard to get yourself to do it when you're not sure 'cause it's not only just the anxiety of being unsure, it's I'm unsure, which might mean I'm using precious energy, precious time, and, uh, money to go see this, you know, new specialist or take this new medication that one person doesn't even agree with, and so I don't even know if it's the right call.
So a lot of barriers in place
Jessica Rabon: And I've also seen, which you probably have too, people getting referred to a specialist and not even knowing why
Destiny Davis LPC CRC: Yeah. Yeah
Jessica Rabon: 'cause one of... Like, even on the outpatient side, like, a benefit, especially if a lot of my clients see people within our health system, and it's a pretty big health system, be like, "Oh, you have an appointment [00:34:00] with endo coming up, or cardiology coming up, or sleep medicine," whatever it is. a lot of times they'll be like, "Why am I seeing that doctor?" And I'm like, "That's a great question. Let me see if I can find out for you." And like, I have the privilege of oftentimes having access to that information
Destiny Davis LPC CRC: Right
Jessica Rabon: being placed. But if I didn't work in that system, l- similar to y- what you would probably have to do is, like, okay, let me, you know, reach out to this provider to see if they can explain to you, or do you feel comfortable reaching out to your provider?
Can we work on, like, advoc- you mentioned advocacy earlier. Like, how can you address this question? Um, or people don't know they're referred, they miss the appointment, and then it goes back to being perceived as because, oh, you didn't go to sleep medicine. Well, I, I don't know why I'm being referred to sleep medicine
Destiny Davis LPC CRC: Yep. [00:35:00] Yep. Yep. Exactly. Yeah, all of that, all of that. It's, we have so many structural, um, the term for it is structural silencing because there's so many structures in place that create a barrier for the patient to even advocate for themselves. Um, they are essentially silenced in that way. And so yeah, we're just, I think, rounding out here the, on one hand, being in a hospital with a team has so many benefits, and there's also still all of these structural barriers in place
Jessica Rabon: Mm-hmm.
Destiny Davis LPC CRC: long-term chronic medical care.
Jessica Rabon: Mm-hmm.
Destiny Davis LPC CRC: Yeah
Jessica Rabon: absolutely. And I guess, I know you said rounding out, but I just had another thought, so hopefully this is
Destiny Davis LPC CRC: Yeah.
Jessica Rabon: tangential.
Destiny Davis LPC CRC: No
Jessica Rabon: another thing I've seen too is even though there are benefits of, like, the teams and things like that, like we were talking about, obviously when you go to a hospital, like a lot of things is wrong. There's only so many hospitals and opinions, like [00:36:00] in, in certain areas. Like I, I mean, I don't live in like a giant city, so I have no idea where like super big cities, like how many options people have.
Destiny Davis LPC CRC: Yeah
Jessica Rabon: But it's like, "Hey, I went to the hospital, they ran all these tests, they put me on this medication. symptoms have gotten worse." Well, my option is to go back to the same hospital.
Destiny Davis LPC CRC: Right
Jessica Rabon: like if you get a different attending on
Destiny Davis LPC CRC: Mm-hmm.
Jessica Rabon: may have different ideas. But like, I was having this conversation recently with a family. They're like, "This is our third admission." And luckily this time the attending like was like, "Hey, we haven't looked at this," and whatever.
But they were like, "We feel like we're just doing the same thing. The closest children hospital to us is three hours away." And like this family was like, "We're willing to travel," but they had access to the resources
Destiny Davis LPC CRC: Right. Right.
Jessica Rabon: if
Destiny Davis LPC CRC: Yeah. And even right for even someone to say like, "We have done all we've can do here. We do suggest going to Children's next."
Jessica Rabon: Mm-hmm.
Destiny Davis LPC CRC: even would be so helpful, but I feel like even that messaging [00:37:00] sometimes just doesn't get communicated and, and maybe sometimes the doctors are just like frus- like you said, like frustrated on their own end that they can't do anything more.
Mm-hmm. But that's where I wish, like maybe they had mental health training around like when your ego is, you know, hurt or when you're frustrated because, you know, you can't help, um, here's the thing you say to a patient rather than kind of getting in your own way and, and not... Yeah. Yeah. And getting defensive or something like that.
Jessica Rabon: Yeah, and I, no, I completely agree with you, and I think, at least in my experience, like, there are definitely certain things, like our hospital kn- knows we do.
Destiny Davis LPC CRC: Yeah.
Jessica Rabon: like, I mean, when it comes to,
Destiny Davis LPC CRC: Right
Jessica Rabon: like transplants for example. That's a clear example. Like, if it
Destiny Davis LPC CRC: Right
Jessica Rabon: is going down the road of a transplant, like, "Hey, we want you to get established at X, Y, or Z," whatever.
But I think when it's kind of going back to this mystery, like we don't have answers, to your point, I think a [00:38:00] lot of times, like, "Hey, let's try this medicine and go home," rather than being like, "Hey, we've done all we can do. Would you like a second opinion at this hospital?" Or, "This hospital may be better for you."
And I'm not saying it never happens, 'cause I've definitely seen it happen, but I often see it happen because the families bring it up. Like,
Destiny Davis LPC CRC: Yeah
Jessica Rabon: you know, "Could we get a second opinion? Could we go to, um, a different hospital?" But, and then going back to the structural barriers, but then it all comes in place of, like, how are they gonna get there? Will their insurance be covered?
Destiny Davis LPC CRC: Right.
Jessica Rabon: all of
Destiny Davis LPC CRC: Yeah
Jessica Rabon: things as well. Like, if they have to take time off of work to get the diagnosis. And, like, I will say, of the families I work with, like, will do anything for their child, so they find but not everybody has the resources and time
Destiny Davis LPC CRC: it sucks that it has to be that way too.
Jessica Rabon: Oh, absolutely.
It's
Destiny Davis LPC CRC: Yeah.
Jessica Rabon: unfair[00:39:00]
Destiny Davis LPC CRC: Yeah.
Jessica Rabon: the family. Like, it
Destiny Davis LPC CRC: Yeah
Jessica Rabon: um, yeah. And, I mean, parents wanna be with their kids too.
Destiny Davis LPC CRC: Yeah
Jessica Rabon: Like, and so they're like, "Okay, if my kid's going to a hospital three hours away, I have to be there.
Destiny Davis LPC CRC: Mm-hmm.
Jessica Rabon: I also have other kids at home," or, "I have, you
Destiny Davis LPC CRC: Right.
Jessica Rabon: a job,
Destiny Davis LPC CRC: It's been a stay
Jessica Rabon: been there long enough to take FMLA."
And
Destiny Davis LPC CRC: Yeah
Jessica Rabon: know there's, there's so many,
Destiny Davis LPC CRC: Structural barriers, yep. I'm curious, maybe we can pivot a little bit. What is the most rewarding part of your job?
Jessica Rabon: Oh, I love that. Mm. Oh, this is so hard. So I mean, okay, the first, like, image that came to mind is a patient I saw this week who, like, I could see day after day just get better, like,
Destiny Davis LPC CRC: Yeah
Jessica Rabon: treatment. Like, starting to feel better, like, color came back in his face, and he was smiling and joking and, like... Like, and so I mean, that's [00:40:00] probably the most rewarding part. Like, when you actually see the change. And even if it's like, "I'm not back to 100%," or, "Now I have this new diagnosis, and my... I'm gonna have to adjust things, but, like, I came in here..." And obviously, these are the ones that, like, get answers and get treatments and feel better.
But, like, that's always so rewarding to me. Like, okay, this has been... yeah, the hospitalization is scary. It sucks. It is traumatizing within itself. I haven't gotten good sleep, all of these things, and, like, feel like now I have some answers. I have a plan. I have coping skills that we've, um, like, been taught. Um, so I would, I
Destiny Davis LPC CRC: Yeah
Jessica Rabon: say probably just, like, when you, don't know, see that positive change and, like, the relief, I guess, goes along with that. Like, got this diagnosis, or this medication finally worked, or, um, whatever it is. And I, I mean, I think [00:41:00] everybody's like, "I know it's not gonna be, like, butterflies and rainbows
Destiny Davis LPC CRC: Sure. But
Jessica Rabon: But, like, I have a plan, and I'm feeling better, and I know what to do. Um,
Destiny Davis LPC CRC: Yeah, when you've been sick for so long, like all anybody wants, like, I mean, the idea or the hope and goal of just not being sick anymore is kind of usually is pretty far gone. It's usually like usually it's like I just, yeah, want a medication that's going to make me feel a little bit better. I want something that's gonna be able to get me out of bed and back to work.
Like, I don't even need a cure anymore. I just need something that's gonna make my body feel a little bit better.
Jessica Rabon: Yeah.
Destiny Davis LPC CRC: Yeah
Jessica Rabon: I hear a lot from people you know, once they whether find the medication or get the diagnosis or get the surgery to address whatever it was, and then they're like, "Wow, I, like, I knew I felt bad, but I didn't realize how bad I felt until I started feeling better." Like, I, I can't remember [00:42:00] how it felt to, like, energy or to be able to, like, stand up for a prolonged period of time without feeling weak or dizzy.
And, and like you said, like, most people's... I mean, okay, I will say some of my kids' goals are like, "I wanna, like, be back to, quote-unquote, 'normal,'" which I hate that word. And, but, like, most people, especially if they've been diagnosed with a chronic illness and been living with it for a while, um, recognize, like, it's not like I'm never gonna have this.
But, like, even those moments of, like, where they feel okay to go back to school. Like, working with kids and teens, like, that is usually their primary goal. "I want to go to school in person. I want to be with my friends. I wanna be able to play with my friends." And when they're, have a treatment plan and treatment team that gets them to a place that they can do that, I don't know, it's so wonderful to see, like, the 12-year-old smiling, like, "I can go play with my friends today," or, "I can attend, [00:43:00] my, I don't know, big sister's graduation," whatever it is
Destiny Davis LPC CRC: Yeah, definitely. Yeah, those I would imagine is, is the m- most rewarding moments o- of this kind of work. What do you see your role as? You know, you're a psychologist in the hospital, but when you think about your role on one's medical team, what is the purpose? What is your purpose there? Thinking more like big picture.
Jessica Rabon: Big picture,
Destiny Davis LPC CRC: Yeah
Jessica Rabon: so Hmm. That, and that's a really good question. I'm trying to see if that, there's any way I can, like,
Destiny Davis LPC CRC: Yeah, if you think,
Jessica Rabon: shortly, but I think I'm long-winded.
Destiny Davis LPC CRC: you... That's okay.
Jessica Rabon: no, I, I mean, honestly, the first thing that came to mind is, um, to help provide holistic care
Destiny Davis LPC CRC: Mm-hmm.
Jessica Rabon: people think of hospital, physical health, and yes, that is what brings people to the hospital. However, I say this to [00:44:00] pretty much every I work with. Like, I would not have a job in the hospital if our physical health and mental health were not interconnected. And while all of these doctors and nurses and everybody is trying to figure out what is going on with you physically, I wanna make sure mentally are doing as good as you can given circumstances.
So I think in the broad picture, it's to of fill a piece of, like, a whole person
Destiny Davis LPC CRC: Yeah
Jessica Rabon: think also a lot of people get whole person care, going back to the disjointed care we were talking about, or
Destiny Davis LPC CRC: No
Jessica Rabon: if they are addressing all components, it is disjointed. Um, so yeah, I think,
Destiny Davis LPC CRC: Definitely. I love that. Uh, is there anything else we haven't touched on about your work that feels like it's important and you wanna share?
Jessica Rabon: I mean, there probably is, but whenever people [00:45:00] ask me, like, broad questions like
Destiny Davis LPC CRC: I
Jessica Rabon: don't know."
Destiny Davis LPC CRC: Yeah
Jessica Rabon: I mean, not... I guess, like, for anybody listening that maybe is or has been hospitalized and the team has a psychologist come see you, or even a psychiatrist, I will say, um, it does- even if it comes across as, um, you know, it's all in your head, it doesn't always mean that. and I can't speak for all physicians, but I truly think that anybody with a chronic illness, if they have access, if willing and able to, having a mental health professional on your team is so important because you deserve to take care of your mental health as well. And so, you know, I remember when I first started at the hospital, people would be like, "Why is a psychologist involved?
Like, my kid's here for And over time, I kind of had to, [00:46:00] like, how to introduce myself. Like I said, I'm, like, here to support you. You know, hospitalization can be stressful and things like that. And, um, you know, even if it's just for the short duration of the hospitalization, like, hospitalizations are s- stressful. It is overwhelming. It is scary. It's frustrating not having answers. And you're somewhere that has a psychologist, like, I tell people, "I can just be a sounding board." We don't have to do activity pacing. We don't have to do, you know, values work or coping skills or, you know, CBT, D- like, whatever it
Destiny Davis LPC CRC: Yeah.
Jessica Rabon: I can just be a sounding board you're in the hospital, a safe space if you deem me a safe space to express your frustrations, express your overwhelm, express your anxiety, having that outlet because I think a lot of times people don't get that space
Destiny Davis LPC CRC: Yeah, I agree.
Jessica Rabon: in a medical setting,
Destiny Davis LPC CRC: Yeah. Honestly, even with outpatient therapists who don't [00:47:00] understand medical trauma or medic- or chronic illness, like they kind of maybe sometimes try to figure out how to like just, you know, buckle, buckle through and like, you know, just push through and get through this because they are also kind of maybe stuck in that system of like, well, whatever we have to offer is what there is.
And like, then we get a little uncomfortable around, um, you know, not having more answers. So that's a big part of why I think training in this particular n- uh, niche, uh, chronic illness, medical trauma is so important because all of that work, like th- like you said, values work, um, even CBT has a place when it's not being used as like, you know, you're just catastrophizing what's going on with you.
Like so yeah. So
Jessica Rabon: Yes. No, I, I agree. I, I always say, like, I was trained very heavily CBT in the hospital setting. I definitely use more ACT,
Destiny Davis LPC CRC: Mm-hmm.
Jessica Rabon: I have found CBT can have
Destiny Davis LPC CRC: Yeah.
Jessica Rabon: [00:48:00] Um,
Destiny Davis LPC CRC: Yeah
Jessica Rabon: know, like, what is this sensation telling you? Is it always that something is drastically wrong,
Destiny Davis LPC CRC: Mm-hmm.
Jessica Rabon: these other things?
Um, and you say medical trauma, um, brought something else up for me that, You know, one part of my role that I do, like if somebody discloses medical trauma to me, I try to always inform the medical team. Like, "Hey, they have a lot of medical trauma. This is how medical trauma might show up." But if you are an individual listening with medical trauma, like, and you feel capable and empowered, like, let your physicians know, especially a new provider.
Just, like, put it out there. Like, "Hey, I've had a lot of medical trauma. You know, I don't trust physicians for X, Y, and Z," or, "This has happened to me, and I just wanna make you aware going into it." And it can be so scary doing that,
Destiny Davis LPC CRC: Yeah
Jessica Rabon: you are able to verbalize that [00:49:00] and you have a physician that understands medical trauma, or at least, like, will hear you out on that, it can make a difference.
Because unfortunately, a lot of physicians aren't trained in medical trauma or don't know how it shows up. But even just putting that out there hopefully will, like, make them attuned or, like, pause and be like, "Oh, tell me more about that." And if they're aware, it might be like, "Okay, well, they're anxious, and that makes sense because of this," versus just documenting, "Patient presented as anxious
Destiny Davis LPC CRC: Yeah
Jessica Rabon: It's like,
Destiny Davis LPC CRC: We're taking it personally. Yeah
Jessica Rabon: their last completely dismissed them or put them on this medication that they had this horrible reaction to, and now they're terrified of taking medication. It's not that noncompliant. It's they had this horrible adverse experience,
Destiny Davis LPC CRC: Exactly
Jessica Rabon: talk about that. 'Cause I think a lot of people have experienced medical trauma [00:50:00] and understandably don't feel safe to verbalize that. But unfortunately, that will impact their care, because care teams look at behaviors and don't try to understand the behaviors which is a whole 'nother conversation I'm, sure of as well. But that might be another, once again, um, if you have access and um, and resources to see a mental health professional who specializes in chronic illness, 'cause they can also help not only empower you to talk about it, but also maybe be a liaison to
Destiny Davis LPC CRC: Yeah
Jessica Rabon: psychoeducation to physicians about
Destiny Davis LPC CRC: Yeah
Jessica Rabon: that might up.
Destiny Davis LPC CRC: I do like to coach clients on if you're going to share with your medical professional that you have anxiety because of past medical experiences, one, knowing that they still might be the type of doctor that might roll their eyes at you, um, 'cause they just don't wanna deal with it at all. But what is helpful is the follow-up [00:51:00] of, "So therefore, I'm the type of person that needs to know that if this happens, then you will do what next?
If you just tell me what we- you'll do next, that will ease my anxiety."
Jessica Rabon: Mm-hmm.
Destiny Davis LPC CRC: know, which is hard, 'cause a lot of times what it might sound, uh, like when a client goes into, a patient goes into the, the ER or, or wherever, medical office setting, they might sound more like, "Well, I'm really scared about this happening."
And then the doctor hears, "Okay, so you don't wanna do it? You do wanna do it? Like, what do you wanna do?" Right? And so we just have to be so, so clear with our request of like, "So I'm saying to you that if the worst-case scenario does happen, how will you handle that? If I have an allergic reaction to the MRI contrast, what's the plan for that?
You know, I ... If I know that, then I can go along with this treatment plan. And yeah, I'm still gonna be nervous about it. Maybe you can give me some medication for that, but,
Jessica Rabon: Yeah
Destiny Davis LPC CRC: you know, for this moment. But outside of that, I'm gonna go along with it, you know?" So yeah, there's so much we can do that doesn't require...
'Cause I think sometimes doctors [00:52:00] even shy away from, like, the question, 'cause they don't want to then feel like they're in the therapist role. And it's like, you're not in the therapist role, but you do have to have kind of an understanding so that you can then say the next best thing for this particular patient.
And yeah. Yeah
Jessica Rabon: Oh, I love that. I do a lot of, um, coaching with my clients as well. I mean, mine, I'm thinking more in, like, inpatient, is more, like, acutely, like, about a procedure. Anesthesia is one I
Destiny Davis LPC CRC: Yeah
Jessica Rabon: a ton. Like, either they've had a bad reaction or anesthesia or, like, never been under, but they know people who have, and I'm like, "These are important things to talk to the anesthesiologist.
Like, let's write down your questions. How can you,
Destiny Davis LPC CRC: Exactly
Jessica Rabon: How can you express your or fears? Like, what type of answers would you need to feel less anxious? Like, do you want me to be present for the conversation?" Or things like that, because to your point, I think the follow-up is also so important, um, and being [00:53:00] clear, which can be hard, in, like, what you're sharing, why you're sharing it, what you need, um, from
Destiny Davis LPC CRC: Exactly
Jessica Rabon: physician.
Because if you add the, like, what you need, that's giving them a clear path. Like you said, there might be physicians that still roll their eyes or don't, but, like, you're literally handing them, like, "This is, this is what I need. Can you
Destiny Davis LPC CRC: Yeah
Jessica Rabon: give it back to me? Or if you can't, let me know, can you refer me to a provider that
Destiny Davis LPC CRC: Yep.
Jessica Rabon: maybe
Destiny Davis LPC CRC: Exactly.
Jessica Rabon: meet my needs?"
Destiny Davis LPC CRC: Great. Yeah. Exactly. Well, this has been such a wonderful conversation. Um, is there anything else you wanna say or leave people with before we end today?
Jessica Rabon: Um, for anybody listening who is living with a chronic illness or symptoms without an official diagnosis, know what that, know what you are going through is real, regardless of whether you have a diagnosis yet, um, regardless of if [00:54:00] physicians have unfortunately told you it's all in your head. Your symptoms and your lived experience are real, and you deserve answers, you deserve treatment, you deserve to live the fullest life that you can.
Um, so get a therapist if you can that specializes in chronic illness. I know I, I keep saying that, and get a treatment team that will listen to
Destiny Davis LPC CRC: Yeah
Jessica Rabon: Don't, don't give up,
Destiny Davis LPC CRC: Yep
Jessica Rabon: trying to find the answers
Destiny Davis LPC CRC: Yes, and for anybody listening, um, there is a directory on my website, thechronicillnesstherapist.com find-a-therapist Everybody there on that directory usually has lived experience or at least professional experience with working with chronic illness. No gaslighting allowed. And, um, I do also have a workbook that has some of these worksheets, um, around, like, building your medical team and, and trusting your medical team, learning how to not fear your own body so much.
So I will link all of that in the show notes, and Jessica, do you want me to link something specific for you?
Jessica Rabon: Um, [00:55:00] if people are interested in me on social media, my handle's everywhere is @JessicaLeighPhD, and then my podcast, Psych Talk. So if you wanna link
Destiny Davis LPC CRC: Awesome.
Jessica Rabon: that would be great
Destiny Davis LPC CRC: Yes. Thanks so much, Jessica
Jessica Rabon: Thank you, Destiny. This was great
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Listen to Jessica’s interview with me, Destiny Davis, on Ep 130: Ep 130: When the Tests Come Back Normal: A Pediatric Hospital Psychologist on Chronic Illness, Medical Trauma, and Disjointed Care with Dr. Jessica Rabon
Dr. Jessica Rabon is a licensed clinical psychologist specializing in pediatric psychology. Her clinical interests include depression, anxiety, chronic medical illnesses, LGBTQ+ health, and eating disorders. She has published a number of peer-reviewed research papers and a book on topics such as suicide, depression, anxiety, self-compassion, gratitude, and forgiveness. Additionally, Jess creates mental health content on social media and hosts a podcast, Psych Talk, with the goal of making mental health more accessible and relatable, and destigmatizing mental health.
Connect with Dr. Jessica:
Meet Destiny - The host of The Chronic Illness Therapist Podcast and a licensed mental health therapist in the states of Georgia and Florida. Destiny offers traditional 50-minute therapy sessions as well as therapy intensives and monthly online workshops for the chronic illness community.