About Yaicha
Yaicha has worked in the healthcare field for 15+ years and has practiced as a Physician Associate (PA-C) for 10+ years. She has a BS in psychology and currently practices as a Psychiatric PA-C, treating an array of diagnoses, including Chronic Pain and Anxiety. She has also treated patients with Ketamine Therapy. She is certified in Pain Reprocessing Therapy™, received training in the Diagnosis and Treatment of Neural Circuit Disorders, is a trauma-informed yoga teacher (RYT-240), a Reiki Master, health coach, and breathwork/meditation teacher.
Yaicha herself has been on an evolving journey with Chronic Pelvic Pain for years - experiencing many treatments such as hormones, surgery, Chinese medicine, and Psychedelics, among countless others. She knew from her lived experience as a patient and provider, along with her training in psychiatry, yoga, and more, that she had a unique set of tools to help frustrated, overwhelmed, women suffering in pain. She is honored you are here.


Everything you need to know about Chronic Pelvic Pain (CPP) and how we treat it! ​
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What is Chronic Pelvic Pain (CPP)?
CPP is defined as pelvic pain that persists for at least 3-6 months (depending on who is doing the defining).
Why is it so challenging to get relief from CPP?
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Barriers to accurate diagnosis. As one example of what women are up against, we now know that the average time a woman waits to receive a diagnosis of endometriosis, an inflammatory condition that can cause pelvic pain, may take 4-8 years (Ballard, 2006)
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Many causes aren’t typically assessed for within the traditional medical system (see below)
What else might be causing or contributing to my chronic pelvic pain?
In addition to structural, hormonal, and physiologic causes, Pelvic floor dysfunction and neuroplastic pain play a large part in the development and maintenance of CPP for most women (we don’t yet have statistics on this as the research has not yet been done, but in my experience, I believe most women are impacted by both - how severely depends on the person and their lived experience). The incidence of CPP is also higher in those with a trauma history, including but not limited to sexual trauma (Garza-Leal, 2021)
What is Neuroplastic Pain?
Sometimes, chronic pain is not caused SOLELY by a structural issue, but instead as a result of a complicated process. Imagine you get a cut on your hand: a signal gets transmitted from your hand to your spinal cord, then to your brain. The experience of pain is generated in the brain. In this case, the pain is healthy, appropriate, and necessary. The pain ensures that you are aware of your injury so you care for it and protect it. Pain ensures our safety and health.
Sometimes, a pain signal can linger after the injury has healed or is generated in its absence. This is called neuroplastic pain. The pain you experience FEELS as real in your body as if you were injured because the brain created a VERY REAL pain signal, but it is doing so inappropriately. The brain misinterprets a message from the body that should be considered safe, as unsafe, creating pain in the absence of physical injury.
It is also possible that a component of the pain is structural, but the pain you are experiencing is disproportionate to the structural cause. In these cases, neuroplastic pain intensifies the baseline pain caused by the structural cause.
A study by Hashmi et al. 2013 analyzed the brains of patients with either acute or chronic pain. fMRI showed that those with acute pain had increased blood flow (which correlates to neural activity) in the following brain areas: primary somatosensory cortex (S1), secondary somatosensory cortex (S2), anterior cingulated cortex, insular cortex, prefrontal cortex and thalamus. However, patients with Chronic pain had increased activity in the medial prefrontal cortex (mPFC), dorsolateral prefrontal cortex (DLPFC), and orbitofrontal cortex. What does this mean? When pain transitions from acute to chronic it shifts to the parts of the brain responsible for “learning and meaning”. Interestingly, they are the same regions associated with anxiety/PTSD.
The silver lining here is that the brain can be trained to recognize that it is sending inappropriate pain signals - it just needs the right guidance and training!
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How are mental health, trauma, and CPP related?
Those who endured childhood trauma have at least a 2 fold increased risk of experiencing chronic pain in adulthood (Groenewald CB, 2020). One study found that of ~700 women who presented to clinic seeking care for CPP, ~50% reported having a sexual or physical abuse history and 31% had a positive screen for PTSD (Meltzer-Brody, 2007). Another study found an 11-fold increased risk of developing pelvic pain in patients who have a history of sexual abuse (Garza-Leal, 2021). Another found that the higher the PTSD score, the more hypertonic or "contracted" the pelvic floor (Karsten M, 2020). This is important as we know that a contracted, or hypertonic pelvic floor, can be the cause or a factor in many cases of CPP.
One way to explain the connection between trauma and pain is by understanding that trauma can sensitize the fear center of the brain. One of the screening questions for PTSD looks at hypervigilance, defined as: “a state of heightened alertness and increased awareness of potential threats or dangers in the environment.” Imagine a brain that has endured trauma - its dial for fear and threat may live at a 7, whereas someone who hasn’t endured trauma may live at a 3. The trauma, or PTSD brain has a higher likelihood of interpreting messages of safety as messages of danger - therefore creating an inappropriate pain signal. The PTSD brain may also get more “stuck” in the fear and anxiety cycle: Fear begets pain, which begets more fear, which begets more pain.
How do I move forward?
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Obtain a thorough hormonal, structural, and physiological investigation of your pain. Yaicha is available for consult calls to help you through this process. With her 10+ years of direct experience working in the medical field as a Physician Associate, Yaicha will be your advocate as you navigate the system. She understands that despite a patient’s best efforts, they may not receive an accurate diagnosis, or feel fully heard by their providers. Yaicha will help you fill in the blanks of the care you may be missing, and guide you to advocate for yourself with your providers. She will provide you with research and data for your specific questions to help you make the most informed decision while minimizing overwhelm.
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Once you have received a thorough medical workup, it is appropriate for you to explore our programs and resources. Some of our course material treats neuroplastic pain - If you are unsure if you have neuroplastic pain, schedule a One on One Session with Yaicha for further assessment.
Ways we treat CPP
Discover our Programs and One on One Services
Nervous system regulation and stress management: Essential for all CPP patients. Anxiety (another name for fear), begets pain, which begets more anxiety, and the loop goes on and on. To stop the loop, we can 1) change external factors in our lives to lessen stress 2) learn anxiety management tools to help us cope better 3) increase our “stress resilience” so that we are more capable of handling stress. The goal is to have a flexible and adaptable nervous system so that we can meet challenges with an appropriate amount of stress. We draw upon Breathwork, yoga nidra, meditation, mindfulness, and other practices for treatment.
Pain Reprocessing Therapy (PRT™), somatic, and mindfulness-based practices:
“Pain Reprocessing Therapy (PRT™) is a system of psychological techniques that retrains the brain to accurately interpret and respond to signals from the body, breaking the cycle of chronic pain. Although various treatments aim to manage pain, PRT stands apart as an evidence-based treatment to eliminate pain” (Excerpt From the PRT website)
Find more on PRT here
Yaicha is certified in PRT™ and completed training in the diagnosis and treatment of Neural Circuit Disorders.
Pelvic Floor Retraining
When you carry pain in your pelvis, your pelvic floor can become tight and dysfunctional. The tightness of the muscles can further exacerbate pain. We teach pelvic breath, external touch, and other modalities to release tightness and restore function. Side note: we love pelvic floor PT/OTs and highly recommend you work with one if you have access! However, these tools will benefit you greatly regardless of where you are on your pelvic floor journey!
Trauma Resourcing
We believe that to safely do deep trauma work, you should be witnessed and guided, and the importance of trauma therapy cannot be underestimated. In our work, we provide ancillary treatment and support to trauma therapy. We focus on embodiment as a way to heal. There is an emphasis on feeling pleasure within the body, movement practices, and more.
We teach you to safely:
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Build resource and safety within your own body (an essential foundation for any type of trauma work)
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Dialog with and understand the sensations and emotions that arise
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and more…
We 100% advocate for those with CPP and a trauma history to work with a trauma therapist. Some of the treatment modalities we find most helpful for trauma work as it pertains to pain and sensation in the body are Somatic Experiencing (SE) and Internal Family Systems (IFS). See the links to these websites below. Both websites have provided a directory of providers so you can also look for a therapist who best fits you and your needs
Transmuting Pain with Pleasure
One of the most frustrating parts about living with pelvic pain is that we are also missing out on pleasure. Our beautiful bodies were built to provide us with the amazing potential to experience pleasure - but CPP stifles that. Pleasure can facilitate healing in a few ways. 1) It feels good! When our bodies feel good, we feel good. We aren’t worrying, feeding the pain→fear loop, we are giving ourselves an antidote to pain! 2) We are teaching our brains that our pelvis IS capable of experiencing a sensation OTHER than pain.
Our courses teach sensual breath techniques that help move heavy, stagnant energy from the pelvis, while safely inviting sensation and arousal.
And much, much more….
Resources:
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What’s the delay? A qualitative study of women’s experiences of reaching a diagnosis of endometriosis Ballard, Karen et al Fertility and Sterility, Volume 86, Issue 5, 1296 - 1301
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Garza-Leal, J.G., Sosa-Bravo, F.J., Garza-Marichalar, J.G. et al. Sexual abuse and chronic pelvic pain in a gynecology outpatient clinic. A pilot study. Int Urogynecol J 32, 1285–1291 (2021).
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Groenewald CB, Murray CB, Palermo TM. Adverse childhood experiences and chronic pain among children and adolescents in the United States. Pain Rep. (2020) 5:e839.
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Meltzer-Brody, Samantha MD, MPH1; Leserman, Jane PhD1; Zolnoun, Denniz MD, MPH2; Steege, John MD2; Green, Emily BA1; Teich, Alice BA1. Trauma and Posttraumatic Stress Disorder in Women With Chronic Pelvic Pain. Obstetrics & Gynecology 109(4):p 902-908, April 2007. | DOI: 10.1097/01.AOG.0000258296.35538.88
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Karsten, M. D. A., Wekker, V., Bakker, A., Groen, H., Olff, M., Hoek, A., … Roseboom, T. J. (2020). Sexual function and pelvic floor activity in women: the role of traumatic events and PTSD symptoms. European Journal of Psychotraumatology,