Jeffrey Rutstein

Dr. Jeffrey Rutstein is a clinical psychologist, an expert in the treatment of trauma, a certified Hakomi Mindfulness-Centered Somatic psychotherapist, and a meditation teacher who has been in private practice for over 35 years. He has practiced meditation for over 50 years. He has devoted his professional life to helping people reduce their suffering and struggle while empowering them to claim their strengths, their talents, and their unique abilities to live a more fulfilling and rich life.

Author photo © Josh Hailey

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Unwinding Trauma and PTSD: The Nervous System, Somatic...

The mind-body connection is still a new concept in Western medicine. Descartes’s declaration “I think, therefore I am” encouraged many to view the mind as separate from and superior to the bodyfor almost 400 years! So, to understand the discovery of feedback loops in the nervous system linking body and mind is to undergo a major paradigm shift, with radical implications for how we view and treat conditions like trauma and PTSD—and how you can empower yourself around your own healing journey.

Why Embodiment Decreases for Trauma Survivors

Until trauma survivors feel their safety has been truly restored, their nervous system relies on defensive mechanisms like dissociation, numbing out, or immobilization. This can feel subjectively like becoming a two-dimensional “stick figure” energetically, with a body that’s barely there.

If you feel like you’re not really inhabiting your body, know that it’s not your fault and you probably had very good historical reasons to leave it. With recent advances in mind-body therapies and somatic psychology, however, there are many ways—when you’re ready—to safely return to experiencing your fully embodied self. 

Perhaps the most popular of these therapies is Somatic Experiencing®.

What Is Somatic Experiencing?

Somatic Experiencing is a form of therapy originally developed by Dr. Peter Levine. It proceeds from the premise that trauma is not just “in your head.” Though you may feel off-kilter psychologically in the wake of trauma, you’re not “crazy”you have a nervous system that has been put into overdrive.

The body can’t distinguish physical trauma from mental or emotional trauma, and this leads the brain, once you’ve had trauma, to get stuck in a state of believing that you’re in perpetual danger.

Without a way to shake off the effects of having been in a dangerous situation in the past, trauma survivors disconnect from their bodies; the trauma gets “frozen” inside. With this frozenness in the body, your emotions can become dysregulated easily; you might at times feel spacey, agitated, depressed, panicky, collapsed—or all of the above.

Again, it’s not your fault that any of this is happening: dissociating and numbing are a natural  defense mechanism. Still, it may take some work, often within a therapeutic container, to start to “thaw” the frozenness or unwind the trauma.

Somatic Experiencing practitioners help clients increase their awareness of their kinesthetic, embodied experience, and lead them through techniques to gradually release stresses that have been locked into the body. Allowing both physical responses and emotions to come through, bit by bit, restores psychological balance and can help resolve even long-term PTSD.

How It All Works: Polyvagal Theory

Neuroscientist and psychologist Dr. Stephen Porges synthesized Polyvagal Theory as a way to explain human behavior in terms of the evolution of our autonomic nervous system. It not only provides a biological frame for parts of Somatic Experiencing, it has helped therapists develop a host of somatically attuned interventions and refined the way they interact with clients.

The centerpiece of Polyvagal Theory is the vagus nerve. This long nerve mediates what Porges calls the “social engagement” system. The vagus nerve’s ventral branch supports social engagement: a calm and playful, pro-social state. Its dorsal branch supports the opposite: immobilization (characterized by dissociation, depression, numbness, or “freeze.”)

If you undergo a trauma, the dorsal branch of the vagus nerve activates a state of immobilization. On the other hand, when you feel safe and embodied, your parasympathetic nervous system functions smoothly and you can (ideally) engage socially. What makes all this possible is neuroception, perception that takes place without our conscious awareness, tipping us from safety into other modes, like fight, flight, or freeze.

Clinicians trained in Polyvagal Theory support clients in making shifts in their autonomic responses, from “freeze” and shutdown to fight or flight—to safety—in order to restore a healthy range of responses and the feeling of being safe. 

Practicing co-regulation with their clients helps the clients to re-establish inner safety and other positive feeling states.

How You Can Increase Your Embodiment

Trauma severs us from our body, and embodiment brings us back. 

Embodiment practices like somatic therapies, qigong, and various athletic activities are some of the best medicine around for the nervous system. Even just taking a long walk while paying attention to your feet making contact with the earth can be quite supportive.

Sounds True also has created The Healing Trauma Program to offer support for your healing. The course has a faculty of 13 esteemed trauma experts—including Somatic Experiencing founder Dr. Peter Levine, Polyvagal Theory expert Deb Dana, Dr. Gabor Maté, Konda Mason, Thomas Hübl, and many others. The program takes place over nine months and is truly an immersion into the world of trauma recovery, with teachings, guided practices, live practice sessions and Live Q&As. Find out more about The Healing Trauma Program.

A Compassionate Approach to Recognizing Trauma Bonding

The theory of attachment styles became popularized in the last 15 years; now trauma is (finally) getting recognition from the mainstream. But most of us aren’t yet clear about the very deep connection that exists between trauma and certain attachment styles. This is where the concept of “trauma bonding” comes into play.

What is trauma bonding?

Trauma bonding happens when we get attached to someone who is often neglectful or abusive (physically, emotionally, or psychologically), but is also occasionally kind. When we’re attached to someone like this, we typically explain away their bad behavior, claiming “they had a hard day” or “it was my fault they got mad at me.” Rationalization offers us a semblance of protection from seeing the reality of the danger and inequality in the relationship. 

It’s common to form a trauma bonding pattern when one of our parents or partners is erratic, abusive, or absent. But often the template of trauma bonding gets applied to many of our relationships.

Signs You Have a Trauma Bond

If you’re in a trauma bond relationship right now, you may make dramatic or sudden life changes or even great sacrifices for the sake of the relationship to the detriment of outside friendships, family, and your autonomy. 

Even if the original, harmful relationship is now a thing of the past (e.g., you moved out, you broke up with the manipulative partner, or your former abuser has died), the trauma bonding pattern may remain embedded until you learn how to consciously uproot it.

Signs this trauma bonding template is still present can include:

  • Emotionally caretaking others while your own needs and desires are swept under the rug
  • Acting as if you continually need to prove your worth to others (and yourself)
  • Avoiding being authentic or open because it feels like too great a risk
  • Feeling frustrated, exhausted, hypervigilant, or unsupported in relationships due to perceiving pressure coming from others
  • A pattern of feeling disempowered around coworkers, a spouse, or family members

What Causes Trauma Bonding?

When we experience stress and feel (consciously or unconsciously) we’re in danger, our sympathetic nervous system activates the “fight or flight” response. As long as that circuitry is activated, we’re not able to plan for the future or assess risks very clearly; our nervous system gets locked in survival mode to get through the stress. In other words, it’s not your fault that you can’t see what’s going on.

The challenge is heightened because of the intermittent reinforcement that characterizes trauma bonds: we receive occasional comfort or love in the relationship, which is sprinkled on top of the typical abuse or neglect. Like other forms of intermittent reinforcement, it’s an addictive combination to be exposed to, and one that hampers our ability to understand we’re being mistreated. 

Because we focus so intently on the positive reinforcement we experience from time to time with our abuser, we contort ourselves psychologically to try to get the love as often as we can. Once this pattern is established, it is naturally hard to stop engaging it—again, because of the way our nervous system developed. Getting outside support to stop the cycle is an act of strength and wisdom.

Should You Break a Trauma Bond?  

If you’re in clear and real danger, it is most important to find a way to safely remove yourself from harm. Over the longer term, the best approach is learning to create healthy relational boundaries so as not to form or reform trauma bonds.  

Once you start to become aware of the trauma bonding pattern operating in you, you can recognize and address the behaviors it causes. You can uncover and listen to your buried needs and wants, and reclaim your personal power and freedom. Doing this can help you shift your nervous system out of past trauma bonding tendencies and toward new possibilities, including nurturing mutual relationships with people who are interested in your happiness and will support your thriving.

To find out more about healing traumas (including trauma bonding), please check out The Healing Trauma Program, hosted by Jeffrey Rutstein, PsyD, CHT.

Healing the Trauma that You Don’t Know You Have

Most people living today are more traumatized than they know. But how could that be? 

When we experience very distressing events, our nervous system goes into a state of overwhelm (or what neuroscientists call dysregulation). You may end up feeling less like yourself, unable to have a healthy range of experiences, but can’t easily connect the dots mentally or heal emotionally. It’s not your fault that this happens—it’s your nervous system’s built-in way of protecting you, and it happens outside your conscious awareness. 

However, you can learn to recognize the effects of trauma. You can follow those threads through the maze of your past, to find ways of healing in the present that will improve your health mentally and emotionally.

Types of Trauma

While individuals differ in their responses, there are broad categories of trauma that we should all know exist: childhood trauma, racial trauma, sexual trauma, religious trauma, narcissistic abuse, war, pandemics and other natural disasters, and intergenerational trauma. Three of these types are briefly covered below.

Childhood Trauma

No family is perfect, but some do active harm. Too often, children suffer neglect and physical, sexual, or emotional abuse, often with no outside resources to protect them. Childhood trauma can also happen if the mother is treated violently, someone in the family has substance abuse problems or a mental illness, the parents are going through a divorce or separation, or one of the parents or a sibling dies. 

In all of these situations, because a child’s nervous system is not yet fully developed, the childhood trauma often goes unidentified until something triggers a memory or compounds it, years or decades later.  

Narcissistic Abuse

Many of us know someone who exhibits signs of narcissism, focusing exclusively on themselves and unable to empathize with or “make room for” others. If you’ve suffered abuse by a narcissist, whether they were a parent, partner, or boss, you may no longer trust your instincts in relationships or feel guilty about things that aren’t actually your fault or responsibility. You may feel you have to be “special” to gain recognition, and you may have developed a case of perfectionism to keep away the shame that your abuser made you feel for not living up to their impossible standard.

Global Events: Pandemic Trauma and War Trauma

The pandemic put virtually all of us into a “sustained survival mode” that evoked or caused trauma. The pandemic saw a 25 percent increase in anxiety and depression, according to the World Health Organization (WHO). As a shared trauma, it also led to widespread Post-Traumatic Stress Disorder (PTSD) and burnout among health-care workers. It affected parents who had to juggle supervising their children and working from home while schools were closed. And it deeply impacted those who experienced the loss of a loved one unexpectedly to COVID, who were often not able to say goodbye in person, weaving trauma into the fabric of their grief.

The first formally identified cases of PTSD (known as “shell-shock”) were in soldiers who served during World War I. Tragically, wars have been embedded into the human experience since recorded history. No matter whether it be the recent conflict in the Ukraine, the uprising in Iran, or ongoing conflicts elsewhere, the impact on the psyche of those living in those areas is severe. As widespread violence and threats of violence go on, month after month, traumatic stress compounds for both soldiers and civilians living in warzones. Even in areas where conflict is not directly taking place, there can be trauma impressed into those living in ongoing fear of nuclear war or attack.

How Trauma Works in the Nervous System

To understand your trauma, you’ll need to get to know your nervous system and how it responds to signals of danger, real or perceived.

Over the course of human evolution, our nervous system developed three kinds of responses to threats to help us get through dangerous experiences intact. These subsystems are known as: social engagement, sympathetic mobilization, and parasympathetic immobilization systems. They usually operate below our conscious awareness, but when someone experiences ongoing distress or a trauma that doesn’t resolve, the neurological connections behind these responses get strengthened and we become “stuck” in maladaptive patterns—through no fault of our own.

When the social engagement system responds, we look for help or someone to rescue us from the situation. If this response is encouraged, we may habitually “fawn” around others, hoping to appease anyone causing us distress. We can develop too much compassion for others, leading us to forget to care for ourselves, which over time creates more stress and trauma in our nervous system.

When the sympathetic nervous system responds, we engage in “fight, flight, or freeze,” to try to figure out what to do with the threat (freeze), then to subdue it (fight), or else escape it (flight). When this system is “stuck” in overdrive, we may have problems like depression, anxiety, or phobias.

If all other tactics fail, the parasympathetic nervous system can still put us into a collapsed, shut-down state (“faint”), as a way to survive with the least possible amount of damage when fighting or fleeing aren’t possible. This state is linked to depression and dissociation.

Symptoms of Trauma and PTSD

If you’ve sustained any form of trauma in the past, you may experience various difficulties, depending on the way the trauma got stuck in your system:

  • Anxiety or Panic Attacks
  • Denial
  • Feeling emotionally numb or hopeless
  • Hypervigilance
  • Difficulty connecting with others
  • Overwhelming shame or guilt
  • Aggressive behavior
  • Self-destructive behavior
  • Addictions
  • Insomnia and dysregulated sleep
  • Flashbacks

Another way to determine whether you’ve dealt with trauma is to think about how you show up in a relationship. Do you enjoy some of your interactions with others, or do you often feel inner pressure around everyone you meet? Do you feel nurtured by one or more people in your life, or do you feel responsible to everyone, all the time? Do you feel uncertain around your loved ones, like you’re not really sure you can rely on them? 

When we’ve experienced trauma in a past relationship, be it with a neglectful parent, an erratic partner, or an abusive boss, our nervous system tracks the impact, and it affects our present relationships—until we shed light on what’s happened and learn how to work through its effects on us.

Treatments for Trauma

In the last few decades, neurobiology has blossomed and cross-pollinated with psychology. New discoveries have been made, new theories have been tested, and thankfully, a range of therapies and treatments for trauma have been developed to help us cultivate deep self-regulation. Among them are somatic therapies such as Somatic Experiencing and sensorimotor psychotherapy, trauma-focused Cognitive Behavioral Therapy and Cognitive Processing Therapy, Eye Movement Desensitization and Reprocessing (EMDR) and “brainspotting,” and trauma-informed psychodynamic therapy.

Therapy is a wonderful option, but if you’ve been through individual therapy or want additional support, there are other ways to learn skills to work through trauma. 

By committing to your own healing, you’ll not only create greater balance in your life, you will stop trauma from being passed on to the next generation—and you’ll bring a healing presence into the world.

If you’d like support in your commitment to healing trauma, you can check out The Healing Trauma Program, hosted by Jeffrey Rutstein, PsyD, CHT.

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Turning to my Filipino Roots to Tend to Womb Loss

October is a meaningful month for me as it honors two important parts of my identity. It is Filipino American History Month, a time to acknowledge and honor the presence and contributions of Filipino Americans. Although my parents immigrated to the United States from the Philippines in 1980, records show that Filipinos were present here as early as 1587, landing in present-day Morro Bay, California as part of a Spanish galleon. In an interesting moment of alignment, I am writing this to you from Morro Bay, feeling the palpable power of the land and seeing the sacred 600-foot-tall Morro Rock–known as Lisamu’ in the Chumash language and Lesa’mo’ by the Salinan people–standing proudly just outside the window of our Airstream trailer. October is also Pregnancy and Infant Loss Awareness Month, a time to increase awareness about and honor those of us who have endured such loss- what I often refer to as womb loss.

This October is particularly meaningful with my book, To Tend and To Hold: Honoring Our Bodies, Our Needs, and Our Grief Through Pregnancy and Infant Loss, officially launching on October 22. In it I share how my identities as a Filipina American and bereaved mother intertwine, and how valuable it can be for survivors of womb loss to turn to their cultural traditions for support as they grieve and as their postpartum bodies return to a non-pregnant state. How I came across this online essay and found solace in the language of my ancestors who use terms to describe miscarriage as “someone from whom something was taken away” rather than placing blame with the prefix mis- which means wrongly or badly. I did not carry my pregnancies wrongly or badly. Loss was something that my body experienced.

The following is an excerpt from To Tend and To Hold that I hold dear as it shares a traditional Filipino dish I grew up eating and that I share now as a postpartum doula to offer comfort and nourishment to those who are postpartum, both with living children and after loss. I hope it may offer you comfort as well, no matter if your experience of womb loss was recent, in the past weeks, months or even many years ago. My heart is with you and please know that you are not alone as you grieve and as you heal- at your own pace and in your own way.

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I recently cooked this recipe for champorado, a Filipino rice porridge, for my beloved friend Katrina on a very tender anniversary, the due date of one of her children and the death date of another. Her child, Zeo Thomas, would have been born that day had he not died in the womb at five months gestation. It was within the same year of his death that her second child, Solis Vida, died in the womb in the first trimester. In truth, Katrina had been bleeding for over a week to release her second pregnancy, but as she bled through Zeo’s due date, she felt an intuitive pull to honor this same date as Solis’s death date. I thought of my friend as I made my way slowly through the grocery store. Though it was crowded and busy, I felt cocooned in my thoughts and intentions for her—how I wanted to help her feel seen and held during this difficult time—and I found myself gathering each of the ingredients in a mindful way that felt like the beginning of a bigger ritual. Knowing I was going to cook for her to honor her, her babies, her grief, and also her longings added a layer of reverence to what would otherwise be a standard grocery run. Later as I cooked the porridge in her home, I channeled my love and condolences into each step. And when I finally brought the warm bowl of champorado to her and saw her reaction, it was my turn to feel honored. Honored  to be there with her. Honored to tend to her. And with a dish we both knew from our childhoods. She dubbed it “postpartum champorado,” and so it shall be known.

Warm and soft, rice porridge is one of the best postpartum foods as it is easy to eat, warming to the body, and gentle on the digestive system. Its very nature is to offer comfort. In my opinion, champorado, a Filipino chocolate rice porridge I grew up savoring, is one of the most heartwarming dishes, with the cacao tending as much to the emotional heart as to the physical body. It can be offered any time of day for both a filling meal and a gentle reminder that there is still sweetness in life even amidst grief.

In this nourishing version, cacao powder is used in place of cocoa so that we may benefit from all that this superfood has to offer, including iron to help rebuild red blood cells, flavonoids to improve blood flow, and magnesium to ease anxiety and depression. In addition to being nutrient-rich, cacao is also known to lift the mood. If the thought of preparing food feels beyond your current capacity at this moment, consider sharing this recipe with a partner, postpartum doula, or other support person and asking them to cook it for you. Additionally, if you are currently pregnant, please consult your health-care provider before consuming cacao as it contains caffeine.

Champorado: Filipino chocolate rice porridge

  • 1 cup sweet rice (also called glutinous or sticky rice) or sushi rice
  • 5 cups water
  • 1/4 cup cacao powder
  • 1/2 cup brown sugar
  • 1 tablespoon unflavored protein powder (optional)
  • Condensed coconut milk for topping
  • Cacao nibs (optional)

Rinse the sweet rice several times until the water runs clear when drained.

Combine rice and water in a pot over medium-high heat. Bring to a boil, then reduce heat to medium and continue to cook until the rice is soft and the porridge thickens (about 20 minutes), stirring often to keep from sticking to the bottom of the pot.

Add cacao powder, brown sugar, and unflavored protein powder. Stir to combine, then remove from heat.

Drizzle condensed coconut milk (or other milk of choice) and top with cacao nibs. Serve hot.

To Tend and to Hold

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Eileen S. Rosete

Learning the Art of Thriving Online

Amelia Knott is an art psychotherapist who specializes in the mental health impacts of hustle culture and social media. In the video below (3:22 minutes), she shares her inspiration behind her written and illustrated workbook, The Art of Thriving Online: Creative Exercises to Help You Stay Grounded and Feel Joy in the World of Social Media and invites you in on the journey of reimagining a healthier relationship with the digital world.

You can also read the video transcript below:

It’s been half my life—literally half the years of my life—lifting my chin for pictures, anticipating the critical gaze of a digital audience, offering my presence half-heartedly to the world around me to to draft a clever caption, choose a flattering filter, and watch as my phone tells me if this time my work will be rewarded with worthiness.

Too many nights avoiding myself, letting the blue-light-lullaby of my screen become a substitute for true soothing. It’s been half my life; holding up the mirror of comparison to everyone’s best days and hottest takes, highlight reels curated with effortless nonchalance, and now the mirror of comparison to a perfected self made in the algorithm’s image. It’s been half my life of fractured attention, commodified vulnerability, fury, and fear taking turns with despondence.

What if my real life stopped being my body or the land, and became the non-place I devote my hours to?

And it’s been half my life wandering daily into the galleries of artists’ and thinkers’ most beautiful ideas. Half my life keeping far-away loved ones close.

It’s true that the Internet gave me my career, my marriage. It made visible the threads of similarity across a quickly dividing globe. It showed me life-saving examples of people who survived what I needed to survive and it broke my heart open at the things no one should have to.

I like to misquote Carl Jung when he said something almost like “a paradox is our most valuable spiritual tool.” I’m not interested in finding the elusive, singular hack that will make screen time less alluring forever. I’m not interested in a lifetime of cycling through eras of detox and excess. Vacillating between the high of a new regimen and the crash of shame when social media works once again, exactly as it was designed.

I’m a therapist. I know that hacks can be tools, or bandaids. A self-help, step-by-step, sales pitch plan can feel like salvation, but it’s not the medicine of being in an evolving conversation with yourself. I am more interested in making art. I’m more interested in learning to tolerate the tension between social media’s danger and its magic. I’m more interested in learning to like myself, unsolved.

And when I’m learning the same lesson, again, the hard way, I know that my allies in finding safe passage through the digital age are art and writing. Creativity is how we imagine a different future.

So I wrote us this book. It’s a place to start that conversation with yourself about what is really happening between you and your screen; who profits from the ways it harms you, and how to protect the parts of it that are genuinely good, because parts of it are.

So if you are ready to join me—an art psychotherapist who both loves the life her phone enables and desperately needs to put it down—we’ll make some art. We’ll sit in the stunning and maddening paradox, and we’ll find creative ways to author our own definitions of real wellbeing when we choose to be on social media.

And together we’ll find the art of thriving online.

The Art of Thriving Online: A Workbook

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Amelia Knott

Five Tips for Postpartum Bliss

Bliss out on baby, mi amor. Love your chichis. Admire your soft curves, your delicate belly, and the way you require intentional care. Everything deep comes to the surface as you pour sweat, milk, blood, and tears onto your sheets. I want your postpartum to feel blissful, so here are five tips to help you make that happen.

1. Make a postpartum plan.

You can’t plan exactly the way the birth will pan out, but you can plan the details of your postpartum support. Bodywork, meals, laundry, and childcare for your other children are some things to consider. Use this book as a guide to feel into what nonnegotiables you’ll need in place during la cuarentena.

2. Don’t DIY postpartum.

There’s a time and place for self-reliance. Postpartum ain’t the time. Postpartum traditions are community centered. Once you know that you’re pregnant, surrender to other folks holding you. Waddle that ass to circles with like-minded familias who you know would be down for mutual support. This is why we have the Indigemama community and so many other comunidades who are dedicated to saving our lives.

3. Shift your mindset.

One of the biggest internal challenges I see postpartum people go through is the mental chatter that puts a wall up, barring any chance for outside support. When we’re socialized into struggling and then rewarded for doing things on our own, it’s easy to feel guilty asking for help. You might be distrustful of other people’s capacity to fulfill your needs. How many times have you heard women say, “If you want something done right, you gotta do it yourself”? This belief sets postpartum people up for anxiety, stress, depression, and overwhelm. If you want postpartum done right, you have to feel in your body that you are worthy of being venerated; you must feel that you are deserving of being held. 

Paying homage to you is paying homage to nature itself. Give your potential supporters that opportunity to connect with creation.

4. Repeat after me: affirmations, affirmations.

It’s easy to feel ashamed to ask for what you need. It’s normal to feel guilty when you see how hard people are working for you. Give yourself a pep talk: I allow myself to be cared for. I accept this help. I trust that I can be held without lifting a finger. I surrender myself to the love and labor of others. I soften and allow myself to be carried. I want you to do this every moment that you need it. When you affirm that you’re doing the right thing over and over, then eventually it becomes second nature.

5. Support your romantic relationship.

Postpartum is stressful AF! Those of us with multiple children can tell you that the little ones tend to take precedent over romantic relationships. But after a while, that really weighs down a union. Plan relationship goals. When will you start to date again? What’s the plan for one-on-one time? Who are the people who hold you and your partner(s) up as a sacred union? What baggage can you each decide to let go of now? What support can each of you get individually from healthy older couples who are content with each other? What can you appreciate about each other during la cuarentena? What words do you need to say to each other when the going gets tough? Nurturing a healthy, loving relationship with each other when you’re parenting children is a practice of discipline.

This excerpt is from Thriving Postpartum: Embracing the Indigenous Wisdom of La Cuarentena by Pānquetzani

Pānquetzani

Pānquetzani comes from a matriarchal family of folk healers from the valley of Mexico (Tenochtitlan, Texcoco, and Tlaxcala), La Comarca Lagunera (Durango and Coahuila), and Zacatecas. As a traditional herbalist, healer, and birth keeper, Pānquetzani has touched over 3,000 wombs and bellies. Through her platform, Indigemama: Ancestral Healing, she has taught over 100 live, in-person intensives and trainings on womb wellness. She lives in California. For more, visit indigemama.com.

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