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Thriving in SLP: Mental Health, Connection, and Compassion

Jeanette Benigas58min

Jeanette Benigas

00:00

Hey, fixers. This is Jeanette. I'm sitting in a busy coffee shop trying to get this thing ready to bring to you. If you are someone who typically listens as soon as our episodes drop, you'll notice that we did not come out with a new episode yesterday, Monday, January, 20, and that is because we received some really, really great news. We needed to have some time to prepare a response to this news and get everything ready for the website. At the time I'm recording this, we still do not have everything on the website that we want, so by the time you listen, it might not be up yet, but as part of tomorrow's workday, I will finish up all the work. So if you're an early listener and you want to participate and don't see the place to click, just check back in a couple hours. And thanks for sticking with us and supporting this movement.

Preston Lewis

00:55

Jeanette and I are giddy right now as we have some very positive news to share. Feels like there is rebirth and that, you know, give me liberty or give me death from one of the cradles of democracy in the Commonwealth of Virginia, we come with great news. Jeanette, tell me about it.

Jeanette Benigas

01:18

In the state of Virginia, the licensing board has a public comment period open because they have proposed, I think they have proposed. This is, this is hot off the press. I just got an email an hour before we started recording, and it's night time. It's almost 10pm here, so I haven't been able to get the full story, but from what I can tell it looks like this was a self initiated thing. The board is removing the CCC from the initial licensure language and removing Asha approved CEUs from their CEU requirements. So it's open for public comment, because that's how it goes. But typically, when you self propose something, you enact it normally. So if they get a lot of pushback, they may not do it. We may do something. We may do a call to action, like we did in Delaware, where we have you print out a letter and we'll just submit everyone's signatures so the board isn't getting 1000 letters that they have to look at. Or if Virginia has something this, if the state association has something, maybe we'll just share what they're doing. So we're here to be supportive. We're here to be collaborative. And this is exciting. This is exciting. We surely inspired this change. This is not a fix. I'm not going to call this a fixed. SLP, win, because we didn't do this work. We were getting ready to launch the team. We have like 13 names on the team list. We're ready to go. We just haven't gotten there yet. We didn't do this, but the tides are turning. People are listening. People are paying attention. People are inspired. We're just going to give props to that Virginia Board if they're doing this themselves. They heard the fixers nationwide, and they said, You know what? They're right. We're taking control back. That's just what I'm going to think.

Preston Lewis

03:18

We don't

Jeanette Benigas

03:18

Gonna let myself think that

Preston Lewis

03:20

We don't need the little merit badges and, you know, all the little stickers and everything, because it's the state license that matters. And so if we get to this point and it is indeed approved by the Virginia Board, then we're down to what one and a half, depending upon what Delaware exactly kind of comes down with. You know,

Jeanette Benigas

03:40

Well, it would be like, this was the half

Preston Lewis

03:45

This was the half, okay

Jeanette Benigas

03:46

This was the half. So it would be Nevada and Delaware. Except we also learned in the last, I don't know how many weeks or months, that Rhode Island actually, right, yeah, yeah. And this was not a new change. We had it wrong. So Rhode Island requires the CCC for initial licensure, and our map is updated so it is reflecting appropriately. But we had that wrong. So really we're down to three our half, if this goes through, our half is off. So the three are Nevada, Rhode Island, Delaware.

Preston Lewis

04:26

I think that we're able to admit that we make mistakes. You know, we're not like some big ivory towered $70 million a year organization that just professes to be perfect in every single way. You know, we make mistakes. And Jeanette and I sometimes shank it into the woods, to use a golf analogy. And it's okay, you know, we we do the best we could, because, you know what, we're really volunteering our time. Here it is, it's 10pm where you are, and it's, you know, we just got through with an interview. We are, you know, imperfect sometimes. But you know what? Like we said earlier, the tide is turning. The momentum is there. The message is getting out, I imagine, like great state associations that are finally saying, Yeah, they've got a good point. And then there are those rogue fixers out there, the ones that just kind of pick up the mantle and run with it. It doesn't matter. The credit is, I mean, we're happy to say, Hey. We're happy this is working, and maybe it came from here. We just want to get there.

Jeanette Benigas

05:24

Yeah

Jeanette Benigas

05:29

Hey, fixers, I'm Dr Jeanette Benigas, the owner of fix SLP, a grassroots advocacy firm here to challenge the status quo in speech language pathology by driving real change from insurance regulations to removing barriers that prevent full autonomy, like the CCC, this podcast is your space to learn, engage and take action in the field of Speech, Language Pathology. We don't wait for change. We make it so let's fix SLP.

Jeanette Benigas

06:15

Hey everybody, welcome back. We are recording today in the middle of the day on a random, not typical recording day. And so this is just Jeanette, no Preston, because the man has a job, but joined with me today is Ruchi Kapila. You're okay with me using she. You can use she because, I mean, basically I was going to say the turn of the century, but the turn of the new year, I just was, like, any all pronouns are fine. I mean, I had some I had some changes, and I was just like, You know what? It's not something you can use, she, you can use, they, he, anything. I mean, if you want to try anything out, practice, it is fine. It's all good, alright. Well, she is with us today. We've been going back and forth for a little while about doing an episode together and just through some things that have happened over the last month or two, we kind of landed on the topic of mental health. So I think this is going to be a really important conversation today. We might hit some other topics as well, but we do have a time constraint, so we'll see where we end up. For those of you that don't know Ruchi, I'm going to practice. I'm going to give them the floor to tell us about himself.

Ruchi Kapila

07:28

Yo, wow, like that. That's the first himself I've had. It. Got a little thrill out of it. So Jeanette, just as you know, I work in gender affirming voice I'm the CEO and SLP of Capilla voice and speech services, so I do a lot of both gender affirming voice other voice, like traditional voice disorders, singing voice rehab. I've had an extensive experience working in inpatient, outpatient medical particularly with adults, so dysphagia, cognitive communication, yada yada yada. Don't want to spend a lot of time on that. And I've taught a couple, a few courses at the undergraduate, graduate, like blended level. So I've had a breadth of experience just being an SLP, in a pretty short period of time from when I graduated in 2016. I'm trans, non binary, gender fluid, whatever, whatever, South Asian, American, Punjabi American by background. A big gamer, a big nerd, a big cat lover. And I'm really happy that we get to talk today, because I feel like we developed a real friendship and a space where, you know, we could be really transparent with each other. And I was like, it would be really nice to be able to share that, especially during really difficult times on on your show. So, yeah.

Jeanette Benigas

08:43

So we initially had one topic we were going to talk about, but then you recently sort of experienced some sudden health changes, yeah. So do you want to talk about that? Because, I mean, Asha was maybe not the cause. Maybe it was, you can tell us, but Asha ended up being wrapped up into that, which is what also makes it relevant to our movement and the podcast. So why don't you tell us about that?

Ruchi Kapila

09:08

Sure, so I would call myself ASHA ambivalent by background. You know, I have my Cs, but like, I don't, and I've done things for you know, whether it's the website for the gender affirming voice they have, like a module or a discussion point, like a standards, let's say, and I have given them a course that was paid for the private practice SLP conference. But I haven't really wanted to be an ASHA leadership. I haven't really wanted to be, you know, on a I'm not really interested in a lot of unpaid labor, because life is hard enough as it is, but if there are opportunities to make things slightly more accessible for people in terms of the work that I did, I was willing to do that. So I got comped registration for an invited panel. I was supposed to basically participate in four talks and a fifth one. Got accepted that was disability related, and being in the disability caucus that was important to me, I felt like this was me, like, I'm gonna do my thing and I'm gonna say my goodbyes, of like I'm not really gonna be doing this kind of work anymore. And I have feelings around having the Cs, but I don't know. I just don't know what those are yet. I mean, I'm just, like, navigating, and so I was just really, let's say, burning the midnight oil when it came to clinical work, when it came to working on publication work this year, there was very little in me that was not SLP related much of this year, and even when my husband would come home and say, Please, get off your phone. Please. You know, like, stop working. Like, I didn't get those cues, and I didn't get those cues that had changed and that at this time, I was a self diagnosed autistic. I was diagnosed, like, confirmed by my psychiatrist, ADHD anxiety last year. I've had a very storied history when it comes to mental health, whether it's depression, this, that or the other. And like, kind of just like pinballing my way through the DSMV, let's say, and so there have been times where I haven't been medicated. This time I had a medication that was not a stimulant, and I had a medication that was specifically for anxiety. That's very, very common. I will say there was like a perfect storm of I was busy, busy, busy. I wasn't eating much during the day. I wasn't sleeping particularly very well. I was caught up in a lot of things, like what people were thinking, what I needed to get done. Am I behind? We have like, two gender impermanent voice trainings that are coming up in Denver and Boston this year. So there's a lot of legwork. As you know. Kevin Dorman from Prismatic and from Trans Voice Initiative, which I'm a part of, got lingual cancer. Like I got the diagnosis the day after elections. Then my dad had heart issues, and we also argued about the election. So there were so many stressors. There were just so many stressors. And then I'm like, my brain was like, I just gotta make it through Asha, and I had booked a nice, affordable hotel way before Asha had even released the block. I like, I booked this in February, March, let's say, because I was like, I just need to get an affordable Hotel. That's actually nice. I was planning for my husband and I had to have a week in Seattle. Like, I was like, waiting for this moment. And I even upgraded us to first class to fly up trying to make this this is going to be romantic time, plus a sprinkle in a little ASHA. I'm not, I'm not going to go to anybody's talks. So I was really trying to make it more accessible and interesting to me that I was like, Seattle is a great town, city, I should say, has a great public transit. There's a lot of stuff to do. Let me share this with my husband. Let's have a romantic time together. That did not happen. So okay, everybody should fly first class if you can, because, like, it's worth, like, just fly less, but go big and, like, it's nice to have somebody know your name. It's nice to have as many beverages as you want. It's nice to be fed, like, it's nice to be cared for, right? And I realized that flying first class. I was like, this is not actually made for rich people. This is actually made for disabled people. Disabled people deserve to fly first class, and especially in fact, disabled people like myself definitely deserve to fly first class. Is so nice to not ask for a seat belt extender to just fit and then not worry about, like, if you're taking up too much or too little space, or if people around you are comfortable. So my husband and I very much enjoyed that. But then getting to the hotel, like it was a it was just kind of a wild ride. We had a wonderful place to stay, and then I just I couldn't sleep, and I couldn't chill out, and we went out down and had dinner, and I was basically on first name basis with everybody at the hotel. And I had basically said, Please don't treat me, treat me as a guest, like, I don't feel comfortable, you know, being waited on like, that's just not my vibe. And I had very deep conversations that went back and forth with, like, everybody there, around election, around backgrounds. I was like, it was like, I was trying to do my own qualitative research. And I told them this, but I was like, this is not gonna get published. This is just for me, like, to to understand what's going on. These are non routine things to do. I had also arranged things like AC Goldberg would in the room I learned about so I had all of my masks, my face shields, like, beautifully. And I, like, basically turned the room into a little suite. And Blake, my husband, is like, what are you doing? Like, this is not like you at all. This is terrifying. And I had a wonderful dinner. I had more conversation downstairs. I'd met another, like, older woman who's kind of local, but like, kind of came down to the city, so we decided to have breakfast together. I'm very rarely this spontaneous, okay, like it's just not like me at all. And so I go upstairs, and I've been texting Jeanette here and there throughout for for months, I think. But also, especially during this process, I had already created care teams that were labeled Ruchi care team. This Ruchi care team that because I knew I wasn't, well, um, I Yes, please go ahead, Jeanette

Jeanette Benigas

15:01

I'm just gonna interrupt, because I think we have listeners from every aspect of life. Can you tell people who maybe don't know, but what is a care team?

Ruchi Kapila

15:14

Yeah, that's a great question. It can be a lot of things, but sometimes you might need a little bit more support. And so this might be friends, chosen family, actual family members, but you kind of put like, these were in text groups, and I was like, I don't know how I'm going to present at ASHA. I don't know how I'm going to be at some of these after parties. We need some safe words around when I need to get out. I'm asking for help and to like for you to observe me, and it's more than I would ever want to ask of anyone. But I was like, if we're in a situation where I have to go, shout out to my friend who I called like, a couple days before, who was like, you can't go like, this is not a great idea. And with them, I was just like, but if I don't go now, I'm never gonna go back, you know, and I know that in my in my body, so it was, it was very much a like, okay, what are my needs? What are ways that you can show up for me? Like, can we come to an agreement? So I'm not overwhelming you with my shit and then, like, let's see what happens. Yes, did that, and I'm just speculating. So tell me yes or no, maybe you haven't been in a good place like you recognize I'm not eating well, I'm not sleeping well, I'm not feeling quite myself, and because I don't know how I'm going to present, I don't know how I'm going to do in these crowds. I don't know how I'm going to do with the stress and all of the socialization, I might end up in a place where I'm really, really not well and need help, right? Is that how that happened? Okay? Absolutely and baseline. And I'll say this, even knowing Vicky Jill Williams and everybody, like a lot of people who've contributed to ASHA, I hate the ASHA convention. I absolutely hate it, even when I'm at my best, like I will go to my talks, and if I have some friends who are talking, I will go, but I'm my I'm high tailing my big butt out of there every minute I can, just for self regulation, and that was just from an autistic ADHDer baseline.

Jeanette Benigas

17:09

Yeah, but also for people who don't understand, and I don't know, I assume you're I'm taking a lot of assumptions today.Are you an introvert or an extrovert?

Jeanette Benigas

17:20

Ruchi Kapila

17:20

I am an extrovert with people I really like, and I love to present. I would say

Jeanette Benigas

17:25

Yes. Okay.

Ruchi Kapila

17:26

and I want to, I really want I have, like, mixed dog, cat energy where, like, I don't want to be a misanthrope, and I really do want to share myself. And I think at the root of it, I want to be loved. I want to share love, it's not always safe to do that with people, and so that's the thing.

Jeanette Benigas

17:45

So for people who don't like who don't present, or who have never presented, I also love to present, but, and I was shocked when I found this, I am, like, addicted to personality tests, and I don't just take the free one. I have paid for the Enneagram test I had, like the full one. I have paid for multiple ones. And so the one that got me started, many years ago was the Myers Briggs

Ruchi Kapila

18:10

yes, um, yeah

Jeanette Benigas

18:12

I found out I was an I. I had it administered in person by, like, someone who administers it. I spoke with him after and I said, I don't think I'm an introvert. And what he said was, introvert versus extrovert is where you get your energy from, not necessarily being outgoing. So what he said was, would you rather be in a coffee shop with one or two close friends or in a party with 50 acquaintances?

Ruchi Kapila

18:42

Oh yeah, yeah, yeah.

Jeanette Benigas

18:43

I was like, Oh, coffee shop all day, hands down. He said, I imagine when you're in those other situations, you could do fine and enjoy yourself, but afterwards you're exhausted. I was in undergrad when I got this test done. He said, As you get older, people tend to move more solidly into their personalities. So he said, as you get older, I imagine that you will want to be in crowds less and less and doing those things might make you more and more tired. So when you are a presenter, just doing one presentation as an introvert can be exhausting. You were gearing up for five, and so the prep is exhausting.

Ruchi Kapila

19:29

Yeah

Jeanette Benigas

19:29

The mental load of figuring out, like, how long is this going to take? It's all exhausting to prep for something like that

Ruchi Kapila

19:36

Exactly.

Jeanette Benigas

19:37

Then you didn't even get to this part. But then presenting, I'm just done. You know that I would be able to do five at a conference like that. So good for you for even thinking about it.

Ruchi Kapila

19:48

I mean, I co authored on five. I was technically going to do four, and all four were going to be a dyad or group effort, and but it was still, it was still very hard for me to be able to see myself doing it in this state, and I didn't want to let people down. There were a lot of people who were like, I want to meet you there. Like, I am really looking forward to this talk. I was also doing the calculus in my mind of, okay, these people, the bigger groups, they can do it without me. The panel can definitely do it without me. And then the dyads, these people can do it. They don't need me there. Like, there was a part of my brain that was working, a very small part of my brain that was like, You are not needed here. You could potentially stay in bed in Seattle the whole time. You don't even have to go that Saturday night, I was up late and the thoughts just kept spinning. I essentially wrote a document. Part of that was me like, I'm deconstructing myself. And I got to a point where I was like, I just want to go to ASHA, and I want to relinquish my Cs. Like, I don't even know what it means anymore.

Jeanette Benigas

20:53

Yeah

Ruchi Kapila

20:54

and it on a deep level

Jeanette Benigas

20:55

You had a plan to do that. You messaged me with that.

Ruchi Kapila

20:58

Yes, I had a plan. I and I was like, I'm just gonna go and I might not, I might not even present like, which is not the, you know, and that's, it's a valid choice. It's a valid choice for people to make.

Jeanette Benigas

21:10

Yeah

Ruchi Kapila

21:11

That is not the way you should make that choice. You should make that choice in sound mind, after weighing out pros and cons and knowing what your plan is, but not in self immolation, let's say, or trying to do some sort of demonstration, because I don't think it would have landed well and like, luckily, by the next day, my friends had read some of this document, and they're like, Ruchi, like, you need to take this off socials. You need to make sure that it's not accessible. You need to go home. My husband's very sternly is like, you know, we need to go home, right? And I was like, Yeah, we need to go home. And I cried because I wanted to say goodbye on my terms. But, you know, life is just the way that it is. There's family medical history because of stigma being South Asian, and because mental health care was the way that it was in the 60s, 70s and 80s, there and probably here as well, where there wasn't as much consent based, client based considerations, and there's a lot of trauma with that. There were a lot of ways where my family was not as transparent about stuff that might or might not be in our family. And so I think I basically got misdiagnosed, and by the time we came home, I mean, I knew what it was, but, you know, I couldn't say it. I'm home, and I talked to my psychiatrist, and he's like, so we're looking at, like, bipolar too. And I was like, that sounds right? Because I can't say if that was a manic episode or a hypomanic episode. And I, you know, I had to just describe the situation, show them, show them what I wrote. And the reality is, this is something that I felt like I was running from for a long time. I wanted a garden variety mental health diagnosis, or I wanted something that falls nicely under the neurodivergent umbrella, as ADHD or autistic identity is starting to but the reality is, I'm neurodivergent, and this is one of the things in the cocktail now, and having to confront the fact that, yeah, I was hyper capable, you know, in the last four years. One of the good things I can say is that I always wanted to be alive. There was no question about that, which is something that's concerning for people who have this diagnosis. And one of the things I wanted to say was, like, I had great friends, including Jeanette, who was like, you have options. It's okay.

Jeanette Benigas

23:28

I want to speak to that a little bit too, so we can tie this to help keep us on track. You also wanted to talk about community connection and collaboration and helping each other. And

Ruchi Kapila

23:38

yeah

Jeanette Benigas

23:39

large organizations like ASHA might help or not help or exploit, but you had messaged me very specifically about your plan for like dropping the CCC. And we have had an interesting trajectory of this friendship. And we had talked a couple times and we had done a zoom, I don't know Ruchi very well as a person, all the ins and outs and what she might do or not do. But when I got the message with this plan to let the CCC go, the first thing that I thought and felt in my heart was this feels very manic to me, and I don't know, zero judgment, but concerned, because I didn't know, is this normal Ruchi, just like making these wild plans, and this is just what Ruchi does, or is Ruchi Okay? And just like you said, the choice for life or not to have life is very concerning. And I thought to myself, if this person is in harm's way, and I don't speak up, I will never be able to live with myself. And so I became very concerned, and again, non judgmental, but we have one mutual friend like I didn't know who else to call or who else to get in touch with, and I'll say it was AC Goldberg. AC Goldberg is a mutual friend of ours, and I've got him on the speed dial, so I try not to bother him because he's so busy, but I sent him a message, and I said, "Hey, I got some concerning messages from Ruchi. I said, as a concerned friend, I want to make sure that everything is okay, because I don't know how to get a hold of anyone if she needs help." And thankfully he did get back to me and said, she's okay. She's going to be going home. Thank you for reaching out. But always listen to that inside voice, because even though I don't know you well, like that to know if like this is just something you do, it was enough to get my spidey senses going to say like this is a person who's valuable and needed and loved by many people, and if something's going on, if there's any chance that something's going on and she needs help, what if I'm the only person she talked to? So always reach out to someone, or don't ever not do it because you don't want to seem like you're being judgmental. That's an action out of love that we need to do for each other as speech language pathologists and just humans in general. So that's so important. And I'm glad that you had those care teams. I didn't know, but, yeah.

Ruchi Kapila

26:16

I didn't communicate that well. But like, I think you were an important voice in that milieu, for sure. You know, to me, where I was, like you showed up, even though we've had, like you said, a trajectory, we haven't necessarily had, like the deep, like conversations of self exploration, philosophical considerations. We've talked a lot about the field, but we haven't talked about ourselves, just as people, I remember interacting with you, and you just being like, you're going to be okay. There are options you I just need to know that you're okay. But yeah, it was, it was hard, and it was like, hard to say, was there planning? Was there not was I posting all of that publicly because I wanted to make sure my family wouldn't sweep it under the rug and my by my family. I'm talking about my parents. My brother was awesome. I basically got a therapist, one who was formally citing seal, and then I have one through my insurance. I made sure to, like, have that team. When I got back, I think I was very scared of it getting called extreme stress, because I was like, I've had moments like this before. This was the only time I had it and I wasn't really angry at people yet, I wasn't trying to externalize things. In my previous iterations, I've had a lot of self hatred in this one, I didn't and I had to, like, learn to kind of love the mistakes I've made love the things that didn't align with my sense of integrity. Now, because we all have them. And I think you wanted to talk about community, but like, I was, like, I had to trust that you... these folks who I have, who are in heart, family or I trust. I had to trust everybody with something very vulnerable about me that has a lot of stigma, and irrespective of how much I've achieved, being not ideally medicated and not really knowing that this thing was a part of my life, for sure, for sure, I still really had to rely on my community. And I think if you have to for something like that, definitely when we're talking about advocacy and being able to hold on to the joy of what it is to work with the people that we do when we're holding on to the joy of why we even signed up or applied to grad school in the first place is so so so important. It's very easy to become cynical. Many of us, including myself, have but finding the joy in what we do that is something that definitely requires community.

Jeanette Benigas

28:46

I want to transition a little bit because we kind of thought out what we might be talking about a little bit in here, and it was ASHA being a clinician, recognizing your your gifts as a as a clinician, and your strengths. So why don't you talk to us about finding your individual strengths as a clinician, recognizing your gifts in order to avoid certain things leading to affecting your mental health in some way that maybe could lower your standards for your career, what you want for your career? I'll kind of just let you shape that. But that was where we had it next.

Ruchi Kapila

29:22

Yeah, I think all of that makes sense to me. So, I mean, I think just from my lived experience, I didn't have balance, at least in the last year, I didn't have balance. And I think part of what makes us great, SLPs, or what what we are outside of SLP, and most graduate programs, most training opportunities will not say that, but that's the reality. When you bring some of yourself into the session and you're able to line it up or link it up to something that is meaningful for the client or the patient or the student you're working with, that's everything, and that's when we kind of achieve a kind of flow of the session where it kind of transcends what's going to be on the SOAP note. It transcends what are the goals you get into a place of like some meaningful communicative interaction. And I mean, even with dysphagia therapy, you can get into that kind of space because you're sharing the love of food and vibement with a more natural reinforcement. Anyway, I think my biggest frustration is that people look outside for how do I be better? And yes, I think I've had a lot of great continuing education experiences that were meaningful, like Walt Fritz doing manual therapy, super meaningful fees and video strabos, copy conference, practical knowledge, very meaningful, but especially when we're looking at things like neuro firming or neuro diversity affirming certifications, or if it's like medical SLP certifications, and I'm not naming anybody in this, I'm just saying like whenever we even think we need to have something more after our letters, or we need to have a listed thing, a certificate of something that doesn't show that you've worked with anybody. CBIS is one thing where you have to demonstrate that you've worked with somebody, and you have to take an exam and whatever. A lot of these things, these are not about building the client, the patient, the student relationship, but that's where the real learning happens. You won't get it from a quote, unquote, master expert clinician, it's when you confront the fear and you embrace the love of the learning in the moment with the person who's the unknown quantity x, and you allow yourself to be vulnerable, to learn about them and see where your brain and where your heart goes in responding. And even if you don't have the ideal interaction, or you don't have the ideal intervention, or you don't have the ideal session, you still get information from that to integrate into your work, but also the amount of fun that you have outside, and the ways that you develop yourself as a person, as it as a philosopher, all of those things, they come back to the session always, because more and more we are the most human, accessible, vulnerable providers that people see. And I think that's important. I think you should want doctors to do it. You should want nurses to do it. You should want PT and OT to do it, which I'm sure they do on their own way, but you should also embrace that speech language pathology is about being human and being vulnerable together. I just don't think there's enough of an exclamation mark behind that in most of our training institutions.

Jeanette Benigas

32:34

A lot of people don't think about this, but it's also why oftentimes in training institutions, we are classified into health and human services or arts. We're more of a profession that falls into the arts, and that's why some of us have an MA and not an MS, because there is that component to it, and it's also what makes our research hard to do, because some of the things that we do that incorporate all of the points that you just named, you can't quantify that this is all person based, relationship based, brain based. Every brain is different, you know. So even some people I always taught in my neuro classes, the right and left hemispheres are reversed. If you're left handed, you're more likely to have your language dominant hemisphere be on the right side. You can't quantify these things, and this is so a conversation for another day. But then that's also why we get to the reimbursement issues we have, because we can improve what we do always on paper, because it is so specific and so ingrained in that relationship and the skill it just again, everything you just named it is more of an art. It does include relationships. It's not lift this weight to make this muscle stronger. There are so many other pieces to it that you just can't put on paper.

Ruchi Kapila

33:59

Yeah, and the reality is, the clients and and the patients and the students, what they do is the proof, and that's actually out of the locus of your control. And I often said when I was working in the hospital, because there was always this stuff about, you have to prove. You have to show you have to. I was like, I'm creating a space, and I'm facilitating an environment for somebody to show up to me, and that's really what it is, more so than is it I'm doing something, they're doing something for sure, or they're not doing something. That's what it is.

Jeanette Benigas

34:33

During my doctoral program, and one of my mentors said speech pathologists don't actually fix anything. They treat behaviors. And I've thought about that over the last 15 years. And we do help, quote, fix things, but largely what we do, really is changing behaviors. Like you said, it's what the patient or the student or the client. Does, right? We're not we're not helping to repair a muscle, right? We're not fixing a bone with a cast or some kind of surgery. We are literally using our therapies and our relationships to help change what people do or how they say something with you know, what they do with their tongue. That's a behavior. So as I've gotten older and thought more and more about this, I was like, Man, she was actually right. We really do mostly treat behaviors. Really started thinking about it and what the person does or doesn't do, right? It's just, it's exactly. But I was so offended when she first said it. I'm like, she didn't know what she's talking about who she never treated. But no, as I thought about it, and these things you're saying, like relationships sometimes that you have with your client or your patient changes the outcomes.

Ruchi Kapila

35:51

Yeah, I would like buid on top of

Jeanette Benigas

35:53

They don't like you they're not going to do what you're trying to teach them to do. They're not going to listen.

Ruchi Kapila

35:56

Yeah, exactly you're right. And I think even I would build off of that. And I think we feel we facilitate whether change happens in behavior or not, and we do it ideally. If you're talking about client centered care, you're facilitating the change of behavior based on whether the client wants it or not. I mean, and that's, that's something I learned from gender affirming voice. And I was like, that's not, I mean, I was like, I think we need to practice with this way everywhere, I think it can't just be gender affirming voice where we do this. We have to facilitate these conversations. Hey, it's valid, you know? It's valid to dislike this process, to not want to go any further, to feel like we're at a place that's good enough, or that you have the supports that are good enough, like it's not for me to say, you know, and

Jeanette Benigas

36:41

Yeah, it's not for us to say

Ruchi Kapila

36:43

it's not for us to say

Jeanette Benigas

36:44

If they don't want it. Sometimes, if there is an identified problem that they want help with, but they don't want the option that we give then it's up to us to use our creativity to help them solve that problem in a way that they do want it so their life improves, their issue diminishes exactly, not always a research evidence based something for that sometimes we are flying by the seat of our pants and using what we know about that person and what their values are and their choices and their preferences, and then what we know about all the things and, like, just figuring it out

Ruchi Kapila

37:27

right

Jeanette Benigas

37:27

We make a difference in a positive way

Ruchi Kapila

37:30

Exactly, exactly. And so I feel like, if you can hold on to that, and the fact that, like you as a human, outside of SLP, is really important to nourish, because you can bring that, those perspectives into the session. Let's walk it back to certification programs, and let's, like, walk it back to the pressures you might have from your employer. You'll start to see those things in a different light. And you you'll have, you'll start saying, not from a fear based place, what am I missing? And will I feel better if I get this thing, irrespective of how expensive it is, or if I make my employer happy, does that make me a better SLP, you'll start to think inward and say, What am I honoring in myself? Am I honoring the limitations of what it is to be a speech language pathologist? What is it that's human about me that I can bring into the session? How can I connect with the person in front of me? And how have they been neglected or betrayed or erased by our medical systems or our educational systems or other systems before and how are, what are ways that I can see them and then they know that I can see them. And what is the impact on that, of that on therapy? We don't even know, but if you're talking about rapport building or counseling, that's the foundation of it, right? And so I think people can build their confidence just by learning more about themselves and just by challenging themselves as people and bringing that into the session and like, collect your own data, even, or data. Like, it doesn't have to be something that you publish, just collect it in your mind. Of like, what do I think worked? What didn't work? Ask the client, like, what do you think worked this session? What didn't work, get make the space for them to review and critique you as well. And just to see, I tried something different. How did it land with this person? Also? Do they feel safe enough to tell me? Can I create space ways for them to, like, email me afterwards, or have a caregiver facilitate that, or a parent facilitate that, or whatever, and not be afraid that like I'm gonna find out I suck as an SLP, because we all have, you know, we've all had our shining moments of flow where, like, that session was great, and we've all run into the brick wall and, like, wanted to bash our head against it, being, like, I've done all the school for what, I've done all these training programs for what. And so I just want to give people the opportunity to normalize that you're just not going to feel like a winner all the time. But if you feel like yourself, and you feel like you didn't compromise yourself, your integrity and your openness, your empathy, your authenticity, you've got something. And you always have. You always have something at the end of the day.

Jeanette Benigas

40:17

If you don't knock it out of the park or you make a mistake being open to recognizing that and then pursuing some mentorship to correct and grow out of it as well mentorship, while there are some very good opportunities to pay for mentorship, especially at a low cost, like you can seek those out, because people this is going to lead into our final point, people do need to be paid. At some point in life, you do need to be paid, right? So there's a lot of free mentorship opportunities out there that you just have to find your person. I suspect if I got a voice person, first of all, I would be drowning. I would have to do so much work. I suspect if I called you, you would talk my ear off for an hour about the the chart, the diagnosis, like all the things, and I would get off that phone ready to go into a session, and I wouldn't have to pay for it. And I'm yeah, when people call me or message me about swallowing issues or dementia issues, I'm like digging in. This happened yesterday with a colleague with the home health company I'm with. She got a head and neck cancer patient, and I have some experience in a head and neck cancer lab from my dysphasia training. And I'm like, what was the treatment? This? Was the treatment this? And she's like, I don't know. I didn't even think to ask these questions. And because we work for the same company, I knew that she could dig into the chart. So we got the answers. An hour later, we were off the phone. She felt good. She was ready to go back to that patient, because she said, I don't think I can help him. And I said, you can help him. The medical chart said he had fibrosis in the tissue of his neck. And I said, he's five years post chemo radiation. He's already fibrotic in his neck. If you don't think he's not fibrotic in his throat, you're mistaken. So you know these are why these things are happening. Because, of course, the swallow study said he aspirated because of residue. No, that's

Ruchi Kapila

42:14

Jeanette Benigas

42:15

That's not the pathophysiology. Rhere was not one lick of pathophysiology on either swallow study he had, but I helped her problem solve with like, the likelihood, okay, there's probably some epiglottic issues, and at the end, I said, you're probably not going to fix this problem, especially in home health when you maybe get three visits, but what you can do is talk to him about his preferences, his choices, because he's currently NPO, they recently put a peg in him after all these years of not having one. I said, Well, you know, does he want to eat? And he's somebody scared him to death, he'll only have ice. I said, okay, so you're going to have to do a lot of education, and you're going to, he's going to have to hear this in 100 different ways. And here's some ways you can say it, and this is how you can help him come up with a plan to manage this chronic condition so he would have a good quality of life for the rest of his life, and know how to go get more help if this gets worse.

Ruchi Kapila

43:15

Yeah, exatly

Jeanette Benigas

43:15

and you know so

Ruchi Kapila

43:17

This kind of mentorship is a really good example of the community building too, because you don't know, yes, I've had those 30 minute, one hour conversations, or been like, I'm going to text you more stuff about this. And I mean, really, based on, like, the things that you've said, as much as you're like, I wouldn't know what to do with voice. I think the foundation of how you want to approach it is totally there. And so, like, a lot of that is, it's all going to be about like, you having to meet yourself and be like, I have a voice. I can work with my voice. I can, like, demo things, and I can meet the person. And I feel like, especially when people haven't had a voice and swallowing clinical fellowship, or have felt like, gate kept out, that's the thing that I say. I was like, I didn't have that. I had an extensive history as a singer. You know, I did go to all of the trainings, but I built, I built the experience. And also, for some of the things that we see, especially if it's a very specific need, there are a lot of things that you can do, even if you haven't had that formal experience. And like, there's so many times where I've gotten clients who had an SLP, that was a little bit more timid, and because they hadn't had that experience, and they were like, well, I don't know if I can do that. And I'm like, you can try some things, you know? You can explore a little bit. You can you can make a voice friend and say, Hey, like, what are some of the things that you can try? Or, like, I don't know. I appreciate you so much about like, kind of making space for us to talk about, like, what does it really look like for a clinician to develop that isn't just based on commerce, you know, or isn't just based on, like, a unidirectional sort of model. It's very it has to be more than that.

Jeanette Benigas

44:49

Yeah, we're almost out of time. You wrote, it's always about the client, patient, student, colleague, etc. And before I say, what else you said? Yeah, we had been talking about certifications, and do you need those? And do those align with your values? And sometimes you may need to purchase those things to become a better patient advocate or a better clinician. And yeah, sure. Example is when I was maybe three or four years out of school, I had a patient that I had seen in a sniff that I was treating for swallowing, but recognized had some voice issues. And we built such a good relationship that they used the home health company I was with, and then I got to see him at home. And I actually got that home health job because of the sniff, because there was no speech therapist, and so they always refer. So that's how I ended up getting hired. But I recognized that he needed some voice help. You could barely hear him long term Parkinson's. And so how am I going to be a better clinician to help this patient? And I didn't have a lot of mentorship back then, I don't even think I had a graduate voice course. So my voice experience had been undergrad only, and so I chose to go get LSVT certified, because I knew in one weekend I would gain the skills that I needed that I could use for the rest of my career to serve people better. But what I haven't done is go back to get recertified every however many years, and I don't say I'm using LSVT now, and I because you can't, because that's not ethical, and I don't sell it like that. But if I get someone with Parkinson's, especially if they're coming to me with swallowing issues, I have that skill set now of doing those exercises and knowing how to use the equipment, and I still have the manual that I can go back and read, and they have updated it a little bit. So a friend shared her manual with me so I could read it and see if there were any changes, but that made me a better clinician. Do I need that quote certification? Do I need to pay for that every so many years to justify who I am or show that I am competent. No, I do not. Yeah, and there's other certifications that you don't ever need, right for sure, and that is an individual choice, and that's what Fix SLP is about, is the ability and the autonomy to make the choice that is right for you. And so then to kind of just like, wrap up this final point. You also said, you have to be paid, you have to take care of yourself, and you have to be more than an SLP, to be a good. SLP, absolutely. Wrap up what we've been talking about. So again, with like, mentorship, sometimes we can offer those things for free, but when people, especially like myself find yourself mentoring over and over and over again, there does come a point probably where you need to start charging just a little bit for your time, because you can't mentor all day all for free, right? Or for like, fix, SLP, all day for free. There does come a point where you have to be paid and that's what you do. I often tell people, I say, This isn't your charity. This is your business. If you want to make it a charity, then make it a charity. Otherwise, you have to remember that your your time is valuable, and you do need to be paid because, yeah, you have to support yourself with food, water, shelter, clothing, you know, like we all, you know.

Ruchi Kapila

48:22

Yeah, and the reality is just for me to be me and to show up. Yes, I'm going to be I have to see therapist. Yes, I have to have a psychiatrist as part of my team. Yes, I need to be able to take my meds and not worry about that. Yes, I need to be able to, like, work in my own time and have breaks that I wouldn't have been able to have in a traditional, like, working environment. That's the reality and and also my services are valuable, like, I've worked very hard, and that that's hard to say it, it's it's still hard to say it, yeah, but my encouragement to you all is to, like, really, you know, take stock of everything that you're bringing in and all the things that you do that are unpaid. Think about how much you would pay somebody else if they were doing it for you, or whether you'd feel entitled to their free time and their free labor.

Jeanette Benigas

49:10

Because I really feel like over the years in speech pathology, I've observed, and maybe this is, like widespread, maybe field, maybe this is just a human thing, and where we are as people, but I don't pay attention much to what's going on outside of our field, but inside our field, people often expect everything for free. And why as a group of mainly women, are we doing that to each other when we recognize things like you need those things to show up as you and they also cost money. Medications not cheap. Health care is not cheap. Therapy is not cheap. You know those we have to take care of ourselves, and that means not being ashamed to charge our worth, but also recognizing as a human I need to pay for the things that I'm taking from people, because they need to take care of themselves, just like I need to take care of myself and my family.

Ruchi Kapila

50:07

Well, I know my dad, my dad's a GI he would always complain about, like, having to pay people, or how much like free services. And I would say, Look, you can't complain about whether people pay you if you don't pay them, like, that's the reality we're all part and that's community based as well. Like, I wouldn't say that that's exactly what mutual aid is. It's not but it's one of those things where we're filling each other's cup as we go along, and that's really important, even when money is flowing. You have to think of it that way, because we're not the big people who are making the big decisions right now. That's not our role. Our role is to take care of each other and to do the best by each other. And that's that's kind of, you know, love that. Yes, that's where we should leave it.

Speaker 1

50:52

Yeah.

Jeanette Benigas

50:52

Yeah. So I have a few final questions for you

Ruchi Kapila

50:55

Sure.

Jeanette Benigas

50:56

Left the ASHA convention, you didn't present, you took some time to heal and get yourself on a right path. So how are you doing now?

Ruchi Kapila

51:04

Um, it's night and day difference from where I was. I needed to stabilize. I just needed to get off the meds that I was on, which I did already, like, I basically stopped taking them in Seattle, as my psychiatrist was like, Yeah, that was the right thing to do. Started the new meds, basically right after I got home. And so it's been over a month since I've been stabilizing. And yeah, it's, it's, we're, we're good, you know, I'm back to, like, a modified work schedule, doing all the planning with AC for these gender affirming voice trainings and getting getting things together, and I'm just following it at my own pace, you know? So I think that's just my encouragement to other people is like, don't rush for it tomorrow, you know, just like, show up. Show up with what's here now. Take care of yourselves, even me, even with all the things that I've done. And people are like, how do you do it all? I'm like, I don't. I do. I do what I can, and I and if it gets finished, that's great, you know, like, but that's how I kind of tried to I'm trying to live my life because I recognize I have human limitations, and that's okay. So then the other thing that I actually don't know, I think I know at least part of it, but don't actually know all of it. You weren't going to let the CCC go in quite a dramatic way. Then you you took some time, I think you still have the CCC, so confirm you've chosen to keep the CCC. It's a business. Write off. So yes, I did. And not only that, I signed up for three SIGs because I wanted to find out for myself how I wanted to find out, because I never go there by fix SLPs, yeah, no, no, no, no, yeah. Don't do what I did. It was, it was really for my like, I want to see if the counseling one and the cultural linguistic diversity one, and I've never, I'd like I pay, I paid for the voice one for a few. I never go. And I know that I never go. And this is me just seeing like, will I go? And is there anything that I want out of it? And I haven't. I have a hypothesis that I'm testing.

Jeanette Benigas

53:02

Okay, you can let us know in a year.

Ruchi Kapila

53:04

And I'll let you know in a year how I felt about it. If it was me, and if I was at ASHA, I would think the smartest thing would be to charge somebody $10 for one sig and they have access to all SIGs like that was how I would do the business. But you know

Jeanette Benigas

53:18

Not how it is

Ruchi Kapila

53:18

It's just not how it is especially but if you want people to be generalists who can work in a school or a hospital based setting, it would be the smart thing to do.

Jeanette Benigas

53:26

yeah

Ruchi Kapila

53:26

But you know, who am I? I'm just small, little Richie over here. So

Jeanette Benigas

53:31

Pod for another day, but

Ruchi Kapila

53:32

Pod for another day.

Jeanette Benigas

53:33

My other question was, did you renew membership? But you did, or you wouldn't have been able to be in the segs. And so look at us still being friends. You've got, your C's, you've got, and you're in three things, and we will remain friends and colleagues. Agree to disagree.

Ruchi Kapila

53:48

But we we're um, also, I don't know if there's that much agree to disagree. I think it's just, I think we both agree. I think we're just, I'm making some I'm making some weird decisions. Let's just, let's just leave it at that.

Jeanette Benigas

54:00

And that's the point. Everybody gets to decide from themselves, and they're all welcome here in Fix SLP. We're probably not going to change each of others minds, and that's fine. You know? It's because there are people who don't agree with us, and that's fine. We're not going to try to

Ruchi Kapila

54:15

I agree with Fix. SLP, though, this is the thing about having the diagnosis that I do. Okay, so not only do I agree with Fix, SLP, I understand that in this particular time frame, I'm doing something kind of weird, and then I'm like, I need some time to figure out what it is that I want to do. And I think there is that much gray area there just is.

Jeanette Benigas

54:34

When AC came on the pod. And if you want to listen to that, I could even link it up in the show notes, because it was some time ago, you know, he's not dropping a Cs and I think he still has that stance, but that was fine too. We've, you know, he came on. We talked about it. We're still friends. And so I, you know, I enjoy, I enjoy talking to you guys, and

Ruchi Kapila

54:53

I know you do

Jeanette Benigas

54:55

Bantering a little bit.

Ruchi Kapila

54:56

Yes, I deserve a good ribbing, absolutely.

Speaker 1

55:00

The

Jeanette Benigas

55:00

The last thing I want to do before we go is just give you a few minutes, because I had thought about putting this up on the platform, and then you brought it up to me, and I said I was going to do this anyway, and I decided not to do it while you were kind of taking some time off, because I don't think I will do the topic justice if I just say something that I'm posted, but we really as a community, want to support Kevin Fix SLP, would like to support Kevin. You were doing a GoFundMe. Are you still doing that?

Ruchi Kapila

55:29

Yeah, we're over $41,000 now, but also

Speaker 1

55:33

because

Jeanette Benigas

55:34

Not everybody knows, not everybody's following the same spaces we are

Ruchi Kapila

55:37

yeah

Jeanette Benigas

55:38

Tell us very briefly. You mentioned at the beginning what happened, what you're doing, and how people can support

Ruchi Kapila

55:43

So Kevin Dorman, they are speech language pathologists specializing in gender affirming voice training. They're my colleague at trans voice initiative. They're the owner prismatic speech services. They have a lot of contractors providing gender affirming voice care in a lot of different states. They got diagnosed with lingual cancer the day after election in November, and ever and have now gone through surgery, and they're home from surgery, but they're looking at radiation coming up, so they're the primary breadwinner in their family. We're fundraising for covering therapy, medical services, medical devices, as well as just day to day living expenses, so that they and their husband, Kelton, are in good hands. Kelton is a PhD student, so, you know, there's not a lot of, like, funding around, and so we're just, we're trying to take care. You know, Kevin is one of the big mentors, the big mentors of gender affirming voice care, like has been the trailblazer of gender affirming voice training to my alongside Wynn Vastine and all of the other great folks. So this is somebody who's done a lot of free mentorship, a lot of free labor through TVI, outside of TVI. Kevin is one of the reasons I'm where I am today. Kevin is and is a gentle soul outside of all of that stuff. So deserves your support. I'll send tinyurl.com/kevindormanhealing is where you can find all the stuff, but I'll make sure that Jeanette has all of the content. And I know money's tight for all of us, so we're not gonna back at how little or how much, or if you're just sharing just we want to get the word out as much as we can to make sure you know, Kevin's supported, and I want to see them back on stage with me in 2026 so yeah.

Jeanette Benigas

57:29

It's amazing how much just someone giving $5 can go. We've seen that with fixed SLP, with our $5 sustaining partners. That all adds up. So you know, if you've got five bucks to drop, and certainly we will be donating as well. So we will link up all of that information on the show notes. We'll end up sharing it in stories. Always we blog these two so it'll be in there if people are searching for it on our website. But Ruchi, thank you. I'm glad we waited to do this. I

Ruchi Kapila

57:56

thank you

Jeanette Benigas

57:57

I think it turned out to be a great episode. Gave people a lot to chew on, and I'm glad that we're being transparent and that that you were so willing to be transparent about your mental health journey. Because, listen, we can't keep these things in we have to talk about them and normalize it. Otherwise, nobody's getting better when we're hiding these things or embarrassed to talk about them with one another. We can't heal and we can't be our best selves. So I'm glad that I have this platform for you to come on and for us to talk about it, and I'm just so grateful.

Ruchi Kapila

58:28

Yeah, absolutely

Jeanette Benigas

58:29

I'm grateful another episode, at least in a year, to get an update on whatever your hyp-, your

Ruchi Kapila

58:35

Yes, I will. I will talk about that at that time. And if there's nothing to talk about, there might be nothing to talk about. And we'll, we'll have, we'll have good chat no matter what.

Jeanette Benigas

58:43

Yeah, all right, guys. So I don't know when this is dropping, but always we'll be back next week, and thanks for fixin it!

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