96. Coping with Dance Injuries and Career Transitions with Chelsea Pierotti, PhD and Guest Cohost, Jennifer Milner

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Linda Bluestein, MD (00:02.476)

Welcome back, every bendy body. This is the bendy bodies podcast and I'm your host and founder, Dr. Linda Blustein, the hypermobility MD. This is going to be a great episode. So be sure to stick around until the very end so you won't miss any of our special hypermobility hacks. As always, this information is for educational purposes only and is not a substitute for personalized medical advice. Today, we are so excited to have Dr. Chelsea Pierotti with us. But before I welcome Dr. Pierotti,

please let me introduce my friend and yours, Jennifer Milner, former professional ballet and Broadway dancer who trains hypermobile artists to work to their fullest potential. She knows a thing or two about being a bendy body as well as working with them. We are so fortunate to have Jen with us here today co-hosting this episode. Hey Jen, it's so great to see you.

Jennifer Milner (00:50.859)

Thank you, it's good to be back as always.

Linda Bluestein, MD (00:53.136)

Awesome. All right, Dr. Chelsea per mistake

Jennifer Milner (01:00.369)

Hang on, because I'm switching out my glasses. Sorry. I go back and forth between my blue light glasses and the ones where I can actually read what's like right up by my face, which is more important. Okay.

Dr Chelsea Pierotti (01:00.641)

It's hard.

Linda Bluestein, MD (01:02.747)

Okay.

Linda Bluestein, MD (01:11.704)

Dr. Chelsea Pierotti is a sports psychologist and consultant for dancers and dance educators. As a speaker, workshop teacher, and podcast host, Dr. Chelsea's mission is to help create more successful dancers through positive mental skills. Dr. Chelsea, hello and welcome to Bendy Bodies.

Dr Chelsea Pierotti (01:28.857)

Hello to both of you, so happy to be here.

Linda Bluestein, MD (01:36.54)

Jen, I think you have the first question. Ha ha!

Jennifer Milner (01:40.805)

I was like, what? Oh, there you go. I do have the first question. Can you just say hello again, Dr. Chelsea?

Dr Chelsea Pierotti (01:46.814)

Of course. Hello to you both. I'm so happy to be here.

Jennifer Milner (01:51.783)

We are really happy to have you here. We have got some questions for you that I think a lot of our listeners are gonna wanna know the answers to. And today we wanna talk about injuries and how they can be challenging, not just physically, but psychologically and emotionally as well. So knowing that injuries can be really challenging, how do you see dancers cope with injuries?

Dr Chelsea Pierotti (01:59.275)

Yeah.

Dr Chelsea Pierotti (02:13.174)

Let's just start with the big question, right? How do we cope with injuries? So in psychology, there's this kind of three step process to it that changes whether you have a kind of positive outcome to the injury and have a easier time in rehab or whether injury is really challenging. And it starts with what we call an appraisal. It's like, how do you feel about what happened? What do you think is the cause or why or what it means for you?

So I look at it as like either you appraise this injury as a disaster, right? Everything is over, I lose this part, I will never be able to do this again, like it's a disaster, or this injury is an opportunity to rise up. This is a new challenge, I'm good at challenges, right? Like dancers are used to taking on challenges and moving forward. So seeing it that way can shift it. So there's that appraisal, like is this...

everything's over, it's a disaster, or is this a challenge that I'm ready for? And then, because that appraisal changes your emotional reaction. And I think we often feel like we have the emotion first, but really, you can shape your emotional response based on what you think of it. Because if you decide, okay, this is a challenge, this is gonna be hard, the emotional response is less devastation edging into depression and more like I'm upset, but.

I've got this, but I'm okay, but I can handle this, right? It changes your emotional response. And the emotional response is what changes the behavior, like how you show up if you're in rehab or if you have to sit out for a while, like it changes the behavior. So it's like, what do you think happened? And then your emotion, and then that changes how you show up. And I think we jump to coping by like, I just have to go back to class, or I just have to get back to work. We wanna get right back to the behavior, and we skip the like,

how are you thinking, how are you feeling, then that'll change how you show up when it's time to either rehab or get back in class.

Jennifer Milner (04:16.467)

Well, and the behavior, like you said, is gonna be dictated by the emotion. And so the behavior is where we often see dancers have their coping mechanisms, because their appraisal has been, this could be the end of the world, this is disaster. So their emotion is, oh no, I either have to ignore it or like push through it super, super fast and get it done. So the coping is, there can be unhealthy strategies that they use to cope.

There can be ignoring it, there can be forcing it before it's too soon, but that the big piece that is what we often think of is really what you're saying is the culmination of going through those other two steps, whether we know it or not.

Dr Chelsea Pierotti (04:55.606)

Right, and I think exactly you usually don't know it. Like we're not often pausing to be like, how do I feel about this, right? Like we just, we feel, we just go there, which is fine. But that like awareness of like, how am I really feeling? What is, you know, is this really the end of it? Or is, am I just devastated in this moment, but it's not as big as I think. And sometimes it is as big as you think. And if it is.

Jennifer Milner (05:04.089)

Mm-hmm.

Dr Chelsea Pierotti (05:20.894)

okay, then let's be real and honest about it. But taking the time with the thoughts and the feelings before, as you said, usually it does go to unhealthy coping if you haven't really processed it and you start either ignoring, pushing too hard, trying to make up for it in some other way that ends up harming the healing process. Yeah.

Jennifer Milner (05:41.355)

Well, and to some people it may sound like the appraisal part is not instinctive or genuine, like, oh, there's nothing I can do about that. But if you think about little kids, as a mother, I would watch my children fall and then they would look around to the adults to see how they should feel about that, right? And if the adults are panicked and freaking out, they panic and freak out. But if the adults are like, you're fine, go ahead and get back up. Not that we're trying to gaslight our kids, but...

Dr Chelsea Pierotti (05:52.471)

Mm-hmm.

Dr Chelsea Pierotti (05:57.566)

Yeah, absolutely.

Linda Bluestein, MD (05:59.289)

Yeah.

Dr Chelsea Pierotti (06:05.639)

Uh-huh. Hehe.

Jennifer Milner (06:09.023)

The children have that moment of weighing, how should I react to this? Like, what is my instinct reaction? And I think we don't think about that as adults, that we do have that choice, that we do have that moment to sort of filter before we move to the emotion of it.

Dr Chelsea Pierotti (06:12.269)

Right?

Dr Chelsea Pierotti (06:22.236)

Yeah.

rate.

Linda Bluestein, MD (06:25.68)

That's a very interesting point, Jen. And Chelsea, I would be curious to, do you think that how our experiences are handled as children also affects how we do that cognitive appraisal as adults as well? Like if our parents freaked out every time we got any little injury, that's different than if they were like, get up and brush it off kind of a thing.

Dr Chelsea Pierotti (06:40.606)

Mm-hmm.

Dr Chelsea Pierotti (06:47.678)

Yeah. Oh, of course it does. Yes. I mean, we learn how to process our world. Like we learn how to process information and, and how we interpret things. And there's, there's this balance, right? It's not ignore, not saying nothing's ever like get up and go again. Cause if you do that too much, you get the other side of like, you know, fight through it. And then you have the people who go through the, through the pain, right? Who work too far. And so it's not like always ignore it, but it's helping to like,

Jennifer Milner (07:12.555)

Mm-hmm.

Dr Chelsea Pierotti (07:16.366)

teach the genuine, like honest assessment of what's really going on, right? So when the toddler does just like flop over and they really are okay, being like, you're okay, keep going, it's going to be fine. If they're genuinely hurt, then having a genuine reaction to that, but a calm one, right? And that's like, again, looking to the parent of like, the panic doesn't help, but you can take it seriously. And then, you know, that leads to these, you know, teenage and adult dancers being able to say, assess their injury, like

Jennifer Milner (07:33.546)

Mm-hmm.

Dr Chelsea Pierotti (07:46.558)

accurately. Is it really bad? Is there really pain? You don't brush that aside, but you can address it and kind of have that honest reaction and processing of what's going on to allow you to cope properly. So it's that in between of like not ignoring, but not overreacting either, because neither one is helpful.

Jennifer Milner (08:03.447)

Mm-hmm. And I think we see the ignoring or undervaluing the injuries as well, especially in the hypermobile population. We've talked a lot about how the hypermobile population can live with a low level of pain all the time. And we know that hypermobile athletes and artists and just generalized hypermobile population will take longer to heal from tendon, ligament, soft tissue injuries. And so,

Dr Chelsea Pierotti (08:14.87)

Yeah.

Dr Chelsea Pierotti (08:20.536)

Yeah.

Jennifer Milner (08:33.215)

people may not, they might be like, oh, you're always injured, oh, it's fine, oh, it's that, and sort of go to that other end of the spectrum a fair amount of time. So dancers with symptomatic joint hypermobility do often face a lot of challenges as their bodies kind of change and bear the brunt of dancing in a very specific way compared to people without that joint hypermobility. So they're learning at a very young age to deal with this pain and these injuries. Is there an age or life stage where you'd suggest starting to develop?

Dr Chelsea Pierotti (08:54.751)

Yeah.

Jennifer Milner (09:02.035)

resiliency and healthy coping strategies. So is there ever a point where it's too young to start?

Dr Chelsea Pierotti (09:07.938)

I love this question. So the short of it is no. Like start as a toddler, start as an infancy. I mean, there is research to show the message and the language you use with a one-year-old shows up in their behaviors in elementary school. So it, no, there's no too soon, start right away. And it's in the messages and the language and like how you handle a challenge, right? Resilience is all built in presenting a challenge.

with a little bit of support and help to get you through it. And kind of being that person like, I believe in you, you can do this, but you have to do it, right? I'm not gonna fix this challenge for you. I believe in you and I'm your support system, but you have to do this. And that challenge happens in the little stuff in toddlers, learning how to use a spoon all the way up to, an adult dancer then is gonna build that resilience of like, I have a big challenge.

but I know I can handle a challenge. I know I can work through that and I have people who care about me to support me, but I have to do the work and I can. So that resilience is in presenting a small challenge and working through it and starting to believe in yourself of like, I'm the kind of person that has a challenge in front of me and I don't back down and I know how to handle it and I keep pushing. And that message can start really, really young and should hopefully.

Jennifer Milner (10:26.175)

Mm, mm. And this reminds me, Dr. Blustein, of the interview we did with Jazz Bynum from Ballet West. And it was all about resiliency. And one of the things she said was that she was injured from a pretty young age, and she learned that was just part of her life, and that she learned how to cope with it and how to move forward. And so her theme was kind of resiliency in her life. And her parents, she said her mother really helped shape that for her. That...

Linda Bluestein, MD (10:34.672)

Mm-hmm.

Linda Bluestein, MD (10:50.082)

Mm-hmm.

Jennifer Milner (10:54.751)

Then she moved forward and thought, okay, I have an injury, it's fine. This has happened before. And that has a huge impact on who you are as an adult.

Dr Chelsea Pierotti (10:57.963)

Mm-hmm.

Dr Chelsea Pierotti (11:02.91)

Absolutely. When we have teachers and parents, a lot of like when we love and care for our dancers, we want to like protect them from going through anything. Like I don't want you to feel sad. I don't want you to be hurt. Of course. But really it's about like being that safe place and supporting them, but not making the challenge go away. Like you don't remove the roadblock. Like it's, it's there because sometimes we could remove it for them. And other times, like if you're hurt, you can't magically fix that. So

once they are gonna come up against something that you can't just magically make go away, you don't want that to be the first time they've had to face that challenge, right? So it's supporting them with learning that they can. Like you said, it becomes a part of your story. It's like, this is who I am, but I can recover from that. I can work past this. I am still a strong dancer, a good person. Like that doesn't shape, change any of that shape, but letting you work through it, which is hard.

Linda Bluestein, MD (12:00.8)

Yeah, I know I can see that, and I actually think in my experience of working with many, many patients and clients, in some ways people who have symptomatic joint hypermobility, I think they're more resilient because we have had to overcome so many things and had to work through so many things, and I've had people say, gosh, I wish that I could just be like a normal person. It's like, yeah, but...

Dr Chelsea Pierotti (12:13.312)

I bet.

Dr Chelsea Pierotti (12:17.303)

Mm-hmm.

Linda Bluestein, MD (12:24.464)

first of all, who is actually normal, right? And people who don't start having problems until later on in life, oftentimes they're not able to cope with it very well. So I think sometimes we're so much more resilient than we realize because we have been dealing with all of these little, and sometimes big things along the way. The other thing I wanted to point out was, when you said something about pain, and...

Dr Chelsea Pierotti (12:26.885)

Right.

Dr Chelsea Pierotti (12:34.655)

Absolutely.

Dr Chelsea Pierotti (12:44.877)

Uh huh.

Linda Bluestein, MD (12:49.668)

Pain is a very interesting thing, because of course you can have injury without pain, and you can have pain without injury. So pain is a helpful piece of data, but it's not always 100%. Because if you're in a place where you're coping really well, you're probably not gonna feel as much pain. But if you're afraid you're gonna lose your role, or you have other stressors going on at home, or whatever, you may feel more pain with the same injury as...

Dr Chelsea Pierotti (13:02.24)

Yeah.

Linda Bluestein, MD (13:17.616)

as you know, under different circumstances might feel very different. So we know that hypermobile dancers face a lot of struggles that maybe are different from other dancers. You know, one example is directors who might not believe that they're actually really hurting, speaking of pain, or you know, knowing when to hold back when everyone is telling them to push into their hyperextension to win competitions, et cetera.

Dr Chelsea Pierotti (13:21.802)

Yeah, that makes sense.

Dr Chelsea Pierotti (13:36.565)

Yes.

Linda Bluestein, MD (13:47.053)

So how do you work with dancers to help them work through those issues? And then how can other people, if they're dance teachers or dance medicine professionals, how can they help dancers work through those issues?

Dr Chelsea Pierotti (14:01.238)

Yeah, you're right. We still have a culture of, you know, the show must go on, right? Like that's kind of the definition of what we look at as a dancer. And so that gets taught really young. And then it's hard to find the line of like, okay, yes, usually the show must go on. But at some point there is a line of like my physical ability in this moment. So if I have a dancer who is injured or has that setback of mental or physical where they can't perform right now, uh, and are being told or pushed.

Linda Bluestein, MD (14:11.612)

Mm-hmm.

Dr Chelsea Pierotti (14:31.294)

you know, to go further than they really are comfortable with. I talked to them about two pieces, their identity and their definition of success. So a lot of dancers, you know, is success being on stage and executing? Like, sure, but that's not the only definition of success isn't having a perfect performance, right? What else is success? Maybe success right now is...

getting up and going to rehab and working on this and feeling better about it. Or your, you know, success is taking care of yourself so that you have a longer career, not just this show and being able to help them define it. So a lot of the dancers I see success is only this external reward, a trophy, a role, a title, the praise from the director, right? It's all rooted in someone else's beliefs. And so we spend time talking through their definition of success.

And it has to be something that's in your control. If your success is only rooted in what somebody else thinks, that's a really hard place to stay motivated, to continue to be happy, to continue to thrive. So finding that success and creating goals to work towards that are in your control, and then talking to them about identity. Because we also have, I don't think people say it out loud, but I think there's the underlying tone that

Jennifer Milner (15:38.039)

Hmm.

Dr Chelsea Pierotti (15:57.438)

injured dancers are worthless, that now you can't do anything. And if your whole identity is a dancer and now injured dancers are worthless, therefore I am worthless. And so we spend time talking kind of around identity, you're not worthless, like where does your worth as a dancer come from, kind of that internal work. And oh, you had a second part to question, but yeah, so that part, that's what I do, working with people. And then the second part about teachers or medicine professionals.

Linda Bluestein, MD (15:59.892)

Mm.

Dr Chelsea Pierotti (16:27.094)

Same kind of idea, but talking to them about their worth as a dancer and like the whole person, right? You're not just a dancer. So even simple things like asking them something about themselves that isn't just about their injury or their rehab. I think, you know, we think we care and we want to help and like, oh, how's your knee? How are you feeling? But if that's the only question anybody ever asks you, then your identity is like, well, I am.

a dancer and I am this injury, rather than like we have so many other aspects of our life. So just maintaining connections and conversations and showing that you value them outside of just being a dancer who happens to be injured at the moment.

Linda Bluestein, MD (16:58.096)

Mm-hmm.

Jennifer Milner (17:11.795)

And that's okay. I'm just thinking back to my experiences and I don't wanna say that teachers and directors and such should give dancers permission to be injured because they have permission to be injured whether they get it or not. But there's that emotional sense of if the signaling from the front of the room, from the other side of the table is, we still love you, you're still a valued member of this company, that's very different than.

Linda Bluestein, MD (17:11.961)

That's really good. Sorry, go ahead, Jen.

Dr Chelsea Pierotti (17:26.78)

Mm-hmm.

Dr Chelsea Pierotti (17:38.135)

Yeah.

Jennifer Milner (17:40.403)

directors that don't talk to dancers while they're injured because I have nothing to say, or they're not useful to me as you were saying. So there is that sense of feeling that you have the support, maybe not permission, but the support of them for being injured. And that just goes such a long way.

Dr Chelsea Pierotti (17:44.097)

Yeah.

Mm-hmm.

Dr Chelsea Pierotti (17:52.864)

Right.

Yeah. Oh yeah. Social support is a huge factor in injury recovery, right? And I've been talking a lot about that internal dialogue and what you think and what you feel, but the social support is huge. And it's your fellow dancers, your family at home, your directors, your boss, your teachers, like that social world has a huge influence on the, how you think and feel about your recovery and then the actual time it takes to get back.

is really influenced by that social network. And if they're there for you and care about you outside of just being their dancer.

Linda Bluestein, MD (18:30.756)

And the interesting thing about that, we know that dance companies, from a financial standpoint, often really struggle, right? But if you, but that's something that's basically free, caring about somebody as a person that doesn't cost extra money, is showing a little bit of compassion towards a person, especially when they're injured. And so I think that's a really, really valuable point. So appreciate that.

Dr Chelsea Pierotti (18:46.021)

Yeah.

Dr Chelsea Pierotti (18:54.654)

Yeah, absolutely.

Linda Bluestein, MD (18:57.592)

So sometimes dancers also, they have to give up certain forms of dance. They might have to dance less hours or stop altogether, especially. I see this happen. I'm sure Jen must see this happen countless of times as dancers are evolving from, you know, dancing as a more fun, casual activity to getting into more serious about their dance, potential dance career, and as they are going through the process. So...

What have you observed about those kinds of transitions?

Dr Chelsea Pierotti (19:28.334)

those transitions are hard and there's two, I mean, there's the difference between the transition that was your choice and the transition that was not your choice. But often, even if it is your choice, even if you're like, okay, I'm gonna make this a career, I'm gonna start going on auditions or, you know, choosing which company that you wanna work for. It's, I think ultimately those transitions are easier back to identity if...

being a dancer is an important part of who you are, but it's not all of who you are. Because if your whole identity is, I am a dancer, that is where my worth comes from, that's who I am, that is my value, that is what is special about me, that puts a lot of pressure on that transition. And then if the transition is out of being a dancer, like that transition at the end of the career can be extremely challenging if dance is your whole identity. So,

I see it a lot with college athletes that I work with because then there's this, you know, college graduation is an end for most of them. Like whether they, and even if it's again, so that may not be their choice, but you can like see it looming for a long time and being able to think about, you know, if your whole identity is I'm a college athlete, so now what am I? As soon as I graduate that that's gone and I don't know what else to do. So I definitely see it.

a lot, whether it's a choice or not in or out, those transitions are really challenging and something to take seriously and like spend the time to like work through and think about and be intentional about and ultimately working on and considering who you are, where dance is a valuable big part of that, but not everything.

Jennifer Milner (21:15.823)

So for people who are going through that transit, okay, so this is a two-part question. As you said, lots of dancers have their identity wrapped up in dance, right? I'm a dancer, period, end of story. So if people are going through that transition, stepping out of dance, what are some actionable things you suggest at that moment, like for them? And also, what would you suggest for them to have done if they could go back in time to better prepare them? So what are some preemptive suggestions for

Dr Chelsea Pierotti (21:25.486)

Mm-hmm. Right.

Dr Chelsea Pierotti (21:33.888)

Yeah.

Linda Bluestein, MD (21:39.569)

Thanks for watching.

Dr Chelsea Pierotti (21:40.735)

Yeah.

Jennifer Milner (21:45.163)

people who are not yet at that point.

Dr Chelsea Pierotti (21:46.974)

Yeah. Um, well, I guess on either side, either preemptively, this would help or you can do it on your way out is thinking about your values. And because that's not an ability, it's a value. What matters to you in life? What do you care about? And it's something simple. It's like, you can find values lists online and just looking through all these words and just trying to like narrow it down to the four or five that are like, these are what truly matter to me. And then that

guides future goals and decisions and where I want to be. And if you have those values, then when you're transitioning, it's easier to see, okay, I may not be performing now, but maybe I'm gonna shift how dance is a part of my life, but it still aligns with this value, or I'm gonna shift, maybe this is not gonna be a part of my life anymore, but I have these other aspects of my life that still fill these values.

Jennifer Milner (22:35.851)

Hmm.

Dr Chelsea Pierotti (22:43.37)

So that sense of self-worth and achievement has other avenues. So with the dancers on the way out, sometimes it's like, how is dance still in your life, but it looks different. Like the three of us who dance is still in our life, it just looks different, right? So being able to keep that alive, or is dance no longer gonna be a part, and you want to use those values to set goals in other areas of your life. So that value work helps.

on the way out, but certainly would be great preemptively to have it be something that you're doing before. I mean, I think developmentally, it's really hard to have a true sense of self until well into our twenties. So I think having late teens, early twenties to even at least start considering that because that's when you're starting to pull away from what other people want for you, right? It's not about what your parents think you should do, what your dance directors think you should do.

Linda Bluestein, MD (23:27.025)

Mm.

Dr Chelsea Pierotti (23:41.77)

So, you know, if I talk to a high school dancer who's trying to decide, do I want to dance in college or not? That transition is usually clouded by what everybody else wants them to do or what everybody else thinks they could do or should do. And that's where starting at least that value work of like what truly matters and then picking, picking the next part of step of your path that aligns with that, helps all of the identity stuff we were talking about.

helps those transitions all along the way in once they're in your control or not. So I think, I'm not sure I think of something different that I would do before that I wouldn't do after, but that's that value work being that first key step, knowing that it's going to change, right? Like my values now are not what they were in, you know, high school, college me, and that's okay. That's part of that work. But starting there at least, so you have that foundation.

Jennifer Milner (24:27.936)

Mm-hmm.

Jennifer Milner (24:38.111)

That's such a great concept too, of looking at your values, like what are the things that are important to you, not like what are the things that you desire, right? Or what are the things that you're good at, or any of those other things that people talk about. And I love the idea of being able to say, I'm a dancer and my value is bringing people joy and this is how I do it. Okay, well, I'm not gonna be dancing, I still value bringing people joy, how am I gonna do that? So you can see how you will be a consistent human.

regardless of which phase of that's such a great tool for people to have. I love that.

Dr Chelsea Pierotti (25:10.302)

Yeah. Thank you. Yeah. Similarly, because I know one of my values are two of them of the five are learning and achievement and those can still be true. And like they were there in the professional dance world and then they're still there. And I now have just shifted to like there's new things I want to learn and other things that I want to achieve, but that are all in my control. And that allows that identity shift. Like dance is still here. It just looks different because I've taken the values to have a different picture on it.

Jennifer Milner (25:25.856)

Mm.

Linda Bluestein, MD (25:38.06)

I'm curious to ask, I've seen this written out in like these long sheets. I am blank. I am blank. Like line after line. So you could say I am a dancer and I am a learner. Do you think that's an exercise that could potentially be helpful? And if so, is there an age at which that's appropriate for people to do?

Dr Chelsea Pierotti (25:44.46)

Mm.

Dr Chelsea Pierotti (25:52.269)

Yeah.

Dr Chelsea Pierotti (26:02.398)

Yeah, it can be. I would start it. I introduced the idea really in high school. I think around those like mid teens is when we have the cognitive ability for that metacognition, like thinking about our own thinking, like the ability to really reflect and think on that is a more advanced cognitive skill. So using that around high school and then yeah, encouraging them to think about it. But what tends to happen if you do it with

Linda Bluestein, MD (26:08.592)

Mm-hmm.

Linda Bluestein, MD (26:18.167)

No.

Dr Chelsea Pierotti (26:32.482)

dancers, athletes, the I am statements are either achievements or like demographics, right? They're like of, you know, of who I am, which is a natural place to start. But for a lot of adolescents, who I am is rooted in my achievements or I'm trying to mimic somebody else. Like I am because of somebody I admire, which could be a celebrity, it could be a dancer you look up to, it could be your parent.

Jennifer Milner (26:42.277)

Mm-hmm.

Linda Bluestein, MD (26:43.302)

Sure.

Dr Chelsea Pierotti (27:02.002)

it's usually this external reference. And so starting with that to then be able to say, okay, my identity isn't about my achievements. I'm not the winner of the spelling bee. I'm not the, like, that's not, it's an achievement, that's cool, but that's not who I am at my, what do I care about in my values? So starting to work through those I am statements is a good place to start. And then I shift it to more of the values of like, what is important to you if you wanna.

think about like who you are and how you want to be. Like you said, I like to bring people joy. Like what is it that brings you joy? So I guess for a concrete activity then to help someone who's like, I have no idea what my values are. I'll take like who is someone you admire and what do you admire about them? Because that usually shows you a value you care about. Right, so if you have like, I have my best friend who-

I admire her so many things. And when I really think about it, what I admire most about her is her ability to maintain relationships, how she cares about other people, how she prioritizes them. And then that made me reflect. I'm like, okay, yeah, relationships are a really important part and a value for me, like that sense of community, that sense of belonging. So thinking about who do you admire and why will often highlight a value that you may not have been able to articulate before.

Jennifer Milner (28:24.043)

Mm.

Linda Bluestein, MD (28:33.788)

Okay, well that's a great way for, I like having concrete things that people can do, so that's really fabulous. And so we've talked about this already a little bit, but is there anything else that you wanna add to the idea that dancers and athletes often foster the dancer or athlete first and then human second mentality? Is that something that you think is really common? And besides the things we've already talked about, is there anything else that people can do?

Dr Chelsea Pierotti (28:39.723)

Yes.

Dr Chelsea Pierotti (29:02.166)

I definitely see it. It is very common and it kind of goes back to what our industry has always valued, right? Our industry has valued the external success. And so I think when it's, I don't know, it's one of my personal missions. I think you guys as well, like we're just trying to help shift that of like the human first, the whole athlete approach, not just what you can produce on stage. So yeah, I think

not necessarily more than what I've already said, that we tend to lose our sense of self when our worth is only what can be done on stage. So instead, being able to think of our worth and our values outside of that. So in psychology, and I'm sure medicine is similar, like it's the whole dancer approach, it's the whole athlete where it's not just what your body can do or what you can execute, but that more holistic view of it.

Linda Bluestein, MD (29:58.135)

Okay and how do you help dancers cope with the grief and loss of a career shift?

Dr Chelsea Pierotti (30:06.302)

Yeah, it's actually that grief and loss, I think first acknowledging that grief over losing a career, which again can be because you graduated college or because you were, you know, released from your contract or because you were injured. Like sometimes it's in your control, sometimes it's not. But that grief is just like the grief of anything else.

And I think sometimes we will say like, oh, I should just be able to get over it. But losing something that you value that much, again, even if you've done the work to say, I am a dancer, but I am also all these other things, like even if you had a solid sense of self where dance is only a piece of it, the grief is real. And I think being able to acknowledge that and understand that and treat it like a grieving process. So I think kind of the famous...

steps of grief, like people have made movies over these, right? But they're in psychological research as well, that there's this sense of disbelief and denial at first, like it can't be over. And I hear a lot of dancers say, and this was my experience too, I didn't realize my last time on stage was my last time on stage. And you just don't always know. And so allowing for, there is going to be a sense of disbelief or denial at first, and that is a healthy normal reaction.

Jennifer Milner (31:04.727)

I'm going to go.

Jennifer Milner (31:19.243)

Yeah.

Linda Bluestein, MD (31:19.802)

Mm. Mm-hmm.

Dr Chelsea Pierotti (31:30.11)

And then you tend to proceed through the stages of grief, just like losing a person or an animal or anything else that you love. You're going to have that sense of potential isolation or anger is really common, having a stage of just being mad that it's over. Sometimes there's some bargaining in there that people will start like, what can I do to fix this? How can I change it? Potentially depression, not necessarily in a clinical sense, but just that sadness.

that this is really over, letting those emotions be and feeling them, and that leads to that sense of acceptance. And what we know from the stages of grief and loss, not everybody does every stage in that order. Sometimes you bounce around, you go backwards and forwards, but ultimately that path to recovery usually involves that process and allowing that grief process to work. So where again, dancers are told and taught to, okay,

stuff it down and keep going, stuff it down and keep going. And this is another time where it's like, take the time to feel what you really feel and know what you really feel. Is there, I know I've talked to some dancers where like there's actually a little bit of relief when their career is over and they don't know how to say that or to how to like everybody else around them is like, oh, you must be so devastated. And they're like, I'm kind of good. Like I was tired or I'm hurt, whatever. And so like.

Jennifer Milner (32:52.779)

Hahaha

Dr Chelsea Pierotti (32:57.202)

sitting with your emotions of like, how do you actually feel? Not what you think you're supposed to feel. How do you actually feel? And then letting that process take its time to work through.

Jennifer Milner (33:00.087)

Mm-hmm.

Jennifer Milner (33:07.083)

Mm-hmm. Yeah, because it is grief, as you said. You are grieving the loss of something and it's okay to have those feelings and it's okay to process this. These are really important conversations to have because there's so much about being a dancer and being in the dance world where you feel, as a dancer, completely helpless, that there's not a lot that's in your control. So everything we've talked about today are things that are within the dancer's control that helps make them more autonomous and that they...

Dr Chelsea Pierotti (33:11.834)

Mm-hmm.

Dr Chelsea Pierotti (33:26.359)

Right.

Dr Chelsea Pierotti (33:32.823)

Mm-hmm.

Jennifer Milner (33:36.991)

they can have ownership of. Also, if I were gonna wave a magic wand or if you were gonna wave a magic wand and you could fix some aspect of the dance world or change the dance world in some way that makes them more supportive of dancers going through these transitions, what would you do or what would you say for the dance world to be able to be more supportive of these?

Dr Chelsea Pierotti (34:03.922)

Oh goodness, that's a huge question. I love that. If I could only pick one thing that I want to fix. I think my focus of kind of my work has always been on using positive coaching and whether it's coaching in like an athletic sense or a dance director, it doesn't matter. But it's like, which is in how you give feedback, how you treat a challenge, the social support around it, rather than...

Jennifer Milner (34:05.471)

Hahaha.

Jennifer Milner (34:19.915)

Hmm.

Dr Chelsea Pierotti (34:32.13)

The negative approach, which is a little bit the old school way that is unfortunately still prevalent, that's more of, you know, shut up and do as you're told, fight through it. This is what I expect at you. Like, I don't care what's going on, leave it at the doors, that classic conversation. So shifting to what psychologists call that positive coaching approach that is in like feedback of like, how do I genuinely help you be better?

because you are good and I care about you and I want you to be better. So you can still have high standards. You can still challenge and push athletes, but doing it with that positive approach rather than feeling like the only way to challenge a dancer is to yell or belittle or, you know, have that kind of negative approach. So if I could make that go away, I'd do it.

Jennifer Milner (35:01.452)

Hmm.

Jennifer Milner (35:18.697)

And I

So much, so many things can be solved with better communication, right? It's just the magic bullet for so many things. And I love that. That's really great. Thank you. Did we miss any topics you wanted to cover or did you have any final thoughts?

Dr Chelsea Pierotti (35:25.823)

Absolutely.

Dr Chelsea Pierotti (35:36.91)

Uh, no, I think maybe the only other thing I would add is that when people are trying to learn better mental skills, like learn how to be more resilient or learn how to use imagery better in rehab or like any of these mental skills, it starts with awareness first, which is that like just knowing who am I, what am I actually feeling? And so taking the time to just learn that being more intuitive and in tune with your own thoughts and feelings.

is hard. Some people are better at that naturally than others, but knowing that is a really great place to start. Just some simple reflections or mindfulness exercises, something that's helping you get to the root of how you really are feeling, what you're really thinking, and not letting the outside dictate that for you. But as you were talking about that autonomy, gaining that for yourself and having more awareness is the gateway to all the other mental skills.

Jennifer Milner (36:34.6)

Awesome, thank you.

Dr Chelsea Pierotti (36:35.755)

Yeah.

Linda Bluestein, MD (36:36.972)

And I love that mental skills, because I mean, whether you're a dancer in the middle of your career or maybe someone's listening to this that never danced. I mean, lots of people listen to other episodes that we wouldn't necessarily expect. And these are mental skills that I feel like are really helpful for all of us. Right. Life skills. Yes.

Dr Chelsea Pierotti (36:55.166)

Yeah. Oh, they are life skills, 100%. Yes. I think they're life skills that dance just happens to be the vehicle with which we learn them, but they are life skills.

Linda Bluestein, MD (37:04.856)

Yes. And, and I think apply so much more so to dance because of the, you know, I know, somebody, I think it was Taylor Peck, Tyler Peck just recently posted something about, you know, can I can I do this? Yes. Can I do this? Yes. Like we're so used to saying yes, right? Yes, I could do that. Yes, I can do this. So I think learning to turn inwards and pay attention to our thoughts and our emotions and everything is really

Jennifer Milner (37:04.951)

Absolutely.

Dr Chelsea Pierotti (37:22.261)

Mm-hmm.

Linda Bluestein, MD (37:32.536)

something that we probably as dancers don't do very well sometimes.

Dr Chelsea Pierotti (37:35.678)

Right. Yeah. No, I think we're definitely, our industry doesn't naturally encourage it by any means. So, you know, we're taught to be outward performers. It's like that. It's like the nature of what we do is pleasing an audience and perform. So even to make a more genuine performance though, we want to turn inward and we want to be able to be, do it from that reflection. So I think even if people who are like not as, don't perceive these mental skills as being that

Linda Bluestein, MD (37:43.728)

Right.

Linda Bluestein, MD (37:48.069)

Right.

Dr Chelsea Pierotti (38:05.086)

It's, it is again, it's life skills and it is going to help you just be an actual better dancer. That awareness and that understanding of yourself helps you bring a more genuine performance. So it's, it's definitely in the nature of what we do as dancers.

Jennifer Milner (38:20.82)

Yes.

Linda Bluestein, MD (38:20.888)

Yeah, yeah, making everything look effortless, even though it's incredibly hard. Making it look like we're not suffering or anything. It's easy. Okay, so before we wrap up, can you tell us one or more of your favorite hypermobility hacks?

Jennifer Milner (38:24.663)

Hahaha

Dr Chelsea Pierotti (38:25.278)

Yes, exactly. Right.

Dr Chelsea Pierotti (38:39.882)

So, of course, I'm going to do a mindset one because that's what we got to share. And we started to go there, Jen was talking about autonomy and like this is all stuff in our control. And that's my mindset hack, my phrase that is my life, guides my life, not just my dance world that I control the controllables of whenever things feel incredibly challenging or you have some big setback or...

Jennifer Milner (39:01.564)

Mm-hmm.

Dr Chelsea Pierotti (39:07.93)

even when things are good, right? That keeping in mind what is in my control in this moment and being able to focus my energy, my thoughts, my effort on my control and letting go of the things that are not in your control. Because there are a lot of things as a dancer that are not in our control. And, you know, Jenny, you're talking about how communication matters so much and it does. But if you are, you know, working for or have a partner or somebody who is not good at that, like what's in your control? How you communicate to them?

is in your control. How they receive it is not. And how the, you know, if you're in part of your dance life where there are judges or there's people choosing you at an audition, like you can't control them. You can control your effort and your preparation and your own mindset. So, and same with injuries, same with, you know, a, being a hypermobile dancer, there's gonna be some of that, that is not in your control. It was how things are in your experience. So how

Like letting go what's not in your control and focusing on what is helps so much with all of the mental skills we've talked about, the resilience, the identity, the positive approach. So, yeah.

Linda Bluestein, MD (40:14.623)

I love that. That's great. And where can people find you online?

Dr Chelsea Pierotti (40:20.026)

Sure, the easiest I guess is my website. It's just ChelseaPerotti.com. I know my last name is a challenge, but it's P-I-E-R-O-T-T-I.

Linda Bluestein, MD (40:31.116)

Okay, very good. And we will definitely have that link in the show notes. And I just wanna remind everyone that you've been listening to the Bendy Bodies with the Hypermobility MD podcast. And our guest today was Dr. Chelsea Pierotti sports psychologist and consultant for dancers and dance educators. And our guest co-host today was Jennifer Milner. And it was so great to chat with you, Dr. Pierotti, and of course having you back, Jen. And I really appreciate you sharing your wisdom and knowledge with us.

Dr Chelsea Pierotti (40:35.778)

Thank you.

Dr Chelsea Pierotti (40:59.966)

Of course, thank you both, this was really fun.