TCS: Therapy and Counseling Services

05/09/2026

How do I balance my physical needs with the needs of the clinic and my clients? That's the question I ask myself constantly, and part of the answer is: intentional structure.

Generally, I don't start client sessions before 10am, and many days not until 1 pm. My mornings are admin time - billing, insurance coordination, development - the work that keeps the clinic running. I can do this reclined, which is easier on my POTS. By the time I see my first client, I'm hydrated, I've had time to settle my nervous system, and I can actually be present.

Throughout the day, I don't do more than 2 or 3 consecutive sessions without a 15-minute break. I come downstairs to the staff space, I rehydrate, I rest. It's not glamorous, but it's essential.

The clinic itself is designed around this too. No fluorescent lighting. Dimmable lights in every treatment room. A quiet break space where I can actually recover between clients instead of pushing through.

This balance didn't happen by accident. It took a lot of intentional work (and trial and error) to figure out what I actually need and how to structure my schedule in a way that honors both my health and my commitment to my clients and the organization as a whole.

05/06/2026

We asked our clients: "What's one thing you wish people knew about hEDS?"

"My disability is invisible. I look fine, but my body is struggling on the inside. People don't get that I'm not exaggerating when I say I can't do something."

"Everyone thinks hypermobility means I'm flexible. But flexibility without stability is a nightmare. I can bend, but my joints don't stay in place. That's the problem."

"I've been told I'm lazy, that I'm not trying hard enough, that I just need to exercise more. Nobody understands that my body works differently. What helps one day might hurt me the next."

"The pain is real. The fatigue is real. The limitations are real. But because you can't see it, people assume you're fine."

These are the things we hear all the time. And they matter. Because understanding what hEDS actually is—not just the flexibility, but the instability, the invisible symptoms, the unpredictability—changes how we support people living with it.

If you're navigating hEDS, your experience is valid. Your limitations are real. And you deserve care that gets that.

05/06/2026

Day 5 – The topic for today is 'What Helps Me Most.' For Sage, art and writing are an outlet.

"As a kid, I knew I was different. Mysterious bruises, chronic pains in my joints that were brushed off as growing pains, along with that tightness in my chest and the dislocating joints. In the rural Alaskan villages, it was almost impossible to get proper medical care and attention. Even more so as a twospirited Native woman.

Two years after my family and I moved to central Alaska, I was finally able to see a doctor who specialized in chronic pain and illnesses. I was diagnosed with hypermobile Ehlers-Danlos syndrome (hEDS), postural orthostatic tachycardia syndrome (POTS), and mast cell activation syndrome (MCAS) all in one month.

After a decade of wondering what was wrong with me, at 17, I finally got answers. It was a tough thing to adjust to, but I finally knew what was wrong with me! It was the most exciting and sad day of my whole life at that point. Over the past years after my diagnosis, I’ve had to re-learn how to live. Researching my illnesses and searching for answers that my primary care providers never had.

Learning to accept this part of my life has been the hardest. I started with answers for my body’s aches and pains, but no answers on how to make it stop. Forced to push through the pain until it was completely unmanageable.

I turn 20 in September now, and I still fear what the future brings me. “Will it get worse? Will my body give up on me?” I asked myself. I heard my whole life from older people that I won’t know what real pain is until I’m their age. I wondered how bad the pain would be when I’m old. I’m terrified of scaring away partners with how much help I need with my chronic illness, along with my autism.

I need more care, more rest, and I need support way more than the average person. I don’t want that burden pushed onto the person I love. This was a common fear with my last partner. They were absolutely unsupportive towards my disabilities, always pushing more from me than I just could not do at that time.

Now I’m in my first year of college, and I have found a girlfriend who is supportive and understanding. We both suffer from POTS, so there is a higher understanding of each other, and I am so grateful for finding her in my life.

I’ve used my art and writing as an escape my whole life, but now it’s an outlet for my pain. I know there are days when I can’t get out of bed, even ones when I can’t move, but I will never let it stop me from creating. Art is a form of resistance, and it always has been. I resist the idea that I am useless, that I don’t do anything for society, or that my life has no real purpose on this earth. My art is my purpose.

My art describes who I am better than any poem or research paper ever could. I may eventually lose my mobility more than I have now, but I will never allow myself to lose my creativity.

The people who see me as me and not just my disabilities, people who want to stay and want to see me flourish. I love my friends and family who stayed and pushed me to succeed, without pushing my physical limits." - Sage

https://www.ehlers-danlos.com/story/sage/

05/03/2026

Your first appointment, you come in saying your shoulders hurt. But then I ask about your sleep. Your stress level. Your digestion. Your focus. And you're probably thinking, "Wait, I came here for my shoulders. Why are you asking about my gut?"

Here's why: your nervous system, your joints, and your executive function aren't separate systems. They're deeply connected.

Someone comes in with shoulder pain. We could do strengthening exercises, and they might feel better for a few days. But if their nervous system is stuck in fight-or-flight, their muscles stay tense. If they're not sleeping, their body can't repair itself. The pain comes back.

Not all pain is the same. There's nociceptive pain—structural damage or inflammation. Neuropathic pain—nerve misfiring. And neuroplastic pain, where your nervous system generates real pain signals based on learned threat patterns. For people with chronic pain and hypermobility, neuroplastic pain is often one of the biggest drivers. This is real pain, but it's coming from your nervous system. Our nervous system-based approach works because we're helping your system learn it's safe.

When we ask about the whole picture—your sleep, stress, digestion, focus—we're building a map of what's driving the problem. Your body is working overtime to stay stable. Your nervous system is hypervigilant. You might have fatigue that doesn't match your activity level. Sensory sensitivities that exhaust you. All of that matters.

So when your OT asks about your sleep, your stress, your digestion—we're not going off on a tangent. We're addressing what's really driving the pain. Because sustainable change doesn't come from isolated exercises. It comes from supporting the nervous system, the sleep quality, the stress load, the sensory overwhelm—all of it.

It's the difference between treating a symptom and supporting a person.

05/01/2026

05/01/2026

This month is Ehlers-Danlos Syndrome and Hypermobility Spectrum Disorder Awareness Month, and we're diving deep into something that doesn't get talked about enough: the intersection of hypermobility, neurodiversity, and trauma—and why a neurodiversity-affirming approach to care changes everything. We're also pulling back the curtain on what real life looks like when you're managing these conditions, and how OT actually works when it's done holistically.

But we're starting here, with this: you don't need a diagnosis to deserve support. You don't need to have it all figured out. You just need to know that help is available, and it can start today.

Throughout May, we'll be sharing my own lived experiences as well as what we've learned from working with people navigating EDS, POTS, autism, ADHD, trauma, and the complex ways these things show up together.

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04/30/2026

I can't believe that April - Autism Acceptance Month and Occupational Therapy Month - is almost over. Where does time go?

This month, we've talked about autism and occupational therapy across the lifespan. Early childhood through adulthood. Sensory needs, executive functioning, chronic pain. What it means to support autistic people in a world that often asks them to be something other than themselves. We've put a special spotlight on the PDA profile of autism, which tends to get less attention.

But before April is over for another year, I also want you to know why this month matters so much to me. I'm autistic. I have multiple chronic health conditions. I know what it's like to struggle with sensory overload, to have your body work against you, to feel like you don't fit. I know what it's like to search for help and find people who wanted to fix you instead of accept you, or whose help was out of reach financially.

I also know what it's like to thrive. To be able to do the things I love; the things that make life worth living. Even if it means accepting and accommodating my limitations; even if it's not the same as it was years ago.

That's why we built TCS. Yes, to validate you, but more importantly to create real, meaningful change in your quality of life. We work with autistic people of all ages and their families to build strategies that actually work. To help you understand your body and your brain. To participate in the activities and relationships that matter to you. To live, not just survive.

We're a nonprofit because we believe that access to affirming, specialized care shouldn't depend on what you can afford.

If you're autistic, or you have a child who is. If you've been turned away or haven't been able to afford the help that was available. We see you. We get it. And we're here to help you thrive as yourself.

04/28/2026

How We Support PDA at TCS

PDA shows up differently in every person. At TCS, we meet each person where they are with an approach built on understanding anxiety, not compliance.

Our treatment starts with education. We help clients and families understand that PDA isn't defiance or stubbornness. It's how their nervous system responds to perceived control. That shift in understanding changes everything.

From there, we work on regulation. We use the Safe and Sound Protocol, sensory integration, and nervous system retraining to help calm the baseline anxiety that fuels demand avoidance. A calmer nervous system means more capacity for daily life.

We also focus on building agency and choice into every interaction. Whether it's through collaborative problem-solving, indirect communication, or giving control back to the PDAer (while maintaining necessary boundaries), we're constantly reinforcing that they have a say in what happens.

Most importantly, we celebrate them. We recognize their strengths, their creativity, their resilience. PDA often comes with incredible problem-solving skills and a sharp ability to read social situations. We build on those gifts while supporting the challenges.

If you're looking for a clinic that gets PDA, that understands it's not about discipline or willpower, we're here.

04/28/2026

How We Treat PDA at TCS

PDA shows up differently in every person. At TCS, we meet each person where they are with an approach built on understanding anxiety, not compliance.

Our treatment starts with education. We help clients and families understand that PDA isn't defiance or stubbornness. It's how their nervous system responds to perceived control. That shift in understanding changes everything.

From there, we work on regulation. We use the Safe and Sound Protocol, sensory integration, and nervous system retraining to help calm the baseline anxiety that fuels demand avoidance. A calmer nervous system means more capacity for daily life.

We also focus on building agency and choice into every interaction. Whether it's through collaborative problem-solving, indirect communication, or giving control back to the PDAer (while maintaining necessary boundaries), we're constantly reinforcing that they have a say in what happens.

Most importantly, we celebrate them. We recognize their strengths, their creativity, their resilience. PDA often comes with incredible problem-solving skills and a sharp ability to read social situations. We build on those gifts while supporting the challenges.

If you're looking for a clinic that gets PDA, that understands it's not about discipline or willpower, we're here.

04/27/2026

PDA Quick Tip: Navigating Sibling Dynamics

When one sibling has PDA, family dynamics shift. One kid might feel like they have to manage their sibling. The PDAer might feel singled out. Resentment builds quietly.

Here's what this looks like in real life:

Your older kid is heading out with friends. Your PDAer is having a meltdown because it's not fair—why does their sibling get to go and not them? The non-PDA sibling feels guilty or annoyed. You're caught in the middle.

What NOT to do: "Your sibling has PDA, so you need to stay home, because they can't understand why you're going out without them." That puts the burden on them.

What TO do:

Acknowledge both kids. "I see you're upset. Your sibling is upset too. These are two different situations with two different needs."

To the older sibling: "You get to go out with your friends. That's your plan and your choice."

To the PDAer: "I know this feels really unfair. Your sibling gets to go out, and you don't. That's true. But fair doesn't mean everyone does the same thing. Fair means everyone gets what they need. Your sibling needs to hang out with friends. You need something different right now. What would help you feel okay? Do you want to [do an activity together], [have some quiet time], or [something else you choose]?"

The goal: Both kids feel seen. Neither one is responsible for managing the other's emotions. Fairness means each person gets what they need, not that everything is identical.

04/25/2026

PDA Quick Tip: Reducing Shame

Shame is one of the most damaging experiences for someone with PDA. When they struggle with demands, they often feel broken, bad, or defective. Your words matter.

Instead of: "Why can't you just do it?"
Try: "Your brain works differently, and that's not wrong. Let's figure out what works for you."

Shame makes anxiety worse and deepens avoidance. When someone feels accepted despite their struggles, their nervous system has a chance to settle.

Small shifts help: validating their feelings, separating the person from the behavior, celebrating effort over compliance, and avoiding blame language. The message that gets through is: "You're not broken. You're not bad. We're in this together."