Chantelle Otten

Case Studies


Chronic Pain | Sexual Identity & Self-Esteem

Sarah is originally from a Hindi background. She lives in Australia with no family, she had made a life for herself that allowed her peace and stability. Except, it was unpredictable and riddled with pain. She suffered from chronic migraines that would leave her crippled for 24-36 hours a week. After trying Triptans and other migraine medication, she was not eased of her headache pressure and made contact with Chantelle to see if therapy might offer a solution.

It was identified that the migraines were usually triggered by the stress of her job or difficult conversations with her family. Sarah did shift work, and felt very confident in her ability to perform, but believed she was a burden because of the amount of time she had to take off due to her pain. Her migraines also impacted her friendships and relationship.

Conversations with her family brought her back to feelings of pain and shame. She and her mother butted heads, and she felt guilty for being away from her brother. She described her upbringing as negative with little friendship support and parents who did not love each other. She described wanting her parents ‘to live’. She would have liked to have stronger relationships with them.


During her initial consultation with Chantelle, Sarah came across as nervous, apologetic and unsure of what was appropriate to say and/or not say. It was difficult for her to make eye contact, and she said ‘sorry’ regularly during the session. She was delightful in every way but did not recognise the person that she was. She lacked self-esteem.

One of Sarah ‘s reasons for coming to see Chantelle was because she identified as lesbian. In Hindi culture, this is not accepted, and for this reason, Sarah had to hide who she was from her family and had not told any friends. Challenges for Sarah were her self-esteem, feelings of self-worth, acceptance of sexuality and ability to be open with others.


Working as a team, it is important to build a therapeutic relationship that allowed Sarah to speak openly about her feelings. Approaching the psychological dimensions of sexuality with behavioural interventions, special attention was given to the cognitions behind Sarah’s distress: her assumptions of herself and her worth. Her beliefs about sexuality and perceptions of how others viewed her were also challenging, as she believed that she was a ‘burden’.

During sessions with Chantelle Sarah was able to explore her behaviours and step outside of her comfort zone. This involved interacting with others, reconnecting with friends, making future plans and tell trusted friends about her sexuality. Emotions associated with her confidence and hurt from the past were explored. She was referred to a neurologist who specialised in migraines, so that her chronic pain could be addressed, allowing her to live her fullest life pain-free.


Sarah is a new person; she bounces into the sessions and has confidence and a new ability to cope with difficulties within. She has formed a new friendship group and is making plans to have a lifestyle change that see’s her balancing shift work alongside her ‘side hustle’ passion project.

Sarah is now able to explore dating women and knows how to communicate that she will have a migraine, without feeling like a burden to the person she is with. Sarah is a testament to the fact that sex is multifaceted, and that feelings of self-are important to explore. Her motivation to improve her quality of life is extremely impressive. Her lifestyle is much more positive and rewarding.


Chantelle is attentive and in such she has helped me to process many issues personally including suffering from chronic pain, she has been warm and supportive throughout the sessions. During consultations with Chantelle, I have had the opportunity to transform my confidence levels and have in-turn vastly improved my relationships with others. Chantelle has helped me greatly to function positively with my life.