I had made the appointment three months earlier. Secretly I was grateful for the long waiting list. Slowly but surely though, as much as I tried to ignore it, the day crept closer and loomed large in my mind. Several times in the weeks leading up to it I thought about cancelling, concocting one excuse after another.
If you’ve experienced sexual trauma like me, you probably understand my hesitation in going. If you have not, then you might be asking “Why the unwillingness to go for such a simple five minute test?”
In this blog post I’ll share my experience of going for my first pap smear test since beginning to recover memories of childhood sexual abuse. More importantly though, I’ll explain why such an experience is not uncommon for any woman with a history of sexual trauma. I’ll detail why it can be so challenging for us and, if you’ve had sexual trauma in your life, I’ll explain what you can do to make it easier for you in the future.
When it comes to immobilization, one common experience that both men and women can relate to is going to the dentist for a routine check-up or cleaning.
While you’re there, you’re stuck in the chair, obliged to stay still while another person does something to your body. You feel powerless and uncomfortable, waiting for the time to tick by until you hear the magic words “you’re all done.”
For anyone with a history of sexual abuse, “routine” medical procedures and tests like this one as well as much more invasive ones such as an annual OBGYN visit, or endoscopy can be extremely triggering. This was definitely the case for me. Why is this?
The answer is that these experiences all have some common elements:
There is a person in authority (doctor/dentist) performing the procedure, while the patient is (to varying degrees) immobilized, exposed and sometimes even mildly sedated.
In psychology terminology this is known as an “inescapable attack”.
Something happening to you that you cannot get out of. Yes, technically you could stand up and walk out of your teeth cleaning, but most do not. For many people with a history of childhood sexual abuse, these elements of immobility (feet in stirrups) can trigger emotional, visual or body flashbacks. The brain has “wired” or “coupled-together” the experience today of being immobilized during a routine medical procedure with the inescapable trauma experience of being sexually abused in childhood.
I’ve had plenty of pap smear tests before. I used to go annually in my late teens and early twenties.
The stirrups, the open-back gown, the crampy swab, always the same. At one point, following an abnormal result showing pre-cancerous cells, I had loop-diathermy to remove them.
You might think that that incident would be more difficult than this one. After all, I was half-naked, surrounded by not one, but an army of over-zealous medical interns while the diathermy took place.
I watched my uterus being scraped clean on a large impersonal monitor. The invasive procedure was followed by bi-annual pap smears for a period of three years. It was not pleasant, but diligently I went. The difference back then was that I had not yet begun to regain any conscious memories of my abuse. I had completely blocked it all out.
Not so when the day of this pap smear arrived. I awoke with a pounding headache. I put the kids on the bus to school and ran some errands, trying feverishly to distract myself from what was coming.
When I arrived at the health center, I did the medical intake with the Nurse. I wrote in my paperwork that “I have a history of sexual abuse. Please have the doctor explain everything that they will do in detail before they do it”. Although no one mentioned my abuse and it felt rather like a huge purple elephant in the room, the doctor did, to her credit, talk me through every step of the procedure.
I was given a cup to pee in and a pink, scratchy gown to put on. Everything was routine. My cervix apparently “looked great”. The doctor called the stirrups “foot rests”. It was over quickly. I dressed and went home.
It seemed simple enough, but there was much more going on than I realized.
I drove on auto-pilot. When I got home, my head was still pounding. I trudged slowly through the day.
By late afternoon, my back was hurting. My left knee was throbbing. My left shoulder was aching. I had sharp, stabbing pains under my left rib cage and another beneath my right shoulder blade.
I went to lie down on the sofa. The light shining from the kitchen was hurting my eyes. I realized that I needed to listen to my body and process what had been triggered from my pap smear test.
I was also giving myself a really hard time. The test had been fine. I’d asked for the doctor to communicate each part of the process with me and she had done so. Everything she had done had been highly professional. Why was I so triggered by this? Why was I being so ridiculous?! I berated myself and I felt so stupid for having this reaction.
As I lay on the sofa, my body wracked by a litany of pain, I revisited the day in my mind, looking for clues as to why my body was so out of whack.
As I thought about myself, leaning back on the pillow in the doctor’s office, trying to sound normal in my conversation, I realized that I hadn’t actually been present at all. I had dissociated and gone numb.
I had been in a state of freeze. I had clasped my hands tightly together and dug the thumb-nail of my right hand into the flesh of the thumb on my left hand. For as long as I can remember, this has been an unconscious habit; a way to feel in control of things that are outside my control.
Back then, self – harm gave me a feeling of control. I used to do it at the dinner table as a kid, when my sister would argue and fuel my father’s rage. I would grip my palms together under the table, digging my nails into my fingers until they bled, silently willing her to stop antagonizing him.
Somehow, the idea of me inflicting even a tiny amount pain on my own skin, made me feel that I had some kind of power to counter-balance the pain inflicted by others. This was a pattern of behavior, a survival skill that I developed at a very young age in order to survive in a highly toxic and dysfunctional family environment. By reverting back to this old habit during my pap smear test, my body was showing me that I did not feel safe in my current experience.
Take a moment and ask yourself – what habits or patterns of behavior did you develop as a child in order to survive? How did they serve you back then? When do they re-emerge for you today? And what could they be trying to tell you – if you’re willing to listen?
Self – harm is a very common pattern of behavior for abuse-survivors, whether it be cutting, self-mutilation or any other form of harm. It stems from feeling fearful, trapped and powerless to escape or change a situation and to the child it can bring a temporary release or relief from the pain being endured.
For me, I engaged in various behaviors including breaking and bloodying my fingers, giving myself a concussion, cutting flesh down to the bone. All in an attempt to find an outlet for my pain as well as an attempt to get the notice of doctors who treated me.
Becoming aware that my body was clearly triggered by the pap smear test experience that Friday, I asked myself what it was specifically that had felt so violating and upsetting?
For me, it boiled down to one thing. The normalcy of the whole situation. This is what triggered all of my physical pains. The idea that a doctor could have her fingers inside my body, examining my cervix all the while casually asking me how old my kids were, actually felt chilling to me. Not because there was anything untoward about what she was doing, but because of what it made my body remember.
You see, as a child, the sexual abuse I endured frequently took place while I was being told ‘this is normal’, ‘nothing is wrong’. ‘This is what we do’.
For a child who is feeling that something is in fact very, very wrong, this messaging is incredibly damaging. It causes a lot of self-doubt and an inability to trust our own thoughts, feelings and body sensations. During abuse, my body was reacting as body’s do to stimulation. What I felt however, was that it wasn’t right to be touched by a trusted adult in this way. The result was massive confusion, fear, guilt and shame.
The trigger that day was the doctor calmly making small talk. My body, through the pain sensations that sprang up, was clearly alerting me to this and my need to process what was really going on.
If you’ve ever experienced seemingly random body pains or sensations, it’s important to ask yourself, “What could these be drawing my attention towards?”
In my situation, once I became aware of all the different body sensations that I was having, I started to track them. As a Somatic Experiencing Practitioner (SEP), this is an essential part of the healing process. I took out my journal and wrote down all the places in my body that were hurting.
Then I noticed and described each pain in as much detail as possible. For example, “I have a sharp, deep red, gnarly stabbing pain going deep into my rib cage” was one sentence that I wrote that day. “The stabbing feels fast and relentless.”
From there, I used this information as the starting point for my Tapping.
“Even though I feel this sharp, deep red, gnarly stabbing pain going deep into my rib cage and the stabbing feels fast and relentless, I know I’m safe right here, right now today.”
By using somatic (body) awareness to inform my tapping, I was able to get to the understanding that the key issue here for me was:
Even though your words are telling me that what you are doing to me is ok, my body does not think or feel that it is ok. I don’t think or feel that it is ok. It is not ok for you to tell me these lies. It is not ok for you to touch my body in inappropriate ways and tell me there is nothing wrong.
It is not ok for you to abuse me all the while telling me that this is normal behavior. It is not ok for you to invalidate my physical pain, fear and terror by telling me I’m crazy and that this is “just what we do to show love” All lies.
So, whilst the pap smear experience in itself was all perfectly proper and not abusive, the body memory and experience that it triggered and brought up in me for resolution was a hugely important one.
By listening to my body and tracking my body sensations in my journal, I was able to release the emotions that had been trapped for so long in each of those body parts. The confusion. The sadness and grief. The feelings of betrayal and overwhelming shame that I must somehow have caused this or invited it. That something about me was inherently faulty, broken and tarnished by what in fact was never my fault.
I’m sure you understand some of my process from what you just read above, but let me summarize it and outline the healing process for your more clearly:
Step 1: Ask yourself “What is it specifically about what has happened today that is causing me body pain and what is it triggering in me from back then?”
Allow the answers to come out unfiltered. There is not right or wrong answer. Notice and describe each pain, sensation and emotion in as much detail as possible.
Step 2: Use your answers to create your tapping scripts like this…
“Even though I’m feeling this _(enter the specific pain, sensation or emotion here)_, I know I’m safe right here and right now today.”
Say the setup statement three times and then tap through the different points, continuing to address the pain and emotions that you are feeling. You may notice that as you tune in to a specific pain, sensation or emotion, it might initially intensify. This is completely normal.
Step 3: Say the words today that it was not safe to say back then. Speak your truth, even if it’s just to yourself. It may come out as just a whisper at first, but keep saying these words. Keep speaking your truth.
Continue saying these words with more emotion and gradually with more volume, until you feel a shift in your body.
As you go through this process you’ll be combining the power of somatic mindfulness with EFT Tapping Techniques, to release the trauma from now and from back then, and to reclaim your authentic voice.
If you are feeling scared or uncertain about going through this process alone, feel free to reach out. Sometimes working with a coach is helpful and necessary, especially when processing childhood trauma. I am here for you. I believe in you. Your voice matters. You deserve to be heard and you deserve to heal.