Coping with medical touch

For those of us with trauma histories, dealing with medical appointments that involve touching can be incredibly difficult. Touch is often an area of great difficulty once it has been used to hurt you in some way. I’ll write more about the whole area later, today I want to talk about medical touch as this was the area we discussed in Bridges recently.

You may feel like you are the only person out there who is so stressed by medical touch that you’d rather have severe infections than go to the dentist, or risk cancer than get intimate checkups at the doctors, but far from it! Most people find these procedures stressful to some extent, and a pretty significant percentage of people are soo stressed and phobic that they avoid them altogether, sometimes with terrible consequences. However alone you may feel, however ashamed and humiliated, you are part of a whole crowd of people feeling the same way. That realisation alone can make a big difference. You are not weak or stupid or pathetic, and being stressed out by these things is nothing to be ashamed of.

You can avoid all the procedures involving touch. The consequences of this choice can range from negligible to catastrophic. This is a very common approach. Many people go down this road, and something I’ve observed is that if this is what you do, you will often stop going back to medical people for anything else either, because you can’t handle the pressure to get your over due extraction/breast exam/prostate check done. Please, don’t do this! If you have to tell your people that you cannot cope with touch but are working on it, please not to harass you, then do it. Unfortunately medical people are not always sensitive to these issues and they may interpret their duty of care as reminding you and pressuring you to have check-ups whenever they see you. Try not to let touch issues cut you off from access to health care in all areas – you need to be able to get medical certificates when you’re sick, pain relief, advice on new symptoms, moles kept an eye on, and so on. Try to limit the possible losses.

If you’re going to have a procedure that involves touch, some planning can make a lot of difference to how you feel about it. Take a bit of time to get to know yourself and work out what will be most calming for you. Will you find it easier to do all the touch things in one hit, or to break them up and spread them out? I’m a n all-in-one-hit kind of person, some of my friends are break-things-up people. Is one gender of doctor easier for you to cope with? Would it help to have a friend drive you home if you’re feeling wobbly afterwards? Are there things you can do to heavily compartmentalise whatever bad memories you’re trying not to stir up before you have the procedure? Can you distract yourself during; by listening to an MP3 player, playing with your bracelet, reciting the periodic table, composing a sonnet (ha ha)? Would it be comforting to take along a soothing item like a teddy, or would that make you feel more childlike and vulnerable? Would having the procedure done by a stranger be easier than going with your regular doctor?

If you’re a multiple, there may be someone in your system who isn’t as bothered about these things. Can you ask them to handle it? Do you need to do or take anything with you to help keep them out? What will you do if they switch?

You always have the right to walk away. Unless the situation is life threateningly urgent, if things start to go badly, say stop, get out, go home, put yourself together and try again another time. If the situation is critical and you are at total overload point, can you use dissociation to dull everything and cope with it? Sometimes creative visualisations can help to disconnect you from intense experiences. This is a little akin to self hypnosis. One I used to use a lot when my pain condition was severe and without relief (I am allergic to most painkillers stronger than paracetamol) is to picture my pain as an oil slick, burning on the surface of water. My body is half submerged and the oil is burning all over me. Then, I would slowly sink deeper and deeper into the water, leaving the burning oil up on the surface. Eventually I would be completely underwater, watching the flames burn on the surface. For me this helped to dull my perception of the pain I was in. It was still there, but a little distant. These kinds of ideas can sometimes help you to pull back from you intense awareness of touch and that agonising sensitivity your skin and body can have when deeply afraid.

Trying things from another angle, sometimes you can reduce the distress by talking yourself through the experience and using intellectual grounding techniques. These are things that help to orient you in time and space, so that you are able to stay in the present instead of getting caught up in flashbacks or emotions associated with bad memories. If  you talk gently and firmly to yourself as if you were a traumatised child, you may be able to start to break the link between touch and painful memories. Explain what is happening to yourself, tell yourself that this person is a doctor/dentist/surgeon/whoever, what they are doing and why. This simply strategy can be surprisingly powerful.

Try to avoid the things that recreate the initial bad memories, whatever they are. The sense of powerlessness that knowing you must have a procedure done even though you absolutely fear and hate the idea can be a strong link to original feelings of powerlessness. Whatever you need to do or say to yourself to break that link will probably help to reduce your stress. You want to try and prevent feeling trapped, helpless, terrorised, violated, overpowered, and abused. You are not going in for a procedure because your doctor is making you (I hope). You are choosing to go in even though you hate it, because you have a health problem that needs taking care of and you are the kind of person who looks after yourself. Same issue, different way of framing it.

You may want to consider recruiting your medical people to help you out in these situations. Hope over at The Road to Understanding DID and Me describes doing this for her recent stressful medical procedure, using a modified letter from the book Got Parts. This won’t always work, depending on the sensitivity of the doctor in question, but it can be very powerful to change the professional involved from a stand in for the abuser, to an ally in helping you get through something difficult as well as possible.

Depending on the procedure and situation, sometimes you may have an easier time if you go to a specialist who does lots of those procedures instead of sticking with a family GP who might do a few a year. Rather the way that blood bank nurses are often the most adept at drawing blood painlessly, the same kind of skill and experience can make things easier for you. For example, for sexual and reproductive health, here in SA we have ShineSA who have doctors and nurses who can perform tests for STI’s, pap smears, and provide information about contraceptive options for you. If the person who is touching you is professional and comfortable with what they are doing, rather than inexperienced and nervous, that can make a big difference to your stress levels.

Anything you can do to create a distinction in your own mind between kinds of bad touch – ‘I’m not very comfortable with this but it is not abuse and is necessary for my good health’ and ‘abuse kinds of touch’ will help. All these different types of touch tend to collapse in together and being able to start to differentiate between them and untangle them from each other can make a huge difference to how you experience and cope with medical touch.

A quick note – sometimes medical people have their own problems, and these are best avoided if at all possible. I mean, drive to the next town rather than let these people touch you. If your doctor is disgusted by touching you, curls their lip in distaste and makes you feel dirty and inferior, don’t let them near you. You do not need anyone who is intimately familiar with you to communicate disgust or revulsion about your body or it’s processes in any way. I mean that even if you have genital warts, scaly infected skin, open sores, whatever. A good medical professional knows you probably feel deeply humiliated and they help you to unplug from that shame and feel more normal about whatever the issue is. They model to you a caring and un-entangled relationship to your body and processes. Some medical folks – like some folks of all professions, have issues around sex themselves. They may behave inappropriately, be flirtatious, drop innuendo, and generally blur boundaries. Don’t let these ones touch you either. Get out, and make a complaint if you can. If you like them, that’s cool – date them, but don’t let them be your doctor! It does not help to collapse and confuse types of touch even further.

Lastly, timing is everything. I once had a doctor ask me about my relationship with my father right before a pap smear. This is not a good thing. If you decide to bring up trauma history or discuss things, try not to do this in the same appointment as the procedure involving touch.

I hope there’s some useful suggestions in there for you, you may have to try a few different approaches before you’re able to find ones that really work for you. Good luck, take care, and go gently.

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