Being vulnerable with anyone is daunting. Add in trauma and power dynamics within doctor-patient relationships and you’re looking at a potential triggering situation that can throw you into a mental and physical health flare. Balancing the risks vs. benefits of seeking care can be utterly anxiety-provoking.
Last week I had to face the reality that I still trigger immensely when I am under stress. I needed to get examined for possible hernias. When triggered, any touching or visual inspection of my knees to the top of my cleavage is a HARD PASS.
Currently, the only provider I am comfortable with doing that is my PT who does lipedema and scar tissue massage for me. It took hours spread over several appointments with talking, no touching, and her earning my trust by accommodating my needs for me to trust her. This issue couldn’t wait for that rapport to be built with a general surgeon.
Thankfully, my husband was also seeing a general surgeon. He was incredibly accommodating to our family’s needs for scheduling and appointment location (the initial consult was virtual which is uncommon for surgical needs), and he did not dismiss my husband’s symptoms even though they were atypical. He squeezed me in last minute staying after his shift ended.
Prior to scheduling and my arrival, I spent a large amount of time talking to the nurses for my PCP, the surgeon’s nurse, and the schedulers for both departments about my trauma and sensory triggers being in full-blown panic mode. Both places assured me that my wish to not be touched or exposed would be honored.
When I arrived at the appointment, I was actually experiencing significant pain along with the triggers. The nurse and surgeon were not thrown by my request to address my husband’s needs first though they wanted to start with me as they could see I was not well. (I normally can mask my pain and issues well enough that it doesn’t attract attention.) Graciously, they took care of him first with no more than a nod of acceptance at my curt, breathless redirection away from me.
By the time it was my turn, my pain had reduced to a point that I could talk. I was in dragon mode. I still did not want to be touched. The surgeon suggested imaging and then, if needed, the hands-on exam. He was attentive and patient. I knew it was late, but instead of going into a fawn trauma response trying to meet his needs by ending the appointment so he could go home, I stayed present.
I told him that I needed to talk out loud to process and talk through my trauma trigger. He just sat there patiently and nodded. Also of great importance, his body language and aura were giving off safety and calm.
I started talking: “My triggered side is very activated. I feel so sick right now from the pain with nausea—that’s the main pain presentation from my neurodivergence—and I don’t want to make it worse. I need to be functional after. I am worried about judgment due to my weight and that my symptoms will be discounted. It has happened many times and it is so hurtful.
“However…
“My rational side has watched how you have treated my husband even though his issues are not ‘normal’ and easy to pinpoint. You also make my body feel safe. I also know you stayed late just to squeeze me in. I can tell that you care and that says a lot about your empathy. So, since I am symptomatic right now, is there a medical benefit for you to do the hands-on examination right now?”
He said yes and reminded me that I described the bulges as “transient” so if I didn’t want to do it during the appointment, I could call to schedule during a time when they are visible again. Ding, ding, ding! Green flag to my trauma brain! He gave me control over my medical decisions. That was the last thing I needed to be vulnerable enough to expose my abdomen and have him kneel before my belly as I stood so he could feel around.
By being honest with myself and the entire care team before, during, and after, I walked away from the appointment without adding more trauma to process in therapy. I was able to receive the best that each person could offer me because I was vocal and explicit in my requests (though I repeated things due to my anxiety and ND).
Sure, I used up more time than most patients need, but I NEEDED that time. I deserved that excellent level of medical care. I could tell they all wanted to help me and I allowed myself to receive it by using coping skills. The providers all were able to add healing experiences instead of medical trauma.
Speak up for yourself. Check your anxious thoughts. The brain and nervous system are quick to find patterns of previous threats but you need to evaluate and sort through if that is true for the present moment. And most importantly, to be vulnerable with providers, you need to trust your intuition. Sometimes the provider is not the right one and sometimes YOU are the one that is not ready to receive. Honor whatever is happening at that moment and it will have the best outcome possible.
Wisconsinite Yooper 