Hi Bea,
I sent the email to my doctor. And she wrote back.
Dear Doctor S,
Thank you for calling to check on me. I’m sorry I didn’t pick up the phone, or return your calls, I just wasn’t ready to talk about what happened last week. I’m really embarrassed over my reaction and behavior during the exam. I’d like to explain what happened and why I reacted in the way I did. I would prefer if we can keep this between us; this isn’t information I want in my medical history.
I have a history of trauma, and a diagnosis of PTSD. Pelvic exams are always hard for me, but I’ve always been quite good at holding things together, at sort of dissociating away my uncomfortable feelings, and not letting anyone know I’m less than okay. Having a male doctor present and performing part of the exam really triggered me. When he touched me, that just sent me back to that very scary trauma place. It was too big of a trigger for me to dissociate away, and I fell apart. I’m glad you asked him to leave, and I’m glad you covered me up. I feel so embarrassed for how I reacted, and that is going to make it very hard to walk back into your office.
I know I need to come back in, and finish the exam. I feel very apprehensive about that. I don’t want to put myself in another situation where I’m triggered and scared. I also don’t want to put myself in a situation where I need to be able to come to the doctor and feel like I can’t. I’m working through what happened with my therapist, and I will schedule something as soon as I feel okay about it again.~Alice
Alice,
I wasn’t aware of your trauma history, or how difficult pelvic exams can be. Thank you for sharing this with me. I’ll keep this out of your file for the moment, although we may want to discuss adding some information so that these situations can be avoided in the future. I’m sorry you were triggered and felt so scared. I don’t think differently of you, and would like to have you come back in so we can talk about how to best proceed with any medical exams/treatments.
Take care,
Cheryl
Ugh. This feels awful. All I can think is she knows, she is having all these terrible thoughts about me, I can’t face her ever again, why did I send that email, ugh, ugh, ugh. I don’t want to talk to her, she wants to talk, I’m not talking. I can’t do this. I don’t like her reply. I don’t know why. Maybe I wouldn’t have liked any reply. I can’t even think to send an email back. Ugh, ugh, ugh. I’m so angry that I sent this, I don’t even know. I just. Ugh. I wanted this to be done with, I didn’t want to keep talking about it, I don’t even know. Nothing felt okay. It seemed just…ugh. I don’t know. Yesterday, I don’t know what I needed. I felt like everything was off, and I was just not okay. So alone and wrong and sad and I didn’t want to keep talking about feeling like that, and I didn’t want to hear about how it was maybe just a pattern or whatever, because that felt terrible, and like it didn’t matter or wasn’t “real” or I don’t know what. So I said lets talk abut the letter. But then I was just annoyed and didn’t want to talk about it, or hear that I needed to do something, and I didn’t want to think about it, or why it was really a big deal, and I was just frustrated and annoyed and almost mad at you and that wasn’t feeling okay, and I didn’t know what was wrong with me or why I was so upset with you, and I wanted to be done with it. So I said ‘if I say I’ll send the email can we be done with this?’ I knew it was this very teenage response, and part of me was trying so hard to just have the conversation and be okay and behave like a grown up and talk through it and send the email and be fine, but I just couldn’t keep talking about it, so I guess I just shut down the conversation as quickly as I could. It hurts too much to think.
And now it doesn’t even matter because I sent the stupid email when I got home yesterday, still feeling irritated, and not really thinking it, just sending it in a fit of frustration and annoyance. And then after I sent it, I freaked out and wished there was a way to unsend it. And then I wanted to email you but I couldn’t because I was still annoyed. I don’t know. I just want someone to be mad at for what, I’m not sure. To blame, to be angry at for me freaking out, for me needing to tell someone else the secret, for someone now knowing and judging, for even having a secret to tell to begin with, mad because you believed her secret. I don’t know. I don’t know what is wrong with me, why I’m having this ridiculously big reaction and feelings over this. None of this feels right or okay. And I feel like this giant whiny drama queen over this, and that just makes it harder to try to talk about. I’m stuck in my head, and I feel alone and like no one understands. It’s like this crazy mix of teenager and little girl running the ship. Angry defiant teenager, but scared of being judged and thought of as a drama queen, scared of being told her feelings don’t matter, or that they aren’t real, or something. Little girl who is afraid of everyone leaving, of hurting people, of not being perfect enough, who just wants to hide, and wants someone to fix it all and make it better. I don’t know. None of this is rational.
Alice,
My first reaction was to want to “fix” this by talking to the doctor, and if that is something you would like me to do I would gladly do it, but I don’t think it’s probably the best option. I’m still viewing this whole situation as an opportunity for growth and empowerment for you, difficult as it might be.
I don’t think you would have liked any reply except maybe, “it’s okay, I’m waving a magic wand and you will never need to go to the doctor again.” I think, objectively, that it was good reply and you can work with it to express what you need next. If you want, we can talk about that on Monday.
Your reactions make sense to me, of course. And if it helps to be mad or to blame me please feel free to do so. I am okay with that–I was pushing for this after all!
I have somebody coming in a minute, but in terms of the patterned emotions, what I think we want is just to be able identify them as such. Of course they still feel just as bad and are just as “real.” Just not genuine, healing expressions of emotion–which, when you think about it, are probably pretty rare in comparison. I don’t think you have to worry about any of that right now. Just engage in self care and self soothing if you’re still feeling yucky. This doctor thing will pass…..
Bea
Falling down the rabbit hole 
Her reply was thoughtful but I know how much it hurts. I get it. You just want an end to all this. I get that and I hear you. B sounds very responsive. Maybe together you and her can come up with some ideas as to how best to proceed now. XX
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When I’m not freaking out, I can see it was a thoughtful reply. It also helps to have that affirmed by others, so thank you. Bea is really responsive and caring and attuned. She’s had lots of thoughts in how to proceed, I’m just being wimpy. Xx
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If I had to talk about that I think I’d be Wimpy to, don’t beat your self up over that, glad you have b to help guide you
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Thank you. Xx
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About the patterned response thing, my therapist has asked me the same question. She stopped asking me it because my answers helped her to learn what I look like when I am processing emotion rather than in an emotional state that needs to be attended to.
It is very, very easy to hear it as a judgement of the second type being “not good”. Been there. Done that. But I’ve learned that it’s just that they require different responses. With the first, it’s ok to stay in that state while you work through the emotions and you naturally come out of it and feel cleaner when you are done. In the second, the focus needs to be on soothing and helping the part cope with the emotion. The emotion is very real, but feeling it only feels bad, it doesn’t feel healing. In that case, learning to soothe that emotional state builds up the strength to get you to where you eventually have the inner resources to do the working through type of emotional experience.
Have you ever had the type of crying session that makes you say, “Oh, I feel so much better!” when you are done? That’s the first type.
The second type is when you cry, but feel just as or even more lousy when you stop as when you started.
So that question isn’t about judging the type of feeling you are having, it’s about giving Bea information about how she should best respond to you. I think that she just isn’t doing a great job of explaining it to you.
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This makes sense. Thank you. I think Bea did try to explain, but I couldn’t hear her because I’d already shutdown because I heard the question as me being bad. You are so right that it is easy to hear it as judgement. Ugh.
Learning to soothe those feelings is confusing and hard. I don’t know. I always feel very resistant to any suggestions Bea has. The ideas make me feel like I’m being told i am not allowed to feel how I feel. I know it’s “transference” from rules growing up, and that makes me more resistant to talking about it. 🙁
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Reading your reply reminded me of how hard it was for me to learn to not hate it when she tried to get me to help soothe the too much emotions! I remember now that it reminded me too much of feeling abandoned with the feelings. I couldn’t even do much self soothing because that felt like I was abandoning the traumatized part that was crying out in pain.
I’m trying to remember what finally helped it all to click into place… It was something about shifting just a bit so that I could take in that allowing myself to be soothed and come down out of that trauma place wasn’t abandoning the traumatized parts. It was about enabling me to get all of me together enough to really be able to help them.
The other thing that helped me was something that is really idiosyncratic and may not apply to many other people… I had a difficult time with my therapist sitting across a coffee table from me. It was just too far away. I felt as though I was straining to “feel” her there all of the time. I finally told her just how much harder it made things for me and she started to bring a chair over to sit next to the love seat it sit in for my sessions. She is within touching distance now, which is what feels “right” to me. It really made things start to move in therapy when we made that change.
Now, I know that we are a bit unusual because I respond very well to being able to physically connect with her and she is comfortable with providing that support to me. Being held by her reaches the very, very young parts in ways that words never will. Loving touch doesn’t lie, but words can. It doesn’t happen very often, but when it does, it has been very, very healing. On the other hand some young part of me holds her hand to make a connection at least briefly almost every session. It helps me to feel more solid.
Sorry, I’m rambling because it’s almost 5 am and I haven’t been to bed. Afraid that my mind is just going to wind me up into an anxious tizzy if I try to go to bed. I sent a text to my parents last night saying that that they can’t do the visit that they want (they are traveling across country in their RV and they want to come here in June). That I do want for my mother to get together with me for an afternoon, but I do not want for my dad to even enter my town.
Some parts of me are terrified about what might happen now. I’d best stop writing about it, otherwise I’m going to open the floodgates which I have managed to keep firmly closed this evening. I turned my phone off after I sent the text and will turn it on tomorrow morning in session with my therapist and husband. Actually, I turned it back on briefly to try to get to something on my phone and got 4 or 5 tones immediately indicating messages, so I turned it off again without looking.
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I think you are right….it is probably a shift that needs to be made to allow myself to be soothed or self soothe….understanding that it doesn’t mean that I am abandoning the vulnerable traumatized parts.
I’m so glad that mama bear is able to sit with you, hold your hand, and really be there for you and be a good support for you. I’m not sure it would feel okay to have Bea sit like that with me, the idea is scary. I don’t know. I don’t really like people to be so close to me…
You should feel free to “ramble” as much as you like. If it helps, at all, in any small way, then I’m glad. It helps me to hear parts of your story and not feel so alone.
I am so glad you set that boundary with your parents. I know it was hard– impossibly hard, can’t imagine hard– I’m sorry. I think it was a really good, self caring choice to keep your phone shut off and check it once mama bear is there to support you.
I can’t imagine how hard and scary all these feelings have to be. I really hope that your parents respect your needs. Sending you support and good thoughts. Xx
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If you don’t mind an outside perspective, I thought your email to your doc and her response really good and to the point. I liked how you were open but not revealing too much painful detail that she doesn’t necessarily need to know. I thought her reply shows she takes your feelings seriously and wants to be helpful. I understand though how this might activate a very young and ashamed part of you. But from an adult perspective, you are handling this well IMO.
I’m actually really interested in Bea’s comments about ‘patterned emotions’. This is the kind of thing I wish my T would get and would be interested in. I know that for you though, any theory talk makes you feel as if Bea doesn’t care. I struggle with plunging into bad feelings, but not being at all sure that this is in a helpful or healing way – I really think there are healing emotions, and others that are maybe more like habits that I fall into but am unable to move through. To me, trying to distinguish them makes sense. Wish we could trade T’s for a few sessions, so I could learn some of this stuff from Bea!
Read your next post, and am glad you had a good day to relax and forget all this trouble for a while!
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Thank you for the outside perspective. It’s really validating to hear I wrote a good email, and it helps affirm to me that her reply was good, even if all of this feels bad to me.
I’m sorry your T doesn’t get or discuss things like patterned emotions. It’s actually really helpful to me to hear why you would want to discuss it, and it helps me see that asking the question wasn’t about her not caring or judging one type as good and the other as bad. Thank you for sharing that. Xx
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Wow. You’re amazing. Your doctor is too. And by talk, she probably only means that you both can take a moment to decide if a quick one liner could be added to the chart, one that you approve of. Maybe, ‘patient has a history of sexual trauma’…that way others know to proceed with extra gentleness.
It sounds to me like a really good doctor. And you, well you have just accomplished a great thing, that of advocating for your needs. Just wow!
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She really is amazing— she is kind and truly caring and very authentic and real. I’m just afraid to talk about this out loud. I don’t know. I’m not ready to have anything about history– even something simple like you suggest– as part of any official record. It scares me and makes it all so very real. But I’m glad you wrote this because it made me think. Thank you. 💟
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Oh Alice, I really get it. I get being triggered during a gynecological appointment (though I just went off in deep, self-loathing space and the doctor didn’t notice). I get the fear of telling the doctor what the problem was. I told her by phone (super awkward) and then gave her a letter. And I experienced all the insecurity and self-doubt ahead of time and then embarrassment when I went to see her again. At the same time, I am glad I did it, and I am glad you did it. There are SO MANY women with experiences like ours. And we are not freaks! We are normal women coping with abnormal, freakish past experiences and their aftermath. We deserve respectful, dignified, gentle care.
Many women with abuse histories don’t get the care they need and deserve. Every time we are able to speak up, we are an empowering voice for ourselves and for the others who don’t feel able to speak up. Every time one more doctor learns or is reminded of what an abuse history can mean for our sense of physical and emotional safety. So you have done something good for yourself and for other women. I think your doctor (Cheryl) was able to take your feedback and respond well. She was probably trying really hard to be encouraging but struggling to find the right words and tone. It sounds like she will work with you constructively.
I know it feels hard and scary, to let someone else know your secret. It makes you feel vulnerable all over again. Breathe deeply and trust that the vast majority of people, including, it appears, your doctor hear the words “history of abuse” with compassion, not with judgment. That was my experience with my doctor and recently at the hospital. It’s okay. There are good people out there who can know this and treat that knowledge, and you, with respect.
Sorry if I went overboard here. xxoo, Q.
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You didn’t go overboard. 🙂 I know you get it. You just went through it. And I have to say, all the self advocating you did before the surgery really inspired me. It helped give me guts to try. Xx
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Just want to say how amazingly strong you are for sending that letter to your doctor. You are one brave woman!
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Thank you. I have in appointment in May, and I’m freaking out a little bit, but I’m working on trying to be okay with it. I think I will,bring another letter, along with something written that I am okay with being in my chart.
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