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September 24, 2010

Health Care and Trauma Survivors

Survivors of sexual violence often have a hard time going to the doctor or the dentist. Doctors have a job to do and a limited amount of time to do it in. They are authority figures and often don't meet the patients until they are in a gown in an exam room. The quick nature of the exam with the added emphasis on the power of the Doctor can be triggering for survivors. 

Survivors struggle to be full participants in their health care. Those who survived the trauma by dissociating may end up dissociating during the exam. They may not remember the conversation afterwards and then left to take care of themselves without the value of what they discussed with the doctors.

For survivors, I would recommend taking a trusted friend, partner or family member into the exam with you. If the doctor doesn't follow a protocol that leaves you feeling safe and able to fully participate in the examination having that person there will help you have the information you need to take care yourself.

For doctors, I would recommend that you meet with new patients in either your office or exam rooms before you have the new patient change into their gowns. Discuss why they are there and discuss what options there are for proceeding on that day. When You do an exam, always discuss the exam with the patient and let her know what you are about to do. Before you proceed, make sure the patient says it okay. Do this for each step of the exam. If the patient says no, then stop. Discuss what happened and don't proceed until you get an okay. If you the patient is triggered ask if they have someone with them that they would like to have in the room. If not, then reschedule the appointment.

This may seem like a lot of work but it will be empowering for your patient and lead to a more productive partnership for you and your patient.   

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