When Survivors of Ritual Abuse or Other Forms of Extreme Abuse Need Medical Care
One topic that often comes up in conversation with other abuse survivors is the need for medical professionals to have a greater understanding of the issues survivors deal with in the doctor’s office. I say “doctor’s office” but I’m really talking about any kind of office where a professional is going to be consulted about some aspect of our physical health. So all of this includes dentists, eye doctors, ultrasound technicians, gynecologists, etc.
Things That Apply to All Survivors
In my opinion, one of the most important things for practitioners to keep in mind is that even the disclosure of abuse history is a very vulnerable and tender place for survivors. Filling out forms with questions about our medical history can feel very cold and impersonal, and we may not initially write these things on the lines on the papers. But face to face, if your staff is friendly and compassionate, if they take their time and don’t rush us through the check-in process, we may tell them snippets of the abuse that relates to the questions they have to ask. It’s awkward and scary for us, and we do it because we want help – not because it’s fun.
Another thing to be aware of is – this may sound counterintuitive – sometimes compassion is not helpful when expressed as noticeable emotion. If I tell somebody about something abusive that happened to me, and that person starts to cry or get very angry, it puts an additional burden on me. I immediately feel guilty for saying something that caused pain – even though the pain was coming from a beautiful place of compassion. I feel I have to comfort them and I’m reluctant to say anything else – even if the information would change the course of my treatment – because I want to protect them from more painful knowledge. It makes it hard to just be a patient.
Presenting a strong and calm presence is beneficial for survivors because it conveys that you can handle anything we need to disclose. Statements like “I’m so sorry that happened to you,” and “I hate that you went through that,” along with, “Thank you for letting me know so that I can do everything I can to help you,” help calm our anxiety.
Another very important thing to know is that every single abuse survivor has been stripped of their own personal power at some point or another. We are in various stages of taking that power back – from not even realizing we have any personal power of our own, to taking baby steps, to full recovery. Making an appointment to see someone perceived to be in a position of power over us is really difficult. Oftentimes the only reason we choose to do it is because we are having some pain or problem with our bodies that has become greater than our fear of your perceived authority.
Because we’ve experienced abuse by more powerful people, we often naturally distrust people in positions of power. This is not personal or a statement about you. Power has been used against us and we have been violated, silenced, and shamed with it.
So with that in mind, one of the best things you can do for us is to honor our voice. Honor and even reiterate the fact that we are in control of our bodies and our treatments. Make recommendations, give us the facts, share your knowledge with us – and then put the ball completely in our court. Don’t argue with us if we choose something different than your first recommendation. Don’t belittle our choices or our questions.
Survivors who have been ritually abused often have specific reasons to fear the medical system. Many have been abused by doctors or people pretending to be doctors and have been told that cult medical personnel are in all hospitals and clinics. We believe, on some level, that all it will take is one phone call to set us up to be abused again. Because of this, many of us are interested in more holistic alternatives to medical problems.
We have often done research and asked questions and investigated alternative treatment methods. Honor our requests for information about other options if you feel professionally capable. If you don’t, be honest without being antagonistic.
Tell us you don’t have enough knowledge or experience to practice what we are asking for but would be willing to make a referral.
Treating Patients Who Dissociate
Here are some questions that would be great for medical providers to ask patients who have disclosed that they have issues with dissociation. Keep in mind that answering these questions may be difficult and make the patient feel very vulnerable.
1) What happens when you dissociate? For example, do you space out, switch to a different part, freeze up, flinch if you are touched?
2) What would be helpful for me to do if I notice that you’re dissociating? For example, give you a few minutes to collect yourself, ignore it, ask how you’re doing?
3) Is there anything that would help make the appointment less stressful? For example, bringing a stuffed animal or other comfort object or having a support person in the room?
4) When procedures have to be done, would you prefer that I tell you everything I’m going to do before I do it or just get it over with as quickly as possible?
5) Do you know of specific things I could do to prevent a flashback or help you through one?
We will try to answer your questions, but we may not be able to tell you everything up front. Some of us may not have the awareness or ability to articulate our experiences. Building trust takes time. There may be events or experiences in our past that relate to present-day medical issues but we just don’t feel like we can tell a complete stranger we’ve only just met. Patience and respect on your part will – over time – empower us to trust you with that information.
This post is just a starting point. I want to address providers on behalf of trauma survivors, but there are so many unique situations represented by this population that a ton of other information could be written about the subject. The best thing to do is to get to know the patient and form a partnership with them.
There is one final thing I would like to share. We don’t have two heads. We aren’t all that different from your other fearful, phobic patients. We just have different reasons for our fear. We’ve lived through things that you may never have heard of, but that doesn’t mean that the things that you do to reassure your patients won’t work for us. And it works the other way, too; if you learn something from us it may be applicable to the rest of your practice.