APPENDIX 2
How survivors of sexual assault can have a positive Pap Smear Experience
The last thing I could even consider for the longest time was having a pap smear following being sexually abused. My GP had the courage to ask me about whether I had had a Pap smear following the abuse and she reminded me that it is an important women's health issue. Although, the thought of having a Pap smear was absolutely scary and frightening on so many levels because it has the potential to bring up memories of the rape and even cause unwanted and undesirable triggers.
I decided to go to Family Planning Association because I believe that the service's staff would perform a lot of pap smears and that would make them very competent and experienced. I was also hoping that the service would be gentle and sensitive to sexual assault survivor's needs. I decided that honesty was the best policy hoping that it would enable me to receive all the gentleness and sensitivity I deserved. I decided to go when I was ready. Although I knew the sexual assault had prevented me from having a pap smear for the last 4 years. However, I knew that I needed to do this so that I could take another step forward in my healing and recovery. For a long time I couldn't even begin to entertain the idea, I knew I needed to do it, but I couldn't even consider doing it. Over time, my feelings changed as I felt my fears about having a Pap smear were getting in the way of my healing and recovery and I would really feel better doing it instead of worrying about not doing it.
When I went for my appointment, I found that being honest was very important because I was well informed by the nurse and I had my questions answered without even having to ask them. Pretty good I thought. Remember you have a right to ask questions first, even if that is all you do; you need to know "will I be comfortable having this procedure done here with these people? Do I feel that they will be gentle and sensitive to my needs?"
You can ask questions about
"How does the service cater for survivor's of sexual assault when doing a Pap smear?"
"Does the service use a small duck bill speculum?"
"Will the person doing the Pap smear offer to go slowly, gently, give you a word to stop the procedure, or something else to draw their attention that you need to stop?"
"Will the person doing the procedure check you are ok during the procedure?" or
"Will the person doing the procedure talk you through the procedure step by step if you would prefer them to do so?"
Don't be frightened to ask the questions you need answers to especially if they are not forthcoming. If you don't get the answers you need to feel safe and comfortable to have the pap smear then go to another service until you feel safe and comfortable that your needs will be meet because it is far too important to your healing and recovery to suffer a negative experience. Remember you do deserve a positive experience, where your needs are focused on in a gentle and sensitive manner. It is important that the staff demonstrate respectful behaviour towards the survivor, be open, honest, understanding of how tough this is for you to do and understanding if you are unable to do it on your first, second or third attempt.
I felt safe where I went because I could feel how sensitive the nurse was to my needs as she would volunteer information that I wanted to know without me even having to ask and she did do everything she said that she would do. I had considered putting the speculum in myself, although now in hindsight, I needed to focus 100% on my breathing and I felt like I was in safe hands that this idea went out of my head because it would have been too difficult to do.
The nurse who performed the Pap smear was slow and gentle inserting the speculum and she gave me permission to opt out by saying, "stop" if I needed too. The nurse informed me that some survivors actually need to make 2-3 attempts before they actually get the Pap smear done. So it was ok if I couldn't go through with it on that day. I knew that if I needed to that I could disassociate from the whole experience. I closed my eyes and focused on my breathing so much so that I could barely interact with the nurse when she would ask me if I was ok. The nurse provided me with positive feedback and I gave myself a big pat on the back to, but it really was a huge sense of relief and a huge weight lifted off my shoulders. I did it!
Finally, I did it. I had managed to overcome my fears from the sexual assault that was preventing me from having a Pap smear and it was so much more positive than I thought it could be. I felt like I had won. It felt like a major achievement because he wasn't going to stop me living my life or destroy me. I did it, I did it and I did it! The nurse did ask me what I was planning to do after and I replied that I was going for a walk on the beach. The nurse responded "Oh no, you need to spoil yourself, go and do some retail therapy or go for coffee and cake". So I went and did some retail therapy and now I have this beautiful new top that is just gorgeous.
Another option to consider is to take a friend or your partner with you. Do whatever you need to do this when you are ready to do it because strangely enough for something that is incredibly invasive it poses many fears for survivors of sexual abuse. Yet it can be positive in the road to healing and recovery if you are ready, treated with respectful behaviour and provided with gentle and sensitive support.
To see an outline of the stages in Evelyn's journey to date
Chapter 1 of her journey 'Love, not Time, Heals all Wounds'
Chapter 2 'Be careful of the men you choose'
Chapter 3 'The Loss of the Age of Innocence'
Chapter 8 'Making Sense of Secondary Wounding'
Appendix 1 - Emotional Freedom Technique (EFT)
© 2005-2008 Evelyn Shakespeare