CLINICAL RESEARCH (over 39 years) - SEVERE TRAUMATIC STRESS DISORDER
*based on about 150,000 pelvic examinations
'Clinical Treatment' of Severe Traumatic Stress Disorder: The Failures
Combat Stress traumatizes the body as severely as child molestation except the childrens brains are not matured, they do not know what is right from wrong, they have not had basic training, they do not know how to defend themselves, they are innocent, no one has their back, they are helpless victims, they can't tell anyone because they were told that they would be killed if they did, and no one would believed them any way, or 'it' was all their fault.
The only way these kids could get their night terrors to stop is by drinking at least one of their dad's beers before bed.
The only way these adults could ever have 'adult sex' is when they were Drunk, Drugged, Dissociated, Dominatrix, or just, Don't do it! (the '5 D's).
And she JUMPED!
Sentient Case: As an intern, you are doing a simple annual exam on a dairy farmer's wife who had 4 normal vaginal deliveries.
The exam of her upper body is normal. As you lightly touch her perineum to start to obtain the pap smear her legs snap closed and her hips instantaneously withdraw 2 feet up and away from you. You ask her if her first pelvic exam was painful.
Neither she, nor your medical school training, nor your residency attendings, nor the published literature could give you an answer.
So you call that 'move', 'vaginal body memory' because the vagina clearly remembers something, but is not talking!
All gynecologists, nurse practicianers, and general surgeons who routinuely do pelvic exams on females know about that 'she just jumped' reaction. She moves her lower body away from the examining fingers. It is found in women who were sexually abused, raped or molested. Her muscles are just guarding her perineum from unwanted entry.The following are case reports of your attempts to help her 'stop' the jump!
Axiom #1: She really does not want to jump. She just can
not control that pelvic muscles' protection response!
Case #1: You tell her , "Don't jump!" She holds on very tightly to the edges of the exam table. You tell her to breath slowly and deeply. You give her a 15 minute break to compose herself after talking with a supportive female health worker.
She jumps.
You give her Valium 5 mgs. or Versed in 30ccs of Pepsi 30 minutes before her exam.
She comes back and jumps again!
Axiom #2: She really appreciates any examiner who is patient,
understanding and compassionate to her needs!
Case #2: She has had two full years of talk therapy around her molestation issues. She has never been able to tolerate getting a pap smear before. But she thinks that she can do this now.She becomes hysterical so you call in a nurse to do labor deck breathing with her. Then gratefully, she just dissociates and you are able to get her pap smear done.
It was not an easy 'pap'. (The year was ~1994.)
Two years of serious talk therapy did NOT help one bit!
Question #1: WHY is she still jumping while under anesthesia? (This is not uncommon.)
Case #3: In the outpatient surgery room it is 'standard of care' to do a pelvic exam under anesthesia (EUA) to orient your mind to the size, shape and position of all the pelvic organs as a safety check before starting to use your instruments.
In the outpatient unit routinuely, anesthesia gives I.V. doses (based on mg/kg body weight) of propofol (which works by dissociation of the cortex) and fentanyl (a narcotic) supported with only O2 (no inhalation gases are necessary) by mask from the anesthesia machine. The patient's legs are in delivery room stirrups. As you enter the space between her legs to do that pelvic exam, she jumps! You tell anesthesia, 'I didn't touch her!' He grumbles and re-doses her. You step back and wait 60 seconds for the drug effect.
When you approach her pelvic space (the 'Root Chakra' cone) this time she does not jump. But, as soon as you touch her perineum, she jumps! Anesthesia startes shaking his head and grumbling, doses her for the third time. You step back and wait again for the circulation time. This time she may or may not jump again. Finally with enough medication on board she stops jumping! Then you can do that 'simple' EUA.
