How do Doctors and Patients Talk About Sexual Trauma History?

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The importance of discussing Sexual Trauma issues with your physician.

Therapist are trained to ask patients about sexual trauma histories when they first present themselves for counseling. In part it is to lay the foundation that if something like this has happened in their lives, it is ok to speak about it.

My experience in over thirty years of counseling individuals and couples, is that many people will initially say no they have never been sexually abused. This may be because they have not been abused and it may be because they are embarrassed to talk about something like this with a stranger (or anyone else), but it may also be because their defense mechanisms are protecting them from knowing something that would increase their pain and anxiety levels. As they become stronger through doing the work of therapy, they often will have flashbacks and memories that reveal the concern about having been abused by someone when they were younger. In therapy we have to be very careful in discussing these possibilities. In part, this is due to the concern about what is called the false memory syndrome. There is something called an iatrogenic (meaning therapist created or generated) memory. Therapist must have training and be skilled in the way that they ask questions and respond to answers from patients regarding possible abuse in their past. It is indeed tragic for all concerned when someone is falsely accused of having perpetrated these heinous crimes.

The truth is that people are abused, and the abusers often get away with it. The damage that can be done by abuse, especially in childhood, is incalculable and can last a lifetime. Many people with abuse histories go through a series of failed relationships and distorted sexual relationships throughout their entire lives. They have issues with anxiety, trust, expressing their own sexuality, alcohol and drug abuse, and multiple psychiatric and psychological diagnoses.

This week we are discussing what doctors need to know and what they need to ask and how they need to invite a discussion into the possibility that the symptoms they are looking at might be as a result of sexual or physical abuse in the childhood of the patient.

Both doctors and patients need to know certain things about presenting symptomology and how to respond when the topic comes up. Doctors need to know how to proceed when they encounter this, whether or not to make a referral for counseling and therapy or whether or not to do some medical intervention such as anxiety medicines. The main thing that doctors as well as therapist need to do is to inform the individual repeatedly, whatever they did or had done to them was the fault of the adult who perpetrated on them and is not ever their own fault. If you feel guilt and shame for behaving in a way that allows you to survive then you are still being under the control of the person that abused. All of the shame and guilt belongs to the abuser, none of it belongs to the victim. This message is one that counselors and doctors must convey to the client repeatedly as long as is necessary to help the individual recover and move own in their lives. In this way you can help them heal.

Listen to our health cast this week to learn what you need to know about the conversations that doctors, and patients need to have and why they need to have them when there is a possibility of sexual trauma histories.

This Health cast was written and presented by Dr. Kathy Maupin, M.D., Bio-identical Hormone Replacement Expert and Author, with Brett Newcomb, MA., LPC., Family Counselor, Presenter and Author.

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