Pap Smear Fear | How to Cope if You Have Had Trauma (or not)

Whether you have trauma in your history or not, a pap smear can be a frightening medical exam. For the past few months I've dreaded, on some level, having my exam, which occurs every 3 years.  The last time I had it done, I had a full-blown anxiety attack and went into what I can only describe as a PTSD episode, with no specific recollection of the actual trigger.

Maybe there isn't one. Maybe just the act of being in the nude, with legs up in stirrups is enough vulnerablity for anyone - let alone someone who has mental health issues.

I did some things to prepare myself for this morning's visit.  This appointment was my second attempt to have the exam done. I had cancelled the first.  I don't even remember the "reason." But I know the true reason: I wasn't ready. I was too scared. So, I reminded myself that the more I put this off, the more anxiety I would have to live with up until each appointment.

Secondly, for the past week, I've been getting into position on the couch, with my legs up and on the arm, sort of in the position I would find myself in the OB/GYN table. The first time I did it, I felt very anxious. I literally had an anxiety attack and said to myself "I can't do it. I can't go through with it." But the wise mind knew differently. I acknowledged that if I would continue to practice this "exposure therapy," it would get easier each time. So, almost every night, I got into position. Each time, it got a little less scary.

I used my imagination to more vividly envision the doctor's office...what she might I might feel.

This morning, although I showered last night, I showered again. I knew I'd feel more confident if I were fresh and clean. 

I got to the office and went through the typical vital signs screening. No surprise - my blood pressure (still normal) was a bit elevated.

When my Dr. came into the room, she asked me typical questions. I remained as calm as possible and engaged in friendly small talk with her.  It helped.  I am sure I was visibly nervous...if not at first, then definitely when she began the physical exam and repeatedly told me in a soft, gentle voice, "Relax your muscles for me honey."  It was difficult. I apologized to her. I told her I was embarassed.

She said there as no need for an apology and to please not feel embarassed. She said there was no need for that either. I told her that I was feeling vulnerable, and she reminded me of how normal that was. I said that I was probably her worst patient. She reassured me that there is "always someone better and worse than you."  I smiled. The whole time, the exam was going on.

I had a very difficult time relaxing my muscles - so much so that she had me hold my knees to my chest as if I were "pushing out a visual." :-D

I focused on the cute "wall of babies next to me."

All in all, the exam, from the pap smear to the internal paplitating to the breast exam, came to about 5 minutes. When it was over, I felt so proud of myself. What might be a routine and ordinary exam for a lot of women was a real challenge for me.

A pap smear saved my mother's life. They found cancer cells in her and had to do a hysterectomy.  I reminded myself of how lucky I am to have health insurance and have access to these types of preventative care.

Yaay for another 3 years before I have to face it again!

What DBT (Dialectical Behavior Therapy) skills did I use? Which ones could I have used? Do you ever have similar experiences with medical or dental procedures? How do you cope?

Thanks for reading. More soon.


  1. Dental procedures I just can't help it and it is embarassing last time I went I waited until the pain was damn near unbearable, when I got there I had forgotten about the pain. I actually started sobbing as I waited in the room for the dentist. I told the assistant and the dentist several times that I was terrified and that I hope he didn't take it personally. I really need to look into DBT for sure.

    1. I think it's a good idea that you told the dentist and the assistant how you were feeling and that it wasn't about them. I think that dentist office staff deal with this issue way more often than you'd imagine. I hope that you've found a DBT class to help you through.

  2. I have a lot of these sorts of feelings in and around birth.



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