I had my smear test this week. It definitely was a journey getting there. I had refused it for two years, then cancelled my appointment once because I couldn’t handle it. To say this wasn’t an easy thing for me to do is an understatement.
Whenever I’ve spoken about smear tests online, the response has been brilliant. I think it has also brought it home that a lot of women struggle with them, regardless whether they have trauma or not. So, I thought that sharing my experience of overcoming this fear to have the test done would be useful to share. There is great work being done to raise awareness on smears online and offer peer support, one of those accounts is the brilliantly named At Your Cervix (AtYourCervix_x on twitter).
My online engagement has also brought home to me that all the things I talk about here are accessibility issues, not my personal problem that I somehow need to get over. It doesn’t matter if this comes from trauma, physical or mental side of things. It’s important to talk about them with medical professionals and they should take steps to support you.
Now, my experience.
Smears are complicated for me because I have specific trauma related to them, on top of my ‘usual’ trauma. I had a smear test done at a time when I was also sexually abused and I was in so much pain that I screamed. My reaction was very extreme but still, nobody ever asked any questions. I try not to hold on to bitterness but had anyone taken even a minute to question why I was so upset, maybe things would’ve unfolded differently for me. After working with trauma professionals, I now understand I was very obviously traumatised at that time, and my reaction should’ve raised eyebrows more than it did.
I should mention at this point that one of my abuser’s tactics was telling me that I was somehow physically damaged and not like other women, so by the time my second smear came around I had become so convinced that there was something wrong with me that I told the nurse that she wouldn’t be able to perform the test.
The nurse was wonderful. She was able to tell me there was never anything wrong with me physically. It had all just been part of my abuser’s smokescreen. Hearing that was almost like a religious experience.
Still, I just couldn’t do it after that. The letter would come around, I’d ignore it. Every time anyone would start reasoning with me, I reacted like a sulky teenager. I’d go through an entire cavalcade of emotions in quick circle but it always ended up with me dropping the idea. Once I started doing EMDR with my current counsellor, the fact that my experiences were preventing me from doing a necessary medical procedure started getting at me more. My abuser had already taken so much from me. What if I’m poorly, and I wouldn’t know in time because of him?
So, I booked the appointment. Then I cancelled it. I was coming off of my antidepressants at the time and I think I was in a bit of an empowerment-spike at the time. It was too much to deal at one time however. One good thing about it was though that I was able to ask for a sedative from a nurse who I had been talking on the phone weekly during my withdrawing. She already knew me well enough that this wasn’t my masterplan to get drugs. I asked for one diazepam and got it. I still had that one pill when I finally rescheduled the appointment.
So, what changed?
I don’t know. I was just ready.
I rescheduled the appointment. It was four weeks away so I had time to prepare. I told my counsellor, and we dedicated two EMDR-sessions entirely on my smear test. For the first time, I was able to break the entire process down and what exactly about it terrified me.
A smear test isn’t a pleasant experience to begin with. Let’s start with the word ‘smear.’ Nothing good comes with that word. It’s not a nice word to begin with. Smearing someone’s name. A smear campaign. It’s an invasive medical process, where you are asked to lie down in a vulnerable and undignified position, with legs far spread. I’d imagine that men can have similar emotions about a rectal exam as that isn’t dignified either. I can definitely empathise with that. However, at least you don’t need to look at the person doing it.
We came to the conclusion that it wasn’t even the part of my body they were prodding that bothered me. It was lying in that position. With my legs placed on supports I’m unable to kick or defend myself in any way. My PTSD just can’t handle that, and no amount of peer support could change it. The loss of control in that situation is key. My counsellor also pointed out that a lot of discomfort is justified under the guise of a medical procedure. It’s somehow OK because it’s a medical procedure and you should somehow be able to put everything else aside for that reason alone.
Those two EMDR sessions were hard by the way. Even though I wasn’t even in the same room as my counsellor, I cried throughout on the verge of a panic attack. We have worked together for a while but this was the first time I was ten on the fear scale. On the second session it went down to nine, so let’s take joy from that at least.
My counsellor also gave me suggestions to reclaim the lost control. I could state in the beginning of the appointment how I expect things to go: tell that I might cry, that I would raise my hand if I wanted to stop in case I couldn’t say no in that moment, ask them to use smallest possible equipment, cover my eyes with a scarf and ask to lie on my side instead of my back. These are all my choices, and would give me a sense I’m still in control and being heard.
On the evening before the smear, he sends me a good luck message.
On the day, I take the diazepam about half an hour before the appointment. I didn’t know how it was going to affect me now that I’m not on antidepressants. Of course everyone is unique, but in my case it eased the physical symptoms of stress but I was still 100% on top of my faculties. I think the biggest comfort in having the sedative was the knowledge of having it as backup. I most certainly wouldn’t have gone ahead of the test if I didn’t have some medical aid.
I walked over to the GP surgery. The journey usually takes about 20 minutes. Now it took ten. I’m always speedy when I’m stressed, and the world seems to have gone from 1.0 speed to 0.5 while I’m 1.5. I couldn’t go in to the surgery until five minutes to my appointment (not that I would’ve wanted to anyway.) So I sat at a bench listening to empowering songs (‘Watch me shine’ from the Legally Blonde montage and the like) and dancing a little by myself. I can recommend public dancing to anyone by the way, it’s quite liberating.
Finally, it was five minutes to my appointment. To the surgery! Then the nurse was ten minutes late. I almost begun our time together by screaming at her. Why are you keeping me waiting, you had no patients before me? Have you got any idea what it means for me to have this done? Keeping me waiting in that waiting room is fucking cruel. Medical appointments seem to be different to all other social situations because nobody ever apologises for being late, still I keep being told to be on time.
‘I’ll put into your notes that you are feeling anxious’ the receptionist said when I booked the appointment. (Anxious does not even begin to cover it, but I was grateful anyway.) Question, why do I keep telling things to put on my notes, when nobody ever reads them? I always have to tell everything twice. This time is the same. I need to explain that I’m terrified and why. This person was late anyway, they could’ve taken a minute to read my notes while at it.
I’m giving her a hard time, because she turned out to be lovely too. I followed the battle plan my counsellor and I came up with. She agreed to my every request and surprised me by taking a step further: she offered that a chaperone could come in to hold my hand, if I wanted. I wouldn’t had even thought of it, but this was definitely something that I never had before.
She explained every step to me. We agreed she won’t be saying what she is doing, she would just give me a five second warning. I would be lying on my left side, and she pointed where the chaperone would be standing.
Another nurse came in. She too was lovely.
“Have I met you before? Your face is familiar”, she says even though we’re all wearing masks. We came to the conclusion she’s taken my bloods. We’re old friends then, it’s only a natural step in our relationship that you hold my hand while I’m having an invasive medical procedure.
“Ida has had awful experiences, so she’s scared”, nurse #1 tells nurse #2 and that’s all that’s needed. A curtain is pulled so I can undress in peace and lie down. I wore a dress so I get to have some dignity throughout.
They work in unison, it’s all quite smooth now that I think about it. One on my left side as discussed, one at the end of the table. I have tied my scarf around my eyes. The scarf is white and my mask is white so I must look a bit like a mummy. They ask me whether they should keep talking or be quiet. I ask they keep chatting amongst themselves as if I wasn’t there, I’d raise my hand if I needed to stop. I can’t handle silence in these kinds of situations. Normal tones of voice help tell my brain there is no danger.
I do cry. They ask if they should stop, I tell them to keep going. She gives me the five second warning as promised. It doesn’t hurt. I can hardly feel the exam itself. I have plenty with the fear itself.
The amount of praise I get from both of them when it’s over.
Nurse #2 squeezes my hand one final time. I think she has carpal tunnel after the amount of squeezing I already had done. Both of them keep telling how well I did.
I’m allowed to lie down alone for a few minutes behind the curtain. The front of my dress is soaked.
She keeps asking if I’m ok. Telling how well I’ve done and how brave I was. I haven’t got any tissues and use my sleeve. She asks what am I doing next. I enjoy this line of conversation, focusing on the practicalities.
I go to McDonalds and get a vegetarian meal and a chocolate milkshake. I have a theory that a lot of people forget rewarding themselves when they’ve been brave after they stop getting lollipops or stickers at doctors or dentists’ and this is a source of a lot of unnecessary suffering. I was brave so I got a reward. Food might not be the right reward for you but do treat yourself after being brave. It’s deserved.
My counsellor and I agreed to ring afterwards. I live alone so I don’t have anyone to attend to me. He tells me he’s proud of me.
When your counsellor says they’re proud of you, it’s like a personal high-five from god.
I eat the fries in three minutes. Salt is saltier than any other salt ever. I’m so hungry. I can’t remember a time when I have been so hungry. I suck on my thumb that collects salt crystals from the corner of my mouth.
I did it.
Do ask questions if I didn’t cover something.
I have been fundraising for the Birchall Trust, a charity that helps victims of rape and sexual abuse, to raise the cost of my counselling back to them, and if you found what I wrote above helpful or meaningful, please consider sharing my fundraising page in your social media. Thank you.