Terrified of smear test (possibly triggering)

[Irishwhiskey]

im booked to go in a weeks time and I'm panicking so much already it's becoming all consuming- I can't stop thinking about it. I had a bad experience the last time I went, nurse was lovely and kept saying she didn't want me to have to come back as I was distressed but after about half an hour she finally admitted defeat and sent me to see the GP. GP was not exactly sympathetic but eventually succeeded, but I just felt like I was being a wimp/a nuisance/time waster. This time I have been ignoring the recall letters for a while, but ive become almost as scared of the implications of not going as I have of going.

I have been assaulted in the past (can't bring myself to type the actual word) and so I know my fear is not totally illogical, but the amount of anxiety this is causing is ridiculous. My GP is doing it (new practice) and she is lovely, so at least I'm not seeing a stranger, but I'm not sure how I will get through it without freaking out.

Sorry for a slightly rambling post- I'm not sure what I'm asking really, just needed somewhere to put my feelings down.

Have you had counselling to deal with the trauma you have suffered? Cognitive behaviour therapy is also good for anxiety. Look into meditation and breathing exercises to help you relax.
Explain to your doctor about your anxiety and why. The exam is much better than it used to be as they used to use what looked like a lolly pop stick. Now it's a brush, which is completely painless. Ask her to warm the cranky thing that opens the lady part.
I do understand how you feel.

You're not a wimp at all. To survive an assault you are the opposite!

Thanks spanky. I've had counselling and CBT in the past (for trauma and ongoing anxiety) and had been doing really well, coming off meds etc. I think I've just let this become a complete phobia (I've ignored symptoms in the past which I know I should of had checked as I couldn't face the idea of being examined), and need to just get on with it. But I can't see how I'm going to cope with the next week getting more and more scared, let alone the actual appointment.

My own way of coping with things is to tell myself it won't last long. The whole procedure lasts about 30 seconds.

I think you have to tell the GP that you are nervous. Then understand you are in control. if it hurts, tell her. If you want her to stop for a moment, say so.

Swap your scared feelings for ones of gratitude if you can. Tell yourself this is a good screening test. It won't hurt and even if it does slightly it will be over really quickly.

It might also help to go back over the CBT you had. Work out what it is you are fearing. is it pain? Is it indignity? What? And for each of those think even 'worst case' it's all over in seconds. All I'm saying is try using CBT to rationalise and dispel your fears.

I was once so afraid I left it for ten years. It was only Jade Goody dying that made me go. I had some tranquillisers left over from flying so took a couple. Do whatever it takes. Once there it was literally 30 seconds and no problem at all.

I found it easier to go to a clinic where they do them all the time. It was fast and easy. Can't do that anymore but have had worse since giving birth.

I like the idea of trying to swap to feelings of gratitude polly; I guess I need to remember that I am walking in on my own free will and can leave at any time, and should genuinely be grateful for the option to be checked.

I think the main problem is that I am guessing it may not be a quick 30 second procedure, as my cervix is apparently 'hidden'. I had to be examined to locate my cervix last time, after lots of painful and futile attempts with a speculum. The parallels between the physical sensations of that with what has happened to me before were very strong, and I struggled with nightmares and panic afterwards. I also had a really strong urge to self harm which i haven't done in years, and did give in to the urge albeit very superficially. I'm just scared of feeling out of control and very very vulnerable mainly.

I was offered diazepam but don't want to take it as feel it will make me less in control. Going to a clinic feels like a worse option for me, only as I can't cope with the idea of a total stranger doing it.

Sorry for rambling on again...I don't verbalise things very well or talk about them in real life so it's quite cathartic to write this down.

Some of these statements might help...or not!
The amount of fear I feel is not proportional to the amount of pain I might experience.
The amount of fear I feel is not proportional to the amount of danger I am in.
I am not in any actual danger at the present time. I can allow my mind and body to create fear and anticipation of a future scary event, and at the same time I know that I am not in any danger at the present time.

My mind is trying to keep me safe by presenting me with scenarios of situations from the future (and in your case the past). It tries to make me live through the fearful scenarios in order to ‘prepare’ myself and make the advancing event controllable. My mind seeks to control future events that it thinks make be harmful for me. There is nothing ‘wrong’ about that. From the brain’s perspective it is a smart thing to do to try to warn me and keep me away from situations it thinks are ‘dangerous’ for me. So the fear is like a really overprotective friend.

I cannot be afraid 100% of the time. Fear and other emotions rise and fall, come and go. The parts of my life in between the pangs of fear are actually ok. If I focus on the parts of my life between the fear, this might help.

Because of the feelings of fear, I may spend a week in painful emotional pain over an event that in reality will last 5 minutes and may be only mildly uncomfortable.
I cannot make the feelings of fear go away. If my mind and body is feeling something, then that is what I have to feel. However I can try to understand what my mind and body is trying to do, they are trying to help me. Anyone who was like me, who had been in that situations I have been in, would be feeling the same right now.
Maybe I can accept and have these feelings of fear and anticipation because I know that what I am choosing to do is the right thing to keep me healthy, and able to live my life the way I want to, doing the things I care about and with the people who are important to me.

I am choosing to go into this situation, because it is important to me. I am choosing to have these few minutes of discomfort in the service of a valued life. I can ask them to stop at any time and I can leave whenever I like.

Thanks Sadie that's a really helpful and thoughtful post. A bit less panicky about it today and trying to keep busy, working tomorrow so that will distract me as well. Definitely good advice to try to use cbt techniques too.

How about taking your iPod in with you with a mindfulness recording talking to you, or some zen music just to take you away from it a bit? Sorry you were assaulted x

I'm sorry you find it so traumatic.

I do smears regularly and would like to offer you some practical tips that may help, given your hiding cervix!

Lie totally flat, and try and tilt your pelvis as you lie down so that you are lying on the top of your bum cheeks, near your back, rather than lying on the bones of your bum, near the top of your legs (if that makes sense!) It's as if you're pointing your pubes at the ceiling. If you have an elusive cervix this can help bring it down.

Wear clothing that you are comfortable in, and maybe a skirt that you can keep on, you can keep your socks on too - I find this makes women feel less "naked" and so more in control of their body.

Focus on your breathing, in through your nose and out through your mouth, nice and slowly. Some of my ladies prefer to wear earphones and listen to music, some prefer to chat, some prefer to be silent. They're all fine. Some like to bring a friend or partner to sit at the head end and hold their hand. That's fine too.

Does your lovely GP know of your history? Remind her how anxious you are and remember you are in charge, it is your body. You can say stop at any time!

Hope it goes ok

Mine is hidden too op and I have found lying on my side helps. They seem to locate it straight away and much less painful than when they try while I'm on my back.

Try some relaxation before you go too. Helps with the anxiety.

Thanks for taking the time to write that Sidge its really useful. I had to lie with both hands under me last time which I think freaked me out even more as it made me feel more vulnerable. Would it seem weird if I said I didn't want to be in that position? Lying on my side also sounds like a good idea.

I had thought about headphones, but think I need to be able to be told exactly what's going on.

She sort of knows my history and I don't think I hid my anxiety very well when we talked about her doing it...I think it will be pretty obvious how anxious I am anyway as I'm crap at hiding it! Just don't want to completely freak out!

Anyway I'm probably massively over thinking things now, just feel so pathetic that I am so worried about something that is routine.

Don't feel pathetic, lots of women find it worrying even without a history of assault.

Lying on your side is a good way to have a smear done too, some women don't like it as they can't see what's going on (IYKWIM) but some prefer it and it can make the cervix easier to find in some women.

Putting your hands under your bum can help tilt the cervix, but if you don't want to do that you could take a small pillow with you in your bag which will have the same effect (if the other ways don't work). Some surgeries don't have pillows due to infection control policy so it could be worth taking one and discussing that with your GP if the need arises.

Big hugs to you and I hope next week goes ok

Hi OP, I've lurked on MN a long time without posting but I really feel for you so wanted to share my experience just in case it helps.

I'm also terrified of smears, mostly due to some awful experiences of them ever since my first one 14 years ago. I still go every 3 years but it's always been an ordeal, and I always have to go back more than once as they just can't do it. I know they're supposed to be a bit uncomfortable but I was in agony every time and just couldn't seem to help tensing all my muscles which obviously made it worse.

3 years ago after a failed attempt with the nurse I saw a GP, who was amazing. She examined me gently first and located my cervix before using the speculum. She explained that my womb was tilted and that my cervix was actually on the front wall and not very far 'in' if that makes sense! Therefore all previous smears had hurt because they were scraping past the cervix, ouch! Anyway, she managed to complete the smear, although still wasn't easy.

Fast forward 3 years and I recently had another smear, which was over and done much more quickly and easily than ever before and in one visit. The things that helped were:

• book a double appointment so that you don't feel rushed
• talking to the nurse beforehand (I've moved house and therefore had a different surgery). I told her how nervous I felt and even had a little cry, which actually released some of the tension!
• ask for a small speculum and try putting it in yourself. This might make you feel more in control, it certainly works for me.
• put a folded pillow under your bum to raise your pelvis up.
• wear a skirt
• take deep breaths and tell them to stop as many times as you like

Doing these things, I was in and out in no time, and the nurse said she appreciates it when women can tell them what they can do to help. I got the results 5 days later and all clear! I now feel so much better about smears and I really think I'll be a lot less panicky next time.

Anyway, sorry for the essay but I hope it helps. Good luck!

Possibly a stupid question but on your side which way are you facing- towards or away from the person doing it?

Thank you for posting that Duchess I really appreciate it, lots of good points to consider. I already have a double appointment luckily, and taking a pillow is a great idea.

And thanks for all the advice and the hugs Sidge, you sound like a lovely nurse!

Wouldn't say I'm looking forward to it but less panicky and feel more prepared. I've ignored gynae issues in the past (which sort of resolved anyway) as I was so scared which is obviously not ideal, so am going to try and see this as getting used to these things so I can start to look after myself a bit better.

Generally speaking you lie on your side with knees bent facing away from the nurse but I've done it the other way. It's just a bit more tricky as you're leaning over the patient's knees to get to where you need to be!

You're doing so well, be strong!

In your shoes I would opt to be tested for hpv. If you don't have hpv there is no need for screening.