From the Research
A therapist would immediately recognize that the client's disclosure of vaginal bleeding and pain as triggering requires careful, trauma-informed attention, and prioritize the client's medical safety by recommending a medical evaluation for the bleeding while offering emotional support. The therapist would consider several clinical possibilities, including past sexual trauma, medical trauma, pregnancy loss, or other traumatic experiences related to reproductive health 1. They would need to balance psychological support with ensuring medical safety, potentially using approaches like grounding techniques to manage emotional distress.
When exploring the triggers, the therapist would consider using evidence-based therapies such as EMDR, cognitive processing therapy, or somatic experiencing if trauma is present 1. The therapist would also assess for dissociation, flashbacks, or other trauma responses during sessions, adjusting the pace of therapy accordingly. Throughout this process, the therapist would maintain appropriate boundaries while honoring the client's autonomy in deciding how and when to address these triggering symptoms.
Key considerations for the therapist include:
- Validating the client's experience and creating safety in the session
- Recommending medical evaluation for the bleeding while offering emotional support
- Assessing for trauma and considering evidence-based therapies
- Maintaining appropriate boundaries and honoring client autonomy
- Being aware of the potential for anxiety and fear related to pelvic examinations, as highlighted in the study by 1, and taking steps to reduce these negative symptoms.
The most recent and highest quality study, 1, published in 2021, emphasizes the importance of addressing anxiety and fear during the female pelvic examination, which is relevant to the client's triggering symptoms.