Benefits of being a sexual abuse survivor…

I’ve been feeling disheartened lately. I’ve been practicing tantric yoni massage (no endorsement implied in the link, but the description seems about right, and it even mentions survivors), both on my own and with my wife and my lover. I have the injured vulva which has been very sore, and I end up crying throughout the sessions, and crying hard. It feels like it’s clearing held energy out of my vagina and vulva. 

I’m not afraid of crying. I know that clearing emotions is just something that has to happen, like vomiting when you’re really nauseous, and that once it’s passed you feel a lot better. Eventually, it clears so much that acceptance happens and that piece of gunk is fully healed. So crying is a good thing.

Meanwhile, I’m giving my partners multiple long screaming orgasms.

This doesn’t feel the least bit fair.

Yesterday I had a good cry and rage about how unfair it is that 4o years later I’m still trying to heal my vulva, while psychopath father still hasn’t done a day in jail.

I’ve developed a chart and am tracking the state of my vulva plus the things I do to treat it.

I have a 5 point scale from ‘blood red and sore without touching’ at 5 to ‘pink and not sore or itchy’ at 1. My vulva has been at a 4 or 5 for several days now. I’m taking turmeric daily, applying vaseline daily, tracking how often I use the high powered cortisone cream, and basically just monitoring what seems to make it flare up or down rather than numbing out that part of my body. I suspect that learning to be more present in my vulva is making me more conscious of the discomfort that has always been there, not worsening it, but it still sucks.

This article about vulvar skin conditions was a source of some good insight and advice. However, it also lets me know that I probably need to do more medical advocacy on my own behalf, including another biopsy, if I can get a dermatopathologist to examine it and refine my diagnosis. Apparently regular pathologists aren’t good at reading vulvar biopsies because the moist skin shows skin diseases differently than regular dry skin.

Anyhow, as expected, the emotional and physical gunk is coming up to clear.  It’s not like I didn’t know it would.

I’m re-reading Malcolm Gladwell‘s ‘David and Goliath: Underdogs, Misfits, and the Art of Battling Giants‘, a book about the benefits of being an underdog, or how sometimes an advantage is not an advantage. He talks about how sometimes not being invested in the mainstream way of doing things can be a big advantage and how skills and attitudes people learn when they are the underdog can sometimes give them an advantage. It got me thinking. What about being an incest survivor gives me an advantage?

Now, let’s be clear, I do not subscribe to any victim-blaming philosophies of growth that says basically that we’ve attracted abuse or are asking for it to grow our souls or it’s karma for being complete assholes in a previous life whatever. Despite being wrong, blaming anyone but the abuser for the abuse has been shown to be associated with poorer emotional health. However, since the reality of what I’ve survived is clearly the reality, I might as well look for whatever silver linings I can, right?

The point of the exercise is to look at things commonly seen as disadvantages and figure out situations or conditions in which they offer an unseen advantage. This is not about minimizing or denying, this is about figuring out what I as a survivor or we all as survivors can find to compensate for*  this thing we’ve been handed to deal with. (*terrible wording, but I couldn’t find a better way to put it. Of course, nothing can actually compensate for childhood abuse.)

Let me think:

As a result of healing myself of childhood sexual assault I have the following advantages:

  1. I understand and surrender to grief, but am not overwhelmed by it. Strong feelings are familiar and manageable, and I have ‘let’s get on with it’ attitude.
  2. I see dysfunction a mile off.   I make good decisions about people.
  3. I have a lot of empathy. As part of figuring out my own gunk, I’m often able to figure out other people’s enough to have compassion for them. I can make a frame for people to be who they are and as they are.
  4. I don’t put up with shit from abusers. I can spot them, and I don’t engage.
  5. I am not afraid of other people’s feelings. I accept them and am not easily manipulated by them.
  6. I know I can handle it if bad things happen, so I’m not as worried about things I can’t control.
  7. I love myself, deep down. We’ve been through a lot together, me and I, and I trust myself. I am proud of myself and what I’ve achieved.
  8. I am willing to speak truth to power when necessary and do it effectively.
  9. I have well defined skills for coping with fear, pain, uncertainty and processes that feel mysterious and involve faith and self-trust.
  10. I have close to me people who are real and grounded and honourable. Everyone else has the lack of these qualities seemingly written in neon paint on their foreheads.
  11. I have a deep, engaged and mature faith, and a strong spiritual practice.
  12. I don’t sweat the small stuff, and am great at reframing things so I can turn it into a win.

As a result of experiencing childhood sexual assault (this is harder) I have the following advantages:

  1. I have only family of choice remaining to me. I don’t ever have to put up with the garden variety of annoying relatives or family drama. Anyone who isn’t good and loving is no longer in my life.
  2. I have very strong friendships with other survivors. Because we don’t have biological family, we make our friends into family, which makes for strong connections.
  3. I am a very sensitive and skilled lover. Because my own vulva is often sore and easily irritated, and I am not always able to receive touch on my vulva without discomfort, I have put a lot of my sexual energy into getting off on giving my partners pleasure. I have also developed skills to touch other vulvae well without irritating.
  4. Disclosing the experience of abuse to friends, family or lovers is a bit of a litmus test for people’s character. You can tell a lot about people by how well they handle it. It weeds out a lot of bad eggs that would otherwise take awhile to show their colours.

That’s all I have for now. I’d love to hear in the comments about what ‘earned benefits’ or silver lining items (no matter how ironic or backhanded) other survivors can think of about being a childhood sexual abuse or assault survivor.

Better, stronger, faster than before.

First off, the specialist did not help me assess the damage from the assault. I was disappointed. However, she did have a very credible theory for what could be causing my pain and took a biopsy to confirm. The biopsy was freaking painful and caused a lot of bleeding (they cut off a small piece of flesh to look at under the microscope) but can be used to confirm the diagnosis.

The diagnosis she’s testing with the biopsy is vulvar lichen planus. It’s an inflammatory condition of the skin, that women sometimes get on the vulva. I have most of the symptoms and the doctor thought there was a good chance that’s what it is. Basically it makes your vulva and vagina look and feel like you’ve had a bad sunburn. I looked up some pictures to add to this post, but I don’t want to inflict them on you. They’re not pretty.

If so, it’s only indirectly caused by the assaults. According to the American Skin Association “Sometimes this disease affects the areas of skin where you had a trauma, such as a superficial scratch, cut, or burn.” So the reason I have it on my vulva is likely to be because my vulva was injured.

It is not caused by an infection, aging or menopause, diet, hygiene practices or sexual activity.” and it is not sexually transmitted.

The gyne wasn’t keen to remove the flesh tag from my vagina, she thought it might cause more scarring. I’m willing to wait to assess that till the lichen planus (if that’s what it is) gets under control. If there are any other women out there who have kept or removed flesh tags from the vaginal opening and want to weigh in on whether it was a good thing, I’d love to hear your comments.

Lichen planus is thought to be an autoimmune disease, but they’re not positive about that. It does run in families a bit too.

One source said that because it’s autoimmune, avoiding allergy triggers or taking antihistamines could help. However, primarily it’s treated with steroid creams, or if that doesn’t work, oral steroids.

She couldn’t prescribe the cream now, because the hole from the biopsy has to heal first, which will take about a week. I can’t get another appointment to see her for a month, so that’s how long it will take.

In the meanwhile I’m going to (sigh!) try and eliminate dairy and gluten, both of whom I have mild allergic responses to, in the hopes that will help calm my immune system down. There are lots of things that are helpful for calming down autoimmune issues too, so I’ll look into those and try them out.

All in all, it’s hopeful. I may be able to have sex without pain and itching afterward. That’d be pretty awesome.

Here’s a video a woman made with art and commentary about a similar condition, called Lichen Schlerosis. The art and sentiments are pretty much the same though. Her drawing of a sore vulva inside an eye is the featured image for this post.

I have an appointment!

tumblr_m8xh9scySH1qery84I just found out I have an appointment with a woman obstetrician/gynecologist for May 10th. The doctor who set up the appointment for me thought that an obstetrician might be a good doctor to help me, as the tearing is similar to tearing from birthing. I can’t find much about her online, but she teaches at one of the local universities so she is experienced and connected.  I expected to have to wait several months for an appointment, so this is really good.

When I got off the phone with the nurse I had a good hard cry and then looked her up, and then had a cry again. It’s relief and fear together. What if she doesn’t examine me very thoroughly and says nothing can be done? I deserve to know exactly the extent of my injuries, and what I might do to improve their impact on my sex life.

I have to remember to confirm the appointment a week before or I will lose it. I tend to get spacey about things with emotional energy attached to them so I’ve already set lots of reminders and will tell my wife and friends to remind me to confirm too.

I’m also thinking of who to bring with me to the appointment. Last time I brought my wife, but she doesn’t do survivor support well. She loves me, but she’s not great at demonstrating empathy in the way I need it when I’m upset. I think I need a survivor with me. My first thought was one of my longer term male friends, who has survived a lot himself and is good at being supportive, or maybe my other survivor friend who is a lawyer and good at collecting specific information. I need someone who will be compassionate, get what a big deal this is, help me remember to ask everything I want to ask, and offer moral support. Perhaps I’ll talk it over with both of them and see which of them is up for it. The guy gets a bit spacey himself so may not be the best choice if I need someone to be my rock. The woman is a bit less amazonian than I am about her survivor stuff so may not be as unflinching as I need. My wife was there when I first saw the scars so she has the history. But she hates talking about our sex life, and I’ll have to do that to really get the information I need. It will come to me who is best.

How to get care for an vulva injured in childhood.

Photocredit/art credit: http://kateordie.tumblr.com
Photocredit/art credit: http://kateordie.tumblr.com

I am going to blow my own horn here. I did good.

First, some background. I had sex for the first time with a new lover recently and my vulva was really not happy afterward, directly related to my injuries. First off, my lover did not respond well to being told I had scars/injuries on my vulva (she ignored the comment. really?) and then was much rougher with me than my sensitive peach can handle. Yes, I probably shouldn’t have continued having sex with her, but you know, sometimes you make a call at the time. I changed the activity, but by then the damage was done. Now I know. Next time I’ll be more firm about what can and cannot happen up front.

The flesh tag at the mouth of my vagina got rubbed raw and my poor peach hurt for days. It was what most women would consider ordinary sexual activities, none of which would have been unusually rough treatment for an uninjured vagina/vulva.

So I put my foot down, and decided by golly I was going to find a doctor and get this sorted. I tried at first to find a family doctor with some street cred about sexual assault. This was a disaster, as the doctor I found at first was, and then was not accepting patients. The sexual assault centre didn’t have anyone to recommend, and I ended the day in tears.

I  waited a week or two to cool down and then a couple of days ago I decided to just go into the walk-in clinic and ask for a referral to a specialist there. Here’s what I did right:

  1. I asked my wife to come with me. She made me eat first so I wouldn’t be low blood sugar, kept me company in the waiting room, and also wrote down what the doctor said.
  2. I asked for support. I messaged four of my friends who know about the injuries and told them what I was doing and asked for energetic support. I said I wanted to avoid crying and find an effective referral. They sent me supportive messages back that I read in the waiting room.
  3. I dressed up. I wore business-casual clothing, did my hair, applied light makeup. Office armor.
  4. I introduced myself and my wife to the doctor with our first names, to make us real people.
  5. I brought a printout of a photo I’d taken of my vulva that clearly shows the scars. This turned out to be a brilliant idea, as I could show the doctor the scars without having to undress.
  6. Some good phrases I used: “I’m looking for a referral to a specialist to address some injuries from a sexual assault.” “I didn’t receive medical attention, but that doesn’t mean I didn’t need medical attention.”  “It healed badly and affects my sex life now.” “I have a picture of the injury.”
  7. I pulled out my printout of the photo my wife took for me. (If you take a photo of your own injury I recommend using a flash, as it shows the scars more clearly) and pointed out the two long lines of scars. Having the photo also allowed me to point out where the flesh tag is and where the vascular damage is.

The doctor said he would try and track down a suitable specialist for me and gave me a timeline for how long he thought it would take. A couple of weeks for him to find someone suitable (he gave me some internet search terms to look under if I wanted to try and find someone myself) and then 3-9 months to get in. He consulted with me about whether I should see an Ob/Gyn (who might have experience with similar injuries from birthing tears) or a reconstructive gynecologist. All in all he was very nice and I was happy about what happened. He said that removing the flesh tag would be straightforward but that there might be scarring which might be problematic. I told him I just wanted to see what I was dealing with and what could be done, surgically and non-surgically, to mitigate it. (I probably used the word mitigate. I’m like that.) Yay.

Bravery and Vulnerability

I’ve been reading Brene Brown’s recent book “Daring Greatly“. Most of the information is stuff I already know, but it’s good to review and there were some new bits. I recommend it for anyone wanting to learn about vulnerability and how to manage shame. She also has a number of TED videos which are excellent.

About a month ago, I went to the STI clinic to get tested. As a lesbian with not a lot of sexual partners, I’m very low risk, but I wanted to be able to truthfully say to any new partners that I’d been tested and was negative for everything, which I am.

The nurse was curious about why I’d come to this particular clinic rather than my doctor, and I said I felt more comfortable with a drop in clinic and that I’d heard this clinic was good with sexual assault survivors (which I had). We talked a bit about how doctors often got weird when the topic of my vaginal injuries was brought up, and how I have some ongoing conditions as a result I need help with but have been unable to get help for. She was sympathetic and gave me the number of a medical practice with two women doctors in it who were on the sexual assault team, and thus unlikely to be freaked out by sexual assault stuff.

So I finally got up the nerve to call the number this morning, and, as Brene Brown would say, dared greatly by winning while being vulnerable.

The reception nurse answered and then when I asked if the two doctors were accepting new patients she said no they weren’t. Then she asked me who I was friends with, and I said I was calling for myself. I eventually figured out she was asking who had referred me and I told her that the nurse at the STI clinic had and that I was a sexual assault survivor and she said these doctors would be suitable.

The nurse said “good for you” when I told her I was a sexual assault survivor, which I took to mean she was approving of me disclosing and asking for help. She said that one of the doctors could see me and gave me a date to call back and make an appointment, and to say I’d been told I could.

I’m in.

I’m really tired of having a constantly itchy vulva that is sometimes quite sore. I have tried all the self care, done everything they say prevents it, and still it persists. I have holes in my underwear in the place that itches most, from unconsciously scratching. I want to talk to someone about my scars, the vascular damage and the tag of flesh and whether I should remove it. I want to know whether the itching is from the blood flow issue or something that can be cured with antibiotics or antifungals.

I’ve had this itching and pain, chronically, for at least 20 years.

I have some hope now I can get it resolved.

No Letter

My wife nailed it. She said “there isn’t going to be a letter, she didn’t get what she wanted.”

According to my aunt, my mom has allegedly written a letter in response to the one I wrote her a few years ago. That letter I wrote 3 years ago is of course out of date, since it was written before I knew about the scars on my vulva which prove not only that I was raped as a small child, but that my mother had to have known about it at the time and didn’t get me medical or police attention for my wounds.

Surely if I’d been brought to a doctor they would have sewn me up, as they would a woman who had given birth and torn in the way I did. I clearly wasn’t sewn up, as I have flesh tags and two long ragged scars. Apparently, vulva wounds on children often heal without scars, so the fact that I do speaks to the severity and perhaps repeated nature of the injury. And if I had been brought to a doctor, my father would have been arrested for raping me. I suppose it’s remotely possible, people being the denying assholes they often are in the face of child abuse, that even with hard evidence in front of them the police or doctor would not have helped me, but somehow I doubt it, and I further doubt that my mom would have hidden it from me all this time if she’d actually tried to get me help. So therefore, she knew and did nothing, and as a result is dead to me.

My mom only told my aunt she’d written a letter to get herself off the hook with my aunt I think, and probably also as a bid to see me. My aunt told me she’d be leaning on my mom to get her to respond to me with the info I requested, so this is the counter move. My response was clear, no direct contact, only via letter. I told my aunt about the scars and that my mom didn’t know about them. It’s possible she passed that information along (which would be fine with me).

Anyhow, I’m going on vacation in a couple of weeks that is a spiritual pilgrimage for me so I was hoping I wouldn’t get a reply before that, so that I could avoid having to process it during my vacation. Status quo has been restored, no contact with my mother, who is dead to me anyhow. There’s nothing she could do now, short of disclosing a phenomenal amount of coercion she’s never mentioned before, to restore her to a living presence in my life now.

One of the temples I’ll be visiting on my trip is called the Hypogeum, it’s a womb-temple to the Goddess. It’s underground, painted in red ochre to resemble a womb and when discovered, contained seeds of grain and a beautiful statue of ‘the sleeping lady’ Goddess. Apparently the acoustics inside are amazing, and we’re going to sing in there. The Goddess is the mother I have now, far more enduring and reliable than my birth mother. It feels like I have shed her like a snakeskin, and only the flakes remain.

Eureka – take that, vulvadynia!

Okay, I seem to have it figured out.

The yoga is great, but I found something even better. Just becoming aware of how often I clench the muscles of my sore, rape-injured body was a big first step. Now I’m learning to train my body not to do it.

It helps that it doesn’t hurt much any more. The clenching was a reaction to the pain. My guess is my smart child self figured out that clenching restricted blood flow, which dampened pain. It does do that, but now, years later when the wounds have mostly healed, the restricted blood flow causes damage and pain of it’s own.

Heating pads.

The yoga increased blood flow thing worked so well at bringing the pain down, I’ve moved on to prevention. I’ve been sitting on a gentle heating pad, set on low, while watching TV with my honey. The constant gentle heat keeps reminding me to relax, and with that relaxation, I feel so much more grounded and safe, less on guard, which should be a paradox, but isn’t. The heat and a conscious decision to relax have allowed me to get familiar with the sensation of not-clenching, and helping me make it the dominant way my body is. I still clench, but not as much, and my vulva is a lot better.

It reminds me of training myself not to clench my jaw (TMJ) a few years ago. I’d do big yawns to loosen my jaw before bed and put heat on my jaw joint, consciously loosen the muscles and put them in a position where they weren’t as easy to clench, jaw hanging loosely. Over time, it gradually lessened, and although I don’t know if I never clench my jaw when I sleep,  I no longer wake up with a sore jaw, and the dentist doesn’t mention it when I go.

I’m thinking this is advanced-survivor stuff. Perhaps ten years ago, unclenching my muscles would have brought flashbacks that would have seemed too daunting to embrace. Perhaps they are still working themselves to the surface, although perhaps not since I’ve remembered the injury I’m recovering from. Perhaps I couldn’t have done it before I saw the scars stretching across my vulva from the rapes. Knowing is always better than not knowing, no matter how hard it is.

A good friend of mine from my teens got in touch recently. I hadn’t seen her since the first year of university, or perhaps before. She asked me how my parents were. I realized she must not have heard, that I didn’t tell her back then, at the beginning of my healing.  I wrote back that my parents had split up, and that I don’t see them, and asked how her parents were. There are many ways to tell, and which I use depends on my sense of balance between a strong certainty that I won’t lie about this any more against the need not to drive people away with awkwardness.

Complete and specific honesty is reserved for therapists, close friends and other survivors, who usually can take it without saying something stupid or hurtful or shrinking away from me, which is worse. This would be “My father is a sociopath and raped me starting when I was a preschooler. We lost touch after I reported him to the police. I recently found out my mother was actively complicit, so I don’t see her any more either.” Telling it this way is the best. It is a truth that prevents ever having to dance around the topic again. It allows my inside and my outside to be congruent and gives accurate context for things that may come up.

The other versions, for trusted non-survivors, are a lot less specific, such as “My parents were abusive and I don’t see them.” If the person accepts this, and leaves the topic alone, or says, ‘mine weren’t great iether’, we have a stronger friendship. If they say some rubbish about forgiveness or parents doing the best they can, I write them off.

If the person or situation isn’t important enough to get into it, I tell the truth, but not much of it.  I will tell strangers and acquaintances partial truths such as  “I don’t see my parents much” or “My mom is in X and my dad is in Y, they split up a few years ago.” A bland partial truth is usually enough to satisfy the question, and change the topic without lying.

I thought about telling my old friend more, but I decided to be more gentle. She knew my mother and father after all. This tragedy happened to people and in places that she is familiar with, that don’t have the distance they might otherwise have. She can read between the lines, and if she wants to know, she’ll ask. If she doesn’t, I have no need to tell her. Another thing that has loosened.

Goddess bless yoga – self care for survivors with vaginal injury

46aRemember when I wrote that I’d read that vulvadynia was related to constriction of blood flow in the pelvis? That makes sense to me as a survivor and I’ve been paying attention since I read it. I realize that I have habit of clenching this part of my body, particularly when I’m feeling pain, and that this probably started when my vulva was injured in the rapes.

There are yoga postures which increase the blood flow to your pelvis. Do a google search on fertility and yoga and you’ll come up with a bunch of them. The one I’ve been doing is to lay on my side with my legs bent from the hip and skooge my butt up close to the wall, then allow my legs to go up the wall. All the blood from the legs drains down over the next several minutes. It’s called Viparita Karani. Here’s a link to a more detailed explanation of the pose: http://www.yogajournal.com/basics/1140

Doing this has brought me out of a really bad bout of vulvadynia (pain in the vulva) and it’s definitely down to almost nothing. Yay! I’m hopeful that doing this sort of thing regularly will maybe allow the skin or whatever to heal. Chances are the vascular damage my nurse-practitioner found (also resulting from the rapes) is a factor in limiting blood flow too, or perhaps is the root cause, but iether way, this helps. I’ll keep you posted if it resolves it completely.

Thank Goddess!

(also see more self care for injured vulvae here and here)

And also: Eureka – take that, vulvadynia!

Vulvanomics

VulvaMy vulva has been very sore the last several days. Over the years I’ve made several attempts to try and figure out what is wrong and fix it.

As you may know, I was raped repeatedly as a small child, and my vagina/vulva was injured. From the scars and my memories of the pain, I’d say it tore from vaginal vestibule (the opening) in two places right over to my clitoris. Just thinking about that makes me want to cross my legs.

When I was a young adult (18) I began having intercourse with my then boyfriend, who was about my age. I had what I thought at the time were horrible bladder infections and yeast infections, so bad that I’d have to sit in the bath in order to control the pain when I peed. The wrinkles in condoms would cause enough friction that I’d be very sore.  During this time the doctor also found a sore he thought was herpes. He tested it and it was negative. I still don’t know what it was. I’ve had other sores since, but rarely. Gods only know what I would have been exposed to from my father, but I’ve gotten a full STD test panel and was negative for everything, which is a blessing.

I didn’t have the knowledge or assertiveness then that I have now. I went to the doctor a few times, but really they weren’t able to to resolve things so that they didn’t hurt. I researched all the usual helpful things:

  • I never did  use scented stuff near the peach (scented pantiliners, soaps, lotions, douches etc… which are supposed to cause reactions.
  • I had a doctor tell me to douche with plain vinegar and water to kill the bad bacteria and then insert a slurry of yogurt and water to restore the good bacteria. Later the same doctor told me to put boric acid in gelatin capsules and insert one when I had symptoms.
  • I bought soft cloth menstrual pads instead of the rough paper ones.
  • I  wore/wear only cotton underwear
  • I had another doctor tell me to use a blow dryer set on cool to dry my vulva after a shower or bath.

All of these things undoubtedly helped a bit, but don’t go all the way and it keeps coming back.

A few years later, having regular painful sex with another boyfriend, I went for several visits to my family doctor to see if I could clear it up once and for all. I told her I thought I had a persistent low grade yeast infection and vowed to keep going back again and again until it cleared up. She prescribed the anti-yeast vaginal suppositories, and I did that. A couple of weeks later, still sore. I went back. Puzzled, she tested me for diabetes and AIDS, which apparently both can cause recurrent yeast infections. Negative. I told her I was a survivor. She was very uncomfortable. I didn’t go back. She went on mat leave and I didn’t see her again.

A couple of years ago I went to a nurse practitioner (kind of like a super-powered nurse who does some of the things a doctor does) and told her about my little problem. I went in when the pain was pretty bad and she could see and feel the red, inflamed tissue. She told me she thought I had vascular damage from the rapes and pointed out my scars. She suggested putting cold packs on my vulva and tested me for infections (all negative). Then, after some promising and useful work,  she gave up and suggested it might be psychosomatic.   I don’t think it could be this persistent and steady if it is psychosomatic, and I’m generally not in a lot of denial about my abuse issues, so if it was really a body memory, you’d think I’d have processed it by now, I tend to not shy away from dealing with this kind of thing.  I think that an injury for which I didn’t get medical attention plus vascular damage might be a more credible cause, frankly, so I’d like to find someone knowledgeable to look at that.

I did some research and found out about vulvadynia, which I’ve written about on this blog before. The main self-care strategy for this is mostly to rinse your vulva with water after peeing to prevent the urine from irritating the sensitive tissue. This has taken my pain down a few notches, particularly in the morning, but not completely.I also read that perhaps clenching the muscles in the area can cause reduced blood flow which causes pain. I’ve been paying attention to not doing this, so it’s not related to the current pain I’ve got.

I know when you hear hoofbeats, think horse not zebra, but given that I have a zebra kind of injury here, and the usual causes have already been ruled out, it’s time for a little digging.

I’m girding my loins (so to speak) to make another pass at trying to figure out what is going on here.  I’m assuming I need some kind of specialist – but who? ob/gyn? midwife? . I googled “long term effects of vaginal injury” and got nothing. There’s a bit on STV’s in children but mostly for doctors on how to test for them following child sexual assault.

Free your vulva and the rest will follow.

I used to know this woman, a survivor, who was a fitness trainer. She loved exercising so much it was actually contagious. She and I used to go dancing a lot. At the time, there was a song called “Free Your Mind” with an anti-prejudice message. The chorus, which was most of what we could really make out in a noisy nightclub, was “Free your, mind, and the rest will follow”.

My friend adapted it to “Free your ass, and the rest will follow”, meaning “be in your body and grounded and everything gets a lot better”. It has a lot of truth, and has stayed with me. When I moved to another town, she made me a dance tape as a goodbye gift and titled it “Free your ass and the rest will follow”.  When I need to ground, shaking my butt or dancing helps a lot. It’s hard to be clenched up and  anxious when your butt is relaxed. Try it.

Artist Taishe sells these t-shirts. The image is linked to her site.

So this morning, after writing about my internal debate over my mother and whether I have more than just the one main abuser (*I removed this post because I was getting homophobic comments on it), I went to a place I go to do do a walking meditation. During the meditation I came to this.

It doesn’t matter if there’s more abuse I don’t remember. What matters is, can I live my life as fully and joyously as I want to? It’s been my experience that by going out and living passionately, the stuff that gets in the way needs to be cleared comes up. If it doesn’t get in the way, it’s irrelevant at this point.

The only tricky thing is when my unconscious hides my limitations from me (like being unaware that I clench my hands or jaw in sleep until it does damage).

In my meditation walk, I suddenly had a flash that my new motto was “Free your vulva and the rest will follow”.

What this means to me is that I need to stop clenching my vulva, in order to improve my vulvadynia, the sensation in my vulva, and hence, my sex life. I also need to unclench my passion and creativity (symbolized by my vulva) in all the other ways that they’re locked up. So instead of whining about how unmotivated I am to do my singing, I need to press into the resistance instead of allowing it to smother me.

Now, I know from past experience that my resistance is extremely well developed, and battling on to create anyways is a central struggle of my life so I’m not going to promise great results here. However, just as focussing on keeping my hands, feet and neck warm has unexpectedly resulted in me being more grounded, I have a suspicion that keeping my vulva relaxed will have good, but as yet unknown effects. If it brings flashbacks, so be it. If I suddenly find myself singing or making love, so much the better.

What I learned about child sexual abuse survivors and sex and relationships

Photocredit: Morning Spiral Rose by Nexus6

Here’s a post from a place where I don’t feel like I’ve gotten a handle on all of the post-traumatic symptoms, although I have come a long way.

Stages of my sexual life as a survivor:

1) Teenage – not going ‘all the way’ and enjoying all the sexual play leading up to intercourse. Being quite prim and avoiding sexual situations

2) Young adult – having intercourse with boyfriends and experiencing pain, fear and flashbacks. Not being able to connect the dots with abuse at first, but trying to avoid sex. Bargaining with sex for safety while sleeping. Needing to make sure my partner was satiated before sleep so I could be assured that I would not be awoken with demands (with variable success).

3) Middle adult – Sex in relationships got good and a lot easier. However, in relationship it always dried up after the first year or two, not always on my end. Partners would lose interest and I would try and interest them in pleasing me the way I needed, which would be interpreted as a criticism.  Or I would lose interest and be harder to please and have a hard time getting into my body deeply enough for things to work well.  Hiding intense feelings (from myself or partner) and having sex at the same time became impossible, so if intimacy was a problem, then sex wouldn’t work either.  On the up side though, the sex I did have was a lot better and more connected and pleasurable, and almost all the time the sex I had was sex I wanted.

What I’ve learned / believe about survivors and sexual healing

  1. If you’re just having sex with someone to have them guard you while you sleep at night, get a dog. They will guard you for free.
  2. Experiencing feelings and flashbacks isn’t so bad, avoiding them is what causes all the trouble. If you allow yourself to process the gunk in therapy, sex gets easier and less like a trigger minefield.
  3. Never ever pimp out your inner child to get your adult self off sexually on things that are part of the abuse. It’s tempting if it’s the only way you know now to have an orgasm or get connected sexually, but it’s not worth it. It cuts deeper a channel between sex and trauma that should never have been there in the first place, making it harder to eradicate. Your child self was used to satisfy an adults sexual wants already, it’s a betrayal to do that to her now that you know better. You can break those abuse-sex connections if you stick with it. Find other things that feel good. Get in touch with your body. Do the work of clearing out and integrating flashbacks and feeling feelings. What fires together in the brain wires together and you owe it to your child self to set her free of abuse. Rewire with positive fantasies that make you feel safe.
  4. Clenching your vagina and vulva cuts off blood flow and can cause or worsen vulvadynia (pain and itching in the vulva). It is possible to be doing this without being conscious of it. Ice helps with the pain of an injured vulva, and heat can help keep it from coming back. I thought I had a yeast infection for years, but it turns out it was actually part of the long term effects of the wounds on my vulva from the rapes.
  5. Use completely different setting to remind yourself you’re not in the same place you were abused in and not with your abuser. Different lighting, smells, textures, positions, activities etc… really help keep you present day.
  6. Develop a routine around staying in your body and a way to get back when you dissociate. Mine is feeling the temperature of my feet, and telling myself “It’s okay, you’re safe now”.
  7. Develop a safe sex list of things that you actually can do without getting triggered, and an unsafe sex list of things you probably can never or never want to do. With a new partner, only do the safe sex things, and then maybe work into the medium risk things as trust and safety builds. Never do the unsafe sex things. If they want to make love with you, your partner needs to understand and accept that the unsafe sex things are forever off the table. You might even have body types or genders of partners that are not going to ever work for you, and that’s okay.
  8. See a therapist regularly if you are going through lots of flashbacks and stuff with your partner. They are too close to the action to help you heal that stuff, no matter how loving and compassionate they are.
  9. Tell your inner child self that sex is an adult thing. You and your partner will play together, and you can meet her needs later (or before). Make sure you do this to keep adult stuff adult. Think of your abused child self as an external child that you can put to bed with her teddy in another room while the adults play. Meet your inner child needs for play, validation, touch  and attention separately if you can. Have some times and places that your partner knows are off limits for initiating sex, where you can meet those needs for nonsexual cuddling and hugs.
  10. If your spirituality makes you feel safe, bring it into your sexuality. Make loving your partner an act of magic or prayer. It will completely change the feel and energy.

What I learned about health care and sexual abuse survivors

I’d like to summarize what resources and history I’ve gathered (or created) that might be helpful to other survivors.

I went from someone who had an 8 year gap in both pap tests and dental work to someone who has had a pap test and a dental cleaning within the past year.  I also successfully asked a health clinician doing my pap test to examine me for scar tissue from the rapes (I have evidence of tearing that no-one had mentioned to me previously.)

Here are my posts about that journey

  1. Warrior Schedules PAP Test– Okay, so I think I found a safe (to me) place to get a gyne exam.
  2. The day before the pap_Yesterday I saw my therapist and we talked about the pap test appointment tomorrow. What’s different about this appointment is: 1) the medical professional will know I’m a survivor. 2) I’m planning to ask if I have scar tissue. 3) …
  3. Warrior Victorious in Pap Test – So the gyne visit went about as well as it could possibly go, and better than I could have envisioned. The nurse-practitioner I saw was very experienced and nice and drew the correct line between warm sympathy and matter of …
  4. In the wake of proof – Knowing I have scar tissue has changed my life I think. It’s like an incontrovertible validation of what I’ve been saying all along. No longer can I doubt or go into denial about the accuracy of my memory. I know …
  5. Icing my vulva – I’ve had pain and itching in my vulva for most of my life.  I’ve worn out holes in the fronts of underwear from scratching. This, I’ve found through some recent reading, is actually pretty common with vaginal injuries like mine.
  6. Hidden Disabilities and Dentists A childhood sexual abuse survivor goes to the dentist, and triumphs over fluoride treatments. Continue reading →
  7. I get an appointment with a gyne surgical specialist and finally get a diagnosis for my sore, itchy vulva, that pretty much always feels like it has a sunburn. I get a biopsy in the first appointment (painful!) and a diagnosis of chronic inflamatory condition in the follow up appointment. After treating with a strong steroid cream for several weeks, I switch to a herbal anti-inflammatory (turmeric taken both internally and as a topical ointment) which has completely controlled the symptoms.  Yay! Autoimmune and inflammatory conditions are apparently common in survivors.

Here are some great information resources I found:

Handbook on Sensitive Practice for Health Care Practitioners: Lessons from Adult Survivors of Childhood Sexual Abuse (applies to doctors, nurses, massage therapists, physiotherapists, dentists etc…) This report is a good read for both survivors and practitioners and is linked below. The one thing I would add is a one page disclosure and accommodation request form, so I created it. This document was written by university professors in the departments of  social work, physical therapy, nursing and medicine of several major Canadian universities. (I love Canada a lot. ) So it’s got the ‘clout’ to be influential with your doctor or dentist.

Here are some links to some other good resources:

And last but not least here’s a resource I created:

I’m really proud of this one. Wouldn’t you like to just hand your doctor a form with checkboxes for the accommodations you need to be able to tolerate a pap test? No working up to disclosing abuse just before getting into the stirrups, no worrying your voice will break or you’ll lose your nerve. All you have to do is hand over a piece of official looking paper. Look no more, here’s my survivor-designed and field-tested version, made using some of the recommendations from the sensitive practice guide linked above: SwordDanceWarrior’s Information Sheet for Gynecological Care Providers Providing Care to Childhood Sexual Assault Survivors I’ve used it. It works beautifully. I ended up in my own clothes rather than a gown, sitting up with a mirror so I could see what she was doing, with everything explained as she went along, and with my partner present. It was way less stressful than a regular pap test. If you use it, I’d love to know how it went.

A picture is worth…

Butt Prints in the Sand, click on picture to view source and credits

I got my wife to take a picture of my vulva so I could see what I’m dealing with. A mirror is quite an awkward way to see one’s vulva if you’ve ever tried it. It was easier at the nurse’s office, but she had a magnifying mirror I think and a good light and angle.

Anyhow I now have this good quality, close up picture of a part of my body I’m trying to have a happier relationship with. It helps.

I can see the two scars leading away toward the front of my body from the vaginal vestibule. One reaches all the way from inside my vagina opening to the place where the two labia minora come together at the top (where it disappears from view in my picture), which is almost to my clitoris. And the other is almost that long, but goes off to the side a bit. They are quite faded now, as she said, very old scars, but I think about what kind of injury would create that much tearing to be that long and that visible over 30 years later.

That old fucker better die soon.

Seeing how faded the scars are, and how clearly healed it is helps. If you know about or suspect damage to your own vulva I recommend taking a picture and having a look. Use a flash, a lot of the detail isn’t easily visible at first, particularly with old scars. Mine look like faded white/pale pink  lines leading out from the vestibule. I probably wouldn’t have known what they were without my nurse, who has seen scars on women’s vulvas from childbirth, identifying them for me. Since I’ve never given birth or been raped as an adult, (and apparently my cervix does not show evidence of having opened for birthing) there’s only one experience I’ve had that could have made these scars.

In my religion, the vulva is particularly holy, being representative of the Goddess’s creative power in the universe and the sacredness of both sex and of giving birth. The Gods are valued as lovers and brothers of the Goddess(es), and also as fathers to Her children. I think it’s great I’ve chosen to participate in a religion that calls this part of me holy, that is unafraid to talk about or honour vulvas. My father is not a pagan, but he’s done what must be the greatest act of sacrilege, violating the most sacred part of a woman’s body and his sacred role as a guardian and nurturer of children.

Well, my little sacred warrior vulva, you’ve come through a lot. May you be blessed, may you be happy and whole and an honoured part of my body and being.

Blessed be.

P.S. I was looking for some links for explanation of the medical terms above, and ran into some journals, which led me to others. I found this article: http://www.ncbi.nlm.nih.gov/pubmed/10533272 which has the following rather chilling phrase, which made me cry a little out recognition of the validation it provided for my recollection of what happened. “repeated abusive genital penetration significantly more often than non-penetrative abuse leaves deep posterior hymenal clefts and/or vestibular scarring”.  This particular study took pains to match the girl’s disclosure of what happened to her with the perpetrators confession, so there could be no argument about what caused these particular injuries. The exams were also done ‘non-acutely’ which I think means that they were done some time after the actual injury took place. This article also might be valuable to other survivors with genital injuries, which talks about the healing patterns of pediatric genital injuries. : http://pediatrics.aappublications.org/cgi/content/full/112/4/829 It also has pictures and shows what the same injuries look like when healed, and has arrows showing where the injuries are. The vulva is such an unfamiliar organ, that the arrows pointing out what’s wrong are helpful. A lot of the sources make it clear that lack of visible injury does not rule out abuse, and that often the injuries heal without a scar or vascular damage. What I am understaning from all of this is that my injuries were particularly severe, even as far as these things go. Yikes.

Figuring out the vulva

Sheila na gig - these are Goddess images honouring the sacredness of the doors of life. This one was found at Kilpeck Church in Herefordshire. Photocredit: Ben Grader

You know, it’s weird. In the aftermath of finding confirmation my vagina had been injured by the rapes, it’s actually empowered me to do something about the physical discomfort I’ve had on and off for a long time.

It’s quite different to look at the pain as discomfort coming from an injury, than to think of it as some sort of nebulous survivor thing, or something that I can’t do anything about. It gives me something to look for for practical help.

I’ve been reading up about vulvodynia (pain in the vulva) online, and even though my nurse practitioner wasn’t very helpful, I’ve found some self-management strategies that seem to be working. I’ve discovered that the pattern of my symptoms and what causes them fits what other women describe. For example, some women feel sore during penetrative sex, but many feel sore a day afterwards when inflammation sets in.

I’m going to list them here in case any other survivors with injured vulvas find them helpful.

In order of helpfulness

  1. VERY helpful: A  squeeze bottle to rinse irritated tissues after peeing. This is so simple and so helpful. Thanks to the gal who runs the interstitial cystitis network for this tip. Instant pain reduction. Perhaps the vascular damage or scar tissue has made the area around my urethra more sensitive. I suppose a bidet would be even better, but I don’t have one. This works great. Just plain room temperature or warm water.
  2. Massage. Yes, I mean massage, consciously loosening up all the muscles in the pelvis and vulva. Thank goodness I have a willing wife.  It’s not foreplay per see, but certainly seems to make sex more possible. One massage got me pain free for almost a week. Apparently one of the proposed causes of vulvadynia is restricted blood flow in the vulva caused by clenching the muscles.  I think that’s really possible as a cause for what’s going on with me.
  3. Just a regular quite soft pillow on my work chair seems to help even better than the donut.
  4. Sitting is bad for the vulva, apparently, and what do I do for hours each day? Sit in a computer chair. I’m trying to sort out my options on that one.
  5. Donut pillow – This is one of those rubber blow up pillows sold at drug stores called an ‘invalid pillow’. It’s sort of helpful, but puts a lot of pressure on your legs if you’re going to be sitting for a long time.    Apparently there are these foam pillows with a cut out or much softer strip down the center that are supposed to be good as well.
  6. Thinking about relaxing my vulva and pelvis while I’m walking or resting. Seems to help a bit. I notice I do seem to clench up a lot of the time, now that I’m paying attention. Interesting.

There were also some tips about sex when you have a touchy vulva that looked helpful too: http://www.ic-network.com/selfhelp/sex.html I don’t know if I have interstitial cystitis, but since many women with it also have vulvadynia too, a lot of the tips cross over. I know I had a lot of bladder infections as a young woman, and I recall recurrent pain and needing to pee but not being able to as a child which probably was a bladder infection then. If I feel one coming on now, I drink a lot of water and eat a lot of vitamin c which usually settles it.

Since the physical things are helping, I don’t think this is a body memory, although the clenching that’s causing it might be. However, I’m not feeling much emotional energy around it, so I think it might actually be mostly physical.

For the first time in a long time I’m actually hopeful I’ll have a sex life again.  It sucks to know that every time you have even gentle sex you’re going to be sore for days afterwards. Kind of makes it hard to feel it’s worth it, you know?  I’m hopeful that if I can find a way to manage it I won’t have to.

It also feels quite weird to be talking about my vagina and vulva, present day, on this blog. “What kind of person discusses her vulva online?” some voice in my head says. Some people I know face to face sometimes follow my blog and I wonder about judgment about my poor taste in talking about my peach. However, my poor little raw vaginal vestibule (see I learned a new term, its the area just outside the vagina entrance) is pretty darn sore a lot of the time, despite almost never having sex and I think other survivors might be having similar issues, so I think it’s worth talking about, despite the embarrassment.  I mean half the population has a vulva, and most of the rest of the world (save gay men, of course) are at least moderately interested in vulvae (my spellcheck rejected vulvas, and suggested vulvae, which sounds so literate)  so I think it’s just cultural bullshit that it’s a taboo topic. Incest and vaginas and vulvae,  oh my!

Vulvodynia and the power of the vulva

Click on this image for the history of the vulva in many cultures as a power symbol of political change and protest

Vulvodynia is a medical term for having persistent pain in your vulva that isn’t explained by the usual causes.

You know what is so wierd? I just had gotten so used to the burning, itching and periodic pain, that I thought it was relatively normal. I’d gotten used to having to have sex in very limited ways and to feeling pain after and sometimes during. At times it hasn’t really seemed worth it. No wonder my sex life has fizzled.

Vulvodynia comes in two types. The first is where the woman experiences pain with intercourse, or inserting a tampon or similar, and afterwards, but not the rest of the time. The second kind is when the woman has the first kind of pain, sometimes not as severely, but also a persistent pain or itching at other times.

That’s the kind I have, and now that I know what it is, I can access the wisdom of women all over the world who have it too. Unlike the pain I had as a child, I’m not alone.

I found a list of things that are thought to be involved in vulvodynia and things that make it better and worse and I’m trying them. It’s actually helping.

One of the things that doctors believed about vulvodynia was that it is psychosomatic, caused by being a sexual abuse survivor.  I think that’s demeaning. Of course there are physical effects of being raped, I’ve got the scars to prove it. And of course there are psychological effects that affect how the vagina and vulva feel and perform, particularly in how relaxed and open we feel.

What is demeaning and insulting to the brave women warriors who have survived rape as children is to dismiss our complaints as if because we know the cause it doesn’t need to be cured, like it’s some kind of hopeless case to have a vulva that feels healthy and good, and it is some kind of hopeless case to have a healthy mind and spirit after being ‘damaged’. It’s like we’re in some feudal culture and we’ve been ‘ruined’ by losing our virginity in an unsanctioned way.

I went to see my nurse practitioner, the one who showed me my rape scars last summer. I wasn’t there specifically about my vagina, but after she looked into what I was there about I asked her about the pain and itching. She told me all her tests had been negative for infection, that everything looked fine.  I said “you think this is psychosomatic?” She didn’t say yes, but she didn’t say no. She said “we’ll you’ve had a hard life”. I said, I had a hard childhood, I’ve had a pretty good life, for the last 20 years, actually”. I hate it when people assume I’m some kind of lifelong victim.  I’ve never been in an abusive relationship as an adult, I’ve never done drugs or abused alcohol, I’ve not been raped or beaten as an adult and I’ve made good choices for myself. 

After I got home from my appointment I did some research. Vulvodynia is thought to be caused by chronic tightening of the muscles of the vagina, which restricts blood flow, causing the pain and itching. There are of course other theories, but I like this one. It looks like everyone wins – psychological: clenching of the vaginal and vulval muscles – physical: restricted blood flow causing persistent pain.

So what part of this allows her to dismiss my valid medical issue?

I’ll tell you what does. Her discomfort with having to help someone who was raped as a tiny child having persistent pain her whole life as a result. In her vagina. People don’t want to think about it. They want me to be crazy. They want it to be something they can discount. It makes it less scary for them.  That a man can rape a child and get away with creates enormous cognitive dissonance for people. It’s nothing that should happen. It’s nothing he should get away with. I agree. But rather than trying to ignore or brush away the effects, I want to resolve them. I’m one of the sanest people I know. I know how to face reality in ways they don’t.

My wife and I are coming up on our ten year anniversary. I joke that it’s actually 40 years in ‘het years’ – kind of like dog years. Because lesbian relationships get little social support, a ten year anniversary is the equivalent of 40 years for a straight couple who have had help and approval from their culture from the beginning, going back as far as high school. How does this apply?

Life is a lot harder without social support. By shunning survivors of abuse, in all the ways our culture shuns us, we inhibit and restrict the healing and change that is necessary to make child rape obsolete. My ally, my nurse practitioner, well meaning and educated, does it, I’ve had a lover tell me, upon looking at a cute picture of myself as a child that “no wonder my father loved me so much”.  I broke up with him soon after. It’s not love. I’m not a victim. Let’s just fix the problem, shall we?

So I’m working on relaxing those muscles, in various ways, on my own and with a little help from my wife. It’s working.

Now was that so hard?