Reclaim Safety: How to Navigate Medical Appointments
I can no longer keep track of the number of times a story similar to the one below has been shared with me.
Your heart feels as if it might explode out of your chest.
You try to slow down your breathing – to catch even half of a breath – just like you practiced. Yet your body seems to forget all the preparation and is instead overwhelmed with anxiety as you step foot into the waiting room of your medical provider’s office.
You arrived as close to the hour of your appointment as possible, in an attempt to avoid sitting exposed among others. Still, you are expected to wait. You wonder how long you’ll need to endure the heavy dread within as you try and find a comfortable chair. One without arms that shame you for not fitting. One that is tucked away from others where you can try and make yourself as small as possible and not be noticed.
Until they call your name.
Then you commence what feels like a death march to an exam room that leads right to the scale.
“Let’s get started with your weight.”
No no no no no…your internal voice cries out as your body tenses painfully. Your heart picks up more pace and you struggle for breath.
Then…the number. The source of shame from time immemorial noted in your record.
Next, blood pressure. A comment about it being high. No shit, you think. I feel like I’m gonna die here. But your heart isn’t the issue. It’s the panic, a vise around your entire being, desperately trying to protect you from what’s inevitably to come.
“I see your weight has gone up again.”
All the words after that are a blur.
Diet.
Exercise.
Diabetes.
Heart attack.
A litany of shame recited once more.
At least I know what to expect, you think.
At least I don’t have to start new with another unknown provider.
The entire appointment lasts minutes after over an hour of waiting. You’re sent home with a parting gift of “change your diet and exercise and get that weight under control and your body will feel better.”
Your inner voice screams out, refusing to be silenced by the shame.
But…how…? Dieting? I’ve been on a diet for my whole life! How do I exercise if I am in pain? My knees. What about my knees? And my lower back? I told you about the pain. Can’t you help? Isn’t there something you can offer besides a euphemistic expression of “it’s your fault because you’re fat”?!
Another year passes by. Maybe more.
You stop making appointments. You carry and internalize the shame as your body continues to suffer pain. Your relationship with food and your body worsens. The more you need help, the less likely you are to ask for it.
You may never return to another healthcare provider.
Shame is the sickness that silently kills you.
We go to the doctor’s office in search of healing, but for many of us these encounters can be sources of distress.
We may have suffered a lifetime of anti-fat bias and carry blame and shame.
Past traumatic events may be retriggered by medical appointments (e.g. accidents; rape, sexual assault, or other physical violence; chronic illnesses, etc.).
However we arrive at our provider’s office, we can begin to take steps to reclaim our bodily autonomy and sense of safety.
Normalize your anxiety- there is ample evidence of anti-fat bias among medical providers.
We know that traumatic experiences contribute to PTSD symptoms that can be triggered by the vulnerability we experience during medical appointments and procedures.
You DO have a reason to feel this way.
Your body is doing it all can to protect you from what continues to feel unsafe.
Care for yourself before, during, and after your appointment.
Before your appointment:
Process your fears with a therapist; engage in behavioral rehearsal with your therapist and identify areas of need or concern.
Develop and practice regulation of your nervous system. Some examples include:
Mindful breathing. Consciously take a breath from deep in your belly. Feel the breath as you inhale and exhale. Try to slow down and deepen your breath (We have this recorded for you in The Free Reclaim You Portal)
Anchoring. Notice and name neutral things in your surrounding environment. Find items of each color of the rainbow in the space. Focus on items outside in nature like trees and flowers.
Affirmations. Identify an affirmation or mantra – a word or phrase that evokes a sense of calm and safety – and repeat this to yourself.
Calm, Safe Place (We have this recorded for you in The Free Reclaim You Portal)
Print out DO NOT WEIGH ME CARDS
Write down any affirmations you need, a list of resources you can use, concerns, and questions you have and plan to bring these with you to your appointment.
Identify a safe and trusted support person whom you can call, text, or take with you to your appointment.
During your appointment:
Remember that you have a right NOT to be weighed.
Ask the receptionist to include a DO NOT WEIGH ME CARD in your file. Bring extras to hand to your medical team at (e.g. medical assistants, nurses, etc.) to help you with this process.
If your anxiety is so overwhelming you forget or cannot advocate for yourself not to be weighed, ask to have a blind weight taken and for your weight NOT to be recorded on any records you can access.
Check in with your body during your appointment.
Medical appointments are scheduled for short periods of time. You may feel flooded, rushed, panicked, or shut down during your appointment. Return to the practice of nervous system regulation. Refer to the place you wrote it down in the items you brought with you.
Include the following:
Breathe. Take one breath. Then another. Keep going. Focus on the space between breaths to help deepen and lengthen the breath.
Use an anchor. Focus on your breath, your feet on the ground, an object in the room, or a comfort item you bring with you and hold in your hand. Use these to continue to anchor yourself in the present moment and calm the nervous system.
Make saliva. Silly as it may sound, the act of making saliva can help shift your nervous system to a calmer, parasympathetic state.
Take a break. Ask for a moment to use the restroom so you can remove yourself from the immediate perceived threat. Use this time to call/text someone or practice regulation.
After the appointment:
Practice self-compassion instead of self-blame. It’s easy to get caught in a shame cycle after an appointment for various reasons.
Tend to your physical needs. Your nervous system will most likely continue to be dysregulated even after you leave the provider’s office. Take the time you need to engage in resourcing activities to reconnect with calm and safety.
Process the experience as needed in therapy, with your dietitian, and/or with other supports.
Follow up. You have a right to follow up with your provider with any additional questions or items that were missed during your appointment.
Take a moment to thank yourself and your body.
You endured and survived and are doing all you can to continue to heal from medical anxiety and trauma.
My name is Laura Gordon and I’m a trauma therapist who specializes in treating eating disorders, trauma and body-shame.
I know how hard it is to face medical appointment due to anti-fat-bias and weight stigma. And, I believe that we deserve better. We have a right to reclaim a sense of safety in our experiences with the health care system.
My hope is that the tips provided support you in navigating medical appointments with a little more space and a little more ease.
🧡,
Here at Reclaim Therapy we provide specialized trauma therapy for eating disorders.
We believe that trauma focused therapy is a conduit for lasting healing from disordered eating and body-shame. We provide EMDR Therapy, PTSD treatment and therapy for childhood trauma online in Pennsylvania and in our Horsham, PA offices.
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