Triggers occur when some aspect of treatment causes recall (flashbacks or vague body memories) or overwhelming feelings as a result of past abuse. 2 13

Although many survivors may have many similar triggering experiences, there is no complete predictable list of triggers for all survivors. Some survivors may be able to identify their triggers while others may be unaware of them. 2

A trigger can be anything that causes the release of emotions or memories of sexual abuse including certain colors, smells, sounds, situations, words, time of day or even seasons. 13 75

Interactions that can trigger memories of sexual abuse

  • Any potentially invasive procedures
  • Removal or absence of clothing
  • Touch
  • Focus on bodily pain or disorder
  • A procedure being done without previous announcement
  • Saying, "This will not hurt," or minimizing the patient's fears
  • In sensitivity to the power differential between the patient and provider
  • Electrophysical agents such as TENS and ultrasound 2
  • Traction 17

Stress reactions- during an examination the provider may observe the following:

  • The patient taking a long time to take off clothing
  • Statements like “how long will this take?” or “I hate these exams”
  • Excessive modesty
  • Fear that a male provider will have any part in their care
  • Twitchy toes or arching back during the examination
  • Sweating and anxious or worried look
  • Dissociation from the exam itself (separating, as if the patient wasn’t present) 18
  • "Body language and how they react to the way you touch them, how they pull away, how they look away, sheets clenched up to their neck, the legs not spreading open. I don't know if they feel bad, they feel dirty, I'm not sure what's going through their mind when they don't want to do that... how they look at you, how they don't look at you, how they are very evasive on answers. I think those are a lot of the key - and you have to learn to read people's reactions..." 6