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When one's own natural tendency to protect oneself is rendered ineffective, one loses a sense of one's own power over one's destiny & survival, and a feeling of helplessness ensues. This occurs in situations of rape, torture and sexual abuse. In a situation where a person feels he or she cannot escape physical attack, the mind will "escape" by a process of "dissociation" - it is as if the mind leaves the body temporarily, so that the body can endure the attack, but the mind does not have to. On returning to the body, the mind may then be subject to unconscious repetitions of the traumatic memories in flashbacks or nightmares. These recurring images may be triggered by any situation which reminds the sufferer of the original traumatic event; a child who has been subjected to a painful surgical procedure in hospital may develop a phobia of hospitals or doctors or people in white coats. The child, or later the adult he grows into, may sweat, have palpitations, feel breathless, nauseated, panicky or dizzy at the thought of the trauma situation and try to avoid it happening again. This may lead to difficulty when medical attention is genuinely needed for a subsequent illness.
One man, who had been subjected to [[circumcision]] at the age of three years old, vividly recalled at the age of thirty, how he had been undressed and his penis manipulated by a man in a mask pre-operatively, without his consent. The child had experienced an [[erection ]] about which he was embarrassed, and then, post-operatively found himself with a bleeding, painful penis from which the foreskin had been amputated without his permission. This event had changed his life. He was angry that this had been done to him and humiliated by his powerlessness to protect himself from what felt like sexual manipulation. He felt that he had been sexually abused. In any other context than the medical one, the same sequence of events would be open to an interpretation of sexual abuse. To the child, the psychological impact is the same, whether it is illegal rape or legalised medical activity.
Another man, who was circumcised at the age of seven, asked what was going to happen to him in hospital. He was told that it was "nothing" and he didn't need to worry his head about it. After the operation he was devastated to find that part of his penis was missing and that his trust in his parents' words had been misplaced. It was as if his experience of losing part of his body was not worth a mention or an explanation.