Q. I work as a medical assistant in an ob-gyn office, I recently have had a patient come to the office and state she was raped she had glass and other objects in her vaginal vault, we removed it she was fine, now again she has come to my office with the same story and more things in the vaginal vault. I think she is in need of help and not sure how i can help her. the doctor i work for keeps telling me that i am to emotional over the situation but i feel like it is my job to help. what should i do. is there any type of disorder like this?

A. It is difficult for me to know what type of disorder, if any, this patient may have. If she is indeed doing this to herself, it may be a type of self mutilation. One possible clue as to whether or not she was raped may be to find out is she filed a police report about either of the rapes. Even knowing this piece of information, however, is not enough to know if she is committing these acts herself. There may be little that you can do especially because the doctor that you work for does not seem to agree this patient necessarily has a problem, and does not seem willing to get involved in helping her to get help. Whether or not she was raped or is committing these acts herself she could benefit from counseling. You can try to refer her to counseling, making sure a referral would be approved by the doctor that you work for (I say this so that you are not in danger of losing your job). You can also try talking with the patient yourself but only if you are supported by the doctor that you work for. After you have tried these suggestions, there is little else that you can do. Try the referral and hope that she hears your message of concern to seek help. I hope this helps.

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Last reviewed: By John M. Grohol, Psy.D. on 21 Aug 2006