Sexual abuse is understood to mean assault and rape. This can have happened once or several times. The offender may be a stranger or an acquaintance, man or woman, family, boy/ girlfriend, partner or social worker. Assault is to force a person to commit or allow sexual acts other than penetration (penetrating the vagina with the penis), by threatening to use violence or other means. Rape is to sexually penetrate an opening of the body by means of threatening to use violence or other means for example psychological pressure inside or outside marriage.

What are the consequences of sexual abuse? What are the effects of child abuse? What are the symptoms of child molestation?
Note that other traumatic events can cause the same symptoms as sexual molestation. Thus, occurence of the symptoms listed below is not proof of sexual molestation.

Depending on the seriousness, the duration and the sort of abuse, some of those who were abused in their childhood, or recently retain certain problems due to this trauma. These can be divided into psychological, social, sexual and physical problems.

Psychological problems:
Fears, panic attacks, sleeping problems, nightmares, irritability, outbursts of anger and sudden shock reactions when being touched.
Little confidence, and self-respect and respect for one's own body may change.
Behavior that harms the body: addiction to alcohol and other substances, excessive work or sports, depression, self-destruction and prostitution.

Social problems:
Have little confidence in other people.
Fear of loss of control in relationships.

Sexual problem:
While making love problems often occur. The partner may be confused by a certain remark, touch or behavior that brings back memories of the abuse.
Patients sometimes don't want to make love at all anymore or make love less.

Sexual relation problems may occur, together whit pain while making love, not wanting to make love and problems in getting aroused. Problems with the orgasm and coming also occur.

Physical complaints:
Abdominal pain, pain while making love, menstrual pain, intestinal complaints, stomach ache, nausea, headache, back pain, painful shoulders, in short all kinds of chronic pain may occur. The pain is often inexplicable.

Eating disorders often occur in sexually abused people.
When the patients, in reaction to a harmful event, disordered for more than a month in such a way that they can't go to school, can't work, isolate themselves or experience other negative consequences, one can talk about a posttraumatic stress syndrome More information . This disorder originates in reaction to a very harmful event and has three characteristic symptoms:

Denial and repression
alternating with re-experiencing,
and they are always over irritated.
Denial and repression ; they deny or repress the harmful event(s): they don't want to talk about or avoid certain situations. At an older age, memory of sexual abuse is often completely suppressed, but can sometimes be recovered in psychotherapy.

It is, however, difficult to determine if such recovered memories are memories of real experiences of memories of dreams or imagined events. This difficulty can be a problem if you want to prosecute the abuser, but it is not a problem for treatment using modern psychotherapeutic methods.

Re-experiencing ; they experience the event(s) again; unintentionally they are confronted with memories of the abuse, for example through nightmares, sudden memories or unexplainable physical problems.

Over irritation ; they are easily affected, hot-tempered, jumpy, excessively alert and don't fall asleep easily.

How often does sexual abuse occur?
Girls are sexually abused more often than boys. The relation between boys and girls at the Dutch offices of doctors at advice centers was 1:3 in 1995. Among adult women, more than 15% have had some kind of negative, unwanted or forced sexual experience with a family member before 16. Of women between 20 and 60, 7% experienced sexual abuse, rape or forced sex in relationships.

How can the psychological consequences of sexual abuse be treated?
The psychotherapeutic treatment of victims of sexual abuse is similar to the treatment of other kinds of Post Traumatic Stress Disorder (PTDS). The treatment normally uses a three-phase model. The model consists of the following three phases:

phase 1: stabilizing the symptoms: in this first phase of the treatment, we work on the relation of confidence between the therapists and the patients. We also work on rest, structure and support. A good night's sleep and good health are important. Sometimes medication is proposed for this.

phase 2: remembering and mourning: in this phase the patients tell about what has happened and what this has meant. The traumatic experience is discussed and little by little the strong emotions that belong to this are readmitted. The trauma is re-experienced, but this time in a familiar environment with support of the therapist who listens and comforts. Looking for the use of the trauma (why me?) can be understood and may forgotten.

phase 3: integration: the event is dealt with. The contact with daily life and others is restored. Certain issues like sexuality are also discussed.
Not everybody is able to go through all the phases. For some people more attention is give to the first phase.
In the case of sexual problems, attention is given to sexual feelings, the right to have fun, sexual advice, limits and the relation between intimacy and sexuality.
Help from a psychotherapist is often needed in order to learn to cope with this.