Praktijk Mirjam

Therapy for seksueel trauma

Welcome!

My name is Mirjam Hachem, PhD. I’m a therapist specialized in sexual trauma. I give therapy for women who have experienced sexual abuse, rape and other forms of sexual violence.

Sexual trauma

Sexual abuse causes deep wounds in body, mind, and soul. Sexual trauma is a profound trauma that affects us all the way to the very roots of our being.

On this page you will find introductory information about sexual abuse and sexual trauma:

To make it easier to read I always use the expression “sexual abuse”. Please know that it refers to all forms of sexual violence.

Sexual abuse of children is committed in many different ways. In most cases, the perpetrator is a family member or friend of the family.

When you are a child, you stand powerless against the perpetrator. The perpetrator is bigger and stronger. He overpowers you, manipulates you, threatens you, and abuses you. He takes possession of your body and uses you to satisfy his sexual desires.

As a child, it’s impossible for you to understand what’s happening. You don’t have the concepts or the words to understand what the perpetrator is doing to you. You don’t know yet what sexuality is. At the same time, you are forced to come into contact with the sexuality of an adult and take that sexuality in with your body.

This forced experience is so overwhelming, so painful, so impossible to process, that it brings you into a state of shock. In this state of shock, a part of you gets frozen. This is the part where the memory, feelings and pain of the moment are stored. This part then becomes repressed. You don't do this yourself. Your psyche and your body do this automatically to protect you.

This is the beginning of sexual trauma.

Sexual abuse of children can also be committed by a person of trust (teacher, trainer, doctor, babysitter, etc.), other children or (groups of) teenagers.

The perpetrators are almost always men, but women can also be perpetrators. Mothers can also abuse their children. This fact is often underestimated. People who have been abused by their mother find it even more difficult to talk about than people who have been abused by a male relative.

The abuse by family members can continue for years all the way into adulthood. During your teenage years you might get pregnant by your father, brother, uncle or grandfather. Both an abortion as well as carrying and giving birth to the baby add further trauma.

The trauma caused by the abuse remains until it is processed at a later point in life. It is therefore never too late to start processing your trauma. Even if the abuse was committed 10, 20, 30 or 60 years ago.

Healing is still possible.

Also as an adult, the perpetrator is usually close to you.

Women are mostly raped by their own partner, male family members, male friends, and male acquaintances. Apart from that, perpetrators are colleagues, supervisors, and people of trust (teachers, trainers, doctors, counselors etc). Rape can also be committed by strangers. However, these are only 10% of the cases. In 90% of the cases, the perpetrator is someone close by.

Being overpowered by the perpetrator causes a state of shock. This shock often manifests itself by freezing of the psyche and body. You can't move. You can't leave the situation. You can't say "no". You can't defend yourself. You can't stop the rape.

In this moment of shock, a part of you gets frozen. In this part, the memory, feelings and pain of the moment are stored. This part is then repressed. You don't do this yourself. Your psyche and your body do it for you to protect you.

This is the beginning of sexual trauma.

As an adult woman you can experience a broad spectrum of sexual abuse:

Sexually suggestive comments and female degrading jokes, sexual harassment on the street and in the workplace, being groped, chased, and followed all the way home. Being exposed to female degrading porn. Being belittled by your partner. Date rape as well as being drugged and raped when you go out.

All of these experiences are traumatic and have lasting effects on your life until they are processed at some point in time.

Please know that it’s never too late to process your trauma and start healing.

As women, we live in a sexually traumatizing culture. No woman can completely avoid this. In the course of life, we are all getting wounded in our femininity. We encounter these wounds repeatedly on our life path.

Therefore, not only the healing of sexual trauma but also the healing of femininity plays an important role in my therapy work.

Sexual abuse creates profound and excruciating feelings of guilt and shame. These feelings cause survivors to keep the abuse a secret.

There are several reasons why survivors believe that they are are to blame for the abuse, while in truth it is always the perpetrator who is fully and solely responsible.

During the abuse, perpetrators take a lot of time to convince you that it is your fault. They say things like:

“I know you like this. I'm doing this for you."

"That's what happens when you're so seductive."

"You’re asking for this."

Because you are in a state of shock during the abuse, you are particularly vulnerable and impressionable. You automatically internalize these messages. This later manifests itself in feelings of responsibility and guilt.

A second important cause of guilt is that you can experience arousal and orgasms during sexual abuse.

This is one of the most confusing aspects of sexual abuse and leads to deep feelings of shame for survivors. You ask yourself, "Does this mean I wanted it?"

The answer is: No. Absolutely not.

Arousal and orgasms are part of the body's protection program that can be activated when the body comes to the conclusion that the abuse can no longer be averted.

To limit the damage, the body then goes along with the violent acts. You can't help this and you can't stop it. You have no influence on this.

In retrospect, this can create the feeling that you “joined in.” But that's not true. You didn't want it and you didn't participate. You were overwhelmed by the perpetrator and overwhelmed by violence. Your body did what it could to protect you.

It is not your fault. Never.

Sexual abuse causes a total disruption of psyche, body and sexuality. The abuse puts you in a state of shock. This creates lasting changes.

Your nervous system is put into a constant state of stress. You feel constantly alert. Fear, panic attacks, re-experiencing and dissociation become companions on your life path.

The relationship with your body is disrupted. You can develop a negative body image and even learn to hate your body. You might start to hurt yourself.

Eating disorders often arise in response to sexual trauma. Anorexia gives a sense of control by not eating and therefore controlling your body. On the other hand, you can use binge eating to end up in a haze that allows you to temporarily forget everything.

Sexual trauma can also lead to psychological disorders such as borderline personality disorder, psychoses, and dissociative identity disorder.

Sexual abuse has profound effects on your self-esteem. You might feel that you are only worth something if you serve others. You might no longer feel your own right to exist.

Sexual trauma can manifest itself in a wide spectrum of physical symptoms: abdominal pain, headache, joint pain, dizziness, fainting, stomach and intestinal problems, teeth grinding, pelvic floor tension, and much more.

Over time, these symptoms can become chronic and turn into chronic pain, migraine, chronic fatigue and chronic intestinal complaints.

Chances are that you will be sent from one specialist to another for years to treat these symptoms. However, there will be no lasting improvement until the underlying problem - the sexual trauma - is solved.

In addition to the trauma in psyche and body, sexual abuse causes traumatization of sexuality itself. Read more below.

During the abuse, you are being overwhelmed by the perpetrator and put into a state of shock and powerlessness. In this state you are forced to experience the sexuality of the perpetrator with your own body. Your own sexuality becomes repressed and controlled by the sexuality of the perpetrator.

As a result, you are being cut off from your own sexuality and your sexual identity. From now on you feel uncertainty, doubt and contradiction around sex and sexuality:

Wanting sex, but also being disgusted by it. Feeling aroused, but also scared. Feeling lust for things you disapprove of. Wanting to feel something during sex, but also not wanting to feel anything. Wanting to be in control and wanting to relinquish control. Wanting a relationship, but fearing a relationship.

You might experience a strong insecurity about your sexual identity:

“Am I straight, gay or bisexual? Am I really a woman? And if I'm a woman, why don't I feel my femininity? Does femininity mean anything at all or is it just nonsense? What are my sexual preferences? Do I want to have sex at all? What are my sexual desires? Can I have sexual desires at all?”

You can experience sex and sexuality in many different ways:

  • Withdrawing yourself and never wanting to have sex again. In a relationship you have sex out of obligation to your partner.

  • Reliving the abuse during sex. You feel yourself dissociating and/or freezing. It feels like you are being abused again.

  • Having the feeling that you must fulfill the sexual desires of others. If you don't, you feel guilty and like a bad person.

  • Letting the sex happen and waiting for it to be over. Feeling like an object during sex. Feeling confused during sex.

  • Having sex with many different partners and trying different things. Visiting sex clubs.

  • Using your body as a sex object to control others. This can give a sense of power.

  • Ending up in the arms of perpetrators again and again. Being abused again. Getting into abusive relationships.

An important part of the therapy is to separate your sexuality from the sexuality of the perpetrator. The sexuality of the perpetrator must be completely put out of your system. This gives you access to your own sexuality and sexual identity again.

If you have experienced sexual abuse, chances are you have problems setting boundaries. This is because sexual abuse has a boundary-removing effect.

Are you the good friend who solves everyone's problems? Are you the loving wife who fully adapts to her partner? Are you the caring mother who lives to fulfill the needs of her family?

Are you the perfect employee who always takes on an extra assignment and helps her colleagues out of a pinch? Do you have a job in health care where you work yourself to exhaustion? Do you spend the last bits of energy you have on volunteer work?

Can you allow yourself a rest only when you are exhausted? Do you feel guilty when you don't meet the needs of others?

Survivors of sexual abuse tend to overcharge themselves until they disappear behind all the work and caring for other people.

An important part of therapy therefore is to find your boundaries again.

In therapy, I accompany you on the way to healing. It doesn't matter how long ago you were abused. It's never too late to heal. You can start at any age.

Click on the buttons below to read more about the way to healing or to make an appointment.