Long-term sequelae for women after sexual abuse and their experience of treatment Master Project Stine Brasgaard Thirslund & Christin Walter 4. semester, Master of sexology (continuing education) Abstract: Background: Long-term side effects caused by sexual abuse (SA) increase the risk of a decrease in health bio-psychologically as well as socially, and also reduce sexual health. Long-term side effects are not a main diagnosis; but a z diagnosis and cover a range of post-reactions caused by having been forced to cope with something traumatic. The chosen coping mechanism seems suitable in the present time, but it can later cause relational complications as a long-term side effect. A neuro-scientific perspective proves that the nerve system of the body freezes in arousal in order to survive traumatic experiences, which makes it difficult to sustain homeostasis, and changes can be seen in the brain due to long-term stress. Methods show that by using a more body-oriented, polyvagal and neuro-scientific approach can help the person suffering from long-term side effects regain calm in the nerve system and body as well as better health and relations. This is possible if the existing Top- down involves a Bottom- up approach to treatment. This knowledge provides a breeding ground for the curiosity to involve a bottom up approach in the treatment of a person suffering from long-term side effects in the conventional treatment system. Purpose: To investigate women’s experiences with long-term side effects due to sexual abuse and their experience and results of conventional as well as bodily-oriented field of treatment. Method: A hypothesis generating, exploratory investigation (HEI) as well as semi-organized, qualitative interviews with four women focusing on their experience from a phenomenological, scientific theoretical perspective. Analysis: the use of IPA and a hermeneutic understanding. Results: HEI shows that 78% experience mixed, bad or deteriorating treatment of their long-term side effects within the conventional treatment system. However, 100% experience improvement, when the body is involved. The informants describe clear inter and intra relational complexity of their long-term side effects, they have somatic as well as neuro-physiological symptoms connected to traumatic stress. The informants pinpoint especially four main fields that they experience as important and insufficient in the treatment of their long-term side effects in the conventional treatment system: Unity (that is, body and mind combined) Relations: equal status, trust, security, presence and open-mindedness Knowledge on long-term side effects due to sexual abuse SA as a natural option for psychological education Sexological support and dialogue in the process of reorientation, when “the body awakens” in the recreation of body, sensuality, sexuality and desire. This topic is inadequately debated and only two articles were found for the discussion Conclusion/putting into perspective: Body-oriented neuro-scientific approach with knowledge on the polyvagal connection with trust and the feeling of security seems to create an effective co-operation with the current approach of treatment. When combined Bottom- up and Top-down prove to be effective. Women with long- term sequelae after sexuel abuse would like to be seen as persons suffering from long-term side effects are treated with this as their main diagnosis. It calls for a paradigm shift and a reorientation of the treatment of women with long- term sequelae after SA. Language: Danish Year of publication: 3th of May, 2021 Pages: 90 Subject heading: Long-term side effects/sexual abuse, coping skills, women, Top-down, Bottom-up, polyvagal, neuroscience, bodily-oriented, dissociation, treatment, sexuality, relations and trust, reorientation, paradigm shift.