Psycho Sexual Health

The psycho-body approach aims to treat physical and psychological trauma by reconciling and reuniting body and psyche. It “invites the person to become more aware of his or her bodily feelings” (GAMS Belgium, 2020, p.96), i.e. to get to know himself or herself, to listen and to trust his or her body. It is particularly appropriate for women who are victims of gender-based violence and helps to counter the obstacles linked to the lack of determination of the trauma experienced by physical and behavioural exercises.

A brief therapy complements other approaches and focuses on raising awareness of the positive resources available to women by setting small, concrete goals and exercises for managing and coping with stress. It “allows women to feel that they are regaining control of their lives despite a still difficult reality context” (GAMS Belgium, 2020, p.99) and to reinforce their optimism.

EMDR (Eye Movement Desensitisation and Reprocessing) works directly on the storage of the event in the traumatic memory and seeks to reprogram and move it into the memory of the autobiographical past where the reminiscences of the event are accompanied by a lesser emotional charge. In order to do this, the therapist uses sensory stimulation when the traumatic event resurfaces and repeats it until the associated emotions are attenuated or even neutralised.

Art therapy (creativity) makes it possible to facilitate the communication and expression of the consulting woman by using symbols and figures rather than language which is sometimes insufficient or difficult to use.

Psychosexual therapy may be appropriate to help the woman reconnect with and re-appropriate her sexuality as a source of pleasure, to improve her self-esteem, her body and her genitals. It is particularly indicated to accompany (before and/or after) reconstructive surgery operations.

The Body Expression Workshop is one of the possible collective approaches to work on body awareness, i.e. the “subjective awareness of body sensations coming from stimuli from inside and outside the body” (GAMS Belgium, 2020, p.113), in particular through dance. It allows both to re-appropriate one’s body and to interact with others.

The discussion groups allow women to confront and share their experiences, to break with social isolation in which they often find themselves, to learn again how to trust others. They can also be particularly appropriate in contexts where the subject of FGM and its contexts areaboo, in order to free individual speech through the empowerment effect of the group.

Reconstructive surgery can be adapted for certain women in the continuity of their psycho-sexual accompaniment. It can be part of a process of identity (re)construction, a way of (re)appropriating and reconnecting with one’s femininity. It can also act as a symbolic and voluntary restitution of what was removed without consent in childhood and as a means of repairing the visible stigma that may reflect the trauma suffered. The physical, aesthetic and symbolic recovery thus allowed can also work to improve sexual and intimate life (Sharif M., 2020; GAMS Belgium, 2020).

With the increase in requests for clitoral reconstruction, the question of why was quickly raised. The importance of stigmatising and victimising discourse on the sexuality of circumcised women and the desire to conform to social standards surrounding the female genitalia was highlighted (Johnsdotter S., 2019). Recourse to the operation is not a solution in itself and is not suitable for all women, as a growing body of research shows (Johnsdotter S., 2019; Mohamed S. et al., 2018; Nawal M. et al., 2019). Sometimes psycho-sexual therapy is sufficient to meet women’s needs without surgery, underscoring the need not to underestimate the importance of holistic and multidisciplinary approaches in caring for women living with FGM.