Trauma in Men
There are many men that I know both in my psychotherapy practice and in my personal life that have been through and are affected by traumatic events. These men have bravely recognized the need to address their issues head on through different therapeutic modalities, including Cognitive Processing Therapy, which helps change the thoughts and feelings associated to the trauma; Prolonged Exposure Therapy, which gradually helps bring up memories that have been avoided; and Eye Movement Desensitization and Reprocessing (EMDR), which helps process trauma while focusing on movements of sound. One friend of mine who was traumatized while working on the grounds of 9-11 was treated effectively by Exposure Treatment which is an aspect of Rational Emotive Behavioral Therapy. He was assisted in returning to the site and had learned to process and manage his emotions.
One aspect of trauma that I would like to focus on is sexual abuse. This type of trauma is very painful for men to speak up about. As it is with sexually abused women, there is a shock and denial about the abuse as well as an underlying shame. Questions that often plague the mind are, “how could this happen to me?,” “how could I not see it coming?,” or “why did I not stop it?” These questions may be constant and often trigger anxiety, depression and physical pain. Sometimes the thoughts are so painful that the survivor learns to either avoid the topic altogether or unconscious store it as a way to cope. When someone suppresses these feelings and emotions long enough panic symptoms may occur.
Sexual abuse is extremely difficult for most men to talk about - even in therapy. I recently read an article on this topic by Robert Weiss, LCSW, CSAT-S called “Treating Male Survivors of Sexual Abuse.” In the article he talks about how many men feel that it is not socially acceptable to talk about being sexually abused. Some men often feel that they should just be “man enough” to deal with it or get over it. Others may feel unable to express emotions and that the only acceptable emotion is anger and not sadness or guilt. Robert Weiss even goes further to talk about how some clinicians even buy into the social norms of masculinity telling their patient’s to move on with their feelings and just accept what was done.
Addressing sexual trauma with men is a delicate process which often takes time and encouragement. Most sexual trauma in men happens in childhood or adolescence, or while incarcerated. It is already a good sign that a man asks for help with these issues but it often comes at a cost. Some of these men had already ruined close friendships or romantic relationships, or they developed physical symptoms (somatic symptoms) to a point where they have difficulty performing at work. These physical symptoms may including shortness of breath, heart palpitations, numbness, sweating or a sudden state of worry. Emotional symptoms may include sadness, listlessness, apathy or low self-esteem.
It is important for a man to first bring the sexual trauma into conscious awareness by telling his story. This is a difficult process because there is so much pain and resistance. The more the man tells his story the more he is able to address its emotional aspects. This is why EMDR is effective, because it connects people to their physical presence while telling their story.
There is often an emotional story attached to survival of sexual abuse. The story may be “I am ashamed,” “I am weak,” “I can’t trust anyone,” or “I can’t get close to anyone because I will get hurt again.” So the next step is to recognize the internal emotional story connected to the abuse.
The next step in the process in dealing with sexual trauma is challenging and re-writing the emotional story. This may be connecting with that inner child (if the trauma occurred as a child) and letting him know that it wasn’t his fault and that it was not deserved. Not everyone has the same story so the conversations are all different and personal. This is also a very challenging process that takes time.
With any trauma the wounds may never go away. It is common for negative self-talk and somatic symptoms to show up from time to time. The process of therapy is not to get rid of the trauma but to get to a level of acceptance that is more manageable. There also needs to be techniques in place to calm anxiety symptoms such as breathing techniques, meditations, exercising or other stress reducing activities.
Trauma can affect anyone but men often try to conceal their pain around sexual trauma. Many men were brought up to believe that it is unmasculine to express certain feelings. The more one keep this pain inside the more it builds up. It’s important to seek professional help to start the healing process, which could be long and difficult. Recovery may not be 100 percent but the level of understanding and functioning should increase in order to live a more healthy life.
I get to my office in Brooklyn during a weekday morning after I drop off our two children at the bus. Before meeting with my first psychotherapy client, I sit silently to prepare mentally for the session. When the client arrives I greet them with a warm smile and a firm handshake. It is at this point that I am fully present. I get into a certain listening mode with my clients where I am deeply focused and not concerning myself with anything else at all. It is like something has taken over, where insights and active listening come through and I am able to lead the client to a point of healing and clarity. I am in a flow. This is extremely rewarding for me and I often come out of the session energized and content. This does not happen during every session but does occur more often than not.
I was reading a book simply called “Flow” by Mihaly Csikszentmihalyi, who is a Hungarian-American psychologist. Csikszentmihalyi has done an impressive amount of research studying the behaviors, biology, brain activity and physiology of those who have achieved levels of ‘flow’ that made them highly successful. Flow is a state where there is tremendous focus and a feeling of freedom and bliss, so much so that time and everything else ceases to exist except for the task at hand. People like Michael Jordan have called it “in the zone.”
Csikszentmihalyi defines flow as “...what we feel when we are fully alive, involved with what we do and in harmony with the environment around us.” Often flow comes about when we are engaged in the activities such as singing, dancing, sports, reading and even having an intriguing conversation with someone.
A great example of someone being in a state of flow is rock climber Alex Honnold in the documentary film “Free Solo.” Alex lives for climbing. He sleeps and eats in a van parked near Yosemite National Park so he can be close to the mountain where he practices free-solo climbing in order to perfect it. Alex planned and prepared each step of the way over several months to climb the 3,000 foot face of El Capitan in Yosemite. When he first attempted to free-solo the massive granite wall (no ropes or cables) he stopped along the way knowing that he was not in the right state of mind. Days later he was ready mentally and physically and was in the state of flow needed to achieve something no one had done before, free-solo El Capitan.
So how does one get to a state of flow? First off one need to recognize what they love to do and what brings them joy and what they are good at. Csikszentmihalyi states that “Happiness is being able to express who we are and our strengths and what we do…[that] this is what I’m supposed to do and this is what matters.” This could include something of the arts or ways in which one help others.
The next step is having clear goals in mind to focus on. These goals need to be measurable in order to know that one is getting closer to accomplishing them. Csikzamtmihaly identifies a four percent challenge to one’s skill-set so that they overcome boredom but, it is a challenge that is doable. Sometimes challenges one sets for oneself are too difficult and they set themselves up to fail. People also have a tendency to overload themselves with so many tasks and multiple goals that they become frustrated and overwhelmed. To get deeper in the flow, challenges are intended to be set over time so that they continue to grow.
When ‘in the flow’ there is a focus so intense that it surpasses the ego; there’s inner clarity, a feeling of blissfulness and a feeling of time flying by. There are no concerns or doubts and sometimes no worries of dying. Can you identify a time that you were in a state of flow? A time you were completely focused and clear about the task at hand and where time ceased to exist? It may be worth pursuing what gives you flow as it can bring increased life satisfaction and confidence.
The Challenges of Parenting
As a husband of 12 years and a father of two children there are many challenges that I was not prepared for. Our son is now 10 years old and daughter is 8 and our biggest challenges are our daughter’s sassiness and son’s sneakiness around technology. We had some other issues along the way, including frequent tantrums, child care issues and sibling rivalry. But, the issues my wife and I are really dealing with now as they get older are more around limitations.
There are dozens of relationship and parenting books out there, but no one actually knows what to expect and how they are going to react in specific situations when it comes to family conflict. I was reading an article on how parents need to agree on how to raise their children before deciding to create a family. The article goes on to say that having these agreements minimizes arguments especially in front of the children. This is a good idea in theory, but is it realistic?
I know that my wife and I would agree that it is not healthy to argue in front of the kids, but it happens. Something we don’t see eye to eye on certain issues and we are both triggered. Our emotions get riled up and we both react in a way that is unhealthy. I am sure this is common in relationships because I hear similar scenarios in my practice and when speaking to parents.
When I speak to other men, we often share our experiences as husbands and dads and we can relate to one another. What we do not share is the same exact experiences or the same reactions. We do our best to support each other and come to a resolution around our particular issues.
There are many conflictual situations my wife and I were not expecting during the planning stage of having a family. Our son is very much into internet video game and some social media sites. My daughter talks back in a fresh and sassy manner manner when she doesn’t get her way. Even though we both recognize there should be limitations and consequences set, as parents we do not fully agree on what they look like. We both appear to stand firm in what we believe is right and we both love our children dearly. There are many conflict resolution techniques but sometimes all rational thinking goes out the window when in the conflict. I should mention that my wife and I are both therapist and have much experience working with families and children. We suffer from the human condition of not knowing everything.
So with all the advice out there, there is no easy solution or recipe on how to raise your child. There are just good models to reference if we want to correct ourselves when we screw up, and we most definitely will. I hold the position that parenting is a learning process of growth and maturity. It is important to reach out for guidance from those you respect and look up to.
One thing I know for sure is that communication is key. It is important to keep an eye on the shared vision and work on an agreement when the challenges come.
Ian Sherman, LCSW-R