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.
Please contact me at Sheric73@yahoo.com or 516-849- 2152