Quote from AStubbs on April 19, 2021, 7:08 pm

Describe some of the possible differences you might encounter if you are working with a male survivor of sexual abuse? How might you approach your questions and interactions differently?

Quote from nkeeter on April 21, 2021, 2:02 pm

When working with men, and sometimes adolescents, I try to stay away from terms like "abuse" or "assault" as they seem to be somewhat conditioned to believe that "men don't get abused." What I find more helpful is to use terms like "unhealthy or unsought sexual experiences." This seems to give men the ability to look at the experience in a way that does not undermine their sense of autonomy.

Depending on whether the "abuser" was another male, which may stir up quite different feelings, or female may also have a great deal of bearing on how a therapist would approach client processing. Allowing for "client story" and interpretation of events to take a fair amount of time to change organically might take a great deal of patience, but have a long lasting difference in outcomes. A man may believe that a male abuser was actually trying to do harm, but have a far different interpretation if the power differential favored a woman, of whom he may say "she was just trying to initiate me into sex."

Quote from Coryrodgers on April 21, 2021, 5:05 pm

Quote from nkeeter on April 21, 2021, 2:02 pm

When working with men, and sometimes adolescents, I try to stay away from terms like "abuse" or "assault" as they seem to be somewhat conditioned to believe that "men don't get abused." What I find more helpful is to use terms like "unhealthy or unsought sexual experiences." This seems to give men the ability to look at the experience in a way that does not undermine their sense of autonomy.

Depending on whether the "abuser" was another male, which may stir up quite different feelings, or female may also have a great deal of bearing on how a therapist would approach client processing. Allowing for "client story" and interpretation of events to take a fair amount of time to change organically might take a great deal of patience, but have a long lasting difference in outcomes. A man may believe that a male abuser was actually trying to do harm, but have a far different interpretation if the power differential favored a woman, of whom he may say "she was just trying to initiate me into sex."

Hey Nick, 

 Good thoughts on the reframing of the word “assault.” I’m curious if that’s the approach you take throughout the entire process of your treatment or if that is more of a “phase/stage 1” approach. I wonder if never labeling the behavior as assault or abuse can backfire in a sense and now allow the weight of the trauma to fully sink in?  The majority of the male sexual abuse survivors I’ve worked with have been teens, so while the “men don’t get abused” stigma is present, I don’t feel it’s quite as strong as a fully grown man. I’d be interested in your perspective!

I also like your thoughts on the implicit interpretation the abused male might feel if their abuse came from a man vs woman. Thinking the abuser was intending to humiliate or inflict pain vs a woman desiring him (even if cognitively they understand it was in appropriate, for example a female teacher and her 16yo male student) I know first hand that the process looks different.  Great perspective here! 

Quote from lpernoud on April 23, 2021, 7:35 pm

Quote from nkeeter on April 21, 2021, 2:02 pm

When working with men, and sometimes adolescents, I try to stay away from terms like "abuse" or "assault" as they seem to be somewhat conditioned to believe that "men don't get abused." What I find more helpful is to use terms like "unhealthy or unsought sexual experiences." This seems to give men the ability to look at the experience in a way that does not undermine their sense of autonomy.

Depending on whether the "abuser" was another male, which may stir up quite different feelings, or female may also have a great deal of bearing on how a therapist would approach client processing. Allowing for "client story" and interpretation of events to take a fair amount of time to change organically might take a great deal of patience, but have a long lasting difference in outcomes. A man may believe that a male abuser was actually trying to do harm, but have a far different interpretation if the power differential favored a woman, of whom he may say "she was just trying to initiate me into sex."

 

 

Nick,

Thank you for your discussion on this important and frequently overlooked topic. You accurately reflected that many men do not view themselves as victims of abuse or acknowledge that men can suffer from sexual abuse (particularly when that abuse comes from a woman). One thought I have around why this is the case is that men, unlike women, have a very obvious physical response to sexual contact; when men become aroused or ejaculate during a traumatic experience, it may lead them to believe that they “wanted” it. It would be crucial in working with a male trauma victim to help him understand his body and the reflexive responses it has to sexual stimulation, as well as to give awareness that physical arousal is not correlational with actual emotional desire or consent.

Further, in looking at our modern culture, the #MeToo movement has been a powerful opportunity for women who have been sexually assaulted to have a voice, but unfortunately, it does not seem to have opened as many doors for males who have experienced the same. We need to create more space for men who have also experienced sexual trauma and are equally deserving of healing!

 

Quote from haley.bryant on April 26, 2021, 9:19 pm

Quote from nkeeter on April 21, 2021, 2:02 pm

When working with men, and sometimes adolescents, I try to stay away from terms like "abuse" or "assault" as they seem to be somewhat conditioned to believe that "men don't get abused." What I find more helpful is to use terms like "unhealthy or unsought sexual experiences." This seems to give men the ability to look at the experience in a way that does not undermine their sense of autonomy.

Depending on whether the "abuser" was another male, which may stir up quite different feelings, or female may also have a great deal of bearing on how a therapist would approach client processing. Allowing for "client story" and interpretation of events to take a fair amount of time to change organically might take a great deal of patience, but have a long lasting difference in outcomes. A man may believe that a male abuser was actually trying to do harm, but have a far different interpretation if the power differential favored a woman, of whom he may say "she was just trying to initiate me into sex."

Nick,

Great thoughts. Another phrase I like to use is asking if they were ever in a sexual situation in which they did not have control, to which many respond “oh yeah, I’ve definitely experienced that.” Phrasing is so important.

I am also very strategic with empowering men, which is often overlooked or even looked down on in our current climate. I’ve long been a fan of John Eldredge’s Wild at Heart. While empowerment is important for all, especially survivors of abuse, I feel that the loss of power in abuse towards men particularly undermines God’s design for men. I believe empowerment is important to incorporate into all treatment but especially when working with men, those whom God designed to be warriors.

Quote from ggeorgina29 on April 27, 2021, 4:03 pm

I personally have yet to work with a male client, yet a male survivor of sexual abuse so this is a stretching question for me to answer as I have so much to learn. Our culture has set expectations and manners in which men are "supposed" to behave and react, this can definitely be experienced and brought up within the counseling room.

A difference could include emotions and teaching about feeling words and developing an appropriate and comfortable language for the client to express their personal experience, shape their narrative, and express emotionally what has happened to them. I can image spending time as needing with a male sexual abuse survivor to share and help them develop their own language and term to verbally explain their past in a way that is healing for them. Our culture has taught me that "men don't cry" or to be strong, but what does strong really look like? The stage of healing which includes grieving and mourning the loss they experienced can be better enhanced with taking space to help male clients develop their own thoughts of what crying or expressing emotions is like for them personally.

Another difference I can anticipate in working with a male of past sexual abuse can be in the area of discussing and working through the understanding and healing of their body's. When men are aroused there is a physical response that can be noticed, this can bring up feelings of shame and false beliefs about their "responsibility" or wanting in abuse when in reality full responsibility belongs to the abuser.

The way in which I would approach with interactions differently would be to welcome whatever they bring into the room. To give plenty of time and incorporate conversations about gender norms. Giving a male sexual abuse survivor and space to develop and use their voice because in our world this is lacking for male survivors.

Quote from lys_kiss18 on April 28, 2021, 2:50 pm

Quote from ggeorgina29 on April 27, 2021, 4:03 pm

I personally have yet to work with a male client, yet a male survivor of sexual abuse so this is a stretching question for me to answer as I have so much to learn. Our culture has set expectations and manners in which men are "supposed" to behave and react, this can definitely be experienced and brought up within the counseling room.

A difference could include emotions and teaching about feeling words and developing an appropriate and comfortable language for the client to express their personal experience, shape their narrative, and express emotionally what has happened to them. I can image spending time as needing with a male sexual abuse survivor to share and help them develop their own language and term to verbally explain their past in a way that is healing for them. Our culture has taught me that "men don't cry" or to be strong, but what does strong really look like? The stage of healing which includes grieving and mourning the loss they experienced can be better enhanced with taking space to help male clients develop their own thoughts of what crying or expressing emotions is like for them personally.

Another difference I can anticipate in working with a male of past sexual abuse can be in the area of discussing and working through the understanding and healing of their body's. When men are aroused there is a physical response that can be noticed, this can bring up feelings of shame and false beliefs about their "responsibility" or wanting in abuse when in reality full responsibility belongs to the abuser.

The way in which I would approach with interactions differently would be to welcome whatever they bring into the room. To give plenty of time and incorporate conversations about gender norms. Giving a male sexual abuse survivor and space to develop and use their voice because in our world this is lacking for male survivors.

ggeorgina29,

I really appreciated your response and thoughts on this topic! I appreciated that you started out stating this is an area where you would need continued education. I feel the same way especially since this is less openly discussed.

I think you are absolutely correct that there would need to be space for male sexual abuse survivors to define for themselves the experience. I think this is a place where we can provide a safe environment that is client-focused instead of attempting to convince them or demand they acknowledge the abuse that occurred.

I think your point about working through physical bodily responses is really important. I can imagine that would be an area of needed work with male sexual abuse survivors especially if there is a spouse or partner involved. I think using activities such as the Magic Pen and Hand to Heart would be effective in facilitating safety in touch with a partner.

Thank you!

 

 

Quote from Efergeson on April 28, 2021, 10:44 pm

Quote from ggeorgina29 on April 27, 2021, 4:03 pm

I personally have yet to work with a male client, yet a male survivor of sexual abuse so this is a stretching question for me to answer as I have so much to learn. Our culture has set expectations and manners in which men are "supposed" to behave and react, this can definitely be experienced and brought up within the counseling room.

A difference could include emotions and teaching about feeling words and developing an appropriate and comfortable language for the client to express their personal experience, shape their narrative, and express emotionally what has happened to them. I can image spending time as needing with a male sexual abuse survivor to share and help them develop their own language and term to verbally explain their past in a way that is healing for them. Our culture has taught me that "men don't cry" or to be strong, but what does strong really look like? The stage of healing which includes grieving and mourning the loss they experienced can be better enhanced with taking space to help male clients develop their own thoughts of what crying or expressing emotions is like for them personally.

Another difference I can anticipate in working with a male of past sexual abuse can be in the area of discussing and working through the understanding and healing of their body's. When men are aroused there is a physical response that can be noticed, this can bring up feelings of shame and false beliefs about their "responsibility" or wanting in abuse when in reality full responsibility belongs to the abuser.

The way in which I would approach with interactions differently would be to welcome whatever they bring into the room. To give plenty of time and incorporate conversations about gender norms. Giving a male sexual abuse survivor and space to develop and use their voice because in our world this is lacking for male survivors.

Thank you for your post and your willingness to be transparent in your need for more learning and experience. I agree with you that we all need to continue to learn and gain experience in dealing with trauma and especially with men who are abused. It is important to give them a safe environment to express their hurts and fears and to find healing. I really resonated with the part about “men don’t cry.” This is one of those things that cause men to hold in their feeling and emotions and not to be able to process through their shame and hurt from abuse. I usually try and normalize crying by asking if they are embarrassed when they laugh and try to show that both are normal expressions of emotions and both are healthy but cultural norms make it difficult to show crying as opposed to laughing. I also agree with you about the physiological response to touching that abused men sometimes associate with desire or agreement to their abuse. Normalizing that the body is designed to be aroused under physical stimulation can help them realize they are the victim and in no way responsible for their abuse.

 

Quote from Natalie Lassiter on April 29, 2021, 12:51 am

For my intake, I ask the question “Has anyone ever made you see or do something sexual, or have you ever seen or heard someone else being forced to do something sexual?” I have found that this phrasing is helpful for both men and women to tell me abuse experiences they have been through that they may not have previously labeled as abuse. When I work with male survivors of sexual abuse, there is typically a reluctance to label it abuse or assault, and so I tend to follow their wording for the abuse while I am building rapport and trust. Typically, once I feel the client trusts me, I will gently challenge the label they have for the abuse and suggest an appropriate label. If they fight me on it, I back off and keep focusing on safety and stabilization. Because of the male arousal response and the likelihood of erection and maybe ejaculation during abuse experiences, I find that I have to do a lot of normalizing the body’s arousal response and response to stimulation, and work around shame and self-blame with men. These are responses I also see in women, but it seems to be talked about less with men and men tend to invalidate their own experiences more. I find a reluctance in clients to see early exposure by another person to porn as sexual trauma, as well as sexual trauma where the perpetrator was a female. I also find that I have to do more education on dissociation and check in with male clients more often about dissociation because I don’t spot it as quickly as I do with female clients. I have found that the best way for me to approach these issues with male clients is to be heavy on education about sexual abuse at first and then work on helping them to categorize their experience  and normalize their response to it and begin working towards healing.

Quote from abostwic on April 29, 2021, 6:52 pm

Quote from nkeeter on April 21, 2021, 2:02 pm

When working with men, and sometimes adolescents, I try to stay away from terms like "abuse" or "assault" as they seem to be somewhat conditioned to believe that "men don't get abused." What I find more helpful is to use terms like "unhealthy or unsought sexual experiences." This seems to give men the ability to look at the experience in a way that does not undermine their sense of autonomy.

Depending on whether the "abuser" was another male, which may stir up quite different feelings, or female may also have a great deal of bearing on how a therapist would approach client processing. Allowing for "client story" and interpretation of events to take a fair amount of time to change organically might take a great deal of patience, but have a long lasting difference in outcomes. A man may believe that a male abuser was actually trying to do harm, but have a far different interpretation if the power differential favored a woman, of whom he may say "she was just trying to initiate me into sex."

 

Nick, as you shared your experience with working with male survivors, it made me think about cultural abuse, another thread but important I think to mention here. As you discuss, there may be a needed shift in language to invite the client into looking at their trauma and experiences of sexual assault. As I have read other’s comments, I think that there is a larger cultural rhetoric about male sexuality and early sexual experiences. I was curious about the experience of young men having sexual experiences with women in their 20s or 30s for example. I asked my husband, who is a financial guy with no therapy experience, was homeschooled, and I was his first girlfriend, what he thinks about men who are 14 having sex with someone in their 20s for instance. He replied that his heart knows that this is wrong, but something else tells him “good for him and that the world we live in would see this as an achievement rather than abuse.” It was interesting for me to hear this, as I think that his frame of mind is not uncommon.  As I reflect on his words, I am curious about how we should approach this in therapy with men, after they see this in movies and hear it in music, but that it’s truly abuse and assault. I agree that language is very key in inviting clients into being curious about their experiences, whether they think things are good or bad, and how it may have impacted them.