It’s a safe bet that every psychotherapist eventually will work with adults, male or female, who are survivors (I prefer this term over the word, “victims”) of childhood sexual abuse, incest, or sexual assault. For the past 26 years, I have been a psychotherapist who specializes in working with gay men, and when I work with sexual abuse/incest/rape survivors (with some exceptions for the occasional female survivors), they are usually gay adult men.
Abuse Does Not Change Sexual Orientation
When we even start to discuss this topic, we always have to give the caveat and clear the myth about the connection between sexual abuse history and sexual orientation, in that many anti-gay bigots (who are usually “socially conservative” Republicans and/or “religious” conservatives) like to propagate this notion that “sexual abuse by a male perpetrator/pedophile will ‘turn’ a straight boy victim gay”, which is not true. Natural sexual orientation and one’s status as someone with a history of childhood sexual abuse are two different personal variables. Pedophiles are people whose sexual urges have a child target, regardless of gender; a homosexual sexual orientation is a sexually-mature adolescent male consenting with another sexually-mature adolescent male, or an adult male consenting with another adult male; let’s get that “straight”, so to speak. The conflation of LGBT identity and pedophile status is a viciously bigoted and ignorant social construct designed to confuse and influence public opinion against equal legal civil rights for LGBT in political campaigns and social policy. Similarly, for example, an adult male pedophile whose victims are girls does not “make the girl straight”.
With my adult gay male sexual abuse survivors in my practice, our work has been about overcoming trauma and learning coping and healing skills, so that the client can move on with his life in many ways that support healthy adult functioning in multiple areas of life, including work, relationships, and sex lives. In addition to the other aspects of trauma recovery, I call this process “reclaiming”. Clients reclaim their right to happiness, relationships, sexuality, and full potential that had been taken away by their victimization and traumatic experiences, and their related legacy of grief, trauma, depression, anxiety, panic, and other symptoms in their wake.
Common Characteristics of Survivors
Perhaps the best resource I know (although there are others) is the book, Victims No Longer, by Mike Lew, M.Ed. His examination of the specific issues relevant to male sexual abuse survivors was groundbreaking.
Lew suggested that survivors shared certain common characteristics, and while this list is not exhaustive, and the ones represented in any person might vary, he found these to be commonly reported:
– Anxiety and/or confusion; panic attacks; fears and phobias
– Depression, including suicidal thoughts or attempts
– Low self-esteem, a feeling of being flawed or bad
– Shame and guilt, over acts of commission or omission
– Inability to trust, themselves or others
– Fear of feelings; a need to control their own or others, or behaviors; compulsive caretaking
– Nightmares and “flashbacks” (waking, intrusive, intense recollections, of images/sensations)
– Insomnia or other sleep disorders
– Amnesia – memory loss, forgetting pieces of childhood
– Violence, or fear of violence
– Discomfort with being touched
– Compulsive sexual activity
– Sexual dysfunction
– Hypervigilance; “on edge”, extreme startle response
– Social alienation, feeling isolated and alone
– Inability to sustain intimacy in relationships, and/or entering new abusive relationships
– Overachievement or underachievement/unemployment, feeling like an imposter professionally
– As adults, becoming abusers or protectors
– As adults, becoming victims of other forms of abuse
– Having split or multiple personalities, or feeling as though they do
– Substance abuse – drugs and alcohol
– Eating disorders – anorexia, bulimia, hoarding, restricting
– Unrealistic and negative body image – feeling distant from their own bodies
– Feeling like a frightened child
– Hyperconsciousness of body and appearance
While many guys can have these characteristics and not be survivors of childhood sexual abuse, it is the collection of these feelings, thoughts, behaviors, and experiences that might point this direction. But often there is no “mystery”; a while back, it was popular among the trendy set of psychotherapists (there is always such a group, heavily invested in “pop” psychology topics, with no real common/official diagnosis, research, science, or legitimacy behind it, much like “sex addiction” today) to spout about “Represssed Memory Syndrome”, which was debunked. Most guys I’ve worked with are quite aware of their sexual abuse history, even if they don’t remember all of it. They also remember the reactions/behaviors of those around them, such as the “non-offending” parent’s reactions, or remember who supported them in their reports, versus who did not. Rage against the parent who failed to protect them is common.
Traumatic Effect and PTSD
Sexual abuse survivors, in addition to the above characteristics, often experience the symptoms of Post-Traumatic Stress Disorder (PTSD), which is characterized by both avoiding some things (that trigger thoughts/feelings/behaviors associated with the trauma) and “reliving” the events by intrusive thoughts or feelings. The symptoms of PTSD can follow experiencing or witnessing an event involving death, serious injury or a threat to the self or others in a situation in which the individual felt intense fear, horror, or powerlessness. Persons employed in occupations that expose them to violence (such as soldiers) or disasters (such as first-responder police, firefighters, EMT’s, and others) are also at risk, as are children or adults who the victims of bullying, either in a school/online environment (children), or workplace bullying, which is often overlooked as a serious adult problem, where the perpetrators can be jealous co-workers, sadistic bosses, colleagues with personality disorders, or superiors/colleagues/subordinates who are involved in crime or who inflict undermining discrimination, which adult gay men can be victims of.
Beyond these common characteristics, there is also the “menu” of what guys have experienced. Childhood sexual abuse can take the form of abuse that happened pre-verbally (such as with an infant), in early school years, adolescent years, or even in adult situations of things like bullying, fraternity hazing, or workplace sexual harassment. Any or all of these experiences are really traumas, and trauma is often defined as experiences “outside the realm of normal human experience”, although this is controversial because it’s regional or culture-bound (some countries are so war-torn that violence is an everyday occurrence). So, help for sexual abuse survivors is really considered help for trauma survivors, just like those who survive other traumas like catastrophic injury, being a victim of other forms of violent crime, major illnesses, accidents, natural disasters, acts of war, or psychological torture (such as “reparative therapy” for gay men).
How a Survivor Recovers and Heals
How an adult person recovers from childhood sexual abuse, as Mike Lew describes, can be a through a process of utilizing many different supportive resources for recovery and healing. It’s a often a combination of individual therapy, group therapy (with similarly-experienced men), possibly a role of confrontation of the perpetrator, and ultimately the process of forgiving, forgetting, and moving on – though some people will not participate in all of these. Other resources can be body work, spiritual guidance, mindfulness meditation, expressive/art therapies, hypnosis, and activism for helping other survivors or educating an often generally stubbornly naïve public.
At my practice, I tend to use a technique in therapy called Trauma Focused Cognitive Behavioral Therapy (TF-CBT), but other techniques shown to have “treatment outcomes” effectiveness include EMDR (Eye Movement Desensitization and Reprocessing), and of course psychodynamic psychotherapy. Others such as Prolonged Exposure Therapy or Mindulness-based CBT are also used. Many theories can have positive treatment outcomes as proven in formal research; in short, therapy works!
Treatment is especially important for supporting adult relationships. Having sexual trauma can impact your ability to enjoy sex yourself as an adult, and it can make you uncomfortable or avoidant of sex, which can frustrate your partner. The sex life of an adult childhood sexual abuse survivor must be negotiated carefully, recognizing the needs that are both emotional and physical. For example, partners who have been sexually abused may be uncomfortable or even terrorized by being penetrated, orally or anally, if they were penetrated with foreign objects, forced, or experienced pain with a perpetrator. Even if the sexual sensations were “pleasurable”, it remains abuse if the power/control dynamics were imbalanced, including in terms of legal consent, and if you were manipulated, forced, or threatened to “keep it a secret”. For these issues, I provide couples therapy for gay men, which is helpful to establish a better relationship sex life, where the issues on what is both safe and satisfying for both partners are discussed.
If you are a survivor of childhood sexual abuse, I believe that the first step is to recognize that you are not at fault, and that you’re not alone. Intense negative feelings such as sadness, guilt, frustration, rage, and overwhelm can easily afflict the sexual abuse survivor. Unfortunately, one of the primary behaviors for survivors can be self-isolation, as if keeping to yourself and insulating yourself from others will keep you safe. It might help to lead to a feeling of safety, but at great personal sacrifice in your personal relationships. The ability to love, to be loved, and to express feelings (especially sexual ones) needs to be reclaimed after the experience of sexual abuse “takes it” from you. Part of the process is resolving the guilt that can come from thoughts like, “But what if I liked it?”. Even so, sexual abuse is about power and control, and it is no more about sex than rape is (which is about violent power and control, not intimacy).
It takes a while to be ready to ask for help, and to speak about your experience. This can sometimes be because when the abuse happened, you were threatened that if you told anyone, some harm would happen to you, or someone you loved (including a pet). Reclaiming your right to life is about reclaiming back the power that is yours, that was taken away from you from the selfish and self-indulgent actions of the perpetrator. Your therapist is your “crime-fighting sidekick” in that process, which can help you restore the confidence and the dignity that was once lost.
When you’re ready to address this, help is available, on your terms, and at your own pace. Recovery — and even thriving as a survivor — is possible.
RESOURCE: Male Survivors Resource Sheet, here
Ken Howard, LCSW, is a gay and HIV-positive (28 years) licensed psychotherapist (LCSW) and life/career coach who has specialized in working with gay men, as individuals and couples, for over 26 years. He helps many gay men (and others) resolve the issues that undermine your quality of life, and helps you to thrive.
For help improving your personal or professional life, whatever your current challenges are, consider sessions with Ken for counseling, coaching, or therapy sessions, at his office in Los Angeles/West Holllywood (near Beverly Center mall), or via phone, or via webcam, anywhere in the world. Text/call 310-339-5778 or email Ken@GayTherapyLA.com for more information.
Ken is also available for expert witness work on legal proceedings involving gay issues, all LGBT issues, HIV issues, and issues concerning psychiatric illness or disability, as well as organizational consulting for non-profit organizations, corporations, college campuses, and conferences.
To get your copy of his self-help book, Self-Empowerment: Have the Life You Want!,visit www.Amazon.com , or wwwLuLu.com. It’s your “portable therapist” for the challenges you face today in your mental health, health, career, finances, family, spirituality, and community.