Gay Men and Moving On In Life After Trauma
As a long-term gay men’s specialist psychotherapist and life/career/relationship coach, I often work with some of the most common psychological and psychiatric challenges any person can have, but they take on a deeper meaning for gay men and others in the LGBT+ community, or any group that might also experience “minority stress” in addition to their condition.
Discussions about this in the context of Depression, Bipolar Disorder, OCD, ADD, etc. are certainly part of this, but I wanted to share some discussion of PTSD, or other situationally traumatic experiences that might not qualify for meeting the official, objective “PTSD” diagnosis in the DSM-5 (American Psychiatric Association, 2013), but certainly have symptoms that are related to the traumatic experience.
In earlier blogs and podcasts, I’ve discussed the different kinds of traumatic experiences a person (specifically, my long-term professional focus on gay men’s mental health and quality of life) can go through, and how to cope with them. Gay Men and Trauma: Reclaiming Your Life was one of them, in addition to my two-part series, Gay Men and Coping with Specific Traumas, Parts 1 and 2, and Covid’s End as Trauma Recovery in Gay Men.
There is a big risk here of repeating myself from those articles, but this time I wanted to focus on the longer-term perspective of trauma recovery. What do gay men do in the aftermath, or the “epilogue to the story,” after surviving various kinds of trauma?
I have this perspective as an older gay man, and I think about my own traumatic experiences, sometimes many years ago, and how I feel about them now. I think of the advice that I would give to younger gay men who might have experienced a traumatic event recently, and how it might go for them moving forward.
Of course, no two people’s experiences with very similar traumas will be exactly alike, which why variables like our genetic resilience, Family of Origin cultural upbringing, individual talents and vulnerabilities, privilege, or access to social support and other resources might affect long-term recovery.
As I’ve said before, we are taught, in general, in our Family of Origin and in our childhood schooling, that our society is civilized; that there are rules, that we are safe. We’re not necessarily barbarians or vicious animalistic creatures that devour each other and eat their young. And, yet, life teaches us – sometimes early on – that the sense of safety that we are collectively taught to expect from parents, teachers, bosses, clergy, cops, politicians, and so on – can be breached, horrifically, leaving our physical and psychological defenses torn from the experience. It’s been said that that ripping of the fabric of our defenses (beyond our ability to cope) is trauma, mitigated only by our resilience, and our social support strategy in the aftermath.
Trauma is when we get overwhelmed by an experience, either as individuals or collectively. At one time, it was defined as a “life threatening” experience, or “experience outside the realm of normal human functioning,” but the term has evolved from that, in part because it’s culture-bound. What is “outside normal human functioning” for one person might be an everyday occurrence for someone else, such as someone living in a war zone.
In trauma, the experience overwhelms our expectations and our ability to cope. We don’t know what to do with it. Nobody ever taught us that such things were even possible in this world. 9/11 was such an experience; collectively, in the United States and in the world; no one saw that coming. It’s similar to the attack on Pearl Harbor by the Japanese in 1941; it was literally awakening to a new world. There would be plenty of non-Western examples, too.
Despite something happening years ago, it can affect our thinking, feelings, and behaviors today. They come in different categories, such as childhood abuse, pandemic/illness, accidents, crime, and interpersonal betrayals.
Other articles and resources discuss what these are, and some about how to treat them using various “models of intervention” in Evidence-Based Practice psychotherapy techniques. You’ve probably heard of how popular some are, such as Eye Movement Desensitization and Reprocssing (EMDR), which has become so “popular” to use among new therapists that it gets awfully close to being a fad; Trauma-Focused Cognitive Behavioral Therapy (TF-CBT); Somatic Experiencing (SE), and psychodynamic models (plus others; some of them evidence-based and legit, and some pure charlatanism masquerading as mental health practice).
Let’s take some of these categories of trauma, and discuss the longer-term effects of them in terms of lingering symptoms and challenges, and how we cope with them:
1. Childhood Abuse
When we experience childhood abuse, which could be in the form of neglect, physical, emotional, sexual, cyber, or bullying, unfortunately, it has been shown to negatively affect our neurobiological development (Bonnie Badenoch, Being a Brain-Wise Therapist). That’s unfortunate, but any challenging experience that leaves us emotionally or physically (in this case, neurobiologically) scarred is unfortunate. Adults tend to have uncanny memory for remembering instances of abuse; they remember the words the perpetrator said to them, they remember sensory stimulation of the place it occurred, they remember where in the body it hurt, and they remember the emotional pain of having to come to terms, even then, with the feeling that was being done to us was just not “right” in the life of a child. We felt that injustice, even if we didn’t know exactly what the law stated on these things as children. We just had that instinct that others either didn’t go through it, or shouldn’t have to.
In the long term, childhood abuse might leave us with a chronic difficulty “trusting” authority figures. We might be wary of people – even friends or coworkers – who are trying to help us, wondering if they help only to forward their own motives and gains. We might “resist authority” and have a natural inclination to “dance to the beat of our own drum” to avoid becoming a target again.
We might find ourselves to be generally risk-averse, and experience the world as more untrustworthy than trustworthy. We might tend to “shrink” away from opportunities or situations that put us in the spotlight or give us personal or professional visibility; by “blending in” we stay safe and out of the target zone of those who might harm us all over again.
We might be keeping ourselves single, because we had learned, as a survival instinct, that you can’t always trust the people closest to you. Maybe our parents didn’t protect us back then, so we are wary of trusting a spouse/partner now.
We might be reluctant to have children, because we are afraid they might experience something similar to what happened to us – or even be afraid we might do it to them.
We might carry around not only distrust of others, a certain “chronic wariness”, but also a general anger, especially at those today who remind us of our perpetrators in the past. Abuse survivors who have a general propensity for anger are, on some level, acting out the rage that justice was not served and that their perpetrator “got away with it” and never really faced a comeuppance for their crimes (this my theory about the faddish “Karen” syndrome online; I think these are either women with Bipolar Disorder, or possibly Borderline Personality Disorder, or they could be sensitive to even the most innocuous behaviors (someone bird watching, for example) being perceived as imminent dangers to their person, with probably quite a bit of racism or xenophobia thrown in there; a fear of the “unknown”, or treating what they don’t know as being dangerous.
Women who have been abused by male perpetrators might have a broad vulnerability to misandry. Men who have been abused by female perpetrators might have a broad vulnerability to misogyny. Anyone who has experienced trauma related to a certain group (teachers, clergy, coaches, parents, siblings) might be wary of anyone who looks, sounds, or holds the same position as the original perpetrator. I’ve known Jewish people who steer clear of anyone and anything German, even in the current generation, due to the history of the Holocaust. Growing up, I had exposure to Vietnam War veterans who held an irrationally xenophobic response to Vietnamese people or to anyone Asian. Our psychological defenses make a split-second connection to our perpetrators by history, and want to “warn” us when anyone or anything comes along that reminds us of that, making us stand on guard in case we have to fight or flight again.
Long-Term Coping: There are many discussions on this, the long-term coping for childhood abuse, and of course the discussion of “forgiveness” and “healing the inner child” have been popular. Spirituality can sometimes help with this. “Living well is the best revenge” is also a popular cognitive strategy. And, of course, therapy can discharge some of the bad feelings over time by expressing them and literally having our brains process the traumatic memories and incorporate them into something more metabolized in our brains.
Cognitively, I think long-term coping for abuse is understanding that unfortunate situations in our own childhood were difficult, painful, scary, and certainly unjust. Any maybe we also felt isolated, because abuse is often hidden and can give us the feeling that we are the only ones it’s happening to. As adults, we learn that it happens not to everyone, and we have to cope with the anger of their “privilege” of being spared, but that we are not alone in the social ill and phenomenon of the various forms of childhood abuse. It can make us feel that we live in a very flawed, even sad, world that allows such a thing to persist in many cultures of the world and throughout history. We are forced to cope with the awareness and the knowledge, first-hand, that there are, indeed, sadistic and deeply disturbed people out there.
But long-term coping also puts the social ill of abuse worldwide, and our own specific experiences, in an existential context. Our abuse history does not always need to define us; we can’t change that it happened, but a healthy reclaiming of our quality of life includes keeping that experience in a certain “container” of experience and memory; it need not color all of our interpersonal relationships with others throughout time.
2. COVID/Illness – The aftermath symptoms of a medical trauma, such as either having COVID ourselves or being part of the global community who faced it, are still somewhat to be determined. The trauma that we can experienced from having a severe illness in the past (that we survived) might influence us now in ways that wouldn’t be so if we haven’t been sick.
For example, I wrote a blog article sharing my experience with a severe staph infection that was almost fatal in October, 2021. To “walk my talk” so to speak, as a therapist, I’ve had to have my own psychological support. One aspect I’ve had to contend with is a somewhat irrational fear of recurrence. For example, because I was probably exposed to the pathogen via my bare leg and dirty gym equipment when I was wearing athletic shorts, I’ve had a penchant for wearing long-legged athletic tights to the gym. This isn’t necessarily irrational, but the gym where I contracted the infection is long-since closed. I had to challenge myself to wear shorts again, and to not let the traumatic experience of being severely ill make me feel like recurrent illness was always just around the corner.
My mother, who at age 87 has survived different bouts of cancer three times, has had to work hard to think and feel that she has a future, and that every year that passed might be her “last Christmas” or “last birthday.” She has achieved this, thankfully, but the once-bitten/twice-shy adage was a challenge for a while.
After a medical trauma, we might experience ourselves as just generally vulnerable to illness, just “constitutionally” weak, when our health systems don’t really support that. We might be wary of doing routine medical care (such as check-ups or colonoscopies) for fear of what they might reveal. We might think of others as “healthy”, or having a certain “health privilege” (particularly younger people), and think of ourselves as being left out, a medical FOMO.
Certainly, for gay men, if we’ve had a medical trauma that was not HIV/AIDS, we might still feel the effects of the long history of HIV stigma, and the “Diseased Pariah” stereotype that happened so viciously, and yet so visibly, in our country’s history at the height of the AIDS pandemic.
Long-Term Coping: The long-term coping after we have ben restored to health after a traumatic illness has many components of the physical, psychological, and social. There is a task of learning to trust our bodies again, and that they are not likely to “betray” us anytime soon, or in the same way. This might be possible, but it’s not necessarily likely. And even if we remain high risk for health challenges because of a chronic condition, we are continually building a strong affiliation to medical resources (with expanding technology every day), as well as building our capacity for adaptive coping, and getting the social support we need, if we should face a health challenge again.
3. Accidents – Over my long career working with gay men, I’ve heard of various physical accidents that a person can have, especially men, which, despite some old stereotypes, gay can be heavily involved in risky situations as straight men. Certainly car accidents, but also ones from recreational activities such as skiing, boating, bicycling, motorcycling, or running.
An acute accident requires an assessment of what happened, and how it affects the body. The human body in general likes to repair itself, but when something is permanently broken, and we lose a body part, or the capacity to use a body part, we must cultivate an adaptive coping for how to live in that new state. There is the business of the medical recovery, such as with bones, ligaments, and tissue, and there is the psychological, coping with the idea that we might have in general felt “invulnerable” to outside forces, and we have to come to terms with the fact that we are not.
Traumatic symptoms after accidents might be an anger at ourselves just for “not being invulnerable”, or a persistent guilt that what happened to us was a result of what we call unreasonable risk-taking or our own regrettable choices at the time, or anger at someone else (a drunk driver, a careless person in public) causing the calamity by their own choices or even self-indulgent behavior.
We might feel “less than” our peers who are “intact” or even “perfect” in our eyes. We might feel less valuable to society. Or, like so many traumatic experiences, we fear ever being in the grip of that kind of vulnerability or helplessness ever again.
Long-Term Coping: Long-term coping after a traumatic accident often involves either coping with the memory of having gone through something rough, and overcoming it, but still dealing with the shock of that it did, indeed happen, or, coping with the fact that after that incident, our lives have never been the same. Coping means living well as best we can, whether we made a full recovery and life is again as it was, or living well despite the new circumstances of having to use a medical device or long-term medications to level the playing field.
4. Crime – The longer-term traumatic symptoms after we have been the victim of a crime, either a violent one or a “white collar” one such as being swindled or robbed, can involve not only a basic mistrust of humanity, but also an anger that everyone is just “out for himself” in this world (which can feel really true).
We also might develop an avoidance of any circumstance that approximates the setting of the crime, such as walking alone at night, or being in a “bad” neighborhood. Coping with white-collar crime (cyber scams, or, such as in my case, a swindler who preyed on psychotherapists to build them new websites, and complete part of the job, and then she ran off with the pre-paid fees; we later learned that she had been disqualified from registering as a therapist trainee in California three times). The anger and frustration of our loss can be strong; we might mourn the loss of money that was stolen when we worked hard for that. We might miss the belongings we were robbed of. We might be enraged that the perpetrator scared us with the use of gun in a hold-up, or even a hostage situation. We might have a moral indignation, such as witnessing white-color crime, such as embezzlement or fraud, and feeling helpless to report it for fear of losing our whole livelihood (this happened to me three times during the course of my early career working at Los Angeles non-profit organizations; there is not enough oversight of such places).
The vulnerability and/or the rageful frustration of injustice can be powerful, but again, the cognitive reframing is our friend.
Long-Term Coping: Long-term coping in the aftermath of being a victim of crime is understanding that it is the Nature of Man that some people are disturbed. They can be sadistic, greedy, egomaniacal, self-centered, entitled, dismissive, or desperate. People who are mentally and socially healthy don’t commit crimes; they work an honest day’s work, save, invest, contribute, and participate in a civilized society. Understanding that sometimes the human brain goes haywire and undermines socially rational behavior takes some reflection. But cognitive reframing demands that we put our subjective perspective after our victimization in a more objective perspective: that despite the fact that there are many anti-social, sociopathic, and psychopathic people in our world – our jails and prisons are full of them, worldwide, and those are just the ones who get caught and don’t have “defense privilege” to avoid accountability (Donald Trump, OJ Simpson, etc.) – most of our fellow humans avoid such antisocial behavior; it’s just that sometimes, it happens, and sometimes, it happens to us. Cutting our losses and moving on – defiantly – lets our perpetrator know, even if in our own heads, that they didn’t break us, despite their efforts. And if they did break us – such as killing our loved ones – perhaps the Universe will mete out justice in a way that we don’t fully understand yet. They could reincarnate as a cockroach eventually, and we just have to trust that, if our justice system (as it often tends to do), fails.
5. Interpersonal Betrayals – The longer-term symptoms that come from interpersonal betrayals, such as learning a business partner has embezzled us (see crimes, above) or that a partner has indulged in behavior that is harmful to us (breaking a monogamy agreement, withholding important information about their history, hiding something relevant to the relationship) can again include a difficulty with our rational ability to trust others. Interpersonal betrayals that are discovered are often discovered suddenly, with no time for us to brace ourselves about what we’re going to learn. Even being told by our adoptive parents that we have been adopted can do this, because what all these require is a sudden adjustment from the world we were living in, just a short time ago, to learning that another “world” had actually been taking place all along. That can certainly undermine our ability to “see what we see” and to existentially trust our own reality.
I remember years ago that I visited the home of a high school classmate on the night before he was leaving for college. I felt compelled to come out to him, and let my feelings be known before he left. It turned out, he was, indeed, also gay, but just not in the least attracted to me. We remained friends, supporting each other as gay male peers who were new to coming out. But a few years later, he confessed to me that when I visited that night, another friend of ours was also visiting him, and that he heard our entire (long) conversation by being hidden in the next room. This made me have to re-interpret my own coming out story to my friend; that what I thought was happening (a very private experience) was actually not the case. I felt “exposed” and angry that the reality of an event so important to me was allowed to be misconceived in my head for so long.
But any interpersonal betrayal is like that. And, here I am, many (oh boy, many!) years after high school, and I still feel the sting of what it was like to learn what betrayal was for the first time. And it’s that way when we remember any incident of interpersonal betrayal by someone we deeply, emotionally trusted. We live on, but we live on a bit scarred by being forced to confront the betrayal that always will make us question our confidence in others, even by just a little bit. We never know when “the friend is in the next room eavesdropping”.
Long-Term Coping: The long-term coping for interpersonal betrayal, one or many incidents, is again to understand and cognitively reframe the situation. Sure, in my experience, I would have liked to have been told, either immediately or shortly after, that someone else had heard our conversation. But with my adult perspective, I realize that my friend who kept that secret was probably responding to an anxiety that he didn’t know what to do then, especially when I didn’t tell him why I was coming over that night when I did. We all can do weird things sometimes when we are panicked with anxiety to know just what the right move should be. So we have to understand that when people betray us, it’s not really about us – which is part of the problem; they didn’t dignify us by regarding us in their plans. But they were responding to their own pressures; partners “cheat” when they have an unmet emotional need and don’t know how, or are willing to, talk about it with their partner/spouse. People lie when their anxiety overwhelms them with a fear of the consequences if they told the truth. People can be fearful of being broke or embarrassed, and that makes them do dumb things that hurt others.
Whether we “forgive” these betrayals is very personal. I don’t put all that much emphasis on “you have to forgive” – I don’t “have to” do anything when someone has already run rough-shod all over me in the first place. I will forgive if I want to – to mentally/emotionally relieve myself of the burdens – but I will also remain steadfast in my indignation when someone was guilty of a betrayal that caused harm that I didn’t ask for, or deserve (see above re. crimes). Sometimes, a victim/survivor will forgive their perpetrator – IF there is recalcitrance – but if the perpetrator remains steadfast in their egomaniacal entitlement, then we get to hold them in contempt for their injustices, to us, or to anyone. That is the Spirit of Stonewall; they didn’t “forgive” the oppression and harassment from their perpetrators – they rioted in violent retaliation to stop it and change the course of history. Wisdom is knowing the difference.
If you have experienced these, or any other form of traumatic loss, and you want support for how to move on, consider psychotherapy (for residents of California), or coaching services (for those in other states or other countries). I can explain the important legal and ethical differences between these professional services when we talk. See GayTherapyLA.com for psychotherapy, and GayCoachingLA.com for coaching, or call/text 310-339-5778, or email Ken@GayTherapyLA.com.