Researcher and clinician Bessel van der Kolk reminds us that when it comes to the immediate and long-lasting impact of trauma, “the body keeps the score.” Psychic and somatic pain are stored, ever-present, ready to break through into consciousness—keeping the survivor in a state of high alert for danger—all the time, everywhere. Helping clients make connections between these painful states and the trauma memories allows them to begin the process of healing and grants the clinician access to this hidden painful domain. In this way, client and therapist can begin to loosen the hold of the trauma, free the victim of its insidious and regressive pull, and help them live less painfully in the present and move less encumbered toward the future.
Sexual abuse is one form of such trauma that is surprisingly common in my practice with men, and that is associated with painfully held secrets and a seemingly desperate attempt to minimize both psychic and physical pain. In my work with these men, I have found that when the trauma narrative is produced and the pain can be present simultaneously, the healing is (in part) automatic. Surprisingly, in men who have had little if any vocabulary for emotions, words to describe painful and long-buried emotions materialize.
I had the opportunity to work with Mike, a large, burly tattooed man in his early 40’s. Tortured by his excessive masturbation, a pattern of frequency that exceeded his already high-baseline, he self-referred, with trepidation. Shortly into the therapy, as the topic shifted from his repetitive sexualized behavior to a challenging relationship with his son, the product of a recent divorce, things shifted. As he recited both his internal and external struggle, things calmed down. Not coincidentally, with a heavy heart, he revealed that his son was the same age as he was when he was abused for a short period by his then 12-year-old brother, a memory that held not only pain but intense shame, guilt, anger and remorse.
Then there was Gabe, a middle aged man with two young-adult children from his first, somewhat unhappy, marriage. As he reluctantly approached therapy, he talked about a recent episode of sexual acting out during his current, second, much happier marriage. With his ultra-conservative Italian Catholic background, he was perplexed with his actions and the lies he employed to shield them. His behaviors had not yet taken full form, as he had only “flirted” with the notion of being with others. Gabe shared that as a young boy, he was repetitively used as a tool for his much older, post-pubescent sister’s masturbation. There was no penetration and he was not asked to do anything specific to satisfy her. Telling the secret was painful for Gabe, who, as his repressed rage was given voice, allowed the pain as well as the tears to flow.
Raymond held his secret for 50 years in a secluded psychic compartment, a private underground space in his life disguised largely by his out-of-control sexual behavior, never changing despite his 15-year marriage, 2 children, house, successful career and twin dogs. Held under wraps inside this man born of two German parents, this classified information was made known one moment after 5 years in therapy that had included couples therapy for his wife to work through the complex partner trauma, and intermittent individual sessions. With an outpouring of pain he cited a now-conscious awareness of a few sexual incidents during childhood with his older brother, a prodigy who was favored by the parents. This new awareness opened a space to create an honest account and narrative of his pain.
The stories seem never ending as is the pain locked within them, until it is finally released. I am not inferring that with the telling or retelling of the event, all will be cured. Yet, the changes I’ve witnessed that accompany the release of the traumatic stories have been profound and have provided an opening for deeper work. Insight was seemingly insufficient. Access inside the mental network housing the injury and its memory was critical.
One of the greatest, if not primary, clinical challenges I’ve experienced is the inability or difficulty for these men to use words to define their experience. Finding a voice for their wounds began a movement towards healing. Still, not all trauma survivors remember their incident that clearly, cannot report it as such, and many become traumatized by the retelling. In these cases, clients need a safe holding space in order to proceed and a skilled process consultant (a.k.a. therapist) to help work through the emotions as they emerge so they may re-weave a self-affirming and empowering life narrative that is neither permeated nor defined by the pain of trauma.
Resources:
APA Guidelines for Psychological Practice with Boys and Men
Male Survivors of Sexual Abuse
Betrayed as Boys, by Richard Gartner
File under: The Art of Psychotherapy
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Sexual abuse is one form of such trauma that is surprisingly common in my practice with men, and that is associated with painfully held secrets and a seemingly desperate attempt to minimize both psychic and physical pain. In my work with these men, I have found that when the trauma narrative is produced and the pain can be present simultaneously, the healing is (in part) automatic. Surprisingly, in men who have had little if any vocabulary for emotions, words to describe painful and long-buried emotions materialize.
I had the opportunity to work with Mike, a large, burly tattooed man in his early 40’s. Tortured by his excessive masturbation, a pattern of frequency that exceeded his already high-baseline, he self-referred, with trepidation. Shortly into the therapy, as the topic shifted from his repetitive sexualized behavior to a challenging relationship with his son, the product of a recent divorce, things shifted. As he recited both his internal and external struggle, things calmed down. Not coincidentally, with a heavy heart, he revealed that his son was the same age as he was when he was abused for a short period by his then 12-year-old brother, a memory that held not only pain but intense shame, guilt, anger and remorse.
Then there was Gabe, a middle aged man with two young-adult children from his first, somewhat unhappy, marriage. As he reluctantly approached therapy, he talked about a recent episode of sexual acting out during his current, second, much happier marriage. With his ultra-conservative Italian Catholic background, he was perplexed with his actions and the lies he employed to shield them. His behaviors had not yet taken full form, as he had only “flirted” with the notion of being with others. Gabe shared that as a young boy, he was repetitively used as a tool for his much older, post-pubescent sister’s masturbation. There was no penetration and he was not asked to do anything specific to satisfy her. Telling the secret was painful for Gabe, who, as his repressed rage was given voice, allowed the pain as well as the tears to flow.
Raymond held his secret for 50 years in a secluded psychic compartment, a private underground space in his life disguised largely by his out-of-control sexual behavior, never changing despite his 15-year marriage, 2 children, house, successful career and twin dogs. Held under wraps inside this man born of two German parents, this classified information was made known one moment after 5 years in therapy that had included couples therapy for his wife to work through the complex partner trauma, and intermittent individual sessions. With an outpouring of pain he cited a now-conscious awareness of a few sexual incidents during childhood with his older brother, a prodigy who was favored by the parents. This new awareness opened a space to create an honest account and narrative of his pain.
The stories seem never ending as is the pain locked within them, until it is finally released. I am not inferring that with the telling or retelling of the event, all will be cured. Yet, the changes I’ve witnessed that accompany the release of the traumatic stories have been profound and have provided an opening for deeper work. Insight was seemingly insufficient. Access inside the mental network housing the injury and its memory was critical.
One of the greatest, if not primary, clinical challenges I’ve experienced is the inability or difficulty for these men to use words to define their experience. Finding a voice for their wounds began a movement towards healing. Still, not all trauma survivors remember their incident that clearly, cannot report it as such, and many become traumatized by the retelling. In these cases, clients need a safe holding space in order to proceed and a skilled process consultant (a.k.a. therapist) to help work through the emotions as they emerge so they may re-weave a self-affirming and empowering life narrative that is neither permeated nor defined by the pain of trauma.
Resources:
APA Guidelines for Psychological Practice with Boys and Men
Male Survivors of Sexual Abuse
Betrayed as Boys, by Richard Gartner
File under: The Art of Psychotherapy