Breaking the Silence: What Therapy Can Offer Male Survivors of Childhood Sexual Abuse

If you are reading this article as an adult, it is my sincere hope that you are now in a place where you are safe from the abuser(s) who victimised you as a child. I know that for some, that this is not always the case. Sexual abusers are often people you know rather than complete strangers; it can be family members, family friends, a coach or teacher, etc. For this and many other reasons approaching this topic can be incredibly difficult to do. Many spend a very large portion of their life having never mentioned it at all. The trauma of childhood sexual abuse can have a long-lasting impact. This can include mental health challenges, relational difficulties and emotional pain. Therapy can help you work through this very difficult traumatic experience, exploring the negative impact it has had on you as well as how you can heal.

Acknowledging Fear & Recognising Safety

Is there anything that you’re feeling in your body right now after only reading the introduction? Think about the sensations, has your heart rate increased? Is there an unease in your stomach? Maybe you’re feeling hot. Whatever sensations may be coming up for you are due to your sympathetic nervous system being activated - this is our bodies natural way of responding to fear.

It is possible that you are not feeling anything at the moment. Disassociating from abuse is a ‘freeze’ response (referring to fight, flight, or freeze) which is common when there is physical or sexual abuse of a violent nature. The likelihood of disassociation as a fear response is also higher the younger your age at the time of abuse. In the case of chronic abuse which happens repeatedly over time, people report becoming ‘numb’ and detached in a dissociative way as a response [source].

In therapy, you will likely become more in tune with your body and these uncomfortable sensations may come about when you start to explore this topic. It is important to feel that you are in a safe space when doing this work. You are no longer a child being victimised by an abuser, instead you are an adult having to unpack the difficult and traumatic memory.

Therapy is designed to create safety. Some of the ways this is achieved are:

·      The therapeutic space being confidential

·      The therapist offering you unconditional positive regard and zero judgement

·      Therapy boundaries such as the time and duration of sessions being contained

·      The therapist being consistent and always showing up

·      Trust and rapport between yourself and therapist which grows over time

Challenging the Stigma for Male Survivors

Being sexually abused does not define your sexuality, make you weak, or an abuser – these are stigmas. Equally, if you have been abused in your past and you are not a heterosexual male or you have abused someone else in your life – this does not make you a bad person nor does it make you undeserving of help.

For men, there is an added layer of challenges in approaching the topic of sexual abuse due to societal pressures and toxic masculinity. Fears about opening up commonly lay in the fear of judgement. In my private practice I have experienced men who fear their trauma will be ‘too much’ for me to cope with, feared that I would think they are a perpetrator due to the statistics that exist, or who had concerns about how I would respond to the things they are ashamed of. By building trust and a strong therapeutic relationship, we were able to explore these fears in a way that helped them understand where they came from. This made those once-overwhelming sensations feel more manageable.

It is important to know that therapists are trained to approach trauma with empathy and understanding, not judgement. Childhood sexual abuse has a mental, physical and emotional impact and is psychologically impossible for a child to make sense of at the time of the abuse. The trauma of this experience leaves a lasting impact on the psyche and takes away from the victim's childhood as it forces them to contend with something of an adult nature that is very confusing.

So, what can you expect from therapy?

The simple answer is – a journey. With a traumatic history of being sexually abused as a child, there is likely to be a lot to work through. You can expect your therapist to work to get to know you in the initial sessions and to build rapport with you while also gathering background information that will be helpful to their understanding of your past and present. Additionally, there are likely to be challenges that you are facing in the present as well that will deserve and demand attention, so you can rest assured that not every minute of every session is going to be centred around this one traumatic event.

Some therapy methods that you might consider as a male victim of childhood sexual abuse are:

·      EMDR (Eye Movement Desensitisation and Reprocessing) – useful for PTSD and when talking therapy isn’t enough. Trauma processing can start as early as 48-hours after EMDR.

·      Somatic Experiencing – an approach that focuses on the body

·      Psychodynamic therapy – looks at the unconscious patterns developed in childhood

·      Trauma Focused Cognitive Behavioural Therapy (TF-CBT) – looks at reframing negative thought patterns and beliefs shaped by abuse/trauma

Each practitioner is going to have their own unique way of working and it is becoming more common in therapy practice to integrate elements of different theories and interventions to help clients work through their challenges. Ultimately, the therapeutic relationship and your ability to feel comfortable opening up is what is going to allow ‘the work’ to take place. Men who have reported feelings of discomfort with professionals when seeking help due to their CSA note this as a barrier to their treatment and ability to speak about the abuse [source]

 The above list consists of just a few types of therapy, but there are many other approaches, and I would recommend looking into what you think is suitable for your needs. Speaking generally, you can expect a trauma-informed therapist to pace the work and be careful not to overwhelm you or cause significant distress. As an integrative practitioner myself, I lean on multiple approaches (such as those listed above) to tailor the therapy to my clients' needs in a way that is fluid and gives space for growth and change within the therapy process. You are a whole person with a whole life story – you are not the trauma you carry so, I believe therapy should engage with all the parts of you and your life experiences. This is especially important due to the way trauma tends to impact our way of being which can affect our thoughts, behaviour, identity, relationships, etc. All of which deserve space in the therapy room.

Healing is possible

If you have never spoken to anyone about experiencing childhood sexual abuse, you probably feel quite isolated; however, you are not alone. You are not your trauma, and you can heal from the negative experiences you’ve had. It is not a linear process and there will be ups and downs, but there is so much value in having a dedicated space where you can be liberated of the burden of feeling like you can’t speak about something. Therapy is the space where you can speak about anything and everything.

Articles of Reference:

Kate, M. A., Jamieson, G., & Middleton, W. (2021). Childhood sexual, emotional, and physical abuse as predictors of dissociation in adulthood. Journal of child sexual abuse, 30(8), 953-976.

Rapsey, C., Campbell, A., Clearwater, K., & Patterson, T. (2020). Listening to the therapeutic needs of male survivors of childhood sexual abuse. Journal of interpersonal violence, 35(9-10), 2033-2054.