Holding Male Survivors of Sexual Abuse in Mind
There has been a huge shift in public consciousness recently when it comes to the scale of sexual violation endured by women at the hands of men. But what about those men and boys who are themselves survivors of sexual abuse? Sarah Van Gogh, author of a recent book on this subject, has seen the impact of such experiences on those men that do find their way to therapy – and suspects far more male survivors remain overlooked and unsupported in their shame and despair.
Most suicides in the UK are male. ‘Of the 6,188 suicides registered in the UK in 2015, three quarters were males’ (Phil Mitchell, ‘Boys Can Be Victims Too', TherapyToday 28 (8), 2017).
It is, sadly, not very difficult to make the connection between male suicide and the sexual violation of men. There are few experiences more calculated to leave a male individual with a sense of being shamed, in another’s power, and humiliated than that of sexual violation. And this shame seems to strike most acutely at the heart of many males, in terms of what they can bear. In his seminal work on therapy with male survivors (Psychotherapy with Male Survivors, Karnac, 2016), Alan Corbett highlights the marked difference between the risk of suicide between girls who have been sexually abused and boys who have been: ‘Girls who have been abused have a threefold increase risk of suicidal thoughts and plans, compared to non abused girls. Boys who have been sexually abused have a ten-fold increase for suicidal plans and threats and a fifteen-fold increased risk for suicide attempts, compared to non abused boys’.
I have lost count of the number of tragic times I have sat opposite male clients who, having disclosed that they have experienced sexual abuse as an adult or child, then speak of the wish to be dead. This is often expressed in a low tone of voice, with little apparent affect. With their eyes on the ground and their hands clasped or clenched into fists, so many men have told me something along the lines of, “It would have been better if he/she/they had killed me. I wished they had. Then at least this would be over. I’d rather be dead than go on like this”.
These are, of course, sobering, distressing statements to hear. But they are also, paradoxically, usually a sign of hope: a sign that the man uttering them is beginning to trust that there might be a point in giving voice to the overwhelmingly dysregulated and traumatised state that they have been in for so long. After all, it is an old touchstone for therapists (which helps us psychologically survive the potentially paralysing feelings in the room, with a client who is bleakly talking of suicide), that it is usually a very good sign if the client can speak to us of their despair and suicidal ideation.
I am sad to say that I think there is an enormous number of boys and men in the world who are even more prone to risk of suicide than the boys and men who can access the support of therapy. There are many, many others, bearing their burden of shame, despair, self-hatred, hurt and rage, utterly alone. These boys and men either turn to behaviours that can numb out their terrible feelings, or take their own lives. My guess is that our prisons and mental health-inpatient facilities are full to the brim with male survivors; but we are sadly lacking in research in this field.
What can be done? The first step is surely an increased recognition of the fact that men and boys do experience sexual violation. Perhaps this doesn’t sound like much, but the current situation with male survivors in the UK is, perhaps, not dissimilar to the position of female survivors 30 years ago. In my adult lifetime I have seen a huge shift in public consciousness around the reality of child sexual abuse, and the seriousness with which we take the domestic abuse of women by male partners, and the rape of women by men. We are not perfect as a society on acknowledgement of the problems of and need to support female survivors; but we are ever so much better than we were in the 1970s. I do hope that we can move in the same direction for men and boys who are survivors. Therapists can play their own small part simply by holding in mind the possibility that sexual abuse may be part of any male client’s history.
But we have quite some way to go, as a society, on this. In a systematic review in the International Journal of Mental Health Nursing (‘Do adult mental health services identify child abuse and neglect? A systemic review’, 27 (1), 2017) it was revealed that only 22 per cent of people using statutory mental health services were ever asked by staff about previous experiences of abuse. Of that rather pathetically small percentage, women patients were far more likely to be asked than men.
Helping Male Survivors of Sexual Violation to Recover: Stories From Therapy, by Sarah Van Gogh, is published by Jessica Kingsley.