April is the month for awareness of sexual abuse. While our society is well aware of female victims, male victims of sexual violence are often forgotten or ignored due to shame and stigma. In fact, it may surprise some people to learn that 1 in 6 children is sexually abused before the age of 18. numbers. A large, crowded college football stadium with 100,000 seats. If the audience is exclusively male, this means that at least 25,000 men have been or will be sexually assaulted. The numbers are amazing.
The public and some health care providers may hear the words men and sexual assault and automatically assume that the perpetrators are men. Either way, it is difficult to understand how men are perceived as victims of sexual violence. The truth is that most men find it difficult to see the victim or the attacker. This is one reason why we encourage the men we work with to see themselves as survivors – a small but significant change in language associated with sustainability and empowerment.
“Bill” 45 years old. He has been married for 20 years and has a wife and two children. Bill reports that he and his wife are no longer emotionally intimate and find it difficult to talk, love and often find themselves in different parts of the world when his wife talks to him. Bill works as a retail overseer; He found it difficult to keep a job for more than a year, often due to tantrums and uncontrolled irritability.
When asked directly if he had any traumatic experiences in his life, he replied that nothing had happened. To answer additional questions He noted that some “joke” happened when he was 14 when his neighbors touched him inappropriately.
Why and why is it so difficult for men to recognize and recognize the presence of this type of trauma and related mental problems, and how can we help them?
Although traumatic events are fairly common in the general population, most people do not have adverse long-term health consequences. However, there is a higher frequency of mental health problems associated with some traumatic events. Compared to other traumatic experiences, sexual trauma has a major problem. The likelihood of negative consequences of sexual assault is much higher than most other traumatic events. People who have experienced sexual assault or abuse are at greater risk of medical, psychological, behavioral and sexual disorders.
Men who have experienced sexual harassment and abuse may have very prominent mental symptoms that are not easily captured in a psychiatric diagnosis. For example, men who have been sexually assaulted often experience intense anger. It never leaves them, but it especially happens when they feel threatened or betrayed. Another example is sexual performance difficulties, such as decreased libido or erection problems, which not only affect self-esteem and sense of masculinity, but also interfere with intimate relationships. They may also feel unable to give or feel love or happiness, effects that resonate in all aspects of their lives.
Men who have been sexually assaulted may be concerned about their masculinity as well as their sexual orientation; They fight intensely with shame and guilt. 3 They are less likely to report sexual abuse, identify experiences they have had as abusive, and seek formal support or treatment for such experiences. 4-6
Boys and men are socialized. Consider yourself strong, tenacious and self-sufficient. Recognizing emotions and revealing weaknesses is in some ways the opposite of traditional male roles. Men also often wear thick coats of shame when they accept guilt. When they disclose information, they are often greeted with distrust, such as: “That’s impossible. A man cannot be raped.” They are met with devaluation and victim-blaming, such as “How do you let this happen?”
All kinds of myths about male rape cause delays in seeking treatment and perpetuate stigma (Table 1 ). Stigmatization concerns are the most significant barrier to mental health services for trauma survivors. shame and rejection low knowledge of mental health Lack of knowledge and doubts about treatment fear of negative social impacts and limited resources7 survivor Typically, the history of sexual abuse and rape is not published for 20 to 25 years.8 They may deny, diminish or see a link between sexual abuse abuse and subsequent mental health problems. Sometimes they differ and do not draw or remember completely what happened.
Since many patients may not be completely honest in their stories, they should always be asked if they have experienced traumatic events, including sexual abuse. It is also important to provide validation of the occurrence of the experience and to help the patient understand the connection between the trauma and the difficulties that arise from it.
It is important that male survivors are offered a safe place where they can be trusted and accepted. Many of the surviving men we have worked with over the years tell us that having someone who listens and does not question the validity of their story is essential to their recovery.
The therapeutic alliance predicts or is associated with reduction of various symptoms. However, having a careful, caring, and non-judgmental therapist is not enough. A mental health practitioner who deals with male sexual abuse must have the knowledge and skills to understand and help patients who are victims of abuse. Some well-meaning service providers may e.g.
While this can be upsetting to the patient, it is helpful to work through the narrative of the trauma in a process-oriented or more formal way, depending on the exposure. Many patients tell us that the more they talk about it, the less they are affected by the violence. These discussions of traumatic events, including the details, no matter how obvious, may allow survivors to understand and process what happened.
We also worked with male survivors who told us that their therapist seemed inappropriate to the voyeurist, wanted explicit details about the abuse, and seemed eager and eager to find out more, who seemed to have been abused again. Others have told us stories of therapists who are upset or in pain or unable to listen to patients’ stories, all with shame and silence.