The heterogeneity of men's experiences, coping and traumatic growth
“The scars are still there, but I am no longer living in constant pain”
As has been discussed, there is no prescribed way that people are impacted by sexual abuse or assault. Every boy and girl, man and woman is different. Whilst we know that sexual abuse or sexual assault has profound and ongoing effects on people's lives, we also know that getting on, developing healthy supportive relationships and making a positive contribution is possible.
Methods of coping
“I buried it [the sexual abuse]. Every time it reared its ugly head I buried it. I put more trash on top of it [violence and drugs] and stomped it down and buried it” (Participant E1, 32 years old).
The development of an effective trauma informed response to men sexually abused in childhood requires not just an understanding of common impacts, but also what ways of coping are typically adopted by men and what coping strategies are 'unproductive' and 'productive' in the long term. As the above quote highlights, some coping strategies might be effective for some people for a while, however, they can outlive their usefulness. In highlighting what coping strategies are most effective in enhancing men's long term coping and well-being, it is useful to have an awareness of what are men’s preferred ways of coping.
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In presenting 'coping strategies' in terms of 'unproductive and productive', it should be noted that some people prefer the terms 'adaptive and maladaptive', in recognition that some strategies can be both adaptive or maladaptive, or both at the same or different times.
For men who have experienced childhood sexual abuse or sexual assault, unproductive coping strategies centre on behaviours that reinforce avoidance of trauma related thoughts, feelings and memories. In an attempt to regain control, avoid re-experiencing the trauma and suppress strong emotions, men often adopt strategies that will allow them to push on through in life.
Identified unproductive coping strategies utilised by men:
- Acceptance that this is my lot in life (O'Leary & Gould, 2010).
It is interesting to note that, whilst the above coping strategies are identified by research as unproductive in terms of men's long term mental health, the very same coping strategies are identified as preferred by men who have been sexually abused.
Men's 'preferred' coping strategies:
- Substance Abuse.
Men's 'least preferred' coping strategies:
- Seeking emotional and social support.
It is also interesting to note that, whilst 'seeking social and emotional support' is one of the least preferred coping strategies, 'seeking support' is also identified as contributing to improved coping and overall well-being of men sexually abused in childhood. This highlights the importance of actively reaching out, addressing barriers and creating pathways to enhance men's seeking support.
The below behaviours have been identified to be associated with productive coping and enhanced well-being for men who have been sexually abused in childhood.
- Accessing information and resources that assist in reducing a sense of isolation and self-blame.
- Seeking practical assistance and developing concrete life skills aimed at addressing the impact of the sexual abuse, e.g. learning to tolerate emotional distress and regulate trauma-related symptoms.
- Talking with a supportive person — worker, counsellor, partner, friend.
- Talking with someone who has experienced a similar event. Plus, actively supporting and helping others (Groups).
- Developing sense of hope, positive re-interpretation and growth. Practicing optimism and self compassion, viewing survival and life accomplishments in a positive manner (O'Leary and Gould, 2010; Grossman, Cook, Kepkep, & Koenen, 1999; Wolin and Wolin, 1993).
O'Leary & Gould (2010). Exploring coping factors amongst men who were sexually abused in childhood.
Post traumatic growth
Emerging research literature about post traumatic growth suggests that, for some people, a range of post traumatic outcomes may occur as part of the sequelue of having been sexually abused. Some men express the possibilities that there is hope, and that alongside the pain and losses, there may have been some valuable by-products of even the worst of traumas. For example, in an Australian research study with men and women who have experienced childhood sexual abuse, one man reflected that having worked through his experiences, he said:
“I feel a greater sense of freedom, I’m looking forward to life and thinking of the future [man #9]” (Pathways to Peace, 2014).
The conceptual foundations and empirical evidence of post traumatic growth were explored in an article by Tedeschi and Calhoun (2004). They emphasised that post traumatic growth is differentiated from resilience, hardiness, optimism, and a sense of coherence (Tedeschi & Calhoun, 2009). What distinguishes post traumatic growth is summed up as follows:
“Posttraumatic growth describes the experience of individuals whose development, at least in some areas has surpassed what was present before the struggle with crises occurred. The individual has not only survived, but has experienced changes that are viewed as important, and that go beyond what was the previous status quo. Post traumatic growth is not simply a return to baseline — it is an experience of improvement that for some persons is deeply profound” (Tedeschi & Calhoun, 2009, p. 4).
Tedeschi and Calhoun (2009) considered the concept of post traumatic growth in the light of published literature about a range of traumatic circumstances. These included trauma, crisis, and highly stressful events. It is notable that most references are made to post traumatic growth after life threatening health incidents as well as accidents, disasters, combat, refugee experiences and being taken hostage. However, Tedeschi and Calhoun (2009) also included the literature on childhood sexual abuse and sexual assault. After considering this research literature, they concluded that it appears that the phenomenon of post traumatic growth occurs in a wide range of traumatic circumstances (Tedeschi & Calhoun, 2004).
Critical points and triggers in responding to the effects of sexual abuse
Experiences of post traumatic growth are not necessarily fixed or static. For a period of time, there may be a profound sense of post traumatic growth; and then there may be periods of distress. Distress does not negate any sense of post traumatic growth, but can coexist and be a further stimulus for change.
Men who have been sexually abused report:
- Stressful life events generally can trigger traumatic effects or be prompts for change (Easton, 2012).
- Point of arrest or incarceration (Johnson et al., 2005). This may especially be exacerbated by prison procedures and processes such as body searches (Meade & Steiner, 2013).
- Medical procedures (Felitti & Anda, 2010; Gallo-Silver, Anderson, & Romo, 2014), especially invasive such as a colonoscopy or prostrate screening (Felitti & Anda, 2010; Cour, Robain, Claudon, Chartier-Kästler, 2013; Teram, Stalker, Hovey, Schachter, & Lasiuk. 2006).
- The invasive nature of dental procedures can be a trigger (Dougall & Fiske, 2009).
- Fatherhood (Price-Robertson, 2012) and infertility (Bartlam & Woolfe, 1998) can re-traumatise survivors.
- Both committing to a relationship and breaking up an established intimate relationship can be a source for re-traumatisation (Easton, 2013; Katz et al., 2015 ).
The Royal Commission Final Report - Trigger Events
“When asked about the short- and long-term effects of child sexual abuse during the case study on Catholic Church authorities in Ballarat, Dr Quadrio gave evidence that:
“‘about 20 to 40 per cent of children who have been abused won’t show any symptoms at all, and that’s because some of them are what we describe as ‘resilient’: children who somehow survive trauma … But some of those apparently non-symptomatic children become symptomatic later on. That’s called the sleeper effect: that they look fine at the time and then some years later something else triggers it.’”
“Mr Troy Quagliata, giving evidence in Case Study 39: The response of certain football (soccer), cricket and tennis organisations to allegations of child sexual abuse, told us his trauma was triggered by the sight of a brown handkerchief because the perpetrator would use one when with his victims. He said the sight of a brown handkerchief continued to make him freeze and would ‘put me back to when I was 12 – when I was 13, 14, 15 and those dates’. He would then go on to re-live what had happened, waking up with cold sweats and night terrors.”
The burden of effects can create a crisis that can become a turning point in more productive coping. For example, in a clinical population study of men sexually abused in childhood, positive reinterpretation and practical social supports were coping strategies associated with better psychological functioning (O'Leary, 2009). The Royal Commission final report found that addressing related impacts may lead to those who have experienced childhood sexual abuse making connections between the impacts, and their experiences of childhood sexual abuse :
“Some victims do not make connections until later in life between their experiences of child sexual abuse and issues they go on to deal with, including addiction, relationship breakdown and mental health issues. It is only when they seek help from support services, for example drug and alcohol services, or experience other significant life events, for example incarceration, that they start to question the source of their difficulties.” - p. 27, Royal Commission Final Report, Vol. 3: Impacts
Critical role of disclosure across the life course
Adult disclosure of past child sexual abuse is a critical time, it can lead to further negative impacts on men's lives and relationships, or provide an opportunity to address effects (Easton, 2014). Disclosure of sexual abuse and its effects is not a one off in men's lives — it is repeated as the moves the life curse and forms new relationships or insights (O'Leary & Barber, 2008). Each conversation can provide a trigger for further trauma or distress, but also might be an opportunity for validation and build growth. This is highlighted by Tener and Murphy (2015, p. 392).
“Whether to disclose or not must be faced each time the adult meets a new situation. Each new social system — formal or informal — and each new relationship — short or long term — necessitates the decision.”
In the time immediately following a disclosure, men's risk to suicidal ideation can increase (O'Leary & Gould, 2009; O’Leary, 1998). It can also result in a positive turning point in seeking assistance and support (Easton, 2014; O'Leary, 2008).
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