Foundations: Session #3 Challenges men face

Structure

1	Housekeeping, announcements, & check In	15 min
2	Module content Challenges men face Masculinity & manhood	45 min
3	Break	15 min
4	Module content Barriers to disclosure Confronting myths and barriers men face in naming sexual abuse as adults	45 min
5	Wrap up: Check out	15 min

Resources & materials

Name tags.
Notepads & pens.
Whiteboard markers.
Refreshments.
Handouts.

Check In

Remind the group of the weekly arrival procedures: name tags, welcome to refreshments, cell phones off, etc.

Introduce session focus

Checking in

Note: whilst check in is an opportunity to reflect on content covered and learning experienced, it is also an opportunity to check in regarding current well-being, part of which is noticing how you are feeling. In this session, we are looking at some of the expectations about 'being a man', how these shape men's lives, and different ways men manage these expectations. We aware that, although we know men experience a variety of feelings, feelings are not something men talk about much. The group program is an opportunity to name and talk about feelings (something we are looking to cover in more detail in session/week 5).

Invite the men to include in this week's check-in, a word or two on how they are current feelings. It is useful to mention upfront that words such as 'good', 'okay', 'fine', or 'better,' are not feeling states, but evaluations of feelings. To support the identification of different feelings, it can be useful to write on a whiteboard/paper four core feeling states, with an option for participants to add to the list a feeling that they are aware of:

Mad.
Sad.
Glad.
Anxious.

Participants may elaborate on how they are currently feeling (and facilitators may ask for expansion on difficult feelings or unclear statements), however the go-around should be brief. Facilitators are to be sensitive to containing extended discussions of events that occurred during the previous week (taking the time to acknowledge the significance of particular events for individual participants, and foregrounding the value of returning to this reflection when it fits with focused group discussion/identified session content).

Module content 1: Challenges men face

This section deals with the idea of 'acting like a man', and how this affects men dealing with past child sexual abuse trauma.

Presentation: Acting like men

Every man has their own experiences and beliefs about what it means to be a man. Gender is a significant part of personal identity, along with a range of other things that 'make up' our sense of who we are: Cultural background, physical ability/disability, sexual preferences, religion, family, where we live...

This exercise examines the gendered expectations men learn to live with and negotiate in their everyday lives. In growing up, men would have been introduced to a set of expectations and ideas as to 'what makes a man' and how a man 'should be and behave' in the world. Whether we buy into particular expectations and ideas, they shape our world, how we and others act and behave, how we make sense of ourselves and others, the ways in which we express ourselves in different contexts, and how we feel about that. Many men may not have had an opportunity to pause and consider how ideas about 'what makes a man' and how a man 'should be and behave' in the world has been, and is, shaping of their lives.

Act like a man

Place on the floor a large piece of butchers/craft/flip chart paper big enough for a man to lay upon and be drawn around to create a generic outline of 'a man' (typically this involves sticking 4 pieces of paper together). Facilitators can volunteer for this, or a participant might be invited to do so – clearly outlining what the process involves prior to asking for the volunteer. An alternative for this exercise is to use a white board to write upon, though the creation of a physical outline of a man is preferred.
Invite the group to write any words, phrases or expectations that they associate with:

acting like a man;
looking like a man; and
being a man.

Specifically, invite the men to include what they saw or heard in growing up as a child in the 1950s, 60s, 70s, 80s, 90s. Instruct the group not to hold back, and that they don’t have to agree or disagree with these ideas. The purpose of the exercise is to name expectations of how a man is meant to act, look, be. It is ok to put down the stereotypes, to be non politically correct.

Support the exercise by using prompt questions such as:

How is a man meant to act?
What do you remember seeing and hearing as you were growing up in your family/in your neighbourhood, in your community, at your school/in the playground
What roles did men play on television, in films or books? How did they express themselves?
Who were the 'iconic male figures/real men' in films? John Wayne, James Bond, Clint Eastwood, Sylvester Stallone, Arnold Schwarzenneger, etc.
What sort of jobs do men have? What is a man’s job?
What recreational activities do men engage in and enjoy?
What sports do men play? What is a man's sport?
Does a man drink alcohol? What is a man's drink?
What if a man does not drink alcohol or cannot hold his drink?
What cars do men drive?
What clothes do real men wear? What is a man's colour?
What should men's bodies look like? What roles and responsibilities does a man have in the family?
What jobs should they do around the home - inside the home/outside the home? What pet would a man have? Cat/dog? What type of dog?
What are the feelings and emotions a man expresses?
What are the ways men should think about love and romance?
Are men meant to be interested in sex, when, with whom? Is sex something they are meant to be interested in and good at?

Part of building a picture of how a man is meant to be and to act involves noting and documenting how a man is not mean to be or act. It can be useful therefore to note:

What is not considered manly? What if he does not act in a manly way?
What behaviour, ways of being, and relating is associated with 'being a woman'?

Module 2: Masculinity and manhood

Facilitate discussion

How was the previous exercise?
What comes to mind in looking at that these suggested masculine norms?
- What impact do this 'masculine ideal' have on men’s lives?
- What are the costs or repercussions if you don’t abide by these rules?

In presenting this information, there is no suggestion that these ways of being men are bad or not useful. We are not wishing to take away from the men ways of being men that have been valuable. The group, and this exercise, is about making visible what the men live with, and what they have to negotiate as men; it is about recognising this whilst working to expand capacity and knowledge, and increasing their repertoire of skills.

What are the valuable attributes and skills here that it is good to have in your toolbox?
How did you learn these 'masculine ideals'?
Do you sometimes find yourself wondering about these expectations, and whether they really suit you or those around you?
How does this code impact on the way you act, look and are? On what you can and can’t do? On what you can and can’t say?
How do these ideas influence friendships and intimate relationships?
What would it be like if you lived by this code 24/7?
Are these 'masculine ideals' realistic?
If these are the conditions of being a man, what happens if a man doesn't fit the code?
How do men feel when they compare themselves to these ideals of manhood?
What 'labels' are placed on men who step outside this or don’t fit this designated masculine code?

It is useful to acknowledge the multiple contextual factors that shape men's lives, and influence the men’s personal and relational health and well being.
Utilise 'Participant resources: Men and emotions' to highlight some of the masculine norms which influence behaviour of men, including:

Strong and powerful – physically and mentally.
Masculinity as instinctual/biological – not trying, just are.
Self-reliant.
In control.
Rational, logical.
Emotional control (not showing emotions other than anger).
Risk takers.
Hard working – Work primary identity.
Pursuit of status.
Able to cope with anything that is thrown at him.
Heterosexual – the doers and instigators of sexual acts (always interested and ready for sex).
Not vulnerable, not a victim.

It is useful to look at and explore differences and contradictions - the different expectations in different cultures, or between city and country. The contradiction of being a man as having a six pack and being a man as having beer gut.

It is useful to look at whether expectations are changing. Are they different now from when the men were growing up? Acknowledge the idea of the new age man, metrosexual, and the increased role of men in parenting and caring.

Include in this change conversation, noting what Katz calls the ratchetting up and amplification of masculinity, becoming bigger stronger, tougher, (WWF). Note change in Star Wars dolls. See 2:45 Mins 'Upping the Ante' grab from Tough Guise Video on YouTube:

Men’s help seeking

Review how this masculine code impacts on men's 'help seeking'.

Optional activities

Short video 'The mask we live in'.
Short videos emphasising how young men feel pressured to 'be a man', to 'man up'.
Short Ted Video 'Be a Man'.

Living with a Black Dog

Image from Living with a Black Dog by Matthew & Ainsley Johnstone

It is useful to acknowledge the multiple contextual factors that shape men's lives, and that influence the men's personal and relational health and help seeking.

Please refer to handout in the Participant workbook.

Men’s difficulties and help seeking sits within a culture where:

Lower knowledge and awareness of health issues.
Less likely to access GP, health care practitioners.
Lower mental health literacy.
Poorer diet and nutrition.
Higher consumption of alcohol and illicit drugs.
Greater use of tobacco.
Increased negative impact of unemployment.
Higher likelihood of being a victim of assault, robbery, and homicide.
Higher likelihood of perpetrating violence.
Higher likelihood of committing suicide.

This exercise challenges and reconfigures the sense of failure men can experience in not measuring up to the masculine ideal, as not the problem of the individual man, but a problem of limited cultural constructions of masculinity. Making explicit, and unpacking the 'straight jacket' of limited masculine norms, assists men to put aside self judgement, and to be able to speak about 'being abused' and 'not coping'.

One of the values of presenting men's health information, and how 'masculine norms' shape men's lives and help seeking, is that it means making change and improving well-being is not solely centred on resolving the legacy of sexual abuse. It highlights how difficulties that men face, and their reluctance in accessing support, is very much shaped by growing up and living in our culture as 'a man'. Making this explicit is useful.

This exercise of 're-viewing' the ways masculine norms have shaped the man's life is also a useful process exercise for the group. It offers an experience of men working through something they have known all their adult life, but not seen in this way before. It prepares the ground for discussions in the next few weeks, for 're-viewing' the experience of abuse through adult eyes, where the events may not change, but the meaning making around them, and the impacts on our sense of self and life, may.
On wrapping up, it can be useful to note again how masculinity, and men’s health and well-being, is shaped by culture (Katz), access to information, resources, and support, and hence opportunities for men to make changes in their lives.

A fifteen minute break is held following this module.

Module content 3: Barriers to disclosure

This module looks at the barriers men might face in disclosing childhood sexual abuse.

Refresher activity: Time2Breathe

Utilise the Time2Breathe function in the Living Well app to encourage group participants to calm, settle, and refocus their attention following the break. The exercise is designed to assist participants to adjust the number of breaths or beats per minute, and can be used by the men outside of group work.

Using a smart device that allows a speaker attachment or a loudspeaker function, play the Time2Breathe function to the group for 5 minutes. Alternatively facilitators may wish to verbally guide participates through the exercise.

Barriers to disclosure

Welcome back.

Presentation: Masculinity & manhood – Specific challenges for male survivors

Acknowledge the social pressures men who have been sexually abused face when confronted by expectations to 'be a man': deal with problems alone, always be in control, express only a limited range of emotions, and never admit any vulnerability. The difficulty with these expectations ‘to be a man’ is that they can lead to men isolating themselves, becoming reluctant to talk about what is going on for them, and/or becoming overly self critical.

Acknowledge that each man who has been sexually abused is confronted by, and has to find a way to navigate and manage, this expectation to live according to masculine norms (underlining that the key code word for mascunility may well be 'invulnerability').

Option: Male code - Pathways

Introduce the 'Pathways: The male code' handout. Work through the different expectations of what men 'should' be according to the 'Male code'; Rugged individual; Big man; Give 'em hell, No sissy stuff, and 'Pathways' of responding. For some men who have been sexually abused, being confronted by dominant ideas of what a man should be means resigning to live a small life, for some men it involves a life of struggle, for some men it involves engaging in and embodying hyper masculinity, for some men it involves moving between these different responses, and for others it means finding new or different pathways.

The 'Pathways: Optional discussion' resource can be found in Facilitator resources.

Discussion

Invite participant’s to reflect, consider, and discuss how elements of the masculine code expectations might influence, or not, participants in this men's group:

If we were to act only according to these masculine ideals, what would it be like in this group?
Are there bits of the masculine code we want to hold onto and foreground? Ideas of 'mateship', of being there and helping out friends, or taking responsibility for self.
If the script for being a man involves not acknowledging vulnerability, would we acknowledge that we had been sexually abused?
Would we be here? Would we talk about how we were feeling?
Would we talk about struggles and not coping?

Module content 4: Confronting myths and barriers men face

Emphasis here is on myths and barriers that men confront as 'adults'. Noting that next session/week to look carefully at the barriers and difficulties that the men confronted in speaking about sexual abuse as children.

Facilitators to present initial information and facilitate discussion.

“One of the things we will be doing throughout the group is examining some of the unhelpful ideas and mis-information you have probably encountered about men and sexual abuse. We are only now beginning to develop a picture of the extent of the problem, and the difficulties men can confront in coming forward to access support.”

One unhelpful idea you may have heard is that:

'Males cannot be sexually abused or victimised'- Obviously this is not true or we wouldn’t be here! Males, like females, can be sexually abused or sexually assaulted. Current research suggests that between 1 in 6 and 1 in 10 boys are subjected to some form of sexual abuse in childhood.

Evidence suggest that, compared to females, males are particularly reluctant to acknowledge and talk about being sexually abused. We now know that:

Boys are less likely than girls to disclose sexual abuse at the time it was occurring, with a majority choosing not to tell anyone (Paine and Hansen, 2002; O'Leary and Barber, 2008; Holmes and Slap, 1998).
Men typically disclose being sexually abused in childhood 10 years later than women – on average 22 years after the assault (O'Leary and Barber, 2008; O'Leary and Gould, 2009).
Men report first in depth discussion 28 years after the sexual abuse, and first helpful in depth discussion 30 years after the abuse. (Easton 2012).
Men are more likely than women to make a selective disclosure (Hunter, 2011).

Discussion

What are the men's comments/thoughts on hearing this information? General questions to invite men to share their understanding and questions without requiring personal disclosure.

What makes it difficult as an 'adult' for men to speak about being sexual abused as a child?
What are some of the barriers to disclosure that men face?
What influences men’s decision to speak or not about sexual abuse?

Note: the next session focuses on looking more carefully at some of the barriers to disclosure, and difficulties that confront children/boys, whereas the focus here is on sourcing the men’s knowledge and experience as adults.

Open up discussion and introduce information detailing common barriers to disclosure. Utilise/introduce the Living Well posters.

Confusion, guilt, fear, shame, embarrassment. Mistrust of others, Identifying the experience as sexual abuse. Concern that he won't be believed.
Restrictive ideas of manhood. Concern that he will be judged as a man. Not being believed because people think that males can't be sexually abused against their will.
Not wanting to open the can of worms. Fear of losing control as a man, and becoming overwhelmed by emotions (or sense of shame).
Concern that people won't believe you because it was a woman, and young men are meant to feel 'lucky' if they have sex with a woman.
Fragmented or limited memory.
What’s the point, you can’t change what happened.
Questioning of his sexuality. Fear of being labelled gay, or that he might be gay and be concerned he won’t be believed and discriminated against.
Suggestions he might become a perpetrator.
Not wanting to put this shit on anyone. Just wanting to stuff it down, put a lid on it, and never think about it or talk about it again.
Not knowing where to go. Lack of identified support, services, community awareness. Not sure who to tell.

Facilitators to identify appropriate time to support extended discussion amongst group participants, in relation to what barriers to disclosure they have confronted, and what may have assisted them in overcoming these barriers.

Myths and male sexual victimisation

It is important for facilitators to take time to carefully examine and pick apart common 'myths' (perhaps better described as cultural delusions) that significantly impact on men speaking about histories of child sexual abuse or sexual assault. This will require facilitators to be aware of the latest research and practice evidence and informed about how these myths influence, operate, and impact on the lives of men who have been sexually victimised, and the people they live and work with (particularly those relating to sexuality and ‘victim to offender’ prescriptions).
Further information can be accessed on the Living Well site: Unhelpful myths about the sexual assault of men.

These 'myths' are presented at this time for two purposes: to provide further, more detailed information on the particular topic, and to explore how deeply these thoughts have been held – or are still currently are being held – and have shaped the lives of the participants. This may be the first opportunity participants have had to examine in detail, and free themselves from the constraints of, these taken for granted cultural misconceptions. Care needs to be taken to present information in a way that makes it understandable that men have 'accepted' and lived by these 'cultural misconceptions', not in a way that evokes a sense of embarrassment or shame amongst the participants.

This discussion requires facilitators to possess a comprehensive knowledge and understanding of the common myths, and how they can influence and delimit men’s lives. This discussion is an ideal opportunity to provide information, and to deal with misconceptions, relating to questions of 'sexuality' and the 'victim to offender cycle'.

Masculinity and the fight, flight, freeze response

'Myth'- If a male has 'allowed' abuse, then he is weak.

Factual references:

This myth is anchored in the male code – that men are in essence 'invulnerable', so any man who 'chooses' to experience this is a non-man.
The statement also blames the victim, by ignoring the responsibility of the offender.

'Myth' - Boys/youth can always say no to abuse if violence is not used. If they didn’t, then they must have wanted the abuse to occur. If a male did not fight or try to run away, he wanted it.

Factual references:

This statement is victim–blaming and ignores the power differentials between adults and children.
It also ignores the biological evidence of 'freezing', or tonic immobility, that many victims experience.

Facilitators should emphasise that in the context of these ideas, it is not surprising that many men understand themselves as 'weak', or that they 'should' have stopped the abuse. These were the 'intellectual tools' for making sense of it that were available to them at the time. We could add here that children’s way of understanding things that happen to them is developmentally self-focused- i.e. 'if something bad happens to me it is because I am bad'. This belief can become crystallised over time if there is no alternative understanding offered.

Discuss common human reactions to danger. The ordinary human response to danger is a complex, integrated system of reactions, encompassing both body and mind. The threat initially:

Arouses the sympathetic nervous system.
Skews one’s attentions on the immediate situation.
Evokes intense feeling of fear and anger.

The person’s reaction becomes overwhelmed and disorganised. Each component tends to persist in an altered and exaggerated state for a long time.

Reactions to danger are 'interpreted' by the victim, yet people are biologically wired to react in three particular ways:

Fight
Flight
Freeze (another name for this is tonic immobility)

As with most animals, the response of freezing is most of interest here. Pull examples from the participants of examples of freezing in the animal kingdom (e.g., deer 'frozen' in the headlights of a car). Suggest that freezing is the most common response of all animals, particularly smaller or younger animals.

Now revisit this conceptualisation, paying attention to the cognitive understanding of the abused child in terms of their perception of the events. Outline for the men that there is a profound shift in how they may have understood their behaviour during the abuse:

Fight – 'didn’t want it'
Flight – 'didn’t want it'
Freeze (tonic immobility) – 'must have wanted it'

Open up this awareness for discussion with the participants:

How do ideas about masculinity shape understanding of these reactions to the abuse?
How does this knowledge of these different physiological responses to traumatic events shape or reconfigure your understanding in the present?

Invite the men to speak about the specific barriers and difficulties they personally have confronted in speaking about sexual abuse.

What has influenced your decision to speak or not about sexual abuse?
What has been the impact on you and your relationships of speaking or not speaking about sexual abuse?
What helped you to name the sexual abuse and seek help?
In what ways have you stood up or challenged myths or misconceptions about men and sexual abuse?

Common reasons or events that promote men's disclosure and talking about sexual abuse.

Seeing a news, TV, film, social media, paper article about abuse, or hearing a public discussion about abuse, e.g. The Royal Commission into Institutional Responses to Child Sexual Abuse.
Disclosure of a friend, partner, or other family member.
Disclosure by member of a men's group.
Seeing the person who perpetrated the assault again.
Having a child of their own.
Having a child of their own turn the age they were when they were assaulted.
Fear of perpetrating against children.
When a partner insists that for a relationship to survive they must see a counsellor.
When a relationship fails or breaks down.
The Royal Commission or other public inquiry into sexual assault.
To support others.
Because the time is right.
When the police are prosecuting a perpetrator, and they need corroborating testimony.
Reliving the assault through flashbacks, nightmares etc., and wanting to do something about it.
Physical or health problems.
When a man feels he must deal with it or die!

There are many reasons that a man may choose to tell someone he has been sexually abused. After talking with someone, he might become worried or concerned that he shouldn't tell, or wish he had not told, believing that people will judge him or not be supportive into the future. A decision to tell someone, or to seek help, does not mean you have to tell anyone else. Discussion in week 7 regarding 'Deciding to tell'.

Wrap up: Check out

Review: Processes/content covered/reflections

Mindfulness, relaxation, or grounding exercise

Depending on the needs of the group, the following options for grounding may be beneficial prior to closing the group:

Body Scan (Living Well app).
Muscle Tension Release (Living Well app).

Provision of handout or resources

Group feedback/evaluation

Introduce upcoming session content

The focus of the next session is to look at the silence and secrecy around child sexual abuse, and its impact on men's lives in the past and present. It is about looking at how silence and secrecy operates, and how those who have been abused can be recruited into silence and secrecy, and subsequently left struggling with self blame, guilt, and shame.