When I was a young psychiatrist, I worked with Vietnam veterans traumatized by what happened to them, what they had seen, and what they had done. As I treated these veterans and studied PTSD, I realized that what I was learning could apply to help women. The first rape crisis units and shelters for battered women opened in the 1970s, at which time we also began learning about the possible lasting impact of childhood sexual abuse—i.e., that panic, anxiety, depression, and other disorders could be persistent symptoms of childhood trauma.
Intrigued by the possibility that some of my adult patients might be survivors of childhood sexual abuse, I added a question about early trauma to my intake questionnaire for adults: “Have you ever been traumatized or abused — emotionally, psychologically, physically, or sexually — at any time of your life?” The answer — from both men and women — was often yes, though not necessarily the first time I asked.
Then, about thirty years ago I found myself treating eight men who had answered yes to my trauma/abuse question. Seven had been abused by men; one by a man and a woman. They were middle class, in their thirties and forties. All but one were married, most were fathers, and they all seemed to be underachievers, given their intelligence and education. Most had problems with intimacy, trust, and sexual relationships.
Each of the men had come to me for individual psychotherapy, but none for treatment of sexual abuse. In fact, about half replied ‘no’ to the abuse question when first asked, but over time no became yes. Eventually each of the eight was dealing with sexual trauma to our individual sessions; that led me to try a psychotherapy group that would focus initially on psychoeducation about abuse and trauma.
I told each man that he was one of several I was treating who had been traumatized as a child: it might be useful to share their experiences and learn what psychiatry and psychology had discovered about childhood sexual abuse and possible adult consequences. All eight agreed to join a 12 week ‘Course'.
At the first meeting I requested that there be no sarcasm. The men wondered how guys can talk without being sarcastic. I explained that the purpose of sarcasm is often to shut down an uncomfortable conversation: having such conversations and getting past the discomfort was one reason we were meeting.
The group met on Monday evenings, from 8 to 10 p.m. Each meeting began with a short presentation on research findings, followed by group comment and discussion. To prevent the men from feeling emotionally exposed and humiliated, I suggested that they report their sexual and physical experiences as brief “examples” designed to illustrate points made in the presentation. The men were requested to not ask follow-up questions that might be embarrassing to the speaker, e.g., “Don’t ask how about you felt at the time the abuse was happening.” The safety zone was needed and effective when we began, but as trust grew it became unnecessary; they wanted to share both experiences and feelings.
In our 11th week, one member said he felt that there was more to be learned, and he hoped we could go for another 12-week course. The others concurred. As we neared our 24th meeting the men again said they wanted to continue, so we decided to meet every other week, from 8 to 10 p.m., for a third 12-week course.
That was 30 years ago, and the group still meets every other Monday evening. One man moved to California, but his place was taken by another, referred by a member of the group. Two men moved to other parts of the country; they continue to participate via Skype.
The content of the group discussion has broadened over the years but always includes personal, intimate issues. We came to know about the sexual and physical traumas and stresses that each man experienced in childhood and beyond. But the frank discussions also help each other deal with everyday issues at home and work.
Martin, (not his real name) for example, initially came for individual treatment for depression, lack of self-confidence, marital issues, and career concerns. When he was first asked about sexual or other childhood traumas he said there were none — that he came from an intact religious family and felt close to his three siblings and his parents.
But a month after we began working together Martin remembered an important incident in the back of the family station wagon. The family was on a long ride to a vacation camp. Martin was about eight years old, and he and his older brother were lying in the back cargo area. His sisters were in the middle seat.
Martin’s brother groped him and kissed him on the mouth. He remembered lying there, limp and bewildered. He never told anyone until he was in therapy thirty years later, and that led to him joining the group. In the group he was able to deal with adolescent uncertainty about his sexuality, a complex sexual relationship with his wife, awkwardness as a father, and issues with men in social and professional settings.
Another member of our group, let's call him Chuck, had come for therapy because of his troubling emotional distance from his wife, and feelings of discomfort with his two young children. When interviewed about his childhood he disclosed a three-year sexual relationship with a wealthy uncle. Beginning when he was ten, he was sexually abused by his uncle on many occasions, on vacation or in the uncle’s house on weekend visits. Not until he had been in our group for a few years did he discover that his older brother had been abused by the uncle before Chuck, and that his younger brother had been abused after him. The uncle, a successful business executive who had never married, had serially abused three brothers over more than a decade
After leading the group for twenty years I decided to cut back my practice. When I told the men that I would be leaving they decided to continue meeting on their own, with the members rotating leadership. They invited me to come to a meeting any time. I still attend a few meetings each year, and recently joined the men at a memorial service for a beloved member.
When I talked with the men about the effect of our group in their lives, they agreed that the negative consequences of childhood trauma and abuse may remain for the rest of a person’s life. Although there may be some individuals who can shrug off dramatic childhood experiences, for most the trauma can drive a person off of the life path they might have chosen. We agreed that it is hard to heal oneself from childhood sexual and physical trauma, and most need the help of others to move from victim to survivor. We also agreed on how hard it is for men to talk about sexual abuse, but that healing can begin at any time, and though scars may remain, childhood trauma can be treated and healed, even if imperfectly.
Some men and women have criticized the men’s group for going on for so long. The group disagrees. They no longer see themselves as a trauma recovery group; that's how they began, but they have morphed into a supportive group of very good, very close friends. Each member has other men friends; some have just a few, and others have many, but the friendship in the group is special.
Fred, a recently retired carpenter and cabinet maker, relentlessly pursues his hobby of climbing mountains, summer and winter. He climbs with several old buddies, some of whom were his friends before he joined the group. He has been teased by these friends since childhood, and the teasing often continues as this 60-year-old man makes his way through winter snowdrifts on mountain trails with these friends. When he challenges their insults they stop, but only for a while, because they are built into the nature of their relationships.
Men in the group have observed that when men get together without women present it is common for old friends to insult each other, while laughing and making light of it. Some men may, if challenged, explain that this is because they are best friends and love each other. But there is no teasing in this group. Two of the current members reiterate to the others periodically that the no sarcasm rule has made self-exposure safer from the first time the group met.
One day, Chuck, a founding member of the group, talked about the regular poker game he has with colleagues from his office. They order beer and pizza, play cards, tell stories, and have a good time. Tim asked why Chuck continued in our group, since he had so much male support from his poker friends. Chuck said, “Are you kidding? If I brought up the kind of things we talk about here the guys would be embarrassed. They’d make a big joke of it. Yes, we’re friends, but we get together to tell jokes, drink beer, play cards — we keep it light, and tell fish stories.”
In recent years society has learned how common it is for girls to be sexually abused. Such abuse is no longer routinely brushed aside, and nearly everyone agrees that it is important to provide treatment and support. Data from RAINN, the Rape, Abuse & Incest National Network, shows that 1 in 9 girls and 1 in 53 boys under the age of 18 experience sexual abuse or assault at the hands of an adult.3 Looking at it another way, 82% of all victims under 18 are female. That means that 18% - about one in five - are boys. 100% of these children deserve treatment and support.