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The impacts and effects that childhood sexual abuse has on survivors in adulthood may be vast and varied to each individual. This essay will, therefore, look at how male childhood sexual abuse affects the adult. Combining the psychological, sociological and physical effects to the roots, to include ethical and legal implications to practice with an understanding of different counselling approaches; drawing on my personal experiences in counselling practice. Volunteering for an organisation run for male survivors of sexual abuse and rape, I recognise and understand the impact this has on individuals. By utilising theoretical frameworks to develop my ability without becoming traumatised myself, I am aware of the preconceptions that prevail in society about sexual abuse in men, and how it can be made to appear even harder for males to be victims of crime.
Research carried out by Scott, D. Easton et al., (2013) ‘Would you tell under circumstances like that?’: Barriers to disclosure of child sexual abuse for men, highlights the need for further research in the varying complexities of this process for men. As Scott D. Easton et al., (2013) points out, although awareness of sexual abuse of boys has increased dramatically, due to news coverage of abuse scandals, public disclosures of celebrities and mainstream films, there is still considerable stigma of childhood sexual abuse (CSA). Could this be that because many men who experienced a physical response during the abuse maybe confused and question their sexual orientation? Therefore, believing that they could have done more to stop it can bring additional challenges because of social attitudes and stereotypes about men and masculinity. Anyone can be sexually assaulted/raped, regardless of their gender, size, strength, appearance or sexual orientation.
Much of the literature or discussion about sexual assault/rape is discussed from the perspective of the female victim, and as such, there has been a ‘feminization of victimization’. As a member of The British Association of Counselling and Psychotherapy (BACP) the importance of good ethical practice is essential for the beneficent of clients and counsellor as it sets out a series of professional and personal values. Sexual abuse is a difficult topic and being resilient as a counsellor as described in its Ethical Framework for the Counselling Professions, the BACP (2018) defines resilience as ‘the capacity to work with the clients concerns without being personally diminished’. By way of example, considering my own experiences and view on sex and abuse, as there may be a parallel process, therefore, working through my own experiences thoroughly before taking on clients who may have similar issues, highlights the importance of good self-care in practice.
From a counsellor’s perspective, most of my clients have been middle aged men who have never spoken about their childhood abuse through fear of other reactions or a misplaced sense of guilt and shame about the events, that maintain their silence. In their silence, my clients developed a method of coping with their internal carnage through an addiction of gambling or alcohol and drug dependencies; relying on these coping mechanisms for most of their life to avoid feelings and memories. An interesting article cited by Jane Ellen Stevens, on Adverse childhood experiences (ACEs) by Dr. Daniel Sumrok, (2017) describe these addictions as ‘ritualized compulsive comfort-seeking’. Which is a normal response to the adversity experienced in childhood, just like bleeding is a normal response to being stabbed. One might infer if this could be why only 1 in 6 men in the UK who have been targets of rape and sexual abuse, that’s 5 million men in the UK, RSVP (2018) do not report this and disclosure is the main issue for male victims. Therefore, an interesting continuous study where integrating science into knowledge to support our clients as whole human beings with compassion, empathy, and medication.
As a person centred (PC) counsellor I have drawn upon other modalities in my client work as I have felt this an ethical way forward for my clients, concerning how they have presented to me. Valuing the foundations of PC therapy, by offering a safe, comforting environment, the client can start to understand their past experiences that have impacted the way they feel about themselves or their abilities and take the steps towards positive change. It is important to note that in the aftermath of sexual assault, male and female survivors share dealing with many of the same issues, namely, anxiety, flashbacks, nightmares, guilt, shame etc. to the same intensity and severity – and all are equally as valid. It is true, however, that there are certain issues that do tend to be gender specific – for example, women have to deal with the trauma of potential pregnancy after rape, whereas male victims have to deal with the increased risk of a sexually transmitted disease (STD’s), after male-on-male rape. Therefore, there maybe cases were as a counsellor we will have reason to rely on the law and break the confidentiality which has its exceptions and limits. The counsellor must break confidentiality in three cases involving the law being broken: terrorism, drug trafficking and money laundering. Strangely, there is no legal requirement currently to report child abuse, though many counsellors include this as one of their reasons to break confidentiality. Additionally, limits on confidentiality may be set by individual agencies.
Several factors can affect a person’s ability to grow, including low self-esteem, a lack of self-reliance and very little openness to new experiences. The person-centred approach recognises that a person’s social environment and personal relationships can greatly impact these, so therapy is offered in a neutral and comfortable setting, where a client can feel at ease, authentic and open to learning about themselves. ’Although, as therapists, we recognise the value of creating a safe relationship in which clients can begin to deal with their lives, we may be less aware of the need to encourage or value stories that show us (them) the means by which they may have found ways to stay safe during childhood, despite being in an unsafe environment. K. Etherington, (2006). While, as noted in chapter 3 – comprehensive treatment for adult survivors of child abuse and neglect; (2017), ‘as these uncomfortable and sometimes debilitating symptoms and memories emerge, many individuals return to using substances to suppress their problems and manage their emotional pain’. I have, therefore, discussed this as an important part of pacing their disclosure and resources available, such as writing journals including relaxation ideas; creating a resilience toolkit. One of my clients participates in weekly yoga sessions and valued the use of stress aids within the therapy room. Dave Mearns states that ‘The Person Centred Counsellor must always remember that she is a guest within the clients world of experience’. As Mearns states this sentence also does encapsulate each unique client I meet and our therapeutic encounter together. Mearns also suggests that person centred counselling does not fit so-called western culture. As cited in Culture and the therapeutic relationship: Perspectives from Chinese clients: Jenny Jim, Nancy Pistrang, 2007.
The need for therapies to be culturally “sensitive” or “responsive” has been recognised for many years. Nagayama Hall (2001) argues that there is a scientific and ethical imperative for developing culturally sensitive therapy, which “involves the tailoring of psychotherapy to specific cultural contexts”. Various models of culturally sensitive therapy have been debated, some applicable across cultural groups and some developed for specific groups. However, there is a dearth of empirical research on the efficacy of different therapeutic approaches with different cultural groups and what make a therapy culturally sensitive. Expertness is the goal at every level of societal functioning. Indeed ‘power is fundamental to PC as the counsellor encourages the client to find and exercise his own power. Reflecting on my client’s cultural roots, one can infer that all family’s ideas about childhood and the upbringing of children vary widely. As culture plays a key role in shaping what is acceptable and what is not. Research does suggest that childhood trauma is a major contributor to the development of psychological disorders. During my training, many clients I have experienced have been unsure of their options within the counselling field, which resulted in them assuming they would be given the answers and not one may infer, work for the answers themselves. Interestingly, Irvin. D. Yalom, writes about researchers having a legitimate need to compare one form of psychotherapy treatment with another. By way of example, ‘all subjects receive the same purity of a drug offering a standardized therapy’.
Depression is the most reported symptom of past abuse. Adult survivors have a four-time greater lifetime risk for a major depressive episode compared with adults who have not been abused or neglected. Some of this vulnerability to depression has a physiological basis. Severe or chronic stressors may alter the way that your brain handles stressful events, leaving you more vulnerable to depression when confronted with a current life stress. Clients I have been in therapy with have all been prescribed anti-depressants for depression throughout their lives, specifically labelling them and how they have struggled with this disorder and stigma for years. Lisa Thompson and Becky Willetts (2019) believe there is a need for society to undergo a fundamental shift in the way we respond to, understand and support sexually abused and exploited children, young people and adults. Therefore, understanding a person’s trauma and their coping methods is a vital aspect to their recovery. Clients in practice have described that due to intensified pressures of life, they find it hard to concentrate, lose track of conversations, have problems sleeping, being distant in relationships.
One could therefore imply, that anti-depressants are not necessarily the answer. As adults one might agree that personality traits are expansions of our childhood experiences. ‘Shame, guilt, self-deprecation, and emotional trauma are so intertwined with sexual abuse that the experiences are frequently layered over with years of denial. The visual arts offer an opportunity for images to come forth when words are not yet formed’. Linking this to interventions with some of my clients, sometimes, we need to use psychological education to give the client facts, backed up with evidence, to help them understand why they reacted as they did to being abused. Chapter 3 – comprehensive treatment for adult survivors of child abuse and neglect (2000) highlights that such an educational approach can be immediately therapeutic because it can help clients understand and control responses and symptoms. For clients understanding their own personal trauma responses to their abuse, helps them normalise and work through their own personal narratives, exploring what happened to them not what is wrong with them. How impacts of this affects their overall personal relationships. Avoidance is another long-term effect; avoidance symptoms can occur because they help our clients cope by temporarily reducing emotional pain.
The first type of avoidance is dissociation. Dissociative symptoms often first appear during childhood, when they become a way to “escape” from abuse or pain. Clients have often described how they were able to numb body parts at will, or how they would “watch” the abuse from above their body. Dissociation gets to be a problem, however, when they have no control over when this happens. In the therapy room, I have been aware of my client’s dissociation, by reliving their story and staring unresponsively. Jacqui Dillon, describes their personal experience of dissociation, as being separate, in another world. ‘I had this public world where everything was OK, and I had this private world where horror happened’, this can, furthermore, highlight the cultural vacuum of societies generalised standardisation of negativity, giving clients a defining self-identity of having a disorder. Overall, it may seem that abuse will be more harmful if the abuser was someone you knew and trusted. Your emotional attachment to the perpetrator and sense of betrayal can be more important predictors of harm than whether they are related to you. In conclusion, this type of abuse has been found to be correlated with adverse consequences for survivors throughout their lifetime. Effects of past abuse can also vary from person to person. The experiences of some survivors are relatively mild, while others experience severe reactions. Even when the experiences are severe, however, there is hope for healing, therefore highlighting the need for future research in this area, continuing to tease out gender differences in victims of sexual abuse.
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