Group Work With Adult Male Sexual Abuse Survivors
by Peter Dimock
Peter Dimock, M.S.W., L.I.C.S.W., is a licensed independent clinical social worker and survivor who has specialized in the treatment of adult male survivors for the past 12 years. He coordinated the first National Male Survivor Conference in 1988 in Minneapolis, and was a major presenter at both the 1989 and 1990 National Conferences. He has authored several publications on this topic.
Rationale for a men's group
Most men who have been sexually abused report feeling fearful and isolated from other men. They may have difficulty undressing in locker rooms, urinating in public bathrooms, participating in traditionally male activities or even being in the same room with other men. Most have had abusive or unavailable male role models. As a result of all this, they often feel flawed as men or experience "gender shame." Men usually deal with gender shame in one of two ways: over-compensation, that is, the need to prove masculinity through hyper-sexuality, invulnerability, and constant efforts at control and mastery; or under-compensation, avoiding traditional male behaviors and interests (often associated with men as perpetrators) in favor of more typically unmasculine qualities such as gentleness, cooperation, and caretaking.
Participation in a men's group provides an opportunity to experience support and validation from other men in a safe environment. Through this acceptance from peers, pride in and ownership of one's masculinity becomes possible.
Being with other men brings up many of the core underlying issues associated with gender shame, which makes them available for therapeutic intervention. Here are some examples:
Many men who were sexually abused (especially those abused by other men), are confused about their sexual/affectional preference. While it is difficult to determine cause and effect regarding this orientation (e.g., whether sexual abuse "causes" homosexuality), most men, gay and straight, have concerns about how sexual abuse may have played a role in determining their sexual orientation.
A men's group, especially if it is composed of both gay and straight membership, offers the opportunity to explore these issues and feelings toward other men in a safe environment.
Many men and women have grown up without the physical and/or emotional presence of a father. For males, the impact of having no fathering is at the heart of gender shame. Without an active father to guide a boy into the world of men, he feels lost, isolated, inadequate, and experiences other consequences that make it difficult to feel he has a place in the world. While women have an important function in the initiation of boys into masculinity, only other males can give the validation and acceptance that enable one to feel like a man. A men's group can fulfill this role.
Rage seems to be more permissible in a men's group than a mixed group, particularly rage at women. In general, most people fear strong feelings, especially anger. People have few models for expressing anger in healthy ways. A men's group opens the possibility of safely experiencing rage in full force--while knowing it can be contained.
Talking about a variety of sexual issues seems more permissible in an all men's group. Some examples of such issues are the details of one's abuse, sexual acting out, sexual experiences, and requests for information.
A men's group helps members in their development and understanding of masculinity by:
Redefining masculine stereotypes.
Giving permission to be vulnerable.
Learning to appropriately release anger and use power.
Identifying healthy role models.
Developing intimacy with other men.
Learning to focus on process rather than end-product.
Learning to compete and value the things men do.
Regaining a feeling of pride in masculinity.
Learning interdependence rather than fearing dependence.
Beginning a group
Number of members
A small number (5-7) tends to be better. This is because the intensity of the group is usually high, and a smaller group offers the safety and time that are needed.
A mixed gay and straight versus an all gay or all straight group is more conducive to evoking the sexuality conflicts likely to be present. Such a mixture is not always possible. Not only is it difficult to find a balance of gay and straight men who desire a group at the same time, but keeping that balance as members leave and new members are added is also difficult. It is not good to have only one gay or straight group member in a group. There are other factors that should also be considered when forming a group.
Including victim/offenders in the group
In my experience, most men who have been sexually victimized have also physically or sexually victimized someone else. This may have been a single episode during childhood and adolescence, but can often create a barrier to recovery due to guilt and shame. When the apparent tasks are helping an individual acknowledge what he did and make the amends necessary to forgive himself, there appears to be no adverse effects on the group. Most often when this happens, one member's disclosure is used by others in the group to talk about incidents in which they abused someone.
If a potential group member has a more extensive history of offending behavior, the picture gets much more complicated. It may have been many years since the last incident, but the current tasks may be to take responsibility for his actions and to understand his behavior. When the focus of an individual's therapy needs to be perpetration rather than victimization, he should not be included in a group for survivors but referred to an offender group.
Some individuals have been through offender treatment programs and never had the opportunity to heal from their own victimization. These men can benefit from a male survivor's group, but may need additional support. In my experience, working on the victimization may trigger old feelings associated with prior offending behavior, so there should be a plan for addressing the possibility that he could relapse to offending.
Criteria for membership
All potential members should be seen individually for an intake session prior to joining the group. The most important factor in this assessment is to determine the readiness of the individual to participate in a group. This can be difficult since many men feel highly motivated to participate, yet when actually in the group situation find it intolerable. Several factors can be helpful in evaluating readiness:
A positive experience in other group settings.
Some idea about how a group might be helpful.
The ability to engage in supportive relationships.
The ability to recognize that a group can be frightening.
Knowledge of his sexual abuse history and the belief that it has had some impact on his life, even if not sure how.
A willingness to learn about himself and what happened.
Compulsive behaviors are being worked on or are in remission.
Some men can talk extensively about what happened to them, but do so as if describing someone else's experience. Readiness to benefit from a group are indicated by the ability to acknowledge this and the desire to explore feelings about what happened.
It is helpful, but not essential, that a group member be in individual therapy at the same time. This provides another place to talk about the group experience and all that it can evoke, which are often much more intense and frightening than initially expected. For a man who is not in individual therapy, such sessions can be offered as needed.