Healthcare Training Institute - Quality Education since 1979
CE for Psychologist, Social Worker, Counselor, & MFT!!
First I would like to address cross-gender issues. Granted it is beneficial in many cases if a boy has been abused by a female that the therapist is male. However with the specific cases I have dealt with regarding sexual abuse of boys, there has been an extenuating circumstance or circumstances that made the referral appropriate.
In several of the cases, I was involved with the boy via a school setting, and we had a prior working relationship. In all cases, the client was offered the option of seeking help from a male therapist. If that request was made, the termination and transfer process was initiated immediately.
In this section, we will examine isolation, as well as the "Power Figure" and guided visualization exercises.
♦ #1 Enforced Societal
According to a study conducted at the Children's Hospital Medical Center of Cincinnati, 11.2 boys per 1,000 children were abused compared to 12.8 girls per 1,000 children. As you can see, there is only a slight difference between the number of cases of boy sexual abuse and girl sexual abuse.
One such client of mine, Andrew, age 13, had a similar preconception about sexual abuse. Andrew had been abused by his uncle at the age of 7. Andrew immediately told his single father about the abuse, but his father was unwilling to acknowledge it. For four years, Andrew felt isolated and was told to keep the secret "in the family". Andrew told me, "My dad made me believe that only gay guys do that to boys and that my uncle was not gay. He said that only girls get abused." I told Andrew that what his uncle did to him was a means of making Andrew feel weak and powerless.
♦ Technique: Power Figure
Here's the definition of control I gave Andrew, "Control refers to the ability to govern, regulate, or manage something or someone. It also refers to exercising power over or dominating another person." I also emphasized to Andrew that power in the sense that it is used in therapy refers to power over oneself and not over another person.
Surprisingly, Andrew chose the historical figure of Gandhi, who he had studied in class, and who he says had power over the British. I asked Andrew how Gandhi achieved this power and he said, "By standing up to the bad guys and driving them out. But he never hurt anybody." Andrew emulated the figure of Gandhi because he had used a nonviolent means of controlling his surroundings.
Unfortunately, many clients do not have the healthy view of power that Andrew had. Sometimes, this exercise reveals boys beliefs that power equals sex and anger. As you know, these types of responses give an important clue regarding which clients will need extra help in developing a sense of empowerment. We will discuss this more completely in the next section.
♦ #2 Client Self-Isolation
I find that group therapy is most beneficial for boy clients that have isolated themselves for several years. It helps them realize that there are other males of his age that are experiencing the same problems and overwhelming emotions and facilitates their recovery. One such extreme case involved Ryan, age 17, who was abused at the age of 5. For over 11 years, Ryan refused to tell anyone about the abuse, thinking he could repress what had happened.
However, as he went through adolescence, Ryan found that he was much more irritable and anxious than his friends. While they became increasingly interested in girls, Ryan found that any kind of sexual thoughts led to extreme anger and fear.
you to sit back in a comfortable position and close your eyes if you can. Take
a deep breath and let it out slowly. Take another deep breath and let it out even
more slowly. Pay attention to your arms. Shake them a little bit and then let
them rest at your side. Notice your legs. Are they in the most comfortable position?
Get as comfortable as you can. See if there is any part of your body that is hurting or feels tight. Taking deep breaths may help that part relax. Feel comfortable
As you walk across the meadow, you see a clear blue pond ahead
of you. Sit down next to the pond and look into the water. Reflected in the water
you see a rainbow. As you look at each color, your body feels more and more relaxed.
Your mind becomes calmer and more peaceful with each color. First you are seeing
red, now orange, yellow, green, blue, purple, violet.
Some clients fidget and are restless during this exercise. I ask these restless clients to verbalize what they are feeling and explore the sensation for feelings of anxiety or fear. Older boys downplay the importance of relaxation or guided imagery, but they usually welcome guidance in learning a new skill.
In this section, we discussed the various forms of isolation that male survivors of sexual abuse experience: isolation by others and isolation of themselves.
In the next section, we will examine the idea of empowerment as the foundation for healing and how to build it: through building a sense of responsibility and accountability; through developing his understanding of his power and its limitations; and through equipping the client with knowledge and empowering skills.