Healing Sexually Betrayed Men and Boys

Treatment for Sexual Abuse, Assault, and Trauma

Richard B. Gartner

• Publisher: Routledge
• Year: 2017
• eBook ISBN: 9781317375517
• Edition: 1
• Topic: Psychology
• Subtopic: Mental Health in Psychology
• Index: Psychology

Healing Sexually Betrayed Men and Boys: Treatment for Sexual Abuse, Assault, and Trauma is the new authoritative source for treatment of sexually victimized men and boys. Male victims and survivors of sexual trauma lived in shadow until the turn of the 21st century, when scandal after scandal about the sexual abuse of boys and men shed light on their suffering. These men and boys require different treatment roadmaps than their female counterparts. Yet there is little in the professional literature to help a clinician work with sexually traumatized boys and men.

Richard B. Gartner is a seasoned psychologist/psychoanalyst who has worked therapeutically with sexually abused men for over three decades. He is a clinician, advocate, teacher, lecturer, and nationally and internationally recognized expert on the subject. Dr. Gartner's classic book, Betrayed as Boys: Psychodynamic Treatment of Sexually Abused Men, is one of the few written to guide clinicians. Now, nearly two decades after writing that groundbreaking volume, he follows up on his earlier work. Healing Sexually Abused Men and Boys, together with its companion volume, Understanding the Sexual Betrayal of Boys and Men, is a thorough, comprehensive guide to learning about and healing male victims and survivors.

Dr. Gartner has invited a group of experts to write about specific problems faced by these boys and men. Specialists from the psychoanalytic, psychodynamic, trauma, and legal worlds fill in the details about a wide range of interconnected subjects related to the complex reverberations of male sexual trauma. Healing Sexually Betrayed Men and Boys covers such diverse topics as:

• therapy with young sexually traumatized boys;
• the aftermath for men who were raped as adults ;
• covert seduction of boys and its aftereffects;
• treatment for substance addictions and sexual compulsions;
• couples work with male survivors and their partners or spouses;
• bodywork with male survivors;
• treatment for male veterans who suffered sexual trauma in the military;
• profiling sexual predators and working with survivors who have also been sexual predators.

This book is a valuable resource for clinicians at every level of training. With strategies for how survivors can build support networks and descriptions of clinical, familial, and community-based treatments, Healing Sexually Betrayed Men and Boys is essential reading for clinicians of all theoretical persuasions who work with male sexual abuse survivors. Filling in gaps in the relatively scant literature on the subject, it will also help sexually abused or assaulted men themselves understand what is available to them.

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Part I

Treating men and boys

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Chapter 1

Treating men sexually betrayed as boys

Richard B. Gartner

I am a psychoanalyst in the Relational/Interpersonal tradition. In my work I emphasize the interpersonal context of a patient’s life. Earlier in my career, I was in a leadership position as a family therapist at a partial hospitalization service where we borrowed from a wealth of traditions to discover what works with a given patient. I am therefore respectful of a broad spectrum of approaches to treatment.

This is reflected in the experts I have invited to write about the treatment of sexually abused and assaulted men in this volume. I also have great respect for, and have written elsewhere (Gartner, 2005) about, non-traditional methods of helping traumatized individuals, including journaling, meditation, yoga, exercise, spiritual practices, altruistic works, good health practices, maintaining personal networks, and art, dance, and music therapy.

Nevertheless, I am at heart a psychodynamic psychoanalyst/therapist who focuses largely on the co-created relationship between a patient and me. In that relationship I try to connect to a man through person-to-person contact, each of us attempting to stay the course as his traumas unfold, often for the first time, and we attempt to make meaning of his life (Grossman, Sorsoli, & Kia-Keating, 2006). Hopefully he learns to trust in the benevolence of interest while I try to respect his life journey.

This is written as prelude to the treatments of three very different men. Each benefited tremendously from his therapy while focusing, concurrently or in sequence, on his traumatic history; the aftereffects of that history in his subsequent and current life; and the meaning and influence of our relationship as all this unfolded.

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Nate: father hunger leads to disastrous choices¹

Nate’s parents married soon after they met, but they were ill-matched. His father was gregarious in public, but remote and uninvolved with his wife. His mother was depressed and emotionally needy. This increased when her husband distanced himself from her as he experienced how much she wanted from him. By the time Nate was born his parents were leading nearly separate lives; his father got more and more involved in his business (and, as it turned out, his mistress) and his mother devoted herself to Nate and his younger brothers.

Nate grew up with what is sometimes called “father hunger” (Herzog, 1983): the hunger children may feel when their fathers are absent from their lives, either literally – through divorce, separation, desertion, or death – or psychologically. Nate’s father was in the latter group, physically present much of the time and a good provider for the family, but “otherwise engaged” psychologically, uninvolved and uninterested in his child’s inner life, unaware of his child’s emotional needs.

Nate’s father, a dedicated athlete who unfailingly exercised every morning (thus absenting himself from breakfast and other early morning routines with his children), was largely indifferent to Nate’s own fledgling attempts to get involved in athletics. He rarely showed up at Nate’s baseball or soccer games or showed enthusiasm when Nate’s teams won. Indeed, Nate could hardly remember a meaningful conversation he’d ever had with his father as he grew up. Meanwhile, Nate’s mother, who came from another country and had no family and few friends in the United States, relied more and more on Nate to fill her lonely life.

Looking back as an adult, Nate realized that during his early adolescence his father started a long-term affair with a business associate. He recalls going with his father to professional ball games where they sat with this woman and her children. The purported reason for these outings was that Nate and her children should become friends. But he had little in common with these children, and his father seldom took Nate to games without this woman. Nate retrospectively realized the situation gave his father an excuse to spend time with his mistress.

When Nate was 11, he went to a day camp, where he met a counselor named Leon. That first summer, Leon was appropriately friendly to Nate. But then Leon took a job as an assistant coach in Nate’s school. From then on he became friendlier and friendlier to this father-hungry boy, often going beyond the bounds of most coach–athlete relationships. Leon groomed Nate for sexual abuse over an extended period of time,² taking an interest in Nate’s studies, giving him special practice time to improve his sports abilities. By the time Nate was 14, Leon began inviting him to spend time together outside of school. He asked about Nate’s friendships, which dwindled as Nate spent more time with Leon. Then he probed about Nate’s feelings about girls and sex, pressing for more and more details about Nate’s sexual fantasies.

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Nate was a reticent teenager, bright but shy, and very insecure about whether he was attractive to girls. Capitalizing on this, Leon remarked again and again that other boys his age were far ahead of Nate in their dating and sexual activity. Nate, Leon said, would have to work hard to catch up so when he finally began to date girls they would not realize how backward he was about sex. Soon Nate was convinced that only Leon could help him master dating and sex. He considered Leon, who was about 15 years older than he, his best friend, the only one who understood his loneliness and insecurity and could save him from social disaster. To accomplish this, Leon proposed doing Nate a “favor” by offering to “practice” sex with him. Initial groping led to oral and anal sex.

Confused by his mixed feelings of guilt, shame, revulsion, and pleasure, Nate nevertheless came more and more under Leon’s influence. Leon claimed he himself had a great relationship with his girlfriend, although in all the years they knew one another Nate never met this woman. Indeed, given Leon’s morbid obesity, slovenly habits, and unfailing availability to Nate, it seems unlikely she existed. But in his naïveté Nate did not doubt Leon’s skill with women until well into his own adulthood.

Leon demanded Nate tell him every feeling he had about girls, every attempt he made to talk to one, every tentative amorous move he made. He then critiqued Nate’s “performance,” undermining Nate’s sense of confidence while seemingly trying to help him become a “better,” more masculine young man. With time, Leon ordered Nate to take risks by, for example, exposing himself in public or having sex with Leon outdoors. Eventually he began to “toughen up” Nate by doing things like inserting safety pins into Nate’s scrotum. “This way,” Leon told Nate, “you will become brave and more attractive to girls.”

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Nate’s mother was alarmed by the intensity of his relationship with Leon, and tried to talk to him about it, but Nate maintained nothing inappropriate was happening. She then tried to enlist Nate’s father to intervene, but he was completely unresponsive and unconcerned.

The intensity with Leon continued until Nate went to college. Even then Leon maintained insidious control over Nate’s life by trying to oversee Nate’s college social life via phone, and demanded sex when Nate was home. Finally, when Nate was 22 he told Leon he wanted to stop the sex. Leon did not protest, but still tried to orchestrate Nate’s relationships with women. When Nate got interested in someone, Leon would comment that she sounded nice but he was sure Nate could do better, that he should not tie himself down, that he had become a “good catch” and should not waste himself on someone unworthy of him. And so, Nate never had anything close to a real relationship with a woman until his late 20s.

When Nate started therapy in his late 30s he’d stopped all contact with Leon for about five years. He felt ashamed, not just about what happened with Leon, but also about how long he allowed it to continue. He spent years in treatment trying to forgive himself for having been such a fool as to idolize Leon the way he had. With time, he began to see the connection between his father hunger and his vulnerability to Leon’s predation. And over the course of the treatment he made me a stepping-stone to adulthood, using our relationship to assuage his father hunger while sorting through the damage from his abuse.

He began to see the extent of his destructive bond with Leon. But it took much longer for him to recognize the effect Leon was still having on his relationships, especially with women. His parents had by then divorced; his father married his mistress almost immediately. His mother, claiming to be totally surprised by her husband’s affair, was bitter and heartbroken. As her health began to fail Nate felt more and more compelled to be her caretaker and support. His father now tried to relate to Nate, who was suspicious of the sincerity of these efforts, which may well have been at the behest of his father’s new wife. In any case, Nate felt conflicted about seeing his father in her company; it felt like a betrayal of his mother to be friendly with them.

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By now Nate’s depression was long-standing. He was suffused with shame about his relationship with Leon, which he had spoken about only to his most recent girlfriend, who urged him to seek treatment. He had a history of short relationships with women that ended because he began to obsess about whether she was enough of a “catch” and whether “someone better” was out there. These were catchphrases Leon had drummed into his head. His longest previous relationship with a woman had lasted about six months. He wrestled internally with his feelings about his current girlfriend, who he felt was a wonderful woman but for whom he felt no physical attraction. Yet he stayed with her for two years, eventually breaking it off when he realized he was painfully and unfairly trying to force an attraction to her.

Despondent and guilty about ending this relationship, Nate immediately began to date another woman, with whom he felt great physical chemistry. Yet he had objections to some of her other qualities. While the relationship lasted over a year, she eventually called it off, citing his depression, negativism, and the way he held himself back from her. He used work or other obligations to keep from spending time with her, rarely allowing himself enjoyment with her, never taking time off to vacation with her. He explained this by saying he never thought of himself as “the kind of man who deserves vacations,” and suddenly realized this was penance for doing such shameful things when younger.

Nate despaired as it hit him how he’d sabotaged this relationship. She was the first woman to break off from Nate – he’d always been the one to pull the plug. He panicked, seeing the possibility of ever marrying and having a family slip away from him. He’d strongly resisted medication for anxiety and major depression, but now agreed to try it. He was barely sleeping or eating and could not stop his fearful obsessions about how he’d wrecked the relationship with the “love of my life.”

At this point, Nate’s father was suddenly diagnosed with a fatal illness. In the few months remaining to them, Nate worked to repair their relationship, accept what his father could offer him emotionally at this point, and forgive. It was a tumultuous time, as Nate was also beginning medication, desperately trying to get his recent girlfriend to give him another chance, starting to date other women, and caring for his mother, whose fragile health worsened with the news of his father’s illness.

Shortly after his father’s diagnosis, Nate met Karen. He was determined to not repeat his past mistakes, to make himself available to her both by his physical presence and his emotional availability, and to not use her flaws as an excuse to pull away. He planned with her the first real vacation of his adult life, and actually let himself enjoy it. That struggle continues as of this writing.

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So, Nate’s treatment over several years explored his feelings about his extensive abuse, but also focused on the familial relationships that led him to be vulnerable to Leon’s predation. He acknowledged the aftereffects of abuse in his familial and love relationships as an adult. These included his fear of intimacy, coupled with his longing for it; his need to be a “good boy,” taking care of others – as he did of his mother – while denying himself satisfactions because he considered himself bad; and his desire for a woman, co-existing with his criticality and restlessness in any long-term relationship. He asked me many times to give advice, tell him what to do, somehow save him. I tried to be a support without leaving him high and dry, as his father had, or running his life, as Leon had. While we rarely talked about this directly, it became clear that through our relationship he was healing the harm these men did to him.

Eventually Nate had an “aha!” moment when he noticed that he “felt forced” to spend time with Karen. He suddenly recognized how often he’d felt this with Leon. Despite their intense connection, he’d felt smothered by Leon’s demands on his time and Leon’s constant breaching of Nate’s psyche and planting ideas there. Nate felt forced to be with Leon even as he sought Leon’s further approval. This dynamic was replicated in some measure in many of his relationships with women: he wanted to be near them and gain their approval, but if they started to connect with him emotionally he felt suffocated and wanted his “freedom.” Then he would find fault with them, consider whether there was a “better catch” out there somewhere, and plot how to spend more time away from them.

At one point I said, “You know, Karen is not Leon.” Nate was still for a long time as this sank in. He paled, and started to consider how this pattern had been replicated with girlfriend after girlfriend. He was stunned to see how Leon had subtly affected and eventually ruined so many of his adult relationships. His struggle continues.

Luis: getting justice is not healing

As psychotherapists and psychoanalysts, we often hear about treatments that seem to go nowhere: patients seemingly make few gains, perhaps making internal but not external changes. Then, so we hear, after therapy ends everything comes together and transformation begins. This can be frustrating for the therapist because there is no sense the therapeutic encounter was useful unless they meet again. Until Luis I had not experienced such a re-encounter.

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When I began running private groups for sexually abused men in 1991, I cast a wide net for appropriate referrals, since most clinicians rarely ...

Table of contents

• Cover Page
• Praise
• Healing Sexually Betrayed Men and Boys
• Psychoanalysis in a New Key
• Title
• Copyright
• Dedication
• Contents
• Acknowledgments
• Notes on Contributors
• Introduction
• Part I Treating Men and Boys
• Part II Focused Treatments
• Part III Women in the Picture
• Part IV Perpetrators and Perpetrator/Survivors
• Index