Balancing exploration with building self skills

Home: Workers: Working with Teenagers & Adults: Working with young males

Some of these ideas have already been briefly mentioned. Typically, many survivors of sexual assault   particularly where other forms of abuse were involved   have had little opportunity and support to learn the skills of tolerating and managing their experience in healthy, integrity building ways (Kepner, 1995). I have noticed how many young men rely on dissociation, numbing, drug and alcohol abuse and other tension reducing activities such as aggression, avoidance and self harm to cope with their feelings. I find it useful to assume that these young men am doing the best they can given their level of development, insight and the internal and external resources that they have at the time. Although sometimes harmful to self and others, I also assume that within some of these survival functions are the genuine need for self coherence, expression, integrity, connection, strength, safety and equilibrium.

Given this point, one of the most important parts of working with young male survivors of sexual assault is to inquire into and honour the underlying need of their current survival strategies. Once this has happened, I am then in a better position to gently challenge their strategies and to support them in creating new, more adaptive skills to meet their needs and to manage their experience and contact with the world. This is particularly important in cases where I think young men disown their responsibility for hurting others or themselves. Without these skills, young men who want to explore their memories may run the risk of being retraumatised. They have no more internal or external resources to face their unprocessed feelings and experiences than they did when the original abuse occurred. Kepner also states that:

we cannot expect the survivor to change ways of being that have worked so well for her (him) in desperate conditions unless We have first helped her (him) to develop new resources in the present and a sufficient sense of support (1995: 64).

Pacing skills

A particularly important part of working with young male survivors is to encourage their awareness of how to pace the speed and level of intensity of their exploration in the session. This can help them to learn to tolerate and ride waves of feeling, without resorting to old modes of adaptation such as denial, self harm, dissociation, avoidance or acting out behaviours. Young male survivors have often had little experience of learning to do this. Collaborating with them to develop pacing skills helps them to know and identify their body signs when they have explored enough and may need to slow down, relax or divert their attention, to more soothing discussions. It also empowers them to make choices about how to manage their level of stimulation during and after the session so that counselling doesn't become a place that can replicate the intensity and flooding of feelings inherent in the original abuse (Kepner, 1995).

For example, one young man with whom I have recently been working did not notice his rising agitation while talking about his past. All of a sudden he became aware of 'rageful' feelings that he did not know how to handle. In hindsight, I can see how I got too interested in his story and forgot to notice his non verbal cues, and to encourage him to slow down and notice what was happening in his body while speaking. This could have helped him to ride the wave of his anger by grounding himself. Eventually this young man did learn to do this and now, according to him, he has an easier time coping with his intense anger. He can also notice his growing body signals (knots in his stomach) that remind him of what he needs to do to take care of himself. It has been through experiences like this, and seeing the consequences of young men uncovering historic memories too fast, that I have learnt the importance of pacing skills.

Other self skills that may help young men to manage and tolerate their feelings and interpersonal situations might include the following:

• Grounding and 'affect tolerance skills'. having the skill to manage intense feelings or dissociation by making contact with the chair, feeling one's feet on the floor, bum on the scat and breathing slowly and deeply while looking around the room (Kepner, 1995; Linehan, 1993).
• Boundary skills: these can be developed by helping young men to actively choose what they want to talk about, where they want to sit, when they have had enough, when to change topics, and acquire the ability to notice one's personal space boundaries and say 'no' to people.
• Self support and self soothing skills: these involve supporting young men to learn how to take care of themselves   to eat when hungry, sleep when tired, relax or talk to someone when stressed, and do things for themselves that they enjoy doing such as take a walk, read a book, listen to music.
• Mindfulness skills: encourage young male survivors to learn to stay with their feelings without judging or wanting to change them (Linehan, 1993). This may first involve externalising and challenging their judgements, and reminding them that feelings come in waves when they don't try to interrupt them (Kepner, 1995).

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