Re contextualising 'creative adjustments' and symptoms

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

Generally, young male survivors of sexual abuse had little power or capacity to act on behalf of their own needs and to manage their interpersonal boundaries during the abuse. Furthermore, the abusive context often becomes internalised and experienced as being about oneself, rather than about the context. For example, this process can be a result of messages internalised by the abuser ('it was your fault') minimisations and denial of the reality of the abuse by caretakers ('what happened to you wasn't important'); childhood conclusions made about the abuse ('I must be bad because this happened to me') and feelings related to the abuse becoming seen to be about oneself (feeling dirty from the abuse becomes 'I am dirty] (Kepner, 1995). Effects that are essentially a result of an abusive context can thus end up being perceived to be solely about oneself. Young men are often left with a set of experiences and symptoms that are severed from the original context, and because of this they become more vulnerable to confusion, self blame, guilt and shame. This is further exacerbated by the effect of the boys' code and mainstream values of individualism that encourage young men to perceive themselves independently from their surroundings.

Given these factors, it can be very helpful when working with young male survivors to help put their current negative perceptions, symptoms and behaviours back into an interpersonal context (often the abusive context) in which they make sense. According to Kepner (1995), the idea is to take experiences or thoughts that are seen by the young men as being about themselves, and reframe them into a context that includes cultural and historical events. For example, one's current belief about feeling unworthy of support may be a result of growing up in a chronically neglectful environment; or one's experience of fear and free floating anxiety may be about having been frightened and terrified by the abuser

So far I have met no young men who have been able to see the effects of their sexual assault as normal reactions to an abnormal and abusive event. If they did, they would not need counselling! Usually, it is the other way around. They perceive their current behaviours and symptoms as abnormal experiences with no connection to previously abusive or neglectful contexts.

When doing this re contextualisation work it is very important to consider how ready the young man is to do this work, and to offer hypotheses tentatively to him. I consider it is important to ask the young man whether the guesses I offer him, fit 'experientially'. It is like asking the young man to try on a coat to see if it fits. I find the following steps helpful in doing this kind of recontextualising work:

1. Explore descriptions of 'creative adjustments" or survival strategies: current patterns, symptoms, self and other perceptions, and coping strategies e.g. drug and alcohol abuse, controlling behaviour, violence, dissociation, self reliance, withdrawal, perfectionism, self harm, workaholism.
2. Look for and validate the 'genuine' purpose and function of the 'creative adjustment' within the current environment e.g. is there a need for safety, familiarity, predictability, comfort, power, equilibrium, survival, security, integrity, self cohesion that gets met in their current coping behaviour, patterns and perceptions? I assume that most young men's current symptoms and problems are a result of once highly adaptive responses to abusive and neglectful environments.
3. Tentatively link the purpose of current coping strategies to its original context (recontextualisation experiments, Kepner, 1995). For example, dissociation, numbing and withdrawing were once adaptive responses to being abused.
4. Explore how the 'creative adjustment' is a resource and hindrance now. What are its costs and advantages? How does it affect others? In what contexts is it strengthening and weakening you? How does it get in the way of you growing/healing?
5. Invite experiments to explore new ways of being   in relating to others and in perceiving oneself and the world   that allows new choices and possibilities, This can involve helping the young man learn new self skills and the ability to separate the present conditions of his environment from his past.

Note: A creative adjustment is a Gestalt therapy term that refers to how we creatively resolve the dilemmas life presents to us to the best of our ability (Perls, Hefferline and Goodman, 1951). In relation to young men a creative adjustment is 'a solution used by a young man that helps them adapt to their abusive environment and its effects in a way that best maintains their self cohesion, integrity and equilibrium, given their current resources and level of development'.

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