Empowering Male Survivors Who Struggle With Addiction

By Howard Fradkin, Ph.D., LICDC-CS and Mikele Rauch, LMFT

man in room on the floor with hands over face

“There is memory that we manage
And there is memory that manages us…”
~Philip Gourevitch

The most recent research has shown that at least 1 out of every 4 males experiences some form of sexual victimization in his lifetime. Worldwide, well over half a billion men have been sexually victimized, but the abuse is rarely acknowledged because of fear, shame, ignorance, or culture.

Male survivors of sexual victimization often struggle with one or several forms of addictive or compulsive behavior- addiction to alcohol, street or prescription drugs, sex, work, or gambling. But the addiction is not the primary issue. Often, it is the response to overwhelming loss and despair, the fear, anxiety and shame that can come as a result of trauma.

Male survivors have been robbed of control over their own bodies. By engaging in addictive behavior, a survivor may briefly feel in control while they are acting out. In the addict brain, all the systems are off kilter. A survivor of childhood sexual abuse has developmental disruptions in the dopamine and opioid circuits, the limbic brain, the stress apparatus and impulse-control areas of the cortex, as well as altered hormone levels. It appears that there is a split in the processing of emotion. A brain that is preset to be easily triggered into a stress response is likely to assign a high value to substances, activities and situations that provide short-term relief.

A survivor’s emotional life has been compromised or even hijacked because of the abuse he has endured. Often substance abuse or sex is the entrapment and the lure for connection, relief, or “safety.” Shame and the secrecy surrounding the abuse are often the major fuel for any type of addictive behavior. Not all addiction is rooted in overt trauma, but most addiction is likely linked to some kind of pain. It may be difficult for a male survivor to enter treatment or tell the story of his abuse because for him, seeking help is an acknowledgement of weakness.

Many survivors lived through the abuse by denial, minimization, dissociation, and often detaching from the people who might value them and support them. These same processes also enable him to minimize or discount the damage he does to himself and his relationships by his addictive and compulsive behaviors.

The craving for contact often accompanies the terror of true intimacy, especially if there was confusion about ways he related to a perpetrator. If a survivor was groomed to believe the perpetrator cared about him, he may reject true emotional connection because it feels dangerous or unfamiliar. Therapy may feel dangerous because it is reframing boundaries, connection and care. Before a therapist can launch into talking about trauma, he or she must have an empathic respectful relationship with the client. It is the cornerstone of treatment. With solid rapport, the survivor learns and practices skills to help him feel safe in his body and in his relationships.

Traditionally, addiction treatment has taken a strong stance against therapists initially addressing trauma in treatment unless there is a solid foundation of sobriety for at least six months to a year. This approach is based in the belief that the process involved in addressing trauma is so emotionally difficult for the survivor, it could endanger sobriety. As clinicians we know that reenactments can often happen in treatment especially as memories surface, but we the writers challenge this long-held wisdom. We suggest that there are safe ways to both help a client become and stay sober while simultaneously working on resolving the trauma. It requires commitment and presence on the part of the therapist. They must be prepared to attune themselves to the impotence, rage, inadequacy, dissociation and shame that their clients experience especially in early sobriety and be grounded enough to hold the container of safety while the going gets rough.

It is important to remember that the addiction is the symptom; trauma is the “it” addiction seeks to cover. The task of the therapist is to support, encourage, and challenge at all stages of addiction management. It is the healing work of good treatment for the client to accept full responsibility for his present behaviors with compassion and self- vigilance, and rectify his beliefs about the shame of his self-defeating or numbing behaviors, finding new ways of being alive in the world.

The effect of the addiction was not to be aware and not to be present. In order to heal and recover, it is necessary for a survivor to create the opposite capacity: to be present to what is going on inside his body as well as what he is feeling and thinking. Mindfulness gives recovering addicts and survivors important tools that will support them. Mind-body awareness, bodywork, certain kinds of weight training, and cognitive behavioral reframing techniques help male survivors tolerate all types of stressful situations. These approaches have been proven to be effective techniques to help men become and remain sober.

An addict may believe he can’t handle dealing with memories or reminders of the abuse. But he has already survived the worst without any support, protection or help. In recovery, much like in 12-Step meetings, he has access to a community of people who could support him, both in addiction recovery and through the ever- growing male survivor community.

Knowing “I am not alone” is one of the most important aspects of recovery. It is profoundly healing for a male survivor to recognize that others can truly understand his struggles and his pain. It is what most survivors and addicts experience in a peer support group, a therapy group for male survivors, when they go online to talk to other survivors, or when attending a Weekend of Recovery for male survivors (www.malesurvivor.org).

It is important to check in with a survivor/addict at the end of each session to reestablish commitment to continuing sobriety and to reaffirm how healthy it is to ask for all the support he needs. It is essential to normalize the survivor’s experience of being tempted to act out or numb out while affirming that he is stronger now, and that he has the capacity to both feel and remain grounded.

Treating survivor/addicts has rich rewards for the therapist. While it cannot be our job to keep the survivor addict sober, it is our responsibility and privilege to help him with as many tools as possible to become sober and maintain that sobriety on his path to recovery.

References Provided Upon Request

Howard Fradkin, Ph.D., LICDC-CS is the Co-Chairperson of the MaleSurvivor Weekends of Recovery team and is a Psychologist in private practice in Columbus, OH. Howard is the author of Joining Forces: Empowering Male Survivors to Thrive, published by Hay House in 2012. hfradkin@malesurvivor.org; 614-445-8277 ext. 1 www.howardfradkin.com

Mikele Rauch, LMFT is one of the founding members of the MaleSurvivor facilitator team, and is the Chairperson of Taking Back Ourselves, a Weekend of Recovery for female survivors of sexual abuse in June, 2016 www.takingbackourselves.com. She is the author of Healing the Soul after Religious Abuse, the Dark Heaven of Recovery, published by Praeger Publishers in 2009. She is a psychotherapist in private practice in Brookline, Mass. mikelerauch@gmail.com 617-734-2007. Ext. 5, www.mikelerauch.com