By Phil Mitchell – Counsellor and Psychotherapist (Male sexual abuse specialist)


The grooming and sexual abuse/exploitation of boys and men is an issue that is receiving an increasingly high amount of attention from the media. Men from the world of sport have disclosed historic child sexual abuse, the Catholic Church has faced numerous allegations relating to priests who have sexually abused boys, and with soaps such as Hollyoaks, Coronation and Emmerdale highlighting the sexual abuse and exploitation of boys and men, the issue has certainly received much needed attention and encouraged boys and men to speak out. I’ve certainly seen an increase in males making contact and enquiring about therapy, referencing something they’ve seen on TV.

Whilst the spotlight has being shone on this issue, the grooming and sexual abuse/exploitation of boys and men is arguably still relatively hidden and many aspects of male sexual abuse and exploitation are still overlooked and in many circumstances ignored. This short blog aims to briefly highlight some of these overlooked and hidden aspects by exploring one the main challenges in working with sexually abused and exploited boys and men and highlighting what can be effective interventions when working with sexually abused and exploited boys and men.

What are the challenges in working with sexually abused and exploited boys and men?

There are many challenges the therapist can encounter when working with sexually abused and exploited boys and men, but what is the main issue that comes up time and time again? In a word: masculinity, or rather the perceptions and ideas some boys and men have about masculinity and what they think it means to be male (that’s certainly been my experience). At this point it’s important to point out that not all boys and men have unhealthy views and beliefs about masculinity and what it means to be male, however I have certainly worked with many sexually abused and exploited males who have held unhealthy views and beliefs which have contributed to additional barriers in addressing the consequences of the sexual abuse and exploitation they have suffered.

I have lost count of the number of boys and men I have worked with who made comment such as; “Real men don’t cry”, or “Well, you know. . . It’s that man thing,” or “I just feel like I’m not a proper man.” The list goes on. Whilst some boys and men have been less explicit, making comments such as “It’s just too difficult to talk about”, through therapy, a significant number of clients have come to realise that their own beliefs about masculinity and what it means to them to be male are preventing them from addressing their sexual abuse/exploitation.

Exploring a client’s beliefs around masculinity and being male may not always be necessary or indeed appropriate, and for other clients it may be extremely necessary and incredibly appropriate. Before understanding and exploring a client’s beliefs around masculinity and what it means to them to be male, it is first important, as many therapists before me have said, to build a healthy therapeutic relationship.

Challenging beliefs about masculinity and being male

Once a healthy therapeutic relationship is established this is when it may be appropriate for the therapist to consider exploring and challenging the client’s underlying and often deeply ingrained beliefs about masculinity and what it mean to be male. One of the biggest barriers I’ve seen boys and men being faced with over the years is their beliefs associated with crying, with many males saying words to the effect of “I just feel like less of a man.” This can be the therapists cue to explore the client’s views around being male, perhaps asking “What do you believe would make you more of a man?” I’ve often found that this question can result in the client listing a number of points which he believes he needs to live up to in order to feel like a ‘real man.’ It can then be useful to explore how these points/beliefs may be making it difficult for the client to process and deal with his sexual abuse and exploitation.

When clients are sitting in front of me crying about recent or historic sexual abuse or exploitation it’s important to remember that they haven’t consciously chosen to start crying. They haven’t made a decision with their per-frontal cortex to produce tears; the tears are happening naturally without any conscious decision making process, so when a client says something to me like “God, you must think I’m a right wimp. What sort of man cries like this in front of someone?” as he desperately tries to stop the naturally occurring tears that need to be expressed, I often say something like “Your natural need to cry was there long before your ideas about what it means to be a man.”

Three things to remind clients who struggle with expressing tears and think it’s something they shouldn’t do:

  1. We are born crying. We need to cry and our brain knows this
  2. It’s good to cry. Some research says that there are certain toxins in emotional tears that are linked to physical stress. Crying could be your body’s way of expelling the stress. How many times do you hear people saying how good they feel after having a good cry?
  3. Crying is natural. When our body physically and naturally responds to stimulus we don’t usually stop it. We don’t stop ourselves from sneezing or going to the loo, so maybe we need to learn to stop preventing the naturally occurring emotional tears

Some of the beliefs clients hold about masculinity and what it means to be male do not automatically contribute towards unhealthy behaviours. Many boys and men believe that being a ‘good man’ means being brave, and it is this bravery that can lead to lives being saved and many selfless displays of courage. However if boys and men believe that being brave means not crying at all, this interpretation can be explored in therapy. If we notice that boys and men have interpretations of masculinity and ideas about what it means to be male that are preventing them from effectively addressing their sexual abuse and exploitation or indeed any problem that are troubling them, I believe it is our job as a therapists to help these clients develop healthier ideas about masculinity and what it means to be male.

What else works?

Psycho-education. Many of the boys and men I have worked with seem to have an innate need to understand what happened to them; why a big six foot guy like him didn’t hit his abuser? Why he walked off with the abuser and got in a taxi with him after the abuse took place? Why he sustained an erection whilst he was being raped? Why he can’t remember bits of what happened? I have found that the majority of boys and men I have worked have responded well to psycho-education and gained a greater understanding of how the brain and body works when under physical stress/trauma. It can be useful for the therapists to be appropriately equipped with the relevant information needed to educate clients on why and how their body responded in the way it did during the sexual abuse/exploitation including the fight/flight/freeze response.

I also find that many boys and men I have worked with responded well to a more direct approach, rather than only being offered the classic core conditions of empathy, congruence and acceptance. A number of boys and men have often told me how they previously met with a therapist, saying “All she did was repeat back to me what I had said, just with different words.” Another client once said to me “We sat in silence for ages. He said that he’d just allow the silence and wait for me to fill it when I was ready. Talk about feeling the pressure.” Adapting our approach to fit with the client is essential regardless of who we are working with; however, from my own 14 years’ experience of working with sexually abused and exploited boys and men I have found that many respond in a more engaging manner when offered “Why?” or “Because . . . . ?” in comparison to being asked “So you’re saying that you don’t feel comfortable talking to your wife about what happened to you as a child. It sounds like it’s something you think you’d find really difficult. I guess I’m wondering what those difficulties could be.”

One final point is around the word ‘doing’. I see many boys and men who have experienced sexual abuse and exploitation who want to know what to do. They want me to tell them what to do. Whilst providing clients with coping strategies and other helpful techniques can be beneficial, many therapists often say “It’s not about doing, it’s about being.” I was certainly one of these therapist when I first qualified, and whilst I agree with the comment to a certain degree I find that many boys and men want to feel like they are doing something and taking some sort of action. One simple tip I have found that works well when working with sexually abused and exploited boys is to give them something to hold in their hand; something for them to play with; something that tells their brain they are doing something. Whilst this approach won’t be appropriate and may not work for all boys and men, I’ve certainly seen more males taking much more freely when they are playing with a Slinkey or jingling their car keys.

Other issues

There are many other issue that this short blog has not addressed. What are the issues experienced by boys and men abused in institutional settings such as the army and prisons? What are the specific needs of boys and men abused in the world of sport? What about boys and men who are sexually abused/exploited by women? These issues and many more issues will be addressed in my upcoming book addressing the sexual abuse, assaults and abuse of boys and men.

Author bio

Phil is an accredited counsellor and psychotherapist with the British Association for Counselling and Psychotherapy (BACP) specialising in working with boys and men who have experienced recent and/or historic sexual abuse. Since 2004 Phil has worked therapeutically with males affected by rape, sexual abuse, sexual violence and sexual exploitation. Phil is an experienced public speaker and has trained thousands of professionals across the country on male sexual abuse/exploitation addressing how masculinity can play a part. Phil is currently writing his first book on the sexual abuse, assaults and exploitation of boys and men. Further details can be found on

© Phil Mitchell 2019

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