“I’m anxious all the time. I get panic attacks and have to go to the bathroom at work to calm down. I get all shaky. I haven’t been sleeping, I avoid events with lots of people. I’ve felt like this for a long time, probably since I was a teenager, but it’s gotten worse in the past few years. I haven’t been in a long term relationship because I’m too anxious to try and start something. I feel like I’ll always be alone.” *
“There’s a restraining order against me. I’m not allowed to see my kids. My ex accuses me of assaulting her. I hardly touched her. She was screaming at me, and I’d had enough. She’s always so controlling, wanting to know where I am, and who I’m with. I got sick of it. This wasn’t the first time things got physical, I don’t know why she’s making such a big deal. She’s the one who needs help, if you ask me. She’s crazy.” *
“I find the people I work with so irritating. People make the stupidest mistakes and I’m sick of cleaning up after them. I’ve starting using cocaine, just on weekends, it helps me to stop thinking about everything. My dad used to use it. I hated him for it. The irony of my using it now to try and forget about what happened with him is not lost on me.” *
*NOTE- these scenarios are not meant to represent any particular person or situation.
These are just a few of the ways that I hear men talk about the effects of trauma on their mental health, emotions, and relationships. Trauma, according to the Diagnostic Statistical Manual (DSM) – the book used by psychiatry, psychology, and mental health professionals across North America and Europe to describe diagnostic criteria for mental illnesses – has a fairly narrow definition of trauma. It includes situations where a person has an experience in which they believe that they are at risk of dying, or of grievous physical harm. Or where a person witnesses the death or grievous physical harm of another. For full diagnostic criteria for Post Traumatic Stress Disorder (PTSD) click previous link.
This narrow definition of trauma does not encompass the experiences of many individuals who suffer with the symptoms associated with PTSD. I feel that definitions of trauma should also include situations where children are psychologically or emotionally abused for prolonged periods of time (see “7 Ways to Love a Volcano” for definitions of psychological and emotional abuse).These type of abuses undermine the normal development of identity and somatic calming (ability to calm or reduce adrenalin in the body). Without the ability to return to a calm state, high levels of somatic arousal can lead to emotional dysregulation and health issues.
For men, the first major recognitions of the effects of trauma came after World War I, when the term ‘shell shock’ was invented.
Later, when it was determined that the effects of war were present, even in soldiers who were not near to bombing, the concept of Post Traumatic Stress Disorder became the term used. Judith Lewis Herman (1997) speaks about war veterans whose experience of trauma was compounded when they returned home and found that the rest of society had idealized war experiences and didn’t want to hear what war was really like. When the war was unpopular, soldiers’ experiences and sacrifices were, at best, un-noted, and, at worst, shamed. Some soldiers reported being physically attacked for their involvement in unpopular wars. Another complicating factor to PTSD, as a result of war involvement, was/is the myth that ‘strong men’ are unaffected by trauma. This myth pervades despite many studies indicating that no human is immune to trauma. This myth/cultural message has led men to avoid sharing the impacts of the trauma on their own mental health, or kept them from seeking help to manage the symptoms.
Today we hear about the high rates of suicide among veterans and the ongoing struggle to get government support for those who are suffering. Partners and families are also speaking out about their loved ones’ struggles with addictions, depression, and occasionally about domestic violence.
While PTSD is becoming more recognized and treated within the military, men also experience trauma in a variety of other contexts.
Men who were sexually, psychologically, emotionally, or physically abused as children carry similar psychological markers of trauma to those of abused women; though these symptoms don’t always manifest in the same way. For men, anxiety might look like difficulty with physical intimacy and/or difficulty with emotional intimacy.
Sometimes anxiety and anger look like the same thing.
Explosive outbursts and emotional dys-regulation can be connected to underlying anxiety. When a child is mistreated, their own physical ability to regulate emotions can be severely compromised. A constant state of alertness can impact the ability to remain calm under stress in future years.
Being constantly insulted or undermined as a child, can result in low self-esteem and long term depression.
It might also result in that person overcompensating, by trying to prove they are an acceptable person, and reacting strongly to any indication (sometimes even their own internal indication) that they are not impressing others around them. If the person who abused them was a parental figure who demonstrated emotional volatility, a man might react to stress in some of the same ways that parent reacted to stress. A highly anxious man might react strongly to his own internal dysregulation, and believe that he is responding to an external event. He may also lack insight into the impact of his behavior on others. Children, in particular, experience fear when in the presence of an adult who is apparently not in control of their emotions. For men who have experienced this as children and not addressed their experience, they may minimize the impact of this behavior on others, including their own children
Childhood abuse might also come in the form of bullying.
Being humiliated, attacked, threatened, or otherwise mistreated are all forms of bullying. Bullying can happen from other siblings, school mates, or community members. Today, online or cyberbullying is a common form of bullying. The effects of bullying, similar to abuse, have been found to result in low self-esteem, suicidality, depression, and anxiety. If an individual is bullied due to some inherent trait, such as ethnicity or sexuality, during childhood (this includes teen years), the formation of a secure sense of identity might be disrupted. Being bullied in the workplace by co-workers or superiors can also impact an individuals self-esteem and mood, sometimes resulting in depressive symptoms.
Experiences in the workplace, particularly in first responder-type work, such as policing paramedics, or fire fighting, are just some of the places individuals encounter trauma.
Witnessing violence, death and grievous bodily harm, as described earlier, can result in trauma. Feelings of helplessness within those situation can compound the trauma experienced. Being the perpetrator of violence, particularly in the case of police officers, has potential to create complex trauma response symptoms. Studies on trauma note that feeling “out of control” in potentially life threatening situations can lead to increased rates of PTSD among survivors. Increasingly, the concept of vicarious trauma has been noted within various helping professions and training about how to debrief from trauma without traumatizing others, is becoming more widespread.
Kids that grow up in high conflict areas, whether it is due to war or crime, experience higher levels of trauma than those who do not. In my city, I talk to men who speak about having witnessed aggressive police engagement with family members, as a child. Some of these men speak about being constantly “on guard” in their neighbourhoods due to ethnic targeting by others in the community, fear of police, or due to gang presence. Men with gang involvement speak about their own guilt, and nightmares about their own violent activities. Many of these men were either born in gang families and engaged from a very young age. Others were involved with the child welfare system.
Anselm Cromlech and Thomas Elbert write about two types of responses to violence. One is defensive and fearful; the other is, “appetitive aggression, which encompasses violence-related feelings of power, excitement, and pleasure. (p. 270)” These are described by men with involvement in combat situations, in community violence situations, and by men whose jobs involve high stress and aggression. This can result in an individual having conflicting emotions about traumatic situations, making it difficult to make sense of their own role and recovery from those situations.
Involvement with child and family services (CFS)
is often a source of trauma for adults and children alike. Being placed in a foster home can be a traumatic event for a child. Having a child taken from you and placed in care is also felt as traumatic. Even when children do not experience abuse while in care, being away from siblings, parents, grandparents, ones’ own home, and community, are all very highly impacting experiences for children. Children who grow up in foster care are much more likely to be involved in the justice system. Within the child welfare system, I have witnessed fathers being treated as disposable and interchangeable. When there is conflict in the home involving the father, the woman is often advised to kick him out or to leave the home. Social workers do not often make any attempt to contact the father, to offer treatment planning, resources, or to engage the father in the family process in any way. This means the mother is held as responsible for making all of the changes to heal the family, and is blamed if the father returns or continues to be involved in the lives of his children. She is often the one penalized if the father has contact with the family or continues using violent or destructive behaviours.
David Denborough, a Narrative Therapist who works with communities who have been exposed to violence says,
“The person is not the problem, the problem is the problem, and . . . the solution is not only personal.” “…I am interested in ensuring that, once the problem is externalized (therefore placed in the social realm), the solution does not simply return to a personal one, and that, instead, opportunities are created for collective contribution… social movement.”
Violence is always unacceptable and individuals need to take responsibility for their actions and children and families need safety (see “Where do I Draw the Line?” and “When Boundaries Aren’t Respected”) AND humans have the capacity to heal and to learn. Men are humans.
Men are not disposable or interchangeable. We need healthy men in our communities and in our families. Our children need healthy men in their lives.
I am not advocating for excusing behaviours or overlooking them (see ““‘Forgiveness,’ A Dirty Word?” )I am, however, advocating for support to be provided for men who are seeking to learn better ways and to heal from their own pain.
Those harmed by violence and abuse are not responsible for making change. It is up to the rest of us to support these men and support programs that provide the healing needed, for the sake of our communities and families – for all of our sakes.
Trauma due to incarceration is common.
Fear is often an ongoing experience for the duration of individuals’ incarceration experience. Mistreatment by other prisoners, and sometimes by guards, can result in further traumatization. Men speak to me about lifelong effects of incarceration, including insomnia, panic attacks, dissociative states and lack of emotional regulation. Most do not speak about becoming better people, partners, parent, or citizens as a result of their experiences in prison. Statistics show that those who are released from our prison systems have a very high rate of re-offending. These systems are not working. They are based on principals of behavioural modification which have limited uses (See Too Many Stick and Carrots) and do not address many of the underlying causes of crime (such as poverty and trauma).
The results of these types of traumas can be seen in difficulties with emotional regulation, explosive outbursts, intense experiences of anxiety, long term depression and interpersonal conflict. See “7 ways to love a Volcano” and “When YOU are the Volcano.” Various types of addictions may be used as a means of ‘self-soothing’ and ‘disassociation.’ See “Addiction, Your best Frenemy” ‘Flashbacks’ and dissociative episodes, insomnia, and nightmares are also common aspects of trauma.
Social ideals of masculinity which may include dominance and a sense of entitlement may contribute to abusive or neglectful treatment of others who might be less physically imposing, or reliant on income or emotional support.
Society tells men that it is not okay to acknowledge pain or to share emotional concerns, problems, or worries with others for fear of being seen as weak or inadequate.
Studies related to high stress professions speak about a culture of “toughness’ where acknowledging the emotional or mental impact of one’s work on one’s life is scoffed at, despite high rates of long term disability due to stress in these fields.
Externalizing stress, anxiety, and anger in aggressive ways, is often considered acceptable outlets for men. The use of violence, high levels of risk taking, and disregard for others feelings, including partners or children, are more acceptable than acknowledging the need for help. Suicide and homocide can be the result of long term, unacknowledged, or untreated trauma.
If you or a loved one are experiencing the effects of trauma, know that there is help and that things can get better. Know that you are not alone and that your experience has nothing to do with any internal deficiency or weakness. No human being is designed to withstand trauma without effects. Acknowledging the impact and finding what you need to heal and manage symptoms is a sign of strength.
Treatment for Trauma
Traditional treatment for PTSD is exposure therapy. This involves talking about and ‘reliving’ a traumatic experience within a therapy context. This has been helpful when there is one clearly defined traumatic event. It has not been so useful in complex trauma situations, or when the trauma was ongoing, as in childhood abuse.
Recently studies using NET evidence have been found to be helpful when used with child soldiers or individuals living within a conflict zone. In this therapy, a person would lay down a string or rope on the ground, and then use sticks, flowers, and rocks at various points on the rope to indicate their role in major life events. Sticks= harm done to them, rock = harm they have done to others and flowers = good things they’ve done. Sometimes more than one item is used for each event. In further sessions, discussions about each event become more and more in-depth, until the person is able to tell a cohesive story about their life which incorporates all of these experiences. In the studies describing NET, individual sessions were supported by group sessions with individuals who had similar experiences, and whom the individuals might maintain connection with outside of, and after the group ended.
In Winnipeg, there are various programs and resource centres designed to work with men who have experienced trauma, particularly childhood trauma, and there is a private trauma centre. Individual counsellors use various therapies such as Eye Movement Desensitization Reprocessing and training in mindfulness and emotional regulation skills (See “When YOU are the Volcano – 7 Ways to Care for Yourself“)
As a society, we can do better.
We can start by acknowledging the impacts of bullying and abuse on boys.
We can teach boys about emotional awareness, expression and empathy.
We can push for more supports and training for police officers, paramedics, fire fighters, and other first responders in the area of trauma, conflict mediation and debriefing.
We can hold our governments responsible for the supports and services given to military personal. We can support programs which engage children and youth living in impoverished communities.
We can consider what inmates need to prepare themselves for re-entry into society and work to create a justice system that seeks restoration, balance and healing in society, not only punishment.
We can stop shaming boys for emotional expression and for communicating their pain.
We can teach boys how to be assertive and respectful without needing to be aggressive.
Men can reach out to men and demonstrate concern, affection, love and support.
If you are having thoughts of harming yourself or someone else, and believe you are at risk of following through with those thoughts, call a crisis line. Click here for crisis lines in Manitoba or call 911 or go to an emergency room. If you’ve experienced trauma and want to find ways to address it, don’t hesitate to contact a counselor for help. If you are in Winnipeg, you can contact me regarding a counselling appointment, by clicking here.
For more on men and emotional connection, See “Men”
For more on addictions, see “Addiction – Your Best Frenemy”
For more on anxiety, see “A Good Time to Panic”
For more on anger, see “When YOU are the Volcano – 7 Ways to Care for Yourself”
For more on depression, see “When You’re Down”