Male Victims of Sexual Assault - Article Example

Discussion In this section I will examine the results of the study in greater detail, and offer some insights and interpretations of the data. I will also relate the data to the Literature Review presented earlier. Glaser (1998) states that in grounded theory research, the literature review should be treated as simply another source of data, to be compared and added to the raw data which one obtains from interviewing participants. Themes As indicated in the chapter on Results, six main themes emerged from analysing the data from the interviews. These were: Changes that may help Experiences of counselling received Helpful things not via counselling Reasons for not accessing sooner Effects of assault Telling people. For each of these main themes a number of secondary issues emerged, as listed in the Results chapter. The issues which were most important to the participants will be discussed in the remainder of this chapter, and I will also show where my results concur with the Literature Review. Changes that may help Fourteen issues emerged for this theme, with all participants agreeing on the importance of the following three issues: Media; More information; and Information in public places. Eighty percent of participants also agreed that the following were important: Information on normal reactions; Support of others; Stereotypical views; and Increase of government funding. A central concern for all participants was that male rape carries a social stigma, which is reinforced rather than challenged by the media. Most participants discussed common stereotypes about male rape, such as its portrayal by the media as an issue affecting only gay men or male prisoners. This is similar to the portrayal of rape as only a women’s concern. Although statistically more females than males are victims of rape and sexual assault, as reported in the Literature Review, literally hundreds of males are affected by these crimes. Many or most victims are heterosexual males who are not prisoners at the time of the assault (Groth and Burgess, 1980; Lipscomb, 1992). Male rape is inaccurately stereotyped or trivialised in the media, and the resulting stigma sets up a major barrier for male victims to access counselling services. Of great concern is that most participants in this study perceived the Police to have the same stereotyped views of male rape. This made them more reluctant to report the assault, and in fact some participants did encounter Police hostility when they reported their assault. Another related concern for all participants was the lack of publicly available information about organisations that serve male rape victims. Several participants indicated that there is an expectation that men should not need to talk about their feelings, not even following a sexual assault. This contributed to their problems with trying to find out if there are organisations to serve male victims. Often it was friends or relatives of the victim who made the initial phone calls or set up an appointment, as the victim himself was in a kind of paralysis or depression. This can make it very difficult for a male victim to seek out sources of support, which means it is all the more important to have information about resources and services widely publicised and easily available. Most participants agreed that there should be advertisements in the Yellow Pages, but it did not seem that any of them had actually looked through the Yellow Pages themselves, but rather relied on friends and family who may have done so. Simon said that the cost of advertising in the Yellow Pages is prohibitive for his organisation. These issues indicate another serious barrier facing male rape victims, and several times the participants agreed that Government funding is essential if these problems are to be overcome. It appears from the interviews as well as the literature review that men are emotionally vulnerable following a sexual assault or rape, which puts them at a disadvantage in terms of having to hunt down a support service which is otherwise invisible. Such a search requires a degree of emotional stamina and optimism which most of them lacked at the time. All participants initially did not know that such groups or counsellors even existed, and in Simon’s case he ultimately could not find such a group and thus started one up himself. The other participants were very surprised and relieved when they did link up with the support group and met other male survivors. Several participants mentioned that they had suicidal ideas following the assault, and that they had survived thanks to their friends, family members or employer having put them in touch with the organisation. Although the social support which these victims received is commendable, the situation should be such that a man does not have to rely on others or go unduly out of his way to find out about support groups. This means that information must be much more freely and readily available. Of extreme concern is the fact that two participants spoke about having tried to get a poster or posters put up in G.P.s’ surgeries, Police departments and other appropriate public areas, advertising the support group. It appears that there was repeatedly a refusal on the part of professionals and institutions to allow these notices to be displayed. This is a very serious obstacle which needs to be addressed at a political level. It is related to the stigma and stereotyping which has already been discussed, and clearly demonstrates the need for a widespread shift in attitudes towards male rape. As one participant put it, if attitudes towards AIDS could be changed, it should be possible to change attitudes towards male rape and sexual assault as well. Eighty percent of participants found it helpful to learn about the nature of rape itself, namely the characteristics of perpetrators, and what is normal in terms of the victim’s reactions. For one participant, learning about perpetrators helped him to stop blaming himself. Another participant had ejaculated whilst being raped and this was a great source of confusion and distress. It helped him to learn that this is a normal reaction that can occur in male victims, and is not shameful and does not imply enjoyment or consent (Groth & Burgess, 1980). Similarly, signs of sexual arousal can occur in female rape victims and they too need to be educated that this is normal (Levin & van Berlo, 2004). Reasons for not accessing sooner Eleven issues emerged under this theme. The main reason given for not accessing help sooner, which was agreed by all participants, was that they were not aware of any support organisations for male victims. This relates to what was said earlier about the need for more information to be made publicly and widely available, not only about the nature of male rape, but also about the existence of support groups, counselling and so on. Sixty percent of participants stated that they delayed in accessing help because they did not feel comfortable in talking about their feelings and problems. This can be linked to the social expectation that men should be invulnerable and not talk about their feelings. Sixty percent also said that they mistakenly thought they were dealing with the after-effects of the assault well enough, and it was only once they went into counselling or joined the support group that they realised they were not in fact doing so well. Two participants said that they had tried to access help earlier, but were turned away from organisations that catered for females only. Experience of counselling received Fifteen issues were identified under this theme. All participants agreed that counselling helped considerably. However, 80% spoke about some conflict in their feelings during counselling, in that they wanted to forget about the rape but they also needed to talk about it, which meant remembering. Eighty percent also said that the first few sessions were the most difficult, and those who had been referred through general counselling services or EAPs found that this type of counselling was less helpful than the more specialised kind. Eighty percent of participants preferred counselling or support groups which allowed them to feel more in control, for example where they were not pushed to talk about things until they felt ready to do so of their own initiative. Other comments made by the participants showed that a person-centred approach was preferred; that it would help to have more counsellors available through G.P.s’ surgeries; that one should not have to wait for a long time before a session; and that having only an hour to talk might not be sufficient. One man had been unable to pay the fees for the counsellors he initially accessed. Helpful things not via counselling Three issues were identified for this theme. Most participants had turned to the internet for support and education on male rape issues. Eighty percent agreed that support groups, whether online or face-to-face, were very helpful, and 60% of participants stated that the internet had helped them. One aspect that was particularly useful here was the cross-pollination of ideas and research from other countries, as well as knowing that they had support without having to be vulnerable in a face-to-face setting. A couple of participants felt good that they had been able to support other victims in turn. Forty percent said that research in general had helped them to understand things better, whether it was the perpetrators or their own responses. Effects of assault Eight issues emerged for this theme, representing a range of responses to sexual assault or rape. All of these symptoms concur with the effects listed in my Literature Review. Normal responses include PTSD and flashbacks or intrusive memory, sleeping problems, anxiety or phobia, substance abuse, relationship problems and especially problems with trust and intimacy, depression, suicidal thoughts, problems concentrating at work, and fragmented memory of the assault. The latter may be due to dissociation. Clients with a history of childhood sexual abuse must be screened for dissociative disorders, as these are currently very under-diagnosed and insufficiently treated (Goldsmith, Barlow & Freyd, 2004; Kluft, 2003). All of the above problems were mentioned by participants, with 60% reporting suicidal ideation or actual self-harm, 60% reporting a loss in self-confidence and 60% reporting problems relating to other men. Whatever the symptoms, it helped them to be reassured that they had been responding in a normal way to an abnormal stress (i.e. a trauma). Telling people Eight issues were identified for this theme. Eighty percent of participants said that having the support of other people was very helpful, and 60% stated that they had told someone about the assault after it occurred. This means that 40% of men faced some kind of barrier to telling anyone about the crime. In two cases the victim had been a child when the assault/s took place, and in one case the child had not been able to tell his mother but felt that she might have known anyway. The issue of whether or not to tell the Police about the attack was a serious one for many participants, with only 40% saying that they had reported it to the Police. There was a similar doubt about the value of telling one’s G.P., with only 40% of the men saying they had informed their G.P, and an equal percent feeling that the G.P. was unhelpful. Because of the seriousness of the issues around telling Police, three further areas of concern were identified for this issue. Forty percent of the participants felt that they had been unable to report the matter to the Police because of the attitude of the Police themselves. One man had been raped by a Policeman in the context of a gay relationship, and he felt sure that the Police would not believe him. Another recounted that when he reported the assault he was not given any privacy and was asked loudly in a public space if he was gay, which he found traumatic. One participant made the suggestion that rape victims should be allowed to report their assaults via special rape units at hospitals, rather than through the Police. He also felt that the prospect of having to undergo an examination was daunting and was part of the reason why he delayed for a month before reporting the incident. Literature review It has already been shown that the symptoms reported by the participants in this research, following their rape or sexual assault, concur with those reported in the literature. Norris (1992) found that sexual assault is one of the most common causes of PTSD and this has been borne out by numerous other studies, as cited in the Literature Review. The current research supports Holmes, Offen and Waller’s (1997) statement that male rape does have very adverse consequences for the victim. Burgess and Holmstrom (1974) and Mezey and King (1989) said the same thing, indicating that male rape victims suffer similarly to female victims. However, as indicated in the current research, there are certain gender differences which need special attention, such as the difficulties men may encounter in talking about their feelings. One participant mentioned that his “male pride” made it harder to talk about his feelings around the rape. The findings of the current research also concurred with Mezey and King’s (1989) finding that men were reluctant to report the crime due to “the stigma, fear of rejection or disbelief they anticipated.” This appears to be one of the main barriers to men accessing help, and must be tackled on a national and governmental level through changes in the media portrayal of male rape. The results of the current study also concur with Miller’s (2003) findings that men experience barriers in the form of stigma and social perceptions about gender roles, as well as knowledge barriers, a lack of recognition that one is not dealing with the problem adequately, and finally finding a counsellor. However, some other recent studies (as reported in the Literature Review) have found that while services are actually available for male victims, men tend not to make use of them. Further research is necessary to assess the extent of this scenario, and possible reasons for it. It may be that not enough information is being made available publicly about these services. Smith, Robertson and Houghton (2002) found that younger G.P.s believe that mental health assessment should be part of the routine physical examination of clients. Given that several of the men in the current study felt their G.P.s to be unhelpful regarding the after-effects of the assault, this indicates a potential avenue for the future training of doctors and the treatment of male clients. Two of the participants in this study remarked that they had simply been given anti-depressants by their G.P.s and were not happy about this; a third had taken anti-depressants but felt he could not talk openly to his G.P. Summary This research has identified several obstacles which male victims face when they attempt to access counselling support following a rape or sexual assault. The main focus points for change are education, advertising and publicity, and funding. Across all categories which emerged from the interviews, the following stand out in importance: Lack of information about services available specifically for men Lack of government funding and recognition The impact of gender stereotypes and the stigma of male rape, which are exacerbated rather than countered by the media A difficulty in dealing with one’s own feelings as a victim or as a man Discomfort with the counselling (e.g. lengthy waits between sessions; too few sessions; sessions too brief; counselling not specialised enough; the counsellor was not of an appropriate age or gender, was inappropriately dressed, or was inexperienced; they felt exposed because members of the public watched them arrive for counselling). The symptoms from the assault itself, such as low confidence or depression, sometimes prevented men from seeking help. On the positive side, there are already several support structures in place which the participants were able to access. One of these was the support of friends, family or employers/colleagues, and another was the internet. Despite the doubt about the value of telling one’s G.P. or the Police, several men did actually do so. If all of these avenues are used to advertise and strengthen existing support, many more men could be reached. Police personnel and primary health care doctors should be required to undergo mandatory basic education about the issues of male rape, and how to help the victim. If it is left to individual Police or doctors to educate themselves, there is unlikely to be widespread change and male victims will continue to face enormous barriers when trying to access help. In other words we need to build on the existing support structures and strengthen and add to them. It is not that we don’t know what to do to help male rape victims, it is a case of needing to do more of what we are already doing. An effort must be made to increase public awareness of both the problem of male rape and of the services offered for those who have fallen prey to it. Goldsmith, R.E., Barlow, M.R., & Freyd, J.J. (2004) “Knowing and not knowing about trauma: implications for therapy”. Psychotherapy: Theory, Research, Practice, Training, Vol. 41, No. 4, 448–463. Accessed 31 Dec 2007 at http://dynamic.uoregon.edu/~jjf/articles/gbf2004.pdf Groth, A. Nicholas and Ann Wolbert Burgess. (1980). "Male Rape: Offenders and Victims." American Journal of Psychiatry, 137(7): 806 - 810. Kluft, R.P. (2003). “Current issues in dissociative identity disorder”. Bridging Eastern and Western Psychology Vol 1, no. 1 Lipscomb, Gary H. et al. (1992). "Male Victims of Sexual Assault." Journal of the American Medical Association, 267(22): 3064 - 3066. Levin, R.J. & van Berlo, W. (2004) “Sexual arousal and orgasm in subjects who experience forced or non-consensual sexual stimulation – a review”. Journal of Clinical Forensic Medicine Vol 11, Issue 2, April 2004; p 82-88 Read More