Male survivors of childhood sexual abuse

I first met male survivors of childhood sexual abuse in my work for the St Vincent de Paul Society where I volunteered for a few years straight after graduating. I'm not sure I was well prepared for they told me, as nothing can prepare you for true stories of evil, but I knew enough to be able to listen to them in a way that showed them I truly heard them.

Not surprisingly alas, a large number of them came to counselling only indirectly because of what had happened to them in their childhood, even though it clearly had repercussions into their adulthood, but rather because they were struggling with addictions, usually to "substances", and for some of them that came hand-in-hand with stints in prison, either for crimes linked to substance-abuse, or for violence.

A few years later I read a wonderful and heart-breaking book by Stephen Grumman-Black called "Broken Boys/Mending Men". Himself a survivor of childhood sexual abuse, he recounts both his story and that of other survivors, covering key aspects of shame, confusion, betrayal, hope and healing. Both the extent and the variety of abuse, as well as the feelings of guilt that those innocent boys felt despite clearly being the victims, did still somehow surprise me.

By then my work had mostly moved to private practice, and more of my clients were seeking me out for addiction problems, and the majority of those were also telling me about the sexual abuse they suffered in their childhood. The link between trying to cope with the unbearable and eventually becoming addicted to the means of self-medication became quite clear to me.

Victims of childhood sexual abuse suffer complex trauma: it is repeated harm that was inflicted on them as children, mostly by a person they trusted, often someone very close. The trauma effects run deep: post-traumatic stress disorder, complete with flash-backs and nightmares, difficulties to trust anyone and long-term health issues are the norm.

I guess I am painting a bleak picture of what the lives of childhood sexual abuse survivors look like. Thank god, or rather thanks to the untiring work of some of them, help is at hand. Obviously therapy can be one of the ways to come to terms with it, and to help becoming a survivor rather than a victim.

But as importantly, if not more, there are people out there, like Craig Hughes-Cashmore and Shane McNamara from the Survivors And Mates Support Network ( www.samsn.org.au ) who are helping male survivors realise that they are not alone, and through group work and peer support offer a way out of the isolation, silence and shame. SAMSN also offers practical help and advice, and both Craig and Shane being abuse survivors themselves, means they truly understand and empathise.

If you have been sexually abused in your childhood, please do reach out. Nothing can change your past, but some support may just be all you need to make your present and future your own.

SAMSN in Sydney: 02 8355 3711

Dementia and anticipatory grief

Today's post is about dementia, and more precisely about the loss that is felt even though the person is still physically there with you - anticipatory grief.

There are few things as devastating as watching a loved one sink into dementia. What starts off as age-related memory loss that can be glossed over eventually becomes something that cannot be ignored anymore.

Often the realisation only starts when something happens that takes the dementia-sufferer out of their normal environment: in older people, that may be a fall, or a severe illness, or the death of someone close. Suddenly the person who has coped really well in appearance finds their landmarks have been shifted dramatically, and they now struggle to find their bearings.

They may find themselves at hospital, and there everything is different - the way to the bathroom, the way the phone looks, the food, the people looking after them. Confusion settles in and the fragile equilibrium that they have managed so far abandons them.

For the carer, this is the moment when it hits home: their loved-one is not "quite right" anymore. Their mental faculties seem halved and their bodily functions that have always been taken for granted take a hit too. There is still hope at that moment, that things will go back to normal.

But the reality is that things haven't been normal for quite some time - human beings are just very good at pretending that change is not happening. Then it starts sinking in: this is the new normal. OK, we think, we can do this, and we take it into our stride.

Until the next thing. It's a bit like watching the wheels of a car fall off in slow-motion - it still runs quite well on 3 wheels, but on 2 the crash is coming dangerously close.

And one day, you realise that the person you love, the smart, argumentative, in-charge adult you have known all your life is not really there anymore. Overnight (over a year or two) they have been replaced with someone looking like them, but not really them anymore. Think invasion of the body-snatchers.

If you are lucky, they have been replaced by a mild older version of themselves. If you are not, you get a more aggressive version. Neither seem to be them though.

And so you start your process of grief and loss: they're very much alive, but lost to you and their environment, existing only in a very reduced version of themselves. They need looking after, often 24 hours a day. From parent, lover, spouse, they have become children again, with all the needs that implies.

And the grief takes over the relationship, because you know that it is only a matter of time until all they have been is gone, and you're only left with the shell of who they were.

But somehow, that is also the moment when you can look after them, make sure they are comfortable, and give them what one gives a baby - unconditional love, despite broken nights and nappies and no conversation...

You can make it bearable for them, so that by the time they die, you have said good-bye in a meaningful way: by loving them to the end.