Men Who Are Subjected to Sexual Abuse

This chapter is based on interviews with ten men who have sought help for sexual abuse. Most of these men have additionally experienced other forms of physical and psychological violence, as well as childhood neglect. Their experiences with these various forms of violence are described here in detail, as are the differing consequences these have had for the men involved.


Men Who Are Subjected to Sexual Abuse
Although the following extracts are taken from interviews with men who sought help because they had been subjected to sexual abuse, it should be stressed that no absolute boundaries can be drawn between various forms of violence. Men who appear elsewhere in this study who sought and obtained help at other crisis centres for physical and psychological violence may also have experienced sexual abuse. It is common for men who have been subjected to sexual violence to be subjected to physical violence too. Where interview material showed or indicated psychological violence or neglect of care, this has been noted. A host of studies show that children and young people who are the victim of one traumatic event are often the victim of further similar events, a fact termed polyvictimisation in the research (Finkelhor et al. 2007).
Since research in recent decades has also shown the profound psychological consequences of psychological violence and neglect-that is, not only violence which is manifest physically and can therefore cause physical damage and pain-we have chosen to include evidence of such experiences where they are indicated in our material.
Most of the men interviewed were middle-aged (between 36 and 48 years), with the exception of one younger man (28) and two who were over 60. Our sample represents a relatively broad spectrum of men who have differing circumstances in life and occupation. Some lived alone, with or without their own children, or were divorced. Others were married or lived with a girlfriend, with or without their own children or stepchildren, or had children who had moved out (and grandchildren).

To What Kind of Abuse Have These Men Been Subjected?
A striking number of the men interviewed here had experiences that dated back to their early teens or pre-dated puberty (10-15 years). In many cases the abuse took place for a limited time at this age; sometimes it continued until much later. But there are some who were subjected to abuse from an even earlier age (4-12 years, 6-8 years). In a couple of cases there are also experiences of recurrent sexual abuse in adulthood, or in one case what may more precisely be described as a form of sexual blackmail which was experienced as offensive and psychologically damaging.
The extent of the abuse suffered varies greatly, from discrete episodes (although sometimes on more than one occasion) to a number of times within a limited time frame, or regularly committed by the same perpetrator over a period of several years. A number of men have also been subjected to abuse a number of times by different perpetrators.
Often, but far from always, interviewees also report other forms of violence during childhood and adolescence. Many have experienced, or witnessed, frightening physical violence, or threats or been subjected to psychological violence, or have experienced neglect. The latter can also be seen as a form of violence from a psycho-developmental and human existential perspective. This definition is incidentally consistent with that used by Sogn and Hjemdal in a previous report on violence against men in intimate relationships (Sogn and Hjemdal 2010).
The perpetrators have generally been family members or otherwise close, but their profile differs widely: in some cases fathers or stepfathers were responsible for the abuse (3), in others an uncle (3), and finally neighbours or acquaintances of one of the parents. The latter category includes a postman and a scout leader. Many, but not all, of the perpetrators are men. In one case the perpetrator is a female friend of the father, in another a slightly older girl. In the case of one of the interviewees, an aunt was in part responsible for the abuse; while not abusing her nephew herself, she contributed indirectly to the creation of an abusive situation. In another case, a mother-in-law subjected her son-in-law to unwanted sexual activity for years. It should also be noted that the mother of one of the interviewees frequently hit him when he was a child. Another mother threatened her son and his brothers with violence from their father in his absence, and supported the physical punishment of the boys in various ways.

Experiences of Violence in Childhood Sexual Violence
All those whose stories are summarised and analysed here were subjected to sexual violence during childhood and/or adolescence. Here are some of the men's own stories about their concrete experiences.
Bjarnar (48) was 11 years old when he accompanied his father (a construction worker) on a job for a man in the village. At one point Bjarnar was left alone with this man, who then took him into the forest behind the house where he lived. There the 11-year-old was undressed and subjected to oral and anal penetration. The man who abused him said he "was as nice as a little girl". Later this was repeated just over half a dozen times by the same perpetrator, who threatened the boy that if he told someone about what had happened, he would be killed. The use of such threats is found in several of the interviewees' stories, and is one of the explanations of their keeping quiet about their experiences.
Terje (46) was first assaulted sexually at the age of 9, by a neighbour and acquaintance of his mother. Although this only happened a couple of times, and was limited to Terje being forced to touch the man's genitals, it was a terrifying experience for one so young. The perpetrator also had a tendency to be physically violent, as witnessed by Terje in other situations. Later, when he was 12, Terje was again subjected to abuse, this time more persistently and for a longer period of time by another man. This man also lived in the neighbourhood and was also acquainted with Terje's mother. The abuse, often oral, could sometimes be repeated several times on the same day, and lasted over a period of at least six months.
Kjartan (36) used to spend time with his uncle, who worked in a newspaper and sweets kiosk in the evenings. Kjartan's uncle allowed him to have all the sweets he wanted. His uncle was also a taxi driver and used to pick up his nephew in his car. Kjartan sometimes stayed the night at the house of his uncle, who drank heavily and watched pornographic films. It was on these nights that the abuse generally took place, although it sometimes happened during the day. This abuse started when Kjartan was only 4 or 5 years old and continued until he was 11 or 12, but was at its worst at about the time he started school, aged 7.
This combination of an abundance of sweets, soft drinks or food, offered at a perpetrator's home, while simultaneously watching porn movies, is one that turns up in several of the men's accounts.
In the case of Odd (63), the perpetrator was a former girlfriend of his father. Odd's mother had died when he was 10 years old and he grew up alone with his father. However, the father was unable to care properly for his son; indeed, he was unable to really take care of himself. He had many, more or less temporary, relationships with various women. When his father was no longer interested in a certain "friend", her focus shifted onto Odd instead. She made him food and bathed him, something nobody else was doing. Bathing Odd gradually evolved into a form of sexual foreplay. As part of the child's bath-time ritual, she masturbated him "and used me in bed and … I did things with her like, yes, did what you do, yes, I was told to do things and I did them …". This lasted for several years until Odd put a stop to the abuse himself.

Range of Violence: Corporal Punishment, Bullying and Psychological Violence
A couple, or at most a few, of the men appear to have grown up in relatively stable and secure environments. Nonetheless, there are sometimes signs that might suggest things were not quite right. Bjarnar grew up in a seemingly safe and normal family, but was exposed to sexual abuse outside the family, and was not listened to by his parents or teachers when he complained about the bullying he was suffering in school. This contributed to Bjarnar keeping quiet about the sexual abuse. Kjartan explains that his parents both had good jobs and have been married for years. In that sense, his family home was stable. Yet both Kjartan and his two brothers have all become drug addicts. Anders (45) describes a secure upbringing in a small community in northern Norway. He experienced no physical or sexual abuse from close family members, but was probably abused by an uncle in another town. At the same time, there are suggestions that strong language was used in the home and that his mother, exhausted and mentally unstable, would shame him and induce guilt in him verbally.
In the majority of the other cases, the circumstances in which these men grew up were more obviously unstable, often with instances of explicit violence.
The wide variety of difficult childhood experiences is illustrated by the account of one of the study's older interviewees, Odd. As a child, he experienced both neglect and sexual abuse. In addition, Odd's time at school was, as he describes it, characterised by "absolutely terrible bullying". His mother died when he was 10 years old and his father could not give the son the care he needed. Nobody bathed Odd or ensured he had proper clothes, or comforted him or made moves to ensure that the bullying he was experiencing in school stopped.
Three participants describe the regular use of corporal punishment during childhood. Sølve (61) was subjected to a form of punishment by his father that crossed the boundary between physical and sexualised violence. When Sølve or one of his brothers had done something to anger their strictly religious and authoritarian parents, they were forced to strip off and go and fetch the stick used to punish them. They then had to go into the bathroom, where whichever boy was being punished had to lie on his father's knee. Before the punishment was executed, it was announced how many strokes had been given on the previous occasion, to which number two additional strokes were added for the punishment that day. Sølve also noticed that his father had an erection when he beat them, and the harder he hit them, the stronger his erection became.
Odd was beaten with a belt by his father. "He hit me … he was a man with hard hitting opinions …,". Ola (46) was also often hit as a small boy, but by his mother. Here, physical punishment seems to have been more impulsive and unpredictable. His mother could hit him without him really understanding the reason for it. In retrospect, he believes that he was simply unable to live up to her expectations of him, either in his behaviour or his aptitude. At the same time, Ola had no real help from her in understanding what was required of him. There was, he says, a lot of screaming and emotional abuse, often under the influence of alcohol, which could without warning also turn into physical abuse. The interviewee describes his mother as a guilt-tripper, erratic and psychologically absent.

Witnessing Violence and Sexual Abuse
Ola also describes his grandfather (on his mother's side) who, although she never actually beat him, was a heavy drinker who liked to fight. Ola's grandfather was a manual worker and extremely strong. The men whom Ola's mother brought home often got a taste of his grandfather's fists. Ola describes his mother as a narcissist: "She was always dragging men back to my grandfather's apartment all the time, and he'd fling them out again, and I watched on. That was my first 12 years of life." Although Ola describes having positive feelings for his grandfather, these violent episodes had a deep and negative impact on the boy's mind. On one occasion, for example, when he and his grandfather were returning from a food-shopping trip, they got into a heated exchange with some boys in the park. This ended with the grandfather lashing out at them with a bottle of fruit squash. Later, when Ola went to mix himself some squash, he discovered that there was blood on the bottle. When asked how these events affected him, Ola says that he was already dissociating himself from most of his unpleasant experiences; that is, he had developed the tendency to protect himself and shut off his emotional life.
Joar (28) reports that he has been constantly surrounded by conflict and violence since childhood. He saw his mother beaten by his father and witnessed his brother being sexually abused by the father, in addition to suffering abuse himself. Various forms of sexual, physical and psychological violence were a regular part of his everyday life. For example, his father would take his two sons in the car when he was inebriated and drive around at top speed, terrifying them. Despite a relatively early divorce and their relocation, his father repeatedly hunted the family down and continued to terrorise them. Unfortunately, the situation did not improve with either of the two new men with whom his mother went on to have relationships, after divorcing Joar's father and finally managing to escape him. One of the men abused the young boys sexually, while the other was physically and psychologically violent; among other things, Joar was subjected to forced feeding. Their mother was raped within earshot of the children.
Being a witness to violence can be very frightening and have a similar traumatising effect to being exposed to violence oneself, something that is stressed in DSM, the North American psychiatry diagnosis manual. Terje describes a man who was acquainted with his family during his childhood. Although no one in the family was violent themselves, this man was a heavy drinker with a violent temper (he was also sexually abusive towards Terje on a couple of occasions). The violence did not happen in the family home, but when they visited the man's house. Terje describes an incident when this man "got into an argument with some mate of his, who got a thorough beating, got totally smashed up. He was super strong and lifted his mate up and threw him up onto a fence." Naturally, this experience was very frightening for the 9-year-old boy.
Research shows various negative consequences of witnessing violence, as well as a correlation between this phenomenon and other manifestations of violence. Among other things, a clear connection has been documented between the experience of witnessing violence and a vulnerability to violence (Mossige and Stefansen 2016). Children subjected to violence by parents run an increased risk of being subjected to violence by their peers (Mossige and Stefansen 2007). Witnessing and/or suffering violence in the family home has grave consequences on children, since a child's home is the main arena for security and development (Thoresen and Hjemdal 2014;Braarud and Nordanger 2011). WHO reports have also shown a strong link between parents' psychological functioning, stress and family structure, and the risk of child abuse (Krug 2002).
As previously mentioned, the concept of poly-victimisation (Finkelhor et al. 2007) has been used in studies to describe the fact that those who are, for example, subjected to one form of violence very often go on to experience other violence. This is true of most of the men in this study, and we will now look in more detail at these men's experiences of bullying and neglect.

Bullying and Neglect
Like many of the men interviewed, Terje was bullied as a boy: "from the first day of primary school to high school. Almost daily. I had to go the long way to get home because people used to throw stones at me." Odd describes ongoing and painful bullying at school. He turned to his teacher for help, but went unheard. So Odd took the matter in his own hands and armed himself with a bicycle chain. When he was cornered by his classmates one day, he took out the bicycle chain and lashed out with it. His teacher sent him to the head of school and the chain was confiscated. But feeling that he had no one to support him or that he could feel at all safe, Odd now armed himself with a knife, which he hid in his boot.
Erlend (41) describes how his divorced mother met a new man when he was 12 years old, which meant moving to another area. But life was difficult, and he was harassed and bullied. Erlend describes this as a level of humiliation that an adult might handle, but not a child. Among other things, Erlend was forced to act as a chauffeur for his stepfather when he was drunk, despite being no more than 13 years old. After one long evening driving the car (illegally), the boy was too exhausted to go on and his stepfather took over the wheel. Being drunk, he soon drove off the road, but blamed the accident on Erlend.
More than half of the men interviewed describe recurrent bullying in childhood and at school. It would be reasonable to ask if this apparent link between vulnerability to sexual abuse and early bullying is a coincidence, or partly a result of the insecure backgrounds from which most of our participants come. However, since our material is neither extensive enough nor takes this issue as its primary focus, we can only point to the prevalence of childhood bullying in the accounts given in these interviews.
Nevertheless, an indication that such a link may exist appears in research that shows that children with ambivalent attachment issues are frequently impulsive and vulnerable, which in turn often makes them susceptible to bullying (Bunkholdt 2000).
Terje's own reflections on why he was bullied are worth quoting in this context: Clear evidence of childhood neglect emerges in several of the men's accounts, as already discussed, and may be discerned in some of the other interviews. The divorce of parents and abuse of alcohol or drugs all feature regularly in the accounts given by our participants. Several have grown up without a close relationship with a father. A couple of men, on the other hand, have lost their mothers early or lost contact with them. In the vast majority of cases, the siblings of the men interviewed (where there were siblings) have had similar difficult experiences, with similar negative consequences.

Consequences of Sexual and Other Abuse During Childhood
Regardless of how and when the abuse took place, as well as its extent and precise nature, it has had profound and lasting consequences for all the interviewees. Most dramatically, Arne (38) describes the consequences of the abuse he was subjected to as a 12-year-old as a "real before and after". He had a relatively harmonious early childhood, but his parents got divorced when he was 7 years old. It was five years later, when Arne was sexually abused by his football coach, that his life took a dramatic turn: "a few months after that, everything that was good Although there are huge variations in the sorts of psychological impact the abuse had on these men, the kinds of relationship difficulties with which they have since struggled, as well as the extent and duration of their symptoms, the evidence is clear that the effects are pronounced and painful. Symptoms include, for example, intermittent or lasting insomnia, difficulties with concentration and problems with anxiety, in some cases very severe.

Shame and Guilt
Like other children who have been subjected to abuse or violence or other destructive behaviours, the interviewees have also had feelings of shame and guilt about what they experienced. The reaction of shame or the taking on of responsibility for what others have subjected one to may seem strange, but is a very common and widespread phenomenon, especially among children. The logic behind this appears to be that since one is subjected to such appalling and negative experiences, the fault must somehow lie with oneself. This simplistic logic is also often reinforced by the perpetrator or the punishing parent, who will state this to be a fact. For those who have suffered abuse, a sense of shame and guilt seems to be more the rule than the exception.
According to studies by, among others, Mullender et al. (2002) and Steinsvåg (2007), children who grow up with violence in the family experience a sense of disempowerment and feel that the world is fundamentally unpredictable. It is not rare for them to assume responsibility for the violence and to experience guilt because they feel they must have done something wrong to cause it. This affects their self-image and sense of worth, and children with this type of experience often describe a pronounced sense of shame (Mullender et al. 2002;Steinsvåg 2007). This is also evident in our material.
Joar, in particular, feels guilt on behalf of his mother and siblingsthey were all victims-for not doing more to put an end to his father's violence and abuse when he himself was only 13. Joar protested and tried to put a stop to the violence, but has since thought he should have done more. He even feels shame about the early abuse he himself was forced to endure. Terje, who describes himself as a very shy and easily embarrassed child, had a sense of shame in his teens, feeling sure that everyone could see what he had been subjected to (i.e. sexual assault) and that he was like an open book. He describes how he almost always went about with downcast eyes as a teenager.
According to research in the field, common consequences of violence and abuse in childhood include problems with attachment, social avoidance, sleep disorders, problems with concentration and aggression, as well as anxiety (Braarud and Nordanger 2011;Glad et al. 2010).

Self-Esteem, Alcohol and Drugs
All the men interviewed describe having low self-esteem. They have all, in their different ways, struggled with a sense of never being good enough. Even those men in our study who were subjected to partner violence describe experiencing a sense of inadequacy and feelings of worthlessness. The majority of men, although not all, who have been subjected to sexual abuse have also used alcohol, analgesics, anabolic steroids, cannabis and/ or other drugs to deal with their sense of worthlessness and other difficult emotional issues. In many cases they were already surrounded by alcohol, and occasionally even drugs, as they grew up.
One of Erlend's earliest memories is of sitting on top of the freezer drinking beer while his father talked on the phone. His father permitted this. Erlend's developmental environment was dominated by regular partying and alcohol. He was only 4 or 5 years old the first time he got drunk at a party. The little boy was so drunk that he could no longer walk straight, but staggered around and fell over. Everybody at the party laughed and found this funny. Although this case is extreme, the easy availability and presence of alcohol (sometimes even drugs) seem extremely common in these men's backgrounds.
The abuse of various substances, with a stimulating or sedative effect, is something that is also found later in these men's lives, for shorter or longer periods. At very least we see the use of alcohol in certain situations in order to cope with insecurity and anxiety (for example, in larger social situations). Arne describes how he started drinking regularly after suffering abuse as a 12-year-old. By the age of 16 he had probably already been held in police cells ten times for being drunk. When he was 21 years old he became a long-term drug abuser. Erlend followed a similar drug abuse career, consuming alcohol from the age of 15 onwards. After a few years he was also using hash, amphetamines, cocaine and other drugs ("I tried everything"). Fortunately, he succeeded in giving up these drugs at the age of 29. Kjartan explains that he started getting drunk when he was only 12 or 13. Now, despite having received treatment for drug use, he still, at the age of 36, struggles not to fall back into his old habits.
Although the majority of the ten men interviewed have abused alcohol/drugs for longer or shorter periods, it should be noted that some have not, or that their use of alcohol has been at a normal and socially acceptable level. There are other men in our study who also display the tendency-albeit not as accentuated or prominent-to drink in order to ease the pain and avoid distressing thoughts.

Social Consequences
Being the victim of violence and abuse early in life often causes various social limitations in the future. According to contemporary psychological research concerning attachment (Bowlby 1994;Wennerberg 2010), as well as psychoanalytic studies of the significance of relationships (Stern 1995;Mitchel 1988) and research on trauma in various fields including neurology (Scaer 2001;Scaer 2005;Gerge 2010; van der Kolk 2014), we now know a great deal about the impact of a child's early relationships with their parents and other close caregivers on their relationships in adulthood (Bunkholdt 2000).
Just as there is an increased risk of psychological problems for a child who suffers sexual abuse, violence, bullying, harassment or neglect, there is also an increased risk that the child's future social relationships will be adversely affected. Our adult relationships tend to reflect our primary, emotionally significant relationships, particularly with close caregivers. It is not that, in an over-determined way, later relationships take on precisely the same pattern as our very first social experiences, but there is often a link.
The adult relationships of the men interviewed have often been influenced by the abuse and other forms of violence and neglect they have experienced in childhood, albeit in varying ways: difficulty in trusting other people (which is heightened if these people resemble the perpetrators of the abuse or are of the same gender) is both striking and common. Difficulties with close and intimate relationships in particular are a recurring theme, as well as a marked unease in various social situations. Arne says, for example, that he has many acquaintances but few real friends, and that he now has just one really good friend. Beyond that, Arne describes friends and family as a bit of a "fantasy". Erlend's statement is very telling: "I didn't let anyone in. I had such high walls. No one was allowed in, I shut down my feelings." Some men who as boys were abused by men may now have very difficult relationships with men in particular. Bjarnar describes this:

Well, it's probably this thing of trusting people, especially men. I didn't have too many friends back then … the mates I have today, of course, I met them in childhood, but I've probably burned lots of bridges and kept people at bay. …
Interviewer: Is it easier with women? Probably, not consciously, but unconsciously, yes. I feel that it's easier to trust women than men. I have more female friends than male.
In a reverse example, Odd who was subjected in childhood to abuse by a woman, says he has always been afraid of women and has difficulty relating to them. His experiences with girls as a teenager were also bad. Odd also suggests that his social relationships in general are not altogether easy: "decent people don't want nothing to do with me". He thinks he sends out signals to, and is also drawn to, those "who are far from being God's chosen." The patterns that emerge are not entirely unambiguous, however. Joar explains that despite his being subjected to abuse by his biological father and other forms of violence by his two stepfathers, it is primarily in his relationships to female partners that he experiences difficulties.
Terje also describes a life marked by loneliness: throughout childhood and adulthood he has been intensely lonely and has few friends. He has never had a girlfriend or lived with anyone. One of the men who abused him in childhood had said repeatedly while abusing him that this was something people did when they "felt affection for each other". Because Terje's experience was so frightening, loving or liking another person seemed equal to subjecting them to abuse. The consequence was a generalised fear of emotional closeness and physical intimacy.
Sexual abuse often occurs within particular kinds of social context, frequently within dysfunctional families and communities. However, one should not be too quick to conclude that all these men belong to one social group. As was pointed out by the director of one of the centres with which we collaborated, what the men who seek help have in common is that they have suffered periodic ill health and/or mental illness, as well as other negative consequences of the abuse to which they been victim. But, according to the director, they are not ill in the usual sense. They have PTSD and have grown up in situations that are characterised by neglect of care.
Several of the men have obviously grown up in unstable and sometimes broken families. A clear indicator of this is that so many of them mention siblings who have also been abused and have experienced similar difficulties, or have struggled with various mental health problems. Joar witnessed his brother being sexually abused by a family member. His brother was 10 before he began to speak. Terje has one brother and two sisters; one was diagnosed as bipolar, the other committed suicide five years ago. His brother has also sought help at the same centre for sexual abuse as Terje has. Erlend's siblings too have had severe problems. Although Erlend stopped his heavy abuse of drugs years ago and has since started to put his life in order, his older brother's life remains hampered by drug abuse and he is dependent on help from social services. In the case of Kjartan, the extent of the siblings' shared social legacy is even more pronounced: out of four children, three brothers are now drug addicts. Nevertheless, several other of the interviewees are clearly from more stable families.
A clear indicator of the negative social impact here is the emotional distance from others and the occasional self-imposed isolation common to many trauma victims-whether traumatised in childhood or adulthood. War veterans and others diagnosed with PTSD, or those who suffer from other mental illnesses due to traumatic events, often choose to live in isolated places, separate themselves off from others or exhibit other social problems (Ruzek et al. 2004; see also Scaer 2005, Figley andNash 2007;Tick 2005). This is also evident in our material, with several of the men showing a tendency to isolate themselves, to retreat or to avoid certain social situations or activities. Or, as Sølve describes it, he feels fine at a conference while the focus is purely on work:

… but in the evenings I give the socialising a miss. Because then I'm completely lost, I don't know what to do, so I might just as well sit alone in my room rather than sitting down there alone.
Researcher: Do you feel distant or alienated to other people? Yes, I get-I don't find it's easy to suss out whether people like me or not. Then I get suspicious. Naturally I've developed a very well-functioning radar for people I should avoid and people I should mix with …. In a way I can spot them from afar. But at the same time I can see that my barriers, my comfort zone-I've built up barriers so as to feel secure. And everything that's between there and there-I lose out on because I display-I get evasive, instead of forthcoming, people give up on me, I withdraw.
As we have seen, the lives of these men are affected and dictated in adulthood in many ways by the violent experiences they have had as children.
In addition to problems with anxiety, guilt, shame and other difficult emotions, many have experienced problems with alcohol and drugs. Poor self-esteem seems to be the rule rather than the exception and often has negative and restrictive effects on these men's social relationships, albeit to varying degrees. Occasionally one glimpses an even more tangible link between painful childhood experiences and similar experiences in adulthood.

Early Vulnerability-Increased Risk of Destructive Relationships in Adulthood?
One question raised by these interviews is whether there might be a connection between early exposure to violence and sexual abuse, putting these men at greater risk than others of ending up in similar situations again in adulthood. The concept of reenactment is very familiar and has been discussed in psychotherapeutic literature since Freud's time, receiving renewed interest in the contemporary literature on trauma. There is a tendency in those who have suffered trauma to repeat very painful experiences over and over again, putting themselves in harm's way, despite the seemingly illogical and destructive nature of such behaviour (Scaer 2005;Thoresen and Hjemdal 2014). While our material is limited, some of the more interesting examples are worth a mention here to throw light on this subject.
Joar has been subjected to a great deal of psychological and even physical violence as an adult, including, on one occasion, being stabbed by his former partner. In his own words: "Because I consistently go after girls who don't feel good about themselves and then I think: OK, now I can help you fix things so you can have a better life." His last relationship (mentioned earlier) eventually became so destructive that Joar lost any interest in life and developed suicidal thoughts. Joar believes that this situation, which he did eventually get out of, came about because he allows himself to be oppressed by women too easily, something he would never allow a man to do. Joar reflects on the fact that his mother was abused by a family member as a child and went on to choose men who in their turn subjected Joar and his brother to abuse. He says: "I choose women who are no good, don't I, I continue on the same path." Odd, who was subjected in childhood to sexual abuse by an adult woman, has been repeatedly sexually harassed by his mother-in-law, who exposed herself to him and made unwanted sexual advances, despite his asking her to leave him alone ("It's been a hell for me"). At the time of his interview, Odd has broken all contact with his mother-in-law for some years and refuses to meet her. As outlined earlier, his relationships especially to women involve a high level of fear, although he experiences social relationships in general as a complex area. Symptomatically, Odd lives with his partner in his country cabin.
Erlend reflects on the lack of boundaries prevalent in the environment in which he grew up, which was expressed most drastically perhaps in the sexual abuse to which he was subjected as a child. Erlend was introduced to inappropriate attitudes to sex, which he believes affected his sexuality as an adult, so that for a very long time his sexuality was disconnected from any emotion-he was obsessive yet totally indifferent. Even when, early on, he was in a long-term, stable relationship with a woman, he had casual sex with other women. Erlend describes how a few years prior to his interview, he had been locked in a threesome with a couple he knew. To his own surprise, Erlend got involved in a sexual act with the woman together with her very proactive boyfriend, without having really understood where it was going. He describes a particular sexual act which the other man carried out on the woman in his presence as both brutal and unpleasant, despite the woman having consented to the act. Afterwards Erlend felt a strong disgust and that he had somehow been abused again. He reflects on his inability to say no in this situation: "that psychological bind you get into" is connected to childhood abuse. In actual fact he had no desire to participate, but still allowed himself to be drawn into this sexual situation.
Sølve describes a complicated and increasingly troubling sexual relationship he had with a female colleague for a period of time. In retrospect, he describes this in terms of his having been subjected to abuse, ending up in the woman's claws and unable to leave the relationship. He says: "Because she played on the same strings as my mother, so I was in a relationship against my will or an abusive situation with her for two years." Eventually the situation got out of control and nearly pushed Sølve to suicide. It was only thanks to the help he received from the crisis centre that he was able to escape this destructive relationship and move on.

Avoidance, Hyper-Vigilance and Other Reactions to Trauma
Other specific difficulties that individual interviewees have had, which can be directly linked to the sexual abuse they suffered in childhood, include difficulties in eating certain foods, compulsive washing or recurring nightmares about past events. All these responses can be seen as indicators of traumatisation, and in the instances described above this is clearly the case. The kinds of situation or activity that other men in our study have avoided for similar reasons-because they involve physical contact or exposure which can be associated with their experiences of abuse-may include football, gymnastics, bathing in public swimming pools or intimate hygiene for others (e.g. through their work) or for themselves (e.g. dentist). Some men indicate that the abuse meant that they also developed an excessive need for control; that is, "hypervigilance". The latter involves an almost constant vigilance and excessive alertness to potential danger in one's surroundings. Former members of the military, for example, who have spent long periods in war zones where they have been obliged to pay close attention to hostile activities and movements, can develop hyper-vigilance. However, traumatised people who have been subjected to prolonged psychological or physical abuse may exhibit similar symptoms, even when they are no longer in a situation where they are exposed to such dangers. Hyper-vigilance means that the central nervous system of the sufferer is overactive, a form of stress which is constantly switched on (Figley and Nash 2007, 50ff;Scaer 2001, pp. 79, 86, 99).
In several cases, the interviewees describe encounters with someone who looked like their abuser, triggering a powerful sense of unease. Terje, who recently encountered a flasher at a party, was so strongly reminded of his childhood abuser and so overwhelmed that he blacked out. He woke up in the hospital, but blacked out again when he was leaving. When Terje actually encountered his childhood attacker in a shop, it was, he says, as though the entire room froze, from floor to ceiling, and as though everything closed in on him, "like a fog". Terje quickly exited the store, terrified of meeting the man face to face.
Ola, who suffered as a child from neglect, repeated physical violence and was also subjected to sexual abuse, said he learned to dissociate early. Although Ola has occasionally had unpleasant memories and flashbacks, he has not experienced much anxiety or any strong sense of discomfort. Instead, the abuse has generated an internal flight mechanism in him, a tendency to consciously remove himself mentally. Already as a child, therefore, Ola became fearless and a risk-taker. And when he was with friends he got a kick out of challenging security guards and other adults, for instance by climbing over roofs or getting them to chase him. His propensity for risk-taking eventually led Ola to a successful military career and later a criminal career.
Terje imagined that he was someone else when he was subjected to abuse. He says that by obliterating his own self, the pain diminished.
Joar says that he is very capable of "closing myself off completely and doing nothing and just staring straight ahead of me". Asked if this is like having tunnel vision, he confirms that this is correct. Erlend says that he was not really troubled by anxiety or painful memories or images, rather that they were "shut down and locked away". He had done the same with the sexual abuse as he now did with any unpleasant experience: "I'd only done what I did with everything, put it behind me and forgot it, we don't talk about it any more, so it didn't happen." Kjartan also managed for a long time to suppress the extensive sexual abuse to which he had been exposed from early childhood to puberty. But later, when his suppressed memories suddenly returned to him in adulthood, he had a substantial crisis, during which he suffered severe anxiety and panic attacks.
All of the above reactions and symptoms described by our interviewees are possible symptoms of PTSD. While this may not be the explanation for all of them, and they may instead be linked to other conditions, it should be noted that some of the men have been diagnosed with PTSD.

Suicidal Thoughts
According to studies investigating the link between exposure to trauma or neglect in childhood and various forms of ill health in adulthood, suicide and suicide attempts are considerably more common in the exposed group than in a normal sample of the population (Felitti et al. 1998). In a meta-analysis of available research on the consequences of sexual abuse, Paolucci et al. (2001) found that sexual abuse in childhood or adolescence results in a significant risk of suicide. Studies of PTSD show the same. A stark illustration of this comes from US war veterans. In recent years during which the US Army had a large, active presence in Afghanistan and Iraq, more soldiers were lost through suicide than died in battle. These deaths often happen after the soldiers have left the battle zone, sometimes long after their actual military service.
A similar vulnerability caused by childhood experiences is also seen among our interviewees. Suicidal thoughts have been found in the majority of them, whether these have been constantly present or only for shorter periods. Although not all of the ten men report recurrent or periodic thoughts of taking their lives, the frequent occurrence of this in the material says something about the severity of the suffering that abused men carry with them.
Erlend was only 16 years old when he first thought that he might just as well die, because he felt he had "no purpose" in life. Joar says with reference to his poor self-esteem and lack of self-confidence that he sometimes had huge doubts about the meaning of life: "so I can just go and jump into the sea, simple". Odd, too, describes his sense of failure as leading to similar thought patterns. Sometimes, when he was driving a car and came towards a lorry, he would think that it would be better if it drove straight into him, as long as it was over quickly. He describes how at such moments he would just think: "come on, come on!" Instead of braking, he would put his foot on the accelerator. For periods of time Odd has seriously contemplated and even made detailed plans to take his own life, but has never been able to go through with it.
Kjartan suffered a severe mental breakdown five years before the interview. The memory of the abuse, which had previously gone from his mind, suddenly resurfaced with accompanying emotions and leaving him unable to sleep. Kjartan eventually attempted to kill himself, an impulse which has occasionally returned since.
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