Researchers and treatment professionals have explored the intersection between trauma and substance abuse for years, as the majority of clients entering addiction treatment have experienced some form of trauma in their lives. But what is often overlooked is how trauma manifests differently in men and women.
Impact of Trauma on the Brain
Traumatic events can lead to a change in the sensitized nervous system in the brain, making individuals more likely to isolate, dissociate and express depression and anxiety symptoms. In turn, this can lead to the development and progression of self-destructive behaviors, including substance abuse disorders, eating disorders, self-harm, and suicide. When the trauma-associated emotions of anger, fear, sadness, shame, or guilt surface, it can be all the more difficult for someone struggling to seek help due to reactive or impulsive behaviors in response to the emotion.
Society Supresses Men’s Emotional Expression
Further, as a result of societal norms and messages conveyed in the media – such as “boys don’t cry” or “man-up” – men’s trauma is often discounted or not acknowledged. The seeds of this are planted at an early age. For example, if a young boy and a girl are running through a playground and both fall, some people are more likely to approach the girl and say, “Are you okay? What can we do to help? Tell me what’s going on.” We are, because of our own gender biases, more ingrained to tell the boy, “You’ll be fine” and to pick himself up and keep going.
Years of social conditioning have led many men to repress emotions stemming from traumatic events and can prevent men from feeling comfortable expressing themselves due to fear of appearing weak or out of control. In the context of counseling, this means that men are often less willing to acknowledge or bring up past trauma when in treatment. Women, on the other hand, are usually more willing to enter a safe, therapeutic space where they can express vulnerability, and are sometimes more comfortable discussing their emotions relating to a traumatic experience.
For treatment professionals, it’s essential that they make it clear that everyone has the potential to experience trauma and the emotional struggles related to trauma – regardless of gender. Part of this includes creating an environment where people can feel secure and at ease when seeking assistance for any distressing emotions.
Treating Trauma and Addiction
As discussed above, men suffering from trauma can use drugs and alcohol as a means of coping. It’s essential that these men enter treatment – not just to help them recover from addiction, but to get to the root of the trauma that is manifesting in such a destructive way. If that trauma isn’t properly addressed, the dangerous behaviors will just perpetuate. But getting individuals into treatment, especially those reluctant to expose their vulnerability and open up that sensitive part of themselves, can be a serious challenge. Professionals should start by communicating to those considering treatment that a healthy recovery is possible and that through therapy and rehabilitation, you can simultaneously treat substance abuse and past trauma.
Once in treatment, it’s also important to gain an understanding of what is happening alongside the trauma. While both men and women may have experienced past traumas such as physical, verbal, or emotional abuse, neglect during childhood, exposure to violent incidences, etc., men may process that trauma differently than women. In addition to identifying the impact of past trauma it is also important to gain insight into other potential influencing factors:
- Are there chemical imbalances in the brain that is resulting in symptoms of anxiety, depression, and other mental health issues?
- Have they recently experienced a loss of social support or connections?
- Psychologically, how are they processing emotion?
- Are they having a difficult time with certain emotions, such as anger, guilt, or shame?
- Socially, what is their home environment like?
In order for clients to overcome trauma and substance abuse, their treatment approach needs to focus on including healthy changes towards physical health, emotional and mental health, spirituality, and developing a strong support network and social environment.
I’ve found that clients see better results when clinicians focus on the client’s strengths and how to embrace those strengths to solve their existing problems. This can be leveraged using solution-focused brief therapy, which has been proven to be successful with those who are attempting to reprocess their shame and guilt into hope and empowerment. While it is important to acknowledge that certain issues or experiences can create “problems,” it is critical to recognize that these factors don’t determine one’s ability to live a healthy and happy life, but rather shape their journey.
Shifting the focus from the “problems” to the “solutions” can assist clients in identifying healthy coping skills and also how to utilize their current strengths through action to achieve their personal goals for treatment and recovery.
Leveraging Individualized and Client-First Strategies
So, how might clinicians approach a male patient suffering from trauma and other behavioral issues? Consider the following three tactics when meeting with a client for the first time:
- Meet the client at eye level: Understand where the individual is coming from and pivot your strategy to provide tailored counsel. It’s important to clearly ask if your client has experienced trauma, but very often, they might not yet be willing to disclose that information. Acknowledging trauma will be essential in eventually working on reprocessing the emotional response toward the trauma, but it must be done on the client’s terms. One of the most important things to remember is to respect the client’s sensitivity to their trauma and not push the client to discuss something they may not yet be comfortable discussing. In the meantime, focus on the strengths that they possess, which will be needed in moving forward with their treatment and recovery.
- Never judge a client: It’s fairly self-explanatory, but clinicians and therapists must establish a safe, open, and therapeutic bond with the clients so they feel comfortable in sharing what can potentially be the most intimate aspects of their history and life. Put extra care and effort into creating that trusting space. It may take some time to develop that trust, but being non-judgmental is vital to successful treatment.
- Empower the client by focusing on their strengths: It’s easy for patients who are entering treatment to feel beat down or at the lowest point of their lives. Often, those beginning conversations with clients center around what has gotten them to this point, and the resulting guilt, shame, anxiety, and fear that they’re now experiencing. Let them open up, but remember to focus more on how we can get the client to where they want to be by focusing on what they’re good at, what healthy things make them feel good, and how you can apply those factors in every facet of their daily lives.
Despite the stigma and societal norms that continue to persist for men who are struggling with their emotions, it’s important that we work together, as healthcare providers and as a community, to challenge those gendered assumptions and erode stigma. Every man who is brave enough to admit they are dealing with trauma and wants to change their life should be treated with respect, and dignity and know that their emotions are valid and accepted.