ALTHOUGH FEWER MEN in our society may be sexually abused in childhood than women, the physical and emotional violence visited upon young males, even in middle-class or affluent families, is enormous. The psychological damage men suffer as a result of this mistreatment is aggravated by a fear of seeming weak if they talk openly about their internal wounds. Many men prefer to suffer in silence or express the turmoil inside them behaviorally in self-destructive or violent ways.
Men with dissociative disorders may be more likely to “act out” against society or engage in antisocial activity than women DID patients are. Actually, the sex ratio imbalance in DID diagnoses—nine females to one male—is often attributed to the fact that many men who have DID are diagnosed solely as substance abusers and are treated in rehabs or are sent to prison for antisocial behavior before they ever come to the attention of a therapist.
Explosive temper outbursts are a common symptom in men with an underlying dissociative disorder, and a man who experiences these outbursts needs to have them evaluated in the context of all five core dissociative symptoms. These symptoms are often masked in men whose anger is extreme. Rather than seek treatment for inner feelings of rage with a possible dissociative basis, many men self-medicate, using alcohol, cocaine, marijuana, heroin, or other substances to relieve their distress. The angry, sometimes filled with rage, out-of-character person they become under the influence may not be “the booze talking,” but a dissociated part of themselves that is making itself heard. In some cases alcoholics (women as well as men) who have intermittent periods of remission and marked mood changes when they drink have a personality inside them who drinks, and one who doesn’t. Since the one who drinks has amnesia for the one who doesn’t, binges feel completely out of their control.
These are some of the more common symptoms or coexisting disorders experienced by men with an underlying dissociative disorder:
depression
anxiety, often experienced as constant terror or a feeling of always being on the edge
substance abuse
sudden outbursts of anger
difficulty in concentrating, jumping from one thought to another, or similar symptoms of inattention or impulsiveness associated with attention-deficit hyperactivity disorder
flashbacks and other symptoms associated with posttraumatic stress disorder
social anxiety disorder (social phobia), characterized by an extreme fear of social or performance situations in which the person is exposed to unfamiliar people or to possible scrutiny by others, as in public speaking
compulsive sex, a history of affairs, or sexual perversions
violence, or engaging in sports that sanction violence, such as boxing or football
Jordan, the forty-nine-year-old general manager of a TV station in New York, exemplifies that the symptoms men present to a therapist often are not the whole story. Jordan’s primary complaint was that he suffered from very severe anxiety, especially when meeting new people or speaking to an audience. He actually had a panic attack whenever he had to attend a social function with corporate clients or was called upon to address a community organization, an important part of public relations for the station. He was also troubled by masochistic fantasies of being beaten by a dominatrix and had a strange sexual obsession that was jeopardizing his marriage. Although he loved his wife and enjoyed sex with her, he felt compelled to visit topless bars and be hugged by anonymous naked women.
Jordan’s previous therapist had diagnosed him as suffering from social anxiety disorder, but when I began working with him, I suspected that there might be a dissociative foundation lurking beneath the surface of his complaints. He revealed that as a young boy he was constantly terrorized by his physically abusive father and ran to his mother to be comforted after his father beat him. Although he didn’t initially realize it, Jordan came to see that to him, love and sexual pleasure were associated with domination and beatings, because his father showed him love by being domineering and abusive. Seeking out women in topless bars to hug him was a reenactment of the pattern of his childhood-being beaten, then enfolded in his mother’s arms. There was an adolescent part of Jordan that was getting gratification by means of this compulsion. Since Jordan was ashamed to admit to his wife that he was so needy, he was risking his marriage for the sake of an anonymous woman’s hug.
It was this adolescent part of Jordan that felt terrorized by social situations or before public speaking engagements, because Jordan identified unfamiliar people or those in a position to judge him with his terroristic father. “Little Jordan,” as he called this inner child, was not sufficiently independent or autonomous to constitute a separate personality but did represent the kind of moderate identity alteration found in DDNOS. Jordan is now learning to reduce his social anxiety, as well as lessen his sexual compulsivity, by calming Little Jordan in situations that are threatening reminders of the past.
DID explains the “warrior personality” that some men in combat have. They are able to shoot and kill and have no feelings for their victims. When they are no longer in a war zone, they may become dysfunctional. A combat veteran walking down a city street in civilian life, for example, may suddenly assault another man who innocently walks too close to him, because the veteran has a flashback to a combat situation and his dissociated warrior takes control. Since people with posttraumatic stress disorder often suffer from undetected dissociative symptoms, the dissociative basis of some cases of PTSD may not be recognized.
A dissociated warrior-type personality may also be found in men who are drawn to violent sports. Tom, a thirty-eight-year-old former professional boxer with a black belt in karate, came to see me after he had become an aerospace engineer and was in a relatively new, but troubled marriage. Joanna, his wife, had insisted that he seek treatment for his uncontrollable jealous rages and furious outbursts at any man who so much as looked at her or otherwise rubbed him the wrong way. Once, when Tom and Joanna were working out at a gym together, he called her a “slut” and a “whore” for chatting innocently with a man exercising next to her and had to be prevented from smashing the man’s jaw. “They were just having a friendly conversation,” Tom said, “but it seemed to me that they were having an affair right under my nose, and it set me off.”
Another time Tom flew into a rage when a distracted driver almost knocked him down as he was getting out of his car. Before Tom knew it, he had grabbed hold of the man by the hair through his open car window and was about to beat him to within an inch of his life. “I didn’t know where I was—maybe I thought I was back in a boxing ring. There was just me and this guy, and I was outside myself, watching the two of us. Then I looked up and saw the line of cars and a cop approaching, and that stopped me.”
Tom told me that he had been severely beaten and emotionally abused by his father throughout his childhood and had taken up boxing and karate for self-protection and as an outlet for his feelings of rage. Tom’s mother, powerless to protect her son from the overwhelming violence in the house, sought solace in extramarital affairs. One day when young Tom went home he found his father throwing his mother’s clothes down the stairs, threatening to throw her out, too. “Slut! Whore!” his father was screaming at his mother, just as Tom screamed at his wife in the gym.
The incidents Tom described indicated that his rage might have had a dissociative basis. Derealization was manifested by his imposition of a past reality on the present. Confusing his mother’s infidelity in the past with his faithful wife’s current behavior prompted his explosiveness toward Joanna and the man in the gym. Tom’s out-of-body experience when he reacted violently to a traffic mishap perceived as a personal attack was evidence of depersonalization. Within him there seemed to be a disconnected state of rage that could only express itself with Tom’s fists, whether in the boxing ring or on the street. “I feel like I’m trying to keep the lid on a volcano,” he said. “I have such a strong rage inside, and I don’t know where it’s coming from.”
The SCID-D showed that Tom had moderate amnesia and severe levels of the other four dissociative symptoms. Since he also described having several well-developed personalities that took control of his angry behavior, my diagnosis was DID. There were three dissociated parts within himself that he was able to identify. Wild Tom, a nickname from his boxing days, was what he called the part that contained the memories and feelings related to his father’s malevolent physical and emotional abuse. It was the repository of Tom’s rage, and it came out appropriately in violent sports, and inappropriately in angry outbursts at people who offended him. Tommy was a spoiled, bratty little boy inside who felt all the hurt from Tom’s painful childhood. He was mean and nasty to Joanna when Tom distrusted her or when she cried, something Tommy considered a sign of weakness. Dad, the most frightening part of himself, was critical and verbally abusive like his father and had a dark, totally destructive side that came out when Tom had too much to drink. “That’s the part that makes me go 125 miles an hour on a highway after I’ve been to a bar,” Tom said. “I think it’s just trying to destroy me, piece by piece, the way my father did.”
Since Tom is a very intelligent man as well as a gifted athlete, he is making extraordinarily fast progress in treatment today. He is learning how to calm his rage by using different strategies to help Wild Tom feel safe in the present. One technique that works for him is to carry a key chain with tiny boxing gloves on it. Whenever he feels Wild Tom taking control and is about to explode in rage, looking at the little boxing gloves reminds Tom that he is a grown man who has the strength to protect himself and doesn’t need to beat people up.
It should be remembered that dissociative men who have temper outbursts are not necessarily violent. Some men (and women) with dissociative disorders have violent thoughts but never act on them. Others, having decided that they don’t want to perpetuate the abuse they experienced, might eschew violence entirely and encapsulate their rageful feelings into a dissociative aspect of themselves that is nonviolent.
The case of Ross Cheit illustrates how men who have been sexually abused in childhood suffer the same deleterious repercussions as women. In 1992 Cheit, an associate professor of political science at Brown University and a happily married man, received a phone call informing him that his favorite nephew had been chosen to join the prestigious San Francisco Boys’ Chorus and attend a special music camp. Cheit, who’d been a member of the same choir and a music camper in his youth, should have been elated, but instead he had a sickening feeling of alarm he couldn’t understand.
Soon after the call Cheit dreamed of a man he hadn’t seen since he was a thirteen-year-old boy at music camp—William Farmer, his most admired and trusted camp counselor. For the first time Cheit remembered in flashbacks how Farmer had entered his cabin each night, when the other boys were asleep, and sexually molested him. Determined to find out the truth, Cheit confronted the retired founder and director of the choir. She revealed that numerous incidents of sexual molestation were reported in the camp’s history but were all hushed up and brushed off as inconsequential compared to the paramount importance of the choir’s reputation.
With the help of a private detective Cheit finally tracked down Farmer, who confessed to the abuse in a tape-recorded phone conversation. Farmer also revealed that after being exposed and disgraced as a pedophile while working as a Methodist minister, he had become—unbelievably—a public school teacher. When Cheit went public with his history of sexual abuse at Farmer’s hands, Farmer moved to another state and taught Bible school.
Criminal charges against Farmer failed because of a statute of limitations. To buttress a civil suit against Farmer, Cheit painstakingly garnered an archive of detailed, corroborated cases of recovered abuse memories and was eventually awarded $475,000 in damages. Michael Landsberg, who wrote about the Cheit case in The Toronto Star (March 4, 2000), was moved by the poignant letters male survivors sent him about feeling isolated and invisible after recovering memories of their abuse.
Male abuse survivors feel isolated for many of the same reasons that women do: being ashamed, feeling that they deserved it, not even realizing that they were abused, feeling that they are different from other people. Their isolation is compounded by the fact that since men are generally not as inclined to seek treatment as women, male abuse survivors receive less attention in the clinical literature and in the media.
Cheit’s case showed that men who have been abused not only travel the same lonesome road as women survivors, but also may experience the return of verifiable abuse memories many years later. Even though men, like women, may have difficulty recalling the details of their abuse, they are at risk for developing a characteristic group of symptoms that underlie a dissociative disorder.
