It is up to the co-therapists to name these processes and to help members to empathically work through their projections and self-loathing without shaming or devaluing the others in group. These individuals can and do trigger each other. The therapist team must hold a firm boundary: they must not engage in the ongoing dance of abuser, victim and rescuer that, unnamed, can create chaos in the group process. Members may also try to reenact the family pathology with either one another or the "parent" figures of the therapists. Here the holding context of the group may make it more tolerable for the men to confront the situations before them and stay present with what is experienced. The co-therapist team has a better chance of catching all that is happening because they have one another to monitor the process.
In the arena of childhood molestation, dissociative defenses often have played a key role in the survival of the psyche. They can be manifested in the personality anywhere from numbed, cut off memories or feelings to separated ego states. It is crucial for co-therapists to be experienced in treatment of the dissociative process so as to most effectively assist members to manage their splitting. It can happen that as one man shuts down or "goes away" another will being him back.
Like women survivors, what may be most common among men who were abused as children is that they feel like they are unfit human beings: "Filled with shame, they experience themselves as profoundly defective and horribly toxic. Often they have internalized the scourges hurled at them in childhood...Frequently told by abusers they provoked and wanted the sexual attacks, survivors see themselves as malevolently powerful." 1 These men may engage in violent enactments or manipulate destructive sexual encounters, masochistically picking up with themselves where their perpetrators left off. Together, the group can face this pain and move through these grim places with more compassion for themselves and one another than they could have done alone. This is a very potent experience because it is often felt at a primitive preverbal level.
In our culture, men are often expected to have words or solutions for everything. Otherwise they simply don't talk about the unspeakable and put it behind them. It is difficult for both client and therapist alike to tolerate the tension of "that which cannot be spoken" in the regressed ego state of the little boy who did not have words for his circumstances at the time. The empathic power of the group here can address the early feelings of shame and genuine abandonment that are the central themes of therapy.
The fruit of deep therapeutic work is not without a series of risks. Because one man's "material" may resonate and activate painful experiences within the other men, it is important for clinicians to be aware of signs of depression. Though this is a necessary component of the grief work involved in this process, depression, even suicidal depression, can be masked in behaviors which include sexually acting out, substance abuse, bodily violence toward others or oneself, angry displaced outbursts, missed sessions, or even sarcasm. While these behaviors often serve a self-soothing function, it is important to take the time necessary to explore and thoroughly understand what may have triggered them. For example, what is the client's perception of the behavior? Does he like it or not, or both? Hence, the survivor gains more of an understanding of his underlying feelings and needs. With this understanding, he doesn't feel so out of control and is empowered. Of course, timing is critical because premature exploration and interpretation can stunt the process. In other words, the client must be made ready to absorb the impact of his experiences on a gut level. Therapists must be watchful and attentive, for this is an important moment in the therapeutic process.