From Silence to Strength: Empowering Good Counselling Outcomes for Male Survivors
With thanks to our member, Rob Balfour MSc, GMBPsS, for this article.
This article discusses sexual violence against men, trauma, and recovery. While the discussion is reflective and non-graphic, it includes themes that some readers may find distressing or triggering. Reader discretion is advised.
I have been working with males who’ve survived sexual violence for nearly 30 years. In that time, the most common statement I hear is: ‘I thought I was the only one that it happened to’.
When I tell male survivors that sexual violence against males is far more common than they have been led to believe, there is often a visible shift - often tears. It is usually the first time anyone has named what was done to them as something real and not something shameful, weak, or unspeakable.
By reinforcing, ‘it didn’t happen to you’. Rain happens; abuse is done to you. That shift of narrative frame matters - its where I often observe the survivor sees the possibly of recovery emerging in their eyes.
My reflections are grounded in almost daily engagement with male survivors in diverse contexts for nearly 30 years. The last 10 developing Survivors West Yorkshire’s Bens Place’s video counselling service. A pioneering service informed by international research evidence, both peer reviewed and grey literature. It draws on established trauma interventions thinking, especially Dr Judith Herman’s three-phase model, alongside developments in post-traumatic growth research, Acceptance and Commitment Therapy (ACT), and Positive Psychology strengths-based approaches. The core aim of the service is to help survivors move from silence towards agency, connection, and a life that feels worth living.
Dr Judith Herman’s seminal work remains foundational to my thinking, because it places trauma where it belongs, not just inside the mind, but within relationships, power, and violation. Trauma is not merely a psychological injury; it is a rupture of trust, safety, and self. For male survivors, that rupture is compounded by sociological factors around how males are socialised.
Most men disclose long after the abuse has ended, often decades later. By then, silence has become a survival strategy. Masculine socially constructed norms of self-reliance, control, and emotional restraint often mean that distress is expressed, through anger, isolation, substance use, risk-taking, or collapse in relationships.
Many men also carry a deep expectation of community disbelief. They fear they will not be taken seriously or believed. Some are unsure whether what was done to them even counts as sexual violence as societal narratives around sexual violence used by Government for example often focused on female survivors with little or no mention of male victimisation.
The psychological impacts of narrative vanishing has complex re- traumatising consequences, and I would argue are evidenced in higher rates of male survivor suicidal ideation, addiction, and relational breakdown. Such impacts are evidenced daily in male survivor services across the world. For this reason, counselling outcomes for male survivors cannot be limited to symptom reduction alone. Good outcomes mean reclaimed agency, restored connection, and a coherent sense of self that is not defined by the abuse.
If I were forced to name one essential ingredient in this work, I suggest the notion of radical empathy, which I would define as a way of being with another person that proactively reinforce, I believe you, I am here, and your pain matters and I will not conclude with the cultural silencing that often surrounds what was done to you.
Listening to survivors has always been a radical act. Listening to male survivors perhaps even more so. Radical empathy involves recognising the ways men have survived even when those strategies later become problematic - withdrawal, emotional numbness, aggression, relentless productivity are not character flaws, they are adaptations.
It therefore means refusing to pathologise. Male survivors are not broken men. They are men who have lived through something that should never have been done to them.
In practice, radical empathy looks like staying present through silence, anger, confusion, and contradiction. It means allowing men to approach the work through action as well as words — through walking, music, movement, creativity — and respecting their pace.
Research consistently shows that survivors experience therapy as helpful when they feel believed, respected, not rushed, and genuinely accompanied. Empathy is not an optional extra. It is the foundation.
The focus of Acceptance and Commitment Therapy (ACT) has proven insightful in my thinking. Many male survivors live with long-standing avoidance of memories, emotions, vulnerability, meaning. ACT does not ask men to eliminate pain before living, it invites a different question:
‘How do you want to live, given what you have been through?’
ACT emphasises psychological flexibility reinforcing the capacity to remain present, to notice thoughts without being ruled by them, and to act in line with values rather than avoiding keeping to them. For males socialised by expectations of control and stoicism, this can be quietly transformative. ACT aligns well with trauma recovery because it does not reduce recovery to symptom eradication. It supports living with history, rather than being dominated by it.
Herman’s three phases remain core to my practice leadership:
Phase One: Safety and Stabilisation
This stage cannot be rushed, and it often begins with naming shame and self-blame directly. However, in a limited 3rd sector context there might not be unlimited sessions to build idealised therapeutic safety. The gold standard for sessions packages is around 24 sessions in the UK sexual violence counselling sector. In my experience this is where radical empath can create safety quickly and of course safety reinforcement never stops when working with human psychological trauma legacies. As part of the process psychoeducation is essential in explaining trauma responses in plain language, helping males understand why they feel stuck, angry, disconnected, or numb and importantly very normal to be so.
Stabilisation must be seen as flexible. Some men regulate better through movement than stillness. Grounding can happen through walking, breathing, music, or physical sensation as much as through verbal reflection. ACT-informed insights focuses on present-moment awareness and acceptance and not forcing exposure or growth but gently reducing the grip of avoidance. Even at this stage, it is possible to introduce a quiet growth narrative: you survived and that matters - you matter.
Phase Two: Remembering and Mourning
For many men, this is the first time their story has been spoken aloud. The work here involves grief, for loss of agency, childhoods, versions of self. It can involve anger, but not always, combined with increasing emotional release. Males may minimise or intellectualise their experiences. Narrative and metaphor can help open emotional integration: ‘If this part of your life had a shape or weight, what would it be? Creative and experiential approaches, music and movement for example often access what words cannot. ACT diffusion is particularly powerful here. Helping a man notice ‘I’m broken’ as a thought rather than a truth can loosen the hold of shame.
This phase is where post-traumatic growth can begin to appear. Males start to redefine their masculinity, reconnect with people, and find meaning not by denying the trauma, but by integrating it – no longer carry the chains of shame and guilt which have wrapped around them since the sexual crimes committed against them.
Phase Three: Reconnection and Integration
This phase is about living well.
Males can feel free to start exploring new questions about themselves and what they want from life: Who am I now? What do I stand for? What kind of male do I want to be? Reconnection often happens through action, work, relationships, creativity, contribution. Many males want to give something back, mentor others, or reconnect with community. This is survivor agency liberated. ACT supports this through values-based action. The focus shifts from managing symptoms to building a life aligned with meaning. The trauma story becomes part of the person’s history, not the centre of their identity, even when society wants to keep them locked into a one-dimensional framing following disclosure.
What I’ve witnessed, is when male survivors feel authentically seen, two shifts are common. First, agency returns, they move from feeling that life happens to them to recognising themselves as active participants who can shape how they respond to what they can’t control. Second, connection deepens, with others, with self, but especially life itself. These outcomes are not always captured by symptom reductions, though symptoms often reduce. They appear instead in statements like ‘I trust people more’, ‘I feel like I matter’, ‘I’m enjoy living, not just surviving’. These are meaningful outcomes which evidence the unlimited possibilities human growth following sexual trauma. The powerful recovery -growth of Gisèle Pelicot evidencing that well.
This work is not straightforward. Disclosure is not a one stop destination. Masculinity norms may limit emotional expression. Intersectional identities add further layers of stigma and risk. The evidence base for male survivor work is still developing, requiring humility and co-production with survivors to advance interventions efficacy. Practitioners must also attend to their own wellbeing. Radical empathy without supervision and care leads to burnout. Finally, growth-oriented approaches must never bypass pain. Hope cannot be imposed - pacing matters.
As I approach the end of my own journey, I’ve learnt good outcomes in counselling male survivors rest on a simple but demanding foundation built using, radical empathy, thoughtful adaptation of trauma frameworks, support for agency and meaning - connection. The work is not about fixing males or returning them to some imagined ‘whole’ self. It is about supporting real men, with real histories, to recover themselves and live their lives well and in peace. Males are more than what was done to them - recovery is possible – profound growth is possible. But only if we are willing to listen properly and to meet them where they are. That it is the core responsibility of this work, and its outcomes should energise us all to do that work well.
