Counseling the Stone Boys: Helping Boys and Men Who Have Been Sexually Abused By Michael Gurian on 12/3/19 - 12:26 PM

The title metaphor of my new novel, The Stone Boys, is of a boy who must become hard like stone to survive childhood sexual abuse. As an adult, he may function well for large chunks of time, even marrying, being intimate, raising children; but his internal resources are thin, and he rarely has any choice, if untreated, but to resort to hardening up against relationships, especially those that become close.

I was one of the stone boys. At ten years old, in 1968, my psychiatrist molested me over a period of six months, first grooming me, then moving to abuse. After I escaped him, my confusion, shame and terror had no outlet except into signs of trauma that adults at the time did not recognize as abuse-trauma for two reasons: I did not disclose the abuse until I was 18, and in 1968, the signs were not public enough for people to know about them.

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A Case Study: Tom, 37

My client, Tom, had some of the same signs I had. In my office, he said, “I’ve never been very good at relationships, and reading your Stone Boys book, I think I finally understand why. It’s so obvious, but I missed it.”

“What’s obvious?”

Tom had been married and divorced twice, had difficulty holding down jobs, and had been in and out of rehab.

“Well…” now, antsy, he stood up out of the chair; I asked if we should go take a walk together, to which he agreed. At a local park, we sat down on a bench.

“Did the story trigger memories?” I asked. He nodded his head but didn’t speak.

“You can tell me,” I said. “I’m safe, we’re confidential, and you know I will get what you’re saying. You know I’ve been there, in my own way.”

“I know,” he acknowledged, standing back up again. We walked again in silence for a while, returning to my office where, once the door was closed, he told me his story. His abuse had been even more brutal than mine.


By now, most or all therapists are familiar with the ACEs (Adverse Childhood Experiences) survey, a very useful tool for trauma-informed counseling. I have also developed my own relationship-based checklist for my clients. Tom had eight of these “Signs of Unresolved Childhood Abuse Trauma in Adult Relationships.”
  1. Alienation
  2. Anger
  3. Hyper-vigilance
  4. Excessive Blaming
  5. Imposter Syndrome
  6. Addiction
  7. Sexual difficulties (includes excessive porn use, promiscuity, inappropriate sexual contact or displays, and avoidance of sex without porn)
  8. PTS (PTSD)
  9. Gender Dysmorphia
  10. Faking it (existing in the world with some success but retreating into a “stone boy” when triggered by the fear of connection and intimacy).

There are more than one hundred brain differences that apply to females, males and trauma, and many of these apply to a single thread: comparatively less developed connectivity between the male mid-brain (where memory, aggression and sensorial activity are mainly housed) and the top of the brain, where intimate decision-making and executive functioning occur. Abuse is not the same for females and males, despite the fact that we are all, indeed, human.

Treating Abused Boys and Men

A first step in treating males especially is Personal Storytelling. Even if a therapist has never experienced sexual abuse trauma, all of us have experienced trauma of some kind: some form of storytelling about trauma in your own life can help males to open themselves up.

A second step is recognition that sexual abuse for males is indeed different than for females (in most cases), not only in the myriad ways males and females are neurobiologically different but in the specific male confusion over pleasure. Most sexual abuse of males, though not all, involves male ejaculation, something that gives pleasure. Much less often does the abused girl experience an orgasm. With Tom, talking about this helped him sort through guilt and shame at deep levels.

More Best Practices for the Abuse Survivors and Their Therapists

For abused males, these are best practices I have relied upon and will likely be needed as ongoing mechanisms for healing.

Therapy, Medication, Brain-Direct Modalities EMDR (Eye Movement Desensitization Reprocessing), Neurofeedback, mindfulness, meditation, prayer, spiritual dialogue (talking directly with God), and ongoing talk therapy.

Ongoing Support Groups Getting men involved in support groups, mentoring/counseling by and with males, and groups and counseling with people from their own milieu (racial, sexual orientation, culture, similar religious background) who have also been traumatized.

Couples Therapy Because nearly everyone who has been sexually traumatized has relational difficulties of some kind, these men often need couples/relational therapy as soon as possible.

Addiction Work Many abuse victims also possess addiction genetics which get triggered by the abuse. Recovery groups and addiction therapy can be crucial.

Choice Theory Because an abuse survivor has felt out-of-control during the months or years of trauma, it is important to give him choices and “control” now, years later.

Help Him Avoid Rumination Loops Negative rumination loops may be precursors to severe depression and actions taken (“What should I do!”), especially in a man’s islands of competence, can help.

Journaling Writing or video journaling can lead to more rumination, so it can backfire, but often it is a good tool for boys and men who lean already toward reading, tech, and/or verbal processing.

Organizations That Can Provide Support

National Sexual Assault Helpline. 800.656.HOPE (4673).
Department of Defense Helpline. (877) 995-5247.
SAMHSA (Substance Abuse and Mental Health Services Administration).

Additional Reading

The Stone Boys, Michael Gurian, Latah Books, 2019.
Saving Our Sons, Michael Gurian, GI Press, 2017
Victims No Longer, Mike Lew, HarperPerennial, 2004.
Abused Boys, Mic Hunter, Ballantine, 1991
Beyond Betrayal, Richard Gartner, John Wiley, 2005.

File under: The Art of Psychotherapy, Child & Adolescent Therapy