The third phase of the group is where group members, after experiencing the modeling and holding environment they need from the therapists, begin to feel more empowered to work with each other, with less overt intervention by the clinicians. We find that the meeting of this population from all areas of sexual orientation is the most restorative in each and every one's sense of their commonalties as men. This permits respectful exploration of the issues regarding sexual behaviors and sexual preference. Because these men were abused by a male or a female or both, the presence of a male and female co-therapist invites the rich and varied opportunities for transference. The group provides a context like a family where the members can work through the disappointment, rage and grief about what has happened to them.
Sexual abuse is traumatic.
These particularities present a dual consideration of a PTSD and borderline profile. Men with a history of long term abuse present a challenge in the group process both because of their fragile ego structures and their propensity to defensively lash out. Because they have been both abused and rewarded inconsistently, they can set double standards between what they expect of themselves and others. They may reenact doublebinds with one another characteristic of a pathological family. Splitting and projections, primitive idealizations and devaluations, omnipotence and diminishment, are all adaptive defenses to long term traumatic survival, and will often be acted out in group.