Betrayed as Boys: Psychodynamic Treatment of Sexually Abused Men. - Review - book review

Adolescence, Summer, 2000

GARTNER, Richard B. Betrayed as Boys: Psychodynamic Treatment of Sexually Abused Men. New York: The Guilford Press, 1999. 356pp. $40.00 (h).

This volume examines how sexual betrayal affects boys and the ways they carry this hurt into adulthood. Blending psychoanalytic understanding with insights from trauma-oriented theory and practice, Gartner presents strategies for meeting the unique therapeutic needs of men with sexual abuse histories. Filled with clinical material, the book draws readers into the direct experience of these clients, the therapists who work with them, and the constantly shifting relational world they inhabit. Following an initial chapter that defines key terms and reviews the existing body of literature, the book explores the impact of abuse on men's emotional development, sexual identity, sexual orientation, and relationships. Gartner describes the different meanings society assigns to abuse of boys by women and by men, explaining how the former is often considered to be harmless sexual initiation while the latter is encoded as a shameful sign of homosexuality or feminization. In either case--and whether a boy is headed for a predominantly heterosexual or homosexual orientation before the abuse--the experience of victimization may combine with cultural assumptions to compromise his developing gender and sexual identities. The book also analyzes the familial and interpersonal contexts of abuse. Gartner conveys the ways that betrayal by a trusted adult informs and shapes the character of a boy's later relationships. He discusses intervention approaches for various relational difficulties and for such trauma-related symptomatology as boundary problems and dissociation. Group and individual treatment issues are considered in-depth, with special attention to transference and countertransference dynamics. Unraveling the tangled cultural, developmental, and personal strands that shape men's ongoing responses to early sexual trauma, this book helps therapists maximize their own skills and inner resources to deal with complex treatment situations. It offers important tools for clinicians working with individuals, families, and groups, as w ell as educators and students interested in psychodynamic perspectives on trauma, gender, sexual orientation, and human sexuality.