The Survivors Guide 2016

The Survivors Guide 2016

Break The Silence We’re tackling Male Sexual Abuse in Greater Manchester

confidential support www.survivorsmanchester.org.uk support@survivorsmanchester.org.uk Tel. 0161 236 2182 @SurvivorsMcr

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Welcome to Survivors Manchester...

Welcome to our second self-help guide, written with male survivors of sexual abuse, rape and sexual exploitation in mind.

As we open our doors to you as you turn each page, we felt this was an excellent opportunity to put right a common misunderstanding regarding our organisation, our services and the men we are here to support.

Survivors Manchester is an organisation that is available to all male (yes, ALL males) survivors of sexual abuse, rape and sexual exploitation - both contact and non-contact experiences.

When we say ALL males, we mean just that. All males, regardless of religion, ethnicity, and sexual orientation. There are some people, including male survivors themselves, who think that sexual abuse and rape only happens to gay men or is something to do with sexuality. Not only is this not true, but we feel that this type of belief becomes one of the many barriers that ALL men face in breaking their silence.

For too long the negative social stereotype of masculinity and what ‘being a man’ actually means has been drummed into the minds of boys and men, not only causing great confusion for lots of lads struggling with their own identity and what their view of their own masculinity is. People begin to confuse a whole load of words and meanings, such as gay, masculine, weak, straight, to the point and end up feeling mixed up with everything!

Unfortunately, the male social stereotype of masculinity still represents such a significant and formidable barrier for men to overcome regarding their experience and expression of vulnerability.

Battling Masculinity _4 Trauma & PTSD _6 Avoidance _8 Substance Abuse _9 Anger _10 Self Harm _11 Psychosexual Symptoms _12 Suicide _13 Attachment _14 Relationships _15 Sleep Hygiene _16 Families Support _17 Criminal Justice / ISVA _18

2 | Welcome

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So much so that the very notion of being a ‘victim’ of sexual abuse, even during childhood (when we are by definition at our most vulnerable) can seem both incomprehensible and unacceptable for many men. These distorted social messages then fuel further harmful distortions, misinformation and social prejudices such as it is only gay men and women who are raped and sexually abused, because it doesn’t happen to ‘real men’.

As a society we have a collective responsibility to challenge such harmful messages and refer to fact, evidence and truth.

When men rape other men it isn’t about sex it’s about power, meaning that sexuality doesn’t even come into it. When a boy is abused or sexually exploited by a male or female, it isn’t because of how they view his sexuality, but that he is vulnerable to exploitation – aren’t children potentially vulnerable by definition?

Any man can be the victim of rape and/or sexual abuse and therefore any and all men are welcome here at Survivors Manchester regardless of individual difference.

So please, spread the word and play an active part of social change.

Go out there and Break The Silence.

Acknowledgements Survivors Manchester is grateful to the Ministry of Justice; North, Central and South Manchester Clinical Commissioning Group; the Office of Police and Crime Commissioner Greater Manchester; Zurich Community Trust; and Arm Trust for their support to sustain our services.

A Special thanks to NHS England, St Marys SARC, Greater Manchester Police, Lime Culture, and Self Help Services.

For information on our services call 0161 236 2182 or email support@survivorsmanchester.org.uk

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Being a Man Unfortunately, the male social stereotype of masculinity still represents such a significant and formidable barrier for men to overcome regarding their experience and expression of vulnerability.

So much so that the very notion of being a ‘victim’ of sexual abuse, even during childhood (when we are by definition at our most vulnerable) can seem both incomprehensible and unacceptable for many men.

Therefore, for the currently recognised ‘one in six’ of men who have experienced sexual trauma either as children or adults, this can both create and maintain a negative view of ‘self’ that often culminates in a literal ‘crisis of masculinity’. Sadly it is all too common for men who have been sexually abused to struggle with their own sense of ‘maleness’ and ‘being a man’ as a result of their experiences.

But surely ‘real men’ are exactly that, in terms of being completely real and true to themselves.

They don’t hide their vulnerabilities and pretend to be something or someone that they’re not. They recognise that as human beings we each have our weaknesses and vulnerabilities regardless of sex or gender. They also accept that by recognising their vulnerabilities and thus validating their existence that they then by definition become strengths.

Pretending that we’re something we’re not, or hiding how we truly feel doesn’t make us masculine, any more than believing that showing our emotions is a weakness does. These are gender myths that affect us all by becoming internalised ‘rules for living’ by boys initially but eventually as men. Not only are they extremely harmful and simply not true, but they also represent these fictional levels of masculinity and maleness that none of us can ever truly reach but many men keep on trying to do so anyway.

4 | Battling Masculinity

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Battling Masculinity Here at Survivors Manchester we work with male survivors of sexual abuse and/or rape.

Each and every man we work with is a ‘real man’, simply because they are breaking their silence regarding their abuse and traumatic histories.

They recognise that the legacy of their traumatic experiences has been in control for too long and make the decision to seek professional help and support in assisting them to take back control of their own lives.

Now ‘that’s’ masculine... that’s what being a ‘real man’ is all about and we salute you.

Battling Masculinity | 5

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Trauma & PTSD (Post Traumatic Stress Disorder)

“A form of amnesia can occur where the details may become blurred and fragmented” Memory may often represent an unreliable ally when significant trauma has taken place, which can occur as a result of war, natural disasters, torture and physical and sexual abuse, as well as a range of other experiences.

A traumatic event can be any experience that is so immensely painful and/or confusing at the time that it completely overwhelms our natural psychological and emotional coping defenses when it occurs. Victims of such events are often left with unspeakable memories that they may try yet can’t forget, yet in many cases may also struggle to completely recall.

A form of amnesia can occur where the details may become blurred and fragmented, which is the brains attempt to bury associated memories of such horrific events and ultimately protect us.

6 | Trauma

Lies and secrecy represent extremely common factors associated with sexual abuse, with perpetrators using lies and manipulation a well as threats and often violence to promote compliance.

People who have been sexually abused will often keep their experiences secret due to feelings of intense shame, guilt and confusion, through fear that they may not be believed or that even worse things may happen if they speak out. Trauma affects the entire human organism incorporating body, mind and brain, and when the physical emotional and psychological memories of sexual abuse are kept secret a tension of conflict exists within the survivor. This can be manifested in a range of thoughts, feelings and behaviours that may negatively effect and severely impede daily functioning. The survivor’s energy can become so intently focused on trying to suppress internal chaos that their ability to engage with the external aspects of their everyday lives is significantly reduced.

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Such an internally distressing process as a result of trauma can lead to a range of physical symptoms including: • Fibromyalgia • Chronic fatigue • Irritable bowel syndrome

“When the memories of sexual abuse are kept secret a tension of conflict exists within the survivor.”

• Various autoimmune diseases Trauma related distortions of thoughts and beliefs may occur such as: • The world is a dangerous place • Events are uncontrollable and unpredictable • Others cannot be trusted • What happened was my fault • Life is meaningless

Post-traumatic stress disorder (PTSD) is a diagnosis used to describe a cluster of symptoms that are common amongst those who have experienced trauma, including those who have been sexually abused.

PTSD is characterized by: • Intrusion (flashbacks, nightmares) • Hyper arousal (Hyper vigilance, heightened fight flight response) • Numbing (feeling emotionally numb and/or emotionally distant)

Thoughts and feelings of anger, rage, revenge, fear and despair can become daily experiences.

Shame, isolation and helplessness may increase the sense of bewilderment; life can grind to an almost impassable chasm of hopelessness. Drug and alcohol misuse, self-harming behaviours, suicidal thoughts and attempts, as well as overworking and exercising to excess are extremely common coping behaviours that can develop as a response.

Working with traumatized male sexual abuse survivors takes time to re-discover the victims’ silenced voice. Trust has to be re-established in a safe therapeutic relationship and then also in other relationships. New meanings to their experiences need to be found so healing can begin. Healing begins when the silence is broken. The road of recovery and healing can be long and difficult, but with the assistance of experienced professionals and others in genuine caring relationships; trust, stability, purpose and happiness can return.

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Avoidance

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We all avoid things – whether it’s a simple task that we’d rather not do like take the bins out, or maybe a difficult phone call we’d rather not make. Avoiding stuff we don’t like or that causes us discomfort or pain is a fairly universal human strategy. And often avoidance is a harmless activity.

But when we think of human psychology and trauma particularly, avoidance or ‘avoidance coping’ as it’s known is something quite different and can often be life-limiting and even psychologically and emotionally harmful.

Imagine a person who struggles with severe panic attacks when they are in busy public places. They might begin avoiding going to the supermarket during busy times for example, which might make life inconvenient but not impossible. Imagine this person’s panic is so severe that they can’t leave their house at all and we begin to see how damaging something simple like avoidance coping can become.

“Simply recalling our memories of these experiences can bring hurt and anxious feelings all over again.”

The same applies to feelings. Sometimes we unavoidably go through experiences that cause hurt, pain or anxiety. These can be everyday things like a harsh word from a loved one or they can be life changing experiences like sexual abuse or rape.

And even long after the experience itself, simply recalling our memories of these experiences can bring hurt and anxious feelings all over again.

And so to try to keep ourselves safe, we avoid these memories and feelings or we avoid people and situations that might cause us to remember.

In our work with male survivors, we see a lot of avoidance coping – avoiding sights, sounds and smells, avoiding feelings and memories, avoiding people.

But we also see men literally transform their lives by facing what they’ve been avoiding, dealing with painful feelings and memories. Seeking support either through therapy, emotional support or group support really can change lives.

8 | Avoidance

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Hallucinogenic and/or dissociative substances such as ketamine, LSD and Salvia represent further ways to escape what can often seem a deeply disturbing and painful reality of everyday life, whilst assisting us to literally disengage from our everyday existence whenever we like.

Substance Misuse Drugs and alcohol represent extremely common coping factors for male survivors, offering an extremely effective way of blocking out uncomfortable and painful thoughts and emotions.

Depressant substances such as cannabis, alcohol and heroin depress the body’s central nervous system (CNS), lowering blood pressure and blood sugar levels, whilst slowing down our heart rate, leaving us feeling extremely relaxed as a result.

For men who may have lived their lives feeling extremely anxious or constantly feeling on edge because of their sexual abuse, the opportunity to feel so calm and relaxed can be incredibly difficult to resist.

It stands to reason that for men who are literally struggling to cope with their everyday existence in the world that drugs, alcohol and other substances can literally become the primary coping mechanisms in their lives. However, this type of ‘self-medicating behaviour can and often will develop into a destructive cycle that comes at great psychological, emotional, physical and relational cost.

“I started to realise they (the abusers) were winning and I was slowly killing myself.”

As previously outlined in this guide ‘avoidance coping’ can be severely damaging and this way of doing so is no different. There are specialist services that can offer advice and support around substance misuse, and engaging in treatment when needed can represent a significant a step towards healing from sexual abuse.

In contrast, stimulant substances such as crack, amphetamine, cocaine and MKat stimulate the CNS, increasing heartrate whilst stimulating the brains release of dopamine – which is one of our neurological ‘pleasure chemicals’. For men who may struggle with issues around low mood, self-esteem, self-confidence, or developing new relationships these drugs can also appear to offer a great alternative experience.

Substance Abuse | 9

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Anger Anger is a normal human reaction everybody experiences it at some point. However it can become a problem when we experience it too frequently or when it lasts for too long. Anger can present itself in many different ways from being slightly irritated to hysterically shouting and can have an impact on those around us.

Anger can be caused by certain life events, the way we think and the behaviour we have learnt. It is not uncommon for survivors of trauma to experience anger as it is a key way in which we as humans are built to survive. It does this by keeping us highly alert for any other threats that might arise. This emotion also helps us to avoid thinking about the trauma itself as it shifts our focus. Learning when you are beginning to get angry is key to stopping it; as when you work out what is irritating you, you can put one of the following techniques into practice to remain calm.

Activities To Relax • Do some exercise • Read a book • Do something creative • Visit a friend or family member • Have a bath

Controlled Breathing Breathing helps stop our body’s automatic arousal when we get angry. To breathe in a controlled way breath in slowly for 5 seconds, hold your breath for 2 seconds and breathe out slowly as if blowing on a spoon of hot soup that you don’t want to spill for 7 seconds. Repeat this until you feel calm.

10 | Anger

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Self Harm

“Wounds whether physical or emotional, are best acknowledged�

Self-harm is when a person, like you or me, chooses to deliberately hurt themselves. It can take many forms. There are obvious ones like cutting, hitting, scraping, burning, poisoning and biting. But there are also forms of self-harm which may be harder to spot, like starving, misusing drugs and alcohol, binge eating and excessive exercising. As with many aspects of life there does not seem to be one reason why people self-harm, it could be about punishing ourselves or trying to release our painful emotions, maybe it can even result from sheer frustration and not knowing what else to do.

It can be difficult to understand why someone would self-harm, both for those who self-harm and those who care about them. This can lead to feelings of guilt, shame, anger and the desire to conceal wounds from others. But, in my experience, wounds whether physical or emotional, are best acknowledged so we can gain the support we need to heal. I am aware that many men who have been sexually abused or raped selfharm as a way to cope. This does not mean they are bad, attention seekers, weak, trouble makers or even mad; it is just a way to cope.

Understanding self-harm as a way of coping means there is a potential for us to learn to cope with our painful thoughts, memories and emotions in a manner which does not involve hurting ourselves.

I think men, with the right support, can learn to self-care instead of self-harm. This is no easy task, but through the support of others and some creative thinking many men choose to self-care.

The most important thing is that if you or someone you love self-harms try to respond to it with gentleness, compassion and understanding so wounds can be revealed and healed.

Self Harm | 11

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Psychosexual Symptoms Sexual abuse whether experienced as a child or an adult can have profound effects on the sexual functioning and intimacy of male survivors.

Such issues are referred to as the psychosexual symptoms of sexual trauma, because they literally describe the psychological effects on sexual behaviour and functioning as a direct result of the traumatic experience.

There are of course a broad range of psychosexual symptoms that may occur, but here are just some of the common symptoms that male survivors struggle with: • Avoidance of all intimate or physical contact • Compulsive sexual behaviour or sexual risk taking, including masturbation • Difficulties achieving and/or maintaining an erection • Feeling numb or disconnected from their bodies during sexual contact • Unwanted or intrusive sexual thoughts or fantasies • Intense feelings of guilt or shame regarding sex • A complete lack of inhibitions or sexual boundaries • Engaging in unwanted sexual behaviour that leads to feelings of shame and/or guilt

12 | Psychosexual Symptoms

• Confusion regarding sexual preference or sexual identity • Feeling unable to engage in sexual behaviour without using drugs or alcohol first • Disliking being touched in a certain way, on parts of their bodies, or specific sexual positions Whatever psychosexual issues that men are experiencing as a result of what’s happened to them it’s important for them to realise that they’re not alone. Sexual abuse is often associated with a wide range of psychosexual problems for those people that experience it and the most important thing for survivors to remember is that they have no reason to feel ashamed or embarrassed or suffer alone and in silence.

Speaking to a trained professional who has experience of working with male survivors of sexual abuse and/or rape means that they are able to listen without judgement and offer advice and ways of managing and coping with these types of issues.

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Suicide At times we can get lost in our own pain; it can feel like there is no way out and feel helpless and hopeless. It is not unusual for people who have experienced trauma to have thoughts about harming themselves or taking their own lives; thoughts that can be both scary and confusing.

It is important to remember that our thoughts and feelings do come and go and you won’t always feel like this...

There are steps that you can take to help you manage your pain and things you can do to help keep yourself safe.

You can also try making yourself a ‘soothe box’ full of things that help you feel safe and calm, it might be a photograph or a letter from a loved one, a favourite song or material that you find soothing.

There are also some things that you can do to keep yourself safe. Firstly, make a promise to yourself not to do anything today or this week; things may seem more bearable tomorrow or next week; it will keep you safe and help put some distance between your thoughts and behaviours. Avoid drugs and alcohol; although they may provide you with a quick fix, they will make you feel worse in the long run. Make you home safe, remove any medication, sharp objects, weapons or anything that you might hurt yourself with – this doesn’t have to permanent, just while you are feeling vulnerable. Speak to someone you trust; this could be a friend, relative, therapist, doctor, clergy or contact a helpline. Remember, people do get through this and so will you; thoughts and feelings are temporary so try to avoid permanent action.

An important part of being able to cope is learning how to self-soothe; a good way of doing this is to use mindfulness techniques to bring yourself in to the here and now:

Notice...

5 things that you can see 4 things that you can hear 3 things that you can touch 2 things that you can smell and taste 1 breath – focus on each breath that you take in and out

Suicide | 13

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Attachment Attachment Theory, in psychology, refers to our ability to relate (attach) to others, and withdraw (detach) from them and function well on our own when needed. Learning how to relate and respond to ourselves, others and the world around us is very much like learning most life skills, in that it initially involves learning from the adults around us from when we’re babies, and throughout childhood. Therefore the environment we’re born into, as well as the people within it and how they relate to each other and to us, are of significant importance. The verbal and non-verbal messages that we receive from this environment represent a point of reference that will then be used as a means of developing our own internal attachment system – a kind of map of how to understand relationships and function within them. This map then becomes vital in assisting us in navigating our relationships throughout the lifespan.

So what if our environment was dysfunctional in some way? This can of course often be the case with male survivors of sexual abuse.

Feelings of abandonment, rejection and intense confusion during childhood can often contribute to the development of a faulty internal map of relationships. This then leads to all kinds of problems because we’ve potentially never really learnt how to understand and respond to the needs of others in a healthy way, nor fully understand, respond and successfully communicate our own needs. This can be complicated even further with deep feelings of shame, guilt and low self-esteem which are common for male survivors, and also negatively affect their ability to maintain relationships.

Whether we’re naturally very emotionally distant and ‘detached’ in relationships, or alternatively very emotionally needy, to frequently behaving in ways that push the people we care about away, when all we really want is to be closer to them, our internal attachment system is at work.

The system is commonly activated whenever we feel alarmed, distressed or under threat, meaning that the attachment system works closely with fear. Therefore, if we were not fortunate enough to be have developed stable relationships with parents and/or carers representing a ‘secure base’ as children, this can lead to all kinds of relationship problems in adulthood.

“The environment we’re born into, as well as the people within it and how they relate to each other and to us, are of significant importance” 14 | Attachment

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We are born in relationship We grow and learn in relationship We are wounded in relationship We are healed in relationship

Our initial experiences of our primary caregivers (usually parents), sets up our relational style. In an unconditional loving experience of our childhood, we develop secure attachments. But sometimes this love is not given without a price. In our need for safety and love from our caregivers, we can deny and distort behaviours and thoughts so that we may be acceptable to them. We develop ambivalent, anxious or disorganized attachments.

This survival instinct for succor is ingrained in our genes. We can therefore perceive ourselves as ‘good enough’, or ‘not good enough’ in our future relationships.

A lot of sexual abuse occurs within the family. This causes huge conflicts in our being. We need safety and love from our family, yet this is betrayed when it is withheld by inescapable conditions. Trust is abused and a lowering of resilience and selfesteem can shadow our future relationships.

Relationships We are social creatures, our brains are wired to seek and foster working and playing together.

This is possibly an evolutionary advantageous trait to increase our chances of survival. Being in relationship is imperative to our daily survival.

When our trust in relationship is destroyed by betrayal, as in sexual abuse, we are wounded to the core of our being. If our attachments from our childhood are secure, we may be able to recover and heal in time. But where those attachments are conditioned by withholding safety and love, the resilience needed to recover may be fragile.

The therapeutic relationship is founded on unconditional caring, genuineness, trust and confidentiality within a safe relationship. Exactly those qualities that have been damaged in sexual abuse. Collaboration, in the healthy relationship with the therapist, creates a safe place where wounds are healed and new meanings are discovered.

Relationships | 15

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Sleep Hygiene You may or may not have heard of sleep hygiene basically it’s just a fancy word for coming up with a plan that might help to get your head down.

Trouble getting to sleep or staying a sleep can be a common issue for men that have been through a sexual trauma this is not rocket science and neither’s sleep hygiene there are some simple things that you can put in place they may help get your head down and keep your head down.

Why not give them a try, what have you got to lose. You might find reading this that boring it sends you to sleep…

- A void napping during the day, it can disturb the normal pattern of sleep and wakefulness.

- A void stimulants such as caffeine nicotine and alcohol close to bedtime, for example chocolate contains caffine.

- E xercise can promote sleep, maybe go for a walk in the morning or late afternoon, even a relaxing exercise like stretching before bed to help initiate restful night’s sleep.

16 | Sleep Hygiene

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“Associate your bed with sleep...”

- F ood can be disruptive right before sleep, stay away from large meals close to bedtime.

Changes in diet can also affect someone who’s struggling with sleep. Especially try and avoid spicy food.

- E stablish a regular bedtime routine.

Try to avoid upsetting conversations before bed, try not to dwell on things before climbing in.

- A ssociate your bed with sleep, try to avoid being on your phone on Facebook or watching T.V. use the bed for sleeping in.

If these things don’t work for you and you’re struggling to stay asleep and are waking up in the night some people find it useful to keep a pad and pen at the side of their bed to jot their thoughts down on paper - better out than in, it may help take the power out of them.

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Families Supporting Survivors

Here at Survivors Manchester we recognise that the impacts of sexual violence and abuse are not only felt by the boys and men who directly experienced the original event, but also those closest to them. Friends, family members and partners also often struggle with intense emotions, and thoughts and feelings themselves as they worry about how to respond appropriately to the torment that the men in their lives are clearly going through, whilst striving to maintain the structure of everyday life. It is unfortunately very common for the family members and significant others of male survivors to feel helpless and frustrated as they often feel unable to say or do the right thing whilst watching their loved one struggling with the destructive cycle of their sexual abuse history.

This destructive cycle does unfortunately often involve impacting negatively on the close relationships of male survivors, meaning that those closest to men are also indirectly affected by the sexual trauma, and therefore also need support.

First of all it is extremely important to remember that there is no ‘right way’ to respond to what you are experiencing. In the same way that each male survivor’s symptoms of their sexual abuse are a normal reaction to an abnormal event, this also applies too as someone who has a relationship with a male survivor, whatever that relationship maybe.

It’s important that you also feel supported throughout this recovery process, and don’t begin feel traumatised yourself by what’s happening, because if you are unable to take care of yourself then you will be unable to take care of anyone else.

“Remember there is no ‘right way’ to respond to what you are experiencing.”

If you are a family member and/or significant other of a male survivor of sexual abuse and/or rape, and you are struggling to cope with what’s happening as a result, speak to a member of the Survivors Manchester staff team about accessing some support for yourself.

Family Support | 17

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Criminal Justice / ISVA

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For men and boys who have experienced sexual violence, whether recent or far into the past, the thought of reporting to the police can be a frightening and overwhelming prospect. For some, this may be the first time they have considered talking about their abuse. Often, the weight of what is unknown can be a source of stress and anxiety – particularly given how difficult the legal system can be to understand. Many men and boys are not aware of the processes involved in making a report to the police, and any subsequent legal proceedings that may follow.

Here at Survivors Manchester, we recognise the difficulties many men face when contemplating reporting to the police, or for those that have made a report but do not have adequate support to assist them through the process. As a result, the Independent Sexual Violence Advisor (ISVA) service at Survivors Manchester offers information, practical and emotional support to those men considering making a report to the police, or those already involved in the criminal justice system that require support to alleviate any stress and anxiety caused by the legal process.

It is perfectly natural to be anxious and to have questions and concerns about how to proceed in a way that is best for you. The ISVA is specially trained to offer assistance throughout the criminal justice system – from initial report to court and beyond. From start to finish.

The ISVA service is confidential and completely independent from the police. Although the ISVA can explain what happens when you make a police report and how the criminal justice process works, you do not have to report to the police.

The role of the ISVA is to ensure that you have all the necessary information and support to make an informed choice about what is best for you. Lodging a formal report with the police is not necessarily what is best for an individual – and as such, part of the ISVA’s role is to provide information regarding your options – including what support is available should you decide not to advance with legal proceedings.

18 | ISVA

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Although ISVA support is not a clinical or therapeutic service, we can signpost you to relevant Survivors Manchester clinical services to meet your specific needs. Furthermore, the ISVA can help you access services outside of Survivors Manchester that may be of benefit to your overall mental and physical wellbeing.

The feedback we receive from the lads accessing the ISVA service is extremely positive: ‘For the first time, I’m beginning to feel how I did before the abuse began.’

‘I couldn’t have gone through with all this if it wasn’t for the support that you have provided.

Without the help, I would’ve been lost’.

‘After giving my video interview I felt broken, I felt like I did when this first happened. You have helped me to rebuild so I can face what happens next.’

For more information about the ISVA service, including staff profiles, please visit our website at www.survivorsmanchester.org.uk or call 0161 236 2182. Alternatively, you can access email support via support@survivorsmanchester.org.uk

ISVA | 19

Friends of Survivors Manchester St Mary’s Centre: 0161 276 6515 Mon to Fri 9:00am – 5:00pm www.stmaryscentre.org LGBT Foundation: Advice, Support, Information 0345 330 30 30 Mon to Sat 10am – 10pm www.lgbt.foundation 42nd Street: 0161 228 7321 Mon & Thu 2.00-5.00pm, Fri 1.30-4.30pm www.42ndstreet.org.uk Self-Help Services www.selfhelpservices.org.uk The Sanctuary: 0300 003 7029 Providing 24-hour mental health crisis support in crisis.

The crisis line open 6.00am – 8.00pm The centre is open 8.00pm – 6.00am

The Mankind Initiative: 01823 334244 www.mankind.org.uk Survivors UK: www.survivorsuk.org Web Chat Mon – Fri 10:30 – 21:00 Sat – Sun 10:00 – 18:00 Shelter: 0808 800 4444 www.england.shelter.org.uk Mankind UK: www.mankindcounselling.org.uk Safeline: 0808 800 5005 Mon 10am - 4pm Tues 8am - 8pm Thurs 8am - 8pm Fri 10am - 4pm Sat 10am - 12noon Samaritans: 116 123 24 hours a day