When Associate Professor Danny Willis was working as a young psychiatric mental health nurse in Louisiana in the mid-1990s, many of his patients were men and boys living with the physical, emotional, and interpersonal aftereffects of childhood abuse or trauma. The repercussions could take many forms, from depression and anxiety to post-traumatic stress disorder, substance dependency, and difficulty trusting others.
As Willis spent more time with these patients, he began to ask himself how he, as a nurse and a person, might best care for these men and boys as they attempted to put those early experiences behind them. What did healing look like for them, and what steps could they take to move past trauma into confidence and well-being? When he turned to the academic literature in search of answers, he found a surprising gap: while there was a body of published research about what it took for female abuse survivors to heal and move on with their lives, Willis says, “Very little was known about the healing process for male survivors of abuse.”
Today, Willis is an international leader in research on boys’ and men’s health and healing in the aftermath of marginalizing or traumatic experiences, ranging from physical, sexual, and emotional abuse to schoolyard bullying and violence in their communities. He sees the question of how to care for men—and how to teach men to care for themselves and for others—as a key piece to solving a greater societal puzzle.
“Worldwide, we have a problem with men and violence,” he says. “From logical analysis, you know that there is something going on in our communities, and you can’t owe it all to biology.” (Indeed, according to the Federal Bureau of Prisons, 93.3 percent of the roughly 2.3 million people currently incarcerated in the United States are male.)
That is why questions about what factors influence men to commit acts of violence, and of how to help men recover from early traumatic experiences, are particularly relevant to health care professionals who work within the walls of American prisons, says Willis. And that in part is what led Jean Watson, a University of Colorado nurse theorist and founder of the Watson Caring Science Institute, to call on Willis to help her design and lead a Human Caring Literacy Training Program for nursing staff, social workers, and physicians working in New York State’s prisons (51 out of 54 of which house men).
The New York Department of Corrections and Community Services invited Watson to lead a two-day workshop on March 9–10 based on her Theory of Human Caring—a seminal nursing philosophy that centers on nurses’ ability to build positive interpersonal relationships with their patients. Ninety nurses, physicians, nurse practitioners, and social workers from correctional institutions across New York State traveled to Fishkill, New York, to attend the training program. According to Willis, the program’s focus was to encourage attendees to think about how they might introduce new practices and thought processes into their work with incarcerated patients—with an eye toward helping those patients heal and build strong relationships. “Ultimately, the majority of people in prison go back out into the world,” he said, “So we need to think about how we are preparing them, not only educationally but emotionally, for that.”
Every human has a need to be heard and seen; a need not to be dehumanized or marginalized. As a nurse in any environment, it is important to pause and think about the human being in front of you as a person who has come into the world, just as you have, with a purpose, with meaning, with struggles, and with a capacity to make mistakes.
—Danny Willis, associate professor
Between 2010 and 2013, Willis received funding from the National Institutes of Health to lead a study about how adult male survivors of childhood maltreatment heal. Over two years, his team of Boston College nurse-researchers conducted in-depth interviews with 52 men who had been abused as children, whether physically, emotionally, or sexually. The men ranged from 18–64 years old and came from a wide range of socioeconomic, ethnic, and educational backgrounds, and many reported having struggled with physical and mental illness as adults.
The researchers found that many of these men had trouble with “emotional self-regulation,” which Willis describes as “the ability to manage impulses, the ability to express one’s feelings, and the ability to not act violently when having experiences that are threatening or fearful.” He speculates that the difficulty male victims of abuse have in controlling their emotions may be key to understanding the link between trauma and later violence. However, the interviews his team conducted also suggested that the ability to manage one’s emotions can be learned, or relearned, through caring relationships and holistic practices—meditation, breathing exercises, physical exercises such as reiki and qigong, music therapy, and spending time in nature.
One barrier that males face when they attempt to move past painful memories, Willis said, is that they often feel reluctant to talk about their emotions—especially painful ones—because they fear being seen as vulnerable. He also noted that this fear is often coupled with a sense that taking care of others is somehow feminine or weak.
“We’re simply not teaching men to be nurturing and caring to the degree that we do women,” Willis says. Many of the men in the study said that breaking through their reluctance to talk about their experiences was crucial to overcoming the emotional shadow of abuse, and Willis speculates that this fear of emoting may conceal a clue to the question of why men commit acts of violence. “It’s a very complex question to answer, but caring and healing offer a solution,” he says. “In my ideal world, I would like to see this be a larger conversation in society—the whole notion of how men can be socialized to better care for themselves.”
“Healing happens in an environment where there is human dignity and respect, and that kind of environment has to be built collaboratively,” Willis says. At the training program in Fishkill, he said, he and Watson discussed how health care professionals might work to help make prisons more humane for both staff and inmates. Willis and the other facilitators led group discussions, breaks for reflection, and simulations of patient-nurse encounters. In one such exercise, participants were asked to speak and then interrupted. The idea, Willis explained, was for each participant to experience the difference between being heard and not being heard.
“Every human has a need to be heard and seen; a need not to be dehumanized or marginalized,” he said. “As a nurse in any environment, it is important to pause and think about the human being in front of you as a person who has come into the world, just as you have, with a purpose, with meaning, with struggles, and with a capacity to make mistakes,” he says.
Healing happens in an environment where there is human dignity and respect, and that kind of environment has to be built collaboratively.
—Danny Willis, associate professor
This daily act of self-reflection takes on additional importance in a prison setting, which can frequently feel dehumanizing for inmates and staff alike. At the training, Willis said, nurses were given a simple suggestion: take a moment each morning before work to reflect on their reasons for going into the prison that day. The program concluded with an open discussion about how attendees might work to encourage practices like this daily reflection in New York’s prisons going forward.
The NIH-funded study represents the latest link in Willis’s line of research into the experiences of men who have lived through depression, hate crimes, HIV, bullying, and sexual violence. Through his interviews with men who are recovering from childhood abuse, Willis has found his way to “moving beyond suffering,” a working definition of healing after abuse. In the NIH study, he defined this as the ability “to make deliberate conscious decisions to no longer be confined to an existence of pain and strife caused by abuse.” For most of the men he spoke to, this has meant building new habits and new habits of mind. Most of the men who had found some sense of healing in their lives said that they had learned to take care of themselves, both physically and mentally, and to care for others and build trust. This mindful outlook, Willis says, is “not expensive, and it’s portable.
“It’s a way of being that, when catalyzed and cultivated, could potentially be transformative not only for individuals but for society at large,” he said. “With all the violence and trauma in the world, we definitely need to do something, in particular with our men.”
In Willis’s view, the focus on caring he and Watson brought to the workshop in Fishkill and the research he has done on men and boys have implications for society as a whole that transcend the prison system and the male experience of abuse.
“I see nursing as a force for social change, and this program was an example of how thinking from our field can go beyond the bounds of the discipline,” he said. “When we take what we know about caring and healing and build on that, it is possible to reach broader and broader spheres of people. Why wouldn’t we do that, when it’s our expertise?”