Over the past several months, I have experienced an influx of men – single, married, and coupled up – in my practice. I consider this to be a positive direction on many fronts! Although some men start therapy on their own volition, the majority have been “encouraged” (and some demanded upon) by their spouse or paramour. I always ask, “Why now?” The most common response? A recent critical incident, which has become the “tipping point’ or potential deal breaker in their relationship. For single men, their behaviors are having significant consequences at work or in their family life (family of origin).
Deeper exploration unveils previous, similar incidents that help connect the dots, tell their story, and provide clarity. However, its the most recent incident that ultimately bears the greatest burden on their relationship, on their life, that puts both at risk. Whether there have been a few isolated incidents with significant time in between or several small infractions, either can prove catastrophic.
Yet, despite the increase in numbers of men receiving therapy, lies deeper questions that demand greater introspection. “What does hold men back from seeking therapy?” “How do men think of themselves if they receive therapy?” “What if their spouse or paramour didn’t encourage or demand they go to therapy to get help, would they still go?”
Why The Imbalance?
Ronald F. Levant, EdD, President of the American Psychological Association (APA) President, coined the term, “normative male alexithymia”, which literally means “without words for emotions”. Levant postulates that “many men are socialized to ignore their emotional sides and therefore struggle to express or understand their feelings.” Further, University of Missouri Counseling Psychology Professor Glenn Good, PhD goes on to say, “I don’t think that it’s biologically determined that men will seek less help than women,” who studies men. “So if that’s true, then it must mean that it’s socialization and upbringing: Men learn to seek less help.”
Moreover, according to Aversion Therapy: Why Won’t Men Get Help? studies indicate that men who equate seeking assistance with weakness, or the appearance of not being able to handle their own problems, experience more soured relationships, higher rates of debilitating illnesses, and earlier death. And, rather than participate in traditional talk therapy, prescriptions for medication to combat emotional issues and mental health issues increased from 68.8% in 1998 to 73.3% in 2007. Thus, the root of the emotional issues are often never addressed, just covered up.
Men, by and large, are taught to be stoic, soldier on, and not to ask for help. The exact opposite of therapy. Imagine their paradox? For some men, its cultural pressure to bottle up problems and emotions as its viewed that having emotions are a sign of weakness. Rather than risk exposure or judgment by engaging in therapy, many men turn to alcohol and drugs to combat their emotional and mental health issues. This direction lends itself to comorbidity issues, only complicating matters.
Key Goals in Treatment: What To Do?
- Solution Focused Therapy (SFT). SFT focuses on what people want to achieve rather than on historical problems. It works towards creating forward momentum building to a person’s ideal future. Utilizing this type of therapy invokes words such as plans, goals, outcomes. Men relate to these words.
- Aesthetics is important. Although this may sound superficial, comfort is key. My office is gender neutral and looks a lot like your living room! Creating comfort for patients, both men and women, is paramount.
- Making a connection, hearing and listening to what they have to say while not judging, and giving them something small to take away, makes them feel that I understand what they are going through and provides some relief and comfort they desperately need. They want to return.
- Because men already feel emotionally isolated and feel biased against when seeking therapy, its important to figure out and understand what they want to fix in their lives and what is working as well as what isn’t working. Sensing that they have much to gain through this process encourages a greater investment in therapy for them.
- According to Rebekah Smart, PhD, ”many men want to be challenged on their “stuff” but not put down, she says. “As a woman therapist, what helps to engage some men is to be empathically confronting in a way that doesn’t demolish their self-esteem,” Smart explains.
- Participating in therapy is difficult enough therefore a little validation and support goes a LONG way. Offer it. Give it. Freely.
- Finally and personally, despite making a few modifications in the language that I use when working with men, my approach, path, and goals remain the same regardless of gender: provide a safe and nonjudgmental place to help each person traverse down a more honest path of living, take a collaborative approach to uncovering their issues and reasons for their behaviors, while ultimately helping each person find and use their voice, whatever that might look like.
