This is from The Onion, so don't take it seriously. However, this little piece of satire points out a stigma that still is common in our culture - that seeing a therapist is weak, especially for men.

Supposed Adult Pays Man To Sit In Room And Listen To Him Talk About His Feelings

News in Brief • ISSUE 50•07 • Feb 19, 2014


BRIDGEPORT, CT—Reportedly going twice a week to his special safe place where he’s told he doesn’t have to be afraid, local accountant and supposedly grown adult Carl Rowley confirmed Wednesday that he pays a man to sit right next to him in a room and listen to him talk all about his feelings. “It’s really helpful to talk through my issues out loud with someone who has an objective viewpoint,” said the feeble approximation of a mature self-respecting grownup, describing the hour-long sessions in which he nestles himself on a big comfy couch with a soft pillow and tells the nice man how he’s sad and lonely and wants everything to feel good again. “I think I’m making a lot of progress, especially around issues with my family. I definitely think it’s something every [oh-so-fragile little infant masquerading as an actual grown man] should try.” At press time, sources reported that Rowley felt much better after the kindly listening man, a so-called doctor, told him that it was okay to cry.

Aaron Anderson - Five Signs a Man Needs to See a Counselor

From the Good Men Project, Aaron Anderson offers five signs that we might need to seek out therapy. I agree for the most part - and none of the reasons given here are indicative of serious psychological symptoms (like suicidality, audio hallucinations, panic attacks, or dissociation).

When I began therapy, it was because I was unhappy with my life, my relationships, and my future. Therapy helped me know who I am, understand how I had come to that point in my life, and how to change the things I was not happy with in my life.

Counseling can save your life, but it can also help you find the life you have always wanted to live.

Five Signs a Man Needs to See a Counselor

September 22, 2013
by Aaron Anderson

Men aren’t supposed to go to counseling, they’re supposed to be tougher than that, right?

—

For a lot of men, the thought of going to a counselor for therapy is silly. It’s just not part of the man code to go and see a counselor. Seeing a counselor means talking about feelings and your childhood and there’s always the potential of the counselor telling you that your problems are occurring because you’re still in love with your mother. It’s no wonder then, why a lot of men don’t seek out counseling. And then there’s always the question of ‘do I need therapy anyway’? Everyone goes through rough spots. But how do you know when you need therapy? Let’s take a look.

Five signs a man needs to see a counselor.

1) The ‘rough patch’ stays rough for a while. Everybody goes through rough patches now and again. Whether it’s a rough time at work, a rough time in your marriage or a rough patch in life. But if these rough patches stay rough for a while you probably ought to see a counselor. You could wait it out, but what’s the point? Seeing a counselor sooner than later ensures that you get back on track sooner and start enjoying life sooner, too.

2) Your wife/mother/significant other suggests counseling. As a counselor who specializes in marriage counseling, I dread phone calls from men. I dread them because they usually go something like this: Me: Hello? Him: Hi, I need to set up an appointment for my wife and I to come to counseling. She’s been threatening to divorce me for three years and she finally left this morning. Do you have any appointments later today? Me: I have an appointment for later this week if that will help. Him: Okay. Great. Let me call my wife and see if she’ll come.

They normally don’t call back. The ones who do call back are just being courteous to tell me that their wife has gone to the courthouse for the divorce papers and won’t be needing my services after all. Men, do yourselves a favor and go to counseling the FIRST time your wife/mother/significant other suggests it.

3) You want more out of life. In his book Real Boys by William Pollack, PhD, Dr. Pollack talks about the ‘boy code’ that we hear as young men. As young men we often hear to sit down, shut up, and don’t complain. We’re also told to suck it up, don’t cry and move on. So as grown men we often feel like we can’t want more out of life because we just have to suck it up and accept our life as it is. But counseling is a great way to get exactly what you want out of life and get the tools you need to get there. You may have to talk about your feelings but you shed those unwanted burdens that are keeping you down. And you get exactly what you want out of your life in the mean time, too.

4) You’re easily irritated. Men display mental health difficulties differently than women do. Women internalize their difficulties by feeling sad, quiet and guilty. Men are much more external in their displays of mental difficulty. This means they get irritated at others more, become more aggressive and even become physical at times. If this isn’t how you normally react to stress and you’re reacting this way more and more it’s time to see a counselor. If you do normally react this way to stress, you still need to see a counselor.

5) You just want to be left alone for extended periods of time. Everybody goes through spells where they just want to be left alone for a few hours, night a day or a weekend. But if you find yourself day after day just wanting to be left alone by your wife, kids and colleagues at work it’s time to see a counselor. Being left alone is a temporary solution. Sometimes being left alone temporarily is all you need to get your mind back in the game and get a fresh perspective on how to fix things. But if you find yourself wanting to be left alone day after day after day, that’s a big red flag that something more serious is going on.

Unfortunately, there’s still a stigma about seeing a counselor. And for some reason, many men wait until the last minute or just don’t go at all. But a real man does whatever a man has to do in order to be a man; including going to counseling.

About Aaron Anderson
Aaron Anderson is a Licensed Marriage and Family Therapist and owner of The Marriage and Family Clinic in Denver, CO. He also writes for several publications online and in print all on the topic of marriages, families and men. In his spare time (whatever that is) he is secretly preparing to be the next great chef. You can find him on Twitter @MarriageDr and on Facebook giving great info without the psychobabble.

This article comes from Dr. Stephen Diamond's Evil Deeds blog over at Psychology Today. I don't know if I would say that psychotherapy has been feminized, but the percentage of male therapists and counselors (who are not psychiatrists) is probably less than 20% nationwide, and maybe lower if you look at the under-40 cohort [Stephanie Coontz, in her New York Times article said that 81 percent of social workers are now female, up from 64 percent in 1980].

Among the men who do go into counseling, at least from what I have seen here in Tucson, it seems a pretty large percentage of them are gay or bisexual. This should not even be an issue, but for traditionally masculine men it can be a serious issue, not to mention for those who are fundamentalist in their religious beliefs.

Anyway, Dr. Diamond (in response to an article by Sherrie Bourg Carter, Psy.D., Is It Really the "End of Men?") looks at the decline of male psychotherapists.

End of Men: The "Feminization" of Psychotherapy

Are we witnessing the extinction of male psychotherapists?

Published on October 5, 2012 by Stephen A. Diamond, Ph.D. in Evil Deeds

A New York Times article by Benedict Carey (May 21, 2011) titled "Need Therapy? A Good Man Is Hard to Find," highlights the fact that men have been abandoning the psychotherapy field in droves for decades. So much so that the profession has now become almost totally dominated by female practitioners. According to Carey, less than 20% of Master's degrees in psychology, clinical social work or counseling are being sought by men today. Women outnumber men in doctoral psychology programs by a ratio of at least 3 to 1. (See an article published by the American Psychological Association on this remarkable development.) But this has not always been so. Certainly not when I was a graduate student back in the mid-1970s. What's happening to the psychotherapy profession? Why have men gradually deserted the field? And does gender really matter in psychotherapists?
 

I personally witnessed this insidious shift to a predominantly female demographic during my twenty years of teaching psychotherapy to graduate students. The reasons for men fleeing the field of psychotherapy are many. First, and foremost, is financial. In recent decades it has become  increasingly difficult to earn a decent living as a psychotherapist of any discipline, be it psychiatry, clinical psychology, clinical social work, marriage and family therapy, or counseling. For men, who traditionally have a family to support or must support themselves, the mental health profession, especially private practice, no longer provides a viable source of steady income. Many male psychotherapists dropped out of the profession, finding work in other better paying venues. While this economic crunch equally affected female practitioners too, those women who were not the sole breadwinner for the family or were financially supported by their partners and therefore didn't need to earn as much money were better positioned to enter or remain in the field. But it is not just about money.

Since so many men in our society place such a high value on status and power, and since status and power are closely associated with money, some men choose to pursue status and power in more monetarily rewarding professions than psychotherapy. Psychotherapy was once a fairly lucrative vocation. But not so much now. Moreover, the mental health professions--especially clinical psychology--have significantly lost status and prestige overall. Whereas, at one time, clinical psychologists were seen as distinguished clinical specialists and uniquely qualified providers of treatment, today we are generically lumped together by insurance companies and consumers as merely one of a multitude of non-physician mental health providers who, unlike psychiatrists, cannot prescribe psychotropic medication to patients. (In a few states, clinical psychologists can, with additional post-doctoral training, prescribe such medications, but this is the exception rather than the rule. See my prior post.) Psychiatrists, in contrast to clinical psychologists, are still mostly males, but this too is slowly shifting. One reason that not as many male psychiatrists have fled their profession is that most, perhaps up to ninety percent, exercised their option as physicians to focus on psychopharmacology exclusively, a far more lucrative specialty than psychotherapy could ever be. Hence, their status and power--and income--was preserved. But most clinical psychologists and other non-medical clinicians don't have that dubious and, in some cases, cynical option.

But this alarming phenomenon goes deeper than any one of these single factors, far deeper than former American Psychological Association president Dr. Dorothy Cantor's simplistic assessment cited in Carey's piece: "Usually women get blamed when a profession loses status, but in this case the trend started first, and men just evacuated. . . . Women moved up into the field and took their place." While this is true, it must also be admitted that during that same period there was a pervasive devaluation of the archetypal "masculine" by women, both within and without the mental health profession. Much of this devaluation was a compensatory reaction against the prior denigration of the "feminine" in psychology and psychiatry, starting with Sigmund Freud. (Freud's famous male pupils, Rank and Jung, both tried to counteract this patriarchal prejudice in psychoanalysis by rehabilitating the "feminine" in their own approaches, as did pioneering psychoanalyst Karen Horney.) One manifestation of this devaluation and rejection of the masculine by women can be seen in the relatively recent trend toward females seeking treatment only from female therapists, a gender preference that presumably negatively affected the caseloads--and already plummeting incomes--of male practitioners, since women statistically comprise a greater portion of psychotherapy consumers. (See Chapter Two, "Sex Wars," in my book Anger, Madness, and the Daimonic. and also this excellent article, "Gender Issues in Psychotherapy.")

Does the sex of your psychotherapist really matter? As Carey's timely article notes, there is nothing in the rather limited mainstream scientific literature on gender and treatment outcome suggesting unequivocally that either males or females make better, more effective psychotherapists. (Having said that, the Helsinki Psychotherapy Study [2004] suggests some significant relationship between professional efficacy and personal qualities such as introversion and extraversion, self-confidence, and active vs. passive approaches to treatment.) So individual differences in personality style, some of which are inevitably linked to gender, do impact treatment. A male psychotherapist may be more effective for some patients than others; just as a female may have more success with certain cases than others. Part of this difference does have to do with gender and often unconscious gender psychology. Some male psychotherapists, for example, are fearful or out of touch with their "masculine" aggression, while others are estranged from their "feminine" side and feelings. Some female therapists either overidentify with the "masculine,"or devalue and dissociate it in their own personalities. This can all come into play during treatment, and commonly does so unconsciously in the form of what we call "countertransference" and other blindspots and biases on the psychotherapist's part. (For more on defining the archetypal "masculine" and "feminine" from a Jungian perspective, see my prior post.)

For instance, when women stepped into the void left by men in the field of clinical psychology and other mental health professions, many adopted men's "masculine" perspective and rational orientation to treatment. Cognitive-Behavioral Therapy (CBT) is a good example of such a highly "masculinized" approach today, one which imputes primacy to rationality and thinking over affect, the unconscious, and the so-called "irrational" (i.e., "feminine" or emotional) aspects of experience. The choice of this one-sidedly logical, mechanistic orientation to treatment represents an overvaluation of the "masculine" and devaluation of the "feminine" in psychotherapy itself. Paradoxically, given the vast popularity of CBT with today's female and few remaining male psychotherapists as opposed to more analytical, humanistic or existential approaches, it is clear that, unfortunately, the "feminization" of the psychotherapy field in terms of gender does not necessarily translate into a more truly "feminine" (i.e., compassionate, caring, affective and relational) orientation to psychotherapy. And, when it does, it tends to be a lopsidedly "feminine," nurturing, soft, passive, supportive approach to treatment in which firm limits, boundaries, diagnosis, structure and confrontation are sorely lacking. Balance between "masculine" and "feminine," between a focus on both feeling and thinking, intellect and experience, rational and irrational, is essential in psychotherapy, whatever the clinician's gender.

One key issue Carey's article touches on has to do with both male aggression and sexuality. Can a female therapist relate adequately to that which is archetypally and instinctually masculine? To the innate, primitive, often intimidating aggression, anger or rage of men? To the unique nature and primal power of male sexuality? Much of that depends, in my estimation, on how conscious and related she is to what Jung called her animus or inner masculinity. And on her own personal experiences with men. For male psychotherapists treating female patients, the same may be said regarding the awareness of and attitude toward their anima or inner femininity. Much like their patients, psychotherapists can suffer unconsciously from either "fear of the feminine" or "fear of the masculine." And unless they have faced that fear in themselves, and its psychological significance, it can be difficult to help others to deal with it.

Still, some men simply don't feel comfortable talking with a female therapist about these intimate matters. Just as some women feel uneasy with male therapists. Now the reasons for this discomfort, for either gender, can be--and, in my experience, often are--neurotic forms of negative transference, resistance or deep-seated distrust and dread of the opposite sex. Or, sometimes, of the same sex. Or one's own sexuality. In many such cases, it may be advisable for the male patient to, despite his reticence, courageously consult a female therapist and work through his anxiety with her as part of the treatment process. Or vice-versa for the fearful female patient. Or for the person who insists on only seeing an opposite sex psychotherapist to work with someone of the same sex. To choose to challenge the conscious or unconscious avoidance. But the fact remains that men and women clinicians have very divergent perspectives, psychologies and life experiences, and each bring something different to the therapeutic table. Not better or worse, superior or inferior. Just different, but equally valuable. This is why it is wisely recommended, and in some analytic training programs required, that therapy trainees undergo two courses of treatment--one with each sex.

Essentially, the best psychotherapy is not merely about eliminating some specific symptom, but confronting one's demons, facing one's fears, discovering one's true self, finding and fulfilling one's destiny. In this sense, psychotherapy is a type of spiritual mentoring and initiation into powerful secret wisdom for dealing with life's most perplexing problems. (See my prior posts.)  In the Arthurian legend of the Holy Grail, Perceval is mentored into knighthood by a wise hermit named Gurnemonz, who served as the model for the wizened and diminutive Yoda in Star Wars. Perceval, whose name means "innocent fool," is a young man destined to find the Holy Grail. But before he can fulfill his personal destiny, he must intensively prepare psychologically, physically and spiritually, a difficult, arduous, painstaking process requiring many years.

Luke Skywalker's secret initiation into Jedi knighthood by both Obi-Wan Kenobe and Master Yoda closely parallels both the psychotherapy process itself and psychological and spiritual development in general. There are similar archetypal examples of initiation of women into the feminine mysteries solely by females. In different cultures around the globe for millennia young men have been initiated into adulthood and the essential secrets of masculinity by men, just as young women have been initiated by women. The time-honored wisdom of such structured, socially sanctioned, transformative rituals suggests that it is crucial to acknowledge and honor the profound differences--both biologically and psychologically-- between men and women, and that there are certain initiatory tasks best conducted by specially prepared members of the same sex. Such painful yet healing  initations or rites of passage are not limited to children approaching puberty or adolescents entering adulthood, but occur also during later stages of psychological development like marriage, child-birth, parenthood, mid-life crisis and old age. ( See, for instance, my prior post "Staring at Sixty.")

Such existential crises and painful rites of passage can differ significantly for males and females. Becoming a mature man is not exactly the same task as becoming a mature woman, and sometimes demands a very different set of skills and values. But, given the current "feminization" of psychotherapy, with the number of female therapists and therapists-in-training far outnumbering males, where will men, already reluctant to seek psychological treatment, go for such much-needed assistance? And, if women dominate the field of psychotherapy completely, what will become of the sacred clinical secrets of masculinity? Who will be the cultural containers and teachers of this sacred masculine wisdom passed down traditionally from one generation of male psychotherapists to the next?  Because of our complementary polar differences, women will always need male psychotherapists, and men female psychotherapists. There are certain wounds inflicted by women on men that only women can help heal, as there are those inflicted on women by men that require a "corrective emotional experience" with a male.

Despite of, or really, because of our profound psychobiological gender differences, we still have a great deal to learn from each other. Female psychotherapists, as women, can provide precious therapeutic perspectives to male patients, and vice-versa. But men will always need mentoring and initiation into manhood mainly by men, and women by women. Now that there is a critical shortage of men remaining in or entering the psychotherapy field, coupled with the scarcity of psychodynamic practitioners in general (see my prior post), consumers have increasingly fewer choices--not only regarding the particular type of mental health treatment they receive, but what gender will provide it. Thie feminization of psychotherapy may be good for women. But can this gender imbalance be good for the profession? I wonder. Women make wonderful psychotherapists. But so do men.

My hope is that, as with the recent signs of renascence of psychodynamic psychotherapy (see, for instance, my forthcoming review of 2012's Psychodynamic Psychotherapy Research for PsycCRITIQUES) now in motion, eventually the gender pendulum will slowly swing back toward middle ground, with men once more being drawn to becoming psychotherapists alongside women. The practice of psychotherapy itself is dying. (See my prior post.) If the profession is to survive, we definitely need men's masculine energy and perspective in clinical psychology to complement that of female practitioners. And vice-versa. But how can we make the psychotherapy profession today more attractive, especially to men? Is it all about money? Prestige? Status? Power? Have men lost touch with their nurturing, giving, caring, compassionate side?  Have we brutishly become more materialistic and selfish than women? Too technical, mechanistic or mercenary? Have men lost their faith in psychotherapy? Or have men in the field of psychotherapy simply surrendered to women in the proverbial war of the sexes? Resolutely accepted defeat and withdrawn from the field of battle?

Is this really the "end of men" in general? Is what we are seeing in the mental health professions merely a symptom or sign of a much more pervasive trend in American culture? (See PT blogger Mark Sherman's review of a recent book by Hanna Rosin titled The End of Men here. See also a response by another PT blogger, Melissa Kirk here.) Reader comments, as always, are welcome on this particularly exquisitely sensitive subject.

Survey Request - Males' Expectations of Counseling

I found this survey through Boysen Hodgson on Facebook, I am assuming they won't mind the added exposure in generating responses, so if you also have blog that reaches men, please consider re-posting this.

Here is the consent form, the link will take you to the page where you can begin the survey.

Males' Expectations of Counseling

Adult Consent Form

 

Western Michigan University
Department of: Counselor Education Counseling Psychology
Principal Investigator: Lonnie E. Duncan, Ph.D.
Student Investigator: Sheryl Kelly, M.A.

You have been invited to participate in a research project entitled "Males’ Expectations of Counseling." This research is intended to study what men expect to encounter when in a counseling session. This project is Sheryl Kelly’s dissertation project. This consent document will explain the purpose of this research project and will go over all of the time commitments, the procedures used in the study, and the risks and benefits of participating in this research project. Please read this consent form carefully and completely and please ask any questions if you need more clarification.

What are we trying to find out in this study?

Research has consistently shown that men are less likely to seek counseling, harbor negative attitudes toward counseling, and are less willing than women to seek therapy for psychological problems regardless of culture, race, or ethnicity (Addis & Mahalik, 2003; McCarthy & Holliday, 2004; Smith, Tran, & Thompson, 2008). To address this, the present study will expand the current knowledge base on men and their counseling expectations.

Who can participant in this study?
Individuals that identify as a male, being at least 18 years of age, have at least a high school diploma or GED, and have access to the internet will be included in this study. You will be asked to provide general information about yourself, such as age, race, level of education received, education status, socioeconomic status, type of area raised in, and previous counseling experience. If the results of the questionnaires indicate that you are less than 18 years of age, or have less than a high school diploma/GED you will be excluded from the study.  

Where will this study take place?
Participants will be invited to complete a questionnaire, and provided with a link to the secure online website where the survey will be housed.

What is the time commitment for participating in this study?
Each participant will be asked to contribute approximately 45-50 minutes of time to complete the surveys.

What will you be asked to do if you choose to participate in this study?
Participants will be asked to provide informed consent and complete questionnaires. No specific identifying information (e.g., email, phone number, name) will be collected in this process. Questionnaire is to be anonymous.

What information is being measured during the study?
This research will seek to measure and better understand the counseling expectations of males. The information obtained from this study will be interpreted for clinical application and program training.

What are the risks of participating in this study and how will these risks be minimized?
Minimal risk should be present, as the subject will be completing an anonymous online survey. As in all research, there may be unforeseen risks to the participant. No compensation or treatment will be made available to the subject.

What are the benefits of participating in this study?
This research would be beneficial to the field of counseling psychology as well as the population being studied. The data obtained from this study will provide counseling psychologists with insight into the expectations of males, and possibly provide the participants with insight into their thoughts about counseling.

Are there any costs associated with participating in this study?
There are no monetary costs associated with participating cost. Participation in this study will cost each of the participants approximately 45-50 minutes of their time.

Is there any compensation for participating in this study?
No compensation or treatment will be made available to the subject.

Who will have access to the information collected during this study?
Only the student and principal investigator will have access to the information collected. To participate in this anonymous survey, participants will not be required to provide any identifying information such as name or date of birth. Potential participants will complete the anonymous survey on a secure web page that can be accessed via invitation only. Upon gathering all necessary data to conduct study all surveys and subsequently web site will be removed from the internet. Subject identification will be made with a number. Data will be retained for no more than 3 years. Data will remain on a password protected flash drive/personal computer during statistical analysis period Following proper statistical analysis results of data will be presented a part of student investigator’s dissertation defense.

What if you want to stop participating in this study?
You can choose to stop participating in the study at anytime for any reason. You will not suffer any prejudice or penalty by your decision to stop your participation. You will experience NO consequences either academically or personally if you choose to withdraw from this study.

If you have any questions or concerns about this study, you may contact either Sheryl Kelly, M.A. or Lonnie E. Duncan, Ph.D. at 269-387-5152. You may also contact the chair of Human Subjects Institutional Review Board at 269-387-8293 or the vice president for research at 269-387-8298 with any concerns that you have.

This consent has been approved by the Western Michigan University Human Subjects Institutional Review Board (HSIRB) on July 31, 2012. Do not participate after July 31, 2013.

Go to the survey.

Why Do Men Still Feel an Aversion to Therapy?

There is a lot of validity to the information in this article (from Pacific Standard magazine), which is why I am sharing it in full. However, my experience as a therapist is a bit different.

I see a lot of men, and I see them in a place that only works with survivors of sexual trauma (rape, incest, sexual abuse, and so on). The fact that I see as many men as I do is indicative (to me) of the decreasing stigma associated with men seeking therapy. More importantly, it also suggests that men are not as unwilling to admit that they are survivors of abuse, rape, or incest. 

As this article suggests, there are still a lot of men who cannot or will not enter therapy, no matter how much emotional pain they experience. I'm not sure how to change that, other than to create more public and cultural awareness that men can benefit from talking about their feelings, or even just seeking better coping skills for the challenges that life brings.

And maybe, as this article suggests, we need to market therapy for more traditional men in a different way. We must do something. Even though many more women than men are diagnosed with depression and attempt suicide, 8 in 10 successful suicides are by men.

There is another issue, however, that I am sure factors into whether or not men seek counseling.

I am 45 years old, 6' 1" tall and weigh about 190 lbs, with around 8 percent body fat; my blood pressure hovers around 100 over 60, my cholesterol is about 135, with a higher HDL (70) than LDL (65); I do not drink, smoke, or use drugs, and I work out at least 4 times each week.

Despite being in the 99.9 percentile for general health, I cannot get a preferred rate on my health insurance because I carry a diagnosis for social anxiety disorder. So I pay more. Any man with a family and facing a similar issue may choose to tough out his emotional pain rather than take the financial hit on his health insurance. This is wrong in more ways than I can count. The man who seeks out therapy is likely to cost less in the long term because he will not suffer from the various healths issues related to mental health issues, such as heart disease, cancers, and other stress-related illnesses. The system needs to change.

Aversion to Therapy: Why Won’t Men Get Help?

Psychologists worry about the Great Recession’s toll on men who define their self worth through work. In every corner of the globe, more men commit suicide than women. Research shows that men benefit from talk therapy just as much, if not more, than women. Yet most men still won’t go.

June 25, 2012 • By Betsy Bates Freed and David Freed 

Twenty years ago, Bob Smith’s wife questioned his commitment as a father. She demanded he see a psychiatrist. Smith (not his real name) grudgingly obliged. He went. Once.

“The idea of paying some guy $300 an hour to massage your issues,” says Smith, a Los Angeles-area attorney in his early 60s, “is ridiculous.”

In fact, the psychiatrist Smith talked to found plenty of issues to massage. His 45-minute assessment suggested that Smith was toting a veritable luggage store full of psychological baggage that needed unpacking. He recommended twice-weekly counseling sessions.

Smith was having none of it. Like millions of other American men, he simply couldn’t see paying good money for spilling his guts.

Fast-forward a couple of decades. Last year, Smith was diagnosed with a particularly virulent strain of prostate cancer that required immediate surgery, then radiation treatment. Still, he was disinclined to consider confiding in a professional all that he was enduring emotionally.

“I’m pissing in my pants and I can’t ejaculate and I want to talk to somebody else about that?” the Harvard Law School grad explains. “It’s a misapprehension that talking with a psychiatrist or a psychologist is going to move the ball forward. Some things … are what they are. The sooner you deal with them objectively, the better off you are.”

Smith is convinced. But increasingly, studies show that men like him who equate seeking assistance with weakness, or the appearance of not being able to handle their own problems, experience more soured relationships with their significant others, higher rates of debilitating illnesses, and earlier death.

The cathartic benefits of reaching out for help are hardly a secret. As scientists have come to better understand the inner workings of the brain, they have documented the potentially catastrophic consequences for individuals, particularly men, who go it alone when confronted by profound emotional challenges. Some men have started to take heed. Yet they remain a small minority. In 1998, about 1.47 of every 100 men in the United States sought outpatient help for depression; by 2007 it was 2.12 men per 100, according to a study sponsored by the federal Agency for Healthcare Research and Quality.

 

 Should therapists be turning to football and jokes to reach a wider audience of men in need?

Often, that help has come in the form of “magic bullet” pharmaceuticals instead of traditional “talk therapy.” In 1998, the study shows, 56.2 percent of men who chose treatment for depression did so by sitting down and discussing their issues with a therapist. By 2007, only 42.5 percent of men interested in treatment chose therapy. Meanwhile, those who popped prescription pills in an attempt to tackle their emotional issues increased from 68.8 percent in 1998 to 73.3 percent in 2007.

While clinicians and academicians may haggle over the pros and cons of treatment approaches—many advocate a combination of psychotherapy and pharmaceuticals—there is no denying the toxic consequences of untreated depression at its most feared extreme. Distraught men are dying by their own hand in ever-greater numbers.

Suicide overtook blood poisoning to become the 10th leading cause of death in the U.S. in 2009. Meanwhile, calls to the National Suicide Prevention Lifeline have continued to escalate every year since 2008, the beginning of the so-called Great Recession. That year, calls to the help line soared a staggering 36 percent.

Men account for nearly 8-in-10 suicides in the U.S. today, even though women are diagnosed more often with depression and make far more suicide attempts. Such numbers are hardly exclusive to U.S. males. Men perish by their own hand in greater frequency in virtually every other corner of the globe. Nowhere, in fact, do female suicides appear to outnumber those of males. Researchers the world over have struggled to explain why. More than a few believe that socialization, not biology, lies at the root of the deadly disparity.

Other Stories in This Series

• A State of Military Mind
• Manic Nation: Dr. Peter Whybrow Says We’re Addicted to Stress
• Just Breathe: Confirming Meditation’s Benefits
• Have You Heard the One About the Guy with Prostate Cancer?

University College Dublin sociologist Anne Cleary published a study in the journal Social Science and Medicine this year that found a common theme among 52 young Irish men who survived suicide attempts: all expressed reluctance to disclose to anyone the “significant, long-lasting” emotional pain that had threatened to overwhelm them.

They “used alcohol and drugs to cope—which exacerbated and prolonged their distress,” Cleary wrote. “Over time this led to a situation where they felt their options had narrowed, and suicidal action represented a way out of their difficulties. … They opted for suicide rather than disclose distress and seek help.”

Frank Ferrante, 60, knows the feeling.

Now a professional speaker living in San Francisco, Ferrante spent a turbulent childhood in the “very gritty, very volatile, very, very pessimistic” Italian neighborhood in Brooklyn that Martin Scorsese brought to life in Goodfellas.

From his passionate but mercurial father, a Merchant Marine born in Sicily, Ferrante began to formulate what he now sees as a “really corrupt notion of what it was to be a man.” John Wayne, Humphrey Bogart, and the larger-than-life wiseguys who lived down the block just reinforced the definition: “A man is someone who can endure as much pain as possible without letting anyone know.

“As an 11-year-old watching a gigantic black-and-white TV, I wanted to be a poet. I wanted to be a writer. I wanted to be a flamenco dancer,” he recalls.

None of which were acceptable—antithetical to masculinity, in his mind, as were the vulnerability, anxiety, and depression he struggled to hide from everyone. “What I was, was a chameleon. I guess I was good at it. But one could say, my ego smelled a rat.

“I escaped into the construction world. I did it for the next 30 years,” he says, pausing for a long moment before muttering, “Jesus Christ. ”

Even before he dropped out of high school, drugs silenced Ferrante’s doubts, reassuringly blurred his memories. He looked at narcotics as “curative”—the perfect self-medication.

It came crashing down along a twisted, violent road that included a corrosive marriage, arrests, and what he vaguely calls “more subtle things: not being present, not being available in my relationships.”

At the worst point, Ferrante, stoned, jumped onto the tracks where he hoped a subway train would provide a solution. But he misread the light he thought meant a train was approaching. Someone pulled him to safety, for the moment.

Eventually, he found his way to therapy (after getting into a 12-step program) where he explored his past, his regrets, and the very structure of his beliefs.

“It’s been a slow and arduous process of clearing stuff up,” he says. (In 2010, three San Francisco filmmakers produced a documentary, May I Be Frank, about Ferrante’s experiences. See the trailer below.)



SUICIDE RATES AMONG MEN AGES 40 TO 49 have been rising for the past quarter century, and rates among men ages 50 to 59 sharply increased between 1999 and 2005, according to the most recent government statistics available. Though the numbers are not yet in for the years since, experts say that this grim trend may well have been exacerbated by the nation’s ongoing economic malaise, in which twice as many men as women lost their jobs.

The so-called “man-cession” sent overall male unemployment rates into double digits by 2009. It hit men in the prime of their work years especially hard, with nearly one in five men ages 25 to 54 left jobless. The pallid jobs recovery of 2011-12 has favored males over females, yet about one in 13 U.S. men remained unemployed as of April 2012. That figure contains ominous subcategories, including almost 3 million men unemployed for more than 27 weeks (three times as many long-term unemployed as in the last 40 years of record-keeping), and a million unemployed veterans (many carrying the wounds of war along with the burden of being without a job). Not counted at all are the nearly 35 million American men who have simply exited the workforce.

Many psychologists worry particularly about the recession’s ultimate toll on men who once may have defined their self-worth through their roles as breadwinners, only to lose those roles amid corporate downsizing and layoffs. How have men coped? Some, evidently, by drowning their sorrows. Alcohol sales rose every year during the recession, including a 9 percent rise in 2010.

In 2003, the federal National Institutes of Mental Health began posting online public-service spots in a “Real Men. Real Depression” campaign aimed at assuring those in the throes of depression that, “It takes courage to ask for help.” The campaign uses a firefighter, a police officer, and other men who’ve struggled with depression to illustrate that there is light at the proverbial end of the emotional tunnel—but only if they first muster the strength to ask for it.

Retired Air Force First Sergeant Patrick McCathern, among those who appear online in the NIMH spots, says he’d drink to “numb my head” to the depression that tormented him. CBut then you wake up the next day and it’s still there. … You have to deal with it,” McCathern warns.

It’s a cliché, but sometimes it’s true: many men would rather be lost in the wilderness than ask for directions; and they don’t like asking for help.

“We’re self-reliant. We want to do it ourselves,” asserts Fordham University psychology professor Jay Wade, president of the American Psychological Association’s Society for the Psychological Study of Men and Masculinity.

Oh sure, one guy might ask another to help him move a fridge if he absolutely can’t do it himself, Wade says. He may bend his bloody knuckles around the phone to call a plumber when the faucet’s still leaking after six trips to the hardware store. But when men at the highest rungs of the masculinity scale are faced with profound emotional pain, “they suck it up, move on, bury it, repress it,” according to Wade. “It doesn’t go away, obviously.”

Consider “Gary” a former big-city newspaper reporter and avid private pilot who was assigned to cover a midair collision between a small plane and a commercial airliner in Southern California in which everyone was killed, including several people on the ground. He arrived minutes after the crash. Homes were on fire. Body parts were strewn everywhere.

“You block it all out,” Gary says. “You tell yourself that detached head laying under that little tree can’t possibly be what you think it is, and do your job.”

Officials later that day released a list of names, people who had been aboard the stricken airliner, including a handful who were merely identified as “lap children.” Gary had two young children of his own. The thought, he says, of what it must’ve been like for the children and their parents as the jet fell out of the sky left him shaken.

When he got back to his newsroom, Gary says, his editor asked if he was okay. He assured him he was. To admit otherwise, he says, would’ve sent a message that he was incapable of handling tough assignments—professional suicide in the news business.

Though haunted by what he saw that day, Gary never sought counseling and says he eventually got over it. It would take him more than 10 years before he could will himself to pilot a small plane again.

“Would I have gotten back into flying sooner had I gone to see somebody? Probably,” he says. “But I just didn’t feel like talking about it, especially to a stranger.”

Statistics show that men are far less willing to visit a doctor of any kind, even when they’re having chest pain or experiencing other life-threatening symptoms, despite the fact that men die in greater numbers from 12 of the 15 most common causes of death. (Remember, women outlive men by an average of five to seven years.)

A study published last year by Rutgers University sociologists Kristen W. Springer and Dawne M. Mouzon found that health-care avoidance is most pronounced among “macho men,” those most invested in the belief that a “real” man is self-reliant and strong to the point of physical invulnerability. In their study of about 1,000 65-year-old men, those least likely to follow preventive health-care recommendations were more likely to favor traditional sex-role beliefs, measured by their endorsement of statements like, “A man should always try to project an air of confidence even if he really doesn’t feel confident inside” and, “When a man is feeling pain, he shouldn’t let it show.” Not surprisingly, those men were also less healthy.

If traditional men refrain from exposing their physical vulnerabilities in a doctor’s office, it stands to reason that they’d be unwilling to expose their emotional vulnerabilities in a counselor’s office, and that’s exactly what the evidence shows, according to Wade, the professor who heads up the masculinity division at the American Psychological Association.

To be sure, not every man needs to see a psychologist or psychiatrist, Wade and others are quick to point out. Many people adjust well on their own even in the face of catastrophic trauma, drawing on inner resources, resiliency, and guidance from family and trusted friends. But it doesn’t take a social scientist to realize that, sometimes, a genetic predisposition to depression or anxiety—perhaps exacerbated by the stresses of ordinary life—can add up to the kind of angst that threatens to overwhelm an individual’s coping mechanisms. Some individuals may initially try to “numb themselves out” by throwing themselves into their work as a distraction. As evidenced by the Irish study, alcohol and drug use are also common avenues of escape.

For many a manly man, a police DUI checkpoint and court-mandated counseling mark the first stops on the path to the therapist’s office. Often as not, it’s a wife or girlfriend who finally says, “Go see somebody or I’m leaving you.” But forcing men to sit through counseling sessions, mental health experts say, can itself be a minefield. Some men become resentful and even more noncommunicative if they are essentially sentenced to talk, even if the disempowering decision was ostensibly “for their own good.”

Where does it all begin, the foundation that in many men becomes a nearly impenetrable wall of stoicism?

It turns out, guys aren’t born as strong, silent types, just as girls aren’t emotive yakkers in the nursery. “The general public thinks masculinity comes with a Y chromosome,” says Ronald Levant, a professor of psychology at the University of Akron and the editor of the academic journal Psychology of Men & Masculinity. “In truth, decades of research show that sex differences between men and women and girls and boys are very small.”

A reluctance to share feelings is hardly exclusively a “man thing.” Many women also shun any form of help that might expose their emotional vulnerabilities. The real difference is the way most boys are socialized to act tough—and suffer social consequences when they don’t, says Levant, whose own traditional upbringing during the 1950s in hardscrabble South Central Los Angeles, where “all the fathers worked at Firestone or General Motors,” was a ready-made laboratory for his future academic studies.

Studies show, perhaps surprisingly, that most male babies actually start out more emotionally expressive than females. It’s not long, however, before they pick up on clear messages from those around them, especially parents and grandparents, that boys are strong, that they don’t cry and never complain no matter what. Sure enough, by age 2, boys are less verbally expressive than girls.

Consider, Levant says, what happens when a boy scrapes his knee while learning to ride a bicycle or playing sports. If the boy cries, his dad or coach will demand he walk it off. By ages 4 to 6, boys are less likely to register their emotions on their faces. As early as fourth grade, Levant says, boys are more reluctant to ask for help in resolving conflicts with peers. These behavioral patterns extend into adulthood.

While it may not seem obvious in these days of macho yoga and stay-at-home fatherhood, the truth is that many American men hold to traditional values: real men are embodied by the archetypal “strong, silent type” characters played by Clint Eastwood or Chuck Norris. Psychologists like Levant even have a term for it: “normative male alexithymia,” which literally translates as “without words for emotions.”

Swept up in the counterculture environment of Berkeley in the 1960s, Levant says his exposure to feminism, civil rights, and sexual freedom made him begin to question his conformity to male “rules.” But it wasn’t until years later, as a single father, that it dawned on him that he was not alone in questioning the emotionally repressed models of masculine behavior from his youth.

In 1995, he helped to create a division within the American Psychological Association dedicated to men and masculinity. The group explores, scientifically, the consequences of and alternatives to rigid social expectations of masculine behavior as a means of “enhancing men’s capacity to experience their full human potential.”

It might sound like so much psychobabble, but a critical component of his mission, Levant says, is to help men learn to be more in touch with their own feelings, to the extent that they can at least recognize when those feelings are symptomatic of a real problem—the psychological equivalent of chest pain.

As Tony Soprano learned when he finally sought help for his panic attacks, psychotherapists today, likely as not, wear lipstick. Nearly three in every four licensed psychologists who hold doctorate degrees are female, as are almost 80 percent of master’s-level students in psychology-related fields of study. This disproportion, experienced counselors say, can pose both an advantage and a disadvantage for male patients.

On the one hand, men who are interested but hesitant to sit down with any psychotherapist may regard a woman as more nurturing, empathetic, and less threatening. The patient may ultimately be more willing to open up. On the other hand, female psychotherapists who tend by their training and their own socialization to be emotive, run the risk of alienating men by trying to counsel them, however subtly, to be like them.

Instead, psychologists like Jay Wade start their counseling sessions by commending reluctant male clients for the courage it took just to show up. Then they strive to cultivate the image of therapist-as-partner. The approach is less like a sensitivity trainer beseeching, “How do you feel?” and more like a golf pro paid to help refine your swing.

Bob Diddlebock, 59, a clinically depressed freelance writer in Denver, says he tried counseling but found sessions with the female psychologist he was referred to, to be distracting.

“All I wanted to do was [have sex with] her,” Diddlebock says.

His brother-in-law at the time, a “cool guy” whom Diddlebock admired, suggested a male psychologist he was seeing. That was in 1995. Diddlebock’s been going to that psychologist ever since, as often as three times a week.

“That guy has basically thrown me a lifesaver,” Diddlebock says. “There have been times I’ve crawled in on my knees. And I’ve been able to walk out.”

That he and the therapist are contemporaries helped, Diddlebock says. So did the fact that the therapist was “very intuitive and insightful, both in a clinical and real-world way. He can go real deep on what [stuff] means, and how it reflects on my thinking. He doesn’t repeat himself.”

Diddlebock, who also takes antidepressants prescribed by a physician, figures he’s paid upwards of $30,000 over the years for services rendered. It’s been money well spent, he says. Still, Diddlebock’s younger brother, a building contractor who lives in Idaho’s Teton Mountains and enjoys elk hunting on horseback, called him a “wimp” for seeking psychological help. The brothers haven’t spoken in years.

The most optimistic psychotherapists envision a day when even the most macho of macho men will sit down with skilled counselors to off-load the emotional burdens of dysfunctional relationships and traumatic events. But old biases die hard: sessions, they predict, will likely be called “skills training” or “weekend solution workshops.” Anything but “psychotherapy.”

East of Los Angeles, at the University of Redlands college counseling center where Fredric E. Rabinowitz has practiced psychotherapy for three decades, change is already afoot. The 3-females-to-1-male ratio of students seeking therapy on campus has hardly budged over the years, Rabinowitz says, but the stigma of therapy among young men has. “They’re less judgmental about guys that go for counseling,” Rabinowitz says. “I believe that 9/11 was a big turning point for this generation. Men were seen crying in reaction to the carnage in New York.”

Depressed college men continue to find benefit in the “feel bad, take a pill” simplicity of antidepressants, Rabinowitz says, but the frequently experienced sexual side effects of these SSRIs often drive them in exasperation to his office.

“Once guys have made it into counseling, they like it,” says Rabinowitz, co-author of Deepening Psychotherapy With Men. “Once it is reframed as a sign of strength to seek help … most men find talking and processing their experience therapeutic.”

Most, maybe, but certainly not all.

Lawyer Bob Smith remains skeptical that he could ever possibly benefit in any measure from psychotherapy aimed at getting to the roots of what he concedes are anger issues and less-than-ideal relationships with others. He says he is comfortable with who he is, angst and all.

“As soon as you get in the hands of one of these guys, you suddenly have a whole panoply of problems you have to ‘work through,’” Smith says cynically. “They want you to set up meetings twice a week. I’m an attorney. I know how the game is played.”

Perhaps.

But experts warn that for men like Smith, the go-it-alone mind-set may exact its own grave price.

About Betsy Bates Freed and David Freed
Clinical psychologist Betsy Bates Freed blogs on psychological issues for The Oncology Report and is a frequent contributor to Clinical Psychiatric News. David Freed, a screenwriter and former investigative reporter for Los Angeles Times, is the author of the new mystery novel Flat Spin.

Psychology Today - The essential guide to defense mechanisms

We all have defense mechanisms - some of them are adaptive (intellectualization, sublimation, and rationalization) and some of them are not. Susan Krauss Whitbourne, Ph.D., posted this explanation of defense mechanisms at her Psychology Today blog, Fulfillment at Any Age.

As we become aware of our defense mechanisms and how/when they are triggered, we become better able to monitor our behavior and become less reactive. One of the keys to successful relationships is being aware of our issues and not projecting them onto others, or repressing them to avoid them, or regressing into childish coping styles when we feel threatened.

Dr. Whitbourne includes a few books to look at for more information on defense mechanisms:

Kramer, U. (2010). Coping and defence mechanisms: What's the difference? Second act. Psychology and Psychotherapy: Theory, Research and Practice, 83(2), 207-221. doi:10.1348/147608309X475989


Larsen, A., Bøggild, H., Mortensen, J., Foldager, L., Hansen, J., Christensen, A., & ... Munk-Jørgensen, P. (2010). Psychopathology, defence mechanisms, and the psychosocial work environment. International Journal of Social Psychiatry, 56(6), 563-577. doi:10.1177/0020764008099555


Olson, T. R., Perry, J., Janzen, J. I., Petraglia, J., & Presniak, M. D. (2011). Addressing and interpreting defense mechanisms in psychotherapy: General considerations. Psychiatry: Interpersonal and Biological Processes, 74(2), 142-165. doi:10.1521/psyc.2011.74.2.142

Personally, I would add Nancy McWilliams and her book (recently updated and reissued) Psychoanalytic Diagnosis, Second Edition: Understanding Personality Structure in the Clinical Process; 426 pages, The Guilford Press; Second Edition edition (July 14, 2011).

The essential guide to defense mechanisms

Can you spot your favorite form of self-deception?

Published on October 22, 2011 by Susan Krauss Whitbourne, Ph.D. in Fulfillment at Any Age


Defense mechanisms are a part of our everyday life. Even if you're not a Freudian by philosophy or training, you've got to admit that there's something to be said for the idea that everyone engages in some form of self-deception at least some of the time. The question is-- can you detect the form of deception that you, your friends, colleagues, and family are using at any given moment?


We'll take a look at the 9 most common defense mechanisms but first, let's set the record straight on two counts. First, it was a Freud, but not Sigmund, who defined the defense mechanisms. Anna Freud defined in detail the defense mechanisms sketched out by her father in her book, "The Ego and the Mechanisms of Defense." Second, defense mechanisms aren't just an unconscoius protective measure to prevent you from connecting with your ravenous instinctual desires. They also protect you from the anxiety of confronting your weaknesses and foibles. You can now add these two points to the 25 surprising facts about psychology I wrote about in an earlier post.


1. Denial. You can consider this the "generic" defense mechanism because it underlies many of the others. When you use denial, you simply refuse to accept the truth or reality of a fact or experience. "No, I'm just a social smoker," is a good example; similarly people can apply this to any bad habit they wish to distance themselves from including excessive alcohol or substance use, compulsive shopping or gambling, and the like. "Just say no," in this case means that you protect your self-esteem by failing to acknowledge your own behavior. Denial may also be used byvictims of trauma or disasters and may even be a beneficial initial protective response. In the long run, however, denial can prevent you from incorporating unpleasant information about yourself and your life and have potentially destructive consequences.


2. Repression. One step above denial in the generic classification scheme, repression involves simply forgetting something bad. You might forget an unpleasant experience, in the past, such as a car accident at which you were found to be at fault. You might also use repression when you "forget" to do something unpleasant such as seeing the dentist or meeting with an acquaintance you don't really like. Repression, like denial, can be temporarily beneficial, particularly if you've forgotten something bad that happened to you, but as with denial, if you don't come to grips with the experience it may come back to haunt you.


3. Regression. From repression to regression-- one little "g" makes all the difference. In regression, you revert back to a childlike emotional state in which your unconscious fears, anxieties, and general "angst" reappear. In Freud's theory of "psychosexual" development, people develop through stages such as the oral, anal, and phallic so that by the time they're five or six, the basic structures of personality are laid down. However, every once in a while, a person either reverts back to a childlike state of development. particularly under conditions of stress. That road rage you see when drivers are stuck in traffic is a great example of regression. People may also show regression when they return to a child-like state of dependency. Retreating under the blankets when you've had a bad day is one possible instance. The problem with regression is that you may regret letting your childish self show in a self-destructive way. Driving badly or refusing to talk to people who've made you feel bad, mad, or sad can eventually get you in worse trouble than what you had when you began.







4. Displacement. In displacement you transfer your original feelings that would get you in trouble (usually anger) away from the person who is the target of your rage to a more hapless and harmless victim. Here's the classic example: you've had a very unpleasant interaction with your boss or teacher, but you can't show your anger toward him or her. Instead, you come home and, so to speak, "kick the cat" (or dog). That's not very nice imagery, but you get the picture. Any time you shift your true feelings from their original, anxiety-provoking, source to one you perceive as less likely to cause you harm, you're quite possibly using displacement. Unfortunately, displacement may protect you from being fired or failing a class, but it won't protect your hand if you decide to displace your anger from the true target to a window or wall.


5. Projection. The first four defense mechanisms were relatively easy to understand. I think. Projection is more challenging. First, you have to start with the assumption that to recognize a particular quality in yourself would cause you psychic pain. Let's take a kind of silly example. For instance, you feel that an outfit you spent too much on looks really bad on you. Wearing this outfit, you walk into the room where your friends stare at you perhaps for a moment too long (in your opinion). They say nothing and do nothing that in reality could be construed as critical. However, your insecurity about the outfit (and distress at having paid too much for it) leads you to "project" your feelings onto your friends, and you blurt out "Why are you looking at me like that? Don't you like this outfit?" See how silly that was? In a less silly case, you might project your more general feelings of guilt or insecurity onto friends - or worse- people who don't know and love you with all your projected flaws. Let's say you're worried that you're not really very smart. You make a dumb mistake that no one says anything about at all, and accuse others of saying that you're dumb, inferior, or just plain stupid. The point is that no one said anything that in reality could be construed as critical. You are "projecting" your insecurities onto others and in the process, alienating them (and probably looking somewhat foolish as well).





6. Reaction formation. Now we're getting into advanced defense mechanism territory. Most people have difficulty understanding reaction formation, but it's really quite straightforward. Let's say that you secretly harbor lustful feelings toward someone you should probably stay away from. You don't want to admit to these feelings, so you instead express the very opposite of those feelings. This object of your lust now becomes the object of your bitter hatred. This defense mechanism could be subtitled the "lady doth protest too much," that wonderful quote from Hamlet. A less highbrow example is "Church Lady," the old Dana Carvey character from Saturday Night Live. Her secret obsession with pornography became reversed into her extreme scorn for all things sexual. In short, reaction formation means expressing the opposite of your inner feelings in your outward behavior.


7. Intellectualization. You might also neutralize your feelings of anxiety, anger, or insecurity in a way that is less likely to lead to embarrassing moments than some of the above defense mechanisms. In intellectualization, you think away an emotion or reaction that you don't enjoy feeling. For instance, rather than confront the intense distress and rejection you feel after your roommate suddenly decides to move out, you conduct a detailed financial analysis of how much you can afford to spend now that you're on your own. Although you aren't denying that the event occurred, you're not thinking about its emotional consequences.


8. Rationalization. When you rationalize something, you try to explain it away. As a defense mechanism, rationalization is somewhat like intellectualization, but it involves dealing with a piece of bad behavior on your part rather than converting a painful or negative emotion into a more neutral set of thoughts. People often use rationalization to shore up their insecurities or remorse after doing something they regret such as an "oops" moment. It's easier to blame someone else than to take the heat yourself, particularly if you would otherwise feel shame or embarrassment. For example, let's say you lose your temper in front of people you want to like and respect you. Now, to help make yourself feel better, you mentally attribute your outburst to a situation outside your control, and twist things so that you can blame someone else for provoking you.


9. Sublimation. We've just seen that people can use their emotions to fire up a cognitively-oriented response. Intellectualization tends to occur over the short run, but sublimation develops over a long period of time, perhaps even throughout the course of a person's career. A classic example is that of a surgeon who takes hostile impulses and converts them into "cutting" other people in a way that is perfectly acceptable in society. This is perhaps putting things in terms that are too extreme. More realistically, sublimation occurs when people transform their conflicted emotions into productive outlets. They do say that psychologists are inherently nosy (not true!!), but it's possible that people who go into human services fields to help others are trying to "pay forward" to compensate for difficulties they experienced in their early lives.


In short, defense mechanisms are one of our commonest ways to cope with unpleasant emotions. Although Freud and many of his followers believed that we use them to combat sexual or aggressive feelings, defense mechanisms apply to a wide range of reactions from anxiety to insecurity.


Which defense mechanism is most adaptive? In general, the more "mature" defense mechanisms include intellectualization, sublimation, and rationalization. According to research by George Vaillant, people who use these defense mechanisms more often than the others tend to experience better family relationships and work lives. You may never rid yourself of all your defense mechanisms, but at least you can grow from understanding what they can, and cannot, do for you.


Follow me on Twitter @swhitbo for daily updates on psychology, health, and aging and please check out my website, www.searchforfulfillment.com where you can get additional information, self-tests, and links.


Copyright 2011 Susan Krauss Whitbourne Ph.D.

Bedi & Richards - What Men Want From Psychotherapy

GoodTherapy.orghttp://www.goodtherapy.org/ posted this brief research review of a new study that looks at what men want and seek from psychotherapy. The study found that the most important qualities in creating the therapeutic alliance with male clients are "Formal Respect, Client Responsibility, Practical Help, and Bringing out the Issues."

These are all very external qualities, about the relationship and solution-oriented approaches and not about healing original wounding as is part of the psychodynamic approach. Yet this is not my experience of all the men I work with - some are certainly in line with this, but others are willing and wanting to do the deeper work.

What Men Want From Psychotherapy

September 30th, 2011 

A GoodTherapy.org News Headline:

Men are much less likely to seek clinical help for their psychological issues than women. Because they hold to traditional male gender roles, most men do not respond to psychotherapy delivered in a generic approach, most often welcomed and received positively by women. “Practitioners who are accustomed to working in androgynous environments may fail to fully grasp the foreign nature of psychotherapy to men who hold “traditional” North American masculine gender role beliefs,” said Robinder P. Bedi and Mica Richards of Western Washington University, authors of a new study exploring what approaches provide the best outcome for men in psychotherapy. “Understanding the perspective of men and further appreciating the impact of gender role socialization on alliance formation will enable psychotherapists to provide improved mental health services to men, a group that appears to be less well served than women by conventional psychotherapy practices.”

The researchers evaluated 37 male clients who were entering therapy for stress, anxiety, substance use, trauma and depression. They found the factors that were most important for the development of a healthy client-therapist alliance for the men were Formal Respect, Client Responsibility, Practical Help and Bringing out the Issues. “Bringing out the Issues (labeled using the language of the men in the study) emerged as a key category in understanding the perspective of men on the therapeutic alliance,” said the researchers. “It was the largest category, found to be statistically significantly more helpful and understood than all other categories except Client Responsibility and Formal Respect.” The team emphasized that clinicians who wish to achieve a positive outcome with their male clients should understand this fundamental difference between men and women in treatment. They added, “In developing a therapeutic alliance with a typical man, it seems important to balance conventional relationship-building techniques, such as empathy, paraphrases, normalization, and validation, with asking questions and providing suggestions.”

Reference:

Bedi, R. P., & Richards, M. (2011, May 23). What a Man Wants: The Male Perspective on Therapeutic Alliance Formation. Psychotherapy: Theory, Research, Practice, Training. Advance online publication. doi: 10.1037/a0022424

Abstract:

What a man wants: The male perspective on therapeutic alliance formation.

 

Bedi RP, Richards M.

Although the link between client ratings of therapeutic alliance quality and psychotherapy outcome has been well established by previous research, there is still much to be done to clarify what variables are important to clients, particularly men, in the formation of an alliance. Thirty-seven male clients currently undergoing psychotherapy categorized 74 critical incidents for alliance formation in an open-ended manner on the basis of self-perceived relatedness. Multivariate concept-mapping statistical techniques were used to identify the typical way in which the participants conceptualized variables that are important to alliance formation. Nine categories of variables were identified (Bringing out the Issues, Nonverbal Psychotherapist Actions, Emotional Support, Formal Respect, Practical Help, Office Environment, Information, Client Responsibility, and Choice of Professional). Bringing out the Issues emerged as the highest rated and most consistently understood category across the men in this study. The results of this study add to a small but growing body of research on the client's perspective of alliance formation and provide an initial conceptual model of how men understand the variables of common alliance formation. The developed model also provides several hypotheses, which are presented for verification in future research and clinical practice.

Secret Lives of Men - The Mindful Path to Self-Compassion: Christopher Germer

In this episode of The Secret Lives of Men, Dr. Chris Blazina talks with Christopher Germer, author of The Mindful Path to Self-Compassion: Freeing Yourself from Destructive Thoughts and Emotions. I read this book a year or two ago and found it incredibly useful.

I think we have a tendency to be hard on ourselves in ways that can be very self-destructive. We need to be more compassionate and accepting of who we are, which is not to say that we should just live with painful thoughts and feelings. But when we are harsh and critical with ourselves, we really are only making the problem worse.

In this intelligent, concise book, Christopher Germer presents an exciting synthesis of mindfulness and self-compassion that is much needed. Drawing upon decades of practice as a clinician and meditator, Dr. Germer offers a rich and insightful guide to emotional healing. Germer shows readers how to use mindfulness and self-compassion to open up to their pain and treat themselves with kindness. Ideal for recommendation those who stuggle with issues of shame, guilt and self blame.

Listen to internet radio with Secret Lives of Men on Blog Talk Radio

Tags: psychology, meditation, mindfulness, counseling, emotions, The Secret Lives of Men, Chris Blazina, Christopher Germer, The Mindful Path to Self-Compassion, Freeing Yourself, Destructive Thoughts, Destructive Emotions, books, emotional healing, self-compassion, kindness, shame, guilt, self blame