Introduction and Part 1

The following is an essay on thoughts regarding how our profession may be falling short in reaching and treating men, and suggestions for improvements.  I will need to begin with somewhat lengthy caveats.  If the reader wishes, s/he may skip to the main body of the essay


Politics/Agendas:  While I am suggesting that we can do better in treating men, I have no, nor subscribe to, any agenda that is political, grievance-driven, or ideological.  I am not suggesting that there is any injustice at work, nor am I pointing to any cultural or societal problem.  I am suggesting that there is exists a female bias in the field of mental health treatment (where the majority of clients and practitioners are women), but I do not suggest that this bias is intentional or nefarious.  Bias is a normal part of human psychology.  I seek only to address the bias, not to inveigh against it.  I do not subscribe to the Right’s sometimes expressed view that society is being “emasculated,” nor do I subscribe to the Left’s sometimes expressed view that the world is filled with “toxic masculinity.”  I seek only to make clinical observations and improve our practice.  That said, I am male, and none of us are free of bias or blind spots.

Generalizations and assumptions:  This is an essay, not a research paper.  As such, I will be expressing generalizations and observations about psychological differences between men and women.  Obviously, this essay does not seek to empirically prove these differences.  If the reader questions these assumptions about such differences, this is understandable and suggests that this essay may not be this reader’s cup of tea.  It is offered for those who resonate with these assumptions and observations.  As for generalizations, even if the generalization is valid, it is not true for every individual.  Thank G-d, we are all unique individuals that can be radically different.  Still, generalizations are useful for the majority that they describe.  Finally, I will suggest that men and women are different in their levels of intensity regarding different issues, but that does not suggest that the opposite gender doesn’t care at all about those issues.  A simple example might be that women are more concerned with verbal expressions of love than are men, but that does not suggest that men don’t care.  Only that the care may be at a different level.

  1. Maybe a little bit of agenda: I’ve often encountered messages, both subtle and overt, in the media and in our profession that seems to suggest that maleness is problematic, and men should learn to be more like women, i.e. more verbally expressive of feelings.  It might be a suggestion for men to “be brave” and express feelings, or a suggestion that “you don’t have to be a tough guy.”  I have no inherent problem with these statements (it is brave to express feelings, and no one should have to be anything), but I find them critical and non-affirming of maleness.  My concern here is not one of opinion.  Rather, I think these messages turn men off to treatment.  Like with well-intended parenting education, these messages tend to resonate only with those who are already inclined to be receptive (and therefore unlikely to need the service to begin with).  Verbal, emotionally aware men will embrace these messages and the echo chamber will validate itself.  We miss, however, a great deal of men who, whether consciously or unconsciously, seek to talk to and connect with someone who is affirming of maleness.  I think we can do a better job of telegraphing to men that we affirm them and honor them, and that we want to hear their stories and struggles

The essay:

I’ll begin with how I came to this project.  Many years ago, I attended a Psychological First Aid training.  This is a training in how to be a Mental Health Professional in a disaster situation.  There was a discussion about first responders (police, fire, paramedic, etc.), and the all-female participants (apart from me) complained that many male first responders that they knew or were related to suffered significant psychological wounds, yet refused to talk about it.  I heard frustration, compassion, and some negative judgment for the men in their lives who rebuffed these women’s suggestions for therapy and other kinds of treatment.  I found myself empathizing with both the women’s frustration, and the men’s resistance.  I began to think “here we have men who are suffering and in need, and women who are eager to help.  This should be a smooth and easy match, yet it’s not.  There is a significant disconnect here.  Why is that?  How do we understand this? Is this (as some women intimated) just men being stubborn and macho?”  Even if such a negative attribution would be valid, it is too pervasive to dismiss it with such shallow analysis, and the negativity and criticism of maleness is not going to be helpful in reaching and treating men.

One more word of introduction.  Below I will enumerate a number of important issues that males struggle with.  Both because these issues are often verbally expressed by males in the language of ideas and concepts, and because of a popular notion that men aren’t in touch enough with their feelings, these struggles are often minimized by women and sometimes men.   These struggles may be called “intellectualizing,” “ego,” or simply ignored on the therapeutic pathway to feelings identification and expression.  I would suggest that, even if not expressed by males in the emotional language that we are accustomed to, these struggles are valid, emotional, possessing of emotional depth, and weighty.   I believe we can and should do a better job of hearing, empathizing, and honoring these struggles, and I believe that the ways in which we fall short turn men off from the process of therapy and mental health treatment.  If this was overly vague, my hope is that it will be better fleshed out in the essay.

In this series, I’ll begin this process with speaking about the following subjects, in separate essays/parts, and their importance in addressing male mental health:

  1. Injustice
  2. Meaning
  3. Suppression of feelings
  4. Anger

Part 1: Injustice:

Here I use the term injustice to encompass phenomenon such as hypocrisy, unfairness, inconsistency, and double standards.  My suggestion is that boys and men are more activated by and passionate about injustice than are women (again, refer to caveat above to note that this does not mean to suggest that women don’t care about injustice).  I’d suggest that the reader conjure an image of child who is in frequent conflict with teachers, and seemingly rooted in the (possibly correct) observation that “it’s not fair!!”  Is the image conjured a boy or girl?  Again, girls do this too, but boys do it more.  Most of us have observed boys or men who struggle so mightily to cope with perceived injustice that they are seemingly willing to pay significant personal cost.  I’ve observed many females and female therapists who have a hard time relating to this struggle.  I imagine that if the choice is taking a stand against injustice versus keeping the peace and not risking significant negative personal consequences, most females would see the latter choice as the obvious best one.  When a choice seems obvious, it can be hard to relate to someone who doesn’t see it as obvious.  All people, men and women, struggle with when to take a stand (and often pay a cost) and when to let it go and keep the peace. I am suggesting that, for males, this is a lifelong, fraught, even torturous dilemma and struggle in ways that I don’t believe it is generally for females.

When we ask males to learn to tolerate injustice (as well we should, especially for those who are shooting themselves in the foot because of their struggle to tolerate it), we are asking a lot.  We are speaking to a core aspect of what many/most males feel to be their very humanity.  As suggested before, this struggle is not about ego, intellectualizing, or feelings avoidance.  The injustice is not simply intellectually offensive, though that may be the way it is verbally expressed.   This is a deep, emotional, and essential struggle that males experience.  Sitting with and tolerating injustice is a painful, emotional task. We need to respect and connect with the depth of that task, rather than minimizing it at best, and shaming it at worst.  Putting aside concern for injustice begs the existential question “who am I, and what is my role/contribution if not to call out injustice?”  This question and struggle speaks to the very core of identity.  We can’t help males with their tolerance in this area if we don’t deeply respect the severity of this struggle and the enormity of what we are suggesting when we point toward accepting and tolerating injustice. 

In following my broader definition of injustice (i.e. hypocrisy, unfairness, etc.), we come to common conflict patterns between intimate partners, where males are often triggered by the aspect of injustice inherent in the argument, and females are often triggered by feelings.  Thank G-d, both areas are essential to humanity and represent the enormous potential of how males and females differ and benefit from that difference.  Unfortunately, males’ struggle with injustice, in these scenarios, are often regarded as obstructive and problematic.  It’s not uncommon to hear, either from the female partner, or even the therapist, that the male “isn’t listening.”  Yet is the female partner, or the therapist, listening to the male struggle with injustice?  Do we fully appreciate how difficult that struggle is, and what is being asked of the male partner when there is a request to put it aside?  Are we recognizing that tolerating the injustice is not merely a cognition, idea, or position, but rather a deeply emotional struggle?  I’ve observed many men in relationships cope with the emotional wounds of injustice for the sake of the relationship, and I can feel the weight of their personal work in doing so.  I wonder if others in the profession, especially women, see and appreciate the enormity of this personal work.  I fear that this prodigious effort on the part of men is often regarded as men just “coming to their senses,” or “getting over their egos.”  Few things are more discouraging and invalidating than working hard for the sake of another, only to have that other dismiss the hard work as no big deal.

As mental health professionals, in addition to appreciating and validating males’ emotional struggle with injustice, we can play an important role by helping men be more in touch with the struggle and its emotional depth.  We can help males see and appreciate their struggle more deeply, and, crucially, give language to the struggle.  As in all interpersonal relationships, there is only so much “mind reading” and awareness of others’ feelings that one can ask of others.  Individuals, if they seek to be understood, have a responsibility to communicate.  We can do a better job of helping men identify and communicate more than just their disapproval of the injustice, but the internal struggle of tolerating it and being asked to tolerate it. 

Part 2: Meaning…to follow