It is an often-overlooked fact, that gender inequalities affect men as well as women, especially in the field of mental healthcare. Research highlights the need to acknowledge the gender differences to help-seeking and male patterns of emotional communication in providing psychotherapy.
The lack of gender awareness regarding differences, can be termed as gender blindness. Why is this still happening, one might ask? Well, there are 2 main hypotheses:
- Men have traditionally been viewed as the “dominant sex” and thus, premature conclusions might have been drawn that they have no gender issues or needs, and that “maleness” is a characteristic that defines them (Addis, 2008), void of any difficulties.
- There are pressures on men to appear strong and invulnerable (Gilmore, 1990; Levant, et al., 2007; Mahalik et al., 2003).
As psychologists our obligation is to study and work with the full spectrum of being human and to replace any prejudice in all its forms, with the light of understanding. As such, we need to acknowledge that society and research experience difficulties in openly exploring and understanding gender differences. This is especially true when exploring the differences in dealing with difficult emotions and asking for support.
Here’s an example, to help in making sense of all of these:
On the corner of a street, a young woman is sitting alone. Tears are rolling down her face. At first, passers-by are embarrassed to even set eyes on her. After a few minutes, someone approaches her to ask if they can help at all. Soon the woman is telling the kind stranger her story.
On another corner, a young man is sitting on a bench half drunk. He sits, staring at the empty beer cans between his feet. Occasionally, he shakes his head. Passers-by prefer to stand around him, with their backs turned on him, rather than join him on the bench. Eventually, the man is approached by the owner of a near-by shop. He is asked to leave, since he is disturbing the shop’s customers. The young man nods to indicate his willingness, slowly gets up and goes on his way.
Out of the 2 people, evidently distressed, whom would you be more likely to approach?
This is an example of how society is gender-blind in understanding that males express distress differently, and thus misinterpreting what happens right before our eyes. This, paired with the disproportionally high male suicide rates, suggests that the needs of men are not adequately served, since they are not recognised.
In the spirit of shedding light to the often misunderstood male distress, a mental health professional needs to work bearing in mind the meaningful sex and gender differences in supporting his/her clients. For example, there is evidence that males have different experiences of being parented (Diamond, 2004; Pollack, 1995) and show different behaviours when stressed (Kolves, et al., 2010) compared to females. Males tend to externalise distress more than females and are more likely to be destructively violent to themselves and others (Logan, et al., 2008). In England and Wales, men produce around 80% of anti-social behaviour (UK Government, 2012). As such, a man’s distress may lead to incarceration rather than psychotherapy (Men Minds Matter, 2013). This phenomenon can be better understood by considering that male distress (of less intensity) goes unnoticed (Swami, 2012) by both men themselves and their environments (Kingerlee, 2012) until extreme behaviours come to light or the attention of authorities.
Levant et al (2009), argue that male socialisation leads men to develop fewer emotional skills, including being less able to identify and describe feelings with words. As a result of this early socialisation, some men might develop “alexithimic” tendencies (Levant et al., 2006). This is an inability to identify and describe emotions experienced by one’s self and others. This highlights the extend of the problem, since society’s teachings on how to turn a boy into a man, gives all the wrong messages. One of the main maladaptive components of such teachings are the characteristics that are put forward as the basis of manhood.
If this is adopted by mental wellbeing consultants, as a traditional and normal characteristic, rather than a maladaptive result of how boys are taught to be men, it closes doors to men seeking therapy, benefitting from their cooperation with a psychologist and achieving general relationship satisfaction. We need to highlight that the individual is not solely responsible for the above difficulties. The maladaptive result is influenced by social variables no single human can influence directly. Adults can develop their emotional skills and intelligence through their cooperation with a psychologist. The younger the boy the easier it is to develop skills which will allow the development and joy of experiencing functioning relationships. Let us reflect then, if we provide young boys and men the opportunities to develop skills that would allow being happily connected to others.
Why is it important to support the men and boys of today’s society? Leaving aside the fact that males account for one half of the population the importance of this topic is highlighted by the following statistics:
- Men represent the majority of all suicides across the world (see tinyurl.com/3cusfc);
- Men represent a large majority of those with major substance abuse difficulties in the UK (DH, 2012); which is a common path via which men aim to deal with their internal turmoil;
- Men represent 95% of the prison population (Wilkins, 2010), and a significant majority of prisoners have very serious mental health problems (ONS, 1998).
These factors alone, show that whilst many men appear invulnerable, something very different is happening behind the scenes of their psyche. Masculine stereotypes are embedded in society, minds of loved ones, and at times they influence the provision of services and support. These only add to the exclusion, isolation, and stigmatisation of men in all ages. Now perhaps more than ever, it is important to provide and promote interventions and services that are based on evidence of efficiency and effectiveness to engage men more effectively in treatment. This can only be achieved by understanding their unique expressions of their inner happenings, and at critical times in their existence, help them put life before death.
References
Addis, M. (2008). Gender and depression in men. Clinical Psychology Science and Practice, 15, 153–168.
Department of Health (2012). Statistics from the National Drug Treatment Monitoring System: Vol. 1. The Numbers. London: Author.
Diamond, M.J. (2004). The shaping of masculinity. International Journal of Psychoanalysis, 85, 359–380.
Gilmore, D. (1990). Manhood in the making. Yale: Yale University Press.
Kingerlee, R. (2012). Conceptualizing men: A transdiagnostic model of male distress. Psychology and Psychotherapy: Theory, Research, and Practice, 85(1), 83–100.
Kolves, K., Ide, N. & De Leo, D. (2010). Suicidal ideation and behaviour in the aftermath of marital separation: Gender differences. Journal of Affective Disorders, 120(1), 48-53.
Levant, R.F., Hayden, E.W., Halter, M.J. & Williams, C.M. (2009). The efficacy of alexithymia reduction treatment: A pilot study. Journal of Men’s Studies, 17(1), 75–84.
Levant, R.F., Smalley, K.B., Aupont, M. et al. (2007). Initial validation of the male role norms inventory-revised (MRNI-R). Journal of Men’s Studies, 15, 83–100.
Logan, J., Hill, H.A., Black, M.L. et al. (2008). Characteristics of perpetrators in homicide-followed-by-suicide incidents. American Journal of Epidemiology, 168(9),1056–1064.
Mahalik, J.R., Locke, B.D., Ludlow, L.H. et al. (2003). Development of the Conformity to Masculine Norms Inventory. Psychology of Men & Masculinity, 4, 3–25.
Men’s Minds Matter (2013). The psychological wellbeing of men. Retrieved 24 March 2014 from www.mensmindsmatter.com/mens-psychological-well-being.html
Office for National Statistics (1998). Psychiatric morbidity among prisoners. London: Author.
Swami, V. (2012). Mental health literacy of depression. PloS ONE, 7(11), e49779.
UK Government (2012). Anti-social behaviour order (ASBO) statistics – England and Wales 2012. Available at tinyurl.com/nn95bj2
Wilkins, D. (2010). Untold problems: A review of the essential issues in the mental health of boys and men. London: Men’s Health Forum.