November webinar: Men and psychotherapy
Dear RP friends,
Research Office webinar season continues! The November webinar, which took place on 26th November, explored the theme of Men and psychotherapy with our wonderful speaker Fredric E. Rabinowitz, Ph.D.
Dr. Rabinowitz has been actively involved in the academic study and clinical practice of masculinity and psychotherapy with men for the past 40 years, working with other psychologists from the American Psychological Association (APA) to bridge the gap between psychological theory and applied clinical practice of the same topic. Dr. Rabinowitz has been a professor of psychology at the University of Redlands in California since 1984, writing many articles, book chapters and five books about working within this specialised field. He was also the President of Division 51 of the APA, also known as the Society for the Psychological Study of Men and Masculinities, in 2006. Finally, in 2018, Dr. Rabinowitz led a group of psychologists to publish the Guidelines for the Psychological Practice with Boys and Men for the American Psychological Association…
As for the webinar itself, the speaker started with an exploration of why men don’t gravitate to traditional psychotherapy. The answer, according to him, lies in cultural gender role scripts, with messages towards boys to stay strong and silent, tough and independent. The premature entry into the male world results in exposure to the “boy code” of being autonomous, tough, and hiding emotional vulnerability at a relatively young age. This results in a diminished capacity for verbal intimacy as an adult, and ambivalence about closeness. As they grow up, men tend to link intimacy only with sexuality and they perceive vulnerable emotions as weakness. Sexuality, therefore, becomes a primary means of intimate connection. Rigid adherence to these scripts is linked with lower rates of help-seeking for medical and psychological problems, higher stress levels, higher rates of perpetrating and being the victims of violence, higher rates of cardiovascular disease, and higher rates of suicide. However, this cluster of characteristics has served men in our culture who needed to portray strength, overcome adverse circumstances, and provide and protect families and communities.
So, under what circumstances do men feel obliged to go to therapy? Mainly, relationship crises, negative affect (depression, anxiety), and addiction crisis push them to seek help. Additionally, court-mandated (anger, abuse) treatment, family/relationship mandated treatment, post-traumatic stress reactions, existential life crisis (often around loss), sexuality conflict, or gender identity conflict are significant causes and motivators to see a therapist.
Importantly, clinicians need to be aware of different kinds of masculinities (e.g., biological, cultural, gender identity, and sexual orientation) to avoid bias and stereotypes. Masculinity is part of the puzzle but people are complex. What we see on the outside is not always what is going on on the inside and coming to therapy is not easy, even when a man doesn’t show his anxiety, worry, or shame on the outside. We need to remember that a tough/neutral exterior takes energy and effort to maintain, it is a way to maintain control, keep others away, and protect against shameful feelings.
Important practical tips for working with male clients are building a relationship from a strongposition to reduce shame and defensiveness in clients, seeing each man as unique, recognising the strengths used to overcome adversity, praising the willingness to make an effort, and forgiving past actions that were based on impulsiveness. Still, holding the responsibility for current actions, and believing in the capability of self-awareness is crucial. In practice, talking to men has to have the qualities of de-stigmatising the process, giving control whenever possible, and showing an active interest in the client’s experience. Being empathetic to the client’s role in this new relationship (counseling, and psychotherapy), using appropriate humor, and being real, humble, and honest is a key in communication. Another important resource is group therapy for men. It provides universality of experience, emotional support, and safe sharing of losses, shame, and trauma. Group therapy helps to overcome isolation, build interpersonal skills, and opens a discussion of existential life concerns and choices in men.
Some of the general principles for psychotherapy with men are:
Creating a Male-Friendly Therapy Environment
Sensitivity to Shame-Based Defenses
Deepening Psychotherapy Conflict Zones to Explore
Deepening Dialogues
Transference and Countertransference Awareness
Leaving the Door Open
In conclusion, male psychological and emotional pain is not always obvious and men are socialised to keep emotional vulnerability hidden. Unfortunately, many men do not acknowledge problems they may be experiencing or communicate about them to others. Our speaker helped us understand the damaging impact of male socialisation, the problems men are likely to present in therapeutic environments, and the special approaches and treatment modalities most effective in making progress with male clients.
The EFPSA Research Office webinars continue. Follow us and join our next upcoming webinar!