30 April 2018 | by Dr John Barry
The following article is a joint effort by John Barry (UCL), Louise Liddon (Male Psychology Network), and Martin Seager (Central London Samaritans).
About 75% of suicides are male, but men are less likely to seek therapy than women are (Kung, 2003). Last year a survey of 2000 men in the British Isles found that men value their mental health over their physical health (Barry & Daubney, 2017). So why aren’t therapy rooms filled with troubled men talking about their feelings?
Einstein is attributed as saying ‘the definition of madness is when you keep doing the same thing and expecting different results’.
At present there have been several well-intentioned campaigns based around the idea that the way to get men and boys to talk more is to simply urge them to talk more. Although this is likely to appeal to some men, for others – especially the hard-to-reach cases with the most extreme issues – this will be about as effective as raising your voice so that a non-English speaker can understand you better.
But let’s presume for a moment that a man is convinced by the campaigns urging him to talk. He talks to a therapist, but is the therapist able to hear him?
He might be nervous and begin the session with a little light banter, but therapists are likely to perceive this as a client who is not ready to properly engage in therapy. Or if he is a victim of domestic violence from his female partner, he might not be listened to with much empathy. This would be especially the case if the therapist had been trained in the Duluth Model of domestic violence, which assumes that the man is always at fault.
With 80% of clinical psychologist being women, how is the average man going to rate his chances of solving his problems by talking to a therapist? He might be better of telling his woes to his mates in the pub.
And in fact that’s not such a bad idea. Studies from Oxford and Glasgow Universities have found that men can get some emotional benefits from have a drink at talk with friends (not to be confused with harmful patterns of drinking). And that’s just the tip of the iceberg, because it seems that men can get some wellbeing benefits from a range of everyday activities, from visiting the barber (Barry & Roper, 2016) to doing everyday activities together, for example, building garden furniture.
It seems that men have slightly different preferences for dealing with emotional issues. For example, in Men’s Sheds it is said that men talk ‘shoulder to shoulder’ rather than face to face. Banter and other humour is used spontaneously as a way to establish rapport. In fact Samaritans (2014) found that training their helpline workers to accept male-typical patterns of communication, such as banter, significantly lengthened the duration of calls from men.
According to a recent study by the Male Psychology Network (Holloway et al, in press), experienced professional therapists say that, in general, when women have emotional issues they want to talk about them, and when men have emotional issues they want to fix the problem. The paper concluded that men definitely benefit from talking about their feelings, but to get them to open up you have to be more sophisticated than insisting they just open up.
Psychologists are intelligent people, and we must use all of our intelligence if we want to have a more gender-inclusive service. Creating a Male Psychology Section of the BPS (this will be voted on in May 2018) would be the ideal platform to achieving these goals, but it is not at all certain that enough psychologists see the value in this.
One of the objections is that it is merely ‘whataboutery’ (as in a plaintiff cry of ‘what about the men?’) but in a culture where there are four UN international days allocated to women, and none to men, we might pause to question whether this is symptomatic of a wider blindness to high rates of male suicide, substance abuse, educational underachievement and imprisonment. It comes across as un-empathetic and certainly counterproductive to bury our heads in the sand. Worse still, it sometimes seems that we blame men for not seeking help from services that don’t suit them.
So let’s make asking ‘what about men?’ a positive thing, and a way to encourage a more insightful dialogue.
After all, helping the mental health of men and boys can only be of benefit to everyone in society.