Men, Therapy and Language
One of the challenges confronting men coming to therapy (if they come at all!), is knowing what to expect and what the experience will be like. I’ve just come back from a conference on Male Psychology, where some really amazing work with Canadian Military Veterans was show-cased. These are guys who have seen some of the horrors of war in Afghanistan and Iraq, and have been diagnosed with PTSD (Post Traumatic Stress Disorder). The work was presented by Professor Marv Westwood, who has been working with the Canadian Military as well as the Australian Military on something called the Veterans Transition Programme – working with Veterans transitioning back to civilian life. The work, video footage and case studies were very moving, but more importantly were the results – truly amazing. The impact this work had, 1-to-1s, group work, etc. is inspiring.
My main take-away though was the importance of language, especially for men displaying typically traditional forms of masculinity. Using language, expressions, labels etc. that are male friendly, not shaming, and ones that don’t undermine “typical masculine norms”, e.g. it’s not “crying” but “releasing”, that it is a “fight” or “battle” with the depression, etc. This seemed to be very important to these men. It is this point that I think is important to men in therapy as well!
My sense of therapy with men is to help them make sense of the past, live in the present and have hope for the future, in ways that are relevant and meaningful to them and are gendered appropriately.
Below is some of the emerging theory, thought leadership, and perspectives on male therapy (if some of the academic material interests you).
A number of researchers (Kinselica, Engler-Carlson, and Fisher, 2008; Kiselica, Engler-Carlson, and Horne, 2008; Kinselica, & Englar-Carlson, 2010) have defined what they believe is a more positive psychology, positive masculinity model of psychotherapy with men and boys. This is based on their study, consistent with a positive psychology perspective, of what they consider to be male strengths. They suggest that promoting the positive aspects of traditional masculinity can enhance our understanding of, and clinical work with, boys and men. (Kinselica, & Englar-Carlson, 2010). They list 10 key strengths in their framework. These are:
Male relational styles – the way men and boys develop friendships and intimacy with each other through shared activities e.g. sport, gaming, projects etc. (Buhrmester, 1996; McNelles & Connolly, 1999; Clinchy & Zimmerman, 1985; Surrey, 1985; Kiselica, 2001, 2003a, 2003b, 2006.).
Male ways of caring – how men are raised to protect their loved ones and friends (Kiselica, et al 2008a; Kinselica, & Englar-Carlson, 2010), and their high levels of “action empathy” (Levant, 1995).
Generative fatherhood – the way fathers respond to the developmental needs of boys in a positive, emotional, educational, interlectual, social and affirmative way (Dollahite & Hawkins, 1998; Kiselica, 2008).
Male self-reliance – the way men & boys are socialised to use their own resources to solve their problems (Levant, 1995), yet considers the input of others (e.g. coaching, mentoring) as well as their needs (Kiselica, et al 2008b).
The worker/provider tradition of men – the way men find meaning and purpose in work and their role as providers (Skovholt, 1990; Bernard, 1981; Christianson & Palkovitz, 2001; Loscocco, 2007) and its centrality to male identity and self-esteem (Axelrod, 201; Heppner & Heppner, 2001).
Male courage, daring and risk-taking – the courage men and boys “muster while taking worthwhile risks – such as facing peril to protect others, completing dangerous but necessary jobs, or pushing themselves to their limits during athletic competitions” (Kinselica, Englar-Carlson, 2010).
The group orientation of boys and men – the way males band together to achieve a common purpose and participate and value groups, “which can provide them with important sources of identify and community (Kiselica, 2008b).
The humanitarian service of fraternal organisations – this includes involvement in male service organisations which seems more US centric, and has no direct parallels, however the rotary club, round-table, sport clubs etc. may fit this perspective within a UK context.
Men’s use of humour – “Many men use humour as a vehicle to attain intimacy” (Kinselica, &Englar-Carlson, 2010), have fun, reduce tension, stress and manage conflicts (Kiselica, 2001, 2010)
Male heroism – an age old exemplar of one of the positive qualities of traditional masculinity (Kiselica, 2003b).
Kiselica, et al (2008b), state that these 10 overlapping male strengths are meant to representative rather than an exhaustive list.
Our challenge as male therapists is to maximise therapy for men, if these help, let’s use them.
Even absence has a presence!
It never ceases to amaze me the amount of psychological space ‘absence’ can take-up in our thoughts and feelings. This can be the loss of a friend, the end of a relationship, the absence of something we longed for but never received. It can be recent, or it can be deep in the past.
For myself the loss of an old friend last year, due to very tragic circumstances, and his battle with a life changing accident a few years before, turned my world up side down. His death stayed with me for many weeks, affecting my mood, outlook on life and perspective. My head was busy with the conversations I’d had, wished I’d had, and all the memories and experiences we had shared.
For many who sit in a room with me, this type of experience is not unique. We all can be preoccupied with that which we have lost, never received but longed for, never found but missed, or just plain missed.
Absence has a psychological presence and giving ourselves the time and space to reflect on what this is for us is important, but more importantly, what we want to do with this experience and learning moving forward, and how we change what we do is also important.
To my friend Richard, may you rest in peace.
I'm often asked to describe my approach to psychotherapy . . so here you are
A Brief Overview of My Therapeutic Approach
I describe myself primarily as an Integrative psychotherapist. My approach has three main theoretical and practice based foundations: I view clients through their developmental past, their unfolding future and the here-and-now as it is experienced by them. Through all three of these perspectives there is a relational aspect, which is about a deeply relational and intersubjective understanding of experience as it emerges within and throughout the therapeutic journey.
My developmental perspective draws the impact of unaddressed developmental deficits, traumas, and conflicts upon the present. Core to this developmental perspective is the belief that we are driven towards relationships in order to achieve safety, security, and intimacy; which in turn supports and nurtures meaningful and nourishing relationships. To this developmental aspect of my model I add aspects of the Humanistic tradition particularly notions around ego states, and the child ego state. Together these perspectives have some sense of causality and show how the past can impact the present.
The unfolding future is informed by transpersonal psychology, which believes that each of us has an organising principle in the depth of our unconscious: namely, the transpersonal Self. This will often be activated to address one-sidedness and can be made known in the the therapeutic space, to address and/or challenge the deficits, trauma, and conflicts of the developmental ego. "Transpersonal psychology addresses the full spectrum of human psychospiritual development - from our deepest wounds and needs, to the existential crisis of being human, to the most transcendent capabilities of our consciousness" (Caplan, 2009: p.231). I also utilise much that is labelled as Buddhist Psychology and Buddhist practice, and the movement towards the cessation of suffering and enlightenment
The third focus of my model draws again upon the humanistic tradition and the core conditions of empathy unconditional positive regard and congruence, which inform my relational presence and responsiveness. To this I add the power of the present moment and how relational engagement at this point can shift a person to engage more authentically in the moment. I also draw upon Buddhist practice again, in relation to mindfulness and its contemporary clinical applications. I do not believe that any of us can go backwards or forwards in time, rather the past and the aspirations of the soul for the future can only be accessed in the here-and-now.
Key to my multidimensional integrative framework is the overarching principle of the therapeutic relationship as a powerful vehicle for healing. I believe that it is the intentional and purposeful use of the therapeutic relationship. Hence, just as relationships can harm so can they heal.
In summary, my integrative framework enables me to work with the unaddressed developmental issues, the challenges of the now and spiritual issues that present themselves in relation to my clients understanding of their world through a relationally focussed and intersubjective meeting.