Working Towards Therapeutic Solutions with Men By Daniel Fryer, MSc on 1/6/21 - 10:44 AM

In my experience, men typically and stereotypically really don’t like opening up about their feelings and prefer not to admit there’s a problem in the first place. So how to help get them into therapy becomes a compelling challenge.

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Many years ago, I read a report that found that one in three of the young men polled within it would rather smash things up than talk about their feelings. It was a tad extreme, I thought, but there you go. Thankfully, things have moved on a bit since then. However, men are still reticent. For instance, it turns out that they would rather talk to their barber about their problems than talk to their doctor, which is why the Lions Barber Collective exists. An international organisation that recognises the unique bond formed between a man and the bloke who clips his hair, it trains members up as mental health first aiders. Not only do they listen to the guys who sit in their chairs, but they can also spot the early warning signs of a developing mental health condition and then point them in the right direction for help. This usually means a psychotherapist. Which means we are back to talking about feelings. Which, as we know, men are not wont to do.

The problem is complex. But a big part of it is that talking about their feelings is still seen as a sign of weakness among many men. And despite the prevalence of metrosexual men in our media, the strong and silent male myth still pervades. Also, when men do talk, because of said stereotypes, what is more than likely depression can often be written off as a “bit of a low mood” instead.

Another problem, to my mind at least, is that when a man who doesn’t like talking about his feelings goes looking for a therapist, he goes looking online. And practically every single therapist’s opening statement will say something along the lines of “I offer a safe and non-judgemental space in which to explore your feelings.”

Egad!, as the exclamation goes. Are you trying to scare them away? Do you want men to come to see you for help? And, if you do, how do you reel them in? (Big hint: male-orientated metaphors help.) Enter then, any form of solution-oriented therapy.

I’m a rational emotive behaviour therapist (REBT) and have found that as a form of cognitive behaviour therapy (CBT), its philosophy and structure are easily explained and understood. As an active and directive approach, it offers me a way of being actively involved in the therapeutic process rather than sitting back and offering a safe space in which my client can talk whilst I sit passively by. As a form of solution-oriented therapy, I can even discuss SMART goals from the outset. And, before it starts exploring all the emotional consequences of a person’s dysfunctional beliefs, REBT can challenge them empirically, logically, and pragmatically.

I explain REBT to prospective clients in a very matter-of-fact way. My webpage is plain and straightforward. It attracts a large proportion of potential clients (including men) who want their therapy delivered in a similar style. This has been very helpful to anybody who is nervous about, or unable to, talk about their feelings.

Many years ago, a highly anxious man was brought to my clinic. In fact, he was so anxious that he was having a panic attack in the waiting room and was breathing deeply and slowly into a brown paper bag. It wasn’t having much effect, and it was clear his anxiety was not going to go away any time soon. I brought him into my clinic room anyway.

“Would it help if you just sat there breathing into the bag while I explain what this therapy is all about?” I asked.

He nodded. And so I discussed both REBT and the ABCDE model of psychological health, as well as the roles played by dysfunctional and functional belief systems. After a while, I simply asked him if he had noticed anything. He nodded slowly.

“What have you noticed?” I asked.

“I’ve stopped panicking,” he said.

I asked him why that was.

“Because I can see a way out,” he replied. “I’ve not been able to see one before.”

Fast forward a few years to a man who came to see me for psychosexual dysfunction, a tricky subject at the best of times. In my initial telephone consultation, before I engaged with him for therapy, this man described himself as a typical alpha male type who didn’t like all that touchy-feely stuff. He’d been living with his particular form of anxiety for over five years, hadn’t had any form of sexual contact with his wife for over three years, and was only speaking to me because his wife had delivered him an ultimatum. He’d had several courses of therapy already, including sessions with a sex specialist.

“I didn’t like it,” he said. “They were all sympathetic, but I wasn’t looking for sympathy. And they were all trying to get me to open up about my feelings, but I either couldn’t or didn’t want to.”

“So, what’s going to be different this time?” I asked.

“I really liked your website,” he said. “It was very direct. I know I will have to speak about how I feel at some point, but there’s a format there that appeals to me.”

Studies have shown that men aren’t averse to therapy per se, but they are averse to therapy that is loose, conversational, and exploratory. One study found that the best treatment styles for engaging the menfolk were, “collaborative, transparent, action-orientated, goal-focused” (Seidler, 2018).

When delivered in the correct way, I have been able to encourage men to talk about their feelings. I haven’t had to get all stoic and blokey myself, I just have to explain myself in a clear and concise way, preferably without mentioning either safe spaces or feelings. In my experience, if a man phones me up for therapy and I ask him what his goal is, he will usually commit to the process. And together, we venture forward on a journey of change


References

Seidler, Z. E., Rice, S. M., Ogrodniczuk, J. S., Oliffe, J. L., & Dhillon, H. M. (2018). Engaging Men in Psychological Treatment: A Scoping Review. American journal of men's health, 12(6), 1882–1900. https://doi.org/10.1177/1557988318792157 


File under: The Art of Psychotherapy