Helping men to help themselves 

Helping men to help themselves

Men2018

It’s been a little while since I blogged about men and therapy. So, at the start of the year, when many people decide to put things in order and turn to psychotherapy and counselling for some clarity about their lives, I thought I’d write something that might help men take a therapeutic step.

It’s a sad fact that, according to the latest 2016 release from the UK Office for National Statistics, men still make up around three-quarters of deaths by suicide and yet are only reported to make up just over one-third of referrals to NHS talking therapies. So, if that sobering statistic makes you think, read on …

Access to therapy isn’t about men vs. women. It’s much more about why, as men, we might find barriers to getting help.

The continued high suicide figures for men by comparison to women suggest there is definitely something going wrong for us men – but taking your life by your own hand is just the start of the male distress story. It’s also true that around three-quarters of adults who choose to ‘go missing’ from home are men, and close to 90 percent of rough sleepers are men. It’s men who are three times more likely to become dependent on alcohol and three times more likely to report frequent drug use. Men also make up two-thirds of drug deaths, 95 per cent of the prison population, and commit more than 85 per cent of violent crimes. Additionally, they are twice as likely as women to be victims of violent crime. Sadly, men have lower access than women to social support networks, and are 50 per cent more likely than women to be detained and compulsorily treated as psychiatric inpatients.

If we look at boys, then we see they perform less well than girls at all levels of education and that close to 80 per cent of children who are excluded permanently from schools are – you guessed it – boys.

While there might be a number of reasons that these gender differences exist, what’s really important to perceive is that, for a large number of men, life is difficult.

When it comes to depression we already know from practitioners’ reports and some academic research that the commonly recognised and described symptoms of depression – being tearful, withdrawn, lacking in motivation and energy – are a more typically female presentation of the issue. Men will actually often express symptoms in an externalized way that we call ‘acting out’. This might be through uncontrolled anger, addictive behaviours that are used as a cover up for the felt distress, or the use of physical aggression. And, of course, if you express your depression in these sorts of ways it tends to compound difficulties in the social world, and will often make family, friends and professional helpers less sympathetic in their response.

Data drawn from population level studies suggest that men who are in psychological distress are more likely than women to choose coping strategies that don’t help them adjust adequately or appropriately to the environment or situation. A popular strategy might be to self-medicate through alcohol, drugs, or porn and/or sexual addictions. Of course, generalised data about gender is just that: general! And so it doesn’t tell us about any one individual. But my experience since joining this profession at the beginning of the 21st century certainly adds up with the data.

This blog hasn’t sought to offer a quick fix or a set of tools to use. What it has done is outline to anyone who reads it that we might need to approach men and their problems in a different way. Men need a space that will reflect their male nature in a positive frame. Sometimes that means that a male therapist can be a good starting point – although it is suggested by some research that as long as the  space takes a ‘male positive’ stance men make better progress. For other men it might be the environment in which they access their therapy that helps them to make progress – for example, men can thrive during online sessions or walk-and-talk sessions where the therapist is alongside them rather than sitting face-to-face.

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In my own practice, I see more men than women (excluding couples work) and I offer face-to-face sessions as well as online video-based counselling, psychotherapy and coaching through FaceTime or What’sApp. I also provide single-session therapy and one-off walk-and-talk therapy sessions (on particular days throughout the year) in Cambridge, Bath and Bristol. And, of course, a one-off session can become a gateway to deeper ongoing work …

Statistics for this blog were drawn from sources reporting between 2014 and 2016, including those from the Office for National Statistics.

A mood forecast for the autumn

octoberblogA mood forecast for the autumn

26 October 2016

As the temperature and light levels drop at this time of year, so each day rapidly shortens. Falling leaves unequivocally announce autumn and the inescapable ‘decline’ towards winter. It’s difficult not to be aware of the lack of vitality in nature and the echoes of endings: the end of summer; the end of long days; the end of warmth; and, deeper down, the counterpart that yet another year has slipped through our fingers – and, for many people, an uncomfortable connection with death.

Like the change in leaf colour, the calls to my therapy practice also alter during this season. Certain types of depression become prominent, and relationships seem to suffer even more as couples and families are thrown into closer proximity by the shorter, colder days … not to mention Christmas already becoming a pressure point for many. I note, too, that the two times when existential issues flurry most prominently into my practice are spring (the counterpart to birth) and once autumn beckons (reminding people of the ‘what should have been’ moments of the year).

But it isn’t just a myth that lower light levels bring about a time of increased depression for many millions of people. The ‘winter blues’ (which start in the autumn) has scientific evidence in its support. Seasonal Affective Disorder (often just referred to by its highly appropriate acronym SAD) is thought to occur because of the way our bodies respond to the lack of light available in the short daylight months. Theory around SAD suggests that the light entering our eyes causes changes in hormone production levels in our body, lowering the ‘feel-good’ hormone serotonin and also interfering with our melatonin levels – a hormone that helps determine sleep patterns. And, overall, the low light levels disrupt our circadian cycle – our naturally recurring body rhythms during a 24-hour period. For many people, these changes add up to considerable lethargy and the experience of other connected symptoms of depression.

So far, I’m not really offering much positive about the final part of 2016 stretching into 2017 – especially as I mentioned death earlier (the one unavoidable issue we must all come to grapple with at some point). And while August has the fewest deaths in the UK, January looms at the top of the chart, which equates to an unwelcoming month with more anniversaries of people’s passing – another great trigger for dialogue in the consulting room.

While we can’t avoid death, we can take a leaf (or perhaps an acorn) from a squirrel’s book and prepare for those light-depleted winter days by taking action and planning a few things before the dark takes hold.

For example, think about good, clean eating rather than succumbing to sugary carbohydrates that will add to a feeling of sluggishness, not to mention a few pounds.

Get active before your New Year’s resolutions. According to Dr Andrew McCulloch, the former chief executive of the Mental Health Foundation, ‘There’s convincing evidence that 30 minutes of vigorous exercise three times a week is effective against depression and anecdotal evidence that lighter exercise will have a beneficial effect, too.’* Of course, it follows that exercising outdoors (e.g. brisk walking**) during this period will be useful in helping to expose you to higher levels of light than you would get indoors.

When it comes to that increase in relationship stress, it might be time to book in a relationship MOT session with a therapist, where you can talk in a safe, comfortable, non-confrontational space about any issues troubling you in your life together.

*NHS website

**Walking for health website

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Why not visit my therapy website – therapy-space – where you can contact me or find further information about the therapies I provide for women, men and couples.

Living life by numbers … and the midlife crisis

Numbers_edited-1Living life by numbers … and the midlife crisis

May 7 2016

Conveniently, for lovers of statistics, the Canadian-born psychologist and social analyst Elliot Jaques – who coined the term “midlife crisis”* – died at the age of 86. I say ‘conveniently’ because his lifespan correlates so well with modern statistical expressions about the mid-point of life. As examples of this, the World Health Organization revealed in 2013 (the most recent figures available) that life expectancy for the average UK citizen is 83 years, and a 2015 report from the Economic Journal revealed that life satisfaction gradually declines throughout the early part of adulthood, reaching a low between the ages of 40 and 42 – so close to Dr Jaques’ midlife point.

The difficulty with reporting averages and statistics about human life is that it can obscure life-lived experience and meaning. If we expect a ‘midlife crisis’ to occur at a certain age, then we will be likely to attribute all negative experiences and challenges to that age rather than to the actual experience triggers and events we are living through at that point in time.

Our later 30s and 40s can be especially difficult times, not particularly because of our age, but because of the responsibility life tends to have assumed. In contrast to childhood – a time when the vast majority of people will have been nurtured, protected and cared for by other people – 35 to 50 year-olds generally have to work hard to support themselves and other family members. And with these struggles come other issues – including depression, anxiety and the realisation that time is passing quickly.

It seems that headline statistics as reported in the media tell us very little about the real nature of a person’s issues – although they do appear to make people feel unhappy when they don’t live up to the ideal average. And how do we, as individuals, ever know when midlife will be? For some, 50 will be the figure they never reached; for a few – take, for instance, therapist Hedda Bolgar** who, aged 102, still worked four days a week – that midpoint would not yet have been reached.

I remember sitting on the sofa with my mother listening to the radio on the eve of my 10th birthday, feeling sad that it didn’t matter how long I would go on to live “I could never count my life in single digits again”. While I didn’t realize it at the time, I was actually making an observation that the middle of life can only be seen on reflection, since the truth of it all is that we are actually continually positioned at the extreme end of our lives. This is as true today at the start of my 51st year as it was at the conclusion of my ninth.

Crises can happen at any time of life and it’s important to see each crisis for what it is – and act accordingly. Then, perhaps we can aim for 45 joyous, rather than a total of 90 miserable, years.

* Elliot Jaques (1965) Death and the Midlife Crisis

** http://www.today.com/id/45287411/ns/today-today_people/t/age-therapist-still-psyched/