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reports and some academic research that the commonly recognised and described symptoms of depression – being tearful, withdrawn, lacking in motivation and energy – are a more typically female presentation of the issue.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.

——–

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.

On breaking resolutions and getting things fixed

Calenderblog19 January 2016

Blue Monday – apparently the most depressing day of the year – has now passed and, according to many reports, three-quarters of those who made New Year’s resolutions have already not seen them through. In fact, badly made plans start to fall apart as early as the ninth day of the New Year and 35 per cent of people break their resolution before the month is out.

Since most therapists (myself included) work with addictions at some level or other, the start of the year brings to our practices some people who already feel pretty deflated by their own effort to control negative life habits. This is a pity, since it’s often not the person’s willpower or discipline that is at fault but the way in which they planned to make their change.

Many people don’t understand how to successfully make changes in their lives and so tend towards ‘over-commitment’ when they undertake those changes. Connectedly, if you try to make too many alterations at the same time, you tend to make a successful outcome harder to achieve.

Evidence from many sources, including my own practice, suggests that making change in life is more easily achieved when you make a proper plan to achieve it. If you simply make up your plans on the spot, there is a much greater chance you will miss the detailed planning that goes along with effective change. (I guess you might already be able to see why deciding to finally give up something on the last strokes of midnight on December 31 often fails so quickly.)

It can also be quite difficult, if you are on your own during the process, to not only make changes but also retain motivation. Sharing your goals with someone, even a therapist, will likely help you to stick to the change. Effectively, when you talk through your ideas for change with someone else you begin to form a contract with yourself. In the 14 years I’ve been involved in helping people to make changes, a well-formed contract has often made the difference between success and failure.

Finally, we tend to underestimate how long it takes to change a habit. According to research conducted at University College London (see Phillippa Lally), it takes a sobering 66 days for simple new habits (such as eating fruit daily or jogging) to become automatic – although individuals range wildly in their abilities, taking anywhere between 18 and 245 days to affect the changes).

When it comes to positive change around issues like overuse of porn or other sexual acting out, then habits are often deeply ingrained and complex. Rather than launching my new porn recovery programme REWIND on 1 January, you can perhaps see why I’m waiting until a little beyond the first few weeks of the year before I open it up.