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reports and some academic research that the commonly recognised and described symptoms of depression – being tearful, withdrawn, lacking in motivation and energy – are a more typically female presentation of the issue.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