Outline of topics

• The Significance of Difference

• Are Men Less Competent than Women in Dealing with Emotion and In Coping with Life's Difficulties?

• Valuable Lessons from Counselling Practice

• Something to Bear in Mind if you Run a Men's Group

• "Doing No Harm" ethics of practice

• Where Men Tend to Seek Support When They are Distressed

The Significance of Difference

We now know that:

   Differences in male/female brain and hormone

      physiology give rise to statistically significant

   on-average sex-specific differences (at the group level)

      in the way men and women:

      Think

      Feel

      Behave

   and View the World

   This doesn't mean that

   all men  act one way

   and all women act  another way.

Rather it means that:

   Men are more likely to act one way

   and women are more likely

   to act another.

We also now know that:

   It simply isn't possible to understand gender differences,

   without we draw knowledge from a broad range of sources:

• - Psychobiology/Socio-biology
• - Anthropology
• - Cultural history
• - Psychology/Social Psychology
• - Neuro-endocrinology
• - Psychiatric morbidity research
• - Traumatology research
• - Bereavement research
• - Mythology and Religion

   Are Men Less Competent than Women in Dealing with Emotion

   and

   In Coping with Life's Difficulties?

An Important Indicator Must Surely be:

   Whether or not men have generally poorer mental health than women?

   Rates of mental disorder (approximate statistics only- WHO & ABS):

• Schizophrenia - Equal number of men and women

• Bipolar Affective Disorder - Equal number of men and women

• Obsessive Compulsive Disorder - Equal number of men and women

• Panic Disorder - Slightly higher for females than males
• General Anxiety Disorder - Equal number of men and women

• Object/Situation Specific Phobias - Two females for every male

• Social Phobia - Equal number of men and women

• Agoraphobia - Higher for females than males

• Insomnia - No differentiation between men and women

• Alcohol Use Disorder - Two males for every female

• Drug use Disorder - Probably slightly higher for males than females
• Major Depression - Two females for every male

• Suicide - Men are at least four times more likely to die from suicide than women, despite more women than men attempting suicide

• Post Traumatic Stress Disorder (Of people who experience an event that might make them a candidate for this disorder) - 5% of men and 12% of women go on to experience PTSD

• Borderline Personality Disorder - There is a 2-4 times higher prevalence amongst women compared to men

• Anti-social Personality Disorder - Prevalence of 3% for men and 1% for women

*WHO suggests that overall rates of psychiatric disorder are almost equal for men and women

   Stand-out issues for Males

   Alcohol use disorder

   Completed Suicide (especially rural men)

   Anti-social personality disorder

   Stand-out issues for Females

   Depression

   PTSD (and some other anxiety states)

   Borderline Personality Disorder

   In Terms of Mental Health,

   in General Men Cope as Well as Women do

   But When Men or Women Cope Poorly,

   They do so in Their Own Characteristic Ways

   The Question of Comparative Competence Leads back to -

   The Significance of Difference

We've Already Noted That:

   "Differences in male/female brain and hormone physiology give rise to statistically significant on-average sex-specific differences (at the group level) in the way men and women: think, feel, behave, and view the world"

   Not surprisingly, these quite different orientations influence: the kind of roles that men and women generally gravitate towards:

• Women favouring roles that have a relational, helping, nurturing, interpersonal and familial orientation

• Men favouring those of a more task/action/protector/provider and extra-familial orientation

When it comes to emotion and coping:

   Women tend to be better than men at expressing, remembering and verbalizing emotion

   They also appear to have more elaborated emotional knowledge structures - enabling them to remember more of the detail of the emotional content of emotion producing situations

   In responding to a negative event,women tend to favour rumination (going over and over the thoughts and feelings associated with the event) and verbal and emotional expressiveness

   Men  tend to favour suppression (putting distressing thoughts and emotions on hold, to be dealt with when a perceived threat or danger has passed) and verbal and emotional economy *

How Men Respond to Threatening or Significantly Negative Events

Negative Event

Suppression    (emotions  'put on hold')

Threat or crisis has passed

Problem has been solved, mastered or redefined in a satisfactory way

Order is restored

Protective vigilance is no longer needed

Seek out a 'safe' environment/opportunity (private or with other men*)

Retrieve emotions put on hold

Work them through/out

Give experience 'existence' and form

Allow emotions to emerge

As a means by which to resolve and disperse emotion

Men and Women Working Through Emotion

Expressive Style of Coping

Women tend to work

through their emotion and achieve  

Verbal and emotional

Resolution    its resolution by  expression

verbalising and expressing it

Instrumental Style of Coping 

Men tend to work through their emotion and achieve

Resolution through Ritualised tasks  

Resolution

its resolution more by and actions

'pushing it out' into

activities - ritualised

tasks and activities

We also know that:

By virtue of their suppressive style of emotion management:

   men actually remember less of the emotional detail of negative emotionally charged events, and may also be less affected by them (which appears to fit with  the traumatology literature, and with what we know of the rational /emotive process)

The coping strategies of men and women can of course go awry

   Characteristically, Women, may succumb to under-regulation of thoughts and emotions - which the mental health literature suggests might largely account for higher levels of depression amongst women compared to men

Men may succumb to over-regulation, leading to problems associated with emotional constriction, such as psychosomatic disorders

Valuable Lessons From Counselling Practice

• Men tend to dislike a process that seems endlessly circular and overly focussed on feelings; they tend to prefer information and a constructive problem oriented process
• Men value clear, frank, and honest communication (seen as sign of competence)
• They will respond to exploring their experience, but at their own pace and often using  action metaphors (it, "knocked the stuffing out of me" rather than, "I feel upset and vulnerable")
• Often men need to engage in a process of progressive approximation building safety and security in moving towards  and engaging issues that hold emotion (e.g. Self-initiated transition to therapy process). This also tends to be the dynamic in men's groups also
• Catharsis can result in a degree of embarrassment and shame unlikely to encourage a subsequent appointment
• Men tend to be most amenable to accessing and engaging with support services, during times of significant change, crisis and challenge - often when trusted coping strategies are found to be inadequate
• The (on-average) male action orientation and  the protective 'must fix it' expectation of the male role, make powerlessness and anger significant issues for men

   The grief literature indicates that, men exhibit more anger than women when they are grieving *

   Many men in rural communities are now preoccupied with the threat to family and community of the drought. Women have complained that their husbands are stressed, angry, and uncommunicative

   Emotions tend to be layered differently in men; men often exhibit anger ahead of more subtle emotions, whereas women tend to exhibit the more subtle emotions ahead of anger *

Something to Bear in Mind if You Run a Men's Group

Orthodox View Of Group Dynamics

Groups have often been observed to develop and evolve in a fairly predictable way:

Dependence

Counter-Dependence

Independence

Counter -Independence

Interdependence

Mens Groups Can Be Very Different

Non-Participatory

Men often spend time 'Sizing-Up' other group members, and especially the group leader

Rapport Building

Men tend to engage in 'Safety' Testing' : "Is this a safe situation in which to be myself?"

Assertive Participation

When men feel safe and in rapport with others they will take great pride in  Group

Ownership: Testing Leader's Knowledge and Skill

When men feel that the group is theirs, they will often Test the Worthiness of the Leader to be the leader

Mutuality, Pride & Cohesiveness

When group development reaches this point, Strong Bonds and Inter-dependence are often in evidence

"Doing No Harm" *Clinical Iatrogenesis (Ivan Illich)

Almost without exception codes of ethics reflect the principles of:

   - 'knowledgeable practice'  

   - respect for human difference

   - equity: being just, impartial and fair

   - "doing no harm?"

Something for us to consider in the context of our professional practice?

Culture of Gender

Health literature is replete with misinformed commentary about why men don't seek help, and don't take care of their health *

If we want to engage men effectively we have to try and understand the: Biological and socio-cultural 'world' men inhabit

• It has different requirements of discretion and confidentiality
• Men are subject to very different societal expectations and demands
• The on-average male is hardwired to think and feel and behave differently to the on-average female
• Men exhibit a different coping style to that of women
• And though women's ways of relating are a vital and humanising influence in society, they are not the only model for understanding relationship or what it means to be a "whole person"

The Significance of Difference

Where Men Tend to Seek Support When They are Distressed

Informal Supports Men Access

When They Are Distressed

(Ministerial Council for Suicide Prevention, 2004)

Formal Supports Men Access When They Are Distressed

(Ministerial Council for Suicide Prevention, 2004)

Used with permission Dr. John Ashfield (please recognise the source if any part is used) copywrite 2007