Webb Therapy Uncategorized Men and Emotions: From Repression to Expression published by AIPC (2019)

Men and Emotions: From Repression to Expression published by AIPC (2019)

In our previous article (read it here), we asked why men do not seem to express emotion as easily as women do. Was there some pathology, or should we just put the differences down to male-female tendencies? We identified Dr Ron Levant’s notion of “normative male alexithymia” as representative of one side of the controversy: namely, that, yes, men do have a restricted range of emotional expression compared to women, but it’s so pervasive in society that it’s normal (Schexnayder, 2019).

On the other side of the debate were researchers such as James Thompson (2010), who – while acknowledging men’s relatively greater “stoicism” or restriction emotionally – nevertheless insisted that it’s invalid to conflate alexithymia with maleness, especially given that men’s holding back from emotional expression is largely culturally induced. Yet we observed that the issue should be dealt with, given the male-female suicide ratio in Australia, the U.K., and the United States of about 3:1 – and the fact that suicide is on the rise in all three countries.

We concluded that therapy might be able to help, and that is where we go with this article: to a discussion of just how we as mental health professionals might be able to help men deal with an outdated but strongly held socialisation pattern which has impacted their emotional expression, and through that, their capacity for growth, satisfying friendships, and intimate relationships. 

We tackle the question in two parts. First, we share psychologist Barbara Markway’s (2014) take on how to help men out of the double bind that leads to their emotional repression. Then we suggest therapies which might be able to assist.

Deciphering the code

Markway (2014) insists that dismissing men as “the feelingless gender” is not only unhelpful, but also wrong. They just, she says, express their feelings using a secret code: one which even they themselves cannot decipher. Let’s do some translation.

Men convert one feeling into another

Let’s say you’re a guy, and you’ve just found out that a good friend of yours has been cheated in business by her business partner: a business you yourself helped them set up. The cheating transactions will cost your friend thousands, and maybe her whole business. You may erupt volcanically, vowing to help your friend sue the partner for all they are worth, or maybe go threaten the partner within an inch of their life. If you react this way, you are showing anger and not a little pride, which are acceptable “male” emotions to express. Hiding underneath them could be sadness for your friend, and even a shared sense of vulnerability, but these are more “feminine” emotions, which by socialisation you are not “allowed” to express. So you convert them into “male” emotions of anger and pride.

Men may shift their feelings into another domain

Are you male, and basically an exuberant, affectionate sort? Markway claims you may not necessarily let this show in your personal relationships, but on the sports field, lookout; you’ll be hugging, high-fiving, and butt-slapping with the best of them. It’s ok in that domain, she says, for men to express strong feelings of delight (over a goal made, say) and affection.

Men may somatise their feelings

Let’s say now that you’re female, and in an intimate partnership with a guy. You make plans to get away for a holiday, but no sooner have you checked into the five-star hotel at the fabulous beach than he gets a migraine and is out of action for that day at least. What’s going on? Markway observes that, with the structure of work, many men are able to squash down feelings, but when they are away from that structure, such as on weekends or holidays, their emotions and needs surface. Not wanting to acknowledge them, many men will convert strong emotions into physical symptoms, such as headaches or back aches. If asked about it, some men would have the conscious belief that women do want them to show their emotions, but only certain ones, and only in amounts they (the women) can handle. Men who deviate from this are, as we have noted, judged to be poorly adjusted or not “manly enough”, because – at the root of it – they are bucking their whole socialisation model.

Men’s emotional expression can put us all off balance

When men do get in touch with emotions, the result can catch everyone off guard, as it may seem to come “out of the blue” and be overwhelming. In fact, for any of us, when we chronically stuff down feelings, we don’t get the practice of handling strong emotion. When it does come up, then, we are ill-prepared to deal with it. Think, for example, of the person stoically putting up with an in-law criticising their partner, probably repeatedly. At some stage, there will be “the straw that breaks the camel’s back” – just one criticism too many – and the person may unleash a massive emotional response, consisting in part of stored-up feeling from previous violations (adapted from Markway, 2014). 

It’s not that these ways of directing emotion “sideways” are bad, but if a more direct emotional expression is desired, how can we help our male clients escape from the clutches of restrictive socialisation?

Re-setting the code

It’s a big job to help someone move past lifelong “training” in a given direction. In the case where the client is keen to make changes in his way of dealing with emotions (that is, his issues with emotional expression are ego-dystonic), psychodynamic therapies and the social constructionist narrative and solution-focused therapies may be hugely helpful; we briefly highlight these, while acknowledging that other therapies, such as motivational interviewing and CBT, may also have a role to play. In the case where the man is dragged into session because his partner is experiencing huge frustration but the man himself does not see that he has a problem (that is: his issues with emotional expression are ego-syntonic), we can look hopefully to emotionally focused therapy, although family therapy and other couples modes, such as imago therapy, likely have much to offer.

We put the psychodynamic therapies right up front in our discussion. Why? If, as is generally claimed, men’s emotional responses are because of socialisation and/or attachment processes, then that therapy may be most efficacious which can take the client back to the root of those processes: the early childhood years when all of us – for better or worse – began to be socialised into our respective “tribes”.

Jung’s psychoanalysis

Carl Jung espoused the essential wholeness of all human beings, but believed that most of us have lost touch with important parts of ourselves. Life’s goal of individuation demands that we give expression to the various components – often conflicted – of our psyche. These typically repressed components cause psychological disturbance until they are made conscious. Each person has a story and when mental illness occurs, it is because the personal story has been denied or rejected; healing comes when the person recovers and owns his or her own personal story (Sonoma.edu, n.d.).

The story will include symbolic archetypes. A man could, for example, be modelling after the archetype of the Invincible Warrior, which could express part of who he is, but he may have repressed the complementary Nurturing Earthmother part of himself (due to that part being discouraged culturally). The task in therapy, then, would be to help the man discover his Nurturing Earthmother side. The two sides, harmonised together, could transcend either archetype and help such a client come into greater wholeness (Geist, 2013).

Psychosynthesis

Similarly, Psychosynthesis, a transpersonal psychology, asks clients to work with body, feelings, and mind to synthesise, or integrate, the various “selves” inside them into a harmonious whole. Psychosynthesis postulates “subpersonalities”: parts of ourselves which constellate and act out in order to meet needs or to defend against needs which seem unable to be met (Assagioli, 1965). Thus, the same man – in angst because of being constrained from tender, loving expressions or emotional sentimentality – may discover an angry subpersonality within himself: one which, he later discovers, is in conflict with its opposite number, a “Sentimental Sally” subpersonality which, while weaker, nevertheless is driving the man’s behaviour from underground because it is not acknowledged; its needs for permission to express a softer side will continue to cause it to act out in some way until those needs are met.

Thus in this mode, therapy consists of finding out what conspired to prevent the man expressing his softer side and working out how it can find expression appropriately in the man’s life. Sentimental Sally also has to work in with the angry subpersonality (as the two will vie for dominance), and both must cooperate with the man’s greater, whole psyche. Somewhere along the way of this, the man is likely to recall early events which shaped his way of being: for example, leaning into his mother for a cuddle when upset and being pushed out and told, “Big boys don’t cry”.

Schema therapy

In some ways, schema therapy would seem to combine the best of several worlds. From its psychodynamic predecessors, it inherits its basic notions that mental health troubles arise from early needs not being met. Five areas of basic human needs are outlined, such as for secure attachment and autonomy/competence. Frustration of these engenders 18 domains of early maladaptive schemas (EMS), from mistrust and abandonment to emotional inhibition (Young, n.d.). The schemas are perpetuated in a person’s life, say practitioners, through cognitive distortions, self-defeating life patterns, and unhelpful schema coping styles, which cause others to respond negatively, thus reinforcing the schema(s) (Young, 2012a). 

In the psyche’s effort to heal, individuals set up relationships similar to the unsatisfying ones which originally engendered the EMS, and thus the unhealthy object relations which stultify growth are continued. The therapist can ask the “lonely child” or “angry child” in a person to set up dialogue with the “healthy adult” in order to heal the overcompensating, avoidance, or surrendering responses that perpetuate a given schema (Young, 2012b). From cognitive behavioural therapy (schema therapy’s other “parent”), there are therapeutic interventions to reframe the cognitive distortions: irrational thoughts are collected in journals/diaries, for example, which are then refuted through rational replacement thoughts.

Narrative

Narrative therapy assumes no single absolute reality, but that realities are constructed by individuals, families, and cultures, and then communicated through language. They are organised and maintained by stories. What is true for us may not be true for another person or even for ourselves at another point in time. In the narrative, social constructionist paradigm, there are no essential truths and we cannot know “reality”; we can only interpret experience. The narrative mind frame, unlike empirical work searching for facts, exhorts us to bring forth our novelist selves. This means that we can understand our client’s story from many perspectives. The work of narrative therapy is to elicit various experiences of the client’s whole self, determine which selves (parts of the client) are preferred in the new narrative, and then support the growth and development of those new selves and their accompanying stories (Ackerman, 2017; Archer & McCarthy, 2007). 

Thus, if a male client has experienced being emotionally stifled in the interest of becoming “manly”, he can be helped to understand how such definitions of masculinity are inherently constructed by society rather than being empirically true. He can be helped to, first, find “sparkling moments” when the issue of being emotionally constricted was not as much of a problem, and then to find ways to “grow” the self – and/or the moments – that were less restrained, more inclusive of perhaps a softer, more emotionally permissive self. In doing this, he is re-storying himself and re-constructing the “reality” that he and those around him will live about what constitutes appropriate masculinity. 

Solution-focused therapy

Like its narrative cousin, solution-focused therapy emanates from a post-modernist, social constructionist paradigm, meaning that it shares with narrative therapy the understanding that there is no such thing as an objective, absolute reality. Rather, reality is co-constructed, so the “truth” of a client’s life is negotiable within a social context; fixed, objective “truths” are unattainable. Clients’ lives have many truths (O’Connell, 2006). Just as narrative therapy tries to elicit the “sparkling moments” in which the problem wasn’t as much of a problem, so too solution-focused therapy enquires into what a miracle would look like if the problem were to be “fixed” or to go away; in fact, much of the therapy has this present or future focus. 

The therapist thus elicits the client’s preferred future. Suggestions for change are based on clients’ conception of their lives without their symptoms (i.e., the healthiest, most empowering vision of themselves and their lives that clients can generate). Changes the client makes will have a ripple effect, generating behaviour to change the whole system (Seligman, 2006; Archer & McCarthy, 2007). Thus a solution-focused intervention could see a male client generating a vision of himself as a fully expressive man living in a community which accepts both his “traditional” male side and also his more emotionally liberated self. The therapy would be likely to search for times and places when this had already occurred.

Emotionally focused therapy (EFT)

Obviously in cases where it is the partner expressing angst and the man sees no problem in his flatter emotional demeanour, the therapies which may be more helpful are those which work with both partners to see how to accommodate both sets of needs and behaviours.

EFT is an empirically supported humanistic (couples) treatment that includes elements of experiential, person-centred, constructivist, and systems theory, but is firmly rooted in attachment theory. It is based on the concept that distress in intimate relationships is often related to deeply rooted fears of abandonment, as an individual’s emotional response to these fears may be harmful to relationship partners and put strain on a relationship. The insecurity may show up as partners asking questions such as, “Do you really love me?” “Am I important to you?” “Are you committed to our relationship?” “Can I trust you?” When intimate partners are not able to meet each other’s emotional needs, they may become stuck in negative patterns of interaction driven by ineffective attempts to get each other to understand their emotions and related needs. 

EFT reinforces positive bonds that already exist, and fosters the creation of a secure, loving bond between partners where there is not one. It does this through expanding and reorganising important emotional responses, which help to shift each partner’s position of interaction while initiating new cycles of interaction that are more beneficial for the relationship. In the non-judgmental environment of session, participants are able to contact and express deep emotions and experiences. In voicing their deepest concerns and conflicts without criticism, they are able to address them and move on to more collaborative, productive behaviours (GoodTherapy.org, 2018). 

Thus if the female partner is experiencing the despair of little emotional validation from a man who does not readily show emotion, he can be helped to see how, if he learns to do that in a way that is meaningful to her, it can benefit not only her but also the whole relationship. She can be assisted to recognise the ways in which he does show emotion – albeit “sideways”, such as Markway (2014) describes above – and to learn to accept how he is without criticism, asking directly at times for her needs to be met. EFT helps people learn to interact with their partners in more loving, responsive, and emotionally connected ways, which can result in a more secure attachment and – we say – greater freedom of emotional expression.

Summary

It’s easy to agree that men generally do not show as many emotions, or as intense of emotions, as their female counterparts. What we have seen to be more difficult is assessing whether a given man is pathological or not in the apparent emotional holding back. Without judging that, this article has demonstrated that there are several options for response if a man’s emotional expression seems greatly inhibited. One is to understand the ways in which men “convert” emotions: to other emotions, to other domains, or to their bodies. The other option is to encourage the man – either alone or with his frustrated partner – to attend therapeutically to the roots of the inhibition, which are likely to reside in insecure early attachments and/or socialisation against expression.

References

  1. Ackerman, C. (2017). 19 narrative therapy techniques, exercises, & interventions (+ PDF worksheets). Positive Psychology Program. Retrieved on 10 October, 2017, from: Website.     
  2. Archer, J., & McCarthy, C.J. (2007). Theories of counselling & psychotherapy: Contemporary applications. Upper Saddle River, N.J.: Pearson Education, Inc. 
  3. Assagioli, R. (1965). Psychosynthesis: A manual of principles and techniques. New York and Buenos Aires: Hobbs, Dorman & Company.
  4. Geist, M. (2013). Reflections on psychology, culture, and life: The Jung page. Cgjungpage.org. Retrieved on 22 July, 2019, from: Website.
  5. GoodTherapy. (2018). Emotionally focused therapy. Goodtherapy.org. Retrieved on 22 July, 2019, from: Website.
  6. Markway, B. (2014). How to crack the code of men’s feelings. Psychology Today. Retrieved on 17 July, 2019, from: Website.    
  7. O’Connell, B. (2006). Solution-focused therapy. In Feltham, C., & Horton, I., Eds. (2006). The SAGE handbook of counselling and psychotherapy. London: SAGE Publications.
  8. Schexnayder, C. (2019). The man who couldn’t feel. Brain World. Retrieved on 17 July, 2019, from: Website.
  9. Seligman, L. (2006). Theories of counseling and psychotherapy: Systems, strategies, and skills, 2nd ed. Upper Saddle River, NJ: Pearson Education, Inc.
  10. Sonoma.edu. (n.d.). Handout on Carl Gustav Jung. Sonoma University. Retrieved on 13 November, 2018, from: Website.
  11. Thompson, J. (2010). Normative male alexithymia. In search of fatherhood. Retrieved on 18 July, 2019, from: Website.
  12. Young, J.E. (2012a). Early maladaptive schemas. Schema therapy. Retrieved on 8 June, 2015, from: Website.    
  13. Young, J.E. (2012b). Common maladaptive coping responses. Schema therapy. Retrieved on 8 June, 2016, from: Website.    
  14. Young, J.E. (n.d.). Schema therapy: Conceptual model. Retrieved on 8 June, 2016, from:Website.

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Are you feeling Restless, Irritable, and Discontent?Are you feeling Restless, Irritable, and Discontent?

I would infer that you may be depleted in some area of your life. Generally, when I am having any of these experiences I can recognise that my basic needs, and possibly even transformative, needs are not met. My basic needs are food and water, adequate sleep, shelter and safety, social connection (belonging), and esteem needs (e.g., self-respect, self-worth, self-competence, mastery and achievement, integrity, sense of freedom and independence etc.). Perhaps only when all my deficiency needs are met, and I’m experiencing dissatisfaction with my growth needs, do I feel Restless, Irritable, and Discontent in this area of my life – however I assume some would argue that if I am feeling that way when attending to my growth needs, then I may have slipped back to Esteem Needs. You can look up Maslow’s Hierarchy of Needs for a visual representation if you like, using a search engine. Below is a GIF that I created to educate people on how we can buffer ourselves to vulnerabilities. It’s very telling to go into the body when we haven’t eat for a while, may be we’re running on caffeine, and you can feel the restlessness in the body. We have to fuel up when we’re hungry to buffer ourselves from becoming irritable and restless. If you’re feeling discontent with life, I would suggest a social activity, play time with friends, working on a project of some kind, or getting involved in your community.

Anxiety, Anxiety Attacks, and Prolonged AnxietyAnxiety, Anxiety Attacks, and Prolonged Anxiety

I want to preface this post by stating that the concepts and suggestions I’ve made below are my own thoughts, opinions, and suggestions based on my own experience working in the mental health sector and lived experience. There may also be numerous grammatical and logical errors. I know that you’re intuitive enough to understand what I’m attempting to describe and explain. Therefore, there will be no references section at the end. This is merely an expression of thoughts, a stream of consciousness (William James coined the term Stream of Consciousness).

Episodic, acute, and chronic anxiety can be miserable and debilitating. Individuals living with anxiety have generally experimented with many techniques to cope with anxiety symptoms, and they have often been practicing these techniques for months, years, or decades. Anxiety is life changing. Current treatment can be efficacious at reducing the intensity or frequency of symptoms for the vast majority of people living with anxiety, but only at best. I, myself, have tried the deep breathing technique commonly advised by mental health professionals, and it can be about as useful as taking a sugar pill. There is credible science that supports deep breathing exercises can improve symptoms and recovery rates for stress, anxiety and depression levels – but what about for an anxiety attack or a panic attack or intense chronic symptoms of anxiety?

Sometimes nothing is effective enough for immediate relief. It is my contention that building a relationship with a trained psychiatrist, specialised in this domain, is an essential first step. Your treating specialist(s) will need to have extensive experience and a comprehensive understanding of the debilitating impacts of anxiety, anxiety attacks, and/or panic attacks. I recommend psychiatry because you will need someone who can prescribe short-term medication, schedule 4 or greater, to alleviate the pain rapidly. All symptoms a person may experience from any condition in the anxiety family present a risk for searching for any immediate relief. This is true for you or me or anyone. Without prompt and effective medical care readily available, many people who do not have a plan for managing anxiety will potentially search for an unhealthy substitute to acquire relief.

These substitutes are often unhelpful long term but effective short term. We all know what they are: alcohol and other drugs, sexual promiscuity or sex addiction, love addiction, gambling, excessive or unhealthy eating habits, self-injury, addictive forms of gaming, impulse spending, co-dependent or dependent behaviours on people, people pleasing, running away (avoiding reality), raging, reckless driving and other criminal behaviour, and relying on pharmaceuticals (legally prescribes or otherwise) that will have long-term unhealthy side effects. People know how to “doctor shop”, and although this area of medicine is becoming much more regulated, it still occurs. Unfortunately, there are people who do require certain types of legal drugs, in a timely manner, to find relief as a means of not engaging in any of the previously mentioned behaviours.

Some people may not have much faith in the field of psychiatry or psychology – HOWEVER – you may find yourself in a situation one day where you will need a doctor who knows your history to increase the likelihood of prescribing medication to treat anxiety when you need it most. This medication usually has addictive properties. An ethical psychiatrist will usually be unwilling to prescribe more than a single repeat of potentially addictive medication to treat their patients. This is standard, regulated medical practice in Australia.

Anyone working in the drug and alcohol sector or has regular contact with a person living with anxiety, or any form of addiction, will know that patients – people – are not being seen in a timely manner top treat anxiety before the patient starts looking elsewhere. Even once the patient has accessed some type of medical care, the length of care is not long enough for the patient to be “well enough” after discharge or ending their hourly session, to be on their own in the community safely without becoming vulnerable to their condition in a short time and looking for more relief to ease their pain and improve their well-being.

If a person or a patient cannot depend on the medical system in the way they need to feel safe and well, they will almost certainly begin to lose faith and trust in health professionals, and ‘the system’. This perpetuates their internalised stigma being reinforced, yet again.

I am not saying the patient doesn’t have a significant responsibly of their own to make valuable choices outside of medical treatment. I quote what someone once said to me, “You may not have asked for this disease, but it becomes our responsibility to stay well”. That is our duty as the person living with a health issue of any kind. There are things we certainly must do (or not do) to stay as healthy as possible. The help make not be there in a timely manner the next time we need immediate help.

It can take weeks or more to enter a detox facility. It can take months to enter a rehabilitation facility. It can take months for an available appointment to open with a psychiatrist. It becomes our responsibility to know that even when we’re feeling well and back to “normal”, we must continue those relationships with medication professionals. It becomes our responsibility to try alternative medicines if that’s something you’re interested in. Let’s face it, psychiatrists cease their practice, our professional relationship has reached it’s potential for adequate, loving care, or we want to try something new.

Start the process of finding a reliable, qualified, and credible psychiatrist today. I would recommend finding a counselling psychologist or other mental health professional that you have a productive and friendly working relationship with – and if you want to practice Buddhism, or acupuncture, or hypnotherapy, or any other complementary and alternative medicine – do it. If you want to connect with God – do it. If you want to see a naturopath – do it. Whatever it is, this may very well be a lifelong journey for you. Based on my own experience, don’t stop because you think you’re “all better now”. The previously mentioned professions or treatment options or lifestyle choices can be extremely expensive, but I would encourage you to save for it, find less expensive options. Sitting in church is free, or listening to an online guru can be the price or maintaining your mobile service bill.

I once knew of a fellow peer in treatment alongside me who said he saved money for years to travel overseas to have a procedure not available in Australia at the time for this purpose. He wanted blood transfusions and heat therapy for chronic pain that didn’t doctors could not determine had physiological origins. The peer was sure it had to, and medical investigations in Australia come up negative. The peer explained the theory behind blood transfusions and heat therapy – he believed – were supposed to improve his blood circulation and blood flow to treat the chronic pain he’d been living with for years after a workplace accident. Even this procedure overseas proved ineffective in mitigating his chronic pain. So, next he tried the wim hof method. He changed is diet. He exercised differently. He tried hypnotherapy. Finally, he turned psychology to treat stress and process childhood trauma. He was being treated for this a private facility where I was a patient at that time. I lost contact with him after I ended my own treatment episode. I don’t know if he’s still living with chronic pain or not.

The following are some very basic and well-known strategies in the Western world of psychology that you can begin to practice today, and then practice every day after that too – even for 5-20 minutes:

– learning about anxiety – your specific “causes” and the conditions more generally

– mindfulness

– relaxation techniques

– correct breathing techniques

– dietary adjustments

– exercise

– learning to be assertive

– building self-esteem

– cognitive therapy

– exposure therapy

– structured problem solving

– support groups

My firm believe is this:

Strong, healthy, quality relationships are essential to treating anxiety and other psychological illnesses. This about your life today: are you lonely (romantically or otherwise), are you a stressed individual, do you regularly feel like you job is stressful or unfulfilling, do you feel sad a lot, are you feeling pointless a lot, or feeling helpless a lot, feeling shame a lot, getting angry a lot over considerably minor things? etc. etc. etc. I would strongly encourage talking to a professional and begin exploring what options you have available to you.

Try, explore, play with a few methods of treatment. However, this must take a priority in your life. It must balance will all the many other obligations and responsibilities people encounter daily.

Type alternative medications or approaches to psychology. There are so many. It can be fun to try out a few when your finances permit. Even planning a holiday every 3-6 months is taking care of your well-being.

Many blessings friends.

Maybe you should Talk to SomeoneMaybe you should Talk to Someone

Author: Lori Gottlieb

Maybe you should talk to someone is a genuine, funny, touching, and realistic memoir of one therapist, as she navigates a difficult time in her professional and personal life. I couldn’t put this book down. As a therapeutic counsellor myself, the book gave me a greater understanding of psychology and human behaviour. It is a vulnerable portrayal of a renowned psychotherapist, her therapist, and the clients lives that she discusses in the book – and how they influence her life. If you have any preconceived bias about the therapy profession, this book might give you a new perspective. I laughed whole-heartedly and I blinked back the tears on one occasion. I’m really pleased I read Maybe You Should Talk About Someone. If you’re a busy person, the audio version may be more practical for you.