Webb Therapy Uncategorized How often do you feel lonely?

How often do you feel lonely?

Dr Rangan Chatterjee chats with Dr Gabor Maté about his radical findings based on decades of work with patients. We’re currently living in a culture that doesn’t meet our human needs. Maté and Chatterjee delve into how our emotional stress can translate into physical chronic illnesses, and how loneliness and a lack of meaningful connection are on the rise, as are the rates of autoimmune disease and addiction.

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Problematic Thinking Styles (continued)Problematic Thinking Styles (continued)

Hello readers! A few of the cognitive styles below were mentioned in my last post. As humans, we have a tendency to forget things so a bit of revision can be useful.

Many people have cognitive processes that result in overall unhelpful thinking styles that they tend to apply globally across situations and which may result in emotional distress (such as depression or anxiety) or unhelpful behaviours (such as anger or avoidance). Some of the most problematic thinking styles are listed in the extract below.


Mental Filter: This thinking styles involves a “filtering in” and “filtering out” process – a sort of “tunnel vision”, focusing on only one part of a situation and ignoring the rest. Usually this means looking at the negative parts of a situation and forgetting the positive parts, and the whole picture is coloured by what may be a single negative detail.


Jumping to Conclusions: I’m sure you’ve heard people say on television, “Don’t jump to conclusions” or “The truth is we just don’t know yet”. We jump to conclusions when we assume that we know what someone else is thinking (mind reading) and when we make predictions about what is going to happen in the future (predictive thinking).


Personalisation: This involves blaming yourself for everything that goes wrong or could go wrong, even when you may only be partly responsible or not responsible at all. You might be taking 100% responsibility for the occurrence of external events.


Catastrophising: Catastrophising occurs when we “blow things out of proportion” and we view the situation as terrible, awful, dreadful, and horrible, even though the reality is that the problem itself is quite small. A helpful restructuring of this cognition is to ask yourself if the situation will still be awful, terrible, or dreadful in a month. There may be ongoing consequences or stress involved if you lose a job or a relationship ends, so validate the experience you are having but also take a look at the big picture. What’s the worst that could happen? Why is the worst so “bad”? And if you are being realistic about the issue, reach out for some help if you can.


Black & White Thinking: This thinking style involves seeing only one extreme or the other. You are either wrong or right, good or bad and so on. There are no in-betweens or shades of grey.


Should-ing and Must-ing: Sometimes by saying “I should…” or “I must…” you can put unreasonable demands or pressure on yourself and others. Although these statements are not always unhelpful (e.g. “I should not get drunk and drive home”), they can sometimes create unrealistic expectations.


Overgeneralisation: When we overgeneralise, we take one instance in the past or present, and impose it on all current or future situations. If we say “You always…” or “Everyone…”, or “I never…” then we are probably overgeneralising.


Labelling: We label ourselves and others when we make global statements based on behaviour in specific situations. We might use this label even though there are many more examples that aren’t consistent with that label.


Emotional Reasoning: This thinking style involves basing your view of situations or yourself on the way you are feeling. For example, the only evidence that something bad is going to happen is that you feel like something bad is going to happen. I live with anxiety and it can be debilitating at times. I use my “wiser thinking” or “rational thinking” to evaluate whether I am operating from an emotional mindset. You might ask yourself: “What’s the evidence?”, “Does the past necessarily predict the future?”, “Am I angry or fearful right now because that might be clouding my judgement?”. It can be helpful to talk to someone who isn’t caught in your emotional headspace, or perhaps wait for the emotion to subside to think about the situation again.


Magnification and Minimisation: In this thinking style, you magnify the positive attributes of other people and minimise your own positive attributes. It’s as though you’re explaining away your own positive characteristics.

(CCI, 2008)

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.

Unhelpful Cognitions (thoughts) and DistortionsUnhelpful Cognitions (thoughts) and Distortions

Unhelpful Cognitions

Mental Filter: This thinking style involves a “filtering in” and “filtering out” process – a sort of “tunnel vision”, focusing on only one part of a situation and ignoring the rest. Usually this means looking at the negative parts of a situation and forgetting the positive parts, and the whole picture is coloured by what may be a single negative detail.

Jumping to Conclusions: We jump to conclusions when we assume that we know what someone else is thinking (mind reading) and when we make predictions about what is going to happen in the future (predictive thinking).

Mind reading: Is a habitual thinking pattern characterized by expecting others to know what you’re thinking without having to tell them or expecting to know what others are thinking without them telling you. This is very common, and most people can identify. Oftentimes, when we are telling someone a story about an interaction, we’ve had with someone else, we will make mind reading assumptions without actually having fact or evidence e.g., “They haven’t phoned me in two weeks so they must be angry with me for cancelling on them last week.”

Personalisation: This involves blaming yourself for everything that goes wrong or could go wrong, even when you may only be partly responsible or not responsible at all. You might be taking 100% responsibility for the occurrence of external events. It can also involve blaming someone else for something for which they have no responsibility. This can often occur when setting a boundary with someone and you take responsibility for their guilt or anger.

Catastrophising: Catastrophising occurs when we “blow things out of proportion” and we view the situation as terrible, awful, dreadful, and horrible, even though the reality is that the problem itself may be quite small.

Black & White Thinking: Also known as splitting, dichotomous thinking, and all-or-nothing thinking, involves seeing only one side or the other (the positives or the negatives, for example). You are either wrong or right, good or bad and so on. There are no in-betweens or shades of grey.

Should-ing and Must-ing: Sometimes by saying “I should…” or “I must…” you can put unreasonable demands or pressure on yourself and others. Although these statements are not always unhelpful (e.g., “I should not get drunk and drive home”), they can sometimes create unrealistic expectations.

Should-ing and must-ing can be a psychological distortion because it can “deny reality” e.g., I shouldn’t have had so much to drink last night. This is helpful in the sense that it communicates to us that we have exceeded our boundaries, however, saying “shouldn’t” about a past situation can be futile because it cannot be changed.

Overgeneralisation: When we overgeneralise, we take one instance in the past or present, and impose it on all current or future situations. If we say, “You always…” or “Everyone…”, or “I never…” then we are probably overgeneralising.

Labelling: We label ourselves and others when we make global statements based on behaviour in specific situations. We might use this label even though there are many more examples that are not consistent with that label. Labelling is a cognitive distortion whereby we take one characteristic of a person/group/situation and apply it to the whole person/group/situation. Example: “Because I failed a test, I am a failure” or “Because she is frequently late to work, she is irresponsible”.

Emotional Reasoning: This thinking style involves basing your view of situations or yourself on the way you are feeling. For example, the only evidence that something bad is going to happen is that you feel like something bad is going to happen. Emotions and feelings are real however they are not necessarily indicative of objective truth or fact.

Magnification and Minimisation: In this thinking style, you magnify the positive attributes of other people and minimise your own positive attributes. Also known as the binocular effect on thinking. Often it means that you enlarge (magnify) the positive attributes of other people and shrink (minimise) your own attributes, just like looking at the world through either end of the same pair of binoculars.

(CCI, 2008)