Why Conventional Therapy doesn’t Work with Men

Conventional views of the origin of men’s psychological problems have got it backwards. Men, they contend, suffer from traditional mental health disorders—anxiety and depression as well as substance abuse and bipolar disorders—and these issues lead to relationship problems. Their marriages don’t work, and they’re too often combative at work and play.

Our clinical work with men often suggests the opposite: Unsatisfying relationships—or, commonly, no real relationships at all—produce loneliness, shame, and alienation, and those feelings generate mental health problems. The failure to engage in intimate, open, and authentic relationships brings on standard diagnoses as well as externalization (acting out) behaviors such as anger management problems, sexual addiction, and working too much.

In spite of themselves, men are pack animals—social creatures. Like the other players—women and children—in the human parade, men need deep connections, but their socialization traps them in emotional isolation—a real man makes it on his own. Men do not trust other human beings and they fear intimate relationships not only because they make themselves vulnerable to rejection but, even more, because they expose themselves to ridicule, bullying and accusation of homosexuality. As a result, many men end up aloof, discontented, and resentful, spending their days in isolated work settings and their evenings in the rec room where the only light is the flicker of the TV screen broadcasting endless hours of huge men lunging at each other across the scrimmage line.

If and when most men eventually haul themselves to therapy, the treatment regimen is frequently individual counseling centering on family of origin or marriage issues to ameliorate depression or anger problems. All too often, they make little progress in counseling because their depression or anger issues are symptoms of their isolation, and what they need is not psychoanalysis but an entrée into human relationships outside their dependence on an intimate partner. While they may establish a temporary relationship with the therapist, it is not nearly enough.

Group programs such as Experiential Reclamation Therapy address the real problems of men—insularity, shame, and loneliness. Men don’t want to enter group therapy, but when they do, they quickly get with the program. They find other men in the group have strong and open relationships with one another and that they are affirmed for sharing personal feelings and stories. New men soon they find the deep friendship they always wanted, and they carry the ability to make new friends outside of the group into their lives. They learn that vulnerability with men can lead to human connection rather than just ridicule and shame.

Lionel is an intensely lonely and estranged man. Over the years, three wives have left him, and he’s moved from job to job. It’s a Tuesday night, and he parks his car outside the Men’s Resource Center, a half-hour early for the seven o’clock meeting. He keeps the car running not because it’s January in his Midwestern hometown, but in case he decides to bolt. Finally, he hesitantly traipses into the building and down the hall to the room where his therapist has told him the group meets. He hears laughter and opens the door. Seven guys look at him, and almost in unison, they say, “Hey, you must be Lionel. Come on in.”

The group starts, and Lionel is immediately stunned when a man says, “My name is Richard. I was a real asshole for a long time. I’ve been in this group for four years, and it’s changed my life. I came to the group after my wife divorced me. In the time I’ve been here, I’ve learned that although I was never abusive, I was a terrible husband. Work and everything else came before my marriage. Whenever Betty wanted to talk about something, I’d find an excuse to disappear into the garage.

“Ill tell you,” Richard concluded, after being in this group for a couple years, I look for people who want to talk about personal things, and I’ve got a great relationship with a terrific woman.” Another guy, Malcolm, takes a turn and talks about how he and his buddies spent every night getting high, never leaving the apartment. He says he went into treatment programs and couldn’t stop using. Finally he came to this group, and though he’s had some relapses, he’s closer to sobriety than ever before.

Lionel’s never heard people admit what they’ve done so openly, in such detail, with so much honesty. He doesn’t know it, but he is being introduced to intimacy. When his turn comes, he tells the group that he’s been married three times and now lives alone. That’s all he can bring himself to say on this first night.

Lionel kept on going to the group. Like most men who attend men’s group therapy, he quickly learned to disclose. He shed some tears, and he found empathy for others and a sense of camaraderie he hadn’t known since he has a child. Almost unwittingly, Lionel incorporated the primary element—relationship—that ameliorated not only his conventional diagnoses of depression and anxiety but also his real problems of loneliness, shame, and alienation.

Conventional therapy might have been helpful, but bottom-line, it doesn’t work because it doesn’t deal with men’s core issues. When Lionel found a place where he was accepted and appreciated, he discovered the ability to develop authentic friendships outside of the group. Without even knowing what separation anxiety or PTSD meant, he re-invented himself as a happy man with people around him who brought meaning and joy to his life.

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