Gender is an obvious factor in addiction and so many other psychological problems, so why is there a gender neutral approach to mental health and psychological therapies?

by Martin Seager, Consultant Clinical Psychologist, Male Psychology Network

I have been working as a psychologist in the addictions field for over two years now and have previously been a psychologist both in the NHS and the voluntary sector for a total of more than 30 years. It seems obvious to me that gender pays a big part in so many psychological problems and issues. Addiction is one obvious example. Approximately 75% of people who use addiction services are male and we must also remember that men are generally less likely to seek help than women so this figure may be an underestimate.

Turning to drugs and alcohol is usually an escape from a life that is hard to cope with, often beginning with trauma, abuse or neglect in childhood.  Emotional damage from the early years can lead to feelings of low self-worth and a need to get away from a hated self and to reduce the pain of living or to create a buzz or a high feeling that is usually missing. Men and women on average deal with their emotions differently. This is not a mere stereotype as the same pattern is found the world over.  Women are more likely to use close relationships to share and process emotions whereas men are more likely to process their feelings through action. This means that on average men will be more likely to do something physical with their pain and alcohol or drugs provides one such option. Of course, the ultimate escape is suicide where men also account for about 75% of cases.

For these same reasons, a depressed or unhappy emotional state is not so easily recognised in men even though the signs are not too hard to read if we are prepared to look in a gender-specific way. But services the land over are gender neutral as if emotional states and behaviours have no gendered qualities or characteristics. With perhaps a few exceptions, we have one size fits all diagnoses and offer one size fits all therapies for men and women as if they were no different. The evidence (e.g. Morison et al, 2014) however suggests that traditional counselling and therapy services are more suited on average to female clients. Within addiction services, as with general mental health services, we deliver counselling and CBT in gender neutral ways and we don’t do enough to offer other options that might help men besides standard drugs or talking therapies. Most of the addiction services that I am aware of do not even have a gender-specific policy on reaching men. Gender specific policies still mainly refer to women only. In some services men’s groups are provided but more often than not men and women are lumped together in mixed groups.

Our own research (e.g. Liddon et al, 2017) shows that although there are many similarities, men and women do show some potentially important differences in preferences for aspects of therapy, coping with stress, and help-seeking. The evidence is also clear that where services are adapted to men (e.g. those provided by the male-suicide charity CALM) they work much better. This is hardly surprising. Men are no different to other groups in needing to be understood and empathised with on their own terms.

All this makes it doubly important that we should succeed in achieving a male psychology section of the British Psychological Society. If psychologists can’t see the difference between men and women, what hope is there for the rest of us?


About the author

Martin Seager is a Consultant Clinical Psychologist and co-founder of the Male Psychology Network. He is Chairing the Male Psychology Conference at UCL this Friday and Saturday (22-23 June 2018)



Liddon, L, Kingerlee, R and Barry, J (2018) British Journal of Clinical Psychology, Volume 57, Issue 1 pp 42-58

Morison, L, Trigeorgis, C & John, M (2014) “Are mental health services inherently feminised?” The Psychologist, Vol 27. No 4 pp 414-6

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