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Some mental health issues in boys are linked to the absence of their fathers

The main reasons the boys were referred to me, a psychotherapist, were: (a) a diagnosis of ADHD with a strapline that nurture had been strongly implicated in causation, (b) self-harm where the referrer had sensed a vaguely seen family issue as part of the causation, and (c) predatory sexual behaviour recognised as similarly reactive. I discovered that the absence of the father was implicated throughout each of these types of referral.

The father’s role in so-called conventional families is to support the mother by helping her calibrate her approach to the baby, and throughout infancy and childhood. It is also to be a different parent to the mother, so that the baby/child recognises difference. This recognition is the beginning of learning that carries on through all situations in life. My case notes revealed that the absence of the father had allowed for an overly close relationship between mother and son. Further, nearly all the children I saw could be said to be under-achieving at school because of a disinterest, through failure to recognise, an inability to learn. Experiencing difference in early infancy acts like a blueprint for apprehending new phenomena through life. By definition, new situations bring difference because they are new and different. Similarly, so too does new information like that constantly available at school. An early appreciation of difference is therefore a strength factor for learning in life and the classroom.

I want to spend a few moments outlining the absent father’s role in the three main referral types mentioned above.



McQuade and Hoza (2015) discuss the psycho-social and emotional problems of children diagnosed with ADHD. They and others (for example, Mikami, 2015) also discuss how such children find relationships with family, friends and peers very difficult because they appear to find self-regulation problematic. Barkley (2015) writes about the lack of regulatory control children have over their own minds, emphasising their difficulties with their executive functioning in the classroom. They cannot calibrate themselves in relation to the tasks they are required to perform.

Calibration and regulation is an essential part of the father’s role. Working individually with the mothers and the boys I was able to help them begin to recognise, and then change, their relationship. Speaking for nearly all such cases, one boy said “I can see now that being in class felt so claustrophobic. It was my only space away from Mum and I filled it up with the feeling of needing to be free of her. I couldn’t concentrate. I couldn’t organise myself. I was disruptive to others.”



The need for escape implied in the previous quotation featured in all three referral types. Self-harm is usually seen by mental health professionals as a cry to release feelings that cannot be expressed verbally or through other means. This is as true of those who cut themselves as it is for those who poison themselves, often through overdoses.

When there is only the mother to confide in, and if and when this relationship is felt to be the cause of the feelings that become unbearable to the young person, then self-harm can provide an escape route for feelings. My work with one young boy ended with him recognising that I had provided a mental space away from his relationship with his mother. He memorably told me – “I realise now that I needed Dad to have been at home giving me a different person, like you have, to feel things with instead of Mum and all her issues.”


Predatory Sexual Behaviour

In no way am I reducing the seriousness of predatory behaviour for the perpetrator, and certainly not for the victim, when I say that the mother with issues played a very large part in the actions of the boys I saw. Whilst some fathers are violent and eventually leave (or are required by law to leave) the family home, it is also the case that some mothers push out non-violent partners because they do not fit with the historical script of these mothers.

Many mothers I saw had very serious issues with men. Some had been abused by their own fathers or grandfathers. Having sons presented them with a problem. How were they to live with a male in their house once they had expelled the boy’s father, but then lived with their memories of being abused by their own fathers? Some mothers pulled their sons close to them, saying that they were their pride and joy whilst, in the next breath, saying they were just like (whoever had abused them). The claustrophobia released by self-harm for other boys was, for these boys, only released by behaving in the intrusive way that these mothers had been at the receiving end of with their own fathers. So disturbing was the relationship with their mothers, so non-existent were the opportunities to find another escape route, that these boys repeated the offences already a feature of their families.

So, in brief, the absence of the father can have profound consequences on both mother and son. There are a great many young boys and, without doubt, young girls with absent fathers who would benefit from an approach to their mental health that takes into account his role and the consequences of his absence.


About the author

Andrew Briggs is an experienced psychotherapist, and former Trust Head of Child and Adolescent Psychotherapy; Organisational Consultant at NHS Hampshire, Kent, London and Sussex; and lecturer.

Andrew is an engaging speaker, and will be expanding on the above theme on Friday 22nd June at the Male Psychology Conference

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Should psychology help all men or just some men?

by Dr John Barry
Originally published on the BPS blog spot as The starving elephant will not be cured by a chiropodist 25th Aug 2017 [here]

There is a wise Hindu parable about how three blind men try to understand what an elephant is. The first one walks over and grasps its tail, and proclaims that an elephant is like a snake. Another grasps his leg suggests that an elephant is like a tree.

You can probably see where this is going: in focusing only on individual parts we often fail to see the full picture.

The elephant in the room in psychology is men’s mental health.

Male suicides around the world average about twice that of female suicides (Värnik, 2012) yet many psychologists don’t seem to notice.

Boys are falling behind in education all over the world (Stoet & Yang, 2016), yet many psychologists don’t seem to notice.

Even when these issues are pointed out to psychologists, many of them demonstrate ‘male gender blindness’ (e.g. Jankowski’s letter in July’s Psychologist) and instead of seeing the problem as a whole, they see the issues in terms of men who also belong to a minority groups by virtue of sexuality or ethnicity.

But if we split up male psychology into small sections, we risk being like the blind men and the elephant, failing to understand the whole picture.

It also begs the question of whether you have to belong to a minority group before psychologists are prepared to help you.

An important common denominator underlying the issues facing apparently disparate demographics of men is the blindness of the field of psychology to issues facing men and boys. If the elephant was being starved, then the solution would not be to call in a chiropodist to treat its skinny feet. The solution is to address the issue holistically and, as psychologists, we can best address male psychology issues by recognizing the totality of the problem, not just the various symptoms.

For the same reason, the Male Psychology Section sees the importance of collaborating with other Sections in order to find positive solutions. For example, educational psychologists might help solve the problem of male underachievement in school, and not only that of working class boys, but of all boys. Additionally, occupational and forensic psychologists might assess how much underachievement in school is related to general underachievement in life, and how much it might be linked to other issues such as homelessness, substance abuse, and criminality.

The roots of the problem are not ‘the patriarchy’, or testosterone, or ‘toxic masculinity’ (we debunked this in a debate at UCL recently). Potentially, the most immediately treatable root of the problem is male gender blindness and the associated gender empathy gap (Barry, 2016).

I say ‘potentially’, because although the concept of male gender blindness is easy to understand, many well-intentioned people find it incredible difficult to see the totality of the problems facing men and boys.

But we would like to invite those who are genuinely interested in men’s mental health to do something positive: join us in healing the problem at its roots.

Because as long as we fail to see problems such as male suicide as being a male gender issue, the problems will continue to fester.


About the author

John Barry is a Chartered Psychologist and one of the founders of the Male Psychology Network.


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Men’s mental healthcare – striving for better reach

Originally published in the BPS Psychologist magazine, June 2018. Accessed online 9th May 2018 [here]
Zac Seidler (University of Sydney) calls on professionals and society more broadly to see beyond ‘boys will be boys’.

Health professionals and society more broadly continue to blame men for their failure to seek help; they reportedly lack emotional communication skills, insight into their psychology, and the foresight to reach out before hitting crisis. This overwhelmingly negative narrative of masculinity, focused on what men can’t do, is epitomised in the assertion that ‘women seek help – men die’ (Angst & Ernst, 1997). The staggering and rising male suicide rate would look to confirm this statement, if it wasn’t for the fact that men are seeking help. The problem is, when they do, clinicians struggle to diagnose, communicate with and treat men’s mental health issues as they often manifest in an atypical way, with externalising symptoms like anger, irritability and substance misuse (Addis & Mahalik, 2003). It’s time we stop passing off such behaviours as ‘boys will be boys’ and learn to address these effectively – as a call for help.

Increasingly, research demonstrates our narrow perspective may be driving this bias. But this is changing, with a slow shift from a rigid construct of ‘traditional masculinity’ (e.g. strength & stocisim), to a more nuanced conception of multiple masculinities, neither all negative nor positive, that result from our complex socialisation (Kiselica & Englar-Carlson, 2010). These masculinities are diverse, intersecting and often contradictory, like the fact that an Indian man in the army who is homosexual has a web of masculinities that must co-exist. With this new wave of masculinity studies, the idea that psychological treatment is ‘the antithesis of masculinity’ is being challenged, leading to questions about what works for men within our existing mental health services, and why. Asking these questions will enable us to adjust from a largely ‘gender blind’ mental health service, to a more tailored ‘gender sensitive’ one (Owen et al., 2009). If we shift our perception of masculinity away from deficit, to one of understanding and using its strengths and diversity to our advantage, we may overcome barriers to men accessing effective psychological treatment (Seidler et al., 2018). The almost 5000 men who lose their lives to suicide each year in the UK must be a catalyst for change.

Researchers and clinicians have been saying for decades that men do not seek help, especially when it comes to psychological concerns like anxiety or depression. What recent research has supported, though, is that men do want to seek help, and will engage in treatment, if they are given the right type of help (Fogarty et al., 2015; Seidler et al., 2017). Indeed, more men are seeking help for mental health concerns than ever before (Harris et al., 2015). However, as these men may already have to overcome self-stigma, discomfort, and negative beliefs surrounding help seeking before initiating treatment, it follows that clinicians should do their utmost to ensure that their efforts do not go wasted through the provision of an inappropriate treatment style (Pederson & Vogel, 2007). The cost of failing to lay a groundwork of trust, respect and rapport with a male client is poor attendance, premature dropout, a negative treatment experience and risk of future avoidance of services altogether (Johnson et al., 2012).

Here is what is needed practically to have real implications on this treatment dilemma:

  1. Clinicians need to be trained to better understand, integrate and adapt their practice when working with men. Clinicians with greater gender-competence (much like multicultural competency) have reliably better outcomes with male clients (Owen et al., 2009). Without consideration of the impact of masculine socialisation on both themselves and the male client in treatment, the status quo of relying on restrictive and often negative assumptions and beliefs about masculinity will remain.
  2. Men may need a stronger emphasis on education and orientation to mental health services to improve insight and understanding into their symptoms, treatment and the potential interplay of their masculinity. An emphasis on active problem solving can be addressed through the inclusion of decision trees, progress reviews and session goals.
  3. Research has shown that the therapeutic alliance is key in engaging men by providing a collaborative, transparent and strength-based framework for treatment that promotes men’s empowerment or autonomy over dependence (Seidler et al., 2017).
  4. Plenty of ‘traditionally masculine’ traits are both amenable to, and useful within a psychological treatment setting. Men’s desire to proactively problem solve, be action-oriented and goal-focused in their attempts to overcome mental health issues translates well into almost all treatment approaches.
  5. Positive and pro-social practices of masculinity (e.g. mateship or family ‘protector’) are gaining traction in the field, and introducing them more readily into practice will only have benefits with male client engagement (Kiselica & Englar-Carlson, 2010).
  6. Language is central when relating with and engaging male clients and therefore more purposeful self-disclosure and use of colloquial, metaphorical or de-stigmatising language may help improve male retention in treatment (Mahalik et al., 2012)

Importantly, the integration of specific male-centred treatment styles and strategies into practice should remain separate from any particular treatment orientation, because the types of treatment preferred and most effective amongst men are diffuse. Rather than focusing on what treatment is offered, attention should be directed to the how of treatment. While these elements are considered ‘micro-skills’ that make up good therapy regardless of the client’s gender, it is becoming increasingly clear that a purposeful amplification of these skills may have greater impact in engaging male clients.

‘Pro-health’ men do not need to abandon their masculine ideals of strength or self-reliance, rather they can redraw more flexible boundaries. These men can symbolically ‘fight’ their mental health issues through the courageous act of seeking help but may withdraw from the process if psychological treatment is not tailored to them. Men across multiple studies have described feeling that their clinicians have preconceived ideas about them as men leading to a consequent failure to build a therapeutic alliance (Seymour-Smith et al., 2002). Instead, collaborative and male-centered modes of working, built on trust, transparency and respect are key for men, leading to better engagement in psychological treatment (Seidler et al., 2017).

The proliferation of mental health awareness campaigns encourage men to seek help to narrow the gender gap. But once they reach out for assistance, it is imperative that the system they are drawn into is capable of effectively treating their needs and concerns in an engaging way. Including the client’s masculine socialisation and its impact on their presenting issues throughout assessment and formulation, seeking and reinforcing positive masculinity in the client and understanding the impact of gender beliefs and attitudes on one’s own practice will only serve to improve men’s psychological treatment. It seems psychological therapy needs to ‘Man Up’, or at least muscle up, to support what is hoped to be an influx of these men in coming years.


About the author

Zac Seidler is a Registered Psychologist, MPsych (Clin)/ PhD (Candidate), in the School of Psychology, Faculty of Science, at the University of Sydney.


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Positive Masculinity is what we need to be talking about now

by Matt Englar-Carlson, Ph.D. (pictured above).

As a child of the 70’s, I had a sense that my boyhood was a slightly different world than my father’s had been. And now as the father of a teenager, I know that his boyhood is different than mine.

Learning about masculinity can be a funny thing. It is in the air all around us, but rarely is direct attention or instruction drawn towards it as an actual “thing” to consider and reflect upon. My research with men of all ages has taught me that very few of them have reflected upon what masculinity means to them.  It is something that they know, but don’t really know. As a boy, like countless other boys, I learned about masculinity by observation, social pressure, and through direct action- often at the end of an insult or insinuation, or by observing – or being the one directing – a comment or putdown towards another.

Rules of masculinity are all around us, yet they are context dependent- meaning that my rural, primarily White community reinforced notions of masculinity that were a bit different from the more racially diverse urban settings less than an hour away from my home. Like most boys and men, I understood what not to do as a male in certain contexts. In fact there were more rules about what NOT to do as compared to what to do. I also understood that these notions had a certain amount of plasticity to them – even though I knew that I should not cry, tears often formed in my eyes as I could not really control them. Rarely did I encounter boys or men who were the rigid masculine caricatures that I saw on television, typically boys and men had a bit more complexity to them. In that sense, masculinity for many men was multi-dimensional as both aspirational and inspirational. No one ever talked about this stuff in public around me, but I had already had the sense the rules of masculinity where incomplete and in many cases flat out wrong. My private and intimate conversations with my male friends were my evidence, and yet so many rules and restrictions about men were omnipresent and constantly reinforced.

Learning about the psychology of men in graduate school was a true change point in my life. Scholarship in the field made sense to me, and digging deeper into men’s lives and experiences provided the mirror to better understand myself and the men around me. The psychology of men and masculinities helped me see my male clients as male and that this meant something unique to how they experienced the world and psychotherapy itself.  I was obsessed with reading all of the research I could find from across the globe.

My knowledge based deepened, and I noticed that like much of the existing psychology scholarship, the focus in the psychology of men was on distress, pathology, and dysfunction. Our knowledge base was skewed towards negative traits and functioning of men. I certainly understood the masculinity literature and could filter my life through it, but it seemed to only be part of the story of the men that I knew personally and professionally, and over time I noticed that I had a harder time finding myself in the literature.

I knew that men experienced both the dark aspects of masculinity- rigidity, pain, and distress associated with denying “unmasculine” traits and rewarding anger, violence, and destructive habits- but as men they also experienced or strove towards the healthy aspects as well. These healthy aspects seemed associated with growth-oriented relationships with others as a father, partner, or friend, community building notions of service and provision towards the greater good, and ideas around personal and social responsibility. As a clinician, these were the areas I focused on since they reflected the aspect of men’s lives that my clients cared about the most. My clients often expressed shame and deficiency around the darker side of masculinity, yet they shared more hope and motivation around notions of the men they wanted to be. They were motivated by health, and discouraged by distress. Growth and change conversations were inspired by the ideas of the men they could be – akin to what Davies, Shen-Miller, and Isacco (2010) called possible masculinities.

 In no way is being male a psychological problem, but the expression of some male roles that encourage shame, aggression, dominance, and indifference often brew psychological problems on cultural and individual levels. For me, this is where positive masculinity emerges. It is about contrasting alignment to rigid notions of masculinity, and allowing the space for men to refine and define what being a man means to them. Defining positive masculinity can be difficult, and I hesitate to fully define it in terms of traits because of the variation in socialization and contextual factors, but term like healthy, prosocial, adaptive, and socially responsible are often in the definitional mix.

Positive masculinity is a counterbalance to shame (truly, the core emotion for understanding men), offering growth and encouragement to men by focusing attention on what is possible and healthy in the lives of men. Importantly, positive masculinity can be beacon for men to strive towards: “As a man, what are you moving towards, and how do you want to contribute?” At a time of so much global transformation around gender and social roles, we need professionals who are able to help men navigate this changing world.

About the author

Matt Englar-Carlson, Ph.D., is a Professor of Psychology at California State University at Fullerton, US. His is one of the co-founders of the Positive Psychology / Positive Masculinity approach to men’s mental health. Matt will be giving a keynote speech and leading a panel discussion on ‘perceptions of men’s mental health worldwide’ at the Male Psychology Conference at UCL on 23rd June 2016.


Davies, J., Shen-Miller, D., & Isacco, A. (2010). The men’s center approach to addressing the health crisis of college men. Professional Psychology: Research and Practice, 41, 347–354.

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The Mojo Programme: helping men transform their lives

by Derek McDonnell

Mojo is a 12 week skills building and personal development training programme for men who are in distress and want to make changes to their lives.  The idea is that men attending our programmes feel empowered to transform their lives and to create positive social change.

Through Mojo, men learn to build their mental and physical fitness, set goals and develop life plans.  The group setting provides a space for men to connect and make friendships with other men that continue long after the programme finishes.  During the 12 week programme, the men link with local services that can support them to return to work, education or volunteering.

 “There is a lot of information out there. I now have my CV updated and have really started to look for jobs.  I even went for an interview last week.  I didn’t get the job, but I’m back out there which is as a result of Mojo”.

Mojo was developed to respond to the high numbers of men dying by suicide (in Ireland, 80% of those that die by suicide are men) and to address the lack of engagement by men in community-based services, especially those with a mental health focus.  The pilot began in 2011 (in South Dublin) bringing together organisations that work across primary care, mental health, employment, education, volunteering, health and welfare.

“It is so different from the work that I do that it was really satisfying to do something so innovative”

The first phase explored why men were in distress and why they did not access local services.  Isolation, Emasculation and Shame of Accessing Services emerged as key themes for men.  The exploration also found that services were working in silos with an obvious divide between statutory and community led organisations.

The second phase focused on building the capacity of local organisations to work together; agreeing interagency working protocols so that statutory and non-statutory services could operate with parity of partnership and develop a service that men would want to attend.

The third phase engaged men on our training programme that addresses the key themes of isolation, emasculation and shame of accessing services.   The programme is divided into two mornings, Wednesday from 10am to 1 pm the men learn tools to build and maintain their mental fitness and Thursday from 10 am to 2 pm they explore options to build a life they are happy with and are introduced to ways of keeping fit.

“Prior to Mojo, I stayed in my house for five years without hardly leaving”

The Programme is underpinned by the principles of Community Development, Adult Education and Mental Health Recovery.  Men on our programmes are treated as equals and are encouraged to become their own experts.  While all facilitators are qualified and experienced in their field, they identify as people (not experts) who also have times in their lives where they feel challenged.  Feedback from the men highlights that our approach helps to build trust which allows them to take more risks in the group, facilitating stronger group bonding and exploration of emerging issues.

“We all threw our stuff on the table, the staff were the gravy that brought it together”.

Crucially, the men attending Mojo are the primary focus of our work. Every decision or change made to our programming must, in the first instance, be of benefit to the men – not the staff, funders or organisations albeit we very much care about them too!

 “We were listened to and treated like adults”

Mojo is an evidence based, innovative intervention producing outstanding results for our men including:

  • * 83% report reduced depression and anxiety
  • * 90% retention rates on the programme
  •  * 70% progress on to work or education
  •  * 4 out of 5 men report an increase in self esteem

Mojo also:

  • * reduces social isolation and increases connections to family and community
  • * positively impacts on self-harm and harmful drug/alcohol use
  • *reduces the overall level of risk among the men
  • *has waiting lists of men wanting to attend our programme
  • * value for money – for every €1 invested Mojo returns €4.96 in social value.

“Thanks to Mojo I’ve reconnected with the world again”.

About the author

Derek McDonnell is CEO and Co-Founder of MOJO. For more information visit our website  or email:  or phone +353 87 66 00 872.

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Life on M.A.R.S. – Piloting a Recovery Group for Men in an NHS Community Mental Health Service

by Dr Amanda Kinsella and Alastair Pipkin

Research and experience recurrently highlights that Secondary Care Mental Health Services struggle to engage with men. Various theories have emerged which attempt to explain this (e.g. Wyllie et al., 2012) – including that men have a distinct style of regulating emotions; that cultural discourses around masculinity inform a reluctance to help-seek in the traditional sense; and that men tend to suit a problem-solving, action-focused approach prior to delving into their emotional depths. Theory aside – suicide rates remain highest for men aged 40-44, and men are reportedly three times more likely to take their own lives than women (Samaritans, 2017). The case for meeting men where they are, engaging with them on their terms and promoting their use of both mental health services and psychological therapy is clear.

Project Summary

The Halton Recovery Team – a Secondary Care Community Mental Health Team; North West Boroughs Health Care Trust – have recognised a gap in service delivery.

The team piloted a 12-week men’s only transdiagnostic recovery group. Referrals were open to the whole service. The program is based on the concept of empowering men to consider themselves as agents in their own recoveries. An assertive outreach engagement model was used, including an initial joint home visit with the nurse and psychologist who would be facilitating the group. Invitation, transparency and equality were key messages. Additional individual weekly telephone support and a post-course individual psychology session to consider “Where to now” and next steps were offered.

The design integrated relational, third-wave cognitive behavioural therapies, focussing on psychoeducation, relatedness and behaviour change, as well as recognising differences between the help-seeking behaviours of men and women and normalising “men’s emotional processes“.

The aim was not about making men more like women but respecting masculinity and intrinsic differences by specifically exploring the why and how men feel “Dis–Ease” and the behavioural and emotional consequences of shame, isolation and feeling stuck. Concepts of wellness and recovery were explored.

The group prides itself on taking an invitational approach – including sessional and home practice, integrating mindfulness and relatedness skills for regulating affect. Delivery included suicide prevention and transparency regarding high male suicide rates and looking at improving safety net strategies in times of crisis. Group exploration within masculine narratives lead the way to compassion for self and others, helping to support change behaviour and individual recovery.


The pilot group had an 80% completion rate, with the one individual dropping out being offered a place on the following cohort.

Across the two cohorts, self-report measures of readiness to change and difficulties regulating emotions were used. The mean readiness to change score showed an increase pre- to post-intervention, denoting a shift from the ‘pre-contemplative’ stage to the ‘contemplative’.  Post mean scores, difficulties regulating emotions also showed a reduction, suggesting a reduction in emotion regulation difficulties. Self-report scales of curiosity about the future, confidence about moving forwards and hopefulness showed increase, while self-report scales of doubtfulness about recovery and self-critical thoughts showed a reduction.

Qualitative feedback was taken from all of the men  This was analysed using a thematic analysis, finding five themes; expectations of the group; past experiences of services; positive gains; positive aspects of the group; self-agency.

Some quotes from the men:

I don’t think any of us realised that when our bodies were doing stuff that our minds would then take over until it was explained … I certainly didn’t realise to the levels our bodies reacted in a certain way and then our minds run off with itself”

It gives me a chance of thinking I can recover, yeah … it’s gonna take a lot of time, but at least now we know there’s light at the end of the tunnel. Somebody actually understands that we’re not totally messed up”

[Being in a group with other men] you know roughly the sort of anxieties they’re going to have about certain things, it’s sort of set in stone because you’re all men, so you know where they’re coming from … It puts you at ease”

The group is currently leading into its third cohort, and the team has established a psychological and social pathway for the men following attendance – including being placed straight into individual therapy waiting lists should they choose, and further psychosocial support via an allotment group and newly established football groups. Men from the pilot group have gone on to individual therapy and attending the allotment group together.

The option for men to co-deliver future groups is currently being developed, as is the men co-producing and co-delivering presentations to the Trust regarding exploring commissioning the service more broadly.

The main learning from the pilot is that meeting men where they are enables engagement, empowerment, and overall, the co-creation and delivery of meaningful therapy.

About the authors

Dr Amanda Kinsella is a Senior Psychologist at North West Boroughs Health Care Trust ( Alastair Pipkin is a Trainee Clinical Psychologist at Oxford Health NHS Foundation Trust ( Website:

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‘Mad and Bad’: Men’s Experiences of Psychological Therapy in a Forensic Mental Health Setting

by Shazia Hussain

Since boyhood many men are socialised to behave in accordance with approved gender role norms, internalising the several gendered messages still rampant in our postmodern society. Inadvertently setting contingencies around appropriate self-expression and a collective set of expectations of how men ‘should be’. This sets them up with a pervasive image of what it means to be a man – what it means to be masculine. This is an image that they carry with them into adulthood.

Masculinity has no set definition, rather it is dynamically constructed through interaction with the dominant socio-cultural ideas present at any given time, within a specific context (Connell & Messerschmidt, 2005), hence it is multifaceted. Nevertheless, the archetype of masculinity as in the minds of many men encapsulates a common set of attitudes, such as, emotional control, self-reliance, power, invulnerability, sexual prowess and success. Those who conform rigidly to these ideals experience what O’Neil (2008) referred to as ‘gender role strain’ and are at the greatest risk of psychological distress (Addis & Cohane, 2005) and engaging in maladaptive behaviours, such as aggression (Amato, 2012) . For they have set themselves the impossible task of achieving an ideal male image that is unsustainable.

Expectedly, when faced with circumstances that result in imprisonment, further affected by poor mental health, this ideal image threatens to collapse (Whitehead, 2005). To avoid complete disintegration of the self, a protective self or persona is erected in its place (Whitehead, 2005). In this new hypermasculine state emotional control becomes callousness, self-reliance and power become dominance, invulnerability becomes violence, and danger is seen as exciting (Beesley & McGuire, 2009). However, this state of manhood is fragile and can be easily lost or taken away (Vandello, Bosson, Cohen, Burnaford, & Weaver, 2008) resulting in increased hypervigilance towards the self and other men.

Where does this leave these men? Forensic mental health services face various challenges in engaging men in therapeutic interventions (McMurran & Ward, 2004). Rates for attrition and non-completion are variable, but reportedly range from 37 to 50% in extreme cases (McMurran & Ward, 2010). Those who do not complete treatment are at high risk of reoffending (McMurran & Theodosi, 2007). In the background, the men admitted to these services are faced with the reality of a loss of autonomy and control, alongside the double-stigma of being both ‘mad’ and ‘bad’ (Adshead, 2012).  For those working with these men and the men themselves, the journey of overcoming these internal obstacles is a gradual, non-linear and often lengthy process. It requires them to move from a position of defensive avoidance towards openness and vulnerability, which for the men in their current circumstances is often too threatening. This plays out in their time in psychological therapy as they attempt to redefine themselves as men.

About the author

Shazia Hussain is a ForenClinPsyD candidate at the University of Birmingham.


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Addis, M. E., & Cohane, G. H. (2005). Social scientific paradigms of masculinity and their implications for research and practice in men’s mental health. Journal of Clinical Psychology, 61(6), 633–647.

Adshead, D. G. (2012). Their Dark Materials: Narratives and Recovery in Forensic Practice. Royal College of Psychiatrists, 1–11.

Amato, F. J. (2012). The Relationship of Violence to Gender Role Conflict and Conformity to Masculine Norms in a Forensic Sample. The Journal of Men’s Studies, 20(3), 187–208.

Beesley, F., & McGuire, J. (2009). Gender-role identity and hypermasculinity in violent offending. Psychology, Crime & Law, 15(2–3), 251–268.

Connell, R. W., & Messerschmidt, J. W. (2005). Hegemonic Masculinity: Rethinking the Concept. Gender & Society, 19(6), 829–859.

McMurran, M., & Theodosi, E. (2007). Is treatment non-completion associated with increased reconviction over no treatment? Psychology, Crime & Law, 13(4), 333–343.

McMurran, M., & Ward, T. (2010). Treatment readiness, treatment engagement and behaviour change. Criminal Behaviour and Mental Health, 20(2), 75–85.

McMurran, M., & Ward, T. (2004). Motivating offenders to change in therapy: An organizing framework. Legal and Criminological Psychology, 9(2), 295–311.

O’Neil, J. M. (2008). Summarizing 25 Years of Research on Men’s Gender Role Conflict Using the Gender Role Conflict Scale: New Research Paradigms and Clinical Implications. The Counseling Psychologist, 36(3), 358–445.

Vandello, J. A., Bosson, J. K., Cohen, D., Burnaford, R. M., & Weaver, J. R. (2008). Precarious manhood. Journal of Personality and Social Psychology, 95(6), 1325–1339.

Whitehead, A. (2005). Man to Man Violence: How Masculinity May Work as a Dynamic Risk Factor. The Howard Journal of Criminal Justice, 44(4), 411–422.




Open post

Overcoming gay shame might reduce suicide attempts

By Soren Stauffer-Kruse

I came across an interesting Facebook post recently celebrating the International Day against Homophobia and sharing the outcome of a recent study [linked here]on teenage suicide in the USA.

Researcher Julia Raifman found that suicide attempts by gay, lesbian and bisexual teens had dropped significantly following the enactment of marriage equality laws in the United States.  Raifman argues that the introduction of marriage equality is likely to have made gay teens feel ‘more hopeful for the future’.  Ellen Kahn, of the Human Rights Campaign observed that ‘what we can learn from this study, and what we know from hearing directly from LGBTQ youth, is that the convergence of a supportive family, a safe and welcoming school, legal protections, and being equal in the eyes of the law can provide the foundation necessary to thrive and flourish into adulthood.’

Suicide rates amongst gay men in the UK have long been found to be significantly higher than in heterosexual men whose suicide rates in turn are also significantly higher than in women.  I have worked with gay and bisexual men as a Psychologist for the last twenty years and amongst all the things my clients have taught me one fact stands out most:  Gay and bisexual men suffer terribly from the shame they have internalised by not growing up in a supportive family or school environment or in fact as an integrated part of society.  Internalised homophobia is the most significant stressor in gay and bisexual men’s lives.  The bullying they may have experienced at school eventually stops but without knowing it many men carry internalised shame around with them, causing them to feel a deep sense of unhappiness without even knowing why.

It is very common for me to see a man in the best years of his life, at the height of his career and who may outwardly be stylish but whose life suddenly hits the wall.  When the celebrations of coming out and joining the pride parade subside, when casual encounters have stopped being fun, these men are left with a deep sense of inadequacy and shame that they have been carrying from their teens.  It may not be until they encounter therapy that they recognise the shame inside them.  Outwardly they can seem to others to be proud members of the LGBT community but inwardly they may feel a profound sense of inadequacy along with the crushing weight of not feeling lovable for who they are.

This can have very negative consequences for mental health and can be reflected in drug and alcohol use and also in bad relationship experiences.  If you feel unloved and alienated, drugs and alcohol may seem like the most obvious escape.  In desperation many turn to mental health services only to get more labels, stigma and shame.

The identity of a gay man is not just about his sexuality but his masculinity. A male psychology section within the British Psychological Society would therefore help recognise the specific needs of gay and bisexual men.  It would help UK psychologists take a lead on researching, raising awareness and reducing shame, stigma and trauma amongst gay men. It would help to advance knowledge and improve psychological practice across all our public institutions.

The US research makes me feel hopeful that we may be entering a new era of helping kids feel better about their sexuality.  Here in the UK we have made so much progress in terms of LGBTQ+ rights.  Now is the time for us to help young gay and bisexual men to get support and recognition earlier in life so that they don’t need to go through years of painful internalisation of shame that places their future mental health at risk.  We need gay pride but just as importantly we need Gay Shame Awareness!


About the author
Soren Stauffer-Kruse is a London-based BPS chartered and HPC registered practitioner psychologist specialising in Counselling Psychology. He has over 15 years of experience of working in Private Practice, the NHS and the Voluntary Sector. He is a guest lecturer at some of the UK’s most prestigious academic programs in Clinical and Counselling Psychology and LGBT Psychology. Soren also writes for both academic and mainstream publications.


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Details are here




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Childhood Trauma and Suicidality in Scottish Men

by Dr Charlotte Lemaigre

Pictured: Men’s SHARE service users attend weekly support groups. Photo reproduced with permission and consent.

The Men’s Suicide, Harm, Awareness, Recovery and Empathy (SHARE) Project is run by Health in Mind in Midlothian, Scotland. It provides emotional and social support to men in the local community who are at risk of suicide. The project works in partnership with the Dalkeith Citizen’s Advice Bureau (CAB), which offers financial and practical support to service users. This holistic approach allows men to take the time to reflect on and prioritise the different aspects of their psychological wellbeing.

As an active member of the project’s steering group committee whilst undertaking my Doctorate in Clinical Psychology, I witnessed first hand the incredible and life-saving work of the SHARE project. Men bravely shared their histories with me and I was struck by the many stories of negative childhood experiences, including abuse and trauma that these men had faced.

Taking a keen interest in the men’s narratives, I started reading around the topic. I quickly discovered that little is actually known about the reasons why men in particular become suicidal despite statistics suggesting that they are the most at risk. The World Health Organisation, for example, estimates that men account for three-quarters of all completed suicides and those aged 45-49 are nearly twice as vulnerable as the wider male population. It seemed obvious to me that better understanding the causes of male suicidal behaviour would be critical to reducing suicide rates in this high risk population. Indeed, understanding pathways to suicide can inform suicide prevention. So, I set out to work with the SHARE project to conduct research that would help to develop our knowledge and understanding of male suicidality.

The study aimed to explore the relationship between childhood trauma and suicidality. It looked specifically at the role that social inhibition and difficulties managing emotions play in this relationship. The study was novel insofar as it focused on a sample from a socio-economically deprived part of Scotland. Evidence suggests that men from lower socio-economic demographics in higher-income countries are particularly under-researched and under-represented in the research despite bearing the highest risk of suicide.

In total, 86 men who accessed the SHARE project over a five-month period took part in the study. They completed four questionnaires: the first looked at their experience of childhood trauma (physical, sexual, emotional abuse and neglect); the second measured their interpersonal difficulties including social inhibition; the third looked at their difficulties in managing emotions and the final one assessed their suicidal thoughts and feelings.

The results showed that higher ratings on the childhood trauma questionnaire predicted higher score on the measure of suicidality i.e. the greater the degree of childhood abuse, the greater the level of suicidality. This demonstrates the possible negative collateral and compounding effect of childhood trauma. The study also showed that childhood trauma may predict suicidality within the context of emotion management difficulties and high levels of social inhibition. Suicide is clearly a multifactorial phenomenon that is the result of a complex interaction between numerous factors. This novel study showed that difficulties managing emotions and interpersonal difficulties (being socially inhibited) are part of this complex picture.

The findings of the study could potentially help shape guidance on suicidality and enhance clinical practice. Firstly it is important for organizations to identify the presence of early childhood trauma, emotion regulation difficulties and social inhibition when assessing men who are at risk of suicide. Thereafter, targeting social isolation and treating emotion management difficulties as possible interventions to reduce active suicidality in this population is imperative. Offering men emotional and social support is strongly advocated in order to directly address and reduce active suicidal thoughts or feelings.

With these results and conclusions in mind, it is not surprising that services such as the Men’s SHARE project are so successful. The project adopts a prevention and intervention approach, offering weekly support groups and one-to-one sessions that focus on the emotional, social and practical needs of men who at risk of suicide. It is a testament to Men’s SHARE that the men whom the project supports often recount how the project has kept them alive and more importantly, has helped them to live well despite their adverse childhood experiences.

About the author

Dr Charlotte Lemaigre, Clinical Psychologist, works with Southwark Integrated Psychological Therapies Team (IPTT) and Wandsworth Consortium Drug and Alcohol Service (WCDAS).  Email:  Twitter @charlielemaigre

Special thanks to John Murphy (Health in Mind), Julie Podet (Dalkeith CAB) and the service users of the Men’s SHARE Project for their time and contribution. For more information on the Men’s SHARE project, please visit:

If you would like to find out more about the study, Dr Lemaigre will be presenting a poster about the research in more detail at the Male Psychology Conference at University College London on Friday 22nd June 2018.


You can vote now (7th May 20th June) for a Male Psychology Section of the BPS.
Details are here




Open post

Why fathers are important, especially for boys

by Dr Kevin Wright

Father’s Day is on 17th June this year. On average, people in the UK spend three times more on Mother’s Day than Father’s Day [see here] . It could be argued that this reflects how much the role of the father is valued compared to the role of the mother.

Are we undervaluing the role of the father? Well, research shows the father-child relationship is an important one, In fact it can be more influential than the mother-child relationship. This is especially true for the 8-12 year old child as they try to make sense of the outside world. At this age, the child – especially the male child – may see the father as representing that outside world. The child may see the father as more representing how to deal with the outside world than the mother so, for example, it has been found that children model their coping strategies more on the models they get from their fathers than that they see from their mothers.

A poor role model or emotional unavailability of the father, particularly to their sons, can have severe repercussions for development, especially if he is the oldest child having to deal with the arrival of a sibling. He may see this baby as usurping his position as the sole focus of attention of the mother. He may experience a grief reaction at the loss, part of which is to feel angry. This loss can be ameliorated if a father is physically and emotionally involved with the older child.

In the absence of positive male role models, sons often drift aimlessly and may end up in gangs.  This not only is a problem for society, but allows a boy to waste his life to criminality, mental illness, substance abuse and even suicide.

The solutions to these issues are no doubt complex, but a sensible start would be more investment in things like supportive parenting classes for fathers, more male teachers in primary schools, more male support workers (e.g. social workers, youth workers, psychologists and mentors), to provide a long-term way of working differently with boys and men.  At present there are no financial incentives for males to stay as in these careers in the long term, so experienced workers are lost to other careers. And there is little support for fathers to be more involved as carers of their children.

Parents, especially fathers, may need help to know how to support their children at school.  Schools need to enable fathers in this and not marginalise them in their parental roles.  Schools can help fathers by, for example, having parent/child classes to model how to encourage/value their children through their development.  Employment conditions need to be such that fathers can feel supported and encouraged to be carers of their children, particularly their sons, otherwise the cost to society is huge if the sons drift dangerously astray.

School support/counselling services should rethink ways to encourage boys to access emotional help. Boys may find it very challenging to talk about their feelings, but they might find it easier to express themselves through writing, or via technology/avatar programmes. It might make entering the process more appealing if ‘therapy’ and ‘counselling’ could be rebranded as something more appealing to boys. Without a doubt, we need to be more imaginative in the ways that we address the issues facing boys.

Society needs to wake up to how important fathers are to their children. Fathers need to know their role is important and need to be helped to understand how to be involved with the care of their children from the moment they are born and need to be supported to fulfil their role in bring up their children. Often they don’t fully realise how important their involvement is for the positive emotional development of their children, particularly for their sons.

Recognising the importance of fathers in the wellbeing of boys would be a step in the right direction for us all, for to look after the boy is to look after the man.

About the author

Dr Kevin Wright is a Chartered Counselling Psychologist. He will be presenting his poster ‘A Boy’s Journey away from gang life to being a man. Critical stages of development & intervention’ at the <Male Psychology Conference, 22-23 June/p>

You can vote now (7th May 20th June) for a Male Psychology Section of the BPS.
Details are here





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