Open post

How can we help men to be more willing to access therapy? Insights from working with prisoners.

by Dr Naomi Murphy.

Within the UK, three times as many men kill themselves as women[1].  Within the Republic of Ireland, this ratio rises to 5:1.  Concern about male suicide, along with male over-representation in other behavioural statistics that are associated with distress (substance misuse and violence for instance) has led researchers and mental health professionals to consider whether therapy as it is currently provided is accessible to men.

Some observe that therapy is unappealing to men. Discussions of gender differences in relation to therapy suggest men find feeling-focused therapy “too woolly”, prefer structured approaches such as CBT and benefit from an approach that is made less intense by “talking whilst doing”, offering gradual exposure to emotions and with an emphasis on strength and empowerment (e.g. Seidler et al, 2017[2]).

Within prison, treatment is most typically highly structured, manualised, offending behaviour programmes (OBPs).  The Fens Service (HMP Whitemoor since 2000) was established for men considered to be challenging to the prison system and perceived as unable to benefit from standard OBPs.  The typical service user has received a life sentence for violent or sexually violent crimes and has to some degree been labelled as “untreatable” or “treatment-resistant”.  This may be because he has completed OBP treatment and is perceived as making no gains but, more commonly, he has been ejected from treatment for failing to attend regularly or turning up and being disruptive.  Not infrequently, he has been unable to access treatment because his daily behaviour has proved so challenging to manage that he has been located within special accommodation that makes treatment more inaccessible.  Despite this, once within the Fens Service, the average man attends 95% of the individual sessions and 88% of the group sessions available to him over the 5 year course of treatment.

Treatment is as voluntary as it can ever be when one is detained in custody.  There are no immediate consequences to failing to attend a session but staff attitudes towards a D.N.A. (did not attend) may be helpful.  DNA is seen as an inevitable part of beginning an emotionally intimate relationship and the struggle to establish intimacy given the context within which these men were generally raised included brutal physical and sexual abuse by multiple perpetrators in ‘care-giving’ roles, profound neglect and loss which becomes an explicit focus of discussion.

Seiger & Barry (2014[3]) highlight the importance for men of being “a fighter and winner….a provider and protector… and retaining mastery and control at all times”.  Seidler et al draw the apparently logical conclusion that therapy must maintain these needs by teaching men skills and being task focused to enable the men to perhaps avoid feeling vulnerable.  The approach that we utilise at Whitemoor is to normalise vulnerability as part of the human condition and to alleviate them of the burden or “shame” of asking for help by pragmatically acknowledging the hurt child that we know each of them is trying to heal.  The bravery required to do this work is spoken of frequently and staff speak openly of their own emotional responses during therapy which inevitably includes feeling frightened, hated or saddened but demonstrates these feelings are not only universal but are not to be feared.

Would these prisoners have gone to therapy more readily had they been offered the ‘graded exposure’ approach suggested by authors such as Seager, Barry and Seidler? This is a moot point at present because neither approach to facilitating help-seeking has been subject to formal research. There might also be contextual and individual differences that make it difficult to compare help-seeking in the general public to help-seeking in a secure prison environment.

One thing we know is that once in treatment, the prisoners at Whitemoor have a good chance of making clinically significant improvements, so it would be very useful to know which method – graded exposure or normalising vulnerability – is more effective in encouraging prisoners to enter therapy.

About the author

Dr Naomi Murphy, currently Clinical Director of the Fens Offender Personality Disorder Pathway Service at HMP Whitemoor, is a Consultant Clinical & Forensic Psychologist with a long-standing interest in the psychological needs of male offenders. She will be giving a keynote speech on Fri 22nd at the Male Psychology Conference at University College London http://www.malepsychology.org.uk/the-conference-2018/

You can vote now for a Male Psychology Section of the BPS.
Details are here http://www.malepsychology.org.uk/male-psychology-network/vote-for-a-male-psychology-section/

 

References

[1] Samaritans Suicide Statistics Report 2017

[2] Seidler, Z., Rice, S., Oliffe, J., Fogarty, A. & Dhillon, H. (2017) Men in and out of treatment for depression: Strategies for improved engagement. Australian Psychologist https://doi.org/10.1111/ap.12331

[3] Seager, M. & Barry, J. (2014) https://www.menshealthforum.org.uk/what-can-tony-soprano-teach-men-about-therapy

 

 

 

 

Open post

We probably need you, but do we want you?

by Anonymous Author

Whilst attending interviews this year, hopeful to be chosen for a place to be trained as a clinical psychologist in our NHS, I managed to talk to many other hopeful candidates. After the textbook icebreaking questions, once they knew how far I travelled to get there and if I had anymore interviews lined up, the next question was usually about my gender. “How does it feel to be the only man here?” or “I have never worked with a male clinical psychologist”. Of course there was no offence to be taken, to me it was harmless, but one comment struck me:

“I would love to be male in this process, it’s such an advantage”.

I felt a bit awkward; I did not want to be selected purely because of my gender. But was it true? Was I at an advantage because I was male? Just as with some of these candidates, every psychologist I have worked with to date has also been female. I knew it was well documented that clinical psychology is a female-majority profession (e.g. Caswell and Baker, 2008; Willyard, 2011), and I knew concern was growing about the lack of males in clinical psychology (e.g. Barry, 2016). I also remembered reading when applying on the clearing house for postgraduate clinical psychology training courses website (www.chpccp.leeds.ac.uk) the statement: ‘We welcome applications from people from ethnic minority backgrounds, people with disabilities and men as these groups are currently under-represented in the profession’. But did this mean, compared to the female who made this comment, my chances of getting a place were higher as a male?

No. In fact, they might not have even been equal. What I have recently discovered is that overall, male applicants are statistically and systematically less likely to be accepted onto clinical psychology doctorate courses than females.

The clearing house website has published equal opportunities data since 2005 (www.leeds.ac.uk/chpccp/equalopps), stating numbers and percentages of the applicant demographic compared to the accepted demographic. Let’s take for instance 2015. In total, 633 males applied and 84 were accepted onto a course. For females, 2,922 applied and 498 were accepted. Of course, there are going to be more female clinical psychologists, after all, there are far fewer males applying. However, what deeply concerns me is when we look at these numbers in relative percentages.

Those 633 males applying made up 18% of the total applicants for courses, and the 2,922 made up the other 82%. Yet, those 84 males that were accepted only made up 14% of total acceptances, with the 498 female acceptances making up the other 86%. Seemingly then, in 2015, females had a statistically higher chance of being accepted onto training than males. In fact, every male had roughly a 13% chance of selection, while females had roughly a 17% chance.

Hoping this was just a one off, I decided to look at other years. The pattern, however, was almost systematic. Apart from 2011, the relative percentage of males accepted onto courses were lower than the relative percentage of male applicants in every single year after 2005, when data started to be collected.

I think it is fair to say that the NHS could benefit with more male clinical psychologists. It makes sense that men and boys entering NHS psychological services can request to see a male psychologist; after all, we all reasonably expect to be able to request to see a same-sex GP when we have personal or private physical health issues. More male psychologists could also inform a more gender-inclusive service, which is critical when we consider that 75% of suicides are male. It is even more critical when we consider that 25% of these males seek help from a health professional in the week leading to their suicide (Mental Health Taskforce Strategy, 2016). There are obvious questions as to whether the NHS is meeting their needs effectively; in 2015, over 88 males on average committed suicide each week (Samaritans, 2017), meaning suicide is the biggest killer of men under 50 in the UK (Mental Health Foundation, 2018).

Many ideas have been offered to try and explain the shortage of male clinical psychologists, such as men are more reluctant to pursue the profession because of its association with ‘caring’ aspects of human nature, that fewer males undertake an undergraduate degree in psychology, and commonly that there are far fewer applicants for doctoral training (e.g. Bradley, 2013; BPS, 2004; Morison et al., 2014). The explanation is far simpler. There are enough males applying; enough to fill over 50% of places in any given year. They are just not given the chance to be accepted; at least not as fair a chance as females.

I do not have enough experience or knowledge of doctorate course selection procedures to evaluate them, though, I do speculate that male applicants typically have lower academic achievement than their female counterparts. I also wonder if male personal statements are less warm-hearted and reflective, and whether males come across less compassionately at interviews.

It makes sense that the top scoring candidates get accepted; presumably they would make higher-quality clinical psychologists. However, the entry requirements from the clearing house for postgraduate clinical psychology training courses website states you ideally need at least a 2:1 in a degree that confers graduate basis for chartered membership (GBC) and an unspecified amount of clinically relevant experience. It would be reasonable to assume that all, if not the majority, of male applicants have met all of these entry requirements before paying £23 to submit an application. Therefore, it is reasonable to say, some university selection procedures, which are not controlled directly by the NHS, Government or the clearing house, are disadvantaging male applicants.

Of course, to look at this through the lens of gender is a one-dimensional and narrowminded view. I may come across bias; I may even come across supporting the comment made to me at my interview, that males should have an advantage in the process. I absolutely do not believe this. The best clinical psychologists I have met are female. Instead, I think the profession needs to look into this issue further and think of its implications if it were to continue. More diversity in the profession will only better meet the needs of our diverse range of service users. But things could get worse yet; less success could be further pushing males away from the profession. In the last three years of data published (2013-2016), the number of females applying each year has fallen 2%, however, for males this has fallen a staggering 8%, from an already relatively small number applying anyway in 2013.

Given clinical psychology training is funded by public taxpayers’ money, directed from our NHS, is it fair to say males should have at least an equal chance of getting onto such programmes as females? If the relative percentages were equal in the years where less males were accepted since 2005 (i.e. 18% of applicants being male lead to 18% of acceptances being male), we might have over 130 additional male clinical psychologists working in our NHS today.

 

About the author

The author has asked for his identity to be witheld.

 

You can vote now for a Male Psychology Section of the BPS.
Details are here http://www.malepsychology.org.uk/male-psychology-network/vote-for-a-male-psychology-section/

 

References

Barry, J. (2016) ‘More male psychologists?’. The Psychologist, (29): 412-419.

Bradley, J. (2013) ‘Where are all the men?’. [Letter to the editor]

British Psychological Society (2004) Widening access within undergraduate psychology education and its implications for professional psychology: Gender; disability and ethnic diversity. Leicester: BPS.

Caswell, R. and Baker, M. (2008) ‘Men in a female-majority profession: Perspectives of male trainees in clinical psychology’. Clinical Psychology Forum, (214).

Mental Health Foundation (2018) Suicide. Accessed from: https://www.mentalhealth.org.uk/a-to-z/s/suicide [01.06.2018].

Mental Health Taskforce Strategy (2016) The Five Year Forward View for Mental Health.

Morison, L., Trigeorgis, C. and John, M. (2014) ‘Are mental health services inherently feminised?’. The Psychologist, (29): 414-417.

Willyard, C. (2011) ‘Men: A growing minority?’. gradPSYCH, 9 (1): 40.

Open post

Good fathers are good for everyone

by Dr John Barry

As you might expect, the Male Psychology Network is interested in the role of the father in the family. Given that our blog spot was recently ranked 3rd for psychology in the UK, I thought it would be a good idea to look at some of the blogs from the past year and see what they tell us about fathers and fatherhood.

The overall message is that fathers have an important role in the family. If they get it right, there are benefits for all concerned, but if something goes wrong, it can be damaging for all concerned.

An example of things going wrong with the fathering was seen in Jennie Cummings-Knight’s review of Grayson Perry’s book ‘The Descent of Man’: “an absentee father and a violent step father are some of the elements that interacted upon the young Perry and led him to taking refuge in his mother’s wardrobe (literally and figuratively)” http://www.malepsychology.org.uk/2018/01/09/book-review-of-grayson-perrys-the-descent-of-man/

One is left wondering whether the various attacks that Perry launches on men and masculinity are a result of unsatisfactory male role models in his childhood. This is echoed in Dr Kevin Wright’s blog: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” http://www.malepsychology.org.uk/2018/05/20/why-fathers-are-important-especially-for-boys/  Child psychotherapist Andrew Briggs observed that father absence is implicated in self-harm, ADHD, and predatory sexual behaviour http://www.malepsychology.org.uk/2018/05/31/some-mental-health-issues-in-boys-are-linked-to-the-absence-of-their-fathers/

Being an absent father is sometimes a choice men make, but all too often it is imposed upon them. Sometimes the children in separated families are turned against the father in a heartbreaking way, as described in the review by Dr Becci Owens of the book by Stuart Hontree http://www.malepsychology.org.uk/2017/11/02/parental-alienation-attachment-corrupt-law-book-review/ The degree to which the distress caused by family breakdown and lack of access to children can lead to suicide is not known due to lack of definite statistics, but is the subject of forthcoming research by the Male Psychology Network.

Inevitably of course some men will make a mess of the father role largely due to their own faults. The Male Psychology Network has no illusions about the possibility of men getting things wrong, as reflected in our support for developments in forensic psychology, including  preventing child sexual abuse http://www.malepsychology.org.uk/2018/05/17/preventing-child-sexual-abuse/ We take a proactive approach to improving men’s mental health, which we believe will reduce criminality and related social problems.

The other side of the coin is that good fathers are good for everyone. This is suggested by the finding of the Harry’s Masculinity report (by Dr John Barry and Martin Seager) that the more a man aspires to be like his father, the better his mental health http://www.malepsychology.org.uk/2017/10/30/the-harrys-masculinity-report/ It seems to be especially important to the stable development of boys, says Belinda Brown, to grow up with a male role model demonstrating positive aspects of masculinity http://www.malepsychology.org.uk/wp-content/uploads/2016/08/article-4.pdf

Although some people are hostile to the traditional role of the father, alternatives roles for fathers haven’t been overwhelmingly popular so far, as highlighted by Dr Rob Hadley http://www.malepsychology.org.uk/2018/05/11/how-involved-are-men-in-involved-fathering/

Some people will have had fathers who fell well short of ideal, but that doesn’t mean the role of the father (or masculinity, or men in general) is inherently wrong. No matter what your views are of the traditional role of the father, it’s a good idea to make Father’s Day a day when you make an extra effort to extend some human warmth to the man without whom you would not be here today.

 

About the author

Dr John Barry is a chartered psychologist and co-founder of the Male Psychology Network

Several of the authors mentioned in this blog (in bold) are presenting their work at the Male Psychology Conference at UCL on 22nd – 23rd June http://www.malepsychology.org.uk/the-conference-2018/

You can vote now for a Male Psychology Section of the BPS.
Details are here http://www.malepsychology.org.uk/male-psychology-network/vote-for-a-male-psychology-section/

 

 

 

 

 

 

Open post

Male psychology: holistic, compassionate, future-facing

by Dr John Barry

Originally published on the BPS blog spot 23 October 2017 https://www.bps.org.uk/blogs/dr-john-barry/male-psychology-holistic-compassionate-future-facing

 

It’s staggering to consider how many men kill themselves every day (around 13 according to recent figures), but perhaps just as staggering is how few psychologists realise this is a field where they can have a positive impact.

Most psychologists don’t realise that although three quarters of suicides are by men, suicidal men are less likely to seek professional help than suicidal women (Kung et al, 2003).

Male psychology is any issue that predominantly impacts men and boys, or is understudied in men and boys. This means that you may already be working in male psychology without having realized it.

Here are some examples:

  • Clinical psychology: suicides and substance abuse are higher in men
  • Educational psychology: boys have been falling behind girls since the 1980s
  • Neuropsychology: most serious brain injury patients are male
  • Developmental psychology: autism spectrum disorder is more common in males
  • Forensic psychology: most prisoners are male
  • Military psychology: most combat-related PTSD is in men
  • Sports psychology: men engage more in sports than women do

There are other fields too, and if we depicted all of these as a Venn diagram, male psychology would be the common denominator.

Developments in one field (e.g. improving boys’ education) might have a positive impact on other fields (e.g. clinical and forensic psychology). Thus male psychology does not take anything away from other areas, it adds to them by facilitating the application of what we have learned about men in one field to other fields.

If you are starting to realise that you are working in a male psychology field, then here are three reasons to be cheerful:

  1. Male psychology is holistic
    It not only spans all of psychology, but is about a diversity of gender and sexuality. It accepts that there are many ways to be a man, without putting men into categories. It is about understanding women as well as men e.g. ‘women in our survey said X; men in our survey said Y’. Women can work in male psychology too, in fact currently about a third of Male Psychology Network members are women. Male psychology unites people, it’s not about dividing people or hunkering down in an academic silo.
  2. Male Psychology is compassionate
    It provides a necessary balance to our normal tendency to overlook problems facing men and boys. It is normal for us to automatically favour women over men (Rudman & Goodwin, 2004). The roots of this ‘empathy gap’ are probably rooted in evolution, with men expected to provide protection, not receive it (Barry, 2016). When men are acting out emotional problems through antisocial behavior rather than talking to someone, our empathy for men, understandably, is reduced.  And it is precisely because we have so little time for men with difficult psychological/behavioural problems that male psychology is such a challenge.
  3. Male psychology looks to the future rather than the past
    The past has been replete with men trying to fulfill a role that was dangerous or damaging to them e.g. trying to be a hero, working in dangerous and damaging jobs, keeping their emotions under tight control.  We are looking to a future where men can feel good about their role in more fulfilling and harmonious ways, and express themselves in more positive ways.

For these reasons, male psychology brings a positive synergy and adds value to many areas in psychology. Although psychologists are already addressing male psychology issues in many fields of psychology, we would all benefit by working in a more holistic way, recognising the common element that unites these areas and can facilitate learning between them.

My challenge to you is to recognize the element of male psychology that already exists in the work that you do, and discover how this knowledge has the potential to impact your work in positive ways.

 

You can vote now (7th May 20th June) for a Male Psychology Section of the BPS.
Details are here http://www.malepsychology.org.uk/male-psychology-network/vote-for-a-male-psychology-section/

Open post

A Psychologist Among Veterans: Co-Producing The Veterans’ Stabliisation Programme

by Dr Roger Kingerlee

My starting point, on first meeting with a veteran of HM Armed Forces in the clinical setting, is that I already owe them a debt. As a civilian, I am conscious of the fact that all veterans have voluntarily put themselves forward to protect me and my fellow citizens against potential harm. In this sense, every veteran I meet has already done more for me than I ever will for them. This, as a civilian psychologist who also works with veterans, I never forget.

Much of my activity revolves around running our Veterans’ Stabilisation Programme (VSP) in Norfolk with my friend and colleague Luke Woodley, Founder of Walnut Tree Health and Wellbeing CIC. Partly via the Walnut Tree Facebook page, Luke engages local veterans, forming a key bridge into NHS services – including the 16-week VSP.

We wrote the VSP jointly, combining Luke’s own experience of combat-related post-traumatic stress, my knowledge of cognitive behavioural therapy (CBT), and our NHS colleague John King’s expertise in mindfulness meditation. In effect, the VSP offers veterans, the majority of whom are male, a bespoke psychological deconditioning process, allowing them to transition into civilian life more fully and more successfully.

Some of the key psychological matters here are invisible to the naked eye, which may help explain why they have taken so long to identify in the UK and beyond. The hidden combination, for example, of military training overlaid with aspects of post-traumatic stress can have profound – and often to individuals and their families – apparently inexplicable effects on day-to-day life. Faced, at times, with mounting emotional pressure, and feeling that there is no-one who can help, many veterans encounter real difficulties, often compounded by anxiety, low mood, and substance use to self-medicate. Understandably, this can spiral.

To counter this, in the VSP, we explore the psychological mechanics involved and how – directly based on Luke’s lived experience – to dismantle the machine. There is a pattern here: I explain the CBT; Luke translates this into military language and metaphor; then John soothes us all with the healing balm of mindfulness.

Quite rightly, most of our veterans are sceptical to begin with. But with military-grade courage in the form of radical openness, and on a more or less weekly basis within the group, Luke walks out into the historical no-man’s land of exploring male feelings in public. He lays bare how it was for him at his darkest hour – and how he clawed his way back to life. This is full mental self-disclosure, and peer role modelling, of the highest order, in true Forces’ spirit. When one man gives of himself and his experience so completely to others, shame is vanquished by hope. A privilege to witness, and to be part of. Where Luke leads, the group can follow, slowly but surely, towards the light.

Each VSP, too, has its own themes, according to the needs of the group. Some recur. One is sleep, since the traumas of the past often linger in the unconscious only to emerge at night, and may need a nudge that – thanks to advances in psychological science and practice – we can now give. Another is family relationships, which can be strained. Frequently, here, gains are possible via improved communication and understanding between partners and family members.

By the end of each VSP, we do our collective best to ensure that everyone has learned and, critically, applied, useful material to enhance their own stability. Some may need further specialist trauma therapy. Some may be ready to return to work, full- or part-time. Many, perhaps even all, feel ‘normal’ again, knowing that they are not alone. Far from it: they are among friends.

So, while my own civilian’s debt to these individuals can never be fully repaid, when they leave the VSP after 16 weeks I can feel that I have contributed at least something. With all the psychological skill I can muster, I have played a small part in explaining how it can help to begin to let go of aspects of the past, and to begin to seize the present. Or, as Luke puts it: it’s time to stop fighting and start living.

 

About the author

Dr Roger Kingerlee is a Consultant Clinical Psychologist at Norfolk and Suffolk NHS Foundation Trust. Roger and colleagues are presenting their latest research findings at the Male Psychology Conference on 23rd June http://www.malepsychology.org.uk/the-conference-2018/

Read more about the Walnut Tree Health and Wellbeing: https://www.facebook.com/walnuttreehw/

You can vote now for a Male Psychology Section of the BPS.
Details are here http://www.malepsychology.org.uk/male-psychology-network/vote-for-a-male-psychology-section/

 

 

 

 

 

Open post

What are the criticisms of the proposed Male Psychology Section, and are they valid?

by Dr John Barry and Martin Seager

Criticism and alternative views are part of science, and we at the Male Psychology Network have benefited from both. We welcome healthy debate, and have held two public debates at UCL in the past year.

After several years of listening to various opinions about male psychology, today we feel that we have developed the basis for a field that is of real scientific and humanitarian worth. Many people within and outside Psychology see the inclusive value in having a male psychology section of the BPS, so it’s perhaps surprising that there are still some people in the field of psychology who are actively opposed to the idea of promoting understanding of male gender issues. What could be the basis for such opposition?

The main source of opposition is a website by Dr Glen Jankowski, lecturer at Leeds Beckett University and committee member of the BPS Psychology of Women and Equalities Section. He claims to use feminist theory to justify his opposition to the creation of a Male Psychology Section. You can find his 6-page website here https://notomalepsych.wordpress.com/ and make up your own mind about it, but here we will simply point out some of the more glaring flaws packed densely into his brief website.

Page 1: The author claims that a feminist approach to masculinity will help men more than the approach advocated by the Male Psychology Network. Feminism is indeed one possible approach to masculinity but not the only one or the most promising from the viewpoint of men themselves. The feminist approach suggested by Dr Jankowski is predicated on negative views of masculinity rather than a sincere empathy for men experiencing mental health issues.

We believe that the notion that masculinity is somehow toxic and in need of wholesale reconstruction is in itself a toxic belief that does not reflect the scientific evidence or everyday life. The prevalence of these toxic views and the need to test them scientifically means that there is even more need for a Male Psychology Section, not less. We are not convinced that blaming masculinity or patriarchy for the mental health problems of men provides a basis for helping men. For example, the Duluth model of domestic violence is blind to the possibility that men can be victims of violence from women. This obviously is a total failure of science and a failure of compassion towards male victims given that men make up anything from 33-50% of the victims of domestic violence.

The author also claims that men are disproportionately advantaged over women (“the patriarchal dividend”). However he ignores a great deal of evidence of male disadvantage, for example, the fact that 75% of suicides are by men, 85% of rough sleepers are men and boys have been doing poorly in education compared to girls for some 30 years.  We suggest that the existence of differences, disadvantages and inequalities in either direction relating to gender are an argument for a Male Psychology Section, not against it.

Page 3: In an apparent attempt to minimise the significance of the fact that most suicides are by men, the author of the ‘say no’ website presents a graph showing that women think about suicide more than men do. No doubt contemplating suicide is serious in itself, but it is bad science and unempathic – especially for a psychologist – to conflate thinking about suicide with the completion of the act of suicide.

Page 4: The Male Psychology Network takes a balanced view of masculinity in both its positive and negative aspects. We have stated very clearly in publications and lectures that men are capable of committing terrible crimes (e.g. Barry, 2016). We are sincere in wanting to understand why these behaviours exist, and how we can address these problems as psychologists. The ‘say no’ website however seems to be arguing that we are trying to deny female suffering and victimhood. This is simply false and a ‘straw person’ argument, attributing beliefs and opinions to us that we have never expressed. We fully accept that women’s issues and victimhood need addressing too, and we hope that women too can benefit from our research. After all, men, women and children share this planet together.

Page 5: The ‘say no’ website tries to make the argument that our research, presentations and publications ignore minority men e.g. BME and gay men. This is simply incorrect. Our research is inclusive of all categories of men, and we are interested in masculinity as a whole. The available data suggests that suicide rates in black men are higher than in black women and higher in gay men than in gay women, thus although it is important to see suicide from an ethnic and sexuality perspective, we also need to recognise the ever-present gender perspective. Without a more scientific approach, the core gender issues behind suicide and other predominantly male behaviours are in danger of remaining overlooked.

Dr Jankowski’s categorisations of our work tend to obscure examples of minorities e.g. one of our most downloaded studies is one about Black men’s mental health (Roper & Barry, 2016). We have also done research in which ethnic and sexual minority variables are taken into account (e.g. Seager et al, 2014). Moreover, we would strongly argue that by and large our work is relevant to men in general, and minority men can benefit from our work. More recently, our work is increasingly focusing on the (less unpalatably “patriarchal”) working class men who make up the majority of prisoners, soldiers, drug addicts, and school drop-outs. The ‘say no’ website has overlooked this.

Page 6: The final page of the website reveals what might be the underlying reason for opposition to creating a Male Psychology Section: “We fear that the new proposed section will divert resources, effort and good will away from helping not only men but also women.”  This defensive ‘zero sum’ mindset is surely not what we want to see in a healthy scientific environment, and it is not clear to us how it can be reasonably argued that having a Male Psychology Section could be bad for men. As to women, who share their lives with men and boys, it must surely be a good thing if psychological science helps society to understand men better.

Dr Jankowski also claims in his website that there has been a lack of discussion about Male Psychology. However we have always been very open about our research, presentations and debates (which he seems to acknowledge on page 5 of his website), and although he has been invited to discuss or debate with us both privately and in public, to date he has not done so.

We think it is a shame that a new Section of the BPS that is potentially so useful to a huge number of people might be blocked by the misguided views of a few. We hope that this short article has helped to persuade you that a Male Psychology Section would be a positive and practical source of help not only for men and boys, but for the women and girls who share their lives.

 

About the authors                                                      

John Barry is a chartered psychologist and co-founder of the Male Psychology Network.

Martin Seager is a consultant clinical psychologist and co-founder of the Male Psychology Network

 

You can vote now for a Male Psychology Section of the BPS.
Details are here http://www.malepsychology.org.uk/male-psychology-network/vote-for-a-male-psychology-section/

 

References

Barry, J. (2016). Can psychology bridge the gender empathy gap? South West Review, Winter 2016, 31–36.

Roper, T., & Barry, J. A. (2016). Is having a haircut good for your mental health? New Male Studies5 (2), 58-74.

Seager M, Sullivan L, and Barry JA (2014).  Gender-Related Schemas and Suicidality: Validation of the Male and Female Traditional Gender Scripts Questionnaires. New Male Studies, 3, 3, 34-54

Open post

Boxing and mental health

by Dr John Barry

It is often said anecdotally that boxing is a good way to help wayward working class boys to learn to be more disciplined. The British Medical Asscociation (BMA) reject this suggestion as patronizing and say that boxing should be banned (White, 2007), but my guess is that wayward working class boys don’t want the BMA to dictate their life choices, and would consider their interference patronizing.

The life story of a boxer is depicted in popular culture as one of hardship and challenge, punctuated by moments of glory. There are many such depictions, from the fictional (e.g. Rocky) to the biographical (e.g. Raging Bull), but there has been little serious academic effort to understand the psychological life of boxers.

We often hear that boxers risk brain damage (‘punch drunk’ syndrome) (Roberts et al, 1990) and other brain injuries (Bernick & Banks, 2013). But the evidence for brain damage in boxing isn’t a no-brainer, as shown by the systematic review of amateur boxing in the British Medical Journal which concluded that “there is no strong evidence for brain injury” (Loosemore 2007, p.812).

Although there are mental health benefits of exercise in general (Callaghan, 2004) and boxing in particular (Bin et al, 2015), there is a tragedy inherent in arc of a competitive boxing career, as depicted so often in Hollywood. The window of opportunity to excel in sports such as boxing is generally limited to youth and early adulthood. Within this time frame, the quality of life of a sportsman may go from humble beginnings to fame and glory, and back to humble again, in the space of a decade or two. The impact on mental health of such a trajectory is potentially immense, and potentially devastating. And although this arc is fascinating from the point of view of Hollywood, the psychological impact of such a life course has received surprisingly little attention from academia.

This is not to say that the trajectory of a boxer’s career is definitely much worse than that of other sportsmen, though given the raw competitiveness of boxing and the extreme demands and rewards of this sport, it is easy to imagine that the highs and lows might be more extreme too. Knowing the importance of job satisfaction to men (Barry & Daubney, 2017), it is difficult to underestimate the impact of these highs and lows.

There is something about the primal nature of boxing that is fascinating. Boxers seem to epitomize the ‘Fight and Win’ rule (or ‘social script’) of traditional masculinity (Seager et al, 2014). However taking this ‘rule’ to an extreme can be predictive of suicidal thinking. The dangers of pushing the ‘Fight and Win’ rule to the extreme correspond with what we know about the stress-inducing consequences of making ‘rigid demands’ of ourselves (Ellis & Harper, 1961). This makes intuitive sense, as shown in a study where participants suggested that irrational beliefs (e.g. I absolutely have to win) were associated with the suicide of a fictional boxer (Sporrle and Forsterling, 2007).

So, is boxing good for mental health? I would love to see more research on this question. What we do know is that although 75% of suicides in the general population are male, men are less likely than women to seek psychological help (Kung, 2003). Although talking about feelings is almost always beneficial for everyone, we know that men are less inclined than women to want to deal with distress by talking about their feelings (Holloway et al, 2018), and some men prefer to use exercise as a way of dealing with stress (Frydenberg & Lewis, 1993). We also know that male depression can sometimes be expressed through aggressive or even violent behavior (Brownhill et al, 2005).

Putting all of this information together, is it not a huge stretch of the imagination to suggest that men might find mental health benefits in boxing. However these benefits are probably masked by other factors, for example, the people who are the most attracted to boxing may have long-standing issues related to being raised in harsh environments, the fact that there is a risk of brain injury and cognitive impairment, and the fact that those taking a career in boxing may be in for a life of extreme highs and lows. Also, helping boxers with mental health issues is likely to be a complex task because therapists simply demanding that they talk about their feelings is unlikely to be the best way to get them to talk about their feelings.

Should we ban boxing, as the BMA suggest? I don’t think so. Rather, we should properly investigate the potential benefits. Should psychologists do more to support those who go into boxing? Definitely yes. Many boxers may have experienced a harsh early environment, and boxing is one way of keeping feelings and behaviours in check. Psychologists might offer other coping strategies, and be more aware of the stressors typical of the boxer’s life trajectory.

 

About the author

Dr John Barry is a chartered psychologist and co-founder of the Male Psychology Network. http://www.malepsychology.org.uk/male-psychology-network/about-us/

  Vote for a Male Psychology of the BPS between 7th May and 20th June.
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References

Bernick, C., & Banks, S. (2013). What boxing tells us about repetitive head trauma and the brain. Alzheimer’s research & therapy5(3), 23.

Bin, W. A. N. G., Yang-cai, X. U., Zhi-kun, W. U., Hua-ping, X. U., & Dong-ying, W. A. N. G. (2015). Effect of wushu boxing teaching on college students’ physical and mental health. Education of Chinese Medicine1, 009.

Brownhill, S., Wilhelm, K., Barclay, L., & Schmied, V. (2005). ‘Big build’: hidden depression in men. Australian and New Zealand Journal of Psychiatry, 39(10), 921-931.

Callaghan, P. (2004). Exercise: a neglected intervention in mental health care?. Journal of psychiatric and mental health nursing11(4), 476-483.

Albert, E., & Harper Robert, A. (1961). A Guide to Rational Living. Hollywood: Wehman Brothers.

Frydenberg, E., & Lewis, R. (1993). Boys play sport and girls turn to others: Age, gender and ethnicity as determinants of coping. Journal of adolescence16(3), 253.

Loosemore, M., Knowles, C. H., & Whyte, G. P. (2007). Amateur boxing and risk of chronic traumatic brain injury: systematic review of observational studies. Bmj, 335(7624), 809.

Roberts, G. W., Allsop, D., & Bruton, C. (1990). The occult aftermath of boxing. Journal of Neurology, Neurosurgery & Psychiatry53(5), 373-378.

Seager, M., Sullivan, L., & Barry, J. (2014). Gender-related schemas and suicidality: Validation of the male and female traditional gender scripts questionnaires. New Male Studies, 3(3), 34-54.

White, C. (2007). Mixed martial arts and boxing should be banned, says BMA. BMJ: British Medical Journal, 335(7618), 469.

 

 

 

 

 

 

 

 

Open post

A conversation evolving away from toxic masculinity and towards positive masculinity

by Dr John Barry

I got an email a couple of weeks ago asking if I wanted to be on a panel discussing ‘What does it mean to be a man?’ by a new group called Can We Just Ask?

This isn’t an excitingly new question, but it looked like a good opportunity to – given the negative narratives around men and masculinity these days – take the opportunity to add balance to the discussion. The format seemed interesting – no presentations or lectures, just straight to Q&A. Also I knew from the media that the opinions of the other panel members would create a diversity of thought.

The other panel members were writer & performer Jordan Stephens, best known for being half of the hip hop duo Rizzle Kicks, and journalist & author Poorna Bell who suffered the tragic loss of her husband to suicide in May 2015.

So a few days ago (31st May 2018) I went to the very salubrious MindSpace in Shoreditch, Central London. It was a sunny evening in late May and we were given a friendly welcome by Alice and Will of Can We Just Ask.

To cut a long story short, some of the issues discussed included men’s mental health, representations of men in the media, toxic masculinity, and why we need to be more positive about masculinity.

Although it’s clear that we didn’t agree on all points, you can see that over the course of the discussion we were converging towards some agreement on the major brush strokes. Overall I think the discussion was positive and thought provoking, with minimal cross-talking or grandstanding.

Well done to Annie and Will for creating such a good forum for intelligent discussion.

You can watch the video of the whole discussion here [here]

 

About the author

Dr John Barry is a chartered psychologist and co-founder of the Male Psychology Network

 

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Open post

Gender blindness is not a blindfold of impartiality

by Dr John Barry

First published on the BPS blog spot on 21st April 2017 https://www.bps.org.uk/blogs/dr-john-barry/gender-blindness-not-blindfold-impartiality

 

A: “Well, we’re academics, so we know we’re pretty objective when it comes to research”

B: “We think we are, but what if collectively we can’t see our biases about gender?”

A: “Oh yeah, but we have unconscious bias training for that”

B: “But what if that is part of the bias”

A: [Silence]

B: “What if not recognizing gender differences is a cognitive bias. What if this bias is causing us to do more harm than good?”

A: [Silence]

 

 

You might end up having the same type of conversation if you try to point out, as I did recently, that academia sometimes has a blind spot for problems facing men and boys.

The truth is that psychologists are, by and large, some of the most well-intentioned people you will find. We all want to do the right thing, to help people, and mostly we succeed.

For example, we have created all sorts of techniques and procedures to reduce human suffering, and we agonise over how well these techniques work, how we can improve them, how widely they can be applied.

But what if we are like a shoe maker who creates lots of styles of shoe, but only in one size?

For many customers the shoe will more or less fit, but for others it won’t fit at all.

In research into the gendered needs of men and women in therapy, we have found that, in general terms, women want to talk about their feelings and men just want a quick solution (Russ et al, 2015; Lemkey et al, 2016; Holloway et al, [2018]).

But psychologists mainly offer therapies based around discussing feelings – a single size of shoe, that isn’t always a good fit for men.

We have also found that many therapists are somewhat uneasy about fully accepting that there are gender differences in their clients (Russ et al, 2015; Holloway et al, [2018]), and experience cognitive dissonance when asked to think about the sex differences they routinely observe.

This tendency would be harmless, except that some gender differences are clinically important – for example, men commit suicide more than women do (ONS, 2015) but seek therapy less (Kung, 2003)

If we are disinclined to explore the reasons for this because thinking about gender differences makes us feel uncomfortable, then we have become a helping profession incapable of helping.

How widespread is this problem? ‘Beta bias’ in research – the tendency to ignore or minimise gender differences – emerged in the 1970s (Hare-Mustin & Marecek, 1988), and today ideas such as Hyde’s (2005) ‘gender similarities hypothesis’ prevail.

But what if beta bias – like Type II errors in research – has led to an inadvertent neglect of men and boys? Have we, sincere and well-meaning psychologists, been trying so hard to defeat sexism that we have inadvertently created a different kind?

But… before we start feeling guilty and blaming ourselves, we need to realise that the roots of what Seager et al (2014) call male gender blindness go much deeper than modern psychology.

Indeed the origins are probably in the evolution of our species, rooted in our tendency to see men as the strong protectors of society, and not typically people in need of protection (Seager, Farrell and Barry, 2016), which perhaps explains why there appears to be a difference in how much sympathy we have for men and women experiencing the same types of problem (the gender empathy gap; Barry, 2016).

For example, when we see a drunk man picking a fight in the street, our first thought is not ‘poor man, acting out his childhood trauma,’ instead we think ‘what an idiot – lock him up!’

So it’s not our fault that we are so easily led away from seeing male suffering – we can blame evolution for that. But as psychologists, it is our responsibility and professional duty to make sure that we do what we can to meet the needs of everyone, even if it means having to face up to gender differences.

 

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About the author

Dr John Barry is a chartered psychologist and co-founder of the Male Psychology Network.

 

References

Barry, J. (2016). Can psychology bridge the gender empathy gap? South West Review, 4, 31-36 http://www.malepsychology.org.uk/wp-content/uploads/2016/08/gender-empathy-gap-BPS-SW-Review-Barry-Winter-2016-author-copy.pdf

Hyde, J. S. (2005). The gender similarities hypothesis. American psychologist, 60(6), 581.

Holloway, K., Seager, M., and Barry, J.A. [2018]. Are clinical psychologists and psychotherapists overlooking the gender-related needs of their clients? [Clinical Psychology Forum, July 2018]

Kung, H. C., Pearson, J. L., & Liu, X. (2003). Risk factors for male and female suicide decedents ages 15–64 in the United States. Social psychiatry and psychiatric epidemiology38(8), 419-426 https://link.springer.com/article/10.1007/s00127-003-0656-x

Lemkey, L., Brown, B., & Barry, J. A. (2015). Gender distinctions: Should we be more sensitive to the different therapeutic needs of men and women in clinical hypnosis? Findings from a pilot interview study. Australian Journal of Clinical Hypnotherapy & Hypnosis, 37(2), 10 http://www.malepsychology.org.uk/wp-content/uploads/2016/08/gender-distinctions-in-clinical-hypnosis-Lemkey-Brown-Barry-2016-1.pdf

ONS, Office of National Statistics (2015). Suicide rates in the United Kingdom, 2013 Registrations http://tinyurl.com/mzplbzr

Russ, S., Ellam-Dyson, V., Seager, M., & Barry, J.A. (2015). Coaches’ Views on Differences in Treatment Style for Male and Female Clients. New Male Studies, 4(3) http://www.malepsychology.org.uk/wp-content/uploads/2016/08/coaching-gender-differences-Russ-et-al-2015-author-copy.pdf

Seager, M., Sullivan, L., and Barry, J.A. (2014). The Male Psychology Conference, University College London, June 2014. New Male Studies, 3, 41-68 http://www.malepsychology.org.uk/wp-content/uploads/2016/08/Male-Psychology-Conf-NMS-Seager-et-al-2014.pdf

Seager, M., Farrell, W. & Barry, J.A. (2016). The Male Gender Empathy Gap: Time for psychology to take action. New Male Studies5(2), 6-16 http://www.malepsychology.org.uk/wp-content/uploads/2016/08/article-2-.pdf

Open post

Helping Male Survivors of Sexual Violation to Recover

Men who have experienced sexual violation often have a kind of invisibility in the world. They are not prominent in literature about therapy, in research about sexual violation, or even generally in the public awareness. This has begun to change somewhat, recently, in the aftermath of the revelations about high-profile predatory figures in the media world and the abuse of young males in football and other sports. But, on the whole, the idea of a man or a male child being raped, sexually abused, manipulated or used by another is still a deep taboo for many people.

If we cannot face this taboo, we are collectively failing to look into the reason behind an enormous amount of suffering and even of death.

In an article in Therapy Today, Phil Mitchell, himself a male survivor of sexual violation and a specialist clinician in this field, makes the point that ‘Of the 6,188 suicides registered in the UK in 2015, three quarters were males. It could be argued that, for some males, especially those who have been sexually exploited, death can be seen as preferable to being seen as less of a man’ (Mitchell 2017).

Sadly, even some in the caring professions continue to feel that there is something so grotesquely awful and unthinkable, so incomprehensible – or even downright unbelievable – about a man or boy being sexually hurt or objectified, that they fear they do not have what it takes to be able to work with this issue or do not wish to even attempt it. In a systematic review of research published online in the International Journal of Mental Health Nursing, only 22 per cent of people using statutory mental health services are ever asked by mental health staff about previous experiences of abuse. Of those who were asked, women patients were far more likely to be asked than male patients (Read et al. 2017).

I wrote a book about effective therapy for male survivors of abuse, which was published by Jessica Kingsley in April 2018: ‘Helping Male Survivors of Sexual Violation to Recover. Stories from Therapy.‘ Part of my motivation in writing it was to honour the courage and the determination to heal shown by the many men I have accompanied in their therapeutic work over the last 17 years.

Another reason I wrote the book was to encourage and embolden those in the helping professions who think they might not have the capacity or skill to support this client group. My hope is that the book will help them trust that they certainly can be of use to male survivors of sexual abuse, whenever they offer a combination of warmth and rigorous thinking within the context of a respectful relationship.

The book takes the form of fictionalised case studies of 7 male survivors from a wide range of backgrounds, ages, and tells the story of the therapy for each one. The common theme, in all the stories  – no matter what the age, education, income, sexuality or family background of the individual coming for support  – is that male survivors have a particular burden that they carry, to do with the deeply held belief that a male should be strong and tough.

Even when this belief is not held consciously, and even when it is vigorously rejected on a conscious level, its roots still seem to go deep, both within many individuals and within our collective. So, in a culture where boys and men cannot help but take on board certain fundamental messages about males needing to embody strength, power, and being in control, when they have not been able to embody those qualities, eg. when they have experienced sexual abuse, they are left with almost intolerable grief, anger and, most crucially, shame.

The American psychologist Silvan Tomkins explains why the shame after abuse is so shattering for men:

“Though terror speaks of life and death, and distress makes the world a vale of tears, yet shame strikes deepest into the heart of man. While terror and distress hurt, they are wounds inflicted from the outside which penetrate the smooth surface of the ego; but shame is felt as an inner torment, as sickness of the soul. It does not matter whether the humiliated one has been shamed by derisive laughter or whether he mocks himself. In either event he feels himself naked, defeated, alienated, lacking in dignity or worth” (Tomkins, 1963).

The good news is that the healing balm for the stinging shame Tomkins describes is available to any man whenever he is able to speak, and feel understood and supported about an experience that has left him with shame. Individual therapy, as well as other sources of emotional and psychological support, such as compassionate friends and/or a partner, and being part of an accepting group or team, can all provide opportunities for this vital dissolving of shame. It seems a simple thing.

But there are still too few opportunities for men and boys to feel helped in this way. There are still too many men and boys staring into an abyss of isolation and a feeling that they are alone and fatally flawed for having once been helpless and vulnerable when they were abused.

 

‘Helping Male Survivors of Sexual Violation to Recover: An integrative approach – stories from therapy’  by Sarah Van Gogh is published by Jessica Kingsley. The book is available at a 20% discount from the regular price of £22.99  for readers of the Male Psychology Network blog from www.jkp.com/uk/products using reader offer code ‘SVG’.

 

About the author

Sarah Van Gogh has worked as a counsellor in private practice for many years and is on the training staff at the Re.Vision Centre for Integrative Transpersonal Counselling and Psychotherapy in North London. She also worked for seven years as a counsellor and trainer for Survivors UK, a London charity that provides support to men who have experienced sexual violation. She studied English at Cambridge University, worked in the fields of theatre, community health and adult education, and has written about the vital connection between the expressive arts and therapy for a number of journals. She writes a regular column in the BACP Private Practice Journal.

 

References

Mitchell, P. (2017) ‘Boys can be victims too’. Therapy Today 28(8), 34–7.

Read, J., Harper, D., Tucker, I. and Kennedy, A. (2017) ‘Do adult mental health services identify child abuse and neglect? A systematic review’. International Journal of Mental Health Nursing    27(1), 7–19.

Tomkins, S. (1963) Affect/Imagery/Consciousness: Vol 2. The Negative Affects. New York: Springer.

 

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