Monday, November 2, 2015

Therapy for Men

America doesn’t have enough mental health professionals. So explains Melissa Dahl in New York Magazine.

We do not know why this should be so but we suspect that one reason is that therapists do not, by and large, do a very good job. Such is certainly true of psychoanalytic and insight-oriented therapies. One suspects that the field has become far too politically correct, more likely to try to indoctrinate than to treat people.

Or else, therapy does not do as good a job as medication. Since any physician can prescribe psychotropic medications, why bother with a therapist. While new forms of therapy, like cognitive and behavioral therapies, have been shown to be more effective than the old style psychoanalysis, nothing is quite as simple as taking a pill.

But, these are not the only reasons for the shortage. Another reason is that the world of therapy, especially psychology and social work has increasingly become a pink ghetto. Therapy has become women’s work. It’s not just that men have been marginalized. They no longer see it as a viable career option. Fewer and fewer men enter the field and those who do are more likely to be in closer touch with their feminine sides. 

Today’s therapy is more like more mothering and nursing, and this is not what men are good at and it is not what they need or want.

Today’s therapists have a vocabulary that consists of two words: feeling and control. If these words suddenly disappeared from the language, most of today’s therapists would be struck dumb.

Therapists like to ask their patients: how did that make you feel, what do you really feel about that. Then they will tell you to express your feelings, openly and honestly and shamelessly. Obviously, they are not healing you. They are making you into a drama queen. If you don't agree they will say that you have control issues.

There is nothing mysterious about the fact that men are turned off by this. They believe that they are being taught a foreign language and that they are being disrespected by people who refuse to accept them for what they are, or who want them to feel guilty for being men.

Today’s feminized therapy tries to help men to get in touch with their feminine sides and devalues and disparages manly behavior… as sexist. Not only is the field becoming overrun with women, but the women who are involved are ideologically driven; often they are feminists. They offer indoctrination disguised as treatment.

Thus, fewer and fewer men are going into the field. When a man has a problem he will be facing the choice of talking to a woman (who is likely to condescend to him) or doing nothing. More often than not he will do nothing.

In the state of Colorado an ad agency concocted a new way to lure men into therapy. It created a fictional character called Dr. Rich Mahogany—thus named because he is wooden—and put him on a website that is designed to treat men like men. Lizzie Crocker reports the story for The Daily Beast.

I reproduce the picture of Dr. Rich Mahogany that Crocker took from Youtube to suggest, kindly, that if this is the ad agency’s idea of a manly man, it should get into a new line of work.

Or better, if this is what passes for manliness in America today, the country is in even bigger trouble than I thought.

Of course, Crocker advises, Dr. Rich is a caricature. Yet, the service he is offering is perfectly serious:

Dr. Rich Mahogany, a mustachioed man with a paunch and a penchant for cursing, orders visitors to his taxidermy-filled office to “take a knee.”

He promises they’re in a safe space where “men come to be men,” as evidenced by the leather furniture and sports equipment in the corner.

Mahogany doesn’t tolerate “complaining, whining, and moping about,” but insists even “real men” could benefit from a man-to-man chat about their mental health.

It’s called “Man Therapy,” and while Mahogany is both a fictional character and a caricature of masculine stereotypes, the services he runs out of his virtual office are not a joke. He is the Internet’s macho, middle-aged answer to Mrs. Doubtfire.

“We’ll be getting off our keisters and form-tackling feelings like anger, sadness, substance abuse, and even suicidal thoughts head on!” he tells visitors to the website, a 24/7 online service that encourages men to seek help for mental health issues who wouldn’t ordinarily do so.

But, if you want to offer therapy to men why would you present them with a caricature? Moreover, Dr. Rich tells men that he is going to help them to get in touch with their feelings. Isn’t that the problem? Isn’t that why men do not go to therapy?

They have had it with all the feeling-talk and are smart enough not to fall for it, even gussied up and spoken by an insulting caricature.

What do you think that men make of the notion that if they want to get involved in an especially manly activity, they should try bird watching. No kidding.

In my experience men prefer to have a coach who will help them to plan and organize their lives rather than a therapist who wants them to get in touch with their feelings.

It is easy to say that the pink ghetto of therapy is made to exclude men. And yet, how much help is it really offering women? It is not at all obvious that today’s women, with one or both feet in the business or professional world will be helped by learning how to introspect and to get in touch with their feelings. Is that the best that a woman can offer to the marketplace, her feelings?


Ares Olympus said...

Wow, that's a good rant against therapy.

And what do men want?
Stuart: In my experience men prefer to have a coach who will help them to plan and organize their lives rather than a therapist who wants them to get in touch with their feelings.

So what we want is to expand the number of competent (life, executive, and relationship) coaches out there who can help men. But it might be finding a good coach is just as difficult as finding a good therapy. And I imagine male therapists will be more than happy to expand their credentials and call themselves coaches, if that's what it takes to find new clients, who want to avoid the stigma of therapy, but in fact do 90% of everything exactly the same as if they were a therapist.

So what we really need is a way to distinguish a Coach from a Therapist, so if we see a Coach and he starts acting like a Therapist, we can say "No, that's how a therapist talk. I want a coach." And it would be a shame if "Life coaches" were to become just as despicable as therapists someday, when statistically you find 99% of them are useless.

I mean consider new age things like "The Secret". How many "Life Coaches" have something like that as their belief system to explain how to be successful?

How do we avoid those people who are two steps worse than idealistic therapists who believe talk therapy helps?

Maybe articles like this would help?
1. We’re the Wild West of helping professions.
2. We’re credentialed, for whatever that’s worth.
3. It’s impossible to separate the personal and the professional.
4. I can’t promise you confidentiality.
5. We can get you unstuck, but we’re not shrinks.
6. We’re on our second career…or our second chance.
7. We won’t tell you what to do.
8. Friends can offer you the same help — for free.
9. We have a financial interest in your dependence on us.
10. Our impact can be hard to quantify.

Ares Olympus said...

Google found me Stuart's old blog from 2009, so here's a quick paste about coaching:
Thanks to Meridith Levinson and Bruce Rosenstein we can now attempt to provide a concept and a face for life coaching.

The concept is self-management in different worlds. The face is that of noted management theory guru Peter Drucker.

A life coach would be happier if you mastered the lessons of Miss Manners than if you slogged your way through Freud's "The Interpretation of Dreams."

Life coaching assumes that your life is something you can learn to manage more effectively. As Drucker suggests, your life involves you in several different worlds, thus, it requires different skills depending on the world you are inhabiting at a particular moment.

In life coaching there is no one-size-fits-all notion that once you remove what is preventing you from succeeding you will just naturally get better.

Life coaching shows you when to step back to analyze a situation, and how to judge the value of your actions as a function of the results produced.

Since life coaching sees you as a social being, it works to apply ethical principles to each of the different worlds you inhabit, to encourage you to be generous and respectful, courteous and polite, to be a team player and to accept responsibility for your failures as well as your successes.

The only thing I might add, from a men's group I was a part of for a while ( incidentally), is the idea of accountability. When you tell another man or coach you're going to do something, you've made a commitment to it, one that is a step stronger than just a commitment you made in your mind. And so my group had the concept of "a stretch" which was basically something concrete you know you can do, but you could also avoid, and report back to the group on the results.

And the coach or group can challenge clarity of the action, and make sure it is stated in a way that is successful just by doing it, rather than demanding specific outcomes that are beyond our control.

The process seemed to work by (1) Having a vision in our minds of something we want to do or change (2) Create a concrete plan for action (2) Performing the action as best one can (3) Reflecting on the difference between the vision and actual performance, and adjusting the vision for future action based on the new experiences.

And all of that can be done alone, but again, having someone else to help keep the process on track is surely helpful. And role-playing can also be helpful, like for social interactions having the coach play someone else, or switch it around, and have the coach play you, and working through the possible outcomes, between a cooperative and noncooperative other.

Anonymous said...

Forming and executing human plans is "mission impossible" without generating feelings. Either the person must generate feelings while making plans and acting on them, or he is paying for help from a mommy-like or daddy-like coach or therapist to help form and execute plans. Someone must process emotions in the process or we are robots (no emotions) or animals (all emotions).

Spinoza correctly asserts that emotion, a feeling accompanied by an idea about its cause, is the basis for emergent reasoning, the ability to form plans and guide actions. If one has no internal model of the emotional consequences of action for self and others then one is operating as what William James called a human crocodile or boa constrictor.

Ares Olympus said...

Anonymous @8:47am said: Forming and executing human plans is "mission impossible" without generating feelings.

I don't disagree with you, but Stuart is touchy on the touchy-feely side of things and believes most men are also, so we blog-coaches, I mean commenters, have to be careful to work within his thought constraints.

I have seen two different models for feelings. One model apparently says feelings are innate, and another (as used by the New Warrior program, and NVC Nonviolent Communication) says our feelings arise from our thoughts and judgements, and thus are derivations, and within our ability to change, that is by changing our interpretations of events.

Specifically the model goes like this (1) Observation (2) Interpreations or Judgments (3) Feelings (4) Action or reaction.

So deprocessing comes by slowing down our reactions and separating observable facts from our judgments of those facts. And when we do that, we can see we have a choice for contradictory interpretations which might all be partially true, or all incomplete, and each creating a different set of feelings, and offering different course for action.

So in part that's why things like Norman Vincent Peale's Power of positive thinking works, and why he says "Change your thoughts and you change your world."

But of course that once we realize we have different possible interpretations, then some of them might be truer, or more useful than others. So when Neville Chamberlain talked to Hitler, he saw Hitler as a man like himself, and saw someone who didn't want war, and just wanted a fair hearing, and fair outcomes. But meanwhile that interpretation allowed Hitler time to further his conquest goals unimpeded. So Gandhi or Peale might try to use positive thinking to change the world, and find only the power to deceive themselves until it was too late to act.

So again, perhaps that's also why its important to separate Observations from Interpretations, and then you can acknowledge different interpretations are all possible and keep them all, and as new facts are gathered, you can perhaps decide some interpretations are better than others and change change course based on them.

It is all tricky, and we can deceive ourselves in any direction, seeing evil where there is none, and seeing goodness when you don't want to see evil. Or worse, failing to see our own hypocritical and divided nature which wants the greatest rewards at the lowest immediate cost.

And we were talking about global warming recently. So if scientists are greedy bastards or nervous nellies, they might have great conviction in their beliefs, but we shouldn't trust them too quickly, at least in terms of dramatic course changes.

So we just don't know, and science isn't going to answer our worries. Somehow we need belief to act, and a conviction that there's a future for humanity without fossil fuels. And a future where we're not just serfs to the new global elite who charge us to breath every day. So if there's no acceptable future without fossil fuels, we might as well just keep going on status quo, until necessity invents something for us in the nick of time, and hope its not World War III or an avian flu that saves us by killing 90% of us.

Fortunately the gods of free will and Life Coaches don't want to tell us what to do, so we have to decide on our own, and bear the costs for our decisions, including the costs of refusing to decide.

sestamibi said...

And here we seem poised to elect someone as president of the US who says we have to empathize with our enemies.

The cuntification of America is complete.

Anonymous said...

I agree with Stuart.
The time I went to a therapist, I wanted help to stop having the feelings that were over activating my HPA, not experience them more.
The therapist was a woman, "progressive" and New Agey, although she tried not to let that show.
After spending ~ $5000, all I got out of it that was useful were the ideas that if I take ownership of my feelings instead of blaming them on some else I have the power to change them instead of victim posturing, and that I'm not responsible for my woman's insecurity about my fidelity (she was correct in that case).

Anonymous said...

Feelings are primary in early childhood and among lower mammals. These creatures do not express conceptual ideas on the level of a reasoning adult. A child cannot be held guilty of a tort (causing harm to another person) until attaining the age of reason. To be guilty of a tort one must recognize what is beneficial or harmful to others and have a causal model of how the self becomes the cause of such harm to others via action. Since children obviously have emotions yet lack causal ideas it is not logical to conclude that adults are driven by reason in the absence of feelings. Prudence, the ability to govern one's actions by an application of reason, must be gained from refining one's infantile ideas about the causes of one's feelings to correspond with adequate causal ideas.

Stewart does not appear to be overly concerned with introspection to observe how the mind operates both in early childhood (highly emotional with emerging ideas) and later as an adult (less emotional with some causal ideas and many iconic ideas).

The primary plan (desire) of any mammal in its right mind would be to secure the services of an external parent and caregiver. Freud, who thinks the sons desire to kill the father and marry the mother, is obviously out of his right mind as a mammal, which suggests he repressed the desire for the father's love, even though Jesus expressed this desire as an open secret in the words of the Lord's Prayer. Hitler wanted to create a Fatherland whereas Jesus taught us to seek first the knowledge of the Father in heaven (the desire for good fathering on earth which one can only discover in the introspective realm before expressing it in outer society).

Stuart Schneiderman said...

Please spell my name correctly.

Ares Olympus said...

Anon @1:56pm: ... Since children obviously have emotions yet lack causal ideas it is not logical to conclude that adults are driven by reason in the absence of feelings.

I'm not sure I understand this assertion, mainly the first part about children. That is I'm sure children at some fairly young age have understanding of causal ideas, but the problem is whether those ideas are based on sound reason or not. So some beliefs may come out more like superstition, seeing cause and effect that isn't realistic.

Like a 3-year-old child can feel in his gut he "causes" his alcoholic parent's rage, and it can be true in a stimulus-response sense, but not by actual responsibility or power to change it.

A child who internalizes his parent's reactivity will try to compensate by "being good", and not question that responsibility, that feeling of duty to not anger his parent, or talk back, or ask uncomfortable questions. Adults who grow up in households like that then can continue the same mistake, as every addict's enabler can attest.

So introspection and reason can help a codependent personality intellectually understand he is not responsible for other people's behavior, but at a feeling level, it may be harder to stop, since the alternative is to feel powerless, and risks judging someone whom you believe you need to feel safe with.

I imagine a Life Coach can help "correct" irrational beliefs in a client, but its probably more important for a Coach to suggest alternative strategies for feeling safety than irrational self-blame.

And I can see a problem of a friend or Coach who will be impatient with irrational feelings, and just try to "fix" them without dealing with the irrational feelings expect to dismiss them and pretend reason is enough. So a therapist might do better with patience to help "wean" a client off irrational feelings.

Like Libertarian Stefan Molyneux likes to give relationship advice and his solution is always for people to leave or break away from abusive family and friends, to cut contact, but if you do that too easily, vulnerable people can just fall back into the same sort of abusive relationships with someone else. Or a vulnerable person can reverse from a passive anger into active rage, and become an abuser himself, and not see what he's doing.

So there's a lot of responsibility if a therapist or coach or friend doesn't know what he's doing, or if he's working though his own irrational feelings with one-sided advice.