Working With Troubled Men

A Contemporary Practitioner's Guide

Morley D. Glicken

• Publisher: Routledge
• Year: 2006
• ISBN:
  9781135611606
• Edition: 1
• Topic: Médecine
• Subtopic: Santé générale

This book offers a concise, readable, research-grounded synthesis of the special concerns mental health and other helping professionals need to address when working with men today, and explains a wealth of effective gender-specific approaches to assessment and intervention that result in more successful outcomes for male clients.Many more women than men seek counseling and therapy, and to some extent standard services have evolved in response to female styles of communicating and problem-solving. Practitioners frequently feel frustrated and baffled by their male clients because they seem unresponsive to treatment approaches that work so well for women. But many men benefit from therapy when practitioners understand male socialization and the ways men communicate and problem-solve.Too many men today are doing badly and are in real need of help. Almost half of America's male children grow up in single parent homes headed by mothers, where they seldom have male mentors or role models. Fewer men than women attend or graduate from college, and increasing levels of binge drinking and date rape on campuses paint a discouraging picture of men on campus. Male violence continues to be a serious problem in many American communities, with male youth violence continuing at epidemic levels. Men die younger than women overall and in much higher proportions from suicide, homicide, and cirrhosis of the liver.

PART I

The Serious Problems Experienced by Men

Chapter 1

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The Troubled Lives of Men

This book about men is written for clinicians who work with male clients but often have limited research information to guide their practice. Men are not typical clients for most clinicians. If they do come for therapy, it’s often because they must: courts have referred them for excessive DWIs or domestic violence, or a spouse has demanded that unwanted behaviors in the relationship must stop or the man risks losing the relationship. Men may be referred by physicians because of self-destructive behaviors that are often seen by other men as desirable, and even essential, to being a man. Employers refer men because of concerns about sexual harassment or workplace violence. The involuntary nature of a man’s use of therapy is complicated by the fact that men often view therapy as feminizing and their resistance to the process can be considerable. Imagine then the clinician working with men who are often involuntary clients and who view the process of therapy as ineffective and in conflict with their roles as men, and you get a sense of the complexities of clinical work with men.

But men often respond well to therapy and make significant gains. Many men are unhappy with the self-destructive paths they’ve chosen. They know that continuing certain beliefs and behaviors will lead to extreme difficulty in their lives. Although they fight the idea of therapy, once it begins, they are often grateful and highly motivated to change. Real change is more likely when the help they receive is respectful, practical, intelligent, supportive, and reassuring, attributes of therapy that may be lacking in our work with many difficult clients but are frequently absent in our work with men. As I note throughout the volume in discussions of treatment attrition, length of time for change to take place, and best evidence of long-term change, our approach to treatment with men requires a uniquely different way of doing psychotherapy. Just as women have argued for a gender-sensitive approach to therapy, men require an approach that is mindful of male development and male roles. And if male therapy is still in a developmental state, hopefullythis book will help bring together what we currently know about successful work with men and make our treatment with men just a bit more successful.

The following chapters explain why men are in such difficulty and provide direction from the research literature suggesting best evidence for practice. The research literature on the treatment of men is by no means extensive, but it is evolving and I have tried to use the research literature to provide guidance to clinicians working with men in today’s changing clinical environment.

Many men feel discounted because they believe that the playing field in the workplace, in education, and in future life opportunities is unfair. One wants to be objective about this feeling of discontent because the gains women have made are satisfying, if still too limited. Because I want to write honestly about the way men feel, there is always the chance that a volume about men written by a man will be overly sympathetic when the purpose of the volume is rather, to share the concerns men often share with other men but are sometimes afraid to discuss publicly. There is a great deal of anxiety among men that anything they say about gender issues will reflect political incorrectness or hostility toward women. This is particularly true in the academy and in corporate America where sexual harassment and sensitivity to women are often taken very seriously and sometimes result in unfair treatment to men. To help with objectivity, a critical analysis of the volume by female clinicians and academics, offering feedback and rebuttal, is provided in the final chapter. Hopefully, you will find this a balanced way of presenting material, which can be highly emotional for both genders.

EVIDENCE OF MALE DIFFICULTIES

A considerable amount of data suggests that many men experience serious emotional, physical, and social problems throughout the life span. These data on men’s lives are presented in much more detail throughout the volume but a brief summary is offered now to lay the groundwork for future chapters. Consider some of the findings reported by Courtenay (1998).

Men in the United States die seven years younger than women and have higher death rates for all fifteen leading causes of death. Men’s age-adjusted death rate for heart disease is twice as high as that of women, and the death rate for cancer is much higher. Men are more likely than women to suffer severe chronic conditions and fatal diseases, and to suffer them at an earlier age. Under the age of 65, three out of four people who die from heart attacks are men. Men’s cancer death rates have increased more than twenty percent over the past 35 years, while the rates for women have remained unchanged during the same period.

In additional data reported by Courtenay, among 15- to 24-year-olds nationally, more than three out of every four deaths each year are men. Among adolescents, males are more likely than females to be hospitalized for injuries. Fatal injuries account for over 80% of all deaths among 15-to 24-year-old men, and three out of four unintentional injury deaths in this age group are men. Young men in this age group are also at far greater risk than women for sexually transmitted diseases (STDs). Heart disease deaths are nearly twice as high for men as for women in this age group, and cancer deaths are also higher. Most of these deaths, diseases, and injuries are preventable

Other evidence of male problems are equally troublesome. Slater (2003) reports that 900,000 Black men are in prison as compared to 600,000 Black men attending college, junior college, or vocational training programs, or half the number of African American women attending American colleges and universities. The discrepancy between Black male and female college attendance will result in such an imbalance of college-educated men to women that it could alter the “social dynamics” of the African American community (Roach, 2001).

Epidemic increases in male juvenile crime suggest another serious problem for men. Commenting on the significance of the increase in male-dominated juvenile crime, Osofsky and Osofsky (200 1) write, “the homicide rate among males 15-24 years old in the United States is 10 times higher than in Canada, 15 times higher than in Australia, and 28 times higher than in France or Germany” (p. 287). Wolfgang (1972) reports that six to seven percent of all boys in a given birth year will become chronic offenders and that these same six to seven percent will commit most of the violent crime in America throughout their life cycle. Adding to concerns about male youth violence, Svaboda (2002) writes, “Boys are in most areas and by most measures doing abysmally today” (p. 67).

In another area of serious male difficulty, men increasingly lag behind women in higher education. Women receive an average of 57% of the bachelor’s degrees and 58% of all master’s degrees in the United States, or, 133 women are getting bachelor’s degrees for every 100 men, a number that will increase to 142 women per 100 men by 2010, according to the U.S. Department of Education (Conlin, 2003). If current trends continue, there will be 156 women per 100 men earning degrees by 2020 (Conlin, 2003). In 2002, there were 170,000 more women receiving bachelor’s degrees than men (ABC Nightly News, June 16, 2003), raising the issue of an economic imbalance that could create “societal upheavals, altering family finances, social policies, and work-family practices” (Conlin, 2003, p. 77). According to Conlin (2003), men are dropping out of the work force, abandoning children, and removing themselves from community involvement. Since 1964, the rate of decline of men voting in Presidential elections is twice that of the rate of women. More women now vote than men. As the decrease in men with comparable credentials and earning power continues, increasing numbers of women will, in all probability, never marry. Currently, 30% of all African American women 40 to 44 years of age have never been married (Conlin, 2003, p. 77). As women pull further ahead of men, the lack of availability of suitable men will reduce the probability of forming families.

Citing similar problems in Canada, O’Neill (2000) says that as boys have done poorly in a number of important ways and as men are criti cized in many sectors of the society, less and less is being done to help young men. O’Neill blames feminist-driven educational policies that encourage the success of girls while boys are falling further behind. Glaring discrepancies exist in Canada, according to O’Neill, in reading, writing, and math scores at grades three and six suggesting that “modern educational practices actually work against boys’ best interests” (O’Neill, 2000, p. 54).

Many of the young men who reject a college education or who do poorly and drop out, complain that universities use learning styles ill-suited to the way many men learn. Complaints are raised that men must sit in classrooms and listen for long periods of time to lectures when more individualized experiential learning suits the needs of a number of otherwise qualified and motivated men. The result of fewer men on campus is increasing efforts at some universities and colleges to recruit and keep men in college, a significant change in admissions policies of the past that actively recruited female students.

To confirm the disparity between male and female performance, Allen (2003) writes, “From kindergarten to grad. school, girls now outperform boys in grades, admissions, student government, and extracurricular activities. Women are rapidly closing the M.D. and Ph.D. gap and make up almost half of law students” (p. 34). She then provides the following aside: “Meanwhile, boys dominate in such dubious categories as remedial education, stimulant-drug prescriptions, and suicide” (p. 34).

The U.S. Census Department (1998) estimates that during a woman’s lifetime, there is a 17.6%possibilityofbeing raped (a 14.8% completion rate and a 2.8% attempt rate). However, when other aspects of violence, including physical assaults and domestic violence, are added to the rape data, American women have an appalling 55% probability of being raped or assaulted by a man sometime during their lifetime. Men have an even greater probability of some form of physical violence. Sixty-seven percent (67%) of all men face the probability of being victims of violence sometime during their lives, generally at the hands of other men (U.S. Census Department, 1998).

WHY MEN ARE IN DIFFICULTY

Lack of Child Support and Absent Fathers

There are many reasons for the deteriorating condition of men in America. Not least of all is a problem caused by men themselves. Half of the divorced fathers in America fail to pay their full amount of child support or fail to pay at all. In Los Angeles County, the District Attorney’s office, which is charged with collecting child-support payments from divorced fathers who won’t pay their legally mandated child support, was able to collect in only seven percent of the cases leaving 500,000 children without court-mandated support (Deadbeat Dads, 1993). The United States Office of Child Support Enforcement, a division of the U.S. Department of Health and Human Services, indicates that the amount of arrears (unpaid child support owed) that has accrued over the years is over $90 billion (U.S. Office of Child Support Enforcement, 2003). In 2002, the same office noted that over 16 million cases of unpaid child support were reported nationally. Many of these men also fail to have any consistent contact with their children, leaving boys and girls without the socializing influences of fathers.

The failure to responsibly care for children often creates social and emotional problems for single female-headed families that are prescriptions for developmental problems in children. Poverty, lack of positive male role models, abandonment by fathers, and overstressed and overworked mothers, all contribute to a deterioration in family life that frequently has a negative impact on boys. As DiIulio (1996) argues in writing about boys who become, in his words, “super predators,” they all too often grow up in an atmosphere of emotional poverty

… without loving, capable, responsible adults who teach you right from wrong. It is the poverty of being without parents, guardians, relatives, friends, teachers, coaches, clergy and others who habituate you to feel joy at others’ joy, pain at others’ pain, happiness when you do right, remorse when you do wrong. It is the poverty of growing up in the virtual absence of people who teach these lessons by their own everyday example, and who insist that you follow suit and behave accordingly. (p. 3)

Freudenberger (1987) wonders where young men go who have grown up without male role models and asks the following:

Where can these confused and vulnerable young men turn for help? At one time, men had older male role models and mentors to emulate. But that route is no longer tenable. Many older men are themselves confused and troubled by the social changes and often the only kind of man-to-man relationship that men perceive, or are comfortable with, is one of competition and rivalry in sports and elsewhere. Intimacy between men continues to be as uncertain as intimacy between men and women. (p. 47)

Levant (1997) suggests that fathers often revert to stereotypic roles in which they pledge an egalitarian marriage but revert to traditional roles of male lack of involvement with family life. This may take place because of job pressures or because they are unwilling to put the time and effort into a truly egalitarian relationship. The lack of involvement in family life fuels potential marital problems and family discord that often ends in divorce. Once a marriage has ended (Levant reports that women end marriages at twice the rate of men and that 90% of the time, children live with their mothers following a divorce), “The reality of visitation fatherhood is dismal, judging from the fact that more than half of non-custodial fathers drop out of their children’s lives” (Furstenberg, Nord, Peterson, & Zill, 1983) (Levant, 1997, p. 224).

Balcom (1998) reports that abandoned sons often suffer lifelong problems of low self-worth and may develop “a sense of self as the kind of person who is abandoned and the son of a father who would abandon” (Herzog & Sudia,1971, p. 30). Abandonment may affect the son’s sense of continuity and stability in relationships and may cause the son to wonder why his father left and whether the son will do the same thing at some point in time. Abandoned sons may develop feelings of shame and stigma that affect their ability to understand and communicate their feelings (Schenk & Everingham, 1995). To mask feelings of shame and sadness, abandoned boys often turn to anger and violence because this may serve to frighten others into thinking the boy is much more emotionally competent than he really is (Krugman,1995). Abandonment often affects men throughout their life cycle as Balcom (1998) notes:

For many abandoned sons the realization of intimacy is a mystery that eludes them. Abandoned men habitually have relationship difficulties with their parents, siblings, chosen partners, and their children. These men frequently enter treatment in response to obvious crises at family developmental transition points. (p. 286)

Abandoned sons often have two primary reactions to their father’s abandonment. They proclaim that they will never be like their fathers, or they overidentify with their fathers and in Balcom’s words, “The son may base his worship on the actual father he experienced, or the fantasy father that he wishes or wished for, in spite of the father’s apparent lack of contact, interest, commitment, or feelings for his son” (Balcom, 1998, p. 286).

Treatment for abandonment often comes when men are in crisis over intimate relationships (Balcom, 1998). One clue that a male client is having abandonment issues is the feeling that something deeper is missing in the relationship. His partner, on the other hand, may complain of emotional and physical distance. Balcom (1998) believes that one central way to help male clients cope with abandonment issues is through grief work: “Helping an abandoned son grieve his actual and fantasy losses is perhaps the single greatest clinical challenge. The losses include the actual father, the ideal or fantasy father, aspects of childhood and adolescence, and other intimate relationships” (Balcom, 1998, p. 286).

Unemployment and Homelessness

Writing about male homelessness and unemployment, Marin (199 1) reports that 80% of the homeless in America are men. Of the many interesting reasons for the number of male homeless, Marin suggests the following: “Poor families practice a form of informal triage. Young men are released into the streets more readily, while young women are kept at home even in the worst circumstances” (p. 85). Life on the streets can be very dangerous for many men and the attempt to find work, associated with traditional transient styles o...

Table of contents

• Cover
• Half Title
• Full Title
• Copyright
• Dedication
• Contents
• About the Author
• Preface
• Acknowledgments
• PART I The Serious Problems Experienced by Men
• PART II Clinical Work with Men
• Part III Clinical Work With Violent Men
• Part IV Clinical Work with Men of Color: Special Concerns
• Part V Aging and Substance Abuse
• Part VI The Future: Improving the Lives of Men
• References
• Author Index
• Subject Index