Men, boys and men­tal health

Toxic mas­culin­ity can cre­ate a bar­rier to seek­ing help, with dev­as­tat­ing con­se­quences.



I was on a hike with a male client who was sex­u­ally abused by his fa­ther and was cur­rently strug­gling with chronic de­pres­sion, an ad­dic­tion to pre­scrip­tion drugs and un­der-em­ploy­ment. Walk­ing sideby-side this par­tic­u­lar morn­ing, we hap­pened across a bull­frog—likely in­jured from some predator—drag­ging a blood­ied limb be­hind. He stared for a while—tears ap­pear­ing on his cheeks—see­ing the metaphor in his life from a new per­spec­tive.

“Some­one hurt me...I am strug­gling to sur­vive...I need help.” This ex­pe­ri­ence be­came a cat­a­lyst for a deeper in­sight and mo­ti­va­tion for change. It’s a “ther­a­peu­tic tech­nique” I could not have made up in an of­fice.

On the one year an­niver­sary of the Lionel Des­mond tragedy, I am re­minded of the stag­ger­ing sta­tis­tics sur­round­ing men and men­tal health. Three out of four deaths by sui­cide are men. One in 10 men will ex­pe­ri­ence ma­jor de­pres­sion or anx­i­ety in their lives. Mak­ing mat­ters worse are the poor help-seek­ing be­hav­iours of men. While some say this is a func­tion of “stigma sur­round­ing men­tal health,” it is im­por­tant that we look a lit­tle deeper into what this might mean. Rec­og­niz­ing that gen­der is bet­ter de­fined along a spec­trum—rather than the bi­nary of male or fe­male—toxic mas­cu­line cul­ture tells us that get­ting help is not “manly.”

The vast ma­jor­ity of tra­di­tional men­tal health ser­vices (in North Amer­ica, at least) in­volve one or two op­tions: In­di­vid­ual or group ther­apy. Both of which are typ­i­cally talk­based, time-bound, held in an of­fice-set­ting and phys­i­cally seden­tary. Taking re­spon­si­bil­ity for an­other stereo­type here, how many men or boys feel com­fort­able sit­ting in a chair, in an of­fice, talk­ing about their feel­ings? If ther­apy op­tions con­nected bet­ter with how men tend to “show up” in the world, I be­lieve we would see a shift in the sta­tis­tics above.

The in­vi­ta­tion here—to both clin­i­cians and clients—is to ex­pand our un­der­stand­ing of where and how ther­apy hap­pens. The key, I be­lieve, is to of­fer a se­ries of ther­a­peu­tic op­tions in the hopes that one or more will have greater res­o­nance with men and boys need­ing help. Ad­ven­ture or wilder­ness ther­apy, ex­pres­sive or arts-based ap­proaches, in­cor­po­rat­ing phys­i­cal ac­tiv­ity, com­mu­nity ser­vice projects or non-tra­di­tional set­tings (like a park bench, a lo­cal walk or chat­ting over break­fast) are but some of the ideas al­ready in ex­is­tence.

Re­cently com­pleted, the TONE project (Ther­apy Out­side Nor­mal En­vi­ron­ments) was a two and a half year long men’s men­tal health pi­lot funded by Movem­ber Canada, where adult men par­tic­i­pated in a free, three-month group ther­apy pro­gram that in­cor­po­rated ad­ven­ture, na­ture, phys­i­cal ac­tiv­ity, vol­un­teer work and ex­pres­sive ther­a­pies. By all mea­sures that were used to as­sess re­sults—in­clud­ing a three per­cent drop-out rate, a stat that is un­heard of in tra­di­tional ther­apy—TONE was a re­sound­ing suc­cess.

It is my belief that many men and boys ben­e­fit greatly from the tra­di­tion­ally of­fered ther­apy ser­vices avail­able to them in Nova Sco­tia. More im­por­tantly, there are many men and boys who struggle with get­ting help, not just be­cause ac­cess to it is dif­fi­cult, but be­cause ther­apy as we see it tra­di­tion­ally does not con­nect how men and boys ac­cess their in­ner states. Like hav­ing dif­fer­ent learn­ing styles, I be­lieve clients (and clin­i­cians) have dif­fer­ent ther­apy styles that have greater res­o­nance with them. A hike in the woods, sit­ting on a rock by the lake or go­ing rock climb­ing, all while ex­plor­ing their de­pres­sion, anx­i­ety or trauma, can have a mo­men­tous ef­fect. Read more opin­ions at at the­coast .ca

Nick Car­done is a reg­is­tered coun­selling ther­a­pist can­di­date in Nova Sco­tia, work­ing in men­tal health for over 15 years. He owns Free Range Ther­apy, a pri­vate ther­apy ser­vice that takes clients out for a hike, rock climb­ing, geo­caching or a walk, all while ex­plor­ing their men­tal well­be­ing.

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