A therapist's first steps can make an indelible imprint on his or her sense of calling, shaping the career to follow. My own first steps included counseling "troubled" boys in several rural Pennsylvania high schools. Most of the boys had grown up in harsh circumstances; their case histories were litanies of abuse, neglect, and conflict. Nonetheless, most viewed counseling as a form of punishment, perhaps slightly worse than detention.
Fueled by enthusiasm, some prior success teaching art to impoverished inner-city kids, an academic education in psychology, and a few supervised clinical experiences, I felt ready to go. I imagined myself teaching tough, sullen kids to open up---the long-suppressed words of their pain gushing forth, as they "got real" with me and began their journey toward self-discovery and healing.
Early each morning that cold winter, I'd toss sandbags into the back of my pickup and wind my way up ice-slicked roads past the corrugated mountains, slate quarries, and swift river waters that flowed through Mauch Chunk and Lehighton. As the sun rose, the snow fell against the treeless, shale mountainsides. This austere, stark, yet ultimately beautiful landscape foreshadowed the kids I'd come to know. These boys seemed to long for the hills---a place where life was more visceral and action oriented than the pastel-hued guidance office where we met, ostensibly to discuss their lives and feelings. Many came to school decked out in camouflage and boots, as if anticipating the deer-hunting season; its first day was an official school holiday.
My initial idea was that offering a receptive ear and verbalizing positive regard would be the key to helping these kids. I thought I could transmit the hope, optimism, and encouragement they needed by expressing unwavering trust and belief in their potential.
There was only one problem with this plan: it didn't work. Nothing changed. I asked them questions like, "Tell me more about what it felt like to be yelled at by your dad?" or "What would it take to feel safe opening up?" But our conversations remained superficial. They responded to my efforts to help them with bored monosyllables or sarcastic quips. Here were boys facing expulsion or even incarceration, whose lives were chaotic and full of conflict, and yet they conveyed no palpable sense of urgency to deal with their problems. And my anxiety grew as I reflected on the ticking clock of their adolescence.
As I drove home at the end of the day, the boys' resistance weighed heavily on me. Lying awake at night, I tried to put my failure into perspective. Maybe these kids weren't the right clients for me? Maybe they weren't the right clients for anybody. Then it dawned on me that maybe I was going about things the wrong way. I'd been so busy trying to give their most limited words and gestures some kind of positive spin that I hadn't paid much attention to their most obvious "symptom"--the difficulty they had communicating about virtually anything, much less expressing their feelings. The few responses they seemed to have were primarily angry, sullen, or glib.
For instance, here's a fairly typical exchange that happened when I asked one boy, "Why did you fight that student?"
"The kid's an asshole and he deserved it."
"But why did he deserve it?"
"Just because he did. Forget it."
"Okay, well how did you feel after the fight?"
"I don't know, good I guess."
"What do you mean good'?"
"You know, like he fucked with me and got what he deserved."
"Do you have any feelings of regret or guilt?
"Nah, I don't know what you mean about regrets and shit. He had it coming and that's it. End of story."
As I thought more, it became apparent that these boys couldn't yet respond coherently to important life situations, because they couldn't describe how they felt, what their experiences meant to them, or what they hoped to accomplish--the basic building blocks of therapy. The only terms they had for describing their rich, if chaotic, inner lives were sledgehammer words and phrases---"I'm pissed," "It sucks," "Who cares?" As they used those phrases repetitively, their emotional lives were effectively flattened, their individuality lost.
If therapy with these kids was to be effective, we needed more and better words, and we needed them to be readily available so they could be used as tools to complement the sledgehammers they already had. I began to think about how I might be a conduit for the emergence of those words. If they felt more comfortable with me, I wondered, would they feel more comfortable adopting the kind of communication I modeled for them?
It was worth a try, so I took off my counselor hat, threw out the scripted language of therapy as I knew it, and just started talking, cajoling, joking---low-key, but definitely insistent. My inquiries were mixed with casual banter about girls, football, and, of course, hunting. Rather than setting an agenda for the therapy, I engaged the topics that emerged, focusing more on talking with them than asking them to talk like me. I asked fewer leading questions and made my comments shorter and more pointed.
I became more sensitive to how much the starkness of their feelings affected their psychological lives. In a way, the frustration of being limited to a narrow range of descriptive words like "awful" and "excellent" intensifies what you're feeling, and your emotional life can feel more extreme and polarized. As I mirrored this perspective by forcing myself to phrase things in black and white terms---"So are you gonna fight this kid or walk away?"---it was amazing to feel the therapy develop a pulse.
Slowly the boys let me see that, in their minds, they were waging near-mythic battles---against peers, a parent, the school principal, or all of the above. Yet these battles were being waged without any coherent narratives, only jumbled images, words, and feelings, all whirling around like a washing machine stuck on the spin cycle. Their minds were too tossed and roiled to make either emotional or cognitive sense of their experiences, and this confusion ultimately led to a complete breakdown in the ability to take constructive action to solve even the most basic problems.
They had many more words for permutations of anger than they did for virtually any other kind of emotion. So we worked on expanding their awareness of words to describe more complex feelings, such as guilt, regret, or satisfaction. To accomplish this, it was critical to focus on concrete situations and to make my emotional work with them a kind of multiple-choice interchange. "You gotta admit, when Darryl 'ratted you out' to the principal, you were pissed, but you also felt regret for what you did---it seems like you wish you could take it back."
The emergence of better communication not only enriched the therapy, but also fostered real accomplishment. Our sessions became more goal directed, highlighting the relationship between cause and effect in their lives. "If you want to be admired by others, you'll have to give them a reason why. Let's talk about how to earn their respect." "I know you want a good job, so let's figure out the steps to make it happen." "If you want your grandfather to take you hunting, he needs to see that you're ready. How could you show him that?" By the end of the year, every boy I worked with had established a tangible plan for gaining something that was important to him. Their goals had lived in their minds all along, but they needed to put them into words to have any chance of achieving them.The Gender Divide
My year treating high school boys taught me a lesson that still guides my work: if words are the currency of most interpersonal exchange, many boys are on the verge of social bankruptcy. When it comes to communication challenges, gender discrepancies are staggering. Boys make up 75 percent of special-education classes, are far more frequently diagnosed with syndromes ranging from ADHD to autism that involve social-learning problems, and account for nearly 80 percent of children identified as emotionally troubled.
Our world is increasingly driven by communication and the need for emotional intelligence---attributes that generally don't come easily for boys---and they're clearly falling behind. In spite of the still-potent icon of the silent male in the American psyche, there are far fewer life options today---whether academic, career, or relational---that can accommodate a boy (or man) of few words.
The schism between the communication skills of males and females has lifelong implications. In education, for example, males are a dramatically shrinking proportion of college enrollments; in marriage, poor communication is cited as the most common precipitant of divorce; in career and professional life, social awareness and communication skills are indispensable to effectiveness and opportunities for advancement. Today's business and professional leaders aren't, by and large, Silent Sams. Furthermore, probably more than at any time in our history, the health of our society depends upon the intricate web of language and communication that binds us together--a kind of interlocking neural network of words that gives us individual access to the collective mind of our culture.
There's also a biological imperative to the deficits in male communication. Our society has seen men's health suffer as the result of stress and underdeveloped coping skills. We know, for example, that men who are divorced in middle age tend to have health that fails much more dramatically than that of women in the same situation. When we talk about building communication skills, therefore, we're also talking about building psychological resilience.
As therapists, we have the tools to build resilience, if we can find flexibility in how to use them. Reframing our approach to treating boys isn't about "dumbing down" therapy, or dishonoring other ways of approaching personal growth. It's about building a platform of safety on which a therapeutic alliance can be constructed.
Therapists may be on the front lines of working with communication challenges, but I suspect few of us are eager to spend our days with verbally disinclined males of any age. The nature of psychotherapy--the "talking cure," still, even after all these years--seems antithetical to the inclinations, and perhaps even the values, of many silent men and boys. Once, I asked a 14-year-old to describe how he felt about his father's death. He looked at me blankly. "Why?" he replied, without intending irony or sarcasm. We were clearly on entirely different wavelengths. But, in therapy, as elsewhere, communication can't happen unless it finds a common frequency--a mental loop that can entwine two minds, or many minds, for the sake of connection.
Uncommunicative boys are often labeled "treatment resistant," but their lack of fluency in the language of therapy may not be because they're consciously antagonistic to therapy, but because they, literally, don't know what to say to a therapist or how to go about "communicating," even when prodded. For youths who don't know what to say, like the high school boys in Pennsylvania, self-expression doesn't initially feel like healing--it feels like coming apart. Withdrawal and silence are unconscious reflexes deployed to prevent destabilization and confusion, which most boys can't tolerate, no matter how much these states are touted by the culture of therapy as necessary to "personal growth."
For those of us who pride ourselves on being able to translate our inner world into words, the expressive void within even emotionally stable and healthy boys may be almost inconceivable. We cannot help but posit "causes." One mother of a quiet but otherwise well-adjusted 16-year-old asked me incredulously, "How can he be so disconnected from us, off in a silent universe of his own? What does he get out of being this way?" She shook her head in bafflement. "I alternate between being worried that he's carrying some intolerable psychological burden all by himself or, on the other hand, that he just doesn't care much about anything at all! Sometimes it feels like he's trying to punish us in some way."
Indeed, it's easy for parents to regard communication resistance as an act of revolt, a sign of adolescent contempt for all things adult. But it's better understood as confusion or anxiety. One reluctant, but insightful, teenager finally managed to find the words for his own anxiety about making his inner life known to others: "If I think about it too much, it's like standing at the edge of a cliff. I can't stand to look. I just want to back away." For other boys, what looks like resistance may actually be a different tempo of thinking and feeling. Behind the blank stare, there's a world of processing going on, but, unfortunately, not at a pace that follows the rhythms of other minds.
In the 12 years since I first began working with boys, awareness of the neuropsychological factors responsible for the development of the brain's capacity for social and emotional awareness, and for the difference in communication skills between males and females, has increased. For example, we've learned that the corpus callosum, the anatomical "bridge" that spans the brain's left and right hemispheres, is generally larger in females. As a result, information can be exchanged between hemispheres more efficiently. This finding becomes particularly important when considering the extraordinary contributions made by the right hemisphere to social perception: this hemisphere is where we make sense of nonverbal communication, and where we detect the nuances that shape deeper interpretations of another person's communication.
Neuroimaging technology has shown us that the male brain tends to process language almost exclusively in the left hemisphere---the seat of logical thought and linear thinking---while the pattern is much more diffuse for females. When boys don't get it, when we see stone faces and shoulder shrugging, we can reasonably conclude that something doesn't compute. Imagine hearing a song in a language you barely understand. You may detect that emotion is being expressed, but you can make little sense of it. While those around you tune in, you opt to tune out, because it's anxiety provoking to exist in a world whose terms and meanings evade you.
The consolation prize for boys who feel deeply but can't express or even decipher their own emotions is the universe of "electronica," a womb of all-encompassing stimulation provided by video and computer games. Here they feel safe and excited at the same time. Electronica is a great alternative for dealing with confused feelings about communication, except that these games are reprogramming the way brains work, making boys even more vulnerable to neurodevelopmental syndromes like AD/HD. This is the conundrum that frames the social lives of many boys, even though few of them have any inkling of it.The Big Impact of Small Differences
In spite of these distinctions in verbal processing among males and females, several decades of research also highlight that the biological differences between the genders are relatively small. The very fact that the genders are more alike than different makes brain differences significant, and proximity makes those differences even more visible. Imagine a visitor from a distant galaxy, hovering above a busy freeway in a spacecraft. Looking down from several thousand feet, our alien can see many red cars driving to and fro. Some may be slightly bigger or smaller, and there are different shades of red, but from an alien's distance, they look very much the same--the differences seem trivial. Yet from the perspective of an earthling on the ground, those differences take on significant meaning. The difference between a Lexus, Ford, and Hyundai may have important implications for reliability, economics, and social status. Even subtle differences in the shade of red may have profound emotional implications for a car's owner! The closer we are to these differences, the more apparent and meaningful they'll be. Important differences in the communication skills of some males, from an inability to initiate friendships in childhood to a hesitancy to express feelings in adult relationships, also become more noticeable through close proximity.
Further, even though boys' innate neuropsychological disadvantage at communication may be small, social and environmental factors certainly contribute to the divide. At my son's school Halloween parade, almost all the boys were superheroes, traditionally men of much action and few words. Metaphorically speaking, many will be wearing those same costumes well beyond kindergarten.
However, the astounding growth of a vast electronic/media culture has had a far more corrosive effect on boys' ability at verbal communication than the influence of social stereotypes. Their senses are steadily dulled by overindulgence in the "drugs" of images and sounds, their capacity for attention and focus undermined by the speed and fleeting nature of constantly renewing images and continual staccato bursts of sound. It's probably no coincidence that the stratospheric increase in diagnosed learning and attention deficits correlates with the advent of the electronic playground.
The fragmented syntax that's evolved from these media---the fast-paced blasts of sound and light bytes of films, television, e-mail, and computer games---ring loudly in boys' minds, more urgently than ordinary conversation. Of course, there's real creativity in many electronic means of expression, but, unlike reading and listening to stories, the blitz of electronica doesn't build deeper listening skills or a greater range of emotional expression.Can't Get Me Out of My Head
Although some communication is purely instrumental---"Pass me the sugar," "Can I have $20?" "Are we there yet?"---social communication is about connection. On a basic level, relating to others is the antithesis of self-absorption. Boys aren't easily dissuaded from pursuing thoughts or activities that effectively put walls up around them. They feel justified in their deep infatuation with personal interests, even when it borders on obsession (trying to collect every Yu-Gi-Oh! card ever made) or narcissism (trying to achieve the perfect body through compulsive, punishing workouts).
Arguably, the single greatest social liability of electronica is the risk of self-absorption. It's tempting to see the internet---e-mail, chat rooms, instant messaging, blogging--as an exception to that risk. Surely, here, boys are comfortable expressing themselves, and can more easily learn how to escape the prison of themselves. Here they can share ideas and thoughts with other people, make new friends and acquaintances, learn to get along with a wide variety of people. Unfortunately, this isn't so. In fact, it's usually just the opposite: the internet expands the potential for self-absorption. While keyboard communication may help a reserved child "get his feet wet" in the social realm, or give an impulsive boy a chance to consider and edit his comments, there are just as many pitfalls.
For many, the ability to develop an electronic alter-ego seduces them into an alienated world of fantasy and projection, without providing the reciprocity that spurs personal growth. Resolving a conflict with a friend, going on a date, and interviewing for a job rely on senses that are largely irrelevant to online communication. In fact, the care and nurture of an internet-created alter-ego---cooler, sexier, tougher, less vulnerable and awkward--fuels the descent into self-absorption. Enthralled with his own projection of an ideal self, a boy becomes less aware of other people as complex individuals in their own right, let alone of the need for any interaction with them in the real, unscripted world.
Why are boys so drawn to this poisonous self-absorption? Not only does withdrawal into electronica enable them to bypass the confusion and pain of trying to give their emotions some coherence, it also helps them avoid the realities of being a flawed, vulnerable, ordinary human being. This internal drama is being played out among boys everywhere, every day, with varying levels of intensity.The Story of Evan
One morning, the principal of a small high school called me about Evan, a ninth-grader who'd intimated to a female classmate that he was going to hurt himself. Specifically, he'd dramatically told the girl that she could have the music scores he'd written, because he wouldn't need them anymore. The school had contacted Evan's parents, advising them to bring him to see me following a hospital evaluation. I met Evan, at 9 that evening, escorted by his worried and exasperated parents. He was a thin, serious-looking teenager with straight, dark hair just long enough to be pulled back into a ponytail.
"I guess you've had a pretty intense day?" I offered.
His father quickly interjected, "We need some answers. He won't tell us anything."
Evan's mother added, "It doesn't seem like he knows what to say. I keep asking him why he did this, and he just shrugs or says he doesn't know. What are we supposed to do?"
During the course of the next hour, Evan's story began taking shape. When therapy with boys feels uncomfortably tense, my favorite default is to talk about their interests, suspending judgment, no matter what those interests might be. By keeping things low-key and conversational, I learned Evan had three passions: computers, music, and martial arts. He'd recently developed an interesting and novel project---translating some of the movements from karate into musical notes. For example, a specific type of kick might translate to the musical note C, therefore a certain sequence of moves might be translated as C, B, E, etc. These sequences would be programmed into the computer and he'd synthesize music from them.
The previous week, Evan had presented his idea to a group at school. His teacher had been very encouraging, but some students wanted to know how he could ever turn this into "good" music. One girl had matter-of-factly suggested that he write the music first and then adapt the karate moves to the score. This had infuriated Evan, who explained that there was a particular sequence to the karate moves and that he couldn't change the order. Afterward he sullenly withdrew from his classmates and continued morosely ruminating about the girl's "stupid suggestion," feeling as though his creativity had been totally invalidated.
Like many boys, Evan covered his feelings of vulnerability with anger---overall a more manageable emotion, because these boys equate expressions of anger with power, the commonly preferred antidote to embarrassment or humiliation. He'd already learned to use anger to ward off "invaders," people who might try to penetrate the protective veneer he'd constructed to conceal his emotional self.
This time, however, the anger was too overwhelming for him to conceal for long. Feeling hurt and unappreciated, he needed to expunge those feelings by acting out to the person he felt was the source of his emotional injury. So he dramatically presented his project notebook and music score to the girl who'd made the suggestion he couldn't stand, telling her he'd never live to hear it played. He'd taken her comment as a deep form of rejection, and lacked the verbal skills to navigate a resolution.
"Does anybody get you?" I asked.
"I don't know, should they?" Evan retorted defensively.
His answer indicated the question had hit home. I learned that Evan was attracted to activities and interests in which there are formulas and structure---mathematical rules that helped him wade through an otherwise confusing world of verbal nuance, shifting perspectives, and diverse groups. He fantasized about creating a musical formula to describe different feelings. His major problem was that he couldn't make music that sounded good to people.
It was obvious that my best chance of connecting with Evan was through his music. At my request, he began to bring in his compositions recorded on a compact disc, which could be played on my office computer. He'd narrate these listening sessions with indications of what emotions he was trying to represent. "Check out this part coming up---it's like what I felt toward Noelle. Now can you understand?" It was clearly engrossing for Evan to observe the emotional impact his music had on others. It was as if, as he presented his music, he was unraveling the code of his own emotional life.
I asked him why he never wrote any lyrics to his music. The question initially surprised him---it had clearly never occurred to him, and he reacted as if the suggestion was almost illogical. At first, he dismissed the idea, but I could tell there was a part of him that was intrigued. We jump-started the process by playing with lyrics in my office. He seldom liked anything I suggested, but my offerings seemed to catalyze his own creativity. It felt to me that Evan needed something concrete against which he could mold and define his own thoughts. I've come to see that this approach is valuable with most boys---give them a tangible thought or idea, and then let them find themselves in relationship to that perspective. For me, the approach recalls how helpful it is to have an identifiable landmark, when you're lost in the woods, to know which way you want to go.
Evan made the leap to working on lyrics between sessions, an important sign that he was taking personal responsibility for working on his communication skills. With much prompting, he eventually produced these lines about his irritation with his parents' worries about him:
I see faces that are angry.
But they can never own me.
Leave me alone. Leave me alone.
I just want to be alone.
When Evan insisted the lyrics reflected what he felt, I suggested they described only the tip of his emotional iceberg. "I hear your anger, Evan, but I think there's more. I still can't find you in those lyrics. Anybody who can figure out how to translate karate into musical notes has got a seriously complex brain. Let's hear it!"
This challenge engaged his natural competitiveness. For the next several weeks, he brought in lyrics that incrementally became more expressive. There were moments of clarity and confusion, yet an overriding sense that Evan was moving closer to learning how to share himself with others. With lots of hard work---perhaps coming from an unexpressed desire to win my admiration---Evan's feelings toward his parents were transformed into a song Evan titled "Growing Up":
It's hard for me to know just why you love me so.
I can see it in your eyes. It cannot be denied.
But there's a part of me that's gone.
It can only live in songs.
On this you can rely.
The lyrics helped Evan define what he felt, but perhaps most important, helped him see that the world wasn't a unidirectional place, where people and events only acted on him: he, too, had a role in how his life played out. He began to realize that his actions, his words helped shape his parents' incessant worry. He still often walked along the edge of an emotional precipice, conveyed by his scores for "Tower of Babble" and "The Void," but there was a dawning realization of a larger world of thought and feeling. Through meeting the challenge of putting lyrics to his own music, Evan learned that words could transform some of his most troubling emotions and help him find new ways to regain his balance when life got difficult.So Many Ways to Connect
Connecting with boys in psychotherapy requires an open mind about the approach to use. One practical way that works for me is tossing a softball back and forth in my office. (I used to go outside and play catch quite often, but was never able to adequately steer the conversation toward topics that brought us closer.) After just a few tosses, I start talking about world records, and how many consecutive catches it would take to get in the Guinness book. The prospect of being the best at something is a major hook for boys of all ages.
From there, the conversation can segue into topics of more personal significance: "How are things at home?" "What's your new school like?" "How will you handle it if she says no?" It's a simple thing, but is typical of what gets boys engaged in therapy. Just getting their heart rate up seems to intensify thinking and communication, making it more likely that the words exchanged will stick in a boy's memory.
I find it valuable to demonstrate this technique in front of parents, often during the initial interview. I want parents to see that involving boys in a physical activity helps reduce their feelings of vulnerability, and actually turns their brains on. Also, first impressions are important, and I want boys to leave that first session with a memory of fun, action, and rapport---quite the opposite of the uncomfortable stillness that often results from direct inquiry into their thoughts and emotions.The Men They'll Become
We think and feel in words. The silent, sullen boy stalking the mall's game store may be next in line for an underemployed, lonely adulthood if we don't teach him how to maintain effective social contacts with others. The need for a social evolution---one that expands our understanding of boys' potentials and supports a broader vision of masculine expression--flows not from political correctness but from sheer necessity. Therapists who work with boys are on the front lines of facilitating this evolution.
As we raise and support the next generation of boys, it's vital that we give them the tools to be full participants in society by helping them find the words to define themselves and relate to others. To do so, therapists and parents alike must explore new means of engaging silent youngsters, going beyond the business-as-usual inquiries about thoughts and feelings to discover activities or conversational approaches that stimulate a real connection and encourage them to open up to a broader range of verbal expression. By doing this with dedication and determination, we can help boys of all ages cross the communication divide.
This article originally appeared in the July/August 2006 issue of Psychotherapy Networker.Want to read more articles like this? Subscribe to Psychotherapy Networker Today!>>