Fine-Tuning Your Therapy Approach for Male Clients

Understanding Shame as a Threat to Perceptions of Manhood

David Wexler

Shame may be the least understood dimension of men's inner experience—by both men themselves and the people who live with them. Men who've experienced toxic doses of shame early in life will do anything to avoid reexperiencing it as they grow older. It can originate from family experiences, from peer experiences, or just from the culture at large. A shamed boy becomes a hypersensitive man, his radar always finely tuned to the possibility of humiliation. His reaction to slights---perceived or real---and his ever-vigilant attempts to ward them off can become a kind of phobia. Tragically, the very men who are most desperate for affection and approval are the ones who usually can't ask for it: instead, they project blame and rejection and perceive the worst in others. Sometimes the smallest signs of withdrawal of affection will trigger old wounds, and they'll suddenly lash out at those they see as slighting them, even as they're unaware of the dark feelings stirring inside them. This is a state of mind that many of us in the field call shame-o-phobia, an endemic condition throughout Guy World.

With their profound fear of appearing weak or---god forbid!---feminine, most men will do whatever it takes to prove their manhood. In one recent study, men were assigned to three different groups and given the task of keeping their hand in painfully icy water for as long as they could. Those who were told that the ability to withstand the discomfort was a measure of male sex hormones and an index of physical fitness showed greater cardiovascular reactivity, reported feeling more performance expectations, and kept their hand in the water the longest. This was in contrast to the group who were told the test was a measure of high levels of female sex hormones and the ability to bond with children, and with the third group, who received no explanation at all.

What does this tell us? The length of time a guy will tough it out with his hand submerged in freezing water depends on whether he thinks his masculinity is in question. For some men, their hand could fall off before they'd risk the shame of not seeming "man enough" to take it.

Women feel shame, too, of course, and much of the emotional experiences for men and women are more similar than not. But there are still some fundamental differences in how men are both hardwired and acculturated that can't be ignored in the therapist's office.

Men and Therapy

The field of counseling and psychotherapy hasn't done a particularly good job of creating a user-friendly environment for male clients. The problem begins with a lack of awareness about the profound impact of shame-o-phobia and the vulnerability to broken mirrors. Furthermore, there's a mismatch between the relational style of many men and the touchy-feely atmosphere of most counseling and psychotherapy.

Think of what we typically ask a man to do in therapy settings: recognize that something is wrong with him, admit that he needs help, openly discuss and express his emotions, get vulnerable, and depend on someone else for guidance and support---all extremely challenging tasks in Guy World.

As therapists, we have two choices: shoehorn men into a process that's traditionally been more user-friendly for females, or reshape what we do and how we present it to better reach male clients.

Rules of Engagement

Men often resist standard therapy because they have a hard time admitting that anything is wrong or, if they think something is wrong, they struggle to identify what it is. Another reason they avoid therapy is that they can't tolerate the internalized stigma---the felt shame---associated with feeling needy, dependent, or incompetent. A third disincentive, even with men who know they need help, is the very idea of sitting in a room, talking out loud about all this touchy-feely stuff; it creeps them out.

Since men tend to loathe the language of psychotherapy, including the name itself, by all means call it something else in your advertising. You don't even have to call it counseling. You can call it stress management, skills training (including parenting skills and building better relationships), coaching, or consulting. Whatever works to get a man in the door and relax his defenses!

Guy Talk

Before you begin to engage a man in therapy, bear in mind the type of overarching, nonshaming message that helps to create a therapeutic alliance with male clients: "You're a good man, and you've been making some mistakes," or "You sometimes act badly," or "You can do better," or "Your kids need you to be an even better model for them. We can work together on this."

How do you explain the goals of therapy in "guy talk"? When I work with men who withdraw or become reactive and belligerent whenever a conflict looms with a spouse or partner, I naturally want to help them react with more maturity and insight. I frame this goal in terms of masculine independence, self-control, and personal agency: "We want you to be really powerful. Not over others, but over yourself." "We want to make sure that the everyday crap that comes up for all of us doesn't control you or provoke you into reactions that aren't good for you or the others around you." "We want you to be in charge, not the stuff outside of you."

The Honor of Men

When we learn to recognize and honor how men communicate their caring, we'll have a better shot at helping them get relief from unnecessary pain and be able to receive and give more in their relationships. When we respect their defenses, honor their intentions in doing the work, speak to them in Guy Talk, and engage them with therapeutic transparency and self-disclosure, the differences in treating men and treating women diminish dramatically.

This blog is excerpted from "Shame-O-Phobia." Want to read more articles like this? Subscribe to Psychotherapy Networker Today!

Topic: Anxiety/Depression | Children/Adolescents | Men

Tags: psychotherapy | relationships | therapist | therapy | marriage | networker | women | Men | David Wexler | masculinity | manliness | gender | men's issues | shame

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