We1 have written up reviews of studies2 that have looked at men’s coping in three separate areas; depression, prostate cancer, and being a carer to someone with a medical condition. Across these reviews, we have analysed a total of 48 studies involving over 1000 men. These studies interviewed men individually or in small groups. Questions were asked about coping strategies used. Interestingly, four groups of coping strategies were found across the three health issues. These were ‘being flexible’, ‘adjusting positively’, ‘avoidance’, and ‘maintaining tradition and the status quo’.
This refers to men who cope by challenging what it means to be a ‘real man’. Men do this by being prepared to take on new roles (e.g., carer), re-defining traditional definitions of ‘strength’ and ‘independence’, and bringing new traits under the banner of masculinity. For example, strength may be re-defined as seeking help when needed, rather than conforming to pressure to be stoic and refuse assistance. Becoming an empathetic listener may be a new way be a ‘provider’ to others. Operating with a more flexible form of masculinity also involves seeking support from others.
This category involves facing up to, and accepting (rather than deny) challenges that come from health problems. For example, this can involve seeking information from professionals and being prepared to problem-solve difficulties. This form of coping also involves looking for positive changes and/or benefits that can sometimes come from adversity.
This is where men try to ignore, avoid (mentally, physically), downplay, or conceal problems associated with the health challenge. There is a reluctance to take full advantage of professional services that may be available, and there is a degree of burying heads in the sand. There are often active attempts to avoid and conceal problems to oneself and others.
Maintaining tradition and the Status Quo
Men attempt to cope by trying to maintain life ‘as it was’ before the health challenge came along. This may include trying to hold down an existing job, keeping up with regular activities outside of work (e.g., hobbies). This category also involves attempts to display ‘traditional’ masculine characteristics, such as ‘taking charge’ of the challenge and exhibiting emotional restraint for example. The idea here is that some men may try to regain masculinity ‘points’ lost due to the health challenge arising (referred to as ‘masculine capital’ by Anderson, 2005).
The Good and the Bad
The first two coping categories appear to be effective approaches. Being flexible in your coping is linked with better health outcomes (Cheng et al., 2014). There is also an area of research called ‘benefit finding’ whereby people look for positive outcomes in otherwise difficult situations. Those who can do this tend to have better wellbeing outcomes than those who do not (Helgeson et al, 2006).
Avoidance is generally not a good strategy. This has been a focus in psychological therapy research over the past 10-20 years. There is a term called ‘experiential avoidance’ which relates to the situation where people try to avoid thoughts, feelings, and behaviours associated with something unpleasant. I have written about this before and, in general, avoidance is linked with increased psychological difficulties (Machell et al., 2015).
Keeping the status quo may be good or bad depending on the circumstances. Keeping up with pre-challenge interests, social groups etc, can be helpful. But, not adjusting when a situation calls for changes can spell trouble. For example, if you are unable to cope with your job but refuse to make adjustments (e.g., reduce hours), then other problems will emerge. Also, trying to cope with a challenge by pushing traditional masculine characteristics is likely to cause grief. The more men stick to traditional masculine traits (especially self-reliance) the worse their mental health, and particularly social relationships, may become (Wong, 2017).
What’s the Lesson?
Men use a variety of strategies to cope, but there are common strategies used regardless of the health challenge. It appears that trying to be flexible, reaching out to others, and looking to accept and accommodate changes in life all lead to better mental health outcomes for men. The question is ‘how do I put these coping strategies into action?’ Well, because I’ve maxed out my word count for this blog, I will make this the topic of my next post!
Jason offers on-line and in-person sessions, so if you need help with a psychological issue visit: www.jasonspendelow.com
1By ‘we’ I mean Bryony Fairhurst, Louise Adam, Eli Joubert, and Haymond Lee
2These studies have an * beside them in the below reference section
Anderson, E. (2005). In the game: Gay athletes and the cult of masculinity. New York, NY: State University of New York Press.
Cheng, C., Lau, H-P. B., & Chan, M-P. S. (2014). Coping flexibility and psychological adjustment to stressful life changes: A meta-analytic review. Psychological Bulletin, 140(60), 1582-1607.
Helgeson, V. S., Reynolds, K. A., & Tomich, P. L. (2006). A meta-analytic review of benefit finding and growth. Journal of Consulting and Clinical Psychology, 74(5), 797-816.
Machell, K. A., Goodman, F. R., & Kashdan, T. B. (2015). Experiential avoidance and well-being: A daily diary analysis. Cognition and Emotion, 29(2), 351-359.
Spendelow, J. S. (2015). Men's self-reported coping strategies for depression: A systematic review of qualitative studies. Psychology of Men and Masculinities, 16(4), 439-447.
Spendelow, J. S., Adam, L., & Fairhurst, B. (2017). Coping and adjustment in informal male carers: A systematic review of qualitative studies. Psychology of Men & Masculinity, 18(2), 134-143.
Spendelow, J. S., Joubert, H. E., Lee, H., & Fairhurst, B. R. (Under Review). Coping and adjustment in men with prostate cancer: A systematic review of qualitative studies. Journal of Cancer Survivorship.
Wong, Y. J., Ho, M. H. R., Wang, S.Y., Miller, I. S. K. (2017). Meta-analyses of the relationship between conformity to masculine norms and mental health-related outcomes. Journal of Counseling Psychology, 64(1), 80-93.
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