(Psychologically) flexible men

Men have a reputation- we're rubbish at seeking help for mental health difficulties. As a group, the stats tell us this statement is on the money. Researchers have suggested several reasons for low rates of help-seeking amongst men. Examples include men's relatively poor understanding of mental health problems (compared to women) (1) and their tendency to make more positive prognosis predictions (2). One really interesting factor is the degree of adherence to the stereotypical male gender role (which involves showing no emotion, being tough, chopping wood, etc). Strong adherence to the image of the traditional 'man’s man' results in negative attitudes toward help-seeking (3) and higher perceived barriers to obtaining assistance (4). Sticking closely to the traditional male gender role also reduces the likelihood of help-seeking in other areas of life. For example, men at university who more strongly endorse masculine norms are less likely to seek help when in academic strife (5) (compared to those who are less closely associated with these norms).

Men (especially those who stick closely to the traditional male stereotype) typically go for 'avoidant' and 'externalising' responses to mental health problems. Examples of these include ignoring and/or denying symptoms, distraction, substance use and aggression (6, 7, 8). The net result is a limited range of options for coping with psychological difficulties. When restricted in this way, you are less able to pick a strategy that best fits a given situation. You are also 'more likely to over-use' a particular strategy (or set of strategies). By sticking to a traditional gender script, you are actually shooting yourself in the foot by taking some smart coping strategies off the table. Higher levels of masculinity are also associated with higher rates of specific problems such as depression (9). Its hard to say which causes the other, but one explanation could be sticking closely to the traditional male image puts you at risk for mental health problems because you don't use a wide range of coping strategies.

Having said this, it would be wrong to think men constantly pick unhelpful strategies. For example, distraction (e.g., thinking of something else, keeping yourself occupied with a specific activity), is a common approach used by men and linked with lower rates of depression symptoms (10). There is nothing wrong with using this tactic from time to time. The problem comes when it is used all the time. Again, we go back to this idea of 'over-used strategies'. As men, I think we need to think about being more 'psychologically flexible'. This simply means expanding our coping toolkit so we can be more effective in coping with mental health problems. Psychological flexibility is (amongst other things) having a range of coping responses to chose from depending on situational needs. This ability has been linked with improved mental health outcomes (11). The point here for blokes is that there is nothing wrong with being a 'man's man' provided you keep in mind the importance of having several coping strategies at the ready. This way, you can use the best tool for the job and avoid over-using specific approaches.

Ok, if the patronising, male-friendly 'took kit' analogy hasn't compelled you to click your Facebook link, the obvious question becomes 'How do I increase my psychological flexibility?' Obviously you need to consider going beyond your usual responses and try something new. There may be an incentive to avoid certain strategies due to cetrain Bufoons labelling them as 'feminine'. But, rather than conform with that lot, I'd say there's more guts and glory in going against the grain to put your mental health in a better state. This shows leadership, brain power and resourcefulness in my book. Below are a list of some strategies that you may not have tried that may be worth a look. 

Challenging thoughts: When you experience an unpleasant thought that has negative knock-on effects for your mental health, try directly examining the thought. Specifically, ask yourself how accurate the thought is. For example, the thought 'I'm a useless idiot' is not going to brighten your day. Unfortunately, such thoughts are common amongst those who experience psychological difficulties. Thoughts like these should be evaluated for their accuracy rather than being blindly accepted: Its the least we can do for ourselves given the potential power of such thoughts. This technique is known as 'reality testing' and can be done by comparing two columns of information; one listing evidence to support the thought being true, one listing evidence to refute the thought. Often these thoughts are not true, or certainly not 100% true. But if left unchallenged, they remain powerful negative agents in your brain. When you specifically evaluate the accuracy of such a thought, you can sometimes see there is little evidence to support it. When the thought is seen as built on a house of cards, they tend to lose some of their power. Try spending a few moments talking about a problem: This simple little strategy potentially takes a weight of your shoulders but it is critical that you pick someone who is likely to react positively to you. Hopefully most have had the experience of getting something of their chest and feeling a sense of relief as a result. If you are a close follower of stereotypical male norms, doing something like this may not feel like a realistic option due to worries about being seen as un-manly. Many men also think they have no one they can talk to. My advice would be to take small steps by talking about a personal issue that's least threatening. It may also help to talk about a subject in general terms (e.g., anxiety in men generally, rather than for you specifically). This can be a good way to check out if someone's attitude towards the subject is accepting and helpful (therefore a potentially good person to talk to in future). Alternatively, try dipping your toes in the pool of disclosure by asking someone about a difficulty they're having. This can be a good way to signal to others that you are open to talking about that kind of stuff. Just listen, ask a few simple questions and, most of all, don't think you have to solve anything. People often don't want a problem-solver, they just want someone who will listen a while without talking over top of them! Ask for a leg-up: When you are experiencing mental health difficulties, its a smart strategy to get some help from others. You can ask for practical or emotional support. For instance, you could ask a friend to take and excercise with you in order to help with low motivation levels typically associated with some psychological issues. Alternatively, you could ask for some company on a night of the week where you feel especially low in mood (depressed people are often prone to feeling relatively more depressed at certain times or in certain situations). I find men are more likely to ask for help if they target (maybe not the best word) someone for whom he's provided help to in the past. Its easier to ask for help when you are in a reciprocal situation and can return the favour at some point. Those are a few suggestions to get you started. The list is endless, ranging from broadening your social support network to adopting a healthier diet. If you're in top form psychologically, then great. But remember, you can reinforce this state by expanding your set of coping tools. If you are experiencing mental health difficulties and are unhappy with your lack of progress, it may be time to think more broadly about your coping style. There are loads of resources out there if you want to investigate this topic in more detail. Visit my resources page for a few tips to get you going. Your comments and questions are always welcome. Jason.  

References: (1) Chandra A. and Minkovitz C. S. (2006) Stigma starts early: gender differences in teen willingness to use mental health services. Journal of Adolescent Health 38, 754–8.

(2) Spendelow, J. S. & Jose. P. E. (2010). Does the optimism bias affect help-seeking Intentions for depressive symptoms in young people? The Journal of General Psychology, 137(2), 190-209.

(3) Berger, J. M., Levant, R., McMillan, K. K., Kelleher, W., & Sellers, A. (2005). Impact of gender role conflict, traditional masculinity ideology, alexithymia, and age on men’s attitudes toward psychological help seeking. Psychology of Men & Masculinity, 6(1), 73-78.

(4) Boman, E. K. O., & Walker, G. A. (2010). Predictors of men’s health care utilization. Psychology of Men 7 Masculinity, 11(2), 113-122.

(5) Wimer, D. J., & Levant, R. F. (2011). The relation of masculinity and help-seeking style with the academic help-seeking behavior of college men. The Journal of Men's Studies, 19(3), 256-274.

(6) Gjerde, P. F., & Block, J. (1989). The early personality context of adolescent dysthymia: A prospective study of gender differences: Access here

(7) http://www.nimh.nih.gov/health/publications/men-and-depression/complete-index.shtml

(8) Magovcevic, M., & Addis, M. E. (2008). The Masculine Depression Scale: Development and psychometric evaluation. Psychology of Men & Masculinity, 9(3), 117–132.

(9) Syzdek, M. R., & Addis, M. E. (2011). Adherence to masculine norms and attributional processes predict depressive symptoms in recently unemployed men. Cognitive Therapy and Research, 34(6), 533-543.

(10) Chang, E. C. (2004). Distinguishing between ruminative and distractive responses in dysphoric college students: Does indication of past depression make a difference? Personality and Individual Differences, 36, 845–855.

(11) Kashdan, T. B., Rottenberg, J. (2010). Psychological flexibility as a fundamental aspect of health. Clinical Psychology Review, 30, 865-878.

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