Caring for men and boys. In this final episode, focussing on psychotherapy with male shame, I look at the qualities that need to be present in the therapeutic environment if men are to feel OK enough about themselves and the therapist, to do their psychological work. I also look at the pitfalls that can prevent a positive psychotherapy outcome. I’ll be redefining aggression as an evolutionary and existential necessity, in a way that I hope will stop it being taboo.
Good Guy of the week is an inspirational young footballer, Nick Tsaroulla who, in spite of serious injury in a car crash and doctors doubting that he would ever be able to play again, made a splendid comeback in league football.
Caring for men and boys. In this final episode, focussing on psychotherapy with male shame, I look at the qualities that need to be present in the therapeutic environment if men are to feel OK enough about themselves and the therapist, to do their psychological work. I also look at the pitfalls that can prevent a positive psychotherapy outcome. I’ll be redefining aggression as an evolutionary and existential necessity, in a way that I hope will stop it being taboo.
Good Guy of the week is an inspirational young footballer, Nick Tsaroulla who, in spite of serious injury in a car crash and doctors doubting that he would ever be able to play again, made a splendid comeback in league football.
Psychotherapy with Male Shame: Part 4
In this final episode that focuses on psychotherapy with male shame, I’ll be looking at the qualities that need to be present in the therapeutic environment if men are to feel OK enough about themselves and the therapist, to do their psychological work. I’ll also be redefining aggression in a way that I hope will stop it being taboo.
I want to emphasise here that we can’t process any of our life experiences if we are in the defence or survival states of shame or rage; we can only process experience when there is a degree of safety. In my experience, when there is a degree of safety, a person’s body knows exactly what it needs to do at any given moment to heal itself and it will naturally do that. It follows then that the main tasks for therapists are firstly, to maintain an optimal environment where the client feels a degree of safety and secondly, to trust in the client’s own natural healing process.
Let’s look more closely now at the qualities necessary for the environment to be optimal for doing the psychological work. Of course, in any therapy we’d expect ‘respect’ to be at the top of any list of requirements, and it is, but I just want to flesh this quality out a bit more. Along with respect for the humanity of a male client there needs to be a respect for traditional masculinity; traditional masculinity as an ok masculine identity amongst other ok masculine identities, for the inevitable strengths that he will have and very importantly, respect for his version of events. So many male clients that I have worked with have not had their version of events believed, often their story has been trumped by that of another person or agency.
It’s also important to respect a male client’s preference for which of the elements, thinking, feeling and behaving which we talked about in the last episode, that he uses to integrate his experience and lastly, I think there needs to be a healthy respect for aggression. I’ll come back to my definition of aggression shortly.
So other qualities that the therapist needs to offer are
· placing their attention exclusively on the client
· allowing the content of the session to be led by the client
· allowing the pace of the session to be led by the client
· offering warmth
· validation in terms of recognising that a person or their feelings or opinions are valid or worthwhile.
· a normalising if trauma, rage and shame
· curiosity, an expression of interest in the client
· affirmation, in the form of emotional support or encouragement
· kindness
· humour
· empathy; the ability or attempt at least, to understand and share the feelings of another person
· and finally there’s a need for a gentle handling of vulnerability
And now I’d like to talk about aggression. This may sound controversial, because of the assumption that aggression is associated with violence, but I think it’s particularly important to welcome this phenomenon, which I don’t associate with violence, and which I’m going to say more about here.
I looked up definitions of violence and aggression in the Merriam Webster dictionary. To my surprise, what I found were two remarkably similar and negative characterisations.
Violence was defined as, ‘the use of physical force so as to injure, abuse, damage, or destroy’; strong words indeed; and aggression was defined as ‘forceful action, attacks, and hostile, injurious or destructive behaviour’, similarly strong words.
So, in the dictionary, and also, I would argue, within the discipline of psychology, aggression is perceived as a hostile process, overlapping significantly with violence.
I’m going to differentiate here between aggression and violence, and acknowledge it’s evolutionary and existential necessity, thereby placing it in a more positive light.
To persuade you and add some credibility for my more positive definition of the word, I’d like to point out that the word ‘aggression’ comes from the Latin verb ‘aggredi', meaning ‘to approach, attack, or undertake’; and when "aggress" was first used in the English language in the 16th century, it meant 'to approach’, not quite as threatening back then.
I’m going to share with you Fritz and Laura Perls’ definition with you and then I’ll share my own.
‘aggression is a biological function and an instrument that enables the very preservation of life……..and which regulates contact with the environment’
Well that’s not too offensive!
And now my understanding of aggression
‘it is indeed a force, but a force for good. Quite simply, I see it as the energy that powers our penetration of the world; the energy through which we make our unique presence felt, the energy that powers our assertiveness, our curiosity; it fuels our exploration of the world and our appetite for learning and mastery of things.
Overall, I see aggression as a means to tackle things, to attain goals for ourselves and to chase our dreams, and also to support others to achieve their goals and chase their dreams.
Aggression is a means to protect ourselves and those we are responsible for, but it is boundaried, executed with care and respect, and it doesn’t harm or belittle another person’.
If we are not allowed our healthy aggression.
It’s my belief that without it, we can’t show up safely and fully in the world, can’t have an impact in the world, can’t build a meaningful life for ourselves and can’t fully manifest our unique contribution in the world.
Many of the clients I work with have never been allowed their aggression, or have been conditioned out of it; they can be passive, too appeasing, pleasing or accommodating which then gives rise to shame and rage.
In my opinion, clients need to be helped to recover or discover their latent aggression, to experience all the benefits of that, which will also benefit other people in their life.
In my mind and vocabulary, aggression has a closer association with healthy anger, indeed I think it’s the energy behind healthy anger. And again, in my mind and vocabulary, aggression has a closer association with healthy anger than it does with violence.
Confusing aggression with violence limits a person’s emergence and growth.
Finally, I include an analysis of therapist practices that could undermine a positive outcome in psychotherapy for a male client.
• If the therapist were to hold a negative attitude towards traditional masculinity
• If they didn’t understand all the ways in which men go unacknowledged for their contribution to the world; all the ways in which they are taken for granted or didn’t understand that men experience many social disadvantages
• If they don’t take the time to build relationship and trust; it’s never OK to rush a client along but bearing in mind Allan Schore’s research, it’s especially not OK to rush a male client, it’s important for them to set the pace
• It’s not helpful if a therapist overestimate their male client’s strength / or underestimates his vulnerability
• It’s not helpful if they make problem behaviour the focus of the work rather than the issues that underly the problem behahiour
• It’s a mistake to overemphasise the emotional component of the integrating process
• It’s not helpful if a therapist doesn’t understand that, for a man, taking action or thinking things through may be more important that expressing emotion. I believe that some therapists lament, in the opposite way to Rex Harrison in the film, My Fair Lady, ‘why can’t a man be more like a woman’ thinking that then they’d be OK!
• It’s not helpful if the therapist lacks an empathic understanding of shame and rage as trauma behaviours;
• or to think that men are in need of reconstruction, reprogramming or other forms of social engineering
• or if they don’t understand that shame may come from many sources, so having too narrow a focus, for example, just from parents or caregivers.
In conclusion to these four episodes I want to reiterate that shame and rage behaviours have nothing to do with natural masculinity; they are human responses to trauma, experienced by everyone; they say nothing about masculinity per se.
Secondly, I want to say that as therapists, we do men a great disservice if we are not aware of, or turn a blind eye to, the misandry, the low opinion of them that is embedded in our culture; and if we turn a blind eye to the many social disadvantages that they experience. I refer you to a book which you are certain to be aware of, written by William Collins, a prolific researcher and conference presenter on men’s issues entitled ‘The Empathy Gap: Male Disadvantages and the Mechanisms of Their Neglect’; I’d also like to refer you to his website, The Empathy Gap.
A penultimate point I would like to make is that of course, the psychotherapy work I do does not suit every man, just as it does not suit every woman; and also, some of the men I have been blessed to work with, go on to complete their work with a male psychotherapist which I am really pleased about. A male friend of mine told me, “I think a female psychotherapist can help a man to process his psychological injuries up to and including adolescence but then he needs a male therapist to nurture his adult male self. I am happy with that!
Everyone needs compassion for the shame and rage issues, including men and boys.
Good Guy of the Week
In July 2017, footballer Nick Tsaroulla had been due to play his first pre-season friendly after being signed by Tottenham Hotspur, but a car crash left him in excruciating pain and with doctors saying he may never play again.
For months doctors tried to work out what the pain was. Nick said ‘It was very difficult to figure out, it just sort of affected the whole nervous system."
Spurs, whose academy he'd been with since he was a boy, let him go.
Nick told Radio 1 Newsbeat, “I went in for the meeting, I've never felt something like that. It was such a horrible day. I remember lying down crying my eyes out and thinking, 'one day I want to prove everyone wrong’ ”.
Sleepless nights followed because of the pain and running for even just a few minutes left Nick in agony. He remembers it as a ‘dark and difficult time.’ And feeling that a superpower had been taken away from him.
Doctors didn't know if the pain would ever go away and he spent a year with a sports injury rehabilitation clinic. Nick said it was about finding that "inner strength"; that he thought ‘these are the cards I've been dealt with, how am I going to react to it? Am I going to let the car crash define me and be the boy that ‘could've made it?' "
"I'd been playing football from being six years old” he said, it was all I ever wanted to do - so having it taken away from me was very, very hard to deal with.
Earlier this month a dream came true for Nick Tsaroulla, now 21; he played in his seventh professional match for the League Two side, Crawley Town in the third round of the FA cup against premier team, Leeds; during the match he scored his first ever senior professional goal; hitting a powerful shot low into the far corner.
In this match that stunned the football world, Crawley Town beat Leeds United 3-0. Following this win, Nick said his life, and all the pain he'd suffered, flashed before him in that goalscoring moment. As he celebrated with his family, ‘everyone was just crying’ he said, ‘they'd all shared my pain. It was a very special moment for us. I just felt very blessed to be able to be on the football pitch and doing what I love doing."
Almost in tears Nick said, “it's nice I can show emotion in football, and that people react to it positively and if it inspires one person, I'm more than happy with that”.
He can look back now and gain strength from what happened and he gave some advice to Newsbeat listeners; “you don't know what's in store keep going, keep plugging away, keep trying. And finally, he said “if there's just one kid out there who's going through something similar , please don't give up."
He got a hugely positive reaction online. And I’d like to give him a hugely positive reaction here for being a fine young men’s role model.