Clinical Work With Men: Integrating Masculinity, Mental Health, and Spiritual Concerns - Episode 2

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Transcript

SPEAKER_02 0:01

You are listening to Vital Signs, a podcast for Sentera providers. This is part two of our two-part series on men in spirituality with our own Brian Helm, licensed professional counselor. And I'm Tommy Bateman, Director of Clinical Practice Management with Sentera Health Plans. Again, before we start the show, here are a few important CME announcements. This episode is accredited for AMA PRA Category 1 credits. For full accreditation, designation, and disclosure information, please refer to the show notes. And now here's the show. What is a core foundation to existential issues but spiritual issues?

SPEAKER_00 0:46

Yeah, the uh healthy masculinity is much like a uh a lake, uh is uh, you know, it has to have areas of depth and it has to have areas of shallows to be healthy and provide nurturance. And the key is both uh fresh water coming in and also pouring out. So because if we are being poured into but not pouring out, we tend to flood. The lake will flood. And I think the metaphor is very real in that uh a flooding lake does not just affect the lake, it affects the environment all around the lake. And so I think it's critical um, you know, when we're being poured into that we're not just holding on to it. That's a spiritual paradox. If you want to keep it, you have to give it away.

SPEAKER_02 1:32

Yeah. We are professionals, there are rules around spiritual things when it comes to bringing them into the counseling room, right? Now, if your client comes in and says, Hey, I am um a Catholic, uh, that's really important to me. And I really want to talk about those themes here in our session. If I were Catholic, I'd say, okay, yeah, let's let's uh we can we can try to work that out, but just so you know, talk to your priest about some of the specifics, you know, I'm a layman here, right? Um but we're we can use that to inform where we're at. But otherwise, you can't proselytize, you can't say, well, in Job chapter five, hardship means this, but the guy goes, Well, I'm a Buddhist, so it means different for me. How do we how do we get into that?

SPEAKER_00 2:19

That's uh I think it's a really good question. It's not often uh brought up in sessions initially. Yeah, um, and I'll be honest, early on, I didn't bring it up with my clients. I think uh as I have uh grown in my profession and comfortable in my role, I think it I have definitely delved into it uh more easily. I think you referenced, you know, if someone comes in and they're Catholic and you're Catholic, um, that it's much easier. Uh in my experience, uh, it's actually more detrimental because I make more assumptions about what Catholicism is to them. I assume they know what I know. And the tenets that I think are most relevant about Catholicism is going to be theirs. And I think uh though we both hold the same faith, the areas that may be most pertinent and most valuable to them is not the same for me. Even though we have the same faith, maybe the same denomination in the faith. Um I think uh that's where I've made the most mistakes is uh assuming that they uh uh have the same faith as I do because they're, you know, I identify as Christian. Um I don't identify with a specific denomination. Um, but I think that's where I've made mistakes. Um and so uh, you know, jumping in, I I uh in my, you know, when I have done private practice, uh, or you know, when I've worked in a uh a setting, I my disclosure shares, you know, my background and my faith because I try to be uh as transparent about uh where I'm coming from and my experiences, so that if that is something they don't want, then let me know. Like I always tell them I can offer uh uh plain glass or stained glass in the session, you know, whichever you prefer. Um, but I want you to know that I do have that lens and I will try to keep it neutral if you request it, but it's there. And I there's no such thing as valueless counseling.

SPEAKER_02 4:24

That's such a yeah, valueless counseling. Absolutely. That's uh let's talk about that. That was a that was striking. First off, I I I I felt a bit humbled there because I'm like, you're right, dude. It would be uh uh I would assume so much if they said they were the same denomination as me.

SPEAKER_00 4:41

Yeah.

SPEAKER_02 4:42

But our intert interaction with that particular the the creeds and confessions within that denomination are gonna be completely different. So that was awesome. But you see you ended on that um on that statement. Tell me more about that. Yeah, what do you mean by that?

SPEAKER_00 4:58

Uh with regards to the uh um the stained glass or plain glass.

SPEAKER_02 5:06

Yeah, you said there's no valueless counseling.

SPEAKER_00 5:09

Okay. Um, I think uh, you know, when I'm working with someone, you know, uh I try to share where I'm coming from. Partially be especially if uh the person on the other side looks different than me. I want to try and uh uh you know be sensitive to cultural difference, faith differences, um uh and also have a conversation. I've I've I've definitely worked with people of different faiths. Um and uh I've worked with people, you know, Christianity uh has so many different dimensions and uh um I think uh I try to uh just understand. I know uh for some people may not be comfortable. I am I always let people know when I have done therapy with them that, you know, if they have a faith, uh if they're comfortable, I am very comfortable praying with them. Um if that is something that would be of benefit to them, um, when I do pray with them, the I always ask my clients to pray first because prayer is a very intimate thing for a lot of people. And the way they pray, who they pray to, how they speak is says something about their spirituality and their faith. And I want to honor that and not take away from that. So um I don't know if uh I'm answering going back to your question, but I think you know, integrating it is that would be some of the ways I do it.

SPEAKER_02 6:40

Yeah, yeah, and and you know, and and the thought that you had with me, Tara, too, was um, you know, when you said there is no such thing as valueless, you know, uh uh my thought was there's no such thing as neutrality. You know, you know, that even if let's say, well, I don't have a spiritual faith background, but you do have things that fill that hole, like uh or that gap um you have core assumptions about existence that inform how you feel about yourself. And so there is no such thing as neutral, there's no neutral clinical grounds, you know that that that doesn't exist, right? Because the the um even the the benefits, you know, the good, quote unquote, the definition of the good of our clinical work has a value to it, which ultimately comes down to ultimate questions, right? So that that's that's always in the room, even if we don't even say it out loud.

SPEAKER_00 7:38

Yeah, absolutely. Like uh for someone to say, you know, they're atheist, you know, you have to answer the questions about you know uh how you view yourself, uh the world around you, and uh, you know, the meaning of life. Like, and that's going to shape, in a sense, the sessions, maybe nuanced, may overtly. Yeah, but it's definitely there. Um so it's unavoidable, is what I'm hearing.

SPEAKER_01 8:02

Yeah.

SPEAKER_00 8:03

I think so. Especially, you know, when when we're working with men, we've talked uh in the earlier podcast about, you know, the the middle-aged uh men that struggle, you know, the higher rates of suicide. I think that it needs that's a definite need uh to discuss the the meaning uh and really kind of unpacking like uh unpacking that spiritual piece, the existential questions. Um I think uh because you know, there's what are the three lies uh men will often buy into that can lead them into those crises is um I am what I have, I am what others say I am, and I am what I do. And if we buy into any of them, then we have gone, we're in a sense leading our, I think leading, leaning the ladder we're trying to climb against the wrong building.

SPEAKER_02 8:58

So have you had do men how do they engage with you? And have you found what what do you see what happens when they engage with you and the on the spiritual matters?

SPEAKER_00 9:10

Um I I have the luxury, uh at least uh like I had said, like I'm pretty open about it early on. Um some of them ask, uh, you know, that's not what I'm here for, and I'll honor that, like absolutely. Um, and others jump right in. Um but I think, you know, if it's a a good working relationship, uh, you know, when we start talking, you know, anytime uh we start talking about uh, you know, reflecting on who they are or reflecting on legacy, like what legacy do you want to leave? Like I think that just it just naturally transitions into that. And so I think people will go there, but I think for some men they have to they have to know one, you care, and they have to know um that you'll honor what they share, because it they may not share it with a whole lot of people. And so you just have to honor and respect in that area is quintessential.

SPEAKER_02 10:12

What I'm hearing here is that as you go down the road, as you start you know, challenging and reflecting and getting deeper and deeper, the ultimate questions eventually are right there waiting for you. And yeah, and even and so the real as you build that relationship, well even if they started the started the their relationship with you, like, hey, I kind of don't want to go down the road, I don't want to talk about the confessional, like no, yeah, okay, sure, yeah. And then you get down to you know why they resent their wife and have anger during the day every time she comes home, whatever, and you go and you start peeling the layers, there's a um, there's a spiritual question right there, it seems.

SPEAKER_00 10:52

A lot of the time there is, or there is a possible spiritual response to this question that they can't seem to figure out. And so uh yeah, I think there is um there's a a real benefit to going in that direction. Um and there is, you know, you can find uh, you know, with the spirituality, there you can find community, which I think is another critical piece of uh you know healthy masculinity is having a supportive community around you. So when you when you hit that crisis, there's other people that know you and can handle what you're struggling with.

SPEAKER_02 11:37

You know, and I'm glad you brought that up because one of the things, you know, what that we we see as as a trend is the effect of loneliness um on our on our total well-being, physical and mental health, uh especially mental health, because loneliness is kind of one of the worst things you can do to yourself. I mean, they do it for torture, you know, they use loneliness to torture and detention centers. Yeah. And uh so why are we doing it to ourselves while we uh work on Zoom meetings like we're you and I are doing right now? Um, alone in my basement, guys. I'm alone in my basement doing a podcast, you know. So those are those are um having a spiritual community. Again, we talked about our tribes and our mentors, and it all kind of intertwines here. I think men uh men need it. Men need it, right?

SPEAKER_00 12:27

Absolutely. I think uh, you know, the one piece uh that we haven't touched on, but I think is a uh important piece is you know, the the spirituality um is kind of like pouring into the the lake. But I think one of the key pieces is learning how to pour it out. Finding uh someone in your community, finding a uh uh it could be someone in the neighborhood, it could be, you know, a uh friend of the family, uh however it is, but finding a young man uh or someone that you can mentor, um it's uh it's something uh in the military they say see do teach. Um and I think you know the see is kind of being poured into and doing, but uh but to teach it, it sharpens you. And I think as you are out uh into a mentor mentee relationship, I think it really can sharpen you. And I mean the benefit, it's a paradoxical benefit again, like you're giving it away, but it you're getting better because of it. Um, and so I I would say, you know, I I can't uh speak enough about uh mentorship um and finding ways to do that. I'll I will call myself out. I have not been able to uh as of late outside of uh, you know, uh the counseling role that I'm in, but outside of that, uh found a good way to mentor young men. Um so, but I think the need is there. Absolutely. There's men I think are desperate. I would say younger men are desperate for it because um nowadays we as older, I will say for myself, as an older man, I don't have I can't give new information. The internet has taken care of that. Right. I can't pass on new information. In fact, I would say most of my information is outdated because the internet is updating so quickly. But I think um the need for mentorship to put context to the content that is constantly coming out to help them navigate this um can't be understated. I think there are men desperate and they're looking to very unhealthy uh masculine uh mentors online, uh, very toxic out of their own brokenness. And they're looking for, I think it's more of an echo chamber than a healthy mentorship.

SPEAKER_02 15:01

Um let's let's give those guys credit, those toxic leaders credit for something, right?

SPEAKER_00 15:07

Okay.

SPEAKER_02 15:07

They see the problem, right?

SPEAKER_00 15:10

It's very true, and they're capitalizing on it, absolutely on it.

SPEAKER_02 15:14

That that uh I mean if anybody listened to this, yeah, we hate or you know, certain just think of you know, I could say names, let's not hear, but one thing they could say is why are they successful? Why have they got a following to begin with, right? Is because there's something crucially missing, missing. I'm turning to Sean Connery there, crucially missing in our culture, especially in the West right now, that leads us to in a uh uh existential spiritual desert, um, no lake at all. So uh uh let's I I'll give them that much credit. I think it shows the need. Um, and we're and we're more disconnected than ever now.

SPEAKER_00 15:55

Um yes. And uh I think I know you've you may have heard uh this there's an African proverb, it sticks out to me all the time. Um, but I I just pulled it up. It just says the child who is not embraced by the village will burn it down just to feel its warmth. And I think if that is not relevant now in our society today, I don't know what is. I think uh the need for like uh healthy embracing of younger men in some way is critical.

SPEAKER_02 16:23

So amazing. I like that a lot because we're seeing it. We're we're seeing literally, in fact, literal burning things down. Um so yes, that's uh um it is a we can say it's a public health issue if you want to, you know, want to keep it to the the this is a healthcare podcast, so we can say this is a public health issue that needs to be addressed, I think, by everybody, not just us counselors, not the clergy alone. I think uh your PCP may need to start looking into this um as a as a component to a person's total well-being, uh especially a man's total well-being. What so you you mentioned some ways that you would engage spiritual issues, and even if they don't want to engage it right away, us counselors, we peel the onions until we tend to tend to get to those poor things anyway. It's it's unavoidable. But what about the other parts of the healthcare world? What how can they navigate this without jumping into pitfalls, you know, like assuming, oh, you're Catholic too? Man, do this. Hail Mary, save my life, right? How can and I mean PCPs, all the types of uh um uh physicians that we we they have to move fast, psychiatrists have to move fast, but how can they start seeing this as a thing as a as something to help round out their treatment even further without jumping and and falling off the other side of the road into that ditch of prophetizing and being harmful? You know, is this something you can say, hey, actually, you know what? Maybe a counselor can help you here. I'm gonna definitely talk. I think you need to talk this out or blah, blah, blah. What do you see?

SPEAKER_00 18:10

Um, you know, I I think you as a therapist, we have the uh time on our side, you know, whether it's uh 54 minutes or you know, uh uh 45 minutes. But uh I think for uh primary care uh and people that, you know, psychiatrists that have a much shorter period of time, I think looking at community resources, um, getting connected with uh resources that can be of benefit, I think, especially in underserved communities, um, spiritual resources tend to be free. Um and uh they're often opportunities of connection. Um and so uh trying to find out like uh and get the patient connected when they're sharing about their spiritual faith would be a key. Um, you know, a lot of the food pantries are run by not-for-profits. Um and uh a lot of the resources, you know, uh like uh recovery-based, I think there's what we're city uh recovery for the city and some of these other uh uh resources that are there. There's a phone call away or a website away. So I think offering that or getting, you know, using uh was it uh transitional care, behavioral health navigators, some of the folks that have these resources into the hands of the provider so they can share that with their uh patients uh during that short session would be my best suggestion.

SPEAKER_02 19:43

And even even you know, counselors have the benefit of time, but sometimes we don't have the benefit of consistent presence, right? And I'm thinking too, just a PCP can have a you know, refer to counseling and all that stuff, but they could also give a list of here's some local men's groups. Um here's some local community events um that we can get plugged into, and then you you have a place to be, you know, um and you're not alone. Uh just handing out a list. I remember I used to work in jails and I would hand out you know, felon-friendly employers, right? And that's all the difference. They were like, oh crap, I have a plan. And then you know, they went to such and such employer. And I think uh a similar thing for physicians be like, hey, I'm gonna send you a list of um uh boys to men mentoring in Virginia, which is it's a a group, uh I think, you know, in a lot of the cities in Virginia um that can help your teenage son or can help you. You can be a mentor to other folks. You have a rich, you know, a lot of it. You talked about teaching and and uh see do teach and doing that teaching part would really so you I I I do think uh uh uh having a list of those type of resources is actually a spiritual intervention, you know, as well as a social one. So I don't know. I just you got me ripping.

SPEAKER_00 21:07

That's okay. I think uh, you know, as you uh as you begin to delve into it, I think uh spirituality and uh community they enter interweave quickly. Um and I think that's uh you know connecting with whoever your higher power is and then connecting with those around you that have a similar faith is uh really a grounding and healthy way to uh walk through life, I think.

SPEAKER_02 21:38

Have you ever seen an experience um clinical professionals that get paid by managed care organizations, you know, the system, right? Engage with clergy in some sort of way, in a in a uh a formalized way.

SPEAKER_00 22:00

I don't know if this is answering the question, but like when I was at, you know, I worked at uh the Barry Robinson Center uh for several years. Uh and so uh I got to the ad uh church on uh days of the week and holidays, and there were opportunities for the clergy to come in. And I was a therapist. I wasn't doing sessions in there, but I got to be a part of that and uh like Ash Wednesday and some of the other events. Um I think it was uh a great milieu, especially for some of the young men that had never been or had never been to a formal church in a sense that way. So it was a different experience, but I think uh interacting with them, uh uh I think we we shouldn't I personally don't feel challenged by uh clergy. I think we can really support well because there's areas that they can speak to that I am not that's outside of my lane, and there are areas where uh we need to take that and say this is our lane, and the clergy can't for because of their professional guidelines or ethics. So yeah.

SPEAKER_02 23:08

And sometimes they're not as good at peeling the onion, right? And and getting to that core thing. Um so I I like that. And and you know, I I've had a similar experience, right? When I did substitute treatment in jails, we kind of did a head nod. They were head nod to the the spiritual matters, like all right, there's a church, there's your uh Jehovah's Witness meeting, go over there, Islam's over here, y'all go do your thing, right? And if if the clergy leaders came in, cool, whatever, we didn't really have much else to do with it. You know, and I think that was an unnecessary I'm gonna opine here. I want to see if you agree. I think that was an unnecessary separation. Um, of course, we have to we get worried about ethical and you know uh ethical dilemmas there, sure, but the what you told me in the first half of this podcast, and what I'm hearing throughout, is this is a much bigger deal than um than we're letting on, and perhaps we need to start more seriously integrating, um at least thinking about it and addressing it more formally in our practice, instead of just head nodding to it and saying, community's great, and and here's some resources, but like this is something that is more important than we think.

SPEAKER_00 24:22

I I would absolutely agree. And uh, you know, to reference that uh group you're running, uh I'm uh in the detention center. Um, you know, the the head nod to go here. Uh I think if I were running a group like that, I would definitely have to put parameters around that because you're working with uh um, you know, folks that are incarcerated. But I would want to, I would want to bring that into that group and talk about like how do you deal with the suffering that you see every day? How do you make sense of this suffering? Uh you know, in my understanding, when I have worked, I have worked in the detention center. It was a juvenile, but you know, there's there are some some pretty good guys that did one or two bad things and they're having to deal with it for long-term consequences. But you know, how do you deal with that suffering? How do you make sense of this? That that could be a really good conversation. No matter what man is in that room, no matter what faith, I think all of them may get something from that, or at least consider a different angle that could help them through the next day.

SPEAKER_02 25:26

So that's what I'm I'm I'm feeling here is that you know your experience professionally is we didn't integrate it enough and it was separated because you know, we all went to grad school, we're scientists, we're we're social scientists, uh, medicine. And um but geez, 90% of our health issues right now come from a behavior, you know, uh obesity, high blood pressure, you know, they come from behaviors that may be coping for ex core existential issues, you know. I'm not trying to over-generalize it, but man, that's certainly a component that we need to take a look at.

SPEAKER_00 26:14

Yeah, I think uh, you know, when I when I went to grad school, there was a professor uh that I just truly loved, like uh Dr. Grassard, he was in the substance abuse program. Um, but he talked a lot about the biopsychosocial model. Um, and he would always add the need, like he's like, we're human. He's like to remove the spiritual part of that model is to remove part of the humanity of the person. And so I don't think one should take precedence of the other. Um, but I think we need to be aware of all aspects of the human experience, especially for men when they're in the session, because they're bringing it in. We're just choosing maybe not to talk about it, either because of our own comfort or our own uh yeah, lack of uh knowing how to deal with it or address it.

SPEAKER_02 27:06

And we've kind of come full circle, you know. We started this thing talking about men, what they experience, their uh the issues that come out of not having mentors in a tribe, and we landed on a lot of the stuff is existential, a lot of the stuff is the messaging we're hearing uh from our culture, um, questionings, questions we have about our own value, and that just naturally led into the spiritual stuff, and then we're thinking, well, man, as you said, biopsychosocial does not include spiritual. All our models, not all of them, but a ton of our models don't even don't even include the spiritual side. But dude, people are you know completing suicide over these issues. Um, their their marriages are falling apart, their relationship with their children is falling apart, not because they have clinical depression, you know, clinical depression, um, explosive anger has been and the it's just the expression of what the core thing is going on. And and and as you said, our current models aren't enough to address that. Um so this has become an advocacy podcast more than anything, I feel like, Brian. What do we I mean? I want to give you the last word. So what what uh how do you want to wrap this up?

SPEAKER_00 28:26

Um you know, I I just think uh, you know when uh you're a man is coming into therapy or into uh a session, um metaphor is great, but I think uh looking at the whole the whole person. Um and you you know what we talked about, you know, the three areas that I think are a sign of healthy masculinity, you know, uh some form of spirituality, um, you know, having a a supportive and uh community around them, and then being able to pour out into somebody. Um, and so I think uh, you know, spirituality, like if you're using the land navigation, like it's great to have a map, but man, the compass is the spirituality, it'll give you a point in the direction that you need to go oftentimes when you're lost. And so I think it can be really beneficial to have those conversations as a provider. Absolutely.

SPEAKER_02 29:27

Brian, thank you so much for coming on and talking about this topic. I mean, typically we're you know, we we talk about trauma, we talk about grief, but we've talked and we talked about clinical models, but this time we talked about something that doesn't get talked about enough. So I appreciate a I appreciate your courage to to come and talk about these things today.

SPEAKER_00 29:45

Sure. I appreciate the invitation, Tommy. Always enjoy it.

SPEAKER_02 29:50

And that concludes our two-part series on men and spirituality with Brian Helm. Again, Brian, thank you so much for coming on. That was a very, very enjoyable episode. As a reminder, if you have any continuing education needs, please check the show notes for instructions on redeeming him. Until next time, this is Vital Science.