November is Men’s Health Awareness Month. In honor of this increasing awareness, I’m sharing what I learned during my time as a Men’s Trauma Therapist. Before pursuing my private practice full-time, I was working at a behavioral health program connected to a large hospital system. For years I worked with adolescents and women and during my last year and a half in my role, I worked as the Men’s Trauma Therapist. During my time there I learned some invaluable lessons about men’s mental health:
1) Men can be vulnerable; let’s give them the space:
We have built a system that does not encourage men to speak up, especially without judgment. Often I would hear from men that if they shared how they felt, they were met with responses that felt shameful and disappointing. I challenge you to think of some of the biases about men and their roles in our society. We must let go of these biases when creating therapeutic space. Imagine that our patients are wearing these assumptions of them as a jacket of perceived safety. Once we acknowledge that men have much more depth than what society expects of them, we open the doors to safe space.
2) Men are not always socialized to seek help:
Mostly all the men that came into our program were there because this was their last-ditch effort. Their partner, job, or family were pushing them to get the help, therefore it was extrinsically motivated. Their childhood experiences were not encouraging of asking for help and most signs of pain or weakness were further neglected and often abused. So how can we expect an adult male to wake up one morning and say “today is the day that I get help” if he has been taught the opposite? Normalizing that asking for help is a HUMAN experience is the first step. Next, I strongly encourage men to acknowledge what they have learned about asking for help. Recognize feelings of shame, anger, sadness, and fear that their inner child parts have experienced in connection to seeking support. As we begin to support men through different therapeutic interventions, build in opportunities for them to ask for help and receive it with compassion.
3) Anger is often a symptom of chronic hyperarousal:
“I have anger issues” was a common complaint from male patients. During the first session with a patient, I’d review the window of tolerance, a model that was built to understand how our nervous system reacts to traumatic memory and experiences. Hyperarousal consists of higher reactivity emotions and sensations: anxiety, irritability, anger, hypervigilance, impulsivity, risk-seeking, overwhelm, etc. Instead of seeing anger, aggression, and rage as undesirable emotions, it is helpful to identify how traumatic experiences triggered a hyper-aroused state. This leads us to go deeper and identify the root of the emotions that are most commonly seen as “anger issues”. While addressing the deeper issues, it’s also important for men to learn the appropriate skills that soothe the nervous system and reduce hyperarousal to get back inside the window of tolerance. I encourage not just learning the skills but practicing and modeling them in real-time to support men in learning how to change.
4) Women can be perpetrators of trauma:
Remember when I said that we are all human? That doesn’t exclude women from being perpetrators of abuse and neglect towards men. Many of the male patients I worked with who grew up in an abusive household had the following: a physically abusive father and an emotionally neglectful mother. Although forms of intrusive and violent abuse are damaging to the psyche and self, neglect can permeate deeper into relationship stability. Many men who have experienced abuse and neglect in vulnerable relationships tend to feel a lack of safety with intimacy, vulnerability, and experiencing deep connection. In heterosexual relationships with women, men can feel triggered by past traumatic experiences whether it was with a female caregiver, family member, or partner. It’s critical for providers and support systems to acknowledge the forms of neglect that are less recognized. Furthermore, supporting male patients in increasing their awareness of triggers relating to the women in their lives can help in building change-oriented skills.
5) Men can lead men through healing:
The program that I led was group-focused which was often a shock for incoming patients. “You expect me to open up and talk in front of all those other guys?” Remember, for men who have experienced chronic hyperarousal, feeling on edge and unsafe can be their norm. What I found to be the most helpful was stepping back and allowing the men to lead one another. As humans, we learn to model behavior, which can be relearned in adulthood within a safe space. We often see leadership being validated in roles that are “socially acceptable” for men, why not validate that leadership where it can support others in their healing journey? Creating a strong bond amongst men can lead to ongoing support even after they leave treatment.
Therapy and trauma treatment is unique to each individual. When working with men it’s imperative for providers and support systems to recognize specific needs. As always, I encourage us to take a look inwards and compassionately challenge our own stigmas and beliefs before stepping into a helping role.
Written by Shikha Patel, MSW, LCSW, Owner & Founder of Collaborative InSights, LLC
