Politics of Masculinity from A Men’s Mental Health Therapist
Written by Dr. Jillian Kaufman, Lead Psychotherapist & Founder of Wavelength Psychotherapy
KEY POINTS:
Boys & men often struggle with what it means to “be a man.”
As a men’s mental health therapist, I know there is no crash course for the psychology of men.
Society teaches men to suppress their emotions, leading to higher rates of suicide, violence, and substance abuse.
We should encourage men to express themselves in life and therapy.
Addressing Masculinity
Among well-intentioned practitioners, I will sometimes raise the subject of men's struggles with upholding standards of masculinity. They often respond with dismissal or questions like, “Were you one of those girls who didn’t get along with other girls growing up?”
As someone whose job is to "ask questions," these conversations that dismiss concerns about masculinity feel suffocating. They permeate my sense of competence as a psychotherapist who has a caseload of men.
A few years ago, I expressed my concerns to a colleague. I explained how, at the outset of my career, I wanted to help female survivors of sexual violence. I feared I had lost sight of my original vision by working primarily with men.
“You are helping women” she replied, “more than you realize.”
Like many young women in my generation, I challenge gender norms and envision a society where sexism and misogyny don't dominate. At the same time, I'm keenly aware of how restrictive sex-role norms shortchange men.
Men's Struggle With Masculinity
I have met hundreds of men and boys who find expressing their emotions challenging. They are in a constant struggle between two versions of masculinity:
Masculinity that is traditional, older, unabashedly patriarchal, and focused on hierarchy and power;
And modern, younger, more ecological masculinity that is centered around mutuality and partnership.
Men of all ages have been coming to me, seeking answers to the cultural crisis surrounding masculinity. The stakes of this struggle are incredibly high and complex.
Unfortunately, my doctoral program didn't offer any 'psychology of men' courses, and my residencies (indentured servitudes is a better term, perhaps?) didn't include any training on men's issues. So, I have been navigating the complexities of working with male clients by myself and continuously learning how to assist them.
What I’ve Learned About the Psychology of Men
So, what have I learned? Our culture often expects men to suppress their emotions, feelings, relational needs, and desires. This leaves men disconnected from emotions and people.
Men have higher rates of:
suicide
substance abuse
prevalence of violence
shorter life expectancies across the spectrum
Authentic connection, meaning intimacy and vulnerability, is our natural human state. It is the state we begin life in, the state we function best in, and the condition we crave despite our wounds and defenses. But disconnection is often imposed on boys and men.
By the time boys reach kindergarten, statistics show they're already measurably declining in their willingness to express their feelings. Men still experience emotions, but they won't talk about them due to the expectations of masculinity. Unfortunately, children as young as three, four, or five years old internalize this. The cost of this disconnection in boyhood is disconnection as an adult.
For This to Change, Men Must See Emotion as Part of Their Humanity
Today, we see the beginnings of societal change. Young people boldly and bravely move forward with new, more flexible frameworks of gender and gender roles. Despite this more progressive culture, there are still days when I feel useless after back-to-back sessions.
Typically, this feeling arises after sessions where a male patient indirectly says, "It's fine. I got it." I can tell these men are feeling something but holding back. I notice constricted jaws, racing knees, and furrowed brows: Their bodies are literally fighting against a revelation.
Men fear showing their emotions partly because having them has real-world consequences. Connecting with emotion may mean they’ll cry and be seen as ineffectual and weak. Men need to understand that emotion is a part of their humanity. We were born to cry. They’ve just lost their capacity and skill.
During therapy, I try to connect with their pre-patriarchal voice, the voice that existed before socialization into ideas of what it means to be a "real man."
Attraction and Sexualization Do Occur in the Male Therapeutic Relationship
QUESTION: “Do you ever feel attracted to a male patient?” “Do they ever admit having a crush on you?”
MY ANSWER: Occasionally accompanied by an eye roll, my responses are, 'Uh, duh, I have eyes and a pulse,' and, 'This is the reality of the human desire.'
Our society encourages boys and men to look at sex as a conquest (For reference’s sake, attempting to sleep with your therapist is a hell of a conquest), where sex becomes the only vehicle for human connection and intimacy. This stereotype is a disservice to the humanity of men and women. It reduces the humanity of women (In this case, a female therapist) to a one-dimensional object rather than a multifaceted individual.
Like most therapists, I didn’t receive training on how to deal with sexual feelings in therapy sessions. Clinical supervisors are skilled at deflecting these conversations. They may do this because of their own insecurities or reactions to patients. So, most of my learning has been on the job, and (potentially to the dismay of my team) I don’t avoid this topic.
I'm keenly aware that men perceive me as a woman first and a therapist second. A patient may interpret my physical presentation as seductive or sexualized the moment I walk into my office. Whether you’re ready to ‘cancel’ this blog post or second-guess my validity as a practitioner…I assure you that my boundaries and self-awareness are intact.
Rather than fearing or dismissing a client's attraction to me or mine to them, I can embrace it as an opportunity to understand what intimacy means to them. There are days when I feel used, sexualized, and resentful, and others when I notice feeling flattered. Both sides of the coin are opportunities. If the patient’s idealization or undervaluing of me does not cause any disturbance in the therapy, it merits exploration.
The client may elicit these feelings in other relationships in their life. Perhaps the client triggers something from the therapist's past or current relationship. I often become a symbol for the women in my patients' lives or the beliefs they've developed about women. Developing feelings for someone who cares for you is also natural; it's a human and relatable quandary.
This element of my relationships with male clients is often hard to explain to outsiders. I’ve only ever wanted respect from my patients. I don’t want to be sexualized in my work, but this is only temporary. I help my clients grow, and this work is very meaningful to me.
Men Are Often Skeptical
QUESTION: “So, Doc, tell me in your own words–what do you think my problem is?”
Unlike my work with female patients, there’s no shared experience on which to build a therapeutic bond. When meeting me for the first time, many male patients are circumspect and test me during initial sessions. I welcome this.
Most beginning conversations aim to discover if I will be helpful or not. Male patients have questioned my work history, academic record, and personal experience with their problems. I have learned not to be defensive when a man confronts me this way.
MY ANSWER: “Yes, I treat erectile dysfunction, but no, I’ve never had a penis.”
Men may be less likely than women to seek psychotherapy, but when their penis doesn’t work, they reach out.
Men's Therapy Requires Working With Both Their Entitlement and Their Shame
When I’m frustrated, I’ll lie on my office floor and ruminate. Thoughts like, ‘Why am I helping this person?’ permeate my mind as I wonder, in disbelief, how any human could be so grandiose.
It's essential to remember how society socializes people. Families often praise boys for their assertiveness and desire for power while discouraging the same traits in girls.
We must work with both the grandiose and entitled part of men and the shamed and disempowered part. I hold both in the highest regard. To love this work is to love all the nuanced complexities of the human condition.
I Believe In Having The Hard Conversations
Most therapeutic training advises taking things slow, creating safety, and remaining neutral when helping clients face difficult truths, especially when addressing their obnoxious, selfish, or self-defeating actions.
In my experience, however, soft-pedaling complex issues doesn't do clients any favors. Some might call my approach confrontational, but “confrontational" is misleadingly adversarial and only addresses half the process. I describe this directness as "having the hard conversations." I hold my clients in the warmest regard while holding their feet to the fire.
I Approach Men's Therapy With Humility and Respect for Their Autonomy
I admit my humanity and imperfections to my clients. I am no better than them. If intimacy is demanding for them, you can bet it is for me, too. When patients come from dysfunctional families, I own that most of us do too. If they look ugly when they lose it, I acknowledge my own 'unflattering' moments.
I often rely on humor, down-to-earth language, and judicious self-disclosure to level the playing field with male clients. They tend to be keen observers who pick up on fakery fast. I display confidence and communicate openness, good humor, and a sense of "keeping it real." Successful treatment is about continuing to show up as a person, not a jargon-spouting expert.
I do not tell men what to do or try to control them. It's their life. They get to do what they want. I am, however, clear that they will suffer the consequences, and I'm blunt about those consequences as I see them.
Ultimately, I tell all my male patients that they decide how interested they are in getting the help they came for. Detaching from the outcome of any client's therapy doesn't mean I don't care–it means I respect their autonomy.
I Honor the Boys and Men Who Sit on My Couch
My goal isn’t to change how men think and feel about themselves or their masculinities. I don’t work to eliminate more traditional characteristics or principles like being strong, powerful, and courageous. I support men being and feeling many things simultaneously: a helper and a student, exceptional and average, high-achieving and calm.
Although all the men in my practice are different, they share a common thread: They are men we know, love, and possibly have lost. They are everyday guys from all parts of the country and various social strata, who could be anyone’s boyfriend, husband, brother, or friend.
You have read this entire blog post now and likely realized it does not contain clinical advice or self-help techniques. It is written in a satirical and personal style, mostly prose, and does not include lists, exercises, or affirmations.
I aim to take readers on a journey with me, in vivo, as I honor the boys and men, made of flesh and bone, who sit on my couch. I offer my analyses and personal reactions to the men, not just as a therapist, but as a woman.
Jillian
Dr. Jillian Kaufman is a therapist specializing in men’s mental health. She’s a newlywed, an adjunct instructor at New York University, and filled with sarcasm and coffee. Her practice, Wavelength Psychotherapy, is based in New York City and Northern New Jersey.
