Men are from Mars...

The majority of clients I see in my private practice are female. I have noticed that I tend to approach therapy from a different perspective when I see male clients, and I decided I might share some of my thoughts on the subject here.

Although this has not always been the case, I've noticed some patterns that have often occurred amongst my male clients:

• Less willingness (ability?) to discuss their issues in terms of feeling and emotion;
• Attending sessions because others (i.e., their girlfriends or wives) want them to, not because they really want or feel they need to be there; 
• Wanting quick, immediate answers to their problems (which sometimes leads to pushiness or impatience). 
• Unwillingness to explore seemingly unrelated matters (i.e., childhood issues, relationships with parents [past or present], relationships with other people). 

I've also come to realize that sometimes I might approach therapy differently not because these patterns exist, but because I have a preconceived notion that they will. I find I have a tendency to "jump in" to issues more quickly with male clients in an effort to have them feel that their time isn't being wasted and that they have a definitive reason to continue attending therapy sessions. In a way, their [real or perceived] discomfort becomes mine, and I want to leave them with something more...concrete. I tend to use more humour, and in some ways make 'light' of the therapy process... as if to say, "it's not what you think! I'm not going to analyze every word you say; I'm not going to emasculate you by making you talk about your feelings for the whole hour. You can relax. It's okay."

And indeed... I think I tend to ask fewer "feeling" questions with this particular sub-group.

In general, there are many narrative, experiential, and psycho-dramatic aspects to my work in therapy. I incorporate a fair amount of cognitive-behavioural techniques as well, but find that I incorporate these to an even greater extent when working with men. It's specific, it's direct, and it's working in the here-and-now. Maybe it's safer ...

But safer for whom? Them? Or me?

Perhaps it's the societal assumption that feelings and emotions are uncomfortable issues for men to explore, and thus they have greater difficulty identifying with them. Many have been brought up to present themselves as strong and stoic; to show emotion is to show weakness and vulnerability. With clients who more are more, shall we say, 'stereotypically male' and out of touch with their emotions, I have brought this to their attention with varying degrees of receptivity and understanding. Some are willing to examine their emotions than others in the context of a safe, therapeutic environment. Others see it as a waste of time and become visibly uncomfortable. Many don't attend more than one or two sessions.

Some male clients I have worked with seem unwilling, or perhaps unable, to discuss their experiences in terms of feelings. I had hoped, during the course of one particular session, to help my client connect some of his current relationship troubles to the events he experienced and witnessed growing up in a household that was, by his account, almost entirely devoid of emotion. He didn't seem to know how to share his feelings at all, and this was, in large part, what his current partner was feeling frustrated by. I felt at a complete loss as to how I was going to help this client access the 'feeling' part of himself. I was confident that taking care to develop a strong foundation of rapport and a therapeutic alliance would facilitate the process...but I had no idea where I'd go from there.

Even now, as I recall these various sessions and think about what I could have done differently or how I'd have proceed if therapy were to continue, I'm not sure I'd know how to best answer these questions! 

How do we most effectively work through the challenges and resistances I've mentioned here, with men or with women? Are there particular therapeutic approaches or techniques we tend to utilize more with one subgroup of clients or the other? Is it because they are, in fact, more effective, or are such decisions more a product of societal norms and stereotypes?

Perhaps they speak more to our own discomforts,  insecurities, and misconceptions than they do our clients'.

-----

Please note that I do recognize that every client, regardless of sex, gender, or any other identifiable characteristic, is unique. I understand that there are many complexities to these issues and it is impossible to compare clients strictly based on one quality such as sex. It has not been my intention to perpetuate stereotypes in this post, only to point out some of my personal observations and to facilitate discussion of these therapeutic challenges.

-----

Thanks for reading!