Healthcare Training Institute - Quality Education since 1979
Psychologist, Social Worker, Counselor, & MFT!!

Section 1
Track #1 - Introduction & Defining Masculine Depression

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Answer Booklet | Table of Contents
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Introduction
Welcome to the Home Study Course entitled "Fear of Feelings: Treating Male Suicide and Depression" sponsored by the Healthcare Training Institute. Our primary intent for this home study course is to provide quality education to foster your professional growth. The Institute has provided quality education since 1979 to thousands in the US and Canada as well.

Hi. My name is Brian Clark. I will be the narrator of this CD. We appreciate that you have chosen our course as a vehicle for you to earn your Continuing Education Credit.

The purpose of this course is to assist you in increasing your knowledge regarding how to treat patients, clients, etc., who demonstrate characteristics of masculine depression.

As each case study is given, if the concepts seem to be applicable to your situation, I encourage you to turn your CD player off and make a few notes regarding the application of the principle to your setting. However, these notes are for your purposes only and are not to be sent to the Healthcare Training Institute. Also each track is very content dense. So feel free to replay the track to review the content.

Regarding completion of the Answer Booklet… at the end of each CD track, a question is asked. This question corresponds with a question in your Answer Booklet. Merely write the correct letter on the blank line that precedes each question. Keep in mind there is nothing tricky or hard about these questions. They are merely intended to verify the playing of this CD.

These questions are sequential and deal with the section of content that preceded it. For this reason, to facilitate answering each question, you might read the question from the Answer Booklet prior to listening to that CD Track. By knowing what the question is ahead of time, you will know the content to listen for that contains the answer. So just a hint, after you answer a question, read on to the next question in order to give you a "heads up" to listen for the content that contains the answer.

For the purpose of brevity, most generally I will use the term "therapists" or "mental health professional." However, don't let these terms deter you from applying the concepts to your situation. When you hear the word "therapists," if your job title is social worker, psychologist, marriage and family therapist, mental health counselor, professional counselor, resident director, program assistant, etc. merely substitute the appropriate term that is the most meaningful to you. In short, don't let my use of the term "therapists" cognitively deter you from hearing the content of a track because your job title is school counselor, for example. I will also use the term "client" for the purposes of brevity. However, if you deal with patients, residents, students, consumers, etc. transpose "client" to the term that is the most meaningful to you in your work setting.

This CD discussion of "Fear of Feelings - Treating Male Suicide and Depression" will include such topics as: Defining Masculine Depression, The Mommy List, Imaginary Stranger, Counterdependence Not too Close, Not too Far Away, Self-Empathy, Homophobia, Fishbowl Technique, Creating Narcissistic Extension, Fighting Fairly, Getting Off the Defensive, ABC's and a D, Lashing Out the Anger Diary, Systematic Desensitization, and Costs and Payoffs of Abuse.

So let's get started…

Far more women suffer from depression that men do, so it seems odd that women would commit suicide at only one-fourth the rate of men. The key difference between the two sexes may be that women talk out their problems. George E. Murphy, an emeritus professor of psychiatry at Washington University School of Medicine in St. Louis, says that women may be protected because they are more likely to consider the consequences of suicide on family members or others. Women also approach personal problems differently than men and more often seek help long before they reach the point of considering suicide. As a result, women get better treatment for their depressions.

As you know, we typically recognize people as being depressed if they exhibit feelings of sadness and hopelessness, a low of self-esteem, changes in diet and sleeping patterns, and tendencies toward isolation. What my colleagues and I have found, though, is that these characteristics describe a typical depressed female. Do you agree that you are more likely to diagnose women with depression because you see these symptoms as classic signs of depression? According Dr. Caroline Dott, when women are depressed, they often avoid conflict, blame themselves, and feel as though they were born to fail. Men, on the other hand, will often create conflict, place the blame on others, and feel as though the world set them up to fail. Do you agree that what we sometimes fail to see is that these criteria for depression are partial to our cultural and social expectations of how men and women should behave? Women are more likely than men to worry, cry, and mope when they are depressed, while men will more often act out aggressively.

You may be asking yourself then, "How is masculine depression different from feminine depression?" Masculine depression involves emotional pain similar to that of feminine depression, but I have found that the pain is manifested in different ways. For instance, as mentioned earlier, instead of crying or talking about his emotions, a man might demonstrate anger and self-destructiveness in response to painful feelings. He might distract himself by drinking, gambling, womanizing, or working. According to Overcoming Masculine Depression, males complete suicide four times more often than females in the United States.

Lynch and Kilmartin have come up with a different viewpoint regarding distinctions between feminine and masculine depression. Feminine depression is characterized by direct expression of feelings, like telling others about their pain. It is also characterized by "acting in" behaviors, which could be crying, moping, loss of pleasure, and insomnia. Masculine depression, on the other hand, features dissociation from feelings.

Dissociation or Disconnection
You already know men and women are conditioned in our society to behave in certain ways according to their sex, referred to as gender socialization. Women, of course, are raised to be feeling oriented and self-reflective, and they often look within themselves first when they feel depressed. Men, on the other hand, learn to look for answers to their depression outside of themselves. They seek to control their emotions rather than express them. Such reactions are common because our society expects men to be powerful at all times, extremely independent, and virtually numb to their emotions.

Think of a male client you are currently treating in which emotional dissociation occurs when he detaches himself from his emotions and cuts off any awareness of what he is feeling. Would it be helpful to share with your client the following information as outlined by Lynch and Kilmartin? I found it helpful to discuss with Foster, a 42-year-old warehouse worker, Lynch and Kilmartin's concept that feelings can be expressed in three ways. Foster hated his job, and his wife Laura had left him for an old high school boyfriend. I explained to Foster, "One way to express feelings is direct expression. An example of direct expression is when you would tell Laura you are feeling worried or angry. The second way to express feelings is an indirect response. An example of an indirect response is when you yell at your children because you are angry with Laura. The third way an emotion can be expressed is in physical body symptoms. A physical body symptom of expressing feelings could be when you feel that pain in your back."

Do you have a client who might benefit from the Lynch and Kilmartin concept of direct expression, indirect expression, and physical expression? You might consider replaying this track prior to your next session. On the next track I will discuss perceived pervasive power.

QUESTION 1
According to George E. Murphy, a professor of psychiatry at Washington University School of Medicine, what are two reasons women commit suicide at a rate of one fourth less than men? To select and enter your answer go to Answer Booklet.