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Section 6
Men's Coping Strategies for Depression'

Question 6 | Test | Table of Contents

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In the last section, we discussed counterdependence. As you know, it's necessary to change thought processes and feelings before you can change behavior.

In this section we will talk about self-empathy as it relates to male depression. I have found the major changes for men to focus on are developing empathy for the self and accepting responsibility for changing their behavior.

Three Steps to become More Emotionally Aware
Carl, a 40-year-old high school teacher was withdrawing emotionally from his wife, Jean, and three children. Jean had filed for divorce. In one session, I described the process of becoming more emotionally aware in three steps.

Step # 1 - Recognize Emotions
First, I told Carl to try to recognize his emotions and understand how his destructive, distant behavior didn't reflect what he felt inside.

Step # 2 - Notice Negative Effects of Masculine Conditioning
Second, I asked him, "What do you think are the negative effects of masculine conditioning?" Carl paused for a long time and finally said, "I guess I don't ever want to talk about how I'm feeling." I then asked him, "Is that something you wanted to learn?" As you can guess, Carl said, "No, but I don't want to lose my kids." I told him it was important to recognize the negative effects of masculine conditioning and realize that his own behavior was a result of what he had learned, not what he wanted to learn.

Step # 3 - Learn how to Express Feelings
Finally, after several sessions, I told Carl that he could learn how to express himself without separating from his emotions or acting in destructive ways. "This includes," I told him, "identifying your feelings and sharing them with others, like your wife Jean and even your children."

Have you found, like I, that if you ask a man, "How do you feel?" he often doesn't answer the question. He might act confused, say he doesn't know, or begin to tell me what he thinks. As you know, men have a hard time recognizing their own feelings because of masculine socialization. Instead, feelings often get expressed either physically, through pain or illness, or through destructive behavior, like violence or isolation. Obviously, Carl chose isolation.

♦ Technique: Feelings Word List
Think of a male client you are treating who had difficulty recognizing his feelings. What kind of intervention did you use? An effective technique I found is using a "feelings word list." Carl told me about a recent tragic incident at school. One of his students had committed suicide in the bathroom of the high school during the period when he should have been in Carl's class. Following the incident, Carl had become even more disconnected and withdrawn from his family.

When I asked him to describe his feelings to me, he answered, "Well, lately I have been meaning to get out and throw the football around with my two sons." As you can see, the response he gave was not a feeling, but merely a thought perhaps used to disguise or avoid having to discuss his emotions.

To help Carl to discuss his feelings about the student's suicide, I offered Carl a list of feeling words like "mad, sad, glad, and afraid." I asked him to "try them on" to see if one seemed to fit. I told Carl, "Many people consider these four feelings of 'mad, sad, glad, and afraid' to be the basic emotions from which all others stem. But if they don't work, feel free to add to the list. What's important is that you learn what the feelings 'feel' like. Then you can begin to name what is going on inside."

♦ Technique: Story Retelling
Another tactic I often use with a client like Carl is to encourage storytelling. Men tell stories all the time to friends, family members, and co-workers. Usually, though, they focus on the events of the story. The next time you ask your client to tell a story, encourage him to focus on the emotions he experienced rather than just the incident itself. After Carl shared a story at the beginning of the session about some upsetting national playoff game results in which he felt powerful emotions, I suggested that he tell someone else. I told Carl it didn't matter who he told the story to, the key is that he is learning to express himself to others.

I used the feelings list and story retelling as a foundation of change regarding empathy for the self. I find it helpful to encourage clients to give themselves a break. I once told Rob, a depressed client, that his destructive behavior was not entirely his fault; that it was the result of what he learned from his family and society.

Rob was relieved. "I always felt I was entirely to blame for how I am." He was more understanding toward himself, recognizing that he could make mistakes, learn from them, and change. I then reminded Rob that it was entirely up to him to make a change. Once he had given himself a break of empathy, he was motivated to learn how to identify his emotions and alter his behavior. Do you have a client who needs to give himself a break and explore empathy?

Once Rob identified his feelings and empathized with himself, he could then begin to better understand how to empathize with others. As you know, compassion for others only comes after he feels compassion for himself and has some idea regarding his own feelings.

Could the tools of a feelings list and story retelling be of benefit to assist your client in developing empathy for themselves, which may lead to empathy for others? In the next section, we will discuss homophobia and relating to other men.
Reviewed 2023

Peer-Reviewed Journal Article References:
Cole, B. P., & Davidson, M. M. (2019). Exploring men’s perceptions about male depression. Psychology of Men & Masculinities, 20(4), 459–466. 

Hoffman, E., & Addis, M. E. (2021). Dilemmas of agency and blame in men’s talk about depression. Psychology of Men & Masculinities, 22(4), 669–677.

Mackenzie, C. S., Visperas, A., Ogrodniczuk, J. S., Oliffe, J. L., & Nurmi, M. A. (2019). Age and sex differences in self-stigma and public stigma concerning depression and suicide in men. Stigma and Health, 4(2), 233–241.

Nadeau, M. M., Balsan, M. J., & Rochlen, A. B. (2016). Men’s depression: Endorsed experiences and expressions. Psychology of Men & Masculinity, 17(4), 328–335. 

Sierra Hernandez, C. A., Han, C., Oliffe, J. L., & Ogrodniczuk, J. S. (2014). Understanding help-seeking among depressed men. Psychology of Men & Masculinity, 15(3), 346–354. 

Spendelow, J. S. (2015). Men’s self-reported coping strategies for depression: A systematic review of qualitative studies. Psychology of Men & Masculinity, 16(4), 439–447. 

QUESTION 6
A feelings list and story retelling are two interventions that can facilitate what "growth point" in your client?
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