Why do men refuse to get help?

Why is it that most American men refuse to get help when they suffer from depression? In their article “Why Won’t Men Get Help?” in Pacific Standard (July/August), David Freed and Betsy Bates Freed tell stories of specific men and point to alarming statistics about men who suffer from depression and other maladies.

In 1998, the Freeds write, “about 1.47 of every 100 men in the United States sought outpatient help for depression; by 2007, it was 2.12 men per 100, according to a study sponsored by the federal Agency for Healthcare Research and Quality.”

And most of those who do go for help prefer pharmaceuticals to “talk therapy.” In 1998, 56.2 percent of those who sought help used the latter treatment; in 2007, that percentage dropped to 42.5. And those who chose pills increased from 68.8 percent in 1998 to 73.3 percent in 2007.

This failure of the vast majority of men to seek help has dire consequences, especially since the economic recession. “Suicide overtook blood poisoning to become the 10th leading cause of death in the U.S. in 2009,” the Freeds write. And men account for nearly 80 percent of suicides in the United States today.

Those rates have been rising in the past 25 years, and the rise in recent years of overall male unemployment will likely send them higher, unless something changes.

Why are men so reluctant to seek help from professional therapists--or even from medical doctors for that matter? It’s something they learn growing up. 

But it turns out they aren’t born that way. “Studies show that most male babies actually start out more emotionally expressive than females,” the Freeds write. But by age 2, boys are less verbally expressive than girls.

Psychologists have a word for the “strong silent type” masculinity that many American men hold on to: “normative male alexithymia,” which literally translates as “without words for emotions.”

Another reality men face who do go for help, the Freeds write, is that “nearly three in every four licensed psychologists who hold doctorate degrees are female, as are almost 80 percent of master’s-level students in psychology-related fields of study.” This can pose both an advantage and a disadvantage for male patients.

On the one hand, men may regard a woman as “more nurturing, empathetic and less threatening.” On the other hand, “female psychotherapists … run the risk of alienating men by trying to counsel them, however subtly, to be like them.”

Once men do get into counseling, they tend to do better. In fact, research has shown that men benefit from talk therapy just as much, if not more, than women.

I mentioned this to some friends of mine who are therapists, and they thought this made sense, since most women are used to talking about their feelings, so therapy isn’t as new an experience as it is for most men.

Men with cancer also don’t usually ask for or get as much support as women. Betsy Bates Freed in her article “Did You Hear the One About the Guy with Prostate Cancer?” (in the same issue) compares breast cancer and prostate cancer, “two diseases that are diagnosed in almost equal numbers each year in the U.S., and take a similar emotional as well as physical toll. As of May, published, peer-reviewed studies on ‘breast cancer and support’ outnumbered those on ‘prostate cancer and support’ by 56,000.”

The macho mentality that we shouldn’t ask for help may be American, but it’s far from being Christian. "God helps those who help themselves" comes from Ben Franklin, not the Bible. 

There are some Christian writers in the field of male spirituality who complain about the "wimpy Jesus" others promulgate. They call men to be strong. I suggest these writers are not only wrong but dangerous. They reinforce a male stereotype many of us have grown up with that has caused much pain. 

I suggest it takes strength to admit when we are hurting. It also takes discernment, wisdom, to even recognize it sometimes. Many men carry great pain and anguish inside and feel unable to face it. Too often that inability leads to addictive, destructive behaviors, such as alcoholism and drug abuse, which not only hurts ourselves but others, particularly spouses.

We men need to encourage one another to talk about our problems and seek help when we need it. That is a truly countercultural, Christian response to the lies we've been told, such as, "Suck it up." "Be a man." "Don't cry." It is also true strength and needed wisdom to talk about our pain and seek help.

Respect

Last week, Jeanne and I saw the documentary Bully, a film many people need to see. Unfortunately, there was one other person in the theater. The movie was in Wichita only one week.
I say many people need to see it. I'm thinking especially of school administrators, teachers, students, parents. I know that sounds heavy-handed, especially since it's a difficult film to watch. I know many people don't watch movies, and of those who do, perhaps most just want to see something enjoyable, whether that's an action film or a romantic comedy. 
But occasionally it's good for us to expose ourselves to something that makes us uncomfortable, that forces us to think about--and feel--an issue that is important and needs attention. Call it a spiritual discipline, if you like. If we just go after what's nice and comfortable, we won't grow in our spiritual lives, and the world won't change much for the better.

One reason Bully should be seen by many is that it reveals such a common problem. Many of us (most of us) have been bullied, or our kids have been bullied, or perhaps we've bullied others. Over 13 million kids will be bullied this year, and 3 million will miss school each month because they don't feel safe there. 
It's not only common, it's destructive. Two of the five families portrayed in this film include kids who committed suicide after being bullied repeatedly.
Lee Hirsch, the film's director, was bullied as a child. In this film he interviews members of five families. They live in Iowa, Oklahoma, Texas, Georgia and Mississippi. One of the most moving subjects is Alex, a 12-year-old in Sioux City, Iowa. The filmmakers capture scenes on the school bus in which several kids not only insult Alex but punch him and even stab him with a pencil. The bus driver and the kids around him do nothing. The filmmakers then decide to leave their objective distance for a time and out of concern for Alex's safety show these scenes to Alex's parents and to school officials.
The parents go to the school, where an assistant principal tells them she has ridden on that bus, and the kids are "as good as gold." The school confronts the kids who bullied Alex, though there's no guarantee it will end. But at least the parents know.
And so do we. That's why this film is so important. We see bullying behavior on film, and we get acquainted with those being bullied and with their families.
The film also interviews Kelby, a 16-year-old girl in Tuttle, Okla., who came out as a lesbian. Although she is a good athlete, she is ostracized at school. Some boys even try to run her over with their truck. Her parents are also shunned by their friends. At one point her father, who was raised to believe that homosexuality was a sin, says, "Now I know what it means to walk in someone else's shoes."
What's particularly maddening about bullying is how commonly it is ignored by schools and other parents. It is a complex issue and not easily dealt with, especially when the bullies' parents deny it or simply refuse to do anything about it. And bullies often are kids who've been bullied themselves. Alex at one point says, "It makes me want to be a bully."
Many of these parents and their families have organized rallies to call attention to bullying behavior. They also call us to simply show respect for one another.
When the film first came out, the MPAA gave it an R rating because of some language at the beginning. After a petition and some negotiation, the Weinstein Company made some changes, and the film received a PG-13 rating, which means children of all ages can see it without an adult. And I hope they do. But adults should see it, too.
Still, it's not getting shown widely. The filmmakers are hoping to have 1 million kids see the film, but so far only 88,000 have.
For more information on the movie and the Stand for the Silent campaign, go to www.thebullyproject.com
And let's all learn to show respect.