Men Are Bad Patients…

When They have Bad Therapists

Posted May 28, 2013

Marriage counselors have a couple of standard jokes. We all have skid-marks at the front door from husbands being drug into the office. And there was a man convicted of tax evasion, who pleaded with the judge that he had to do it because his wife spends too much. The merciful judge decided to give him a second chance. “If you like, I’ll send you to marriage counseling instead of federal prison,” to which the guy replies, “Could I have a private cell in federal prison?” Though there are exceptions, of course, men tend to go into therapy when they are court-ordered, work-ordered, or wife-ordered or when their wives are walking out the door with bags packed.

The usual explanations for male reluctance about couples therapy are that socialization discourages them from seeking help of any kind but particularly in the mental health system; men are less comfortable talking about emotions at all but especially with their wives present – it’s her turf; men tend to be more instrumental in emotional experience – when he feels something he prefers to do something rather than just talk; and, of course, the expectation that he’ll be blamed for everything wrong with the relationship – “Let’s skip the prosecution and get right to the sentencing.”

Even highly skilled therapists can have trouble handling male reluctance about joint counseling. Some bend over backwards to engage the guy, which can reinforce his conviction that his partner is the real problem. Others simply pathologize, “He’s narcissistic, depressed, sociopathic, or a chronic intimacy-avoider, so there’s no wonder my therapy didn’t work.”

I specialize in boot camps (three 8-hour days) for couples struggling with chronic resentment or anger who are verge of divorce. The vast majority of my couples have been referred from therapists who have gotten stuck trying to deal with a recalcitrant, emotionally unavailable, or passive-aggressive man. Most of the women are exasperated or bitter and ready to give up. Most of the men cynically describe what they’ve learned in their previous therapy: to improve their relationships they have to become women.

Of course, what they really dislike about therapy is not that they might have to talk like women or adopt feminine sensibilities, but that they have to experience the most heinous of emotional states: feeling like a failure.

Most men have a terrible dread of failure, particularly as providers, protectors, and lovers. The unhappiness of their wives, even if the women don’t complain about it, much less drag them into therapy, makes them feel like failures. Their large egos, seeming narcissism, and compulsion to be “right” derive from their need to be seen as anything but a failure; for most men who need marriage counseling, it’s better to be regarded as a jerk than a loser.

The need to ward off feelings of failure is why many men seem annoyed when their wives are unhappy and why they are so heavily invested in blaming their partners for being too sensitive, obstinate, demanding, selfish, nagging, or critical. Blame temporarily relieves their shame but at the cost of the power to improve. The act of blame, whether directed at their wives, therapists, or themselves, renders them powerless.

Therapy has to show men how to succeed, rather than focus on their failures - no small task during the initial information periods, which tend to be driven by the complaints of the one who made the appointment, almost always the aggrieved woman. Therapy also has to empower men, which, on the surface, goes against the grain of many who see male shame-avoidant behavior (withdrawal or aggression) as a power issue.

Internal Regulation of Shame

The men who come to the boot camp feel powerless because they cannot regulate their dread of failure sufficiently to sustain intimate connection, which requires letting down defenses and keeping them down. As a consequence, they’ve developed habits of empowering themselves against the vulnerability of attachment with resentment and anger. The boot camp trains them to replace the shame-based focus on themselves with compassion for their wives, which makes them feel more protective and less vulnerable to feeling inadequate. It employs a manual filled with self-regulation and relationship skills, which, over the course of the 24 hours, empowers them to be the kind of partners they want to be. Most men really do want to have as close a relationship as their wives, but the way they go about connection is different. The boot camp shows the couple first that that their styles of connection are different and, second, how to reconcile their differing styles in ways that move them both a little out of their comfort zones to achieve the secure connection they both want.

Interpersonal Shame Regulation: Protect and Connect

The typical male relationship style, at least for those who want to form deeper connections, is “protect and connect.” If he can feel protective of his partner, i.e., if he can feel successful, he is more likely to connect with her. If he cannot – if he feels like a failure – he likely will withdraw or aggress. I try to get my male client to talk about their courtship and then point out that when his future partner talked about various things that made her feel anxious or insecure, he reassured her, let her know that he’d be there for her, out of a sense of protectiveness. If she felt disregarded, he paid more attention to her. If she felt unimportant, he showed her that she was important. If she felt guilty, he supported her. If she felt devalued, he valued her more. If she felt powerless, he supported her. He fell in love because he was able to connect and he was able to connect because he felt protective. It started to go wrong when he began to confuse his impulse to protect with a signal to control. It will not go right until he develops enough confidence to trust his instinct to protect without trying to control. Non-controlling support of loved ones is skill that can be learned and practiced.

The practice of boot camp skills makes men feel more confident about their abilities to sustain intimate connection. It helps couples see that differing connection styles can be made compatible by appeal to their deepest values. It provides the self-regulation skill necessary to sustain love, compassion, and kindness.