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"Sad is How I Am!" Treating Dysthymia in Children and Adults
Dysthymia continuing education psychology CEUs

Section 28
Masculine Depression; The ABCs of Change

CEU Question 28 | CEU Test | Table of Contents | Depression
Counselor CEUs, Social Worker CEUs, Psychologist CEs, MFT CEUs

What kinds of direct self-destructive behaviors do men frequently engage in?
Direct self-destruction involves behaviors that cause damage to the body in a straightforward way. The two major direct self-destructive causes of death are substance abuse -- including tobacco, alcohol, and other drugs -- and suicide.

One of the largest factors in the seven-year, male-female longevity difference is the sex difference in the use of tobacco products; the only legally available commodities in the United States that, when used as intended, will likely result in the death of the user if given enough time. There is a long tradition in advertising of associating tobacco use with masculinity. The Marlboro Man is probably the best example, a rugged cowboy who enjoys smoking cigarettes in wide open spaces. Suicide is the ultimate self-destructive act. Although females attempt suicide more often, males complete suicides four times more often than females in the United States. Teenage girls make 75 percent of all suicide attempts within this age range, but boys make 80 percent of all complete suicides.

Like Father, Like Son
To appear masculine, boys must develop those qualities that fathers seem to have: rugged independence, dominance, self-confidence, and restricted emotionality. These characteristics are some of the extreme aspects of masculinity. Yet the extreme becomes the norm, and sadly, a boy’s first model of masculinity is often based on the exaggerated behaviors of a man who is emotionally isolated from his family. In order to keep their masculine identities intact, boys gradually lose awareness of any sense of personal inadequacy and take on the habit of masculine posturing. Because his father does not display any evidence of self-doubt, the boy unconsciously learns that feelings and displays of inadequacy are indications of a lack of masculinity.

Any feelings of vulnerability, sadness, or hurt are similarly seen as evidence of masculine weakness. To further complicate the picture, boys cannot name or talk about this conflict. Acknowledging or asking for help with self-doubt is considered unmanly. Doing so would threaten the masculinity they have learned to value so highly. Losing awareness of these feelings becomes a valuable coping skill. A boy learns how to “act like a man,” to avoid losing at all costs, and to not tolerate making mistakes. He defends himself against anyone who thinks that he is not powerful, strong, or forever right. The son grows into the man that his father appeared to be. When he grows up and marries, he wants and needs emotional closeness with his wife but is terrified of intimacy, so he settles for what he knows how to do: compete, detach, bully, and act in other stereotypical and unhealthy masculine ways. To a great extent, he becomes his father, shaped as much by his fears as by his strengths.

Men who consistently, habitually, and systematically squelch their feelings for long periods of time eventually cease to feel altogether. When they do, they lose their points of reference for understanding the feelings of others, and they become dehumanized. Empathy for the self is gone, and thus empathy for the other has become impossible. Empathy for Self does not result in self-indulgence. When a man recovers his emotional experience, it becomes possible to access the emotional experiences of others and have satisfying and intimate relationships. Appropriate empathy for the self leads to acceptance of the responsibility for changing destructive behaviors.

What are the ABCs of Change?

-Learn a language for feelings.
-Learn to feel for yourself as well as for others.


-Try on new words and meanings.
-Learn how to support and encourage yourself.
-Work at understanding the pain behind your own mask so that you can develop empathy for others.


-Give yourself a break.
-Remind yourself that you are not to blame for growing into these problems.
-Destructive behaviors do not mean that you are flawed, bad, or a failure. They do mean that you are responsible for changing them.

What happens to men who grow up without learning to deal with feelings and inner conflicts?
Adult men who fail to deal with emotional conflicts suffer themselves and/or cause others to suffer. The most severe cases involve homelessness, criminal behavior, and suicide. Consider the following statistics, all of which are related to the phenomenon of masculine depression:

-Of the over 1 million people in United States prisons, 90 percent are men.
-52 percent of all female murder victims in the United States are killed by their male ex's or partners.
-1.8 million women are victims of spousal abuse each year.
-70 percent of homeless people are men.
-Men die an average of seven years earlier than women.
-Men are disproportionately involved in substance abuse.

We can look at a variety of social and psychological forces that conspire to encourage men to deal with depression by becoming destructive to themselves and/or others. They involve problematic childhood relationships with their mothers and fathers, the learning of poor techniques for dealing with emotional difficulties, and the failure of social systems to hold many men responsible for their destructive behavior. Even in relatively “normal” men, these conflicts can emerge when emotional pain combines with the cultural directives to “be a man.”

In the laCEU Continuing Education for
Social Worker CEUs, Psychology CEUs, Counselor CEUs, MFT CEUs
rger culture, masculine depression is often seen as moral failure, mainly because of the harm to others that masculine depression usually breeds, and because men are considered to always be in control of themselves. Moreover, there is a sense that nothing can be done about disturbing male behavior. This “boys will be boys” attitude leaves people feeling helpless in addressing the problem. Because the pain is behind the mask, the depressive origin of these behaviors is not well understood; solutions are often punitive or misguided. Instead of looking at the origins of male behavior, people tend to focus solely on its harmful effects.

Even when depressed men are well aware of their problems, they are less likely to seek help in a culture that considers help seeking to be unmanly. Unable to express themselves, gain support from friends, or request professional help, many depressed men are left alone with their problems. All depressed men are disturbed, and unfortunately, many also become disturbing. The solution is elusive because the appearance is deceiving.

Adapted from The Pain Behind the Mask: Overcoming Masculine Depression. Lynch, John & Kilmartin, Christopher.

“Personal Reflection” Journaling Activity #8
The preceding section contained information about Masculine Depression. Write three case study examples regarding how you might use the content of this section of the Manual in your practice.

Online Continuing Education QUESTION 28:
What are the ABCs of Change? To select and enter your answer go to CEU Test

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