Bereavement · Coming to Therapy · Difficult Emotions · Loss · Men's Issues · Men's roles · Relationships

The pain of bereavement… How loss makes us disorientated.

This is my first post in a few weeks as I have been busy with work and research and have also not really felt like writing.   Today’s post will have a personal element as I suffered a loss during the week and I am hoping this will be a way of both processing the event and achieving some learning for when I work with clients undergoing their own losses.  Much of my work is centred around loss and these can be located on a very varied spectrum.  The most obvious are the bereavements of family and friends, but loss can also take the guise of the breakdown of intimate relationships, loss of a job, changes in health or as more abstract losses such as when one loses personal choice, autonomy or liberty.

I have worked with some really excruciating losses with clients in recent months, the most difficult perhaps being the sudden passing of a child.  It is easy to empathise and imagine how this type of event would cripple the most resilient of people.  I think the underlying feeling expressed here is that it does not represent the expected natural order of the world.  At some level we all understand that parents and grandparents will eventually die and that as you approach middle age this becomes normalised as peers experience the parental departure. Even though when it happens it can be devastating, there is a part of the psyche that expects and understands that this is an existential inevitability of being human.

When the bereaved is a child, this mechanism is disrupted and the loss intensifies by the natural order of the world being defied and the perceived proper sequence of events becoming disjointed.  In these type of cases, clients often struggle to reach acceptance that the person has gone and they will often voice irrational bargaining narratives that they would swap places or that life will forever be contaminated and never as good as it was before the death of their child.  These type of expressions are not usually heard when the loss is in line with the natural order of things.  The function of the counterfactual expressions are often around alleviating guilt on not saving them, or simply that they are still here, yet their child is not.

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Another loss that often affects men I work with is how ill-health of themselves or a loved one forces an aspect of their identity to shift.  Many men, including myself define themselves by their vocation and we still have societal discourses that men are less masculine or emasculated if they adopt traditionally feminine roles of being either stay at home parents or a carer for those in need.  I have worked with numerous men who occupy archetypal male personas and have strong and masculine jobs such as policeman, builders or financiers.  When these roles are removed through circumstances such as declining health the individual suffers a catastrophic loss to a core identity component.  This leaves men wondering what their roles are and places them into unfamiliar positions of marginalisation and disempowerment.

An interesting phenomenon that occurs here is that men will often fantasise about their previous life, which they view as empowered and idyllic.  Similarly to the loss of a child, there is a real resistance to change expectations, to renegotiate their roles and decide what is now meaningful, rather than clinging to the memories of what they used to ascribe value to.  I think that this type of impasse epitomises the position of not being able to reach acceptance, a position that is often seen as the successful resolution of grief. I often wonder that is this ‘stuckness’ related to the increased levels of atheism that are now prevalent in contemporary British culture.  We may become isolated and helpless through our grief, as we no longer have the strong spiritual and religious beliefs that previous generations were able to use to sooth and re-balance perceived injustices and unfairness that often accompanies unexpected loss.

In comparison to the types of loss described above, mine feels inconsequential but as I always say to clients “We live the lives we do and that our experiences are valid”.  This sentiment is explained by the idea that we cannot simply compare our situation hierarchically to others by looking at people who have undergone greater suffering, or at the other end of the spectrum seem to lead easy and charmed lives.  I think that this type of rationalisation does not allow us to connect with our emotional state and can leave us with shame or anger as we try to suppress and resolve our own situation without being able to authentically process our emotional material.

My loss was of a pet bearded dragon, imaginatively named ‘boy beard’, I had been his owner for over 15 years and raised him and his mate ‘girl beard’ from small ‘moustaches’ to fully grown dragons.  When he died on Monday, I was expecting it and was relieved, as he had been shutting down for a few weeks and was ancient by species standards.  Yet,  I have spent the last few days feeling tremendously melancholy.  I have even had some bouts of uncontrollable tears and intrusive thoughts about missing him.  I rarely cry and this has been a comfort to me, as it enabled me to understand that he was a hugely important part of my life.  I have always been puzzled by the anthropomorphism of placing human emotions and traits onto animals, but I can say that I genuinely loved boy beard.

After much thought, I think I loved what he represented to me and that he had become internalised as a sense of security and safety.  I have many friends, but have always felt distance and an innate feeling that I am able to leave human relationships and survive. This has probably been derived from the fractured and at times unsupportive family of origin that I hail from.  I keep in touch with relatives, but I suppose that unlike many people they are not the place I go when in need or relationships that I greatly invest in.  The fear of being vulnerable and exposed is too much and somewhere I do not trust that these relationships will be consistent and available.   As a result boy beard had been a stable and constant ‘secure base’, that I had symbolically internalised as the ‘good mother’, a role that has been vacant for me for some time.  He was always available and never questioned me or asked too much.  He also had the fantastic ability to just allow me to be in his presence and feel content.  This is much like how Bion describes containment or how Winnicott talks about the holding of the infant by mother, that ultimately allows the infant to just sit and be without tension or impingement.

This was vitally important as the last 15 years have involved family estrangement, my journey into psychotherapy, loss of relationships and periods of physical, financial and emotional instability and uncertainty.  Boy beard was my transitional object, a symbolic entity that I was able to equate to reassurance and safety when distressed, and importantly was an object that I could take wherever I went and at some level represented home, safety and the feeling that things would be alright.  This is perhaps why his passing has had such a profound effect on my sense of well-being, as it has disrupted my sense of safety in the same way a toddler is inconsolable when leaving his favourite bear on the bus.  Like the missing teddy, I have fond memories of boy beard and will forever think of him as source of comfort when I feel that I am struggling.

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Addiction · Coming to Therapy · Difficult Emotions · Men's Issues · Relationships

Can you have an addictive personality? Exploring how addiction may not simply be down to a personality trait.

Last week a prominent addiction academic published results that have been accumulated from thirty years of research and refute the highly popular idea that certain people have predisposed addictive personalities Mark Griffiths -The Myth of ‘Addictive Personality’.  This is a claim that I often hear within the therapy room as men talk about their own compulsions as genetically inherited phenomena.  Last week’s blog post posited the idea of neurological processes leading to some men being unable to move away from strings of superficial romantic liaisons that lead to entrenched and repeating behaviour of trying to gratify a desire for the ‘honeymoon period’ chemical buzz associated with fledgling relationships.  These type of conversations have been similarly applied to alcoholism, recreational drug use, gambling and pornography, but all seem to conclude that the addict is an unfortunate victim of the genetic lottery, where they have inherited a defective DNA blueprint that removes control and ultimately any autonomy.

My position as a social constructionist is in accordance with the published paper and suggests that this type of discourse alleviates responsibility from the addict and as a result would concluded that the addict can never recover or will always be waiting for the next form of addiction to accost them.  I agree with Griffiths that this position makes us helpless and also means that the addict’s social network will be responsible for managing the addictions or policing this person’s behaviour, so that they are forever kept away from the gym, betting shops, the internet and any form of licenced premises. Griffiths couches his findings within a positivist scientific framework by suggesting that the addictive personality has some correlations to the popular psychological theories of personality traits.  He has identified that individuals who score high on traits of neuroticism

Neuroticism is a trait in many models within personality theory, but there is little agreement on its definition. Some define it as a tendency for quick arousal when stimulated and slow relaxation from arousal; others define it as emotional instability and negativity or maladjustment, in contrast to emotional stability and positivity, or good adjustment. Others yet define it as lack of self-control, poor ability to manage psychological stress, and a tendency to complain

and low on conscientiousness

Conscientiousness is the personality trait of being careful, or vigilant. Conscientiousness implies a desire to do a task well, and to take obligations to others seriously. Conscientious people tend to be efficient and organized as opposed to easy-going and disorderly. They exhibit a tendency to show self-discipline, act dutifully, and aim for achievement; they display planned rather than spontaneous behavior; and they are generally dependable. It is manifested in characteristic behaviors such as being neat and systematic; also including such elements as carefulness, thoroughness, and deliberation (the tendency to think carefully before acting.) Conscientiousness is one of the five traits of the Five Factor Model of personality and is an aspect of what has traditionally been referred to as having character. Conscientious individuals are generally hard-working and reliable. They are also likely to be conformists. When taken to an extreme, they may also be “workaholics”, perfectionists, and compulsive in their behavior. People who score low on conscientiousness tend to be laid back, less goal-oriented, and less driven by success; they also are more likely to engage in antisocial and criminal behaviour

are more at risk of developing addictions.  He also notes that people who fit this criteria are not always addicts and that other addicts do not show these levels of personality trait.  Therefore, we cannot simply say that any one trait of personality is a definitive marker for being addicted.

My position is more rooted within social psychology and the individual’s actual lived context, rather than their inherent character.  I feel that addictions are often used as substitutes for meaningful and effective relationships and whenever I have worked with an addict, they have always spoken of a history of fractured or inconsistent relationships with important caregivers such as parents.  The use of substances, sex, gambling etc. is then used a way of managing and regulating both anxiety and psychological distress. These patterns become established as they temporarily experience relief or escape from an unpleasant state during the placing of a bet , sexually releasing or through becoming intoxicated.  As the pleasure drops and the difficult feelings reemerge they go back to their addiction and essentially setup a mechanism of self-soothing.  This mechanism then becomes established as a way of negotiating stress and starts to setup a psychological dependency that is the the root of uncontrollable compulsion.  This process is a substitute for the individuals inability to always regulate their own distress, which has become maladaptive due to past experiences where attachment interactions have been inadequate.

These individuals have internalised this history of insecure relationships, which means that they relate to a world that has the potential to be uncertain and unsafe.  So what causes the addict to choose certain addictions and not others?  I think that this has a lot to do with availability and will be determined to what sort of activities or substances can be easily attained and also what can be maintained financially and socially.  This is the idea of being able to partially function in terms of keeping some relationships and normal practices, as well as satisfying the addictions.  For example the ease of access to gambling and pornography means that men can access these services quickly and privately, and can effectively still work and be partially active within society.  I have heard stories of men masturbating in work toilet facilities using smartphones or following bets on obscure foreign sporting events in the middle of the night whilst their partner sleeps on completely unaware.

One point to note is that addictions such as exercise are very difficult to identify as problematic because they are often seen positively and encouraged as healthy living practices.  In comparison, drug use is usually met with social disapproval and certain drugs such as heroin instantly provoke interventions or concern by others.  In contrast, drugs such as cannabis and cocaine are increasingly being viewed as acceptable by certain groups, which can lead to there use and abuse being unnoticed or minimised. Alcohol, steroids and stimulants are are also being seen as perfectly normal practices, especially in aggressive male environments such as bodybuilding communities and intensive city vocations, where the discourses around working hard and playing hard are activated and alcohol and party drugs are used as in networking rituals, to facilitate social bonding and establish hierarchical structure.

The last component that I feel contributes to addiction and to what practice is chosen, is the experience of a traumatic trigger that has a relationship to the addiction.  This can be something like being raised by an alcoholic father or a less obvious interaction which was built around a  risky event, for example; a one off bet that led to high wins or losses, or being disturbed during a sexual encounter.  Therefore, my feelings are that the addiction is born from an insecure relational history managed by self-soothing, access to the addictive behaviour and a related trauma trigger.  Relating to the journal article and thinking about the idea of how high neuroticsim is a predictor of addiction, individuals who are neurotic present with histories of turbulent relationships and have the need for lots of intensive arousal to make experience meaningful, as well as having a likelihood of experiencing various traumatic events that have occurred due to living unpredictable lives. Similarly, low conscientiousness can be framed as not always taking account of consequences and having a tendency to avoid responsibility for actions by blaming others or saying that the addiction took hold of them and diminished their control.

The take-home message here is that many men are addicts, but my belief is that these addictions are both understandable and treatable.  By subscribing to the myth of the addictive personality, we run the risk of being incapacitated by addiction and effectively being slaves to negative behaviours or substances.  The first step to taking back control is to accept the behaviour as part of us and taking the responsibility for allowing it to happen.  This allows us the potential of being able to make alternative choices in the future and not simply being a victim of a genetic lottery…

 

 

Coming to Therapy · Couples · love island · Men's Issues · men's mental health · Relationships · Society

Where has all the love from Love Island gone?… How relationships fade as fast as they form.

So a month after the finale of Love Island and its seems that the promises of perfect matrimony and the finding of soul mates have become shipwrecked upon the jagged rocks of relationship breakdown.  What has caused this rapid decline of romance from excited and anticipatory talk of settling down to many of the new relationships nose diving into the ex-partners graveyard?  A simple and sceptical analysis would say that the show is a constructed entity and the relationships are dramatised, with the contestants simply trying to launch a potential career in day-time television.   Therefore, the romances are scripted to engage viewers and any observed relationships are attempts by the production crew and cast to create a love fantasy that the viewers can indulge in.  This makes perfect entertainment senses as trying to promote a ‘Love Island’ that is devoid of any love would leave us with a desolate version of the Bear Grylls show where miserable middle classes become eternally frustrated whilst trying to start fires and catch fish.  What is more interesting is that this pattern of intense passion and expectations of lifelong partnership that very quickly turns to disharmony and disintegration is one that I often see within couples in the real world.

The very concept of Love Island seems like a fairly artificial place to meet a partner as the couples have limited choice, enormous amounts of time together and no escape-hatch to other stimuli and networks external to the show.  This creates a very intensive environment where relationships move rapidly, simply based on the amount of contact time.  By comparison, it is unlikely that traditional courting would have this level of time together so early on, so the pattern plays out at a slower pace.  Many men describe this initial and intense part of the relationship as a ‘honeymoon period’, and there is a real expectation that this is part a prescriptive journey that inevitably comes to an end after a few months.  The relationship at this point is categorised by lots of sex, intrusive thoughts about the other person, prioritising time with them over usual work/social activities, elation and positive mood.

Neurological explanation is that this process floods our neural system with the hormone oxytocin, this neurotransmitter facilitates bonding and is linked to our very early experiences of birth, feeding and maternal security.  Our brains become consumed with a natural drug that makes us feel good and motivates us to spend more time with the source of our pleasure.  Unfortunately, as with any pleasurable high, repeated exposure starts to lessen the effect and the effect diminishes over time.  Interestingly, oxytocin also has a sinister social side effect where we begin to establish allegiances by creating in/out groups.  Love Island exhibits this perfectly where we observed couples became collusive and suspicious of the other couples, as well as fostering competition, rivalry and envy. This neural circuit activation is also one contributory factor which causes some men to be promiscuous, serial cheaters or unable to commit to relationships.  In these cases the internal chemistry of the man acts very similar to that of a drug addict where desire must be satiated and moving to new partners gives a temporary high.  The behaviour starts to become entrenched and circular as once the buzz of the relationship lessens another source must be found.

Men with these compulsions have often struggled to establish fully secure early attachments and as a result require higher and more frequent levels of oxytocin to feel emotional and physical intimacy.  One presentation that occurs alongside compulsive pleasure seeking is the absence of guilt and conscience, this can be construed by the man’s partner as lack of care or even maliciousness.  Men who exhibit this lack of concern about the consequences of their actions do so because they have a reduced capacity for empathy, this is due to experiencing positive affect from the new sexual encounter which makes identifying with another person’s distress difficult.   Previous post It’s your fault I had the affair… has looked at how blame is attributed during infidelity.  The pleasure associated with new relationships begins to setup an unrealistic benchmark that longer term relationships have no possibility of reaching and maintaining and therefore this cognitively positions them as unfulfilling and monotonous, this motivates behaviour to seek a new relationship that offers the promise of the hallowed honeymoon hedonism.

We create a socially constructed, illuisonary and idealised template of how we should feel in a relationship for it to be deemed satisfactory and when our current relationship loses the initial high it, a comparison is made against this template and we reject the relationship as failing or not right for us.  The process is self defeating as these are not objective comparisons but a natural process of a relationship neurologically plateauing and then being dismissed for a new relationship that generates the much sought after high.  This is a very similar process to how psychological substance dependency is established.

I also think think that the mystical and almost supernatural form of language that gets used around new relationships contributes to maintaining this biased comparison.  We enact terms such as ‘soulmate’, ‘fate’, ‘destiny’,’we have a chemistry’, ‘they are like a version of me’ and ‘we just get each other’ when we want to position the relationship as almost pre-ordained.  This is a bizarre contradiction as the same people often dismiss religious, spiritual or unexplained phenomena as nonsense and unscientific, yet they describe relationships as having mystical and cognitively irrational properties.  Similarly, when the relationship fails we employ the language of mumbo-jumbo to describe why; ‘we just don’t fit’, ‘turns out they were a psycho’, ‘they have issues’, ‘they changed’, ‘just doesn’t feel right’, ‘the sparks gone’ etc…

Alongside the chemical explanation and how it sets up an unattainable expectations, we also have numerous social factors that compound the problem.  When partners first meet they work very hard to be what they believe the other wants them to act.  For example if a partner is fond of dogs we may over inflate our own affinity to pets so that we seem likeable.  We may also espouse political or cultural attitudes that seem desirable, an example here would be a allegiance to gender equality when a private view may be one which is more patriarchal and that women are better suited for being the main caregiver with children and that men should be the primary worker.  The main issue here is that we begin to create a false-self that in context is completely understandable, we want this person to like us so we simply say, do and act in ways that will please them and increase their fondness of us.

The problem is that this is not possible to maintain over time and we begin to revert to type. This can be perceived as that we have changed or that we are no longer making an effort by the other person.  This occurs simultaneously with us having a greater threshold for the prospective partners undesirable traits, as due to the oxytocin rush we want more of the good feeling and we let transgressions or failings pass without criticism.  Over time the chemical high lessens and we begin to be more judgmental and can become antagonized by the same traits we previously found endearing.  An example here is that a spontaneous and fun seeking person could be viewed initially as exciting and adventurous but after a period of time may be seen as childish and immature.  In real terms, both partners start to act less accommodating, as well as being more critical and less tolerant. Again, this can be perceived as not putting in effort or not being of consistent personality, another fallacy that we believe we possess and that thoroughly concerns us when we see instability in the other.

To summarise, when we see relationships that appear to be all consuming, indulgent and fulfilling in the initial stages but then to fall apart as quickly as they occurred, we need to consider the actual chemistry that is going on.  In the case of Love Island, we can dismiss the issue as ‘showmances’ or scripted pantomimes, but is interesting to explore the pattern further as it often manifests itself in everyday relationships.  The bias that we establish around relationship expectations that occur when we stop over-performing our pretend desirable traits and overlook our partners negative are forever doomed to disappoint us by positing the view that something better must be around the corner.  So to coin a popular island based phrase “There are plenty more fish in the sea”, but unfortunately in the end they all taste the same and maybe we need to treat the fish we have with care and not be so demanding of their capabilities, otherwise we may end marooned on Love Island all by ourselves.

Men's Issues · Society

Why can’t young, British men stop binge drinking?

This week the local government in Malia, Greece officially banned large groups of young British holidaymakers from visiting after numerous years of alcohol fuelled ‘rampages’ that bring carnage to their picturesque Mediterranean community Daily Mail Article. Interestingly, the ban only applies to tourists from the UK and young people from Germany, Russia, Holland etc. are not subject to the same prohibition.  So what is it that makes the British exceptional in terms of not managing their alcohol consumption? The government seem to see this problem being created with how marketing firms portray youth, attractiveness and the ability to attract the opposite sex as being dependent on being completely inebriated and have proposed restrictions of advertising;  Guardian Article.  This new 2017 Bacardi advert echoes this glamorisation of alcohol being associated with having fun, looking good and the promise of offering young people access to a desirable lifestyle; Bacardi Advert.

I think that the role of advertising is but a partial factor and a reductionist stance would be taken if we suggest that the problem lies solely with manipulative advertising executives and the ease of gaining cheaply purchased alcohol .  Other government initiatives have wanted to target the financial aspects of alcohol and essentially tax the industry to a point where people reduce consumption because they can no longer afford to purchase it.  I think that it is far more interesting and enlightening to consider the relationship that British men in particular have with alcohol and  the resulting culture of binge drinking, as this problem is not restricted to young men going abroad and similar scenes of alcohol fuelled revelry can be witnessed in UK town centres every weekend.  I think that the idealised masculine image that advertising conveys, where men are positioned as sexually potent and attractive when they are assisted by alcohol plays into bolstering the hidden and fragile male sense of self that has been discussed here previously in How do I look?!?!?

 

 

The fantasy is that by consuming alcohol, men become more confident, attractive and are then able to be socially successful. There is also a strong element of drinking being linked to being convivial, again this plays on a very accessible discourse that being young means a real commitment to having as much fun as possible whilst you are able to, as in comparison adult life is full of responsibilities, hardship and difficult decisions.

 


One group of researchers recently proposed that one cause of excessive alcohol use was that the activity had become enmeshed with people having fun and propagating entertaining drinking stories that create a shared social narrative and bonding between those who are part of the group.  They produced an excellent and summary of their findings in Branded consumption and social identification: Young people and alcohol, that suggested that young people weighed up risks associated with dangerous levels of intoxication and the potential fun that could be had.  This ‘calculated hedonism’ is a process that ultimately leads to risk taking, with a pay off that hopefully allows the highest amount of enjoyment with the least amount of negative consequences. Unfortunately, this is an often misapplied theory, and I have worked with numerous young men who have served prison sentences, been seriously injured or have destroyed social and professional relationships through excessive and regular drinking.  Having been a young man and now an older man who thoroughly enjoys and looks forward to drinking, it is easy to understand how this relationship can become unbalanced and calculated hedonism can lead to miscalculated ruin.

Men also often discuss the function of alcohol as a social adhesive and that because of how alcohol is so ingrained in our culture with rituals of celebration and manhood; ‘wetting the babies head’, ‘toasting success’, ‘birthday drinks’ and paternalistic tribal ceremonies; ‘stag parties’, ‘university club admissions’ ‘watching sports’ etc. consuming alcohol is vital to masculine social group inclusion.  This idea is also looked at by the aforementioned researchers who suggest that traditional patriarchal communities such as factory work-forces, trade unions, town community centres and religious groups have been made redundant in contemporary culture and as a result alcohol has now replaced them as the vehicle that ensures social cohesion and acceptance.

One point of interest is that highly defined groups such as Muslim communities, which as a rule abstain from alcohol, have traditional religious structures that allow men to be part of a shared collective that allows male bonding without the use of drinking. Conversely, young men in Britain who are not part of any alternative communities have very little in the way of forming groups that can be a safe place to express masculine needs and explore males issues. As a result an unhealthy dependence on drinking can be formed which is further reinforced by the advertised promises of success and manliness. This comes alongside the lack of alternative bonding outlets that together constructs a social reality that by not drinking, young men face isolation and communal pariahdom.

Men's Issues · Society · Suicide

Thoughts on the male suicide epidemic.

With yesterday’s news about rock singer Chester Bennington (41), who sadly took his own life on Thursday, I thought it would be fitting to use this as an opportunity to discuss the worrying trend increased suicides amongst men in middle age.  Chester’s suicide was one that seemed to emerge from nowhere as bandmates said that they were planning to make videos for their new album, whilst friends commented that at recent meetings he spoke of being happy and enjoying himself.  Looking from afar and with no knowledge of his personal circumstances, Chester was a successful singer, liked by friends and fans and was a father to six children.  Yet, something was so difficult that he was unable to share how much he was struggling with those around him and ultimately felt the only solution was suicide.

This story is unfortunately not a unique one as fellow singer Chris Cornell (52) took a similar decision few weeks previously after performing on stage for his many fans.  It is also a narrative that I have heard many times in my treatment room where men talk about how they are considering suicide or I speak to clients who have lost important men in lives this way.  Below is an excerpt from the Telegraph in 2015 that reports on the increase of successful suicide attempts by men like Chester Bennington and Chris Cornell…

Figure 1- Age-standardised suicide rates by sex, deaths registered between 1981 and 2015

The number of people killing themselves in the UK rose in 2013, official figures have revealed, as male suicides hit their highest rate in more than a decade.

A total of 6,233 suicides were recorded among people aged 15 and over, the Office for National Statistics (ONS) said, up 252 – or four per cent – on the previous year.

The UK suicide rate was 11.9 deaths per 100,000 population in 2013, while the male suicide level was more than three times higher than for females, with 19 male deaths per 100,000 – the highest since 2001.

The male suicide rate in the UK has “increased significantly” since 2007, the ONS said, while female rates have stayed “relatively constant” and been “consistently lower” than in men.

In 1981, 63 per cent of UK suicides were male, compared to 37 per cent who were female.

The UK suicide rate of 11.9 deaths per 100,000 population was last seen in 2004, it added.

Of the total number of suicides in the UK, 78 per cent were male and 22 per cent were female, the ONS said. Some 4,858 male suicides were recorded in 2013, compared to 1,375 female suicides.

The highest UK suicide rate was among men aged 45 to 59, with 25.1 deaths per 100,000 – the highest for that age group since 1981 and the first time that age group has recorded the highest rate.

North East England had the highest suicide rate among the English regions, with 13.8 deaths per 100,000 population, while London had the lowest at 7.9 per 100,000.

Women aged 45 to 59 had the highest female suicide rate with seven deaths per 100,000 population. The female suicide rate across the UK was 5.1 deaths per 100,000.

In England, the suicide rate in 2013 was 10.7 deaths per 100,000 (4,722 deaths), compared with 15.9 in Wales (393 deaths).

Suicide remains the leading cause of death in England and Wales for men aged 20 to 34, accounting for 24 per cent of all deaths in 2013, and for men aged 35 to 49 years, where it accounts for 13 per cent of all deaths.

The suicide rate among men aged 60 to 74 also “rose significantly” from its 2012 level to 14.5 deaths per 100,000 population in 2013. There were 672 suicides among the age group in 2013, up from 562 in 2012 when the suicide rate was 12.3 per 100,000.

In contrast, men aged 15 to 29 were the only age group to record a decrease in the rate of suicides in 2013 to 12.5 deaths per 100,000, compared to 13.6 in 2012.

In previous blogs, I have spoken about how men are somehow disillusioned with their roles being unclear and not as defined as previous generations, and this is one of the factors that academic literature cites as a possible cause of the phenomenon.  Other authors discuss that men are less interdependent than women and as a result tend to not share problems as easily or ask for help.  My experience is that men will often struggle to seek help and will often be constrained by gendered societal discourses around being strong and that expressions of feelings are weak.  Common language such as ‘man up’, ‘grow a pair’, ‘boys don’t cry’ and similar epitomise how men are conditioned by parents, media, contemporaries and each other to not discuss their problems or notice when they need assistance or no who to ask.  When I see men who are suicidal, they are often on the surface like the two rock singers mentioned earlier, with family, friends, children and successful careers.  On face value they seem to have most of the elements that most of us feel are essential for contentment.  It somehow seems easier to understand suicide amongst the marginalised and un-visible in society such as the addicts, homeless and chronically mentally ill, as these individuals are somehow not as representative of our own fathers, brothers and sons and their despair is more accessible as we can easily imagine how their lives may not be worth living.

What seems to be really difficult to interpret is that men who are successful or not completely fractured through substance abuse or trauma can be that unhappy that suicide is their only remedy.  My thoughts are that this perceived expectation can also further suppress men from getting help, as why would someone with all these reasons to exist not want to be here?  I feel that all men who feel suicidal have internalised a feeling that they have no meaning and that even though others may feel they matter, the suicidal men feel that they don’t and that it is this existential meaninglessness that is fueling the epidemic.  Carl Jung describes this sense of loss as a vocational crisis and I believe that this manifests as a feeling of being trapped.  If one feels trapped with no escape then it starts to become more understandable that suicide can be one avenue of escape.

I often discuss how suicide impacts families and that many people see suicide as a weak choice, especially with fathers who should somehow be able to rally with the thought that all they are achieving is abandoning their children.  My experience is that suicide is an incredibly frightening, brave and usually the only perceived choice, and that to be so despondent and unhappy to even consider it means that an individual is suffering immensely.  People often minimise the suffering of individuals by saying that people need to ‘get a grip’ or ‘cheer up’ and ‘do something about it’.  These further isolate already depressed people and compound the powerful social construction that those who take their own life were weak or could not be bothered to make themselves better.  I often hear men who are severely depressed talk about being unable to connect to the people and things that they love and are usually in bleak, dark and lonely places as their conditions mean that they become shut off from the emotional context of reality.

The moral implications of suicide have long been discussed with English philosopher David Hume writing a seminal piece in the 18th century.  He described that suicide is a choice and is a right of autonomous being, he discusses how suicide does not harm society as we stop receiving societal benefits and that we are then free of moral obligation and duties once we make this choice.  In some ways, I agree that suicide is the right of the individual but that perhaps if that individual could get help before making the choice, then they may see that other choices are also available and may then pick another.  As the selection of only once choice is tantamount to a democracy with one candidate.  I believe that men should be able to have opportunity in discussing suicide as a choice but should also be allowed to also reject that choice in favour of another choice to live and that my work has often showed that with the right help we can start to increase our potential choices when we feel trapped.

In order to do this conversations must be had and we must get to point where we can start to be work out our choices before only one fatal choice is available to us.

If anybody resonates with the feelings above, The Samaritans are often the first port of call where men start their journey to not choosing suicide and are a brilliant service that are available 24/7 365 days per year and are free from any phone, even with no credit by calling 116 123. I always advise depressed patients to put this number in their phone as it may be a number that proves invaluable when the world is horrendously dark.  Calling this number may be the one extra choice that may just help start a journey to stop the sad figures increasing by one more.

Coming to Therapy · Difficult Emotions · Relationships

It’s your fault I had the affair… How gender can influence infidelity blame attribution.

This weeks post has been triggered by a recent The Independent newspaper article that I heard being discussed on the radio last Friday.  Essentially, the researchers made some suggestions that men and women apportion blame around an extra-marital affair rather differently.  The author comes from an evolutionary perspective that I always struggle with, as I think making everything about genetic predisposition is slightly reductionist and does not account for the complexity of environmental social and cultural factors.  He writes that men will blame the partner and women often direct their anger towards the offending other woman.  This is based upon a theory that women are viewed in evolutionary terms as the main child carer and so are jeopardising the survival prospects of any offspring.  For any of the more scholarly readers the original article is linked to here academic article.

My experience of working with affairs does often mirror this pattern of blame but I feel that the reasons are different.  Whenever I work with affairs I try to get past the initial blaming interaction as it often becomes clear that it is the relationship between the couple that has been struggling for some time.  This is often hidden as partners gradually grow apart and become caught in familiar patterns of not making much effort or being absent because of work, children or social commitments.  I always feel that at some level an affair is about resolving a loss and this loss can be one that it very obvious such as parental bereavement, redundancy etc. or it can be more subtle such as the loss men often experience when their partners have children. This is a very common presentation and has a number of symbolic meanings to the man involved.  The first is being subordinated to the new child’s needs. Most men understand and at some level and expect and overcome this feeling of becoming less attended to.  The second common but more abstract aspect is where men suddenly experiences disorientation at how their partners have moved from sexual objects into parental archetypal images.  This can manifest sexually in the pregnancy as men often feel guilty about having intercourse with a pregnant partner or concerned they may damage the baby.  Some men see their partner as unattractive as they now view them as a mother and not as a sexual being, this is not usually around physical changes but how men struggle to feel sexual desire for a woman who is now responsible for their children’s survival.

This sudden female role change also resonates with the primal oedipal conflict of having to disentangle their early unconscious sexual fantasies towards their own mothers. The point at which current partners become defined as mothers can often trigger the difficult emotions that were previously resolved during childhood.  Children often express their oedipal struggle by saying things like they will marry the opposite sex parent, wishing the same sex parent would leave or by constantly invading the marital bedroom.  Men often struggle with rituals that they are excluded from such as breast feeding and how they remember the breast having a sexual function for them.

I think these type of interactions are some of the factors that the article above’s position is based on.  At this point when a man is unfaithful the blame toward the other woman is around the loss of the woman’s position as the sexual object in her relationship.  A jealous rivalry is setup as she becomes rejected in favour of another woman she perceives as being able to be seen as a sexual being by her man when she is not.  She also wants to maintain an image of her partner as predominantly good and that he has somehow been lured by the other woman rather than face the reality that he may no longer desire her in the same way as he once did.  This also acts as a protective mechanism, as if the man is blamed directly it challenges how good her own judgement was when picking him to have a relationship with and also safeguards support to be still available for the family.  At this point we often see younger women being chosen to have the affair with, the common discourse is that this is about men being shallow and in some mid-life crisis but I think it has a more complex function of men being able to reassert power in the relationship, as they subconsciously feel that a younger and less experienced woman will be easier to assert dominance over and buoys their sense of vulnerability caused by their own loss.  They are also able to reactivate their internal schema of seeing a woman as a sexual object that they can possess and be possessed by in entirety and to not have to share her.

I agree with the article that states that men are more activated when they hear their partners being physical and women become more distressed at the emotional content of the infidelity.  Men’s sense of self is often damaged when they imagine their partner being being physically taken by another man.  This is the narcissistic wound that men suffer about their belief that they are competent, strong and potent lovers.  Women on the other hand are often more wounded by words of affection or emotional intimacy.  I think that this aspect is important as again it epitomises current and historical losses, I often hear how a partner feels tremendous grief as they hear how their other half engages in physical or emotional acts that they may have not received for some time.

One common dead end in couple’s therapy around affairs is that the person not having the affair often feels they are lacking in something and will constantly make comparisons to the person their partner had the affair with. Women will often be self-deprecating in their physical appearance, weight or that their sex drive as lowered over time, and that this is why their men have sought another.  I think this is a decoy and that the loss is actually occurring for the person who is having the affair.  It is at this point I often ask more questions to the man about what was it like coming home to your family after meeting the other woman? or when you were spending time with your family did you feel close?  It is here that you can then start to understand the real feelings of what the man was experiencing in the relationship, rather than endless interrogations about what did she have that i did not? or enquiries about the quality of the sex being had.

Men who are being cheated on will often blame their partner for not telling them what they needed and I think that this is to avoid their own shame by distancing themselves emotionally and viewing themselves as betrayed victims.  I feel that they often demean their partners personally as whores or sluts who are not worth being with.  Interestingly, this interaction comes full circle and actually re-frames the woman as a sexual being but with the difference that she is simply owned and paid for sexual services by any man and not respected as a woman with agency, in some ways this dehumanises her.  The article mentioned earlier discusses the implications of men’s blame towards their partner as being a precursor for domestic violence when he punishes her for the transgression.  Again this links to last week’s article as David Buss studied homicide rates in Baltimore and showed 25 out of 36 murders in his sample were results of male to female violence that occurred due to spousal jealousy David Buss 2014 book (p.313). Interestingly, I believe the dehumanisation allows this violence to be morally sanctioned as it is easier to be aggressive or violent to a person who has already been psychologically subjugated and made less than human.

Ending on a positive note, one thing that I often see in the therapy room is how an affair can help a couple redefine their relationship and what it needs to be fulfilling to both of them.  It is important that the aggrieved partner stops punishing the perpetrator as this drives them further apart but it also requires that the offending partner acknowledges and takes responsibility for the hurt their affair caused.  This is often the dysfunctional cycle of one partner bringing the affair up to remind the other of the pain and the compulsion for the guilty partner to avoid ever speaking about it.  One position antagonises the other and form these quite disruptive and negative cycles.  I often hear how couples will resolve the affair and relish the opportunity to have a second go at their marriage with very different expectations, objectives and understanding.

 

Difficult Emotions

I’m going to kill you…!?!?! The angry face of the humiliated man.

I struggled a little this week to come up with a good topic to talk about.  I’m not sure why but I have been busy and slightly consumed with writing academic work so maybe my mind was in researcher mode rather than therapist.  I like to keep abreast of the latest cultural and political ideas and what with the election and the recent terror threats and tragic tower-block fire, the theme of the week has been anger.  In fact, not just angry but vitriolic, consuming vexation… There was even a day last week entitled the day of rage. So, as always the topics for my blog can emerge from the strangest places and even though anger is engulfing Britain at the moment, I failed to pick up on it and gained my muse today from the recent events in Big Brother.  I used to watch this show religiously as it essentially re-enacted many of psychologies seminal studies, such as Milgrim’s obedience and Asch’s classic expression of conformity.  I was completing my undergraduate degree at the time that the show had just started to be a cultural phenomenon and I loved watching the real life application of dry old accounts of social psychology that I was being introduced to in the lecture theatre.

Anyway, the show has become tired and at best a platform for aspirational Z list celebrities, but I was interested in a recent incident and tuned in to have a look for myself as whatever Big Brother attempts to grossly pantomime, it does at times capture the essence of the human condition and how we socially interact in participatory sense making.  The news story that ran was that the show faced being pulled (not dissimilar to Zimabado’s prison experiment that quickly spiraled to due degradation practices and power abuse) because of a  mass brawl that was started by three imperious men.   The gist of what happened was that the three individuals had started to be powerful and domineering figures who had as a group started to play increasingly nasty pranks and antagonise mainly female housemates.

One young lady had stood up to the ringleader Lotan, who was constantly berating her use of fake tan and general personality and she challenged his behaviour by asking him what sort of role model does he want to be to his young son?  Her intention was to make Lotan reflect on his immature and at times bullying antics and she attempted to place him as person who could potentially be responsible for passing on misogynistic and macho beliefs to the next generation of men.   Incidentally, he had also enlisted two weaker men as lieutenants, who effectively provided him with an echo chamber to assert his dominance and create a group social norm that bullying could be construed as laughable banter and that if you thought otherwise you were too stupid to get the joke or no fun.

The reaction she received was not one of sombre contemplation but an intense rage which led to a fully grown,  muscle bound man to leap up in a murderous rage ,throw anything in sight, square up and threaten all forms of torturous death and destruction upon a physically diminutive teenage girl who had simply asked him about the type of man he wanted to portray to those watching.  His rationale was that she had offended him by bringing family into an argument. There seems to be a bizarre code in the show that pretty much anything goes but do not talk about my family, it is like some sort of working class form of the mafia’s omerta of silence.  My feeling here is that it was not that the challenge had breached some odd and arbitrary code of discourse but she had humiliated the man.  By implicating how his actions may lead to his own son to become bigoted and sexist, she had inadvertently triggered a primal anger that has been ignited by humiliation.

Humiliation is the abasement of pride, which creates mortification or leads to a state of being humbled or reduced to lowliness or submission. It is an emotion felt by a person whose social status has just decreased. It can be brought about through intimidation, physical or mental mistreatment or trickery, or by embarrassment if a person is revealed to have committed a socially or legally unacceptable act. Whereas humility can be sought alone as a means to de-emphasize the ego, humiliation must involve other person(s), though not necessarily directly or willingly.

This comment caused Lotan to appear foolish and ashamed in front of his peers and diminished his status as a respected man who will be able to pass on a legacy to his son. I am not familiar with how much contact he has with his son but this may have resonated with his own feelings of being an inadequate father who maybe was not doing enough real parenting and who may have been already experienced a private shame about not being a more active and available, as well as the loss and shame generated by the failed relationship with the child’s mother.

We have all experienced the burning embarrassment and crushing loss of status that humiliation brings to the psyche.  It can be activated by others ridiculing us or our own clumsiness or incompetence in cultural and social ceremonies.  I think that being humiliated by people close to us in public arenas is often the ember that starts the fight that ends the relationship or symbolically initiates the first occasion we raised our fists in anger and retribution to someone we love.  The reality is that humiliation is often the reason that lovers murder their partners or a furious husband bludgeons the love rat who seduces his bored wife during the fallow phase of a suburban marriage.  David Buss, an evolutionary psychologist writes about this type of sequence to slaughter in his book the ‘Murderer Next Door’.  His message is that murders are not acts committed by unknown evil psychopaths but are often the social product of a humiliating encounter with a friend, partner, stranger or family member.

The evidence suggests that most homicide victims know their killers and that when Buss surveyed 1000 ordinary people about their murderous impulses, he was caught in an avalanche of dark and twisted fantasies of torturous murder towards seemingly innocuous targets such as parents, children and siblings.  These fantasies were further investigated to reveal that the targets were chosen because at some time in their history, this person had transgressed a boundary and caused humiliation and degradation. These acts were often put downs or off colour comments about sexual performance, appearance, family background or skill at an activity and in the scheme of things may be viewed as inconsequential or petty.  The reactions are anything but…  Take a moment to reflect on how you have reacted to a humiliating remark or event.  Did you shout and scream, throw a punch, cut a family member from your life, call a close person an unspeakable expletive or threaten to leave and never return…?!?

Going back to the event on Big Brother and making a hypothetical exploration of what if…?  I wonder had security not been called in or had other contestants not rushed to intervene and had Lotan been close to a kitchen knife or heavy object, he may have been taken over by the responsibility abdicating ‘red mist’ and when he regained composure may have been looking at the young lady laying prone on the floor with her head caved in or a knife protruding from her chest.  He may have played out his violent fantasy to try and redress the narcissistic wound inflicted by the suggestion he was a poor father and he may have regretted his actions for the rest of his life.

I often see men, who in various guises have been faced with humiliation that has been directly struck, indirectly experienced from more subtle discursive insinuations or born of institutions and organisational patriarchy.  Sometimes, this first realisation is terrifying as one wrestles with the dark passenger who whispers coldly in your ear to claim vengeance and flashes a scene of macabre and arousing massacre vividly in your imagination.  I always say to these men, who are often gentle and kind in their everyday lives, that these are natural thoughts.  The skill is being able to understand their function of preventing emasculation and to not act upon them, but instead to allow them to be expressions of our shadow selves and incorporate them into our everyday selves in order to be sentient, thinking, feeling and existing humans who are all potentially the murderer next door.