DEEPENING P SYC HOTH E RAPY WITH MEN FREDRIC E. RABINOWITZ SAM V. COCHRAN AMERICAPNS YCHOLOGICAALs soc IATION WASHINGTODNC, CONTENTS Preface ................................................................................................... ix Acknowledgments ................................................................................. xi Introduction ............................................................................................ 3 Chapter 1. Understanding the Problems Men Bring to Psychotherapy. ............................................................... 9 Chapter 2 . Theoretical Foundations for Deepening Psychotherapy With Men .................................................................... 33 Chapter 3. Practice-Oriented Foundations of Deepening Psychotherapy With Men ............................................ 51 Chapter 4 . Early Phases of Deepening Psychotherapy With Men ..... 89 Chapter 5 . Entering the Working Phase of Deepening Psychotherapy With Men .......................................... 117 Chapter 6. Working Phase Through Termination of Deepening Psychotherapy With Men .......................................... 137 Chapter 7 . Deepening Group Psychotherapy for Men .................... 157 Chapter 8. A Question-and-Answer Session With the Authors: Some Final Words ..................................................... 177 References. .......................................................................................... 193 Author Index ...................................................................................... 203 Subject Index ...................................................................................... 205 About the Authors ............................................................................. 215 oii PREFACE It was in the fall of 1980 that we met each other in a graduate course called “Structured Groups for Consultation and Psychotherapy” at the University of Missouri-Columbia. As our major fieldwork project for the class, we designed and led a self-esteem group for women who were serving life sentences in the state women’s penitentiary. The intensity of the stories the women told about abuse, rape, and murder led to many hours of discus- sion in the car on our way to and from the prison and resulted in a deep and enduring bond between us. One of our many discussions turned to the challenges we faced as men. In the prison, the women seemed to both love us and hate us. In our own lives we found similar but less intense dynamics in our relationships with women. Women’s liberation issues were paramount. Women were uniting, feeling their power, and letting us men know that we had better not treat them as objects or second-class citizens. Much anger was directed toward men, especially those of us who were willing to listen and hear what the women were saying. We agreed with many of their complaints but also won- dered why men didn’t talk to each other about their own lives. In response to our recognition that many men did not talk in much depth about their lives, we decided to see if there would be some interest in a men’s consciousness-raising group. With the support of Drs. Puncky Heppner, Helen Roehlke, and Dick Caple, and the sponsorship of the uni- versity’s counseling center, we advertised for our men’s group. After getting very little response, we found out about a film called “Men’s Lives” and decided to invite the university’s students to a screening of the movie. To our surprise, more than 100 people showed up, more than half of them men. We recruited some of our friends to help us lead small group discussions afterward to talk about the issues raised in the movie. We also gave out a questionnaire and on it left a space where a man could indicate that he was ix interested in joining a men’s group. After the discussions, we had the names of 15 men interested in the group. Of these, 8 eventually became a part of the first experiential men’s group at the University of Missouri-Columbia. The rest is history. We not only led a series of semester-long men’s groups while graduate students but we videotaped them, collected research data, and presented these findings at national conferences. We both became interested in working with men in individual and group therapy, an interest that quickly became the focus of our careers as clinicians, researchers, and theorists. Of course, there was a selfish aspect to this work. Our own develop- ment as men was being profoundly affected by our personal explorations. We read the early books on men’s issues and are indebted to Herb Goldberg, Joseph Pleck, Bob Brannon, and Warren Farrell, who broke the ground on popularizing men’s issues. In the academic realm, we read Murray Scher’s insights about working therapeutically with men and Jim O’Neil’s early work on gender role conflict. On the national level, we joined the National Organization for Men Against Sexism (at the time called the National Organization of Changing Men), the Standing Committee for Men of the American College Personnel Association, and eventually the Society for the Psychological Study of Men and Masculinity of the American Psychological Association. In each of these groups we were invited to join in the ongoing discussion, research, and personal camaraderie of fellow men who were challenging the gender role stereotypes of masculinity. Fred was hired by the University of Redlands in California as a profes- sor, and Sam went to the University of Iowa as a staff psychologist in the University Counseling Service. Although we traveled separate roads, we maintained our contact through our work on men’s issues. Each of us main- tained clinical practices that specialized in working with men in therapy. Our academic careers included researching, theorizing, and writing about men’s issues. We spoke on the telephone; roomed together at national con- ferences where we presented our findings; wrote articles about men through long-distance computer disk sharing and electronic mail; and collaborated on two books: Man Alive: A Primer of Men’s Issues (Rabinowitz & Cochran, 1994) and Men and Depression: Clinical and Empirical Perspectives (Cochran & Rabinowitz, 2000). The present volume is our attempt to share the thera- peutic perspective that we have developed from our many hours of discus- sions, clinical practice with male clients, research, and personal experiences as men challenging traditional masculinity in our own lives. X PREFACE ACKNOWLEDGMENTS We are indebted to many people who have supported us, taught us, and allowed us to be a part of this wonderful field. We are especially thankful that we have had the unconditional support of our families. For Fred, his partner Janet and his two children Karina and Jared have enriched his life more deeply than they can ever know. He is also fortunate to have grown up with two great brothers, Mark and Josh Rabinowitz, who have continued to stay close and connect him to his roots. For Sam, his spouse Lucy and his daughter Katherine have given him an abundance of love, support, and emotional grounding, providing him the base from which to explore the frontiers of his own and his male clients’ lives. In our professional lives, we are deeply indebted to the men from our consulting rooms. Through their struggles and therapeutic journeys, they have taught 11s much about masculinity, psychotherapy, and life. We are also grateful to the faculty at the University of Missouri-Columbia, who encour- aged our work from the beginning, especially Puncky Heppner, Paul King, Helen Roehlke, Wayne Anderson, Joseph Kunce, Corrine Cope, and Dick Caple. Fred is especially fortunate to have been able to lead men’s groups for the past 13 years with two of his best friends, Tom Elliott and Jim McFarland. Without their loving, supportive, and creative notions of how to work with men, he would be less effective in his ability to understand, empathize, and intervene with the variety of male clients he has encoun- tered in his practice. He is also thankful that he was able to work with Ben Shapiro, a bioenergetics therapist who taught him about the power of body- oriented interventions. He is deeply grateful to his mentor and friend, the late Frank Blume, who showed him the value of being honest in all encoun- ters and not regretting speaking from the heart. Sam is fortunate to have worked with a supportive and talented staff at the University of Iowa, xi including Gerald Stone, Cheryl McNeilly, Julie Corkery, Audrey Bahrick, Martha Christiansen, Kathie Staley, and Scott Stuart. We have also appreciated the encouragement of our academic and clinical work by many of our fellow members in the Society for the Psychological Study of Men and Masculinity of the American Psychological Association. This wonderful “think tank” for understanding the psychology of men has given us a warm and friendly professional home that has helped us stay on the cutting edge of the field. Fred was also lucky to have been given the academic “go-ahead” intellectually and financially for his work from the University of Redlands and Sam, likewise, from the University of Iowa. We have had terrific editorial assistance and direction initially from Margaret Schlegel and, more recently, from Edward Meidenbauer and Jennifer Macomber of APA Books. We are eternally thankful to the review- ers of our book, who gave us critical feedback, good advice, and encouraging comments about our work. Finally, we are indebted to our parents, Sam and Bobbi Rabinowitz and Sam and Marilyn Cochran, who have always supported our endeavors and raised us to follow our own paths. xii ACKNOWLEDGMENTS DEEPENING P SYC HOTH E RAPY WITH MEN INTRODUCTION Then wilt thou not be loath to leave this Paradise, but shalt possess a Paradise within thee, happier far. Let us descend now, therefore, from this top of speculation. -Milton, Paradise Lost, 1667/1951, Book XII, verse 585 Much has happened in the study of men in the past 25 years. David and Brannon (1976), Farrell (1975)’ Fasteau (1974), Goldberg (1976), and Pleck and Sawyer (1974) were among the first to critique traditional male sex role behavior in response to the women’s liberation movement. Many of these early writings in the 1970s on the psychology of men provided an impetus for the men’s liberation movement. This movement was devoted to challenging society’s scripts for men and women, believing that the future held egalitarian liberation for both sexes. Whereas profeminist men con- tinue to support this goal through social activism, in the 1980s the “men’s movement” split into factions with their own agendas. Notable among these were the men’s-rights movement and the mythopoetic men’s movement. The men’s-rights groups, who have taken a legal tactic, were formed mainly by men who felt betrayed by the concept of egalitarianism. They per- ceived themselves as victims of child custody and alimony laws that clearly favored mothers over fathers in the aftermath of divorce. Political advocacy and activism became a primary means by which proponents of this move- ment pursued their goals. The rnythopoetic men’s movement was led by poet Robert Bly. He articulated an appealing and honorable vision of masculinity that served as a salve for the confusion and pain stirred up in men reacting to the changes occurring in women’s roles in society. The men who affiliated with the mythopoetic groups were drawn together by a desire to expose and heal their wounds in the supportive atmosphere of other men. As scientists, we have noted that in the academic world theorizing about men has evolved in many directions informed by various philosophi- cal, empirical, and conceptual underpinnings. Notable among these were the psychoanalytic developmental viewpoint, which focuses on the inner emotional and relational worlds of men, and the gender role strain perspec- tive, which concentrates on how cultural, economic, and family structures 3 affect men’s lives. Tension between these two perspectives, in writings on the psychology of men, is reflected in what could loosely be called the social constructionist worldview and the identity development worldwiew. As practitioners, we have been disheartened to notice that men have been reluctant psychotherapy clients. They make up only one fourth to one third of most clinicians’ practices (Vessey & Howard, 1993). The psy- chotherapy process, with its emphasis on personal sharing and self-disclo- sure, is foreign to many men who have been raised to avoid intimacy and vulnerability. Even though many men have endured wounding and shaming since they were boys, they are wary about opening up this cauldron of pain to anyone, especially a psychotherapist (Osherson & Krugman, 1990; Scher, 1979). Some clinicians have even expressed doubts about whether men can actually engage in more traditional psychotherapy processes and have sug- gested that therapy be modified so that it fits a more masculine framework (Shay, 1996). Some men have difficulty engaging in the classic psychoana- lytic or client-centered process, with its emphasis on client revelation to a mostly passive therapist. For men who struggle with generating verbal mate- rial on their own, a more active, structured therapy can lead to increased depth and meaning. We have found that experiential interventions that allow a man active expression of his feelings and behavior enhance the therapy process and work well in combination with traditional psychotherapeutic strategies. No intervention or strategy with men will work, however, without empathy for and sensitivity to a man’s personal and cultural history and how it has affected the way he navigates his world. Even though a man may have initial difficulty with the structure, for- mat, or relational quality of psychotherapy, these challenges do not mean that the therapy won’t work. In fact, by focusing on the relational difficulty of the situation in therapy a man may unlock many of the factors that con- tribute to his psychological suffering. We make the assumption that all men have psychological depth, but for many men this terrain has been obscured by years of neglect and active avoidance inspired by our culture. Traditional gender role socialization is a powerful force that inhibits and restricts knowing this internal terrain for many men. This socialization comprises the parental, peer, and social rules of what it means to be a man (Levant, 1995; Pleck, 1981,1995).T his set of proscriptions on how to think, feel, and behave has urged men to avoid getting too close to their feelings. Instead, men have been encouraged to take a more active, problem-solving approach to life’s dilemmas. As a result, this conditioning frequently lends itself to finding quick solutions to uncomfortable affective states. Although surely multidetermined through biological, psychological, and cultural pathways, we believe some aspects of what is today considered the traditional male gender role originally had survival value (Jones, 1999; 4 DEEPENING PSYCHOTHERAPY WITH MEN