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Section 3
Perceptions About Male Depression

Question 3 | Test | Table of Contents

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In the last section, we talked about male vs. female patterns of depression. Now let's turn to the causes of masculine depression. Have you found, like I, that family influence can be the most major contributing factor?

In this section we'll discuss how family relationships particularly affect masculine depression.

Divorced or separated men are more than twice as likely to commit suicide as men who remain married, a US researcher reports. But divorce and separation do not appear to affect suicide risk in women, according to Dr. Augustine J. Kposowa, of the University of California at Riverside. Kposowa examined the link between suicide and marital status using data on nearly 472,000 men and women.

As you know, in a healthy family, both parents are equally close to their children. The parents have struck a balance between their own relationship and the relationship with their children. However, as you are aware, such a balance is often not the case. In reality, many times we see families, such as Mark's, in which the mother is closer to the children and more available both physically and mentally.

In Kilmartin's book, he states traditional fathers are less open, less attentive, and less involved in their children's emotional lives than their mother. If the father is the breadwinner, as our society often dictates, then he is less involved with his children in virtually every aspect of their lives.

Sons and Their Relationships With Their Fathers
In families like the ones we've been discussing, sons don't know their fathers very well. Mark, age 35, is married and had two sons. On the surface, Mark is quite successful: he is an investment banker and makes a good living, and he seems to be in control of his household. Every night, when Mark comes home from a long day at work, he barks orders at his wife Julia and criticizes the mistakes of his sons.

As you can see, he feels he is being "manly" by never sharing his emotions or doubts with any family members. What Mark sees is himself being self-confident, emotionally in control, extremely independent, and dominant. What Mark does not see is that he is creating an emotional gap between himself and his children.

I stated to Mark, "A traditional father's commitment to work and his inability to open up can often lead to his isolation from other family members. The marriage might become strained, which would in turn affect all family relationships. With such an imbalance of power and emotion it becomes difficult for children to learn how to cultivate healthy family relationships themselves."

In addition, Mark's sons don't realize that he was actually very insecure. They do not see how angry Mark was about his depressed feelings and avoidance of his problems. They do not ever see their father express his emotions. Nor do they ever see him ask for help with his internal conflicts, or try to work out problems in his relationships.

"Primary Unnamed Difference"
Instead, his sons see an angry, powerful man, and they think this is what a man should be. However, the sons cannot identify with their father. They do not feel the power inside of themselves their father appears to have. Kilmartin refers to this as a "primary unnamed difference" between sons and their fathers. This unnamed difference causes a feeling of inadequacy in boys.

Think of a client you are currently treating whose children rarely see their father express feelings, show internal conflict, or ask for emotional support. Do you feel it would be a good idea to provide this client with the concept of a "primary unnamed difference"? By doing so, I have found the client is able to label, perhaps for the first time, the difference between the powerful man they saw in their father; and the lack of power the client feels within himself.

Regarding female clients, daughters are often able to identify quite well with their mother, who is more open with her emotions than their father. But sons do not recognize their father's actual isolation and try to live up to his perceived pervasive, all-encompassing power.

Eventually, a son becomes exactly what his father is, a man controlled by fear rather than a man in control. Do you agree?

Technique: The Mommy List & The Dad Zone
To you, as a therapist, it is obvious boys tend to pick up on their fathers' aggressiveness and behaviors in general. However, to depressed men, as you know, it's not so obvious. The use of a "Mommy List" is a way to break the cycle of masculine depression passed on from generation to generation.

As you are aware, many families fall into a pattern in which the mother takes all the responsibility for the everyday things: the health, comfort, appearance, and happiness of the family. The father, on the other hand, often falls into what Lynch would call the "Dad Zone," where he withdraws from the family's needs and leaves the burden on the mother. Because he feels the need to be not-feminine, he stays away from little tasks that seem "motherly."

Daniel was in the "Dad Zone." My colleague, Lee, treated Daniel, a 48-year-old carpenter who seemed to be the epitome of a "man's man." Daniel frequently hunted, fished, and stayed out late at the bars with his fishing buddies. In their first session, Daniel told Lee that he didn't need to participate in the everyday family activities and that his wife, Sharon, always handled those. He stated, "I'm the major money maker in the house and deserve free time with my friends." In a later session, Daniel admitted "I feel inadequate as a father. My kids always turn to Sharon. When they have a problem, I feel kind of useless as a father."

Lee asked Daniel to make a list of tasks that Sharon always did, called the "Mommy List." As you will see, the tasks toward the end of Daniel's Mommy List became increasingly meaningful, shifting from tasks to emotional support.

Here are some of the things Daniel came up with:
-- attending parent-teacher conferences,
-- shopping for school clothes,
-- planning the week's meals,
-- buying the groceries,
-- arranging for after-school playmates,
-- developing ways for children to overcome their fear of having nightmares while sleeping,
-- participating in children's religious studies and spiritual development, and
-- handling social problems like fear and rejection at school with peers.

I told Daniel, "Look at the list again. Do any of those activities require breast milk?" Daniel replied, "No, it just always seemed that the kids went to Sharon for those things."

Think of a male client you are currently treating who feels shut out of his children's lives. Would a Mommy List be beneficial in your next session?

Lee told Daniel, "A way you could prevent masculine depression in your sons is to overcome your own depression. When you begin to recognize your emotions and share them, your sons will learn to do the same. The major mechanism for passing down masculine depression is shame, for example, if you were to tell your son you were disappointed that he's behaving in so-called feminine ways. Your most important task as a father may be actively reassuring your children."

Lee then told Daniel, "Instead of being only the disciplinarian, a father could expand his definition of being a good father to one who takes on the nurturing role as well." Think of your Daniel who is experiencing masculine depression. Envision your next session. Would it be beneficial to indicate in your next session that by challenging, encouraging, and nurturing his children, a father can help stop the masculine depression they are experiencing?

Now that we have discussed the "unnamed difference" which may result in a feeling of being an inadequate father, in the next section I will discuss the "Imaginary Stranger."

Peer-Reviewed Journal Article References:
Charak, R., Eshelman, L. R., & Messman-Moore, T. L. (2019). Latent classes of childhood maltreatment, adult sexual assault, and revictimization in men: Differences in masculinity, anger, and substance use. Psychology of Men & Masculinities, 20(4), 503–514.

Cole, B. P., & Davidson, M. M. (2019). Exploring men’s perceptions about male depression. Psychology of Men & Masculinities, 20(4), 459–466. 

Hoffman, E., & Addis, M. E. (2021). Dilemmas of agency and blame in men’s talk about depression. Psychology of Men & Masculinities, 22(4), 669–677.

Lopez, M. N., Pierce, R. S., Gardner, R. D., & Hanson, R. W. (2013). Standardized Beck Depression Inventory-II scores for male veterans coping with chronic pain. Psychological Services, 10(2), 257–263. 

Nadeau, M. M., Balsan, M. J., & Rochlen, A. B. (2016). Men’s depression: Endorsed experiences and expressions. Psychology of Men & Masculinity, 17(4), 328–335. 

Parent, M. C., & Bradstreet, T. C. (2017). Integrating self-concept into the relationship between drive for muscularity, and disordered eating and depression, among men. Psychology of Men & Masculinity, 18(1), 1–11.

What feeling does the "unnamed difference" cause in boys?
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Section 4

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