DISCLAIMER: I am not a man.

I have never been a man. I have no idea what it’s like to be a man. But I am a daughter, sister, partner, colleague and friend to many men, and I am the mother of three teenage sons. So, men’s well-being matters to me.

Given that men in their middle years are dying by suicide at increasingly higher rates, I spend much of my time speaking and training in male-dominated industries like construction, transportation, veteran and first responder communities. The men I have met along the way have taught me much about resilience and honor.

In addition to partnerships forged with groups and associations within these industries, I’ve also have the privilege of collaborating with Cactus and Colorado’s Office of Suicide Prevention as we continue to innovate new ways to reach “double jeopardy men.” Double jeopardy men are men who live with a number of risk factors for suicide and who also are least likely to seek help on their own. Together we created “Man Therapy” (www.ManTherapy.org), a program that uses humor and digital media to engage men to think about emotional well-being as a manly part of their overall health.

I've also played a leadership role in Healthy Men Michigan a website created to make it easy for men in Michigan to get and stay mentally fit. The CDC funded project helps me take a free and anonymous online screening that offers real time customized results and links to local Michigan resources that reduce stress and improve well-being.

In both projects -- Man Therapy and Healthy Men Michigan our goal is to meet these men respectfully where they are and to help them connect the dots between traditional models of masculinity and mental health.

I am proud to announce, this month marks the 6th year anniversary of Man Therapy. Over these 6 years we’ve spread the campaign to nine states and even to the country of Australia, and have created specialized campaigns for first responders, military/veterans and primary care communities. To learn more about our incredible journey in this campaign (and these new developments), view this new video: https://youtu.be/XxOAS339aLE

Given the Man Therapy anniversary and the fact that June is “Men’s Health Month,” I am reflecting upon ideas of masculinity and how they relate to suicide prevention. As I do, it becomes clear to me that we need to dig deeper into our existing scripts on what it means to be a man and that our evolutionary history may be challenging some men in adopting contemporary ideas. I also challenge any shaming approach that says all traditional ideas of masculinity are wrong.

Nature and Nurture

In the world of cognitive psychology (Psychologist World, n.d.), schemas are mental blueprints that we form through our experiences and culture that help give us cognitive shortcuts when processing large amounts of information. We tend to remember what fits with our schemas and explain the rest away. Scripts are specific schemas linked to events that tell us how to behave in certain situations. Scripts and schemas are learned mental models — the nature argument for why we do what we do. Without a doubt unhealthy, limiting and toxic ideas about masculinity have conditioned many men to develop problematic schemas and scripts that lead to all forms of self-destruction and interpersonal violence (Katz, 1995a; Katz, 1995b).

What often gets left out of our contemporary conversations is the role nature plays in understanding male behavior. Males of most mammal species are larger and more aggressive than females. Mammalian males are also more likely to die of risky and violent behaviors than females. From an evolutionary perspective, females of many species are more inclined to choose the stronger male as a mating partner. While the 21st century man is certainly not “most mammals,” our civilization’s evolution has far outpaced the human body’s, and clearly more than a trace of this history remains among us.

As my mentor and evolutionary psychologist Dr. Paul Quinnett (Spencer-Thomas et al, 2013) reminds us, evolution is not just about survival, it’s also about reproduction. Not too long ago, men who found themselves “lost in another man’s woods” were often killed, and males who couldn’t defend and provide for their families often didn’t have off-spring. From this perspective, it is unlikely we will be successful in creating completely new concepts of masculinity that will stick for many — the wiring for some just goes too deep. That said, I do believe there is a place for appreciating the good qualities along a broad spectrum of masculine ideals.

When it comes to mental health and suicide prevention, Quinnett (Spencer-Thomas et al, 2013) states, “So long as we keep repeating the phrase, ‘encourage male help-seeking behavior’ in our grant applications, public health marketing, and outreach efforts, suicidal men will just keep dying. Hoping men will become more like women is costing us the lives of our fathers, brothers, sons, uncles and nephews.”

The Epidemic of Loneliness

For many men, white American men in the middle and older years in particular — the demographic most at risk for suicide death— the scripts for masculinity have allowed for achievement and privilege and have also been deadly. Dr. Thomas Joiner shares in his book “Lonely at the Top” (2011) that there is a high cost to men’s success. According to the former U.S. Surgeon General Dr. Vivek Murthy (2017), loneliness is associated with a reduction a reduction in lifespan similar to that caused by smoking 15 cigarettes a day and even greater than that associated with obesity. Loneliness is also linked with a greater risk of dementia, cardiovascular disease, anxiety, and depression. And despite the incredible social connectivity many of us experience on-line, the rates of loneliness have doubled since the 1980s.

Evolving Forms of Masculine Self-Identity

In their incredible presentation entitled “Be a Man! Male Identity, Social Change in Contemporary America, and the Impact on Mental Health” presenters Brennan Gilbert and Robinder Bedi (2014) remind us that “For many men (and perhaps all of us in the right situation), threats to masculinity are a threat to self.”

Those of us who are trying to prevent suicide and promote mental health among diverse groups of men must seek to understand and respect the diverse and evolving forms of masculine self-identity and how these identities came to be. Shaming people for not being “politically correct” is not a helpful option and often shuts down conversations rather than elevates them.

Traditional scripts for men identified a generation ago are being challenged today on all fronts, and as a feminist and suicidologist, I am grateful for these challenges. Just a couple of examples include:

Over the last decade, the number of stay-at-home dads has doubled (Kramer, Kelly & McCulloch, 2013) and paternity leave is considered increasingly important (Harrington, Van Duesen, Fraone, Eddy, Haas, 2014)
Cross-gender friendships are more common and acceptable (Felmlee, Sweet, Sinclair, 2012)
Challenges to gender binary frameworks and heterosexism are everywhere (Heasley, 2004; Henig, 2017).

AND I would caution all of us to think about what is working within the traditional models that might be hard wired for many, and difficult to change. In other words, how can we both expand contemporary ideas of strength, success and providing for one’s family while keeping what’s honorable and functional within some of our more traditional models. If we embrace the diversity of many expressions of manhood, we will be a far more resilient species.

Scripts of Masculinity: Traditional and Contemporary

Referring back to the 1976 (David & Brennan) book The 49 Percent Majority — let’s dig a little deeper into these common and traditional scripts of masculinity:

1. “No sissy stuff”

The idea behind this script is that to be a true man, one must not do things that have traditionally been thought to be feminine. For instance, if women are generally seen as skilled at expressing emotions and are more likely to seek mental health care when feeling unwell, then the “no sissy stuff" script tells men not to do this. On one hand we know emotional intelligence is a critical part of overall intelligence, and the ability to effectively express emotions is essential for effective interpersonal communication. Additionally we know that not seeking preventative care for many health issues is one of the main reasons women are outliving men by about seven years on average in the U.S. (Desjardins, 2004).

On the other hand, within our current civilization, we also need certain people to effectively compartmentalize emotions to perform necessary functions that would not be possible if emotions were being fully felt — for example surgical, combat and rescue functions. Men’s adherence to social scripts that support stoicism and emotional inexpressiveness are in opposition to “help-seeking” (Nam et al, 2010), and yet many men would benefit from counseling and other forms of mental health treatment.

How do we bridge this gap? I have worked with many fire fighters who have sought psychological services — fire fighters whose lives depend on decisiveness and emotional control — and they have reframed their experiences this way, “I didn’t see it as seeking help. I saw it as learning new coping strategies, like a physical trainer for the mind.”

2. “Be a big wheel”

For this script men are conditioned to strive for achievement and success with a focus on beating the competition. Again, striving for excellence is a good thing. The problem with this script is that success often becomes the “single source identity.” Men who buy into this script often identify primarily with what they do and are constantly striving to reach the “top.”

The challenge becomes that the goal post for achievement is an ever-moving target. In these circumstances, striving for success can become “the golden handcuffs” because men can begin to feel trapped when the achievement identity loses its connection with a far more important concept: purpose.

Work-related humiliation, failure — or even retirement — can lead men who subscribe to the “big wheel” script to feel like they’ve lost themselves. They can start to feel unneeded and adrift, a burden unto others. Thomas Joiner's (2006) model of suicide risk clearly links perceived burdensomeness to a desire for suicide. Thus, our opportunity for the future is to help men find multiple pockets of purposefulness that can shift over the lifespan.

3. “Be a sturdy oak”

This script tells men to be the one that people depend on, not the one who needs others. Self-reliance is a virtue in many circumstances. Having an ability to persevere through and innovate around problems is highly admirable. Nevertheless, the truth is not all problems can be solved by oneself, and rugged individualism is lonely. Research supports the paradoxical finding that self-reliance increases risk for suicide (Pirkis et al, 2017).

What gives me hope is a great emerging appreciation for the effectiveness of peer support among men. Over the past decade, we’ve seen a proliferation of formal and informal peer support programs in male-dominated communities — in construction, law enforcement, fire service, military and more. Why have they been so popular? Again, Dr. Quinnett reminds us (Spencer-Thomas et al, 2013), that when men ask for help they run the risk of appearing weak and incompetent BUT accepting help is another matter. When a man accepts help offered he is still seen as strong, “but not quite strong enough to lift a car out of ditch or drag whole elk back to hunting camp…” Accepting help is acceptable because it creates the opportunity for “repayment reciprocity” — or the notion of “I’ve got your back, and you’ve got mine.”

4. “Give em hell”

Finally, this script calls for men to act aggressively and to display dominance, especially when threatened. In threatening situations, strong stances are often needed to establish boundaries and regain control. Thank goodness we have brave warriors and first responders who are able to protect the rest of us with these skills. Let us also not forget how many of us are inspired by the incredible accomplishments of some of our most aggressive athletes.

When this aggression is not used for a noble mission, however, men prone to aggression are more likely to perpetrate domestic violence, physical and sexual assault, and other criminal activity. On a lower level, the agitation and irritability related to this script leads men to get in trouble rather than get support or empathy. Often what is behind this aggression is depression (NIMH, n.d.). In our new diverse appreciation for masculinity, we can cultivate an awareness that emerging agitation may be a signal of depression or the experience of feeling threatened, and intervene much earlier — and in compassionate ways — before violence erupts.

In conclusion, I am thrilled my sons are growing up in an era where concepts of masculinity are as diverse as they ever have been. I am hopeful that however they mature, they will find healthy role models that will help shape them into men of honor and substance. For those of us excited about these changes, I would encourage us to not throw out traditional models of masculinity as there is great value for having many ideals for the many different roles men now play. By looking deeper into evolutionary psychology, we can better understand how diverse patterns of male behavior have developed the way they have and how we can best position health and well-being within many different social scripts.

References:

David, D. S. & Brannon, R. (1976). The Forty-nine percent majority: The male sex role. Random House: New York

Desjardins, B. (2004). Why is life expectancy longer for women than it is for men? Scientific American. Retrieved on June 3, 2018 from https://www.scientificamerican.com/article/why-is-life-expectancy-lo/?print=true.

Felmlee, D., Sweet, E., Sinclair, H. C. (2012). Gender rules: same- and cross-gender friendships norms. Sex Roles, Online. DOI 10.1007/s11199-011-0109-z

Gilbert, B. & Bedi, R. (2014, October). Be a Man! Male Identity, Social Change in Contemporary America, and the Impact on Mental Health. Presentation at the Washington State Psychological Association Conference. Retrieved on June 3, 2018 from https://c.ymcdn.com/sites/www.wapsych.org/resource/resmgr/Fall_Convention_Handouts/Be_a_Man-FC_2014_Handout.pdf.

Harrington, B., Van Duesen, F., Fraone, J. S., Eddy, S., Haas., L. (2014). The new dad: take your leave. Perspectives on paternity leave from fathers, leading organizations, and global policies. Boston College Center for Work & Family.

Heasley, R. (2004). Crossing the borders of gendered sexuality: Queer masculinities of straight men. In C. Ingraham, (Ed.). Thinking Straight: The Promise, the Power, and the Paradox of Heterosexuality. New York: Routledge.

Henig, R. (2017). How Science Is Helping Us Understand Gender. National Geographic. Retrieved on June 3, 2018 from https://www.nationalgeographic.com/magazine/2017/01/how-science-helps-us-understand-gender-identity/.

Joiner, T. (2006). Why People Die by Suicide. Cambridge: Harvard University Press.

Joiner, T. (2011). Lonely at the Top: The High Cost of Men’s Success. New York City: St. Martin's Press.

Katz, Jackson (1995a). Reconstructing masculinity in the locker room: The Mentors in Violence Prevention Project. Harvard Educational Review, Vol. 65, No. 2, Summer.

Katz, Jackson (1995b). Advertising and the construction of violent white masculinity. In G. Dines & J. Humez (Eds.), Gender, race and class in media: A text reader. Thousand Oaks, CA: Sage Publications.

Kramer, K. Z., Kelly, E. L., & McCulloch, J. B. (2013). Stay-at-home fathers. Definition and characteristics based on 34 years of CPS data. Journal of Family Issues, doi: 10.1177/0192513X13502479

Nam, S., Chu, H., Lee, M., Lee, J., Kim, N., & Lee S. (2010). A meta-analysis of gender differences in attitudes toward seeking professional psychological help. Journal of American College Health, 59(2):110-6. doi: 10.1080/07448481.2010.483714.

National Institute of Mental Health (n.d.) Men and depression. Retrieved on June 4, 2018 from https://www.nimh.nih.gov/health/publications/men-and-depression/index.shtml.

Murthy, V. (2017, September). Work and the loneliness epidemic. Harvard Business Review. Retrieved on June 4, 2018 from https://hbr.org/cover-story/2017/09/work-and-the-loneliness-epidemic

Pirkis, J., Spittal, M., Keogh, L., Mousaferiadis, T. & Currier, D. (2017). Masculinity and suicidal thinking. Social Psychiatry and Psychiatric Epidemiology, 52(3), 319–327.

Psychologist World (n.d.) Schemas and Memory: How schemas influence what we pay attention to and the memories we recall. Retrieved on June 3, 2018 from https://www.psychologistworld.com/memory/schema-memory#references

Spencer-Thomas, S., Quinnett, P. & Hindman, J. (2013, April 26). Man Therapy: An Innovative Approach to Suicide Prevention among Working Aged Men. Keynote, American Association of Suicidology conference in Austin, Texas.