No Health Without Mental Health
Male mental health has received a lot more attention in the media, particularly because of the high incidence of suicide amongst adult men, and this attention should be welcomed. However, despite good intentions the views expressed by those writing on the subject are not always helpful.
The reason for this is that those commenting are not mental health professionals. Instead, they present a social theory view that male mental health issues are solely caused by the pressure placed on men to behave in stereotyped ways, which include suppressing emotion, an expectation that they must always appear strong and avoid expressing how they feel.
The solution to the high incidence of male suicide, from this perspective is for men to ‘open up’ and express how they are feeling. In other words, men should adopt a strategy more akin to the way in which women are believed to process emotion.
Is there any evidence that if men adopt this approach they will experience less mental ill health? If we look at the statistics for mental ill health in women, the answer is no. While men are five times as likely to attempt suicide, women experience higher rates of mental illness than men and are twice as likely to be diagnosed with anxiety. So talking about how we feel alone cannot be the solution.
What about the suppression of emotion? Is this an unhealthy coping strategy?
Firstly, the studies which are cited in support of this idea do not compare suppressing emotion with expressing emotion, so it is wrong to read them as evidence that expressing how we feel is better than suppressing emotion.
Instead, studies compare suppressing feelings with reevaluating or reframing the way we see events to change the way we feel about them. Reframing the way we see the world is undoubtedly the best strategy for handling strong emotions, which limit the way we see the world.
Reframing means reminding ourselves that although today was tough, tomorrow may be better; that when things go wrong, it’s an opportunity to learn; and that when people don’t agree with us it isn’t always personal. But to master the essential skill of reframing we have to suppress our first reaction and calm down in order to see the bigger picture. So suppressing emotion is an essential part of a strategy which allows us to reframe – a skill we all need to learn in a stressful world.
In fact, far from being unhealthy, suppressing our immediate emotional response in social situations is sometimes necessary. If we react in anger in the workplace or when we are in a sensitive social situation then we risk damaging important relationships – context is important.
And far from having no feelings or lacking empathy, studies show that on average, men experience stronger physiological responses, including increased heart rate and release of stress hormones like adrenaline and cortisol, when they witness distress or pain in others. It is unsurprising that they would seek to put the brakes on strong emotion.
It is likely that suppressing emotion evolved as a strategy to protect the relationships our survival and mental wellbeing depend upon. Suppressing strong feelings, or ‘keeping a lid on it’, is also useful if we are to keep emotional arousal under control while we seek a solution to whatever is causing us distress. This is not to say that men should not be encouraged to ask for help when they need it – far from it. But the way in which we encourage men to reach out, needs to take into consideration the way in which they handle emotion.
Encouraging men to ‘open up’, a metaphor which suggests opening old wounds might have the unintended consequence of causing men to run a mile from the services which seek to offer help! Instead, we could use healthier metaphors for describing how to talk about difficult feelings – ‘getting it off your chest’ or ‘finding some solutions’ might work better.
So do social expectations have no impact on male mental ill health? Undoubtedly, social conditioning and traditional gender stereotypes – the need to be a breadwinner and provide for the family, for example – play a role in creating stress and mental ill health, as well as inequality between sexes.
These factors, in an environment where rising costs and debt are barriers to meeting emotional needs for security, control and autonomy, respect and, in turn, give us less time and headspace to reflect, and give attention to needs for emotional connection with loved ones and activities which give us meaning and purpose.
But we are a blend of social conditioning acting upon our genes and we can never separate the two. To ignore and devalue the skill of suppressing emotion because it is at odds with our beliefs about how men should behave, may cause unintended harm to their mental health.