Men and Depression
For individuals in the U.S. & U.S. territories
Fredric E. Rabinowitz demonstrates the "deepening psychotherapy" approach with men, integrating a psychodynamic developmental perspective with a gender role strain perspective.
Dr. Rabinowitz works with a young man who shows characteristics of masked depression, in which the symptoms of depression are obscured to some degree but perceptible just beneath the surface of the patient's affect. With the use of empathy, along with asking questions and reflecting, Dr. Rabinowitz draws out the underlying sadness, anger, and feelings of emptiness related to the client's early life experiences.
The "deepening psychotherapy" approach with men integrates a psychodynamic developmental perspective with a gender role strain perspective. The distinct features of combining these two points of view includes a recognition of the emotional "depth" of men, an approach to opening up or uncovering this depth, and a "mapping" of the masculine-specific conflicts that have been encouraged and reinforced by our cultural attitudes toward masculinity.
The most significant of these aspects are in the realms of male interpersonal dependence, the management of grief and loss experiences, the shaping of masculine-specific self-structures, and men's comfort and preference for "doing" as opposed to "being."
"Deepening" refers to a process of uncovering and elucidating masculine-specific conflicts that many men experience on an emotional level. Of course, a big emphasis in our culture is the denial or avoidance of emotion in men. Hence, the deepening approach directly addresses this element of masculinity by encouraging therapists to look beneath the surface and to help men embrace in a more holistic manner the emotional aspects of their lives.
Often, a traumatic experience or wounding event that has led a man to come to psychotherapy serves as a catalyst for deepening. This wound, which has pierced a man's psychological armor, is usually the result of an immediate loss experience, such as the end of an intimate relationship, the loss of a job, a death of a friend or loved one, or a perceived failure.
The pain from the wound awakens a man to his inner emotional life. Like a beacon, it points the client and his therapist toward a portal to the man's emotional world. The portal — a psychological window into his deeper, genuine, true self — is made up of a constellation of images, words, thematic elements, emotional associations, and bodily sensations that reflect the core themes of his emotional existence. This portal is illuminated most brightly by pain caused from a wounding experience.
The deepening therapy process allows the client and therapist to enter a portal and cojointly navigate the fears, defenses, and cultural gender-role obstacles that have kept the client's inner emotional landscape from being owned and understood. Therapist sensitivity to a man's verbal and body language and to the metaphors for his life allows the process to proceed as a partnership. The result of this exploration is a reconnection with the emotional world, outwardly manifested by increased vitality and emotional expressivity.
A man must develop a strong relationship with his emotional life in order to become whole. Deepening therapy helps men to focus on reconnecting with emotions from which they have learned to disengage. With the help of a therapist, and by following the "leads" from their words, body reactions, and recurring life themes, men can find their portal and rediscover the hidden "communication conduits" to the emotional world.
Any true, authentic engagement with a male client will almost always result in a careful look at his existential and spiritual concerns — that is, issues around meaning and purpose in life, isolation and connection, personal values, and so forth. These issues are the real grist for the "deepening" mill, and it is in the arena of these values that men's emotional lives come alive and are given deeper meaning.
Once a man gets on the path to finding his wholeness, he can't help but to see his world in a different way. It is very difficult to go back to the previous vision of his emotional world once he has experienced a more enlightened path. Living a life that feels authentic does become a kind of "soul" journey. Deepening therapy helps men find an inner core that can function as an internal center or grounding.
The practice-oriented foundations of deepening psychotherapy involve a focus on exploring and exposing elements of the unconscious, including long-standing psychological dynamics, internalized emotions, and archetypal images. Connecting the psychological aspects of self with the body's reactions in the context of an authentic and empathic therapeutic relationship also enhances depth. Another cornerstone of deepening therapy is formed by existential concerns about the meaning of one's life in the context of a humanistic and holistic world perspective. Together, these classic depth-oriented interventions, combined with the theoretical and clinical understanding of the new psychology of men, create a therapy process that is both expansive and eclectic.
Fredric E. Rabinowitz, PhD, is a professor of psychology and the associate dean of the College of Arts and Sciences at the University of Redlands in California. Since 1984, he has had a private psychology practice in Redlands, California, specializing in individual and group psychotherapy with men.
Dr. Rabinowitz has authored and co-authored numerous articles, book chapters, and three books: Deepening Psychotherapy with Men (2002); Men and Depression: Clinical and Empirical Perspectives (2000); and Man Alive: A Primer of Men's Issues (1994).
Dr. Rabinowitz is an accomplished professor who earned outstanding faculty teaching and research awards in 1995, 1996, 2001, and 2002. He is an APA fellow and the past president of the Society for the Psychological Study of Men and Masculinity (Division 9 of APA).
- Rabinowitz, F. E., & Cochran, S. V. (2002). Deepening psychotherapy with men. Washington, DC: American Psychological Association.
- Cochran, S. V., & Rabinowitz, F. E. (2000). Men and depression: Clinical and empirical perspectives. San Diego, CA: Academic Press.
- Rabinowitz, F. E., & Cochran, S. V. (1994). Man alive: A primer of men's issues. Monterey, CA: Brooks/Cole.
- Rabinowitz, F. E., & Cochran, S. V. (2008). Men and therapy: A case of masked male depression. Clinical Case Studies, 7, 575–591.
- Rabinowitz, F. E. (2006). Thawing the ice man. In M. Englar-Carlson & M. A. Stevens (Eds.), In the therapy room with men: A casebook about psychotherapeutic process and change with male clients. Washington, DC: American Psychological Association.
- Rabinowitz, F. E. (2006). Crossing the no cry zone: Doing psychotherapy with men. Retrieved from http://continuingedcourses.net/active/courses/courses.php
- Rabinowitz, F. E. (2001). Group therapy for men. In G. R. Brooks & G. E. Good (Eds.), The new handbook of psychotherapy and counseling with men (pp. 603–621). San Francisco, CA: Jossey-Bass.
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