Archive for January 27, 2010

Hormones And Men’s Parenting Behaviour

What kind of dad are you?  Research is beginning to show that the kind of parent you are is to some extent controlled by a number of key hormones.

In the journal Hormones and Behaviour the anthropologist Alexandra Alvergne studied the level of the hormone testosterone in men’s saliva, and how this correlated with family behaviour.  On average, the higher the levels of testosterone in the saliva, the less time and money the man invested in their wives and children.

Another study, by Ruth Fieldman, reported to the Society for Research in Child Development in Denver, Colorado, indicated that when men become fathers they undergo biochemical changes which affect how they relate to their children.  The study looked at the hormone Oxytocin, also called ‘the cuddle hormone’.  Fieldman found that the levels of oxytocin raised after the birth of a child in both fathers and mothers.  Furthermore, the more oxytocin was present in the fathers, the more they were seen to play, bond and attach to their children, then men who had low levels of oxytocin.

What both these studies appear to show is that your parenting style has something to do with your biology.  Indeed this makes sense in terms of evolutionary theory, as “investment” in offspring could be seen to be an evolutionary relevant trait, and therefore mediated by biology.

Whether it is better, from an evolutionary perspective, to father many children and offer them poor support, or fewer children, and offer them more support, is an interesting backdrop to understanding men’s parenting preferences.  To reason from biology to morality, of course, is an example of what philosophers call ‘the naturalistic fallacy’.  However, some men, or so it might seem, are going to have to fight against their biology in order to become ‘responsible’ parents.

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Boys Don’t Cry?

One thing has struck me over the years in my practice with men, they don’t cry very often.  For sure I always have a box of (man sized) tissues strategically placed so that, should my client wish to cry, he can.

When I was training I was told that crying is a good thing.  It releases tension, helps you to connect with your feeling, and the crying process itself serves to rid the body of unhelpful toxins.  In fact we were trained in how to spot when someone was about to cry, and how to help them do so.

So if crying is so good for us, why don’t the men I see cry more often?  For a while I thought that maybe I was to blame.  Perhaps, so I thought, I was not creating the right atmosphere where the client felt safe enough with me to cry.  Then, I thought, it was because I was a man, if my client was seeing a female therapist, then perhaps he might feel more able to cry.

Of course sometimes men do cry.  My experience is that when the men I see do cry it is usually for deep existential pain: death, abandonment, loss.  For sure women cry for these reasons too, but women also cry to express other feelings, like frustration or disappointment.  Women, it seems to me, also cry as a means or aid to communication, rather than simply an expression of inner pain.

The ‘standard’ explanation for the differences between men’s and women’s crying is that men have crying ‘socialised’ out of us.  We learn as boys, so the ‘standard’ theory goes, that our crying is not acceptable to others.  According to this view men are both capable of crying more, and if it wasn’t for our dysfunctional emotional upbringing, we would cry as much, and as often as women.

I have come to reject this idea.  I don’t believe the socialisation hypothesis anymore.  Not least because it forces men to apologise for the emotionality they do express (“I know I should cry more” etc).  It seems to me now that men not crying as much as women is not so much a problem for men, but a problem for the women in our lives.  They would feel better if our emotionality were the same as theirs.  The fact of the matter is they are not.  My experience of working with men is that our emotional worlds are different to women’s.  Not better, not worse, but different.  I now hold the view that if a man cries in therapy that’s fine, but if he doesn’t cry, then this is not a problem with him, or indeed, with me.


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Getting Ready For Retirement

A man knows it is time to retire when:

  • his children have already retired
  • his passion for golf exceeds his passion for his job
  • he begins to notice not only that policemen are getting younger – but even the chief of police looks younger than he does!

No man likes to be told that he is getting old – but successful aging is something that men should prepare for, from both a physical and a mental point of view. It is important to plan for retirement – perhaps even to gradually wind down rather than abruptly stop working – so that one can prepare for the time that one no longer has a regular job and has time on one’s hand. Making appropriate changes to one’s lifestyle and health care is essential.

Investing in Health

While most men understand the importance of making financial investments in preparation for the day when they will have to give up their steady job, few realise that investing in in their health is as important as investing in shares and property.

A man who spends money in the prime of life on a gym membership (and making sure this membership is utilised!) can help in preventing those chronic diseases like diabetes, high blood pressure and heart disease that diminish his chances of working longer and/or enjoying his years of retirement. Spending money on consulting a physician and having a regular check-up – rather than proudly boasting “I never need to see the doctor” – is a wise move – because many diseases when they are in the treatable stages do not cause obvious symptoms. If detected early, many of these conditions – like pre-diabetes, high blood pressure, prostate cancer etc – be cured or managed effectively so that they do not kill or maim a man in the prime of his life.

As a man gets older both his physical and mental capability slow down – so it is important that he continues to exercise both his body and mind regularly. If you don’t use them you will surely lose them!

Physical Exercise

Physical exercise – whether walking, swimming, cycling, ballroom dancing or some similar form of aerobic activity – is vital in maintaining a man’s physical fitness. It is equally important to undertake regular resistive exercises (push ups, squats, lifting weights etc.) to keep the muscles strong and in good tone – because human muscles tend to get smaller and weaker with the gradual fall in male hormone levels that naturally takes place as a man ages.

As important as keeping the muscles and joints exercised is mental exercise – keeping the brain challenged and active.

Mental Exercise

Whether one does crossword puzzles or sudokus – or participates in mind- exercising activities like Bridge or Scrabble – or undertakes intellectually stimulating courses through an organisation like the University of the Third Age – it does not matter as long as the brain cells are kept active.

If you fail to plan for retirement, you are planning to fail – in achieving a healthy and successful retirement!

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Sex Addiction

sex addictionAs a men’s psychotherapist, I have talked more often to the media about sexual addiction than any other topic.  This is strange really because the assumption is that it is only men who become hooked on inappropriate sexual activity.  In fact 40% of sexual addicts are women. Women’s patterns of sexual addiction might be different to men’s, but they suffer in almost equal measure.  Having said that, this article is about sexual addiction in men, and if you are a man who thinks you have a problem with sex, you have come to the right place.

So what kind of sexual activity can men get hooked on?  Well the main ones are ‘dogging’ areas, where straight men and couples cruise car parks for sex, public toilets and other gay cruising areas, prostitution (both selling and buying), masturbation and internet porn.  In fact internet porn is so easy to get hooked on that it has been dubbed the ‘crack cocaine’ of sexual addiction.  As a sexual addicts pathology develops, of course, he can often find himself moving into areas of sexual interest that are even more antisocial and/or illegal.

Sexual addiction first started to come to the attention of professionals who were involved in the treatment of other addictions, such as alcohol.  It was found that if a person has an addiction to a substance, there is a high likelihood that they will also be addicted to sex.  As many as 42% of people addicted to cocaine also have a co morbid sexual addiction.  Some theorists have argued that the neural pathways associated with sexual addiction are the basis for all addictions.  Whether this can be bourn out by the facts I don’t know, but what is clear is that sexual addiction is closely linked to other forms of addiction.

The natural history of the sex addict can often be quite tragic. The man starts to chase sexual ‘highs’ often involving situations of risk.  Risky sex enhances orgasm and sets the man in a trail of activity of escalating risk.  Eventually, it’s the chase of sexual activity that starts to take up more and more of the guys time.  In turn, sexual highs become harder and harder to achieve, a situation which, paradoxically, makes the ‘hit’ of a ‘good’ orgasm all the more addictive.  As the guy spends more and more time searching for sex and sexual activity, he spends less and less time with his friends and family. Social relationships are put at risk, and the man can become socially isolated.  Like other addictions, sex addicts can lose everything, partners, children, jobs, even liberty.

So what can be done to help the sex addict?  One really good intervention is sex addicts anonymous.  This format is similar to narcotics anonymous and alcoholics anonymous based on regular self help group meetings.  Group meetings are a format that does not suit everybody.  I have had good results with clients using various cognitive behavioural techniques such as active monitoring of sexual behaviour and understanding thought processes.

One theory of sexual addiction is that ‘sexual maps’ are laid down in childhood about age 7, and it is these sexual maps that guys continue to ‘act out’ as adults.  It seems appropriate that there is some therapeutic work undertaken aimed at understanding the origin of the sexual behaviour before cbt work is started.

Like all addictions, the hardest thing for me to work with is clients ambivalence about changing their behaviour.  Men often come to me in the ‘pre-contemplation’ phase of trying to decide whether to stop or not.  The good news is that if a man really wants to change, then the approach I use is really effective.  I can’t, however, make a man want to stop.  Unfortunately, for some men, they really do need to loose everything before change seems the best option.

One final word on the matter of shame.  Many men feel ashamed of their sexual behaviour and this inhibits them from coming forward for treatment.  I really understand and respect this.  My suggestion is that men choose a therapist who is experienced at working with sexual addiction, because such a therapist will be best able to help you explore your behaviour comfortably.  If seeing someone face-to-face is too intimidating at first, consider telephone counselling as many men find this safer.

If you want to find out more about sexual addiction, either for yourself or someone else, I can really recommend Patrick Carnes book on the subject, Out of the Shadows: Understanding Sexual Addiction which is now in its third edition and published by Hazelden.

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Another Aggression And Gene Link Found In Men

Research by Kevin Beaver at Florida State University has found a link between the low-activity version of the gene MAOA and gang behaviour in men.  This gene, which is rarely found in women, has been shown to be related to aggression in men who have been abused as children.

Beaver found that men with low-activity MAOA were twice as likely to join gangs as men with the normal version.  Furthermore, of gang members, men with low-activity MAOA were four times as likely to have used a weapon, compared to men with the normal version of the gene.

This is the latest in a number of studies that relate genetics to aggression in some men, some of which I have reported here.  Men with the XYY chromosome variation have long been identified as more aggressive than the more common XY chromosome variation, and are overrepresented in the prison population.

What these studies are showing is that, for some men, aggression is likely to be a problem for them, and those around them – for genetic reasons.  Furthermore these men, in principle anyway, could be identified by genetic testing.  It follows that these men could be targeted for early intervention before their aggression causes them difficulties.

Anger is the only emotion that, if seen in excess, is dealt with by the criminal justice system rather than the health care system.  What is disturbing about this is that the criminal justice system may be good at ‘containing’ these aggressive men, but offers precious little to address their underlying emotional regulation issues.  In fact I have worked with many men who have received repeated prison sentences for aggressive behaviour – in none of these cases did the criminal justice system offer anything to help the man understand and moderate his aggressive behaviour.

I can’t help thinking that if ‘aggression’ was something identified by women as an issue within their ranks, aggressive behaviour would have become a health care priority a long time ago.

Things might be about to change.  The American Psychiatric Association has been reported recently to be considering ‘aggressive behaviour’ as a distinct clinical diagnosis.  If they proceed with this, and I hope they do, this might force service providers and clinicians to provide services for these men – many of whom, as I have repeatedly shown, often have a biological predisposition to aggression.

It seems to me to make sense to address the cause of aggressive behaviour in some men.  Such a strategy may well reduce the burden on the criminal justice system, and the social distress these men’s behaviour causes, not least to the men themselves.

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Roids, Bigorexia And Men’s Body Image

With the passing of the new year my attention turned to what I want to achieve in the next twelve months.  Yet again I find myself resolving to go to the gym more often, and when there, work harder for longer.

What is it I want to achieve while I’m there?  Well for me the most important reason for working out is that it improves my mental health: a good workout gives me a sense of achievement, purifies my body of stress toxins, and releases the ‘happy’ chemicals, endorphins, that lift my mood.  Then there is looking more attractive: as I am getting older, or so I reason, my body is one area that I still have some control over.  Alarmingly, making an improvement in my physical health comes a poor third in my list of priorities.
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I suspect it’s the same for a lot of men.  What is interesting is the increasing pressure men face to ‘own’ the beautiful body.  We can’t do much about our faces, but we can change our physique, right?  But which physique?  For many years the fit and toned look epitomised by David Beckham was the gold standard of male physical beauty.  But ever since Daniel Craig emerged from the sea in Casino Royale in 2006 there has been something of a shift to a more rugged muscular build.  The pressure is on to not only slim down to a percentage body fat that reveals a washboard stomach, but also pile on the muscle to create that more angular ‘masculine’ silhouette.

What are these pressures doing to men?  Well for many men it is simply no longer acceptable to abuse your body and accept the middle age spread as an inevitable consequence of growing older, just like a receding hairline.  In some ways this is a good thing.  Bodies that are worked out, generally speaking, are healthier than those that never see the inside of a gym.

For some men, though, this has simple gone too far.  The eating disorders of anorexia and bulimia, once diseases mainly restricted to women, are becoming increasingly prevalent in men, particularly young men.  This is understandable when you realise you need a percentage body fat below 14 to reveal your abs (however big they are), and that maintaining this level of body fat is both difficult and unhealthy.

To these can be added a related, but peculiarly male disorder: bigorexia.  There have been many attempts to define this condition, and they tend to come under guises such as ‘exercise addiction’ or, more formally, ‘muscle dysmorphia’, but they all capture one essential feature: the man is unhappy with how muscular he looks and, however big he builds up his muscles, he still feels that he is too small.  Even if the man is asked to compare himself with another man of similar physique, he still sees himself as being smaller.

Bigorexia, in this sense, is closely linked to anorexia and bulimia, in that all three stem from a problem with the way the person perceives their body.  Just as anorexia and bulimia leads to secondary problems, such as the use of laxatives or throat and teeth damage, men with bigorexia, can also develop a dependence on anabolic steroids – or ‘roids’.

Roids are freely available in most gyms around the country, and hold the advantage that they can make you bulk up on muscle really quickly.  You still have to put the hours in at the gym, but you get better results from the time you spend.

Sound ideal?  Well consider the side effects of roids.  First there are the risks of psychological dependence and the kind of physique they produce.  Second is the disturbance in mood that roid use can bring about, particular making men more irritable and aggressive (hence the expression ‘roid rage’).

The dangers are not just psychological, but physical.  Many men develop acne on their face and back.  Roids can also stimulate the latent breast tissue in men causing what is sometimes referred to as ‘bitch tits’.  The long term damage can also be severe, causing serious hormone regulation problems.  If you use needles to inject the roids (which is not uncommon), there are also the risks of infection including hepatitis and, if needles are shared, HIV.

For guys with bigorexia though, these dangers are worth the price.  In fact this is the real danger of bigorexia, the men who have it don’t identify as having a problem.  For them, getting bigger becomes an all consuming passion, even an obsession, and they can’t see that they are doing themselves harm, and certainly wouldn’t consider getting help.

So where is the dividing line between wanting to shape up and look fit, and exercising to the point you are doing yourself psychological and physical harm?  Well for me the real point of danger is if you consider using roids to boost your muscle bulk.  If you need to change your body shape so badly, there is a potential problem.

For many men concern over their physical appearance is just one of the ways they experience low self worth.  It’s not just men with bigorexia who are unhappy about their shape.  Inevitably as men’s bodies continue to be object of fashion and used to boost commercial products from films to talcum powder, such low self esteem is set to continue to grow.

What can be done about it?  The good news is that if you are continually obsessing about your body shape there are things that can be done.  Learning to identify and change your style of thinking is central to therapy in this area and, provided you can accept you have a problem, is highly effective.  The trick is to catch it early.  If you leave it until you have full on bigorexia, you have probably left it far too late.

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