Please Note: The ideas contained in this FAQ are the opinions of the writer and are communicated without reference to supporting documentation in most cases. Other inspiration and influence for the writing came through consultation with other mental health professionals but the writer “Peter Quintano” is also fully qualified in DBT making him qualified to talk about the things discussed in this article.
To grow up in a cultural context inevitably leads to some level of indoctrination into that culture. What it means “to be a man” can be different from culture-to-culture, although generally involves identifying with sets of gender-based ideas that are capable of compelling a male to think, speak, and act in specific ways rigidly.
In my experience growing up as a male in Western culture, these gender-based ideas included things like “getting educated/skilled,” “getting employed,” “getting status,” “getting money,” and “getting things.” These ways of thinking, speaking, and acting have much more to do with the perceived need to “fit in” and “be acceptable” and “be worthy” than with experiencing long-term mental health benefits. Mental health considerations aren’t usually even on the “manhood radar,” actually.
Difficulties with mental health can be hard for anybody to face, but especially for men in a culture where both emotional honesty and vulnerability (two main components involved in working on mental health) are not encouraged. To take time for such things takes time away from dominant cultural priorities, such as getting educated/skilled, getting employed, gaining status, getting money, and getting things. To be honest and vulnerable (especially for a man) also risks being judged by others as “too feminine,” or inversely, “less masculine,” and therefore, potentially less appealing to sexual partners. To explore emotions openly (especially for a man) raises the fear that he may become unwanted, alone, and unable to attract someone who might want him to “provide a lifestyle” and need to depend on him for periods of time (e.g., wife/children).
In their mutual contacts with each other, men easily fall into believing classic stereotypes and falsehoods such as: “emotions are a weakness,” “emotions are childish,” “men don’t show emotions other than anger,” and “financial worth equals human worth.” With these kinds of beliefs firmly fixed in place, it makes perfect sense that having emotional/mental health issues could be perceived as interfering with money-making activities and other cultural priorities, and so, become a significant conflict of interest. For instance, if a male needed to take time off work or get off work early to attend mental health appointments, he would most likely fear being judged as unreliable, less worthy or unworthy of work opportunities. He would also fear the possibility of facing discrimination from fellow employees and even losing his job. In this kind of context, why would a male take the time and the risk to take care of his mental health?
Fitting into this kind of “masculinity box” might not be a problem for males who are more naturally insensitive and less prone to mental health issues. However, not all males are the same and can so easily go along with living in a culture of emotional neglect. Some males are emotionally sensitive and more genetically susceptible to mental illness, and therefore, need to take their mental health seriously. Some males also grow up in unhealthy family situations where there are experiences of neglect, abuse, and abandonment. Despite these differences, my observation as a therapist (having worked with many) is that males will still attempt to fit into the “masculinity box” and wait until something goes wrong with their mental health before taking the risk of looking into things further.
The first thing that a man will often do when faced with mental health problems (such as anxiety or depression symptoms) is to meet with his family doctor and hope that a pill will take care of things. After all, this type of treatment seems like a quick fix and least likely to produce an interruption in money-making and other cultural priorities – take the pill and go back to work! Unfortunately, taking a pill is very often not enough to solve mental health problems involving unhealthy thought patterns and patterns of emotional neglect. Just because you take a pill, it doesn’t necessarily give you the capacity to adjust your inner workings to the point of sufficient symptom relief and optimized functioning. It can take a long time to realize this, often because people give doctors and pills way to much credit for their ability to manage mental health issues.
For a man to develop a severe mental health condition like Borderline Personality Disorder (BPD) that requires in-depth self-reflection and practising mental health skills, the time commitment for working on health issues can seem entirely unrealistic. Men have mortgages to pay, car payments to make, so many other bills to pay, employers to impress, and marketable skills to continue developing so they can make more money in the future! How in the hell are they supposed to set aside time for learning about mental health and looking into the nature of their thoughts, feelings, and behaviours, and how everything connects and turns into life problems!? Getting mentally healthy could mean spending or losing money, taking time off work and risking reputation!
The bottom line for many males living under the pressures of Western industrialized culture is that their mental health will continually take a back seat to cultural priorities. The long-term consequence of this reality is to become sick, and then become even sicker as the health issues are not adequately addressed. And if the diagnosis is anything like BPD, then the prognosis for the man who has it will not be good. He may turn to substances and other forms of addiction to cope with his worsening mental health condition. He will then very likely also experience the consequences of falling into patterns of addiction, such as loss of physical health, partner and family relationships, and employment. It is a self-defeating cycle that many males fall victim to, all in the name of “becoming a man.”
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