Book Review: Engaging Men In Couples Therapy

Engaging Men In Couples Therapy sets out to help counsellors work more effectively with couples by helping us to better understand men's particular needs and psychological issues. The editors brought together authors with a wide range of expertise in 'male sensitive clinical treatments' to address this subject. This volume should be of interest both to couples therapists and to those who work with men individually.

The book is structured into three sections. Part One identifies some critical issues regarding men in couples therapy; Part Two introduces a range of different therapeutic approaches including psychodynamic, Alderian, Imago, Emotionally Focussed Therapy (EFT), and Integrative Behavioural Couple Therapy (IBCT); whilst part three considers working with special populations, including men with low sexual desire, infidelity and working with couples of colour.

There are some inevitable limitations in the scope of the book. All of the authors live and work in North America, suggesting a lack of cultural and geographic breadth. Somewhat surprisingly, this book does not deal with issues associated with working with gay couples (which is to be dealt with in a subsequent book in the series) potentially narrowing our conceptions of both men and masculinity. A number of theoretical perspectives (including existential, and humanistic approaches) were not covered here, but would have introduced valuable complementary and alternative insights.

In their introductory chapter, the editors argue that the failure to engage therapeutically with men's particular needs and relationship issues has been a major cause of the relative failure of relationship therapies in alleviating psychological distress. They propose that adopting the approaches and techniques described in this book may help counsellors to better address men's issues and needs, so increase the effectiveness of relationship therapies.

An orientating assumption adopted in this volume is that men's particular needs and psychological issues can be best understood in terms of what has become known as the New Psychology of Men (Levant & Pollack, 1995). From this perspective, maleness and masculinity are conceptualised as gender roles that are not biological or social givens, but rather as socially constructed entities into which men are socialised. Men may be seen to endorse (to varying degrees) cultural norms and values about masculinity (for example where one might feel one is failing to live up to one's internalised manhood ideal), or to experience strains associated with their socialisation (for example, that caused by living up to 'desirable' ideals of being a man). From this perspective, one of the roles for therapy is to help alleviate the emotional strain caused by the nature of men's socialisation. For example, the chapter on life memories by Robertson and Khamphakdy-Brown argues that men's socialisation predisposes men both to emotional inexpressivity, and 'problem solving' rather than self-revelation. For these authors, the therapeutic process with men involves them learning how to become both more emotionally expressive and less solution orientated. Similarly, the chapter on Imago Relationship therapy by Luquet starts from the view that men learn through childhood to suppress their emotional reactions and to not rely on others for their physical well-being. One of the key objectives in Imago therapy is to help develop men's relational skills, particularly developing the capacity for emotional connection through the three-part process of mirroring, validating, and empathy.

Does this approach provide a compelling way of describing men's particular needs and relationship issues? These chapters do provide valuable and interesting insights into men in their most intimate relationships. However, a major therapeutic issue that is not well addressed in this book is the low rates of participation by men in individual and couples counselling. Addis and Mahalik (2003), propose that one of the roles for therapy based on the New Psychology of Men is to encourage men to develop the capabilities they lack to improve the quality of their relationships, whilst downplaying their own strengths and capacities. Perhaps it is not surprising that men might not enthusiastically embrace therapeutic approaches underpinned by the premise that they are lacking the skills to make their relationships work.

This analysis of men's needs in relationships presented in the book raises the fundamental existential question about men's existence and their 'essential' nature. The socialisation approach developed here carries a prescriptive suggestion that if men experienced a different form of socialisation, or that they could develop particular skills later in life through therapy, then many of the relationship issues between men and women would be able to be resolved more easily. Heideggerian notions of thrownness on the other hand challenges us to consider what it means to be thrown into the world as a man, and how men's freedom to choose their life possibilities might be constrained by the nature of male 'thrown-ness'. Rather than prescribing the skills men should have in relationships, a Heideggarian approach might instead focus on 'being with' male thrownness, and 'be it, rather than run from it, evade it, analyze it, or cover it over' (Fox, 1997). An existential approach might start from understanding who we are as men, rather who the therapist thinks we should be.

Do the approaches and techniques described in this book allow counsellors to better address men's issues and needs as they are understood in this volume? A number of the authors show how existing therapeutic approaches to working with couples can be extended to become increasingly 'male sensitive' in addressing their particular needs and psychological issues. For example, the chapter by Greenman, Faller and Johnson on Emotionally Focused Couples Therapy (EFT) describes its basis in attachment theory and the universal attachment based needs amongst men and women for safety, security and closeness. In this model, men and women are encouraged to recognise, express and respond to each other's needs for the creation of a secure attachment bond. Potential inhibitors to expressing and responding to emotional needs are identified and ways of overcoming them discussed in the service generating lasting loving relationships. They discuss the particular effects of male socialisation on relationship dynamics such as 'shutdown' and 'withdrawal', and discuss how these particular issues may be particularly experienced by men, and how they might be best addressed. Similarly, the chapter by Baucom on IBCT sees male socialisation as one of the potential barriers to promoting reconciliation and intimacy. IBCT is based around finding strategies for restructuring the demand-withdraw pattern that characterises many relationships in distress. One of the particular considerations described by Baucom in working with men is accomodating their sense of self-reliance, action orientation and emotional inexpressivity. These chapters provide insights and guidance about working with men in couples therapy based on male socialisation theory. However, I was left with a sense of discomfort with therapeutic approaches based on theory-derived views of how men should be in relationships, and putative explanations as to why men are as they are.

For me, one of the most compelling parts of the book addressed men's particular needs and issues in the context of the therapeutic. In their chapter, Shepard and Hardway reflect on the considerable body of evidence showing the importance of 'common factors' such as the quality of the therapeutic relationship, or the attitude of the client in affecting the outcome of couples therapy. They argue that the way in which the therapist shows empathy and understanding whilst being non-judgmental with both the male and female partner within the therapeutic relationship is of critical importance for the outcome of couples therapy. They highlight the difficulties of managing a strong relationship with both partners, particularly when the man may have different ideas to those of the therapist and the female partner about the value of expressing emotions, the importance of mutual dependence and talking about emotional needs. These issues are developed in the chapter by Baucom. Research evidence shows that women are more likely than men to initiate therapy, and that they are also more likely to identify areas of relationship dissatisfaction. The male partner may become alienated from the therapy process if the therapist starts the counselling with the issues that are brought to therapy – typically issues that the woman has with the relationship. This common factors analysis emphasises the importance for therapy outcomes with men in building a strong therapeutic alliance with both the man and the woman.

Overall, I found this a well written, interesting and engaging book that would appeal to all counsellors working with couples. The volume provides an interesting and valuable perspective on the nature of men's particular needs and relationship issues, and suggests a range of valuable approaches and techniques to better address them. However, it would have been enriched by a section that started from men's own experiences of being men, rather than being driven by socialisation theory about them.

References

Addis, M.E. and Mahalik, J.R. (2003). Men, Masculinity and the Contexts of Help Seeking. American Psychologist, 58(1): 5–14

Fox, R. (1997). On Thrownness. The Institute for Existential-Psychoanalytic Therapy, Retrieved from the internet, 03/10/2012 http://www.focusing.org/apm_papers/fox.html

Levant, R.F. (1996). The New Psychology of Men. Professional Psychology: Research and Practice, 27(3): 259-265

Mark Jepson