Neil
Chethik
 

December
Where Are the Male Clients?


Where are the men? Ask any bereavement counselor, hospital chaplain, or hospice administrator to give you a breakdown, by gender, of those who use their services, and you’ll probably get a similar response: Somewhere between 60 and 90 percent of their clients will be women.

In part, these lopsided figures reflect the fact that men die earlier than women, and thus, are less apt to face bereavement over the loss of a spouse. But every year, millions of American men lose their parents, children, siblings, and other loved ones. And yet, even in those instances, men seem to stay away from grief services in droves.

Why is this the case? And what, if anything, can be done about it?

I recently finished writing a book on how sons come to terms with the deaths of their fathers. As part of my research, I conducted in-depth interviews with 70 men whose fathers had died. Based on those interviews, as well as the valuable work of Thomas Golden, Kenneth Doka, Terry Martin, and others, I intend to suggest in this article that 1) men avoid grief services in part because those services tend not to reflect their styles of grieving, and 2) grief counselors can help more men by shaping some of their services differently.

In the course of my research on father-loss, I always asked my male interviewees whether they sought grief counseling. More than 90 percent said no. As one 34-year-old man put it: “Why should I go to a therapist? She’ll just try to get me to cry.” This statement goes to the heart of why men tend not to seek grief counseling: They perceive grief services as being for women.

They’re only partly wrong. Over the past 40 years, tremendous strides have been made in our understanding of grief and mourning. But because widows are more numerous than widowers – and more willing to participate in grief studies – most of the research thus far has focused on how women handle loss. Thus, affective expressiveness – especially crying and talking about the loss with others – has come to be seen as the accepted norm for grieving. Those who cope with loss in other ways are often considered to be doing it “wrong.”

And yet, the few studies of men’s grieving indicate that men tend toward a different way than women, and that this way is often just as effective.

In the mid-1990s, Marion and Sidney Moss of Philadelphia’s Polisher Research Institute, along with R.L. Rubinstein, interviewed 43 mid-life men who’d lost elderly fathers. They found that men tended to control their emotions after the death, emphasizing action and thinking instead. Some of the sons turned their attention outward, focusing on funeral planning, taking care of the estate, supporting relatives, and similar activities. Others turned inward, mentally reviewing their relationships with their dads, or rationalizing that the father’s death was best for all concerned.

The surprise for the researchers was that these mourning strategies seemed to be effective. The researchers noted: “We suggest that the male orientation (toward grief) is essentially adaptive. Rather than leading to a vulnerable self, action-oriented coping may enhance immediate mastery and bolster self-esteem. A cognitive orientation to loss may better enable a long-term processing that is slow and incremental rather than sudden and jarring.”

In their provocative new book, Men Don’t Cry... Women Do, Doka and Martin also assert, based on decades of clinical experience, that men tend toward a style of grieving that focuses on thinking, mastering feelings, and action. The action, which may include running, lifting weights, stacking wood, or chiseling a tombstone, seems to serve as “a way to restore normalcy and a sense of security” after a loss, the authors write.

The men I interviewed about the deaths of their fathers also tended toward active grieving. Among the four categories of male grievers I identified – Dashers, Delayers, Displayers, and Doers – Doers were most common. Men told me that after the deaths of their fathers, they coped by walking, running, gardening, building with their father’s tools, and taking over the father’s business, among other activities. Through these activities, they said – often repeated many times – the men were able to gradually release the energy that built up inside them after the loss.

It’s important to stress that gender is not an absolute determinant of styles of grieving. About 20 percent of the men I interviewed said crying and talking were their primary ways of coping with the loss of their dads. And some women with whom I’ve shared my research told me they mourn through action.

However, given that men tend toward a different style of grief than women, is there anything counselors and death educators can do to better serve men in grief? Following are three suggestions, representing a consensus among researchers and therapists with a particular interest in men and grief.

1) In setting up grief groups, innovate. Many men avoid bereavement groups because they expect to sit in a circle and talk about their feelings. The Canadian psychologist Philip Carverhill suggests re-framing grief groups as “mutual story-telling” sessions in which men have an opportunity to simply relate their loss experience.

Maryland therapist Thomas R. Golden goes as far as to suggest that grief groups for men be held outside of a standard clinical setting. For example, Golden says, a hospice counselor might invite local widowers for a day-long fishing trip in honor of their deceased wives. In Golden’s experience, men are more likely to show up for such an excursion than for a group session in an office. When the boat trip is over, Golden predicted, the men will “walk off in pairs and threes,” having made connections that might even continue on outside a formal group.

2) In individual therapy with men, be open to non-traditional styles of grieving. Doka and Martin suggest that in the opening sessions of individual therapy with a bereaved man, therapists focus on assessing the client’s past grief patterns and adaptive strategies. Language is very important during this phase. When a therapist asks, “How did you feel?” it implies that “feeling” is the primary domain worth exploring. Doka and Martin suggest asking: “How did you react?” or “How did you respond?”

If the client and therapist can identify an effective coping strategy from the client’s past, they should play to that strength. In the self-help book, When a Man Faces Grief, Golden and co-author James E. Miller speak directly to bereaved men: “Are you a quiet one? Then write rather than talk if that feels right. Or take slow walks. Or listen to soothing music.... Are you expressive emotionally? Then cry or laugh, rant or rave.... Are you precise by nature? Then try keeping track of your grief with a daily record.”

3) In all kinds of therapy, be a witness. Carverhill contends that male clients are generally not that interested in feedback, analysis, or judgment. Carverhill writes: “The bereaved male tells his story to others as an attempt to make meaning of his loss experience. By being a reflecting surface, the therapist can aid him in his search.”

In the interviews for my book on father-loss, I personally experienced the power of witnessing. As a journalist, I was interested primarily in recording exactly what happened to each man, step by step, before, during, and after his father’s death. So my main question was, repeatedly: “What happened next?” Most of my interviewees seemed to appreciate this approach. In fact, toward the end of each interview, I asked each man what had helped him most in dealing with the death of his father. More than a few said talking with me.

In the end, it is unlikely that male bereavement clients will outnumber females in the foreseeable future. But as we learn more about men’s styles of grieving, and apply that knowledge to the act of therapy, I believe that more men will seek help, and when they do, get what they need.

©2008, Neil Chethik

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For 20 years, Neil Chethik has made it his goal to find out what men really think -- about family, relationships, fathering, aging, sex, and more. He is the author of two best-selling books, Fatherloss (Hyperion) and VoiceMale (Simon & Schuster). He’s been a nationally syndicated columnist, a big-hall speaker, and now, the national media’s go-to guy for what men really think about their everyday lives. Contact: Neil Chethik, P.O. Box 8071, Lexington, KY 40533 or 859.361.1659 or E-Mail or www.NeilChethik.com



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