How Masculinity Can Harm Men’s Mental Health, According To This Therapist

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Masculinity, as we’re probably all aware by now, can turn nasty with catastrophic consequences for the person affected and the people around them – something Mike Miller knows all too well. Miller is programme director of Reach at The Cabin Group in Thailand, a rehab centre for men struggling with addiction. While Miller believes traditional masculinity – “a set of accepted behaviours for men” – is not all toxic, he thinks there are things that men get “trained” to do that don’t help them to thrive. We asked him to explain what these were, and what you can start doing about it if you think any of what he says applies to you.

What are the expectations of masculinity?

A lot of the time our worth is attached to what we provide and what we produce. When men introduce themselves they’ll say, “What do you do?” Not, “Do you have kids? Do you have a family?” It can make our worth attached to what we do, not who we are. Feelings are sort of in the realm of women, and we get messages like don’t be weak, don’t be vulnerable.

Which parts of masculinity can be unhelpful?

The message of being very stoic and keeping your feelings inside. That doesn’t have to be harmful, unless you have a need for support to get your emotional needs met – if you’re carrying a lot of stress, pain, anxiety, fear, depression. If you’ve been trained not to reach out and admit that your need help, there are going to be some maladaptive [not helpful or appropriate to the environment or situation] coping behaviours that come into play. That could be things like drinking and drug use, problematic gambling, problematic sexual behaviours like promiscuity that gets in the way of intimacy. And if you can’t have intimacy and you need help with getting your emotional needs met, how is that going to happen?

What sort of emotional needs do you mean?

The biggest things are connection to other people, feeling heard, loving, feeling love, empowerment, having agency and having self-esteem.

Activities like drinking, gambling and sex aren’t illegal, so how can you identify when they become a problem?

If you do it in a compulsive way where you can’t control it, or tell yourself you’ll stop and you can’t. And then there are negative consequences. If we take drinking, for some people it starts off as relief, to get away from the stress and pressures of life, but if it becomes compulsive the consequences may be that it affects their employment, their health, their relationships.

If people are having problems, how can they start addressing them?

I can tell you how we started addressing it at Reach – granted these people are perhaps further along the track. The first thing we do when people come into our programme is get involved in psycho-dynamic group therapy, which is about men having relationships with other men, and being able to drop the mask and just tell the truth about what they’re experiencing and what they’re feeling. It starts teaching them to honour what’s going on. Connecting with someone and being able to be honest, to say “I’m having some struggles right now and I need some support”, really does go against traditional men’s gender training and socialisation.

A lot of men also have adverse childhood experiences – what I, as a trauma therapist, would consider to be trauma. I’m not talking the classic things people might think of like childhood sexual abuse, or being in a war zone. I’m talking about, for instance, having two parents who work and being raised by a nanny, and when your parents come home they’re too tired to spend too much time with you. Then the nanny leaves and you get a new nanny and what may happen is you grow up with attachment problems. Those are what we would consider to be traumatic events and those can really inform how you behave in relationship to people for the rest of your life.

I work in a luxury rehab centre and there are people here for whom money is never going to be an issue, yet they’re not happy people. The way they cope with the emotional pain is drinking, drugs, gambling, food. There’s a lot of examples where people eat to soothe their emotions, or because they don’t know how to reach out to other people.

What I would suggest is that therapy is a good idea. This might seem like a really big stretch for some people, especially for men and especially when you don’t feel you’re in some kind of a crisis or at rock bottom, but I’m a big believer in reaching out to somebody who can listen and provide feedback.

Mike Miller is programme director of specialist men’s programme Reach at The Cabin Group, Chiang Mai

Jonathan Shannon
Former editor

Jonathan Shannon was the editor of the Coach website from 2016 to 2024, developing a wide-ranging experience of health and fitness. Jonathan took up running while editing Coach and used the training plans on the site to run a sub-40min 10K, 1hr 28min half marathon and 3hr 6min marathon. He’s an advocate of cycling to work and is Coach’s e-bike reviewer, and not just because he lives up a bit of a hill. He also reviews fitness trackers and other workout gear.