Male-Friendly Couples Counseling

You’ve heard the jokes. Every couples therapist has skid marks at the front door from husbands being dragged into the office. Or this one: A man is convicted of tax evasion, claiming that he had to do it because his wife spent too much. The sentencing judge gives him a choice: “Do you want to go to federal prison or marriage counseling?” The guy asks, “Could I have a private cell?”

You’ve also heard the usual explanations for male resistance to couples therapy: socialization discourages men from seeking help of any kind, but particularly in the mental health system; men are uncomfortable talking about emotions, especially with a wife present: it’s her turf! Men tend to be more instrumental in the way they express emotion: they prefer to do something to show their feelings, rather than talk about them. Men expect to be blamed for everything that goes wrong in a relationship, so why even try explaining themselves or talking about how they feel? “Let’s skip the prosecution and get right to the sentencing.”

Even highly skilled therapists can have trouble handling male resistance. Some bend over backward to engage the guy, which can make him drop out early, convinced that his wife is the problem. Sometimes frustrated therapists are tempted to do just what men say their wives do: blame them, but in the language of psychopathology—he won’t talk about how he feels because he’s narcissistic, depressed, passive-aggressive, sociopathic, emotionally unavailable, phobic about intimacy—and that’s why therapy isn’t working!

It was because couples therapy has such a hard time engaging men that I began what I call “boot camp” couples therapy—a tough, concentrated format, consisting of three eight-hour days with a one-year follow-up. Men seem to prefer this approach to drawn-out weekly therapy with no conclusion in sight. The vast majority of the couples I see are therapy veterans, whose former therapists have thrown up their hands in defeat and referred them to me. When these couples come to my office, the women are exhausted, or bitter, or both; the men cynically describe what they’ve learned in their previous therapy: “To save my marriage, I have to become a woman.”

I typically ignore this assertion because it isn’t the real issue. Men don’t dislike therapy because they might have to talk like women or adopt feminine sensibilities: what they hate is that therapy forces them to experience that most heinous emotional state to a man—feeling like a failure. Most men dread failure, particularly as providers, protectors, and lovers; their wives’ unhappiness makes them feel like failures. Their seeming narcissism and compulsion to be “right” reflect their need to be seen as anything but failures. They sometimes agree that it’s better to be a jerk than a loser. “Death before dishonor” isn’t a phrase associated with women’s groups.

The need to ward off feelings of failure is why many men seem annoyed when their wives are unhappy, rather than ready to sit down and have a long, revealing talk about “feelings.” It helps explain why they’re more inclined to blame their partners for being too sensitive, too demanding, too selfish, too critical. Such blame temporarily relieves their shame, protects them from emotional reflection, and gives them a sense of empowerment. They can blame people and still be tough and in control. Unfortunately, being in continual blame-mode renders them powerless to engage with their wives or their therapists, or to improve their relationships.

Men who come to the boot camp feel powerless because they can’t regulate their dread of failure sufficiently to sustain intimate connection, which requires letting down defenses and keeping them down. As a consequence, they’ve developed habits of empowering themselves against the vulnerability of attachment with resentment and anger. The boot camp trains them to replace their shame-driven behavior with compassion, an attitude that makes them feel more protective and less vulnerable to feeling inadequate.

I’ve developed a manual of self-regulation and relationship skills, which they learn to use during the boot camp. Having these skills in hand empowers them to be the kind of partners they want to be. Men really do want to have a warm and close marriage as much as their wives do, but the way they go about connecting is different. The boot camp shows the couple how their innate styles differ and how they can reconcile their differences to achieve the connection they both want.

Boot Camp vs. “Feelings Words”

Sherry and Carl had been married 17 years, during the last 5 of which they’d been to three experienced marriage counselors. An attractive couple (if you looked beyond the resentment in their faces), they sat on a love seat in my office—as far apart from each other as was physically possible.

Sherry started the boot camp with 15 minutes of the usual complaints about an emotionally unavailable man, but at the end of her list of grievances, sadness overshadowed complaint, when she mentioned something her husband hadn’t heard before: “I’m not sure that he loves me anymore.”

Carl was astonished at first, and then offended: “What do you mean I don’t love you? I go to work every day!”

“You’d go to work every day even if I weren’t with you,” she snapped back. But, noticing the look of frustration on his face, she explained: “I know in his heart he loves me; he just can’t show it.”

Their previous therapists had worked hard to teach the couple active-listening, mutual-validation, and other empathy-inducing skills. One had taught Carl a series of “feelings words,” so he could better express how he felt and validate Sherry’s emotional states.

“He says the right words,” Sherry complained, “but it always sounds phony at home, like he doesn’t really mean it. He’s supposed to say something he appreciates about me every day, and he can’t even do that.”

“How many times can you tell her she’s smart, competent, attractive, and . . . ,” Carl grew more frustrated as he forgot the other compliment he was supposed to give. “What else was I supposed to say?” he asked his wife.

“In the therapist’s office, he can do it just fine,” said Sherry. “He can listen and open up about himself without resentment or anger—everything I want. It’s worse to know that he can do it and just won’t when we’re home.”

“I did it already!” Carl said, implying that he’d said the words, paid his dues, and shouldn’t have to repeat the performance over and over.

I asked Sherry to think of a time when she’d felt that Carl was understanding her and communicating more openly. It took a few moments, but she came up with a time when they’d been walking by a lake near their house: he’d talked about feeling vulnerable at work; people who’d been with the company for less time than he were getting promotions, while he was stuck in midlevel management.

“I said it’d make me nervous if he was thinking of quitting his job when we had all those bills. And he heard that. He put his arm around me. And we felt connected.”

“What did he say,” I asked.

She looked surprised. “He didn’t say anything, but I knew he’d heard me and wasn’t thinking about quitting his job.”

“And did she say that you’re a loser at work, and that’s why you’re not getting promoted?” I asked Carl.

“She said the other people getting ahead of me were ass-lickers, and it was more important to have integrity—something like that.”

“You reassured each other,” I pointed out. “Carl didn’t say anything, yet Sherry felt reassured and said something in return that reassured him. Those are different styles of connection, and you made them fit together.”

Fitting Different Styles

I mentioned to them that men talk more freely when they feel emotionally connected or when they’re doing something, like walking, driving, or playing. The connection or activity eases the transition from their sense of inadequacy to a gut-level compassion for the women they love. It’s often said that women need to feel close before they have sex, while men want to have sex to feel close. But the opposite is true when it comes to the verbal communication of feelings. Women expose their vulnerabilities to feel close: they typically call girlfriends and say they feel bad, or they complain about bad things that have happened to them. These gambits interest their girlfriends, who then share similar experiences. But men have to feel close before they can expose their vulnerability. Carl felt close enough on his walk with Sherry that he could express his self-doubt about work and reassure her when she expressed concern.

The reason that Sherry and Carl had felt close in sessions with former therapists wasn’t that Carl had been taught the “correct” language; rather, the therapy experience itself—the session—fostered a sense of connection and mutual compassion. His words in therapy, which had pleased his wife, flowed naturally from that experience. The talk had worked because they felt connected, but Sherry and their therapists mistakenly thought that the talk had worked simply because they’d said the right words—a common mistake among clients and therapists.

Carl and Sherry clearly got the first concept of the boot camp: that different styles of connecting—emotional talk, shared activity, common experience—have to be fit together, none taking precedence.

Now we turned to what makes differing styles fit together. It’s often a matter of choice: we consciously choose to feel connected by realizing how much we value the other and deciding to be open and receptive. When Sherry and Carl felt connected, they did so by a choice that came from their deeper values (how important they are to each other), rather than transitory feelings or moods. If you approach someone you love having already made the choice to feel connected, you’ll be more successful in whatever you say or do than if you make the connecting conditional on specific behaviors.

I secured an initial agreement from them on two fronts. First, they had to commit to valuing their connection more than their transitory feelings or moods. (“Even if I don’t have the energy to invest in showing connection, I’ll still value my connection to you.”) Then, accepting that connection is a choice, they had to be willing to make the choice to connect, regardless of the other partner’s behavior. Making the choice to connect raises the likelihood of reciprocity, just as making a connection contingent on behavior increases the likelihood of disconnection.

They signed an agreement that their connection was important to them and that they’d try hard to choose to feel connected, even if their partner exhibited defensiveness, withdrawal, resentment, or anger. Now we had to find ways by which each could make it easier for the other to choose connection.

“It’s hard when you don’t feel appreciated,” Sherry said.

“Do you want it to be hard for her?” I asked Carl.

“No, I don’t.”

Many men confuse appreciation with compliments—a mistake compounded by assignments to come up with nice things to say. Appreciation is a complex emotional state compounded of interest, admiration, affection, gratitude, and value, all of which are difficult, even for poets, to express in words. Sherry was dissatisfied with Carl’s compliments because they didn’t make her feel anything. I assured her that he could convey the feeling of appreciation much better nonverbally. She agreed to an experiment.

Experimenting with Visualization

I asked Carl to come up with mental images of Sherry that would symbolize interest, admiration, affection, gratitude, and value. (He imagined her reading a book, reaching out to hug him, sitting by his side in the hospital after his surgery, and tossing her pony tail as she exercised on a treadmill.) He was to focus on feeling appreciation for her without saying anything. When he felt ready, he faced her, focusing on these mental images. Unencumbered by the task of translating his emotional state into the right words, his expression and body language changed, as if he were seeing her through new eyes. Spontaneously, he turned this emotional state into an embrace. She felt appreciated, even though he didn’t state what exactly he appreciated about her. More important was the change in his behavior and attitudes that his appreciation would foster over time. His images were personal and from the heart. Because he liked how they made him feel, he began to conjure them at home without much effort. Appreciation is a part of love that goes beyond words.

Although aware of his love for Sherry, Carl, like many men, underestimated his wife’s importance to him: he knew he loved her, but he didn’t realize how vital she was to his emotional well-being. I asked him to remember when she’d questioned his love for her by pointing out that he’d go to work every day even if she left him.

“She’s right about that,” I said. “What she doesn’t get is this: your work, and everything else you do, wouldn’t mean the same without her.”

I told them I thought Sherry provided the meaning of life for Carl: without her, he’d carry on his routine, I said, but he’d do it as a shadow of himself. Like many divorced men, he might start drinking heavily, driving more aggressively, getting depressed, neglecting his health, and barely going through the motions of living. He nodded emphatically. The image of desolation without his wife resonated with him; he said he worked with a couple of divorced men who’d “lost their spirit” after their wives had left them.

“That’s what you believe?” Sherry asked him, a bit incredulously. “If I left you, work wouldn’t mean the same?” She gave him a moment to find the words.

“You and the kids,” he said softly. “Without you, nothing makes any difference.”

I asked Carl to come up with some brief, nonverbal acknowledgement

of Sherry’s importance to him that he could do at the four major transitional times in the day: waking up, leaving the house, coming home, and going to sleep. (Rituals done at transitional times tend to carry over into the rest of the day.) He chose to touch her hand for a few seconds at those times, as an unspoken gesture of her importance to him.

One problem of trying to fit men into a feminized, tend-and-befriend ideal of attachment is that the male attachment style is generally more protect-and-connect: if a man can feel protective of his family, he’ll connect with them; if he feels like a failure as a protector, he’ll shut down or hide behind a wall of aggressiveness. To our great misfortune, our culture defines male protection almost entirely in financial terms, which tragically devalues the emotional support most men would like to give to their wives.

The strategy at this point in treatment was to expose opportunities to protect and connect.

In a nonabusive relationship, when a woman initiates divorce, the decision typically comes after the parties have experienced a personal crisis, like a serious illness, a death in the family, work failures, depression, or prolonged bouts of stress or anxiety. During the crisis, he withdraws, telling himself that he can’t “go down that path,” that he needs to remain steady and strong and keep the family safe, that he’ll “give her space until she gets it together.” In fact, her distress triggers his feelings of inadequacy and dread of failure. Eventually, she recovers from the crisis, but not from her feeling of having been emotionally stranded, isolated, and uncared for. She loses interest in the attachment, which has failed even to give her the security of knowing her partner will be there when she most needs him.

In this case, Sherry was still recovering from a bout of chronic fatigue syndrome, so there were opportunities for Carl to show that he could be supportive and protective. “When she feels bad, all you have to do,” I told him, “is step into the puddle with her: just be there, with and for her. You don’t have to do something to make her feel better (she has to get well herself), as long as she doesn’t have to react to your avoiding or rejecting her.” Carl had to understand that feeling isolated was as bad for Sherry as feeling like a loser was for him. Protection is less about achieving something (which is susceptible to failure) than being lovingly present. From this presence comes the capacity for emotional talk—not the other way around.

Using Core Values with Heals

The rest of the boot camp was spent on developing emotional-regulation skills to accomplish two things: reduce the baseline resentment level, which had made them so emotionally reactive to each other, and help them turn irritation and other low-grade anger states into compassion, before they negotiated resolutions to the problems at hand.

I asked them to identify their core value, the most important quality for and about each of them. Always among the qualities clients list is something like being loving and compassionate to the people they love. Whenever we violate our core value, we experience guilt and shame. If we blame our partners for forcing us to violate it (“You’re the reason I’m not compassionate and loving,”), this projection sparks resentment or anger.

Building self-regulation skills requires more than insight: what’s needed is something along the lines of basic training in the military. Like soldiers, the wife and husband need skills that kick in automatically under fire. These skills must be acquired through conditioning and activated by the earliest physiological experience of anger or resentment. One method of building such a conditioned response is a technique called Heals, a centerpiece of the boot camp.

Heals is short for heals, experience, access, love, solve. It sounds determinedly cognitive, but it’s aimed at producing an immediate and unconscious response, one that transforms anger, resentment, or anxiety into focused interest or compassion. I’ve found that, on average, it takes 6 weeks of 12 repetitions per day to develop a conditioned response that significantly reduces the frequency and intensity of any future waves of anger.

Before clients practice this technique, I ask them to recall an incident that made them angry and to think about it until they actually feel the physical sensations of their anger. The first task of Heals is to disrupt the motivations inherent in anger and resentment. To accomplish this, clients visualize “Heals, Heals, Heals” flashing over the face of the person who made them angry. This starts them on an inward journey to their core value.

Clients then Experience the core hurt that stimulated their anger. They say something like, “I feel inadequate or unlovable,” and feel those core hurts for just one second. (Each time they do this, their sensitivity to these core hurts decreases.) They then Access their core value, by remembering the most important thing about them—to be loving and compassionate to loved ones. Next they Love themselves—that is, they make themselves feel lovable by feeling compassion for the core hurt (not their behavior). In the Solve step, they address behavior. I ask clients, “Will you solve this problem better with anger or compassion? Which do you prefer? Which is the real you?” With core hurts regulated, clients have their full mental resources, including perspective-taking, available for finding solutions. As a rule, several occur to them immediately.

The Heals component of the boot camp is repetitive and tedious, but it produces long-lasting results, as it, literally, rewires couples’ brains to be more compassionate.

Of course, Sherry and Carl had specific problems—concerning in-laws, parenting, and finances. But as often happens, we didn’t need to spend much time on those in the boot camp. The therapists they’d already seen had given them sufficient insight and skills to solve typical relationship disputes. The missing element was skill in self-regulation, to enable them to hold onto self-value and value for each other, when the other’s behavior stimulated core hurts. With a newfound ability to self-regulate under stress, they could access the skills they’d already learned. Solving problems is the easy part; holding onto self-value and value for loved ones during hard times and adrenalin rushes is much harder—and much more rewarding.

Case Commentary

By Michele Bograd

Family and marital therapy became more sensitive to issues of gender two decades ago, and since then the profession has become far more sophisticated about the intersection of therapy and many social dimensions: class, race, age, sexual orientation, and gender. In the culture at large, a generation of younger men and women hold expectations and beliefs about gender roles and intimate relationships that are completely different from those of their parents. At a time when diversity is widely embraced, we’re all very much aware that there isn’t one way to be masculine or feminine, but many.

Thus, it was surprising to read a case study that makes use of worn stereotypes about men, albeit with a light, humorous touch. I don’t see many of these men in my clinical practice: there are no skid marks outside my door, no men worried about becoming women—no men, in short, who look like two-dimensional masculine cutouts. In fact, I feel it’s important for me, as a therapist, to question my own beliefs about “men in general,” since no individual man fulfills my best or worst fantasies of who he really is. It’s hard to accept that the author believes that a simple description fits all men who’ve “failed” previous rounds of marital therapy.

The first clinical task is not to assume the necessity of getting around male-gender stereotypes before “real” therapy can begin, but to track whether and how these patterns may manifest in this particular man, this particular couple. The therapist should be alert to how some individual couples may themselves use these stereotypes in ways that obscure who their partners really are. Instead, the author bears down hard on the old dichotomy of “Women are from Venus; men are from Mars.” In my experience, this kind of polarization and focus on one aspect of identity—presumably male or female gender-linked traits—blocks many other important avenues toward change.

Useful avenues may take many forms, as they’re woven into a complex tapestry of identity: family-of-origin history, including how men and women want to be different from their role models; exploration of historical times that provide many different models of masculinity; the developmental arc of family life, and how the freedom to construct gender roles widens and narrows over time; men’s relationship to “how men should be,” including who defines that for them and where they’re located on the continuum from conforming to resisting. In couples therapy, context is all.

Both the stereotyped gender platform and the metaphor of therapy-as-boot-camp don’t do justice to the genuine clinical acumen and sensitivity evident in this case study. Steven Stosny’s way of working with clients’ values about how they want to love is compelling. Too often, couples therapists work primarily on dissolving painful interactions, rather than connecting people to their deeply held yearnings to love well and be well loved in return. In moments of hurt, which become chronic realities in embattled or disillusioned couples, people can, literally, lose sight of what they care for in their partner.

Stosny provides concrete tools and interesting strategies to try with different men and their partners that emphasize behavior, working with private but insistent beliefs that partners maintain about each other, and the reality of the basic principle of change: practice, practice, practice. These strategies can be added to the repertoire of therapists sensitive to the undeniable ways that social factors foster or constrain intimacy. However, the nuanced and specific way he works with this couple and their particular hopes and struggles around intimacy seems qualitatively different from the unyielding theoretical and relational framework from which the clinical strategy is presumably drawn.

Author’s Response

The point of the tongue-in-cheek opening to the case study was that hard-to-engage men, most of whom are chronically resentful or angry, traditionally are less eager to enter therapy than women, drop out more frequently, and sabotage the process more regularly. However, I’m delighted to learn that Michele Bograd has a better track record in attracting such men and retaining them for the duration of her treatment, and that the men she retains have maintained their improvements at one-year follow-ups.

The men referred to my boot camps come from therapists not as fortunate as she. Many of them complain that it’s hard for some women therapists to understand, much less appreciate, male dread of failure, which permeates all the “ways to be masculine” I’ve seen in difficult men. I’m certain that dismissing dread of failure as a gender stereotype exacerbates it.

As to my attitude about why men “fail” therapy, I don’t believe that men fail therapy at all. Therapists certainly fail men, often because they stress context and process more than behavioral outcome.

Generalizations about gender, like those any other a therapist makes, should only be considered as verifiable tendencies (not capacities) and used as guides for intervention. That therapists must be sensitive to the many exceptions to all tendencies seems too obvious to note. Incidentally, gender tendency predicts more accurately than any contextual variable. The exploration of the contextual variables that Bograd cites is, in general, appealing to women, but it conforms to the worst stereotypes that many men have about therapy and is part of the reason that thousands of men reject it out of hand.

As Bograd notes, the exploration of gender roles and ways to be masculine or feminine aren’t part of the actual therapy I do. The mutual compassion that heals couples arises from the motivation to relieve suffering and promote mutual well-being, not from being sensitive to whatever roles or generalizations men and women may lapse into when cut off from their deepest values about themselves and each other.

Michele Bograd, Ph.D., is a couples therapist in private practice at Arlington, Massachusetts. The editor of several books on gender and family therapy, she’ long been involved in the feminist movement in family therapy.