Wednesday, February 19, 2020

The stories of our fathers: Men’s recovery from intergenerational wounds


The following post is taken from “The stories of our fathers: Men’s recovery from intergenerational wounds”, by MICHAEL R. DADSON.

To view the full paper please see https://ubc.academia.edu/MichaelDadson

Excerpts from pages 149 -157 of A THESIS SUBMITTED IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF DOCTOR OF PHILOSOPHY in THE FACULTY OF GRADUATE AND POSTDOCTORAL STUDIES
(Counselling Psychology)

Abstract

This study investigated the narratives of recovery for men who have been injured in their relationship with their father. Six men participated in the study and each man reported that they had been injured in their relationship with their father and have therapeutically engaged in the process of recovery. These men worked with the researcher towards the co-construction of their narrative of recovery and this provided an in-depth examination of the men's subjective experiences. Six narratives were written in the first person focusing on the process of recovery.

Each narrative was co-analyzed with individual participants by using Arvay’s (2003) Collaborative Narrative Method. Narratives were returned to the respective co-researcher in order to evaluate the worth of the study. The study explored the process of recovery in the unique personal context in which it occurred and provided concrete examples of what the recovery process is actually like. In order to uncover the patterns of recovery, a cross narrative theme analysis was conducted that revealed six primary patterns of recovery. The results show that there may be a convergence of trauma for men when developmental trauma and masculine gender role trauma intersect. The narrative patterns of recovery that emerge help highlight and provide critical components of treatment and recovery for men who experience this convergence of trauma.

Implications for treatment

The narratives and patterns of recovery presented in the results of the study here invite therapists to pay attention to the rules of masculine ideology as relevant for assessment and treatment of traumatized male clients, particularly men who been injured in their relationship with their fathers or have experienced other forms of masculine gender role trauma. Men may have difficulty containing the overwhelming effects of trauma and the gender role strain they experience. This can cause men to externalize distress and react with inner and outer anger, aggression, and isolation (Noleen-Hoeksema, 1990; Rabinowitz & Cochran, 2002).

Men's underlying anxiety, depression, grief, and identity confusion may be overlooked and more obvious behavioural issues such as violence, substance abuse, and sexual compulsivity may receive exclusive therapeutic attention (Brooks, 2010). Brooks (2010) recommends that counsellors should assess men for gender role strain at the start of therapy. He suggests this initial assessment can be accomplished in several ways. First, the male client could take any of a number of masculinity inventories like: the Gender Role Conflict Scale, Male Role Norms Inventory, and the Conformity to Be Male Role Norms Inventory (Levant & Fishcher, 1998; Mahalik et al., 2003; O’Neil, Helms, Gable, David, & Wrightman, 1986).

Second, the male client could be asked to respond to specific provocative questions about his views of manhood. This qualitative assessment is one way to generate information that can not only inform therapy but also stimulate a male client to reflect on the material he may have never before considered relevant. Third, questions that explore the male client's ideas about what it means to be a man can be incorporated into the three phases of trauma therapy explored further below.

Some treatment options like group therapy and therapeutic enactment begin by preframing the structure of the therapy with an awareness of the effects of rigid masculine ideology (Westwood et al., 2010). For example, the language of “group work” is chosen over “group therapy” and “dropping the baggage” is preferred over “processing trauma”. Through the early establishment of group norms, men are empowered to help each other. Giving and receiving help is modeled and normalized. Building on these social norms in the group facilitates the spontaneous sharing of emotions. Careful consideration of the language counselors choose to describe what will happen in the counseling process with the male client is important because it can facilitate or hinder the establishment of a therapeutic relationship that can acknowledge male issues.

Participants in this study described two main issues that motivated them to enter into therapy. The primary motivators were the fear or loss of a significant female relationship and the recognition of the pain and discomfort. They did not enter into therapy with a clear recognition that they had suffered an injury in their relationship with their fathers. Nor did they recognize the implications of that injury on their identity confusion, their relationship challenges, their difficulties with emotional expression and regulation, and the limitations of their intrarelationship and interrelationship skills.

It is not surprising, given the challenges that men who suffer developmental and masculine gender role trauma face, that the participants in this study highly valued the qualities of the therapeutic relationship. How the therapist viewed them as a person and how the therapist treated them was critical. As Rick says, "I think the most healing event for me was the ongoing consistent experience of being heard and received with understanding and compassion."

Ford, Courtois, Steele, van der Hart, & Nijenhuis, (2005) describe a three-phase sequential integrative model for counseling complex posttraumatic self-dysregulation: The three phases are conceptualized as flexible, intermixed, and cyclical throughout the process of therapy while maintaining a cycling forward movement toward recovery and overall wellbeing.

Phase 1 emphasizes the importance of building a positive therapeutic alliance Ford, et al., 2005). This involves the formation of a physically and emotionally safe, stable therapeutic relationship. Phase 2 emphasizes trauma processing. This phase of therapy is more directly “trauma-focused,” actively involving the client in recalling traumatic memories as well as related body states, emotions, and perceptions in amounts and at a pace that is safe and manageable. Phase 3 emphasizes functional reintegration. This frequently involves intensive work on the difficult task of learning what to hope for or expect from life after symptom reduction, and facing the fear of change. This phase focuses on fine-tuning the self-regulatory skills developed in phase 1 and increasing a conscious understanding of the impact and costs of past traumatic experiences addressed in phase 2, while applying these skills to understanding and address life’s problems, to the end of deriving a growing satisfaction in daily life (Ford, et al., 2005).

The current study and the narrative themes and patterns of recovery described here can help therapists
understand and apply specific interventions within the three phases of treatment. For example, exploring masculine identity and questions about what it means to be a man may be addressed differently in each phase. This can be a particularly useful strategy when the male client is highly guarded or intimidated during phase 1 of treatment and there is a need to move slowly in approaching sensitive issues. Phase 2 may provide the opportunity to more explicitly address the effects of trauma on men’s masculine identity while reflecting about changes that have resulted from treatment and consolidating client’s new experience of themselves may be effective during phase 3 of treatment.

Furthermore, the patterns of recovery reported in this study support the three-phase treatment orientation of Ford, Courtois, Steele, van der Hart, & Nijenhuis, (2005). For example, phase 1 establishing safety: studies have shown that men are often extremely reluctant to seek help for physical and psychological health care concerns (Addis, & Mahalik, 2003). The demands of the perceived client role, at least superficially, seem to conflict with the primary tenets of the traditional male. That is, traditional masculine ideology predicts that many men need to be in control, to suppress emotions, to be self-reliant, and to engage in action orientated activities. Assuming the client role can exacerbate gender strain when it is perceived to contradict with this ideology.

Relationships for these men are often framed by power. One male client voiced his reluctance to enter therapy because “he didn’t want someone else telling him how to be and what to do.” Men who are victims of masculine gender role trauma and are injured in their relationship with their fathers simultaneously face increased GRS that manifests in identity confusion, while also coping with the symptoms of developmental trauma.

This present study helps us understand the importance of building safety with men in phase 1 of treatment. The therapeutic relationship helps men move progressively through the patterns of recovery. As well, by recognizing the convergence of trauma and the kinds of symptoms these men suffer as a result, reinforces the importance of the person and the competencies of the therapist. Just as Robert noticed, “The therapists were able to speak truthfully about themselves and they were able to facilitate trusting, loving, respectful relationships.” Cory experienced the effectiveness of his therapist facilitating a conflict
resolution and it was then that he began to trust him. The therapists of these men seemed particularly competent and capable of demonstrating both their own strength and vulnerability to the men who were in therapy. That helped men move forward in an atmosphere of safety in phase 1 of treatment.

When counselors are attuned to the concerns of men who have experienced a convergence of trauma they can reframe the counselling process, validate men’s need to internally and externally struggle with their masculine identity while maintaining their need for personal power. The counselling relationship can be contextualized as a process of supporting and building on that need. Counsellors position themselves as expert facilitators who have specialized skills that support and maintain men’s power and their responsibility. By helping reluctant men experience counselling as a “teamwork” process that aims to replace ineffective false control with a more meaningful, genuine, empowerment. As Rick framed it, "They (the therapists) were able to communicate their own vulnerability. There was also a pretty consistent feeling in the group of were all in this together.”

The embarrassment and shame men can feel when they are vulnerable and seeking help can be tempered by an acknowledgment of the normativeness of male distress and a shared comradely and compassion for men’s situation. Sadly, many men avoid help seeking because of the mistaken idea that their problems are unique, that help seeking is something that no man does (Addis, & Mahalik, 2003). If they do seek help some men believe they must give up control, accept that they are deficient as men and now must accept what they are told about how to be different. This belief is embedded in the masculine ideology that men who suffer a masculine trauma seem to embrace. This belief can interfere with the development of an empowered belief in their capacity to learn new ways of being, new ways of relating, and a stance of emerging competency.

The goal of safety in phase one is furthered by acknowledging the particular kind of inner gender role conflict men can face when they engage in seeking help learning expressing difficult emotions. The counselor begins by engaging men in a relationship where they are able to acknowledge this inner conflict, explore its source, and express their distress in ways that keep pace with the man’s relational style and comfort range. Pacing this process is particularly important because it builds a foundation that will establish the secure and emotionally safe relationship needed to process traumatic events.

Phase 2 processing trauma: One devastating consequence of developmental trauma is the compromising effect this can have on a person’s self-perception and identity (van der Kolk, 2009). This can manifest in painful shaming beliefs like believing oneself to be permanently damaged. Our study shows that the effects on men's self-perception and identity when they have experienced a convergence of developmental trauma and masculine gender trauma may manifest in in masculine identity confusion.

The counselors who helped the men in our study recover were able to facilitate emotional expression and the re-experiencing of memories of the injury that participants described as a way of releasing the intensity of the emotions, expressing it and processing anger, rage, sadness, confusion and disgust. This at times was directed at their fathers. In order to do that, counsellors must be sensitive to the ways men’s past traumatic experiences have affected their inner self identifications as men. This process demands a highly attuned, nonjudgmental, and empathetic therapeutic presence combined with the willingness and ability to monitor one's own emotional reactivity. Men may have never expressed this kind of range of emotions and their core distress and their inadequacy, embarrassment, and fear that may be mixed with aggression, sarcasm and resistance. These defensive expressions may signal a lack of safety rather than an unwillingness to participate.

Phase 3 functional reintegration: Ford et al (2003) emphasizes that “the goal [of this phase] is for the client to acquire experiential evidence of safety and empowerment, and to thus to gradually replace constricted or self-defeating beliefs, schema, and goals that have resulted in a constricted lifestyle with a more flexible, specific, and self-enhancing personal framework.” (p.441)

The participants in this study developed internal and external relationship skills for living. They learned new ways of being with others, new interpersonal relationship skills, new ways of being with themselves, new intrapersonal relationship skills. They experienced new skills like self-awareness, self-reflection and self-regulation. These are the kinds of skills that therapists can expect men who are recovering from developmental trauma to develop.

The narratives and patterns of recovery described in this study also highlight or focus the therapist on the distinctive, devastating results of the father-son injury. Perhaps what needs to be a critical focus of phase 3 for men who have experienced and convergence of developmental and masculine gender role trauma, is to assist men in examining the growth that they have achieved and consider how therapy has transformed the way they now thinks about themselves, experience themselves and perform their masculinity. The narratives and patterns of recovery highlight the importance of the transformation of the self and the transformation of masculine identity as a result of therapy. As Cory says, "I have become a man who is a warrior and a Hunter who wants love hanging in his meat house." Dean also has a new way of thinking about what it means to be a man. He says, "I think men need to be more rounded and not necessarily lose their toughness. Men need to just expand their masculinity a bit and grow some emotional balls."

It will be important that the therapist look for ways to directly address masculine identity confusion for men who have experienced an injury in their relationship with their father based on the findings of this study. This needs to be considered as a goal and a focus of the recovery process. This focus complements other important goals of phase 3 such as fine-tuning self regulatory skills through enhanced emotional awareness and expression. Enhanced emotional expression is a potential gain for men who are recovering from a convergence of developmental trauma and masculine gender role trauma. These gains can be validated to help reinforce the changes that have taken place. Counselors can reinforce the man’s expanded understanding of masculinity and how that has changed his emotional processes, beliefs, activities, and interpersonal relationships. Like Dean says, "To be a man means I need to have love for my kids. I need to be patient, share my feelings, ask questions, and keep open. That kind of communication and being in relationships like that is an important part of being a man."

In this way the therapist can emphasis the gains the man has acquired as pertains to phase 3 goals: new
skills in relationships, solving life problems, and his growing satisfaction in daily living (Ford, et al., 2005). At the same time, the therapist can consolidate the masculine identity transformation that has taken place.

Summary

Adverse interpersonal traumas in early childhood disrupt childhood development and can be conceptualized as developmental trauma. Masculine gender role traumas are events that invalidate, restrict or violate men’s internal or culturally defined standards of what it means to be male. When men experience the convergence of these two of traumas the results can be devastating. The masculine socialization process creates conditions that can mean men must contradict masculine norms in order to engage in treatment. This study provides a rich, in-depth description of the recovery process for men who have experienced and convergence of masculine gender role trauma and developmental trauma. Understanding the way these two conceptualizations of trauma intersect for men is important for both trauma specialists and therapists who want to work with men, as they can gain valuable insights into men’s internal conflicts, the barriers they may feel about engaging and participating in therapy, the challenges that men face as they process trauma, and what recovery for these men looks like. Considering
these challenges is vital if counsellors are to help men recover from trauma and establish an adaptive perception of their gendered self.

#trauma #men #father #Langley #Brookswood #Therapy #michaeldadson

No comments:

Post a Comment