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MEN, BOYS and MENTAL HEALTH (by Nick Cardone)

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Toxic masculinity can create a barrier to seeking help, with devastating consequences

Article by Nick Cardone* 

Background: Nick Cardone is a Registered Counselling Therapist in Nova Scotia (Canada). He is also the Owner and Lead Clinician at Free Range Therapy – a private therapy clinic specialized in working with men and adolescent boys.

“A culture clash exists between men and therapy. How many men or boys want to sit on their butts for an hour, talking about their feelings? There are other ways of ‘doing’ therapy tend to align with how guys are wired, like going on a hike, shooting hoops, going out for coffee, or playing music - and they are showing up!”

Recently I was on a hike with a male client who was sexually abused by his father and was currently struggling with chronic depression, an addiction to prescription drugs and under-employment. Walking side-by-side this particular morning, we happened across a bullfrog—likely injured from some predator—dragging a bloodied limb behind. He stared for a while—tears appearing on his cheeks—seeing the metaphor in his life from a new perspective.

“Someone hurt me...I am struggling to survive...I need help.” This experience became a catalyst for a deeper insight and motivation for change. It’s a “therapeutic technique” I could not have made up in an office.

On the one year anniversary of the Lionel Desmond tragedy, I am reminded of the staggering statistics surrounding men and mental health. Three out of four deaths by suicide are men. One in 10 men will experience major depression or anxiety in their lives. Making matters worse are the poor help-seeking behaviours of men. While some say this is a function of “stigma surrounding mental health,” it is important that we look a little deeper into what this might mean. Recognizing that gender is better defined along a spectrum—rather than the binary of male or female—toxic masculine culture tells us that getting help is not “manly.”

The vast majority of traditional mental health services (in North America, at least) involve one or two options: Individual or group therapy. Both of which are typically talk-based, time-bound, held in an office-setting and physically sedentary. Taking responsibility for another stereotype here, how many men or boys feel comfortable sitting in a chair, in an office, talking about their feelings? If therapy options connected better with how men tend to “show up” in the world, I believe we would see a shift in the statistics above.

The invitation here—to both clinicians and clients—is to expand our understanding of where and how therapy happens. The key, I believe, is to offer a series of therapeutic options in the hopes that one or more will have greater resonance with men and boys needing help. Adventure or wilderness therapy, expressive or arts-based approaches, incorporating physical activity, community service projects or non-traditional settings (like a park bench, a local walk or chatting over breakfast) are but some of the ideas already in existence.

Recently completed, the TONE project (Therapy Outside Normal Environments) was a two and a half year long men’s mental health pilot funded by Movember Canada, where adult men participated in a free, three-month group therapy program that incorporated adventure, nature, physical activity, volunteer work and expressive therapies. By all measures that were used to assess results—including a three percent drop-out rate, a stat that is unheard of in traditional therapy—TONE was a resounding success.

It is my belief that many men and boys benefit greatly from the traditionally offered therapy services available to them in Nova Scotia. More importantly, there are many men and boys who struggle with getting help, not just because access to it is difficult, but because therapy as we see it traditionally does not connect how men and boys access their inner states. Like having different learning styles, I believe clients (and clinicians) have different therapy styles that have greater resonance with them. A hike in the woods, sitting on a rock by the lake or going rock climbing, all while exploring their depression, anxiety or trauma, can have a momentous effect.

Men: Ask your Therapist to take you Outside - Nick Cardone (TEDx Talk)

Nick further describes his work, “Specifically, I come from the lens of working with men and boys, the culture of masculinity, etc. Terms like 'treatment resistance' or 'poor help-seeking behaviours' (to describe tendencies of men/boys and therapy) are misleading. A growing body of research is pointing to what many already know - that 'traditionally' offered therapy (office/sedentary/talk-focused) tends not to resonate with men and boys. In raising awareness about this, I honour those of you who are ALSO expanding on the idea of WHERE and HOW therapy happens!”

Check out Nick Cardone’s TEDx Talk here:

* Nick Cardone is a registered counselling therapist candidate in Nova Scotia (Canada), working in mental health for over 15 years. He owns ‘Free Range Therapy’, a private therapy service that takes clients out for a hike, rock climbing, Geocaching (outdoor treasure hunt recreational activity using a GPS or some other mobile device) or a bush walk, all while exploring their mental wellbeing.

OGA: This talk by Nick is exceptional. Having conducted wilderness-adventure therapy programs with boys and also with men here in Western Australia over the past 4 decades, we know this works. We also know that the psychological and health benefits of being in nature/wilderness works incredibly well too. But as a community, as a society, as a Nation - why do our governments still continue to only commit minimal funding towards these amazing programs! In comparison, often these government politicians continue to 'take-away' these types of activities and programs that barely survive.

Check out this recent news article on Outdoor Education in our WA schools: "Insane New Schools Rules Could See Cancellation of outdoor Education Classes?"

Outdoor adventure therapy and also wilderness therapy programming works, we all know it, and there is a raft of research that continues to confirm all of these amazing outcomes!  So then, why is it that our governments simply don't get it?  This concerns many of us in the professional fields of adventure therapy and also therapeutic counselling. I totally agree with Nick - we desperately do NEED more professionals and also more professional & high quality training in this vitally important field of working with MEN and BOYS. This is what happens when clients "Breakthrough at the Edge" of their own self-perceived limitations in adventure therapy.

Creating emotionally and therapeutically 'safe' outdoor spaces for boys and men, provides wellbeing, fun, freedom to move, explore and develop for all ages. As we have found, it can be also be a space to revitalise, recover and unplug, to be inspired and connect to a trained professional therapist, others, self and best of all - Nature.

Using the wilderness environment or just the outdoors in a therapeutically supportive environment through immersion, experiential impact and ecological-aesthetics are especially unique opportunities for both boys and men. For instance, in addition to counselling opportunities, the outdoors also aids in the prevention of lifestyle diseases, mental health problems, and also our disconnection from nature.