Mental health services responding to men and their anger

Abstract

Due to their propensity for acting out with antisocial behaviours, angry men are often regarded as having antisocial personality disorder with little hope for treatment success. Whilst not denying the difficulties in working with angry men, this paper looks to challenge some of the received wisdom in this area. Antisocial personality disorder is compared with borderline personality disorder and the many similarities, including the association with childhood trauma, course of illness, symptoms and rates of occurrence, are discussed. Differences between the two groups may be associated with the internalization or externalization of anger. Some issues related to bias in diagnosis are raised, as is the universal hopelessness implied in the literature related to treatment of antisocial personality disorder. Some issues related to engaging traditional men are discussed. In this paper the term 'traditional men' is used to describe men who value stoicism, self-reliance, strength, work, status and aggression highly whilst denying any vulnerability and exhibiting restricted emotionality. There is a need to reframe the diagnosis in order to recognize the associated behaviours as being an adult manifestation of complex childhood trauma. Further, there is a need for treatment directed towards altering ongoing patterns of retraumatization which characterize the lives of these men. A case study is included to demonstrate a number of the issues involved in working with angry men. These include issues of connection, boundaries, safety and utilization of the general practitioner in setting up a containing structure. The case study is used to illustrate that when issues of connection and anger containment are positively addressed, good therapeutic outcomes are possible.

Psychometric properties of Liverpool Stoicism Scale (LSS) in a cohort of patients with resected cancer in adjuvant treatment

“…It is possible that stoicism increases as part of age-related maturity, due to increased acceptance of loss as inevitable (Judd et al, 2006). Likewise, there are authors who have explained it as a cohort effect; that is, that older individuals have grown up in a culture that values abnegation and resignation (Corboy, McLaren, Jenkins, & McDonald, 2014;Stewart & Harmon, 2004;Wrigley, Jackson, Judd, & Komiti, 2005), as well as stoical attitudes, for instance as regards pain, and the propensity to hide it and not seek help to avoid appearing weak (Judd et al, 2006;Yong, 2006).…”

Crisis and Triage Clinicians' Attitudes Toward Working With People With Personality Disorder

“…The significance of positive attitudes toward those with mental health problems and optimizing health outcomes has been widely discussed in the literature (Holmqvist & Armelius, 2004; Horsfall, 1999; Read & Harre, 2001; World Psychiatric Association, 2001). In Australia, concern about negative attitudes toward those with mental health problems has increasingly been the focus of mental health commentary (Department of Human Services, 2002; Hugo, 2001; Jorm, Korten, Jacomb, Christensen, & Henderson, 1999; Stewart & Harmon, 2004). The Equal Opportunities and Human Rights Commission (2005) concluded that insufficient attention has been directed toward responding constructively to consumers and carers' experiences of mental health care.…”

Exploring difficulties in men’s experience of self and agency during antidepressant use.

“…More specifically, men report struggling to reclaim the strength and independence that is threatened by the lived experience of depression, but is demanded of them by dominant gender norms and practices (Emslie et al, 2006; O’Brien et al, 2005). Research also suggests that depression can be perceived as a risk to one’s “status” relative to other men and women (Courtenay, 2000) and that men show strength through restricted emotionality and denial of vulnerability (Gough, 2013; Stewart & Harmon, 2004).…”