Not supposed to feel this: Traditional masculinity in psychotherapy with male veterans returning from Afghanistan and Iraq.

Abstract

Traditional masculine socialization presents challenges in psychotherapy, for example, by decreasing the likelihood of help-seeking and by making emotion-laden content more difficult to address. While this has been established in civilian populations, more intense forms of masculine socialization found in military settings may amplify such issues in male veteran populations. Male veterans returning from and Afghanistan (OEF) and Iraq (OIF) exhibit strong traditional masculine socialization and generally present in a unique manner. It is posited that OEF/OIF male veterans' unique presentation is in large part because of an interaction between high degrees of endorsement of traditional masculine gender role norms, relative youth, recency of distressing events, and recent experience in the social context of the military where traditional masculinity is reinforced. The impact of these variables on the psychotherapeutic process for male OEF/OIF veterans is significant and likely adds to ambivalence about change and increases dropout from psychotherapy. Modifications of traditional psychotherapeutic approaches designed to address traditional masculine gender role norms and their many interactions with other variables are discussed.

A Bourdieusian Analysis of U.S. Military Culture Ground in the Mental Help-Seeking Literature

“…Support for the supposition that the military field reinforces and elicits behaviors congruent with hegemonic masculinity comes from studies that underscore the complex intersection of "traditional masculine gender role norms, relative youth, recency of distressing events, and recent experience in the social context of the military" in ambivalence toward treatment for psychological problems, and increasing dropout rates from psychotherapy among U.S. veterans (Lorber & Garcia, 2010; see similar findings in Green, Emslie, O'Neill, Hunt, & Walker, 2010;Hoge et al, 2004). The salience of hegemonic masculinity in informing a habitus related to gender and eliciting gendered mental health-related practices both within and without the U.S. military makes it difficult to discern if a veteran says, "You don't talk about what could be deemed as emotional weakness" (Green et al, 2010(Green et al, , p. 1484 for fundamentally different reasons than any other man who is motivated to enact hegemonic ideals might state that, "A real man puts up with pain and doesn't complain" (O'Brien, Hunt, & Hart, 2005, p. 508).…”

The psychological challenge of genital injury

“…Support for soldiers with GU injuries is drawn from psychology provision, together with input from a team of four Mental Health Nurses. Although within complex trauma early psychological interventions can help prepare the patient for rehabilitation34 soldiers returning from recent deployments may be less likely to seek psychotherapy,35 potentially due to shame, embarrassment or social stigma 33 36. Many injured soldiers may feel isolated with their emotions and fears and may not have felt able to talk openly with anyone.…”

Animal Companions and Military Veterans: How Dogs Can Help America’s Heroes

“…Even when veterans do seek clinical care, it may be difficult for them to fully engage in therapy, as their masculine gender roles "create avoidance, rigid emotional control, and can make veterans reluctant or unwilling to experience the emotions they learned to 'turn off'" (Lorber and Garcia 2010, p. 297). Furthermore, the unspoken collusion to conceal any psychological or adjustment difficulties may lead veterans to inaccurately believe that such experiences are abnormal and that they are alone in their suffering, perpetuating feelings of shame and the pressure to "keep holding it together" (Lorber and Garcia 2010).…”