Working with Men in Individual Psychotherapy from an Integrity Model Perspective: The Unsung Heroes

Abstract

For over four decades, a continuing thread in the literature has emphasized the unique challenges and impasses in psychotherapy with men. Parallel to this, empirical and clinical research for over four decades has documented men's positive response to a values-based Integrity model of psychotherapy across a wide spectrum of issues. Only recently have other researchers begun focusing on the merits of a strengths-based positive perspective on men and masculinities. This paper offers a theoretical and clinical exploration of an Integrity model, values-based therapeutic perspective in working with men in individual psychotherapy from a strengths-based, gender-sensitive, positive psychology framework. Three case examples—Mark, François and Peter—presenting with significant distress including sexual dysfunction, illustrate the viability of this existential perspective in engaging and working with men in individual psychotherapy.

Engaging Men in Psychological Treatment: A Scoping Review

“…Of note, there has been a shift from viewing traditional masculinity as “deficit” towards greater acceptance and integration of strength-based approaches ( Sloan, Gough, & Conner, 2010 ). However, the current review highlighted that despite approximately 50% of the articles providing peripheral, surface-level suggestions for taking note of the “noble” or positive aspects of male client’s masculinity, only around 10% provided adequate detail regarding devising and implementing a strength-based conceptualization, assessment, and treatment for men (e.g., Englar-Carlson & Shepard, 2005 ; Kiselica & Englar-Carlson, 2010 ; McCarthy & Holliday, 2004 ; Nahon & Lander, 2013 , 2014 ; Wong & Rochlen, 2005 ). Moreover, within this positive masculinity model, only those behaviors aligned with traditional masculinity were framed as positive.…”

“…Afforded here is a synthesis of recommendations regarding what may attract and retain men in psychological treatment. Providing an engaging treatment approach from the outset may curb many men’s experience of the “revolving door phenomenon” related to patterns of disengagement, dropout, and subsequent relapse followed by reuptake of services in crisis periods ( Nahon & Lander, 2014 ). This pattern challenges limited mental health system resources, impacts economic efficiency and likely contributes to men’s high suicide rates ( Pederson & Vogel, 2007 ).…”

The Integrity Model

“…The Integrity model conceptualizes Horney's three coping strategies as comprising three major existential choice points in any relationship, and particularly in dealing with conflict, while offering an entirely different understanding from Horney's concept of "moving towards people": We view "moving towards others" as a healthy and profound form of intimacy that reflects the third leg of Integrity-that of closing the psychological space with others or increasing a profound sense of community. Thus, a key concept of the Integrity model is that in any relationship, one can only take one of three stances: to move toward, away from, or against another at any given point in time (Nahon & Lander, 2014). Integrity is about daring to resolve value clashes with others in a manner that allows one to move toward them-especially when one is angry.…”

“…Nahon and Lander (1998) have referred to this pessimistic and pejorative view of men in the literature with respect to men’s capacity for emotional relatedness and their likelihood to seek psychological help when needed as the myth of the “emotionally defective male” (p. 16; Nahon & Lander, 2008). Nahon and Lander’s (2008, 2010, 2011, 2014) reviews of the literature indicate that a number of empirical studies have pointed to the presence of a negative bias in the attitudes of therapists with respect to male clients. Englar-Carlson, Evans, and Duffey (2014a) suggested that a counselor’s bias in working with men .…”

Will to Masculinity: An Existential Examination of Men's Issues

“…For over 3 decades, the literature on men and masculinity has reported on a crisis of masculinity (Kimmel, ; Levant, ; Nahon & Lander, ; Rochlen, ). What it means to be a man has not evolved with larger social movements, thus engendering feelings of disconnection and confusion for many men (Wexler, ).…”