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How men are raised creates roadblocks to successful treatment

August 2, 2015
by Gary A. Enos, Contributing Editor
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Several of the most basic lessons men are taught as boys stand in direct conflict with the principles that govern therapy, which makes men's addiction treatment a minefield of challenges, men's treatment leader Dan Griffin told a workshop audience Aug. 2 at the National Conference on Addiction Disorders (NCAD) in St. Louis.

Griffin's talk, titled “It's Us, Not Them: Why We Are Failing Men in Treatment,” issued some strong retorts to widely held practices in treating men with addictions. One of his concerns centers on training. He says that while it rarely would be considered acceptable to give a caseload of female patients to a male counselor untrained in women's issues (as evidenced by the lack of male clinicians working in women-only programs), the opposite situation occurs all the time, where female clinicians treat male patients often with little consideration to gender-specific topics.

In addition, Griffin said, the treatment field minimizes the prevalence of trauma in its male patients. If surveyors expect to get an honest assessment of the incidence of trauma by simply asking a man in a brief interview if he was a victim of childhood abuse, that is wishful thinking, he believes.

“The idea that men don't have as much trauma as women, it's a lie,” Griffin said. He added later in his talk at the conference produced by the publishers of Addiction Professional and Behavioral Healthcare, “The men's recovery community is slowly dying of trauma.”

Conflicting values

Griffin, an author of several books on men's treatment and a consultant to numerous addiction treatment centers seeking a more gender-sensitive approach, outlined the typical lessons boys are taught about being a man, then compared them to the basic principles of therapy. For example, under the trademarked “The Man Rules” is listed “Always be in control,” while in therapy the patient is taught to “let go of control.” Appearing side by side on the lists are “Don't ask for help” and “Ask for help,” and so on.

“Men are not the problem,” said Griffin, who has blogged for Addiction Professional on issues in men's treatment. “I really believe how men have been raised is the problem.” For instance, he said that males are trained practically from the beginning not to prioritize relationships, which are at the heart of successful therapy.

Griffin urged treatment programs to adopt a sense of “cultural humility” in understanding men. No amount of training can make one culturally “competent” in the way that term is commonly used in the field, he suggested, but the clinician can develop a fascination for what makes the male patient tick.

Experts in trauma-informed care have cited the five core principles of such care as safety, empowerment, trust, collaboration and choice. Griffin said he would add two more to that list for trauma-informed care for men: compassion, and mutual responsibility between the therapist and the client. He said he often asks men in treatment, “How does that behavior fit with the man you want to be?”, as opposed simply to the man one was taught to be.

Griffin's concluding comment to the NCAD audience: “There's so much more to men than we give credit.”