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Section 7
Potential Pathways to Higher Rates of Male Suicide

Question 7 | Test | Table of Contents

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As we discussed in the previous section, family relationships are an essential part of how a boy forms his own identity.

Dr. Farrell, author of The Myth Of Male Power, believes that men commit suicide in far greater numbers than women when they feel unloved, unneeded, or that they are a burden on society. Men have spent their youth training to be achievers, to be providers and protectors, and never learned the skills to deal with the humiliation that comes with failure in any of these areas. Whereas women are often encouraged to develop nurturing skills, taught to help each other through life's traumas, men are rarely taught these skills.

♦ Technique: Exploring the "Imaginary Stranger" Relationship
As you know, sons often don't know their fathers very well. However, what they do know about their fathers is many times false. They see their fathers as hyper-independent, self-confident, and emotion-free. In the therapy session with James, 35, a realtor, I found it beneficial to refer to this relationship with his father as the "Imaginary Stranger." James was on the in-patient unit because of his failed suicide attempt. His wife woke up when she heard the car running in the garage.

James' view of his father as an imaginary stranger is fostered by societal pressure. Because James could not become close to his father and understand manhood, he took cues from the media, his peers, and other outside forces. It seemed beneficial to explain to James, "You receive what are called gender messages every day, which show you that men and women are supposed to act and feel differently. These gender messages are rigid, unrealistic, and unhealthy for you to develop into a nurturing father. They are the cues that tells you you can't play with dolls, you can't cry, and you can't submit to females."

Here's how I outlined for James Lynch's Four Key Gender Differences. As I read through this list, think of your depressed male client. Evaluate if any part of these four points would be beneficial in your next session.

4 Key Gender Differences

♦ Gender Difference #1
Boys are held less often than girls, even though physical contact has been shown to be good for psychological development in both sexes. Would this piece of information be beneficial in your next session with you male client suffering from depression?

♦ Gender Difference #2
Adults tend to handle boys more vigorously than girls, which teaches men to be "tough." Would this second piece of information be beneficial in your next session?

♦ Gender Difference #3
Boys are more likely to spend time away from the home through typical male chores and activities. This teaches boys that the domestic space is reserved for females. It also emphasizes their dealings with things rather than people. Would this third piece of information be beneficial in your next session?

♦ Gender Difference #4
 Boys' peer groups behave very differently from girls' peer groups. In play, boys will focus more on the game itself and the rules surrounding it, whereas girls tend to pay most attention to the people involved.

These differences in socialization are just some of the ways boys begin to learn what masculinity, in society's terms, means. Would this piece of information be beneficial in your next session?

♦ Three Effects of Anti-Femininity on Male Development
Because James, like most males, had limited access to positive role models, like his father, he formed an identity with negative information or in reality, information based upon an "Imaginary Stranger," his father. Therefore, James looked at females, like his mother, and decide this is what he should not be. He defined masculinity as anti-femininity.

-- Effect # 1 - Anti-femininity caused James to avoid many potentially healthy activities that he considered feminine, such as expressing emotions, taking care of his body, and benefiting from close relationships.
-- Effect # 2 - Anti-femininity also caused him to devalue feminine qualities and females themselves.
-- Effect # 3 - As you've probably guessed, this attitude against what is feminine restricted James' ability to form a well-rounded self-identity and have an intimate relationship.

As this information unfolded in a succession of sessions, James asked, "What does all this have to do with my depression?" How would you answer this question? See what you think of my response.

I stated, "As a boy you gained your gender identity based on gender socialization. Since you didn't know what it is to be masculine, you avoided feminine characteristics and relied on such stereotypes as male action heroes in the media. How can anyone compare with the military hero or the sports superstar? However, since you did not feel comfortable sharing your feelings of inadequacy, you compensated by separating from your feelings and tried to be the "real man" you imagined your father to be…The "Imaginary Stranger."

Which male clients are you currently treating who have gone through this process and are left in the aftermath of feeling helpless and hopeless, which is the bedrock of their depression? I told James, "Men feel hopeless because society demands the impossible of them. He is missing out on the rewards of intimacy and emotional support.

♦ Five-Step Process of Value Transformation
I found it beneficial with James to use Julian Simon's five-step process of values transformation

-- Step # 1 - First, I had James write down his most important aspects of his life, such as good health, healthy children, long life, etc.

-- Step # 2 - Second, I had James rate these aspects according to their importance, 1 being very important and 5 being not important. This forced him to decide what came first, work, family, exercise, and so on.

-- Step # 3 - Third, I asked James if there was anything missing from his list, such as good health for his family, etc.

-- Step # 4 - Fourth, I went through the list with James to find contradictions. For example, health was at the top of his list, and work was second. James was a workaholic and was not being honest with himself. His drive to succeed was keeping him from being with his family, which was his main source of happiness.

-- Step # 5 - In the fifth and final step I helped James address the areas that are causing problems and find simple solutions. For Alex, he was having trouble feeling overwhelmed at work because his employer encourages competition between employees. The purpose of this activity was to help James create a simple structure of personal intimacy goals.

As I review the Five Steps, evaluate if they might be of assistance in value transformation with your James:
#1. Important life aspects
#2. Rate these aspects
#3. What's missing?
#4. What's contradictory?
#5. What's causing a problem?

The next section will discuss counterdependence and how it relates to masculine depression.
Reviewed 2023

Peer-Reviewed Journal Article References:
Conner, K. R., Bohnert, A. S., McCarthy, J. F., Valenstein, M., Bossarte, R., Ignacio, R., Lu, N., & Ilgen, M. A. (2013). Mental disorder comorbidity and suicide among 2.96 million men receiving care in the veterans health administration health system. Journal of Abnormal Psychology, 122(1), 256–263.

Granato, S. L., Smith, P. N., & Selwyn, C. N. (2015). Acquired capability and masculine gender norm adherence: Potential pathways to higher rates of male suicide. Psychology of Men & Masculinity, 16(3), 246–253. 

Mackenzie, C. S., Visperas, A., Ogrodniczuk, J. S., Oliffe, J. L., & Nurmi, M. A. (2019). Age and sex differences in self-stigma and public stigma concerning depression and suicide in men. Stigma and Health, 4(2), 233–241.

Roy, P., Tremblay, G., & Duplessis-Brochu, É. (2018). Problematizing men's suicide, mental health, and well-being: 20 years of social work innovation in the province of Quebec, Canada. Crisis: The Journal of Crisis Intervention and Suicide Prevention, 39(2), 137–143.

Vannoy, S., Park, M., Maroney, M. R., Unützer, J., Apesoa-Varano, E. C., & Hinton, L. (2018). The perspective of older men with depression on suicide and its prevention in primary care: Implications for primary care engagement strategies. Crisis: The Journal of Crisis Intervention and Suicide Prevention, 39(5), 397–405.

QUESTION 7
What is a description of the Imaginary Stranger process defining a son's relationship with his father? To select and enter your answer go to Test.

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