As a man, does asking for help feel foreign or ‘wrong’ somehow? It may be that many traditionally male tenets may be useful or adaptative in certain environments. However, at least some of them might come at a significant cost in other areas.
A relatively recent study shows that at least for some men, believing in the importance of self-reliance as a man can actually reduce psychosocial functioning outcomes following therapy, while believing in the importance of toughness as a man can be beneficial over time (O’Loughlin et al., 2023).
Breaking down the study
That study involved 178 male military veterans participating in a group therapy program. The groups consisted of 6-8 veterans and occurred as weekend retreats over three weekends, such that the participants got about 80 hours of group therapy. Note that “83.2% of the participants had probable PTSD; 84.7% had probable moderate to severe depression; and 31.6% had moderate to severe alcohol use disorder” (p. 19).
The study monitored psychosocial functioning using the Outcome Questionnaire-45, a tool for “measuring patient status and psychotherapy outcome [including] symptoms characteristic of anxiety and depression (i.e., symptom distress); difficulties with family, friends, and marital relationships (i.e., interpersonal relations); and problems in the context of employment, education, and leisure pursuits (i.e., social role performance)” (pp. 18-19). For the study, treatment outcome was determined based on psychosocial functioning at five time points, including posttreatment and ending at 18 months following treatment.
Meanwhile, that study employed five subscales of the Male Role Norms Inventory—Short Form to measure the extent to which participants agreed with how men should behave relative to traditional masculine approaches regarding “restrictive emotionality”, “self-reliance”, “avoidance of femininity”, “dominance” and “toughness” (p. 19).
What did the researchers find?
Firstly, having a higher score on any of the traditional masculine approaches studied (i.e., restrictive emotionality, self-reliance, avoidance of femininity, dominance and toughness) was associated with lower psychosocial functioning scores on average.
Fascinatingly, participants who scored higher in terms of agreeing with self-reliance also had lower levels of psychosocial functioning improvement from before the treatment to the post-treatment interval: a negative for them.
But endorsing toughness had a positive consequence as follows. In fact, participants scoring higher regarding toughness showed better predicted psychosocial functioning at the 18-month mark.
So, the study indicated that for the veterans participating, agreeing more with toughness in terms of male role norms led to better results following treatment at 18 months; self-reliance, meanwhile, was a liability. Self-reliance, in this case and as found, was not adaptive, instead just the opposite.
For toughness, as the researchers described, “One of the more interesting findings from our study was that veterans with higher levels of toughness endorsement (when compared to those with lower levels of toughness endorsement) had lower average levels of psychosocial functioning; however, they also had greater improvement in psychosocial functioning from posttreatment to 18-month follow-up” (p. 23). What this means is that although toughness was not seen as beneficial to psychosocial functioning on the whole, and though it did not help during the treatment itself, it did assist with greater benefits months later at the 18-month check-in.
The authors of the study noted the following: “situation and context may alter the degree to which endorsing traditional masculinity is adaptive or maladaptive” (p. 16). Indeed, restrictive emotionality, self-reliance, avoidance of femininity and dominance were not measured as being helpful within this study. And self-reliance actually impeded improvement as measured at posttreatment. But toughness was helpful in the particular context described above (in the space after treatment, between posttreatment and 18 months).
Naturally, this is only one study, focused on military veterans taking part in group therapy, so it is unclear to what extent we can extrapolate findings more generally beyond that population and in the context of the study (e.g., group therapy). However, the possibility that belief systems like self-reliance could become self-sabotaging for men is a fascinating one. Also exciting is the potential benefits of endorsing toughness, at least in some contexts.
Self-reliance, at least in some contexts, appears to be harmful and counterproductive. And importantly, there is no shame in seeking out help and new tools and approaches as a man, including through psychotherapy.
If this resonates with you, I invite you to book an appointment or call 647-220-4709 / email matthewpittspsy@protonmail.com
References
O’Loughlin, J. I., Cox, D. W., Ogrodniczuk, J. S., & Castro, C. A. (2023). Traditional masculinity ideology and psychotherapy treatment outcome for military service veteran men. Psychology of Men & Masculinities, 24(1), 16–25. https://doi.org/10.1037/men0000415