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Autobiography In Five Short Chapters by Portia Nelson.

Changing our behaviour is difficult.  If it were simply a matter of deciding to change, and following through on that change, there would be no need for psychotherapists.

When working with clients I am often struck that they have an unrealistic expectation of how change comes about in therapy or in life.  For some clients, they expect a linear relationship between number of sessions and incremental improvements in problem behaviour.  For other clients, they expect that insight in therapy is a necessary and sufficient condition for the change in behaviour they seek. Both are unrealistic.

In reality, change is hard won.  There is a subtle interplay between insight in therapy and making different choices in life.  Both are necessary.  Change is often slow, and comes about in apparent leaps forward, followed by apparent slips back.  The steps forward are experienced as triumphs, and the slips back are experienced as disasters. 

In reality steps forward and back are progress.  My role as a therapist is to help the client find the learning in both. 

The process of change has been wonderfully captured in a short poem by Portia Nelson.  I often offer this poem to clients to help them reflect on their “successes” and their “failures”.  I offer it to you so you may do the same.

 

Autobiography In Five Short Chapters

by Portia Nelson

I

I walk down the street.
There is a deep hole in the sidewalk
I fall in.
I am lost ... I am helpless.
It isn't my fault.
It takes me forever to find a way out.

II

I walk down the same street.
There is a deep hole in the sidewalk.
I pretend I don't see it.
I fall in again.
I can't believe I am in the same place
but, it isn't my fault.
It still takes a long time to get out.

III

I walk down the same street.
There is a deep hole in the sidewalk.
I see it is there.
I still fall in ... it's a habit.
my eyes are open
I know where I am.
It is my fault.
I get out immediately.

IV

I walk down the same street.
There is a deep hole in the sidewalk.
I walk around it.

V

I walk down another street.

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Dr Phil Tyson is a Men's Psychotherapist based in Manchester in the UK.  He offers:

• Group therapy weekends for men in London and Manchester
• Beginners meditation weekend retreats for men in London and Manchester
• Counselling for men in Manchester
• Psychotherapy for men in Manchester
• Cognitive behavioural therapy for men in Manchester
• Telephone and online counselling for men wherever you live
• Mediation for conflict resolution at work in London
• Mediation for conflict resolution at work in Manchester and the North West
• Supervision and consulative support for therapists in Manchester

Dr Tyson is also regularly quoted in the printed media and as a guest on local and national broadcast media.

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Hormones and Men’s Parenting Behaviour.

What kind of dad are you?  Research is beginning to show that the kind of parent you are is to some extent controlled by a number of key hormones.

 

In the journal Hormones and Behaviour the anthropologist Alexandra Alvergne studied the level of the hormone testosterone in men’s saliva, and how this correlated with family behaviour.  On average, the higher the levels of testosterone in the saliva, the less time and money the man invested in their wives and children.

 

Another study, by Ruth Fieldman, reported to the Society for Research in Child Development in Denver, Colorado, indicated that when men become fathers they undergo biochemical changes which affect how they relate to their children.  The study looked at the hormone Oxytocin, also called ‘the cuddle hormone’.  Fieldman found that the levels of oxytocin raised after the birth of a child in both fathers and mothers.  Furthermore, the more oxytocin was present in the fathers, the more they were seen to play, bond and attach to their children, then men who had low levels of oxytocin.

 

What both these studies appear to show is that your parenting style has something to do with your biology.  Indeed this makes sense in terms of evolutionary theory, as “investment” in offspring could be seen to be an evolutionary relevant trait, and therefore mediated by biology. 

 

Whether it is better, from an evolutionary perspective, to father many children and offer them poor support, or fewer children, and offer them more support, is an interesting backdrop to understanding men’s parenting preferences.  To reason from biology to morality, of course, is an example of what philosophers call ‘the naturalistic fallacy’.  However, some men, or so it might seem, are going to have to fight against their biology in order to become ‘responsible’ parents.

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Dr Phil Tyson is a Men's Psychotherapist based in Manchester in the UK.  He offers:

• Group therapy weekends for men in London and Manchester
• Beginners meditation weekend retreats for men in London and Manchester
• Counselling for men in Manchester
• Psychotherapy for men in Manchester
• Cognitive behavioural therapy for men in Manchester
• Telephone and online counselling for men wherever you live
• Mediation for conflict resolution at work in London
• Mediation for conflict resolution at work in Manchester and the North West
• Supervision and consulative support for therapists in Manchester

Dr Tyson is also regularly quoted in the printed media and as a guest on local and national broadcast media.

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Boys Don’t Cry?

One thing has struck me over the years in my practice with men, they don’t cry very often.  For sure I always have a box of (man sized) tissues strategically placed so that, should my client wish to cry, he can. 

 

When I was training I was told that crying is a good thing.  It releases tension, helps you to connect with your feeling, and the crying process itself serves to rid the body of unhelpful toxins.  In fact we were trained in how to spot when someone was about to cry, and how to help them do so.

 

So if crying is so good for us, why don’t the men I see cry more often?  For a while I thought that maybe I was to blame.  Perhaps, so I thought, I was not creating the right atmosphere where the client felt safe enough with me to cry.  Then, I thought, it was because I was a man, if my client was seeing a female therapist, then perhaps he might feel more able to cry.

 

Of course sometimes men do cry.  My experience is that when the men I see do cry it is usually for deep existential pain: death, abandonment, loss.  For sure women cry for these reasons too, but women also cry to express other feelings, like frustration or disappointment.  Women, it seems to me, also cry as a means or aid to communication, rather than simply an expression of inner pain.

 

The ‘standard’ explanation for the differences between men’s and women’s crying is that men have crying ‘socialised’ out of us.  We learn as boys, so the ‘standard’ theory goes, that our crying is not acceptable to others.  According to this view men are both capable of crying more, and if it wasn’t for our dysfunctional emotional upbringing, we would cry as much, and as often as women. 

 

I have come to reject this idea.  I don’t believe the socialisation hypothesis anymore.  Not least because it forces men to apologise for the emotionality they do express (“I know I should cry more” etc).  It seems to me now that men not crying as much as women is not so much a problem for men, but a problem for the women in our lives.  They would feel better if our emotionality were the same as theirs.  The fact of the matter is they are not.  My experience of working with men is that our emotional worlds are different to women’s.  Not better, not worse, but different.  I now hold the view that if a man cries in therapy that’s fine, but if he doesn’t cry, then this is not a problem with him, or indeed, with me.

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Dr Phil Tyson is a Men's Psychotherapist based in Manchester in the UK.  He offers:

• Group therapy weekends for men in London and Manchester
• Beginners meditation weekend retreats for men in London and Manchester
• Counselling for men in Manchester
• Psychotherapy for men in Manchester
• Cognitive behavioural therapy for men in Manchester
• Telephone and online counselling for men wherever you live
• Mediation for conflict resolution at work in London
• Mediation for conflict resolution at work in Manchester and the North West
• Supervision and consulative support for therapists in Manchester

Dr Tyson is also regularly quoted in the printed media and as a guest on local and national broadcast media.

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Sex Addiction.

As a men’s psychotherapist, I have talked more often to the media about sexual addiction than any other topic.  This is strange really because the assumption is that it is only men who become hooked on inappropriate sexual activity.  In fact 40% of sexual addicts are women. Women’s patterns of sexual addiction might be different to men’s, but they suffer in almost equal measure.  Having said that, this article is about sexual addiction in men, and if you are a man who thinks you have a problem with sex, you have come to the right place. 

 

So what kind of sexual activity can men get hooked on?  Well the main ones are ‘dogging’ areas, where straight men and couples cruise car parks for sex, public toilets and other gay cruising areas, prostitution (both selling and buying), masturbation and internet porn.  In fact internet porn is so easy to get hooked on that it has been dubbed the ‘crack cocaine’ of sexual addiction.  As a sexual addicts pathology develops, of course, he can often find himself moving into areas of sexual interest that are even more antisocial and/or illegal.

 

Sexual addiction first started to come to the attention of professionals who were involved in the treatment of other addictions, such as alcohol.  It was found that if a person has an addiction to a substance, there is a high likelihood that they will also be addicted to sex.  As many as 42% of people addicted to cocaine also have a co morbid sexual addiction.  Some theorists have argued that the neural pathways associated with sexual addiction are the basis for all addictions.  Whether this can be bourn out by the facts I don’t know, but what is clear is that sexual addiction is closely linked to other forms of addiction.

 

The natural history of the sex addict can often be quite tragic. The man starts to chase sexual ‘highs’ often involving situations of risk.  Risky sex enhances orgasm and sets the man in a trail of activity of escalating risk.  Eventually, it’s the chase of sexual activity that starts to take up more and more of the guys time.  In turn, sexual highs become harder and harder to achieve, a situation which, paradoxically, makes the ‘hit’ of a ‘good’ orgasm all the more addictive.  As the guy spends more and more time searching for sex and sexual activity, he spends less and less time with his friends and family. Social relationships are put at risk, and the man can become socially isolated.  Like other addictions, sex addicts can lose everything, partners, children, jobs, even liberty. 

 

So what can be done to help the sex addict?  One really good intervention is sex addicts anonymous.  This format is similar to narcotics anonymous and alcoholics anonymous based on regular self help group meetings.  Group meetings are a format that does not suit everybody.  I have had good results with clients using various cognitive behavioural techniques such as active monitoring of sexual behaviour and understanding thought processes. 

 

One theory of sexual addiction is that ‘sexual maps’ are laid down in childhood about age 7, and it is these sexual maps that guys continue to ‘act out’ as adults.  It seems appropriate that there is some therapeutic work undertaken aimed at understanding the origin of the sexual behaviour before cbt work is started.

 

Like all addictions, the hardest thing for me to work with is clients ambivalence about changing their behaviour.  Men often come to me in the ‘pre-contemplation’ phase of trying to decide whether to stop or not.  The good news is that if a man really wants to change, then the approach I use is really effective.  I can’t, however, make a man want to stop.  Unfortunately, for some men, they really do need to loose everything before change seems the best option.

 

One final word on the matter of shame.  Many men feel ashamed of their sexual behaviour and this inhibits them from coming forward for treatment.  I really understand and respect this.  My suggestion is that men choose a therapist who is experienced at working with sexual addiction, because such a therapist will be best able to help you explore your behaviour comfortably.  If seeing someone face-to-face is too intimidating at first, consider telephone counselling as many men find this safer.

 

If you want to find out more about sexual addiction, either for yourself or someone else, I can really recommend Patrick Carnes book on the subject, Out of the Shadows: Understanding Sexual Addiction which is now in its third edition and published by Hazelden.

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Dr Phil Tyson is a Men's Psychotherapist based in Manchester in the UK.  He offers:

• Group therapy weekends for men in London and Manchester
• Beginners meditation weekend retreats for men in London and Manchester
• Counselling for men in Manchester
• Psychotherapy for men in Manchester
• Cognitive behavioural therapy for men in Manchester
• Telephone and online counselling for men wherever you live
• Mediation for conflict resolution at work in London
• Mediation for conflict resolution at work in Manchester and the North West
• Supervision and consulative support for therapists in Manchester

Dr Tyson is also regularly quoted in the printed media and as a guest on local and national broadcast media.

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