The Boys are Back in Town

Here at NorthStar Therapy, home of Wichita DBT, we have seen a steady and impressive increase of men self-referring for therapy. These self-referred men range in age from twenty-ish up to their forties. They come seeking support for their mental health issues that range from ADHD to trauma, and from depression to relationship issues. Additionally, many of them are trying to overcome compulsive and excessive internet usage, especially around gaming and pornography. For the most part, nearly to a man, each of them expresses a desire to be a good father, partner, spouse, or just a good man.

The first striking feature shared by these men is the fact that they’re self-referred. They come of their own free will and hope for change. For the vast majority of these men, there is no probation officer or spouse exerting legal or relational mandates to get help. They are coming with their own respective what if, rather than the or else of others. Whatever their reasons for presenting to therapy, as a man and a therapist, I am joyed by the influx of men seeking help.

Common Struggles

While each of these men moves in this world with a unique nuance, they present common struggles regarding cultural themes that beleaguer men, such as:

1. Fatherlessness/Aloof Dads. At least half of these men tell tales of fathers who were absent or aloof. Some lost their fathers to divorce. Others lost their fathers to workaholism. Some of these men lost their fathers to incarceration, addiction, or unmitigated immaturity and self-interest. Some say their fathers were at home, but otherwise aloof, turned away from the household, and relationally dissociated. Their fathers’ bodies were in proximity, but their minds and hearts were a million miles away.
2. Excessive free time. These days, most men have more free time than men in prior generations. There are many more conveniences of course, which we all take for granted, and which I LOVE by the way. There is no demand for hauling water up from the creek for drinking, cooking, or washing. There is no need to check the fishing lines for dinner. There is no need to hunt game with our food readily available at local markets. Work, which is good for income and structure, only structures narrow stretches of time each day. This surplus of time can be gaping and makes men vulnerable to boredom and the common twin of boredom, loneliness. A man who doesn’t know how to structure his time outside of work may turn toward drugs, alcohol, or pornography to pass the time and to anesthetize painful emotions.
3. Dopamine pinging/Internet Hypnosis. We’re all in the same boat when it comes to the presence and influence of the Internet. From social media, online shopping, and the myriad of digital content that our brains find very commanding. Men are being shaped by the chronic dopamine pinging of the digital world. The digital world’s influence is imperceptible at first. It’s just watching. It’s just learning. It’s just consuming as capitalists do. What is the harm? Some men become their aloof fathers. By way of digital consumption, some men lose interest in their own children and spouses. Other men become aware of their own growing social isolation and disinterest in the natural world. Some men note that they feel their willpower was siphoned away as their minds and bodies atrophied.
4. Lack of skills. Finally, any or all of these dynamics converge over a lifetime of experience and habit, depleting men of meaning and joy, and without the skills to do otherwise, many of these men are adrift. They lack attentional skills, or mindfulness, to identify and connect with their deepest values and to pursue the embodiment of enduring and transcendent principles. They often lack a vocabulary for their emotions and are unable to name what they experience daily. They may turn toward limiting tropes of masculinity, bouncing between the old masculinity of callous stoicism and the new demands to embody softer and more sensitive masculinity. In either trope, there is little meaningful help for these men, as the expectations for them, the what, exceeds the hows of actual skills for effective self-management and problem-solving.

Resolute DBT for Men

In my efforts to respond to the needs of these men, I have drawn on my primary specialization in Dialectical Behavior Therapy (DBT) and mindfulness-based therapy to cultivate for them a program that is principle-centered, values-driven, and skills-based. And, with the honest real-time feedback from these men, we are finding a path toward a program that integrates inspiration and practicality.

DBT adherents know that it is a principle-based therapy. For further inspiration, I have also drawn from the works of Stephen R. Covey, famous for his books Principle-Centered Leadership and the Seven Habits of Highly Effective People, to name two. As a matter of convergence and consilience, to borrow a term from Daniel Siegel, we import from Covey his deeply personal challenges to “begin with the end in mind,” which DBT posits as the larger goal of therapy is to build a life worth living. With mindfulness, we help the men identify their deep values, as well as the obstacles that impede them from actualizing these values. Perhaps factors emerge from the transactions between one’s biology and one’s environment (the biosocial theory). And further, the men are challenged to review their present values, which can be relative and changing, in the light of enduring, immutable, and transcendent principles. These principles are called “true north.” Both the identification of one’s values and true north principles are akin to DBT’s wise mind.

And to fully embrace the necessity of commitment in DBT to live into one’s own mission and goals as well as the undertaking of learning and applying new skills in all relevant contexts, this program has been dubbed Resolute, which has an empowering and challenging resonance with the men. It appeals to their desire for purpose and connotes determination and adherence to a cause. This will be to self, the shaping of integrity, and fidelity to friends, family, and community. To be resolute is to cultivate a willingness to subordinate moods to principles and to avoid avoiding. It suggests a willingness to work hard and to be steady in acquiring and generalizing skills necessary to live a principled wise mind life.

Coveys Four Human Endowments

Resolute DBT presents to men four human endowments, which are unique to human beings, and these reside in the space between stimulus and response, between the events which unfold around us and how we respond to them with purpose and intention. These form “our ultimate human freedom: the power to choose, to respond, to change. They create the compass that empowers us to align our lives with true north” (Covey).

1. Self-awareness: This is mindfulness/mindsight. The capacity to stand apart from ourselves and examine our thinking, motives, history, scripts, conditioning, and habits. This self-awareness helps us to broaden the space between stimulus and response.
2. Conscience: Connects us with the wisdom of the ages and the wisdom of the heart. It warns us when we begin to act against or even consider acting against principles. It also helps us sense our unique gifts and mission.
3. Independent will: With willingness, we can act against our biological inheritance, and our conditioning, and we can re-write our scripts as we live into principle-centered living vs. pleasure-centered or reactive living.  This is willingness arising from and further strengthening wise mind.  We can work with opposite actions to embody our values and to flow with what’s real, with True North. We can act on self-awareness, conscience, and vision.
4. Creative imagination: We can envision a future state, creating a vision with our mind. We can see ourselves and others better than we are now. It enables us to write a personal mission statement, set a goal, or plan a meeting.  It empowers us to see ourselves living our mission statement even in difficult and testing situations.  We can use imaginal practice to see ourselves as increasingly skillful and coping ahead to learn skills to help us to deal with future challenges, and opposite actions to help us avoid avoiding.

Covey-Infused DBT Practices

Establishing the above with the help of the work of Covey, we coach the Resolute men in the classic DBT skills: Core Mindfulness, Distress Tolerance, Emotion Regulation, and Interpersonal Effectiveness. These skills, these tools, are the means by which the men embody their wise mind values and connect with true north principles.

Mindfulness skills help them de-literalize their reactive and conditions cognitions and self-talk that tend to be catastrophic and limiting. Distress Tolerance skills help them to down-regulate limbic arousal that precedes self-defeating impulsive behaviors, or speaking carelessly to children or partners in a manner that is harsh and alienating. They also learn the power of willingness and turning the mind to simply be open to testing practices for change before dismissing coaching. Emotion Regulation skills help them cultivate balance and emotional resilience with self-care and they find their much-needed lexicon for their emotions which they come to articulate, and they come to understand as fundamentally adaptive for survival, work, and loving relationships. Interpersonal Effectiveness helps them to verbalize their needs and objectives in relationships without aggression or passive aggression, and connecting behaviors such as validation of others, vitally important in their work relationships, friendships, marriages, and their role as fathers.

Just the Beginning

As of now, Resolute DBT is in its infancy, and ever-developing, with only anecdotal support that it is helping some men. The Resolute DBT Program is not to be considered a substitute for standard comprehensive DBT, for men who are at present engaged in active suicidal behaviors, ideation, or self-harm or who are otherwise screened as in need of comprehensive DBT. At present, it is being deployed as a principle-centered, values-driven, and skills-based adjunct to men who are engaged in comprehensive DBT, or other therapy services. The aim is to further develop this into a structured and brief time-limited program offered in a group format to support men in their unique challenges.