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By Dan Mills-Da’Bell, Clinical Lead at XenZone.

Imagine a playground full of children. Now imagine a young girl trips up and grazes her knee. Not an untypical scene, perhaps. The girl might cry. She will probably be looked after by her friends; a teacher might cuddle and reassure her until she feels better.

If that child was male, however, it wouldn’t be surprising to see him being cajoled back up, told to be brave and sent on his way.

Of course, this is a generalisation. And the differences in how boys and girls are treated may seem insignificant.

Toxic messages

I would argue though that it’s messages just like these that are contributing to a restrictive idea of what is it to be male: boys and men should be tough; they don’t express their feelings; above all, they don’t deal in emotions. Think of any male superhero and what their characters consistently convey about being male.

It’s the culmination of hundreds of similar messages we’re feeding young boys which has created a crisis in men’s mental health, essentially teaching boys to shut off from their feelings. 
Boys get so many toxic messages that they often grow up thinking it’s okay to be angry, it’s okay to play with aggressive toys. But it’s not okay to cry. It’s not okay to be sad. It’s not acceptable to play with a doll and look after that doll.

Immediately boys learn that their role is not to be nurturing or caring.

In not being given ‘permission’ to access emotions, boys are not benefitting from the same experience as girls. They don’t have the opportunity to learn how to manage their emotions. This can leave them completely at sea in adult life when they might be in serious need of those ‘emotional management’ skills.

In the many therapy sessions I’ve run with young boys, it’s clear that they are perfectly able to express themselves and to talk about their feelings. But it can take a long time to build the trust necessary for this to happen.

It’s easy to see that their most accessible emotion is anger. It’s not uncommon to see this rise to the surface as they start to open up during counselling. For boys – unlike sadness or fear for example – anger is an acceptable emotion. It’s an emotion that males can show and which society is not surprised to see. As males typically bottle up their feelings, sometimes that anger will explode.

It’s only when we start to unpick this emotion and understand where it's coming from, that we see it’s often a cover for something very different: loneliness, grief, sadness, or fear.
It’s not that girls and boys are dealing with different issues. Largely speaking, they have the same worries: boyfriends, girlfriends, friendships and family relationships, along with depression and anxiety. It’s how they are dealing with them that is so starkly different.

One of the issues boys seem to deal with a lot more than girls though is suicide ideation. Suicidal thoughts are a lot more prevalent in boys than in girls.

This is reflected in suicide rates today. Suicide is the single biggest killer of men under 45 in the UK, and the biggest killer of young people. Around three-quarters of suicides are male, and this truth is something that isn’t addressed in any meaningful way.

For me, the early emotional shut-down of boys can translate to an inability to manage or process complex emotions, becoming more and more intense and overwhelming, to a point where suicide can feel like the only option.

Accessing therapy

Unsurprisingly for males unused to expressing themselves and who may not have had the opportunity to open up, therapy can feel like a very alien process. Generally, girls are more ready to talk and have a broader emotional vocabulary.

With boys, it’s necessary in therapy to focus on building a solid foundation and working on the relationship you have with a boy or group of boys. They need a lot more time and a lot more engagement in a relationship to feel safe and trusting enough to sit in a room and start to unpick where their really explosive or difficult emotions are coming from. They need a very specific and flexible kind of approach.

Early intervention

The majority of my work is with children and young people. Offering this early help is essential. Male suicide rates tell me that early interventions for boys are becoming more of a necessity. 
As well as providing services better suited to boys and men, I think we need to revisit that scene in the playground and question where our assumptions about gender come from. In particular, I think we need a really big cultural or societal shift in terms of the messages we give boys about what and how they should or shouldn’t be.

My therapeutic work with boys gives me hope this can happen. Boys do, over time, understand they can talk about what it’s like to be a boy. In group therapy sessions, we end up talking about the most difficult and sensitive subjects. I wouldn’t dream of coming with an agenda, but they will end up talking as a group about everything from their own suicidal thoughts to past traumas and current anxieties. One boy’s thoughts will trigger another’s and they find they have a shared experience, whether of suicide ideation, loneliness, loss or bereavement.

Continuing to give them a safe space to do that is crucial and powerful. And as a therapist, I feel incredibly inspired and privileged to be part of that process.

See a video interview with Dan on male mental health, covering differences in how boys and girls manage their emotions and how boys in particular can be better supported.

Are there gender differences in the way boys and girls experience mental health? from XenZone on Vimeo.

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