Men are emotionally competent: considerations on group therapy with men

Celebrating men as fully human

Men are whole human beings, of course. Yet expressing this simple understanding disrupts what has become the common and dangerous narrative on male emotions, especially in South Africa, and particularly about Black males. The narrative is most aptly captured by the psychological term alexithymia – the inability to express emotions, especially tender ones (Parker, Taylor, & Bagby, 1998). Alexithymia does not mean that men do not experience all the human emotions, but simply that they do not give themselves the opportunity to express soft emotions like empathy, joy, sadness, and love. Disproportionate rates of male-driven violence perpetration and victimisation in South Africa (Ratele, 2014; Seedat, Van Niekerk, Jewkes, Suffla, & Ratele, 2009) co-exist with observations of human beings as ethically organised persons and as emotional to the core (Alcaro & Panksepp, 2017). The often-extreme brokenness of men’s group participants expressed in addictions, relational failures, identity issues, severe childhood trauma, and socio-economic frustrations or aggression does not erase men’s emotional character but rather draws attention to their imperfections as human beings.

When we genuinely trust and celebrate men as fully human we are able to therapeutically engage them as such and they are expected to respond accordingly. With amazing speed small groups of strangers from diverse social classes, ethnicities, cultures, and religions form cohesive bonds with each other, the group, and the group facilitator – as if samples drawn from preexisting corps of male alliances! Their sometimes lively post group banter extends into the parking lot of the venue. Under certain conditions, even some violent men stand to benefit from competently facilitated emotion-focused groups, because forming attachments and feelings of belonging are in themselves healing experiences.

Male vulnerability

Adult males can be as vulnerable as any group of human beings (Van Niekerk et al., 2015). I recall how the most recent five men group that concluded in December 2018 rapidly transformed into ‘group siblings’, establishing a brotherhood sanctuary of trust. Without fail, groups of men like this small group – as others before them – take advantage of the healing that becomes accessible through talking and sharing stories, breaking with the societal taboo against the expression of male vulnerability. Conventional male competitiveness is set aside in favour of the usually disavowed narratives of sorrow and unpleasant emotions (Reddin & Sonn, 2003).

To feel is to be human. To tell stories of joy, achievements, pain, and rejection is indeed to express what many Southern African cultures refer to as botho/ubuntu (Kamwangamalu, 1999). Moreover, for men to be enabled to express sympathy and offer support to each other and to women and children are some of the most basic and primal human responses. We heal when we allow ourselves to feel. Only when we touch our own pain, and relate to ourselves, can we extend humanity to others (Fosha, 2000; Greenberg & Pascual-Leone, 2006). Participants of these groups disclose sensitive information. They make themselves vulnerable through acknowledging fears, and insecurities, openly grieve losses, and reflect on hurts and inadequacies. They complete each other’s sentences in the course of risky personal revelations and during exchanges of heartbreaking emotional accounts.

Emotional work involves the processing of failure, anger, shame, and tragedy. As affirmed by some of the most thoughtful affective neuroscientists, central to grieving is to ‘be in’ the awful, painful, devastating, and despairing feelings that working through loss requires (Panksepp & Biven, 2012). Men can be supported to engage a range of feelings; however, time and space are of the essence (Keesing, 1974). The how of therapy matters significantly with men. Let me now briefly reflect on some of the ‘knowledge in practice’ of gender-conscious emotional work.

Centralising personhood, not a diagnosis

Long before the start of the group, referrals are screened and selected for ‘self-transformative will’, rather than diagnosis or labelling. The men’s group is composed of small groups of emotionally adventurous – for want of a better term – men who are invited to self-select to ‘work with their feelings’. They volunteer to endure the rigours of authentic and lasting personal transformation.

At the beginning of the group, the traditional therapeutic frame of clinical data gathering, diagnosis, and treatment is postponed to make way for the centralization of personhood. Entering the group as a human being is foregrounded through positive education about the socio-spiritual nature of people, that is, a dialogue about botho/ubuntu (Kamwangamalu, 1999). Their multidimensional but integrated and coherent personhood is highlighted, which redefines the group as a social space populated by culturally intelligent beings (Ratele, 2014). Ideas of what it means to be human in the different cultures represented in the group are drawn on to navigate the complexities of mental health challenges and support. The latter is especially pertinent to socio-economically disadvantaged men presenting with psychological symptoms with additional concerns of poverty, inequality, and social exclusion.

Men as moral beings

Men are moral beings. The men’s groups are located inside moral discourses (Cushman, 2002). From pre-group preparations to termination, the explicit mandate of these open-ended process groups is emotional risk-taking, preceded by contractual agreements on trust and psychological safety. Abiding by the rules, codes, and prohibitions secures membership, with explicit liability for positive transformation by going near the feelings usually avoided. Consistent with emotion-focused treatment modalities, participants are individually accountable to realise the purpose of the group, which is to activate, there and then, the transformative power of emotions (Fosha, 2000; Greenberg & Pascual-Leone, 2006).

The absence of women further reinforces male responsibility for emotional tasks like owning and enacting nurturance and caring activities inside the group (Van Wormer, 1989). From listening attentively, to reflecting feelings, to the collective containment and processing of in-session expressions of anguish and distress.

The peer-centred men’s group

I, the female group facilitator, surrender to the dispersed power hierarchy of men’s groups, staying close to the periphery, only approaching the centre to discharge technical and therapeutic functions (Ringer, 1999). Consequently, participant-healers are elevated as the true source of transformation of each other, transference objects that mirror and validate each other’s experiences (Garland, 2010). They understand much better the nuances of their shared stories than I sometimes can. They are also the first to notice and respond to strategies of deception or less-than-honest therapeutic engagement.

Explicit gender framework

And finally, during masculinised, male-friendly therapeutic encounters participant-healers are addressed as a unique culture. As a gender culture with its own worldviews and values, they are responded to in a gender-sensitive and gender-consistent manner. Their emotion regulation strategies and expressions of gendered subcultural norms are taken seriously. Frequent jokes and raucous verbal sparring are not uncommon as they harmonise the tensions that build up during powerful emotional work.

In closing, the award-winning Nigerian novelist, Chimamanda Ngozi, blessed us with the now famous TED Talk, ‘Danger of the single story’ (Adichie, 2009). Effective therapeutic engagement of men demands courage to expand therapeutic paradigms—a willingness to think, believe, value, anticipate, and therefore practice differently with boys and men (Haen, 2011). I am the grateful witness of men consenting to be taught and transformed through ‘sitting in’ distressing emotions, flanked by an intimate network of same-gender participant-healers. I recollect my professional isolation as I charted into unfamiliar therapeutic territory. It was the young, largely Nguni-speaking participant-healers of the men’s groups at a local university, who embraced the alternative offerings. Perhaps one day, many more of us will be listening to men, in addition to reporting about them. That is the day when larger numbers of male gender emotional geographies will support men to share and care for other men, and for themselves.