Dan Griffin believes that addiction treatments will be more effective when we treat men as men.
How much can really be done to improve men’s treatment for addiction? The myth is that men have a hard time engaging in treatment. The truth is that we have a hard time truly engaging men in treatment – meeting them where they are at, speaking to them in their language, and listening to everything they don’t – and cannot – say. The field of addiction treatment has not spent a lot of time creating a true framework for treatment that speaks to men’s unique issues and needs – treatment for men, created by men, with men in mind.
For years now there has been an expectation that addiction counselors need specialized training to work most effectively with women. Despite the fact that 70% of the people going through treatment are men and 70% of the people working in treatment are women, there has never been any such expectation when it comes to men’s treatment and working with men. Until now.
Here are five critical elements for making men’s treatment services more effective:
1. Men’s Socialization Should Be the Context. Given how contrary being in recovery is to “The Rules of Being a Man” that dichotomy and the tension between the two should be a constant context for the conversations we have with men. When we embed this awareness throughout the treatment experience we give men a language for talking about the dissonance they are often experiencing without making it about them. There is nothing wrong with them – they are simply trying to rectify how they have spent their whole lives trying to be certain kinds of men and a core part of who they think they are with the expectations of being in recovery that can often feel quite “unmanly.”
How many men are constantly fighting against the stranglehold that The Rules have over them as they attempt to apply the principles of recovery to their lives? Just look at some men in the recovery community with five, ten, fifteen or more years of sobriety who struggle to be close to someone, share what is really going on with them, struggle with violence and abusiveness, and/or are paralyzed by codependent behaviors? Guaranteed, The Rules are at the heart of so much of this suffering.
Finally, look at any man’s relapse and we guarantee that a major factor was one or multiple Rules that kept him isolated and disconnected from himself and others. When you talk to a man about his relapse in the context of The Rules you help to take away the shame and any belief the man may have about being unable to achieve sobriety because of who he is.
2. Safety First. You need to be focused on safety because the men will not likely talk about it but it is on their minds, in their gut. No matter how a man acts when he first comes into your treatment program – apathetic, belligerent, sarcastic, or overly enthusiastic – you should be thinking in terms of safety. If you were to do this then everything would change. The lens through which you view his behavior would lead you to respond to him differently. Your environment could not help but change as everyone, including staff, in the organization would begin to feel safer. This is a critical element in becoming trauma-informed when providing men’s treatment.
3. Small Groups. If you want men to open up, put them in small groups. And we mean small groups, as in breaking the men out into sets of threes. The effect is transformative. Men who normally would fly under the radar or simply present as though they are less emotionally engaged will show up in a completely different way. The number three is important – two is too easily turned into a conversation and four can split into twos or even lose someone. But three, well there is something almost magical about it.
4. Let’s Talk About Sex. Let’s not just talk about sex but talk about sexuality – the whole thing. What percentage of men’s relapses are directly related to sex? Close to, if not 100%! Not feeling comfortable with engaging in sex while sober, fear of sex, discomfort with themselves sexually, pain from sexual trauma, body image, and many others. Let’s not even talk about men’s use of pornography while they are in treatment programs – let alone once they get out. Let’s definitely not talk about the unhealthy use of porn amongst all of the male counselors out there working with men! Add to that our growing awareness of sex and love addiction and its impact on men and all of our relationships.
Therefore, the real question is: How can we not put a major focus on helping men develop a healthy sense of their sexuality? That is a primary question that everyone who works with men’s treatment services should be asking themselves.
5. Homophobia. How many men’s treatment programs incorporate homophobia into their treatment regimen? Very few. Of course, an addiction counselor can’t simply say to men, “Okay guys, let’s talk about homophobia.” It’s more complicated and requires a high degree of finesse. When we talk about homophobia it goes far beyond a fear or hatred of homosexuals, especially gay men – for us it means men’s fear of men – our fear of getting close to other men and having any kind of intimate connection with them.
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If these five elements become incorporated in men’s treatment plans, you will see marked differences – if not a complete transformation – in how men respond to their treatment experience and how effective clinicians feel working with men.
You are quite right, we started a Peer-to Peer relapse group because we saw that the men needed a venue to share where they knew that nothing would go into note’s and they would be able to share with out worry that the Counselor’s would mistake some thing they mentioned and be questioned. Sex is a hugh unspoken issue that many men are uncomfortable speaking about there is a lot of shame involved and many of the men do not know how to show love and intimacy with a woman not being on a substance. They are ashamed that they… Read more »
not scientific- but I’d say the # 1 cause is the inability to admit one is just a garden variety drunk/junkie
#2- hanging out with the same old crowd, which sometimes includes the person with whom they’ve been getting it wet
#3- not believing in a higher power…
I’m not trying to be a ball-buster here- sex has rarely come up as a cause for relapse in my experience,
yeah every guy worries about tipping over the first time he dances with a woman, without the counterbalance of a longneck….
Seldom have we seen…..
I hear ya. If you were to start asking guys directly about sex you will likely hear some amazing things – whether they are the source of relapse or not.
It become a source of relapse because they seek out the only kind of woman they know other substance Abusers. I being with veterans have alway’s been amazed at how often it is a cause of relapse. These men want what all Humans need companionship, Love, caring The problem is they have never had a healthy relationship and therefore they return to what they know. i think the reason many who have commented on this site and say they are not aware of this problem makes your overriding point “Men do not share”. It is an embaresment to them that… Read more »
Not scientific but A lot of relapse is connected to sex. Non-scientific polls taken with counselors all over the country from my trainings indicate a very high agreement. But at the end of the day, sure, it’s because they picked up but it’s never that simple.
Not scientific but inability to have sex sober, unaddressed sexual abuse or orientation issues, separating sex from intimacy, feeling comfortable sexually, etc. A lot if it. A lot of relapse is connected to sex. Non-scientific polls taken with counselors all over the country from my trainings indicate a very high agreement. But at the end of the day, sure, it’s because they picked up but it’s never that simple.
J.A – sex and relationships seems to be the number one factor. Not scientific but inability to have sex sober, unaddressed sexual abuse or orientation issues, separating sex from intimacy, feeling comfortable sexually, etc. A lot if it. A lot of relapse is connected to sex. Non-scientific polls taken with counselors all over the country from my trainings indicate a very high agreement. But at the end of the day, sure, it’s because they picked up but it’s never that simple.
Not to be trolly – where do you come up with- close to 100% of men’s relapses are directly related to sex?
Is there something more to that correlation than “biological imperative?
The only sure thing I’ve noticed about guys picking up in the past 27 yrs is everyone of them picked up.