Monday, 31 December 2012

Social Model And Men's Help Seeking Behaviour


Why do some men find it difficult to get help? There are different theories on the matter, one of which is the social model which takes into account of the different contexts in which men’s help-seeking behaviour takes place.


The social model recognises that men's help-seeking behaviour isn't a fixed entity. The same man’s help-seeking behaviour will change in different settings, for example he may be happy to get help from his for a bad back but not talk to the same doctor about his depression.

From a social constructionist perspective, gender is something that is actively done in specific contexts rather than a fixed property of individuals. 

This thinking has some similarities with other perspectives such as feminist theory, the social model of disability and “The Surpising Power Of Social Networks”.

Addis and Mahalik, for example, “speculate that a feminist analysis of help-seeking….might highlight the way men benefit as a group by avoiding and discouraging help seeking (eg., maintaining positions of dominance by hiding apparent weaknesses)”.

The social model of disability identifies systemic barriers, negative attitudes and exclusion by society (purposely or inadvertently) that together create a context that disables people. The argument is made that an individual’s disability need not be disabling if society takes account of the disability and adjusts to include people irrespective of their differences. It can be argued that a failure to adjust our systems and beliefs to create a context that includes and helps men more effectively, contributes to men’s lower levels of help-seeking.

Another powerful perspective on the role of context is the work of James Fowler and Nicholas Christakis, authors of Connected: The Surprising Power of Our Social Networks and How They Shape Our Lives (2009).

Fowler and Christakis put forward a their “Three Degrees of Influence” rule about human behavior, which asserts that our individual social influence stretches three degrees before it fades out.

This builds on Christakis’ earlier research which showed that obesity can spread through social networks like a virus. He went on to show that other health states and behaviors, including smoking, drinking and happiness were also passed from person to person through social networks with individuals influencing (and being influence by) their friends’ behaviour by up to three degrees (ie influencing a friend of a friend of a friend).

It is possible that men’s ability to seek help (or not) on particular issues will be influenced by the norms of their social networks. 

Encouraging Help-Seeking Behaviour Among Young Men by Youth Justice in Glasgow considers the hypothesis that men seek help less because they lack the necessary social support networks within which to seek help.

“The lack of appropriate social support is a pertinent issue for vulnerable young males, as was identified in the recent literature review (Vaswani, 2011). The theory is that appropriate social support networks facilitate help-seeking by providing positive role-models and are sources of support, encouragement, advice and help (Rickwood et al, 2005; Barker, 2007).”

Thus social support has been found to significantly affect a variety of mental health and academic outcomes during adolescence (Wentzel 1998, cited in Colarossi, 2001). For example, social support has been found to be a protective factor in preventing suicide in young males (Mishara, 2005, cited in Centre for Suicide Prevention, 2007); safer sexual behaviour; lower substance use; delayed sexual activity; and reduced offending and violence (WHO & UNICEF 2000, cited in Barker, 2001).

“However inappropriate social support networks can provide the opposite effect, with teenagers experiencing emotional or behavioural difficulties often forming relationships with, and therefore seeking help from, young people experiencing similar issues (Farrand et al, 2007).

“Males are frequently found to lack positive social support networks. A survey by Deviron & Babb (2005) for the Office for National Statistics found that respondents with large social networks were 2.5 times more likely to be female. However the same study also found educational attainment and employment status also increased the size of the support network among males and females.

“In a study of male offenders Howerton et al (2007) found that an absence of stable and supportive relationships contributed to reduced help-seeking upon release. Research suggests that girls are more likely to use social support systems as a source of help than boys, who are more likely to try to manage on their own (Barker, 2007).

“The reasons behind the gender differences in social support systems can potentially be linked to emotional competence. It appears that girls replace familial support with support from their peers and increase their intention to seek help from professional sources, whereas boys are less likely to create a supportive friendship network and are reluctant to seek professional help due, in part, to lower levels of emotional competence, thereby not filling the role that the family once had.”

Taking context into account and considering a person-situation analysis provides a better understanding of men’s help-seeking behaviour and is still limited to considering specific situations like the type of problem, the type of help available and how serious and urgent the man sees the problem as being.


To read more more about different theories on men's help-seeking behaviour see our post: Understanding Why "Men Don't Get Help".

Men's Help-Seeking Behaviour - An Integral Perspective


NOTE: This Think Piece Was Written In December 2012 and some minor aspects are under review. Please consider this a guide to emergent thinking (rather than a definitive finalized theory!)

Why do some men find it difficult to get help? There are different theories that can help us understand gender, one of which is Integral Theory.

The integral approach to understanding and analyzing gender is an emerging perspective that is based in Integral Theory, different aspects of which are increasingly being applied in work with men and boys. More broadly, the theory has been applied in a variety of areas including art, ecology, economics, politics, psychology, spirituality, leadership and organizational development. 

An example of Integral Theory being applied to understanding gender is Learning From the Unfathomable by Anders Behring Breivik by Pelle Billing and Kristian StÃ¥lne  in which the authors consider the ways that gender identity and gender politics were at play in the terrorist murder of 77 people in Norway in July 2011.

There are two models often used in integral thinking that may be useful in understanding men’s help-seeking behaviour. They are the Spiral Dynamics model for value systems (based on the work of Clare W. Graves) which was further developed by Beck and Cowan and Ken Wilber’s AQAL (All Quadrants All Levels) model.

Starting with Spiral Dynamics, Graves asserted that human values typically occur in systems called value memes, which are coherent sets or clusters of values. These values are a consequence of an individual’s worldview – including their views about money, problem solving, seeking help etc.

Graves identified eight different value systems that describe how humans as well as cultures evolve. Most cultures and individuals will be predominantly characterized by just one of these eight value memes, though more than one can be at play in any individual or any community.

To get a sense of how these different value memes might relate to gender, money and help seeking behaviour we will look at four of the eight memes listed below. Each meme in the Spiral Dynamics has a name and colour which are listed below.

Meme
Colour
Characterisitcs
Wholeview
Turquoise
Holistic, global concerns, collective individualism
Flexflow
Yellow
Independent, self-sufficient, functional, knowing, has personal value system
HumanBond
Green
Collaborative, community-focused, concerned for the ‘have nots’ 
StriveDrive
Orange
Goal orientated, success driven, out to achieve
TruthForce
Blue
Absolutist, conformist, follow rules, obey higher power
PowerGods
Red
Egocentric, exploitative, dominating, seeking power, survival of the fittest
KinSpirits
Purple
Living according to tradition and ritual
SurvivalSense
Beige
Living in self survival mode

One area where this model  has been applied to try and understand men's help-seeking behaviour was in UK research into victims of loan sharks, which found that female victims were considerably more likely to access help and support and come forward as witnesses.

In looking at of how these values might be act as a motivator for men to get help the researchers made the following observations in terms of the blue, orange and green meme: 


  • Blue Meme male victims may be motivated to get help the Loan Shark is morally and legally 'wrong' and transgressors should be punished
  •  Orange Meme male victims may consider that Loan Sharks are bad for the economy and be motivated by the goal-orientated calls to 'beat the loan sharks'
  • Green Meme male victims may be motivated by the notion of protecting and supporting the 'have nots' 
In terms of the male victims of Loan Sharks the researchers observed that many male victims seemed to be operating at the level of Red Meme values.

Red Meme is about ego and empire and is seen historically in times of ancient empires and contemporaneously in rogue states and dictators. Those embodying Red Meme values are generally driven by a need to express themselves impulsively, to break free, to be strong. In child development this meme is at play during the ‘terrible twos’ and culturally we see this meme expressed through rebellious youths and gang culture.

In the Red Meme value system individuals are concerned with power and action and asserting themselves to gain dominance and control of others. In terms of gender, these values would link with rigid ideas of masculinity and what a man ‘should’ be, ie strong, independent, powerful etc.

Seeking help is not a common characteristic of the Red Meme value system whereas taking action to resolve the problem yourself without any outside help would be. This value system is often at play in local communities where there is deep mistrust of authority, which can make it even harder for men to get in these communities to get help from official sources. 

In the Blue Meme value system there is more of a collective mentality usually ordered around an agreed ‘truth’ such as religion. There is an acceptance of obedience to a higher authority (often guilt driven), a focus on conforming and following rules and a reliance on structure and authority.

Blue Meme gender values would tend to be traditional with ideal masculine qualities including being reliable, structured, authoritative and moral. In terms of help-seeking, it is part of the value system to seek help from a higher authority – God, the police, a doctor - however, where a man has transgressed a moral boundary, guilt and shame may be a big barrier to getting help.

A male Loan Shark victim with Blue Meme value, for example, is likely to feel guilty and blame himself, but also be motivated to ‘do the right thing’ and make sure that the shark is caught by the authorities and held to account for his wrongdoing.

In the Orange Meme value system there is drive to grow, develop, prosper, better one’s self and improve life conditions for others. The focus is on goals, achievement, success, status and image.  Consumerism and materialism are key manifestations of the Orange Meme.

From a gender perspective, ideal masculine qualities in the Orange Meme could include success and status. Getting help - particularly help that you pay for in pursuit of your goals or to maintain your lifestyle  – is common. Getting help with problems that don’t have a clear solution or suggest a lack of status or success may be more in conflict with the Orange Meme value system (eg trying to deal with a large debt).

The Green Meme value system is egalitarian and concerned with human needs, particularly the needs of the ‘have nots’. There is a focus on community, feelings, inclusion, understanding and working together for mutual benefit.

From a gender perspective, Green Meme can tend to relate to men as being in the ‘have’ category and consider ‘traditional masculine values’ as the cause of the world’s problems. Although Green Meme values promote inclusion, those who seek to embody these values can end up excluding men.

In terms of help-seeking behaviour, the authentic sharing of personal problems is encouraged within the Green Meme and so a man with this value system should be better equipped to access help.

However, culturally the Green Meme can struggle with the concept of men as victims and can have difficulty accepting and understanding the positive aspects of other value memes which may be part of the reason that help-giving services, which tend to have Green Meme values, can find it harder to engage with men.

Moving on from Spiral Dynamics and value systems, another model used in integral thinking is the AQAL (All Quadrants All Levels) model which provides a holistic framework for assessing any object or subject.

Using this model – which comprises four quadrants –helps us to consider the personal, cultural and systemic barriers which may be playing a role in preventing more men getting help.

One insight that using this model reveals is that when we map the answers generally given to the question ‘why are men less likely to get help’, most of the answers fall in the upper left quadrant – which relates to an individual’s intention. The answers provided about why men are less likely to get help tend to focus on ‘male pride’ and men’s intention to protect their ‘fragile male ego’.

The AQAL model helps us take a much wider perspective on any issue such as men’s help-seeking behaviour.

Upper Left: Interior Individual
Upper Right: Exterior Individual
I / INTENTIONAL

The subjective experience of individuals
IT / BEHAVIOURAL

The data  - the tangible, measurable, verifiable facts of the matter


Our shared social and cultural experiences, values and beliefs

WE / CULTURAL

The things that are happening collectively at a systemic level

ITS / SYSTEMIC
Lower Left: Interior Collective
Lower Right: Exterior Collective

The model below shows some of the insights that begin to emerge when applying this model to men’s help-seeking behaviour. It’s important to note that the subjective view of the author (upper left quadrant) is at play here:

Upper Left: Interior Individual
Upper Right: Exterior Individual
I / INTENTIONAL

Men may not access help for a variety of reasons including fear of admitting weakness, fear of the consequences, desire to work it out themselves, not feeling worthy of help

Help-giving professionals may have beliefs about men that act as barriers  - eg men don’t have problems, men don’t deserve help, men should be strong. This may create a learned sense of helplessness amongst professionals and contribute to a self-fulfilling prophesy that ‘men don’t get help’

IT / BEHAVIOURAL

When we look at men’s help-seeking behaviours by measuring the ratio of men and women accessing helping services in areas like health, social care and community safety we find over and over that men are disproportionately less likely to access help. The data on male victims of loan sharks suggests men are around three times less likely to access help from support services. 

Some of the cultural barriers to men getting help could be lack of positive gender discourse about men, difficulty identifying men as ‘victims’ or needing help, female dominated referral services, a lack of social projects involving and working with men, male social conditioning, negative attitudes about men, unhelpful local male cultures


WE/CULTURAL

Some systemic barriers include opening hours and locations that are more female inclusive, international, national and local strategies that focus on women but not men, financial systems that favour women (eg financial support for separated parents which can disadvantage the non-resident parent (usually dad) and his/her children.

ITS / SYSTEMIC
Lower Left: Interior Collective
Lower Right: Exterior Collective


To read more more about different theories on men's help-seeking behaviour see our post: Understanding Why "Men Don't Get Help".

Sunday, 23 December 2012

Five Ways #2: Understanding Why “Men Don’t Get Help”


A Jewish comedian once observed that the reason that Moses and the Israelites wandered in the wilderness for 40 years was that none of the men would ask for directions.

The joke works because it reflects a cultural meme, than men don’t ask for help because of ‘male pride’ and ‘fragile male egos’ – and just like jokes about the Irish being stupid and women being bad drivers, it as joke based on a universal stereotype not a universal truth.

When considering why men in general are less likely to access a service it can be useful to consider some of the most popular approaches used to analyze and understand sex and gender.

Some of the many different approaches to understanding gender include:
  • Sex differences
  • Gender Role Theory
  • The Social Model
  • The Psycho-Social Model
  • Integral Gender Theory

One of the most useful texts on the subject is “Men Masculinity And The Contexts Of Help Seeking” by Addis and Mahalik, who consider the merits of the sex-differences approach, gender role theory and social conditioning before proposing their own psycho-social model. 

Below we provide a short overview of each of these five approaches with links to a more detailed overview of each approach.

1. Sex Differences

In very simple terms the sex-differences approach takes the essential view that men and women are biologically different which is why they get different outcomes.
A sex-differences view of help-seeking behaviour would consider help-seeking to be a staged process whereby an individual experiences feelings of concern, translates those feelings into a conscious recognition that help is needed and then take action to get help.

For example, a survey on in Sex Differences in Psychiatric Help-Seeking found that “women translate non-specific feelings of distress into a conscious recognition that they have an emotional problem more readily than men do” an concluded that “between 10% and 28% of the excess female psychiatric morbidity measured in treatment statistics could be due to this sex difference in problem recognition.”

The psychologist Simon Baron-Cohen, a leading voice on the essential differences between male and female brains, champions the benefits of the sex-differences approach with a dose of caution. He says:
“My own position is that biology and culture interact to create this sex difference. There are some people who would argue that its just biology or just culture but I think the moderate position is both are at work it’s very easy to make sweeping statements about groups of people, including the two sexes, which could easily become forms of discrimination or generalizations which simply don’t apply.”

To find out more read our post Is Men's Help Seeking Behaviour A Question Of Sex

2. Gender Role Theory

One alternative to the sex difference approach is to understand men’s help seeking as a product of masculine gender-role socialization, an approach which makes the assumption that our gender is conditioned by our environment - our parents, our communities, our culture etc.

These types of findings support the Gender Role Theory. According to the Magnus Hirschfield Archive For Sexology, children learn at an early age to identify themselves as being male or female. At the same time, they also learn to behave in a way that is considered typical of males or females. In short, they learn to adopt a masculine or feminine gender role.

According to the report Encouraging Help-Seeking Behaviour Among Young Men the gender differences in help-seeking begin to emerge between the ages of three and five and are well-established by middle childhood.

According to Addis and Mahalik there “are theoretical and methodological strengths to the masculine role socialization approach, not least because it accounts for differences between different men whose “help-seeking behaviour is predicted to be a function of different men’s degree of endorsement of particular masculine gender-role norms that are incongruent with seeking professional help”.

To find out more see our post on Gender Role Theory - Is Men's Help-Seeking Behaviour Conditioned?

3. The Social Model

What’s missing from the Gender Theory approach is it doesn’t take account of the different contexts in which men’s help-seeking behaviour takes place.

The same man’s help-seeking behaviour will change in different settings, for example he may be happy to get help from his for a bad back but not talk to the same doctor about his depression.

From a social constructionist perspective, gender is something that is actively done in specific contexts rather than a fixed property of individuals. 

This thinking has some similarities with other perspectives such as feminist theory, hegemonic masculinity, the social model of disability and “The Surpising Power Of Social Networks

It is possible that men’s ability to seek help (or not) on particular issues will be influenced by the norms of their social networks or the social situations they engage with.

The Encouraging Help-Seeking Behaviour Among Young Men report highlights the hypothesis that men seek help less because they lack the necessary social support networks within which to seek help.

Taking context into account and considering a person-situation analysis provides a better understanding of men’s help-seeking behaviour and is still limited to considering specific situations like the type of problem, the type of help available and how serious and urgent the man sees the problem as being.

To find out more about read our post on the Social Model And Men's Help-Seeking Behaviour

4. The Psycho-Social Model

Returning specifically to men’s help-seeking behaviour, Addis and Mahalik suggest a psycho-social model of understanding men’s help-seeking behaviour in a variety of situations perspectives which considers:

The psycho-social model considers there are at least five key factors at play that will help or hinder men from getting help
  • Social norms: is the problem I am experiencing socially accepted?
  •  Ego centrality: is the problem a central part of me?
  • Reciprocation: will I have the opportunity to help others?
  • Social network: how will others react if I seek help?
  • Perceived loss of control: what can I lose if I ask for help?
Using this model, suggests that an individual man is more likely to get help with a specific problem if:
  • He feels that dealing with this problem is a normal thing for a man to do
  • He feels that the act of getting help is aligned to his own values
  • He feels that getting help is in some way a contribution or help to others – for example getting help with problem debt for the sake of his family
  • He feels that his family and friends will be supportive of him seeking help
  • He feels that he has more to gain than he has to lose by getting help
This provides a much broader perspective of the barriers men face to seeking help and one of the notable aspects that’s missing from this model is a consideration of systemic and strategic barriers that can be more readily uncovered using an Integral Model.

5. Integral Gender Theory

The integral approach to understanding and analyzing gender is an emerging perspective that is based in Integral Theory, different aspects of which are increasingly being applied in work with men and boys.

There are two models often used in integral thinking that may be useful in understanding men’s help-seeking behaviour. They are the Spiral Dynamics model for value systems and the AQAL (All Quadrants All Levels) model which provides a holistic framework for assessing any object or subject.

The model below shows some of the insights that begin to emerge when applying this model to men’s help-seeking behaviour.

Upper Left: Interior Individual
Upper Right: Exterior Individual
I / INTENTIONAL

Men may not access help for a variety of reasons including fear of admitting weakness, fear of the consequences, desire to work it out themselves, not feeling worthy of help

IT / BEHAVIOURAL

When we look at men’s help-seeking behaviours by measuring the ratio of men and women accessing helping services in areas like health, social care and community safety we find over and over that men are disproportionately less likely to access help.

Some of the cultural barriers to men getting help could be lack of positive gender discourse about men, difficulty identifying men as ‘victims’ or needing help, female dominated referral services, a lack of social projects involving and working with men, male social conditioning, negative attitudes about men, unhelpful local male cultures


WE/CULTURAL

Some systemic barriers include help-giving services with opening hours and locations that are more female inclusive; international, national and local strategies that focus on women but not men; financial systems that favour women (eg financial support for separated parents which can disadvantage the non-resident parent (usually dad) and his/her children.

ITS / SYSTEMIC
Lower Left: Interior Collective
Lower Right: Exterior Collective

To read a fuller integral analysis of men's help-seeking behaviour seek our post: Men's Help-Seeking Behaviour - An Integral Analysis

In reviewing the many different approaches to assessing men’s help-seeking behaviour one thing is absolutely clear – there isn’t one singular answer to the question ‘why are men less likely to get help’.

What’s also clear is that a man’s ability to get help is not simply a question of him having the right help-seeking skills. There are a host of systemic, cultural and situational factors also at play and anyone concerned with helping more men to get help will have greater success in adapting men’s help-seeking behaviour by considering how to shift the systemic, cultural and situational context they are operating in first.