On the surface, Rajesh (42) and Roma (39) Sharma (names changed on request) are the typical upper middle-class couple, except with marital issues. They approached clinical psychologist Dr Seema Hingorrany who advised them to opt for individual sessions.
Counselling indicated that their unresolved childhood issues and conflicts had affected their marriage. When Hingorrany suggested therapy, the wife agreed readily, but the husband dropped out and yet urged his wife to opt for it. After noticing the changes in his wife, he decided to rejoin therapy, almost a year after dropping out.
Says Hingorrany, “Male patients are often poor expressers of emotions and are scared of diagnosis. At times, men feel that their wives need such sessions and not them. It’s a very India-centric problem and probably, due to the mental conditioning from childhood. While five years ago the ratio of women to men attending my sessions were 40:10, it stands at 150: 75 now, and this is due to greater awareness and the fact that its not considered a weakness to open up about the trauma.”
She adds that a lot of her male clients are hesitant initially to give out personal details when they visit her and consider counselling as a last resort. She also refutes the common myth that males prefer a male counsellor: “In the first place, there are few male counsellors in India. Secondly, male patients perceive female counsellors as nurturers and mother-sister figures and they are gradually able to open up to them,” she reasons.
Psychiatrist Dr Yusuf Matcheswalla, professor of Psychology, Grant Medical College, feels that issues related to counselling cut across gender. “If a person is neurotic or psychotic, they lose touch with reality and are not immediately ready to accept that they need help.” He admits that he gets more male than female patients but attributes it to his area of expertise such as addiction and sexual issues. “Women connect and emote better while men tend to bottle up their feelings, which leads to breakdowns, crimes, alcoholism and suicides. Some of the indicators that people should watch out for are sleep disorders, mood changes, emotional disturbances, gain or loss of weight, change in appetite and forgetfulness,” he adds.
Bridge the gender gap
Ameeta Sanghavi Shah, Integrated Wellness / Marital therapist and psychotherapist has been counselling couples for over two decades. “These days, men and women are ready to talk as they realise the value of counselling and are more open-minded. While six years ago I only had a handful of males come by, today they make up 40% of the client base; the gap is closing up,” she observes.
Shah adds that in earlier days, men were more task-oriented while women were more emotion-oriented based on their occupation. “But times have changed and in a relationship nowadays, there is a switch in roles at times, so that if one person is task-oriented it triggers the other person to become more emotion-oriented. Thus, the gap is bridged. In my practice, I prefer to leave aside gender issues and focus on each person as a unique individual with specific issues,” explains Shah.
Clinical Psychologist and Psychotherapist Susan Walker, who studied in London but first worked as a psychotherapist in Mumbai, towards the end of the 1990s, and recently restarted her practice in the city, offers a global perspective: “There is definitely a difference in attitude. Things are gradually changing abroad, with people being much more willing to see counselling and therapy as a solution. Men, however, are still less likely to seek psychological solutions than women, largely due to societal pressures on males to solve their own problems, and to not ask for help, which is seen as a weakness and thus shameful, and also because they are less willing to engage in a process that deals with feelings which are seen as being in the female domain.”
Resist no more
Walker describes the resistance of men to therapy to lead to the Octopus / Turtle Syndrome, where the man starts to feel overwhelmed by his partner’s need for attention and retreats into his shell, leaving his partner trying to make a connection. “This can lead to significant problems in communication where both partners tend to become defensive. Thus the problems intensify until an impasse is reached, and one partner ‘exits’ the relationship, perhaps with an affair or an addiction.”
To break the ice and start counselling on a positive note, psychotherapist and trauma therapist, Hvovi Bhagwagar, gives her patients a handout with Frequently Asked Questions (FAQs) about counselling. It addresses concerns that people may have about counselling being expensive, only for the “mad” patients, the confidentiality levels and their relationship with their counsellors (Can my therapist be my friend? MiDDAY carried a connecting feature on September 25, 2012).
Bhagwagar adds that her female to male patient ratio is 80:20 and admits that she has had male clients drop out. “Males feel they are strong and should be able to deal with any problem. They are more likely to keep problems to themselves and search for solutions from books or on the Internet. In Asian cultures, we believe in being stoic and handling problems on our own. I have several male dropouts in therapy because of the teasing or disapproval from family members about a ‘man needing therapy’. Similarly, several patients waited for years to attend therapy because they feared being looked down upon by their family,” she says.
All experts, however, advise patients to persist with therapy for long-term benefits. “Since we are residing in a country with the highest suicide rate (which is highest among males) it’s time we sat up and took notice about the declining mental health of our population,” observes Bhagwagar.
Susan Walker recounts the five years she worked in English prisons, where she helped men deal with addiction. “Many of these men grew up in the toughest of environments, learning in their early years that any kind of emotional vulnerability was mocked and abused. This had lead to them bottling up their feelings, and then having them explode as anger and rage, often at their wives and loved ones.”
She adds that many had turned to drugs or alcohol to further deaden their emotions. Working with them and helping them express themselves was a rewarding experience. “For these men, to experience that emotional intelligence is actually not a weakness but an incredible strength, was a revelation indeed, though for some it came too late,” she asserts.