Case Study, Men Helping Men: Using Men's Groups to Enhance Couples Therapy
Garfield, Robert, Psychotherapy Networker
Men Helping Men
Using men's groups to enhance couples therapy
By Robert Garfield
My best friend, Jake Kriger, and I have been running therapeutic men's groups--we call them "friendship labs"--for the past 18 years. While everyone believes that emotional intimacy is important in relationships, men often struggle with certain skills--like emotional expressiveness, self-disclosure, vulnerability, giving and getting support, letting go of control, cooperation, and reciprocity--that are at odds with our cultural definitions of successful masculinity . Psychotherapy has developed clever methods to persuade men to adopt the more open and expressive habits, but many guys entering therapy still feel as though they're walking into a lion's den of shame, humiliation, and failure if they acquire them--specifically, failure as men.
We've found that groups are particularly appealing for men who experience traditional individual or couples approaches as being too alien or off-putting. There's something comforting about being part of a group of guys dealing with similar issues, who are there to ask for and give support to each other.
Because our groups are therapeutically oriented, rather than simply supportive or educational, men can develop the emotional skills with each other similar to those learned in therapy. We emphasize that emotional intimacy skills aren't just for women--they're a central part of healthy masculinity, and as the men in our groups discover, they take work to develop.
Men in our groups often lament the superficiality of their friendships with other men. We've found that fostering intimate male relationships can greatly help men better care for themselves and connect with each other, while deepening their relationships with their partners and children. We don't expect that all our guys will become best friends, but we do expect them to learn ways to deepen relationships with each other. Most of them do come to care for one another. Our friendship labs are particularly helpful because we collaborate with therapists who are seeing our men individually or in couples therapy.
Jack and Caroline
Jack and Caroline had been in couples therapy for only a few months when their therapist, Rhonda, a colleague and friend of mine, noticed that his interest appeared to be flagging. He seemed sincere, but continued to zone out when Caroline asked him to attend to her emotional needs. He'd shake his head affirmatively, but nothing seemed to be getting through. When they tried to speak at home, Jack would drink, argue, and withdraw.
Jack was 44 and Caroline was 42 with two daughters, ages 7 and 9. Money was a focal point for this couple. Jack was a successful banker, but would become impatient when Caroline would press him for details about their finances. During Caroline's childhood, her father had periodically gambled away the family's money, and she and her mother had been left to fend off the bill collectors. The thought of financial instability caused Caroline major anxiety.
Close inquiry revealed that the couple was, in fact, on good financial footing; however, none of this explained Jack's dismissiveness or his aggravation in response to Caroline's distress whenever they discussed money. He seemed to revel in her upset mood while stonewalling her around financial details, arguing and then leaving the scene in a huff. Rhonda admitted she was "pulling her hair out" trying to get Jack to feel the slightest bit of empathy for Caroline. In a private session, she asked him if he was having an affair. His puzzled and hurt response convinced her that he wasn't.
Jack was the oldest of three children. When he was 10, his father had left his mother for a younger woman. After this, Jack felt that he'd become the scapegoat for his parents' divorce. His mother became increasingly critical and, according to Jack, "never failed to compare me negatively to my father." For a while, he'd tried to be a model son, accommodating his mother in whatever way he could, but eventually he realized this wasn't productive. Listening to his description of these years with his mother, Rhonda said it seemed like he was "sitting on a pot of pain." His father had dropped out of his life, providing financial support but not much else, and later moved to another community with his new wife. Over the years, Jack's relationship with his father had improved, but their meetings were infrequent.
After a few months of getting nowhere with Jack, Rhonda, called me and said, "Do I have a guy for your men's group!"
Meeting to Decide
"Rhonda thought I might like your group and that it might help our couples therapy," Jack said, when he came in for his screening evaluation. "I have an easier time with guys," he admitted. "With Caroline, I just don't know. I get so angry with her. It's irrational. She just pisses me off when she presses me about money."
Jack seemed affable and easy to connect with on the surface. When men feel shamed, however, they can become irascible and even violent, so we always carefully question how anger and frustration get expressed at home with the partner and children.
"If you mean, do I hit her or get physical? No, no! I cuss sometimes, but mostly I argue with her and then withdraw." He didn't seem to be taking much pleasure in describing this scenario.
In eliciting these kinds of details, we try to reduce the shaming experience for a man, to normalize his reactions. We do explore, however, whether additional interventions, such as anger management or drug or alcohol treatment, might be needed before accepting someone into our groups.
Jack was embarrassed about his behaviors. "I don't speak to anyone, my friends included, about these things." Jake, my coleader, stepped in to reassure him, "The whole idea is that the group is a place where guys can feel safe to talk about things they normally don't share, and get support from each other. You can share details at your own pace. We're not going to force you to reveal anything." Jack seemed relieved to hear this.
We got his permission to speak with Rhonda while he was in the group, emphasizing that this kind of collaboration usually adds to the progress on both sides. We make sure our men feel safe and protected around issues of boundaries and confidentiality between the therapists and therapies, however. For over 18 years, not a single man has objected to this collaboration.
Making Meaningful Connections
When Jack came to his first meeting, we encouraged the guys who were already members to give updates on their own situations first. We have six men in each group, and wanted Jack to get comfortable with the kind of sharing that occurs. He was riveted, listening to these men opening up about their personal issues. Men like the idea that they're not alone when they struggle with emotional problems. When they find that there are other men who, like themselves, are generally regarded as successful and competent, but also struggle with difficult emotional issues, they feel relieved and uplifted.
When it was his turn, Jack jumped in, sharing his childhood history, what he thought were his "therapy issues," and how he routinely got annoyed with Caroline. The group's attention seemed to energize him, and when he'd finished his story, he presented his dilemma: "It seems like I'm not the only guy here who has trouble with his wife. What would you guys suggest I do with her? That's what I'm trying to figure out." There was silence in the room.
Finally, Ed, one of the group members, responded: "I guess if I were you, I'd start by trying to figure out why you're so angry with your wife--a person who you seem to love--and try to get this under control." Jack was stunned. He'd never been confronted by another guy about his behavior before. Come to think of it, he'd never shared anything like this with anyone. He felt surprisingly relieved. He nodded and responded thoughtfully. "So maybe I can get some help with this here?" The other men nodded with encouragement.
Conversations from the Heart
What Jack experienced was a far cry from the locker-room banter that most men complain about and feel so limited by in their daily lives. We encourage our guys to express their feelings, disclose important information, be vulnerable, and provide each other with honest emotional feedback, as opposed to problem solving or intellectual analysis.
All this requires creating an atmosphere of safety. We start by insisting on confidentiality outside of the group. Our men agree that they won't repeat what's discussed in the group with anyone outside, even with intimate partners. If they wish to share their own experience with a partner, it's at their discretion.
Inside the group, we encourage our men to voice their genuine affection and empathy to each other, while discouraging "innocent" put-downs, dismissals, and jokes at another man's expense. Men will often put up with this kind of banter, but they won't open up when it's going on.
We introduce structured exercises and discussions around particular themes that arise (our models for manhood, what we expect of ourselves as husbands, fathers, and professionals, sex, money, and status). These discussions provide opportunities for emotionally intimate exchanges.
During his second month in the group, the topic of money came up, and Jack was particularly keen to speak about this. He couldn't understand why Caroline constantly quizzed him about their financial situation, since, as he said, "She knows I bring in a six-figure salary. Why does she get so bent out of shape?" He was clearly angry and hurt about this. Stanley, a teacher, looked pained as Jack was speaking. I asked him if he'd be willing to share with Jack what was going on in his head.
"Mixed feelings," he replied. "On one hand, I'd be angry, too, if my wife was badgering me, if I were bringing in six figures--which I clearly am not," he said, smiling. "But," he said, looking at Jack, "I have this feeling that there's more to it. You're so angry. There's something else going on here, and I don't know what that is."
Jack was quiet at first. Stanley's observation had struck a chord. He looked sad. "It's just like what used to happen with my mom," he said. "She was always putting my father down. He tried to support us and always sent money. Every time I tried to defend him, she put me down, too!"
Stanley didn't miss a beat in responding. "So when your wife gets anxious about money, you react and go ballistic, or withdraw? Something like that?" He was being direct with Jack, but his voice tone was comforting.
"That's right," Jack responded. "I can't hear her when she starts talking like that."
It's hard to know what impact a group intervention will have. When Rhonda and I spoke the next week, she reported that Jack had seemed more present in their couples session. He was able to let Caroline voice her anxiety about money and not take her feelings so personally. He even expressed some empathy for how terrified she felt when her mom would discover her dad had emptied the bank accounts during one of his gambling binges. My take was that Jack felt heard by the guys in his group, and, as a result, was better able to hear his wife.
Cooperation and Conflict Resolution
The men were talking about their fathers in a session a few months later. One of the members, Frank, was touting his father, a man he'd frequently described as a drunk and a bully, as a good role model for him. Frank was a salesman who thought of himself as "old school." He prided himself on being a "no-nonsense" guy, who could be hard on the outside. Our men, however, had seen he could also be incredibly gentle on the inside. Jack was looking at Frank skeptically. When I asked him what he was feeling, he responded, "I'm not really comfortable saying."
Frank looked at him and said, "Oh, c'mon, Jack. I'm a big boy. I can take it." Jack swallowed hard and said, "Well, Frank, you're usually pretty honest. But now, I think you're making excuses for your father, I don't think you think he was a good role model."
The other guys concurred, supporting Jack's reaction. Frank quickly conceded, "OK. I guess I was padding my old man's resume a little bit. He could be a pretty scary guy."
Jack admitted that he himself had never been comfortable challenging his own father, because "my mother was always doing that, and I figured my relationship with him was fragile enough." He also reported that he thought his dad liked to be in control of things and didn't have much patience when he was challenged.
Our men often function in leadership roles at home and in the workplace, and are routinely asked to make important decisions. However, social expectations about maintaining power and control often make them reluctant to share authority or ask for help from others. While they may advocate egalitarian values, they struggle about giving up control in their relationships with other men and in their marriages. When their decisions are challenged, they can become defensive. The men in the group were easily able to identify with Jack and Frank's issues with their fathers over the difficulty of challenging them in any way. They went on to agree that social expectations of leadership often made it difficult for them to share authority; to let go and resolve conflicts when they arose.
We try to help men become secure with their own authority while they're learning to share power and address conflicts that arise in their relationships. When we sense an unspoken tension in the group, we often introduce the topic of competition and sharing, which gives the men a chance to acknowledge these feelings.
Jack was getting progressively better at advocating for himself in the group. This was reflected in his couples therapy with Caroline. Rhonda reported, with delight, that he'd discussed his frustration with Caroline about her family's annual holiday gathering. He wanted their family to stay in a hotel this year, rather than cram themselves into one of the small bedrooms in his in-laws' house. In the past, he'd have had a tantrum about this, sulk, and then miserably concede to stay in uncomfortable circumstances. This time, however, Caroline was able to hear his feelings and work with him to come up with an alternative plan that they both liked.
Cotherapy and Collaboration
I learned something else from Rhonda: Jack was angry with me. He'd told her that in recent sessions, he felt I was coming down hard on him, challenging him in ways that made him feel stupid. I was upset to hear this, and realized that I'd had no clue he was feeling this way. "He's a good actor," Rhonda reassured me. "I told him to bring this up with you or Jake in the group. I think he'll do it. Let's see."
Jake told me that Jack had called him, and that he, likewise, had encouraged Jack to bring this up in the group. When the next meeting came, I waited patiently to see whether Jack would say anything. He was reluctant at first, but when it was his turn to speak, he addressed me: "I guess, in the spirit of therapy, I need to tell you I've been pissed off at you."
"Talk to me about it," I offered. Jake made sure that Jack was able to speak his feelings without interruption. The guys were quiet, waiting to see what would happen. I told Jack that I was genuinely sorry that I'd hurt him, and that I'd had no idea this was going on. Jake then invited the other guys to share their reactions.
Ed said to Jack, "I've felt uncomfortable at times when Rob has pushed me in the group. I think it's good that you're speaking up about this. At this point, I don't take it personally. Rob's not perfect," he said, smiling at me, "but I think he really cares about us."
Having a cotherapist and colleagues is an enormous benefit in situations like this. It allowed me to be the "guilty party," a human as well as a therapist, while supporting Jack in voicing his feelings in a way that was therapeutic for him. Here, we modeled how sharing power and flexible authority can promote intimacy for men; I might have navigated this issue by myself had Jack confronted me independently, but these supports made the process easier and allowed the group to participate in a deeper way. Jack himself seemed a lot more at ease with me afterward.
Commitment: Staying on Course
After several months, Jack was calmer and more consistent in his marriage and with his kids. Bickering between him and Caroline still occurred occasionally, but it was resolved more quickly. Tension around money dissipated as they continued to discuss their finances regularly and openly.
Jack found himself thinking about his father and his role in the divorce. As a husband, he was seeing how improved communication had better connected him with his family, and consequently, how this improved his participation in family life. He felt more like a competent man now, and wondered what had really happened with his parents' marriage.
Jack's father was in his eighties, and in poor health. The thought of dredging up this material and upsetting the old man was appalling to Jack, but he couldn't get the question of what happened out of his head. He shared this with the group and their reaction was immediate and strong: "You should go see him," Stanley said. "You need to talk to him before he dies. Trust yourself. He cares about you. This will help you both."
Jack was skeptical, but he called his dad, who was weak but happy to hear from him. He made an appointment to drive to visit him. He told himself he'd abandon his question if the situation felt wrong. He thought about the guys in the group and their frequent calls to him during the week before his trip while he drove to see his father.
In our groups, we emphasize loyalty, a strong feature of male friendship. Traditional myths about loyalty in men's friendship stress male bonding under crisis (heroic friendship), or men coming together against a common adversary, as in war or sporting events. We challenge this notion, stating that less dramatic but more consistent contact with your friends, particularly during emotionally trying times, is more important for guys in today's world. As one of our men said, "So we don't have to throw ourselves over a bridge for each other for our efforts to count, right?" Unlike in traditional group therapy, we encourage our men to contact each other and get together between sessions. As long as they bring back any important and relevant feelings to the group, we consider their attempts to reach out as part of their progress in the group.
Jack's meeting with his dad was profound in ways he couldn't have predicted. The man was ready to talk--possibly because of his illness, Jack reflected. There was some remorse when he recalled the early days of his divorce from Jack's mom.
"I wasn't a very good father then, and probably not that good a husband." When he talked about his tendency to withdraw from conflict, Jack sat up straight in recognition. "It took Annie [his second wife] and me 30 years to work this out," his father concluded. "I hope you and Caroline can do better than that."
Jack drove home in a daze, grateful for the visit. When he got home, he had a group of phone messages awaiting him from guys in the group, inquiring about how the trip had gone.
When I spoke with Rhonda the following week, she said Caroline had expressed how moved she was by the guys' genuine caring for Jack, and how personally supported she felt by this. Jack concurred and said his father's willingness to be honest with him had reinforced the value of the work he and Caroline had been doing in couples therapy and his group therapy. The couple was able to complete their important work with Rhonda over the next few months, and Jack continued on in the men's group for another year.
We've found that therapeutic men's groups that focus on developing emotional intimacy skills not only help men bond with each other, but also, as with Jack, help strengthen their marriages and other close relationships. This seems to echo Henry Ford's praise for close male relationships: "My best friend is the one who brings out the best in me."
By David Wexler
Robert Garfield's wonderful description of a group of men helping men highlights what men are so damn afraid of--and what to do about it.
The men's group worked for Jack because of the twinship he experienced. Like many of us men, he spent a lot of time suffering alone and dreading the exposure of his deficiencies. He labeled himself (sometimes consciously, sometimes unconsciously) as shame-worthy--until he heard other men, his "twins," revealing their similar struggles. The destigmatization of failure (or perceived failure) allowed him and others in the group to move on to the next healthy phase of genuine problem-solving--which men are born to do.
The group also worked because of the reframing process. This begins with the group name: the Friendship Lab--not Men's Emotional Retraining or even Men's Therapy. Who would have any problem with entering a Friendship Lab? The author also talks about redefining emotional intimacy skills as part of healthy masculinity. This reminds me of Terry Real's use of the term relational heroism, which frames these relational skills as acts of courage (always appealing to the male consciousness) rather than ways of just becoming more like women. It's clear that the group therapist and the group members themselves incorporated this language and this reframing consistently, and it paid off.
Part of what sabotages a man's ability to relate more deeply with his intimate partner is the "relational dread" phenomenon (a term coined by Stephen Bergman). A man is afraid he's going to fail at the task at hand, so he enters fight-or flight mode: emotional withdrawal or aggressive defensiveness while blaming his partner for nagging him or demanding so much. But when he feels more competent at this task (and stops perceiving her needs as such a threat), he relaxes. When he relaxes, he can actually see, feel, and hear that there's another real human being over there. This is what happened to Jack when he finally was able to let his wife voice her anxiety about money and not "take her feelings so personally"--and he was able to express "some empathy for how terrified she felt."
I have a slightly different take on the "power and control" issue that the author identifies. Plenty of men, of course, are obsessed with this theme. But plenty of others only look like power and control freaks because they're wearing a mask to hide their vulnerability about feeling incompetent. Men in therapy respond best when they feel like we're really speaking to them, and we can usually hit the nail on the head by talking about shame. A good approach is to talk about shame by other names--like needing to feel "valued" or "successful" or "needed" or "competent" or "important"--that don't cause further shame.
One other suggestion for a man in a men's group is to educate his partner about what he's learning about himself. A man cares so much (often way too much) about how his partner views him. If his partner mirrors a "good man behaving badly" or a "good man struggling with his vulnerability" (rather than a cold guy who doesn't really care about anyone but himself), her mirror will make it easier to believe this more hopeful narrative about himself, and his better self will emerge.
Much as I hate to give Henry Ford credit for anything other than producing a lot of cars, I love the use of his quote at the end of this case study. And as Jung once said, "One is always in the dark about one's own personality. One needs others to get to know oneself." This applies to intimate partner relationships, and it applies to groups of men helping men as well.
Robert Garfield, M.D., who codirects family therapy training in the Department of Psychiatry at the University of Pennsylvania, writes and presents extensively on men's issues. His forthcoming book is My Guys: How Men Can Make and Keep Close Male Friendships.
David Wexler, Ph.D., the executive director of the Relationship Training Institute in San Diego, is the author of many books and articles about men in relationships, including When Good Men Behave Badly; Is He Depressed or What?; Men in Therapy; and STOP Domestic Violence. Contact: firstname.lastname@example.org.
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Publication information: Article title: Case Study, Men Helping Men: Using Men's Groups to Enhance Couples Therapy. Contributors: Garfield, Robert - Author. Magazine title: Psychotherapy Networker. Volume: 36. Issue: 3 Publication date: May/June 2012. Page number: Not available. © Psychotherapy Networker, Inc. Mar/Apr 2009. Provided by ProQuest LLC. All Rights Reserved.
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