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Conversations with Dr. Wear on the APA’s New Guidelines for Working With Men and Boys

Dr. Douglas Wear, Psychologist and Director of Antioch University Seattle’s Community Counseling and Psychology Clinic, was recently interviewed twice – once by Margaret Larson of KING5 News as part of New Day Northwest’s Wellness Wednesday programming, and then in a follow-up interview by Antioch University – about the American Psychological Association’s new clinical guidelines for psychologists who work with men and boys.

On Television

In his television interview, Dr. Wear answers many questions that viewers are likely to have about these new APA guidelines. For example, he explains that although many people find the subject of masculinity and mental health to be highly topical, the guidelines were not specifically created in response to current events. Instead, the new, 30-page guidelines are the culmination of 13 years of hard work, incorporating hundreds of references and over 40 years of research. He says, “It’s meant to be solid material, and it’s not necessarily a political statement.”

After explaining how long it took the APA to create the guidelines, he teaches viewers about the role guidelines play in clinical practice. “They’re not standards. In psychology, in a lot of healthcare professions, there are standards that you must follow. Guidelines are like recommendations, good advice. We’re not bound by that. Our clinical judgment, the situation that we’re dealing with, with the client, is what is the final determinant of what we do.”

Dr. Wear then provides clarification about how the research term ‘traditional masculinity’ is not a synonym for ‘traditional values,’ or even a description of how all men feel and behave. He says, “In the research, they use the term ‘traditional masculinity’ and some people mix that up with ‘traditional values.'” He adds, “‘Traditional masculinity’ in this academic research is about the tendencies and values of men to be violent – and of course, most men are not violent – to be controlling, dominant, and to extremely restrict emotions. And what they’ve found is that those qualities have repercussions both inward – as inside of men – and outward in society, and how it affects other people.”

Larson observed that masculine friendships often don’t have the same freedoms to be vulnerable as more feminine friendships typically do. In response, Dr. Wear explained, “As you said, vulnerability is one of those words that doesn’t work with men, in terms of this traditional concept of masculinity. You need to be tough, ‘Boys Don’t Cry’ and you don’t go there with these feelings.” To further illustrate this point, he added, “So if something doesn’t feel okay inside, you think something’s wrong, because that’s not ‘how a man is.’ And then you look around, and other men aren’t showing any vulnerability, because you don’t talk about it.”

Dr. Wear continued to describe ways that the isolation that can come from this lack of psychologically intimate fellowship with same-gender peers often hurts men in mortal ways. “You’re the only one, you’re alone, you think something’s wrong with you, you think you’re weak – which is another no-no – and that leads to a lot of problems. Men, in terms of depression, *seem* to have a lower rate than women. But it doesn’t show up [in traditional measures of depression] because men play it out in substance abuse and risk-taking behavior, and other things.” Larson contributed, “And not self-report it.” Dr. Wear affirmed this, “When you switch to suicide, which is often a result of depression, men commit suicide 3 1/2 times more often than women.”

Dr. Wear then described ways that a lifetime of traditional masculinity – “some of these problems start with young children and problems in school, and on the playground, and with academics” – can culminate in a loss of identity and social connection at retirement, explaining that “the highest demographic for suicide is men over 70.” Dr. Wear further explained, “Men don’t seek healthcare, and they don’t check out things when they’re sick, so they get sicker and their heart attack rate…” Addressing Larson directly, for emphasis, he ended his sentence by saying, “We have a 5 year shorter lifespan than you.”

With Antioch

In a follow-up interview with Antioch University Seattle, Dr. Wear took the opportunity to discuss how these guidelines inform clinical practice at Antioch:

“[The] APA has previously released other practice guidelines. They include those on older adults, lesbian, gay and bisexual clients, and women and girls (recently updated). The research behind all these guidelines likely is being taught in Antioch classrooms. I will send links of these newest guidelines to clinic staff, supervisors, and student therapists and also share with the broader clinical faculty. We always want our clients to benefit from the most recent evidence based research available.”

In this interview, Dr. Wear also provided “some things I did not get to cover before the interview ended.” Specifically:

“Men do not have to be trapped in just the negative aspects of traditional masculinity. They can be and are adaptable and flexible, emotionally expressive and fully able to engage in all aspects of both intimate and parental relationships. The purpose of these guidelines is to help psychologists (and other therapists) treat their clients and move them in this more positive direction.”

“Race, class, sexuality, power and privilege, racism, and sexism complicate the picture for men and boys and those they relate to further, taking a greater toll on some groups than others.”

“Researchers are finding that in the end, there is not that much difference between the behaviors and expectations of men and women. In many ways, we are more alike than different.”

Dr. Wear is a member of the Washington State Psychological Association (and its former Executive Director). He volunteers with its Public Education Committee to which KING TV reached out for this interview. He is also Director of the Antioch University Seattle Community Counseling and Psychology Clinic, which offers free counseling to matriculated Antioch Seattle students, and sliding scale services to everyone else. More information about this clinic is available here.