Manual Impotence - Self-Help: Learn Eastern secrets to rekindle your sex life

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Learn more about Amazon Prime. Tennis Mind: Here are dozens of step-by-step techniques to help you perform with excellence Feb A Mind 4 Cricket: Raise your game with mental training Apr A Mind 4 Cricket Apr Usually dispatched within 1 to 3 months. More Information. Anything else? Provide feedback about this page. Back to top. Do not believe in anything merely on the authority of your teachers and elders.

Do not believe in traditions because they have been handed down for many generations. But after observation and analysis, when you find that anything agrees with reason and is conducive to the good and benefit of one and all, then accept it and live up to it. If I believe I cannot do something, it makes me incapable of doing it. The real tragedy of life is when men are afraid of the light.

One of them is to transcend reality by imagination, as I try to do. It is self-created as long as the unobserved mind runs your life. Regularity chauvinists are people who insist that you have got to do the same thing every time, every day, which drives some of us nuts. Attention Deficit Disorder - we need a more positive term for that. Hummingbird mind, I should think. For example, if I was going to teach arithmetic and I only knew about Roman numerals, you might get the idea that multiplication is extremely difficult.

Given the idea of Arabic numerals it becomes a lot easier. If we took Roman numerals, the Romans have no way to express zero. If we have the wrong abstractions, we can make things which are intrinsically rather simple very difficult. It is both. Appreciating the gloriousness inspires us, encourages us, cheers us up, gives us a bigger perspective, energizes us.

We feel connected. The gloriousness becomes tinged by craving and addiction. Knowing pain is a very important ingredient of being there for another person. The wretchedness humbles us and softens us, but if we were only wretched, we would all just go down the tubes. Gloriousness and wretchedness need each other. One inspires us, the other softens us. They go together. It is because we dare not venture that they are difficult.

It manifests as inquisitiveness, as adaptability, as humor, as playfulness. But such uncertainty lies at the very heart of human creativity. What if I embraced it? They simply have impotent goals that do not inspire them. First, it is ridiculed. Second, it is violently opposed. Third, it is accepted as being self-evident. The answer is surprising but clear. In weakness. Why there? Because in our weakness, our familiar ways of controlling and manipulating our world are being stripped away, and we are forced to let go from doing much, thinking much, and relying on our self-sufficiency.

Right there where we are most vulnerable, the peace that is not of this world is mysteriously hidden. You can tell whether a man is wise by his questions. It is not so interesting that every person is seeking pleasure, but it is most interesting to see how everyone is seeking his pain, looking out for it. So it is with the human soul. While the soul goes through pain, torture and trouble it thinks that it would have been much better if it had gone through life without it. But once it reaches the culmination of it then, when it looks back, it begins to realize why all this was meant: it was only meant to tune the soul to a certain pitch.

The immense fulfillment of the friendships between those engaged in furthering the evolution of consciousness has a quality almost impossible to describe. And it makes it practically impossible to argue about programs independently of their being executed. Sometimes this makes planning the day difficult. Ask what makes you come alive, and go do it.

Because what the world needs is people who have come alive. Brutality is not honest. Otherwise we love only the reflection of ourselves we find in them. The moment you try to free yourself from fear, you create resistance against fear. Resistance in any form does not end fear. What is needed, rather than running away or controlling or suppressing or any other resistance, is understanding fear; that means watch it, learn about it, come directly into contact with it.

We are to learn about fear, not how to escape from it, not how to resist it. Only your grievance about the past can do that. Knowledge is a love affair with answers. Just keep going. No feeling is final. Where people fail is that they wish to elect a state and remain in it. This is a kind of death. You may cheat yourself out of much of life. So aim above morality. Be not simply good; be good for something. A love where no one sacrifices to another, but grace is evoked through the sharing of deep vulnerability. It is rather the result of unhampered participation in a meaningful setting.

Just listen. Perhaps the most important thing we ever give each other is our attention…. A loving silence often has far more power to heal and to connect than the most well-intentioned words. Pragmatists suffer it. Some can avoid it. We must acquire serenity in all feelings and sensations about the future. We must look with absolute equanimity to everything that may come and we must think only that whatever comes is given to us by a world direction full of wisdom. It is part of what we must learn in this age, namely to live out of pure trust without any security in existence, trusting in the ever present help of the spiritual world.

Truly nothing else will do if our courage is not to fail. Let us discipline our will and let us seek the awakening from within ourselves every morning and every evening. People need to be given a chance to tune into themselves. Dialogue is a deep process. For me, this requires some quiet and inner peace — and some time for interaction. When you feel it, you move through to space, resolution and peace.

So long as men are not trained to withhold judgment in the absence of evidence, they will be led astray by cocksure prophets, and it is likely that their leaders will be either ignorant fanatics or dishonest charlatans. To endure uncertainty is difficult, but so are most of the other virtues.

The opportunity for simplification is very encouraging, because in all examples that come to mind the simple and elegant systems tend to be easier and faster to design and get right, more efficient in execution, and much more reliable than the more contrived contraptions that have to be debugged into some degree of acceptability…. Simplicity and elegance are unpopular because they require hard work and discipline to achieve and education to be appreciated.

It may be better to live under robber barons than under omnipotent moral busybodies. Only when we know our own darkness well can we be present with the darkness of others. Compassion becomes real when we recognize our shared humanity. It is a fact today that one in ten thousand of us can make a technological breakthrough capable of supporting all the rest. The youth of today are absolutely right in recognizing this nonsense of earning a living.

We keep inventing jobs because of this false idea that everybody has to be employed at some kind of drudgery because, according to Malthusian-Darwinian theory, he must justify his right to exist. So we have inspectors of inspectors and people making instruments for inspectors to inspect inspectors.

Family Origins

The true business of people should be to go back to school and think about whatever it was they were thinking about before somebody came along and told them they had to earn a living. Much of the practical work done in computing, both in software and in hardware design, is unsound and clumsy because the people who do it have not any clear understanding of the fundamental design principles of their work. Most of the abstract mathematical and theoretical work is sterile because it has no point of contact with real computing. One of the central aims of the Programming Research Group as a teaching and research group has been to set up an atmosphere in which this separation cannot happen.

Hence, to think creatively, we must be able to look afresh at what we normally take for granted. The open mode is more relaxed, more receptive, more exploratory, more democratic, more playful and more humorous. The closed mode is the tighter, more rigid, more hierarchical, more tunnel-visioned. Most people, unfortunately spend most of their time in the closed mode.

Not that the closed mode cannot be helpful. If you are leaping a ravine, the moment of takeoff is a bad time for considering alternative strategies. In other words, we must return to the open mode, because in that mode we are the most aware, most receptive, most creative, and therefore at our most intelligent. It is this absorption in what you are doing that frees your unconscious and releases your creative imagination. Rollo May. It is the measels of mankind. Never do anything against conscience — even if the state demands it. There are only—eventually—ethics of processes by which we treat the possibilities of a situation.

Because there are always more than two sides. When did you stop dancing? When did you stop singing? When did you stop being enchanted by stories? When did you stop finding comfort in the sweet territory of silence? Where we have stopped dancing, singing, being enchanted by stories, or finding comfort in silence is where we have experience the loss of soul. Dancing, singing, storytelling, and silence are the four universal healing salves. You cannot transform yourself, and you certainly cannot transform your partner or anybody else.

Carlos had never been in counseling, but told her he would give it his best effort. During the first session, Carlos told the counselor that he was there mainly to please his wife. It took a few more sessions of increased sharing about his life, assurances of confidentiality, and the building of a solid working relationship with the counselor for Carlos, who first appeared cautious and tentative, to become more animated and open. His big revelation was that he had been having an affair with a coworker, and this was not the first time he had strayed outside the marriage.

He revealed that he had grown bored with his marriage long ago and had felt rejuvenated by the mainly sexual relationships he had taken up. For Carlos, the sessions represented a way for him to explore what had happened in his marriage, and try to understand why he was having affairs.

Through counseling, Carlos recognized that he had been struggling with depression most of his adult life. He had medicated his low energy level and pessimistic thinking with alcohol, pornography and, eventually, sexual affairs. His father had died when he was 11 and, as the oldest boy in the family, he had taken on a very responsible role growing up. He had learned to give up his own needs to help his mother and younger siblings.

Aside from trying to decide whether he wanted to work on the relationship with Helen, Carlos talked emotionally about his father. He became aware that the loss of this significant relationship had had an impact on how he saw himself in the world. Underneath his competent exterior, he worried about fulfilling his expected male role as a provider, including whether he was a good father and made enough money. As Cochran and Rabinowitz note, an important aspect of assessment with men presenting with depression is to evaluate suicide risk.

Many authors e. Presence of ideation, plan, means, and intent are important topics to cover. In addition to these aspects of suicide risk assessment, it is important for the clinician to be sensitive to masculine gender role derived risk-taking behavior and its possible relation to self-destructive behavior. Careless and risky driving practices, heavy alcohol or substance use, extreme risk-taking in leisure pursuits, and other practices that may be sanctioned by the culture of masculinity that disdains self-care or help seeking may actually be manifestations of a wish to die.


Such considerations are important for the counselor to recognize and discuss directly with the male client. In addition to the clinical interview and history-taking in the initial sessions, the counselor may also utilize various scales to assess the male client's depression. Magovcevic and Addis created the Male Depression Scale, a self-report inventory to identify atypical symptoms of depression found in men. It is comprised of 21 items that assess symptoms of depression, to which the client answers on a scale from zero to three, with higher endorsement indicating higher levels of depression.

The Beck Depression Inventory has very impressive reliability and validity data to support its use. It is a dilemma for many men to seek treatment for any kind of health concern, let alone something as serious and shame-provoking as mental health. Men are often told to "man up" when faced with life problems. While some men find relief in physical workouts like running or weight lifting, feelings of doubt, shame, and depression are not so easily resolved in this manner.

Often it is someone other than the man himself who initiates the possibility of psychiatric or psychological treatment; such as a concerned partner, family member, coworker, or even a legal sanction. It is not uncommon for a man to first seek out his primary care physician with tangible complaint like sleep problems; sexual performance concerns; headaches; or pain in the back, neck, or gut. Physicians who do not probe deeply about a man's psychological state may find themselves prescribing pain medication, sleeping pills, and erectile dysfunction drugs when a man is really experiencing depression.

Since men are often less than forthcoming about describing the depth of their mood disturbance, depression must sometimes be inferred from the configuration of symptoms. When depression is diagnosed, medication is often a first step in treatment. Many men feel more comfortable with a medical model approach that emphasizes their condition being a biochemical abnormality that needs a biochemical treatment. In recent years, there has been a proliferation of antidepressant medications introduced that are effective in altering the amounts of neurotransmitter substances in the brain.

The three major types of antidepressants are monoamine oxidase MAO inhibitors, tricyclics, and selective serotonin reuptake inhibitors SSRIs. MAO inhibitors allow the neurotransmitters dopamine, norepinephrine, and serotonin to remain at the synapse of the individual neurons longer, resulting in more being available and a corresponding subjective lifting of the depression LeDoux, Unfortunately, one of the side effects of this drug is the breakdown of the amino acid tyramine, leading to life-threatening high blood pressure when certain fermenting foods are digested including wine, beer, and cheeses.

With significantly fewer side effects, this class of drug selectively targets either serotonin or norepinephrine receptor sites, leading to the alleviation of depressed mood. Most of these drugs take weeks of continuous use to become fully effective. For men, the main side effects of these medications has been found to be sexual dysfunction in the form of lower libido and delayed ejaculation Stuart, Electroconvulsive treatment ECT for depression, also popularly known as shock treatment, involves inducing an epileptic-like seizure in an individual.

This treatment, which takes place over several consecutive days, is used on a limited basis for individuals with the most severe catatonic forms of depressive disorder and who have been resistant to other interventions. ECT, which has been found to increase short-term memory loss and cause some confusion, has also been found to be effective in alleviating severe depressive symptomology for several months at a time.

The mechanism for its effectiveness is thought to be a resetting of the neurotransmitters serotonin, norepinephrine, and dopamine, but is still not fully understood Mayo Clinic, Research suggests that SSRIs alone may not be as effective without concurrent counseling. Cognitive-behavioral therapy for men focuses on confronting unrealistic expectations of the male role, and distortions in thinking and behaving that lead men toward a depressed outlook and mood Mahalik, Interpersonal therapy emphasizes examining and improving how the depressed individual approaches relationships and communicates needs and desires to others Elkin, et.

Recently, more innovative approaches to psychotherapy have shown promise as treatment for depression. Pollack has proposed a therapy that focuses on repairing childhood relational trauma, which has resulted from the abrogation of important interpersonal relationships. Cochran and Rabinowitz have described a counseling process that addresses the accumulation of losses at various developmental periods of life that make men more susceptible to depression.

All three of these approaches have shown that vulnerability to male depression has a strong interpersonal component that should be addressed in treatment. Mood changes, side effects, and reports about the effectiveness of a particular medication are relevant information for both the psychological and psychiatric treatment of the individual. Although an initial awkwardness is to be expected, it is the counselor's job to make the creation of a therapeutic relationship a less threatening process.

Starting with the present symptoms rather than quickly delving into the past can facilitate this. By carefully listening to the story the male client weaves, the counselor can combine in his or her responses empathy for the losses and traumas expressed, as well as relevant questions about history and suicide risk that don't change the context or flow of the story being told. Most men seem more receptive to revealing themselves when their experience is framed by the counselor as a rich revelation of their life journey. Paradoxically, the depressed male client seems to want the counselor to have the energy to help him and at the same time, feel as depressed as he does.

The energy drain that depressed clients seem to have on the therapist is a reminder that he or she must be willing to enter into the "low psychic space" of the client. It is only from this space, that the clinician can truly empathize with the patient's experience and offer an existential kinship with life's downside Yalom, This willingness by the counselor to be with a man experiencing negativity in his life often gives the male patient hope and a sense that he is understood.

In group therapy, this function can be shared among supportive group members Rabinowitz, This introjected self, which often has the voice of a parent, carries much power and when turned against the self has the capacity to immobilize the individual with anxiety and depression. Often, this is projected onto the therapist.

Some kind of man I am. Good thing you are getting paid for this. Drawing out the projection on the counselor allows these negative messages to be said aloud and confronted. Often, a man does not realize how much impact these ideas have on his self-esteem and behavior. Assumptions about what it means to be a man, including being a son, father, partner, or worker, may be a big part of the unrealistic thinking in which a depressed man might engage Mahalik, This can be seen in the following exchange between Carlos and his counselor:.

Counselor: Sounds like someone in your life may have told you these words, and you bought them hook, line, and sinker. It is usually a private berating with myself. Counselor: Perhaps it is a part of why you have felt a sense of depression over the years.

Carlos: I think you are right. Nothing I do measures up except when a woman is interested in me. That perks me up and takes me away from self-pity. Carlos: Yes.

Greece: The Crossroads of East and West

Carlos: You know it. She just sees I am withdrawn and I just say it has do with work. Carlos: Maybe too much for both us. Counselor: You have really established a pattern and it is hard to break. Withdrawing is familiar. Talking about it is still not comfortable for you. Carlos: Talking to you is easier than I thought it would be. Carlos: You might be right. Maybe when I actually stop beating myself up and accept myself, I can be more open. Held up to the light, depressive thinking is not very convincing. Often, the emotional retelling of hopes, triumphs, mistakes, and failures opens a man to see connections and patterns that he had never before noticed.

With reflections of meaning and feeling by the therapist, an isolated series of life events can be transformed into an intricately organized web of pictures, emotions, and connections. The therapy relationship itself serves as a model of relationships in which a man can be less than perfect, and emotionally open, while still being valued by another adult. By fully investing in the therapeutic relationship, it is possible for a man to have breakthrough feelings of anger, deep sadness, joy, and laughter. Although it is rarely what he thought he was looking for, a man who can feel and express a range of emotion perceives himself less broken, and more whole.

By learning how to disarm the shame brought on by his own harsh self-criticism and society's script for him as a male, he opens himself up to the world of connection and emotional aliveness. The outcome of psychotherapy is not necessarily a permanent removal of depressing feelings but rather an acceptance of the emotional spectrum that comes with living life authentically Rabinowitz, In addition, being able to practice what was learned in therapy in his everyday world encourages a man to establish new patterns of behavior in which depressive thinking can be counteracted.

Erotic Love and Marriage

Poor intimacy skills in the form of shyness, isolation, and limited emotional expression may also lead to disturbances in relationships for men. It is also possible that underlying depression might exacerbate or even be a root cause for interpersonal difficulties. Depending on the stage of relational disturbance, a therapist must identify the form of therapy that would be most likely to be beneficial. Often, a clinician will see a man who is in the final stages of a deteriorating relationship or one that has recently resulted in separation.

In this circumstance, a therapist is more likely to work with the man individually to deal with unresolved emotional issues. While individuals grieve in distinct ways, Worden has suggested that those going through relationship separation or divorce have the following psychological tasks to manage — accepting the reality of the loss, experiencing the emotional pain of grief, adjusting to a life without the partner, and detaching from the ex-partner in order to be psychologically open to new relationships.

Male socialization issues often keep a man from fully acknowledging the impact of relationship loss. It is more likely that his emotional response is being acted out in other venues. The clinician needs to take a slow approach to uncovering grief in men. For many men, it is much easier to access anger than it is to access sadness, especially in interpersonal relationships Brooks, a. This might involve asking what he is doing in response to the relationship issue.

Later, it might mean discussing actions that he might take in a more cognitive way. Rich, 27, had recently found out that his wife of three years had been having an affair after he had noticed her withdraw from him over the past six months. Early in their relationship, they had talked of having children. At that time, Rich had been hesitant since he was just beginning his career as an accountant with a big firm. He knew he would be working long hours. Rich, who often worked six days a week and hour days, was shocked when he came home unexpectedly and found his wife in bed with another man.

Without saying a word, Rich had left the house and driven his car five hours to Las Vegas, where he spent the weekend drinking, gambling, and going to strip clubs, things in which he had never allowed himself to indulge. When he returned, Judy had moved all of her belongings out of the house with a note that she was not in love with him anymore.

R: The bitch betrayed me big time. I was working my ass off for both of us, and then she has to go fucking around. T: It seems like you have really been able to feel your anger, but you lost someone you really cared about. The way she did it, too…screwing some guy in my bed. R: No. I never touched her in a violent way ever. R: The rest of my life?

Work seems boring.

Ed Folsom and Kenneth M. Price, "Walt Whitman" - The Walt Whitman Archive

The house is empty. R: I just figured we were working too much. She always said she was tired. I thought that made sense. I was certainly tired. But she lied to me. I trusted her. I wonder where you would be without that feeling? R: I got to keep going to work. At this point in therapy, Rich makes it clear that he does not want to deal with his grief.

Fueled by his anger, he is determined to keep up the facade that everything is okay. His denial of the loss keeps him from feeling as if he is going to fall into the abyss of pain. His socialized sense of self includes denying his dependence, avoiding grief, adopting a tough guy identity, and keeping himself busy for fear of approaching the depth of his wounding.

R: I was looking forward to talking to you today. I was really distracted at work. R: I guess you could put it that way. Usually I can work out and feel better. You lost a lot. I lost my whole dream. Having a family with her. Growing old together. In this later session, Rich is no longer dominated by his anger. He is beginning to feel the loss and looks forward to being able to talk about his feelings with a therapist he has come to trust.

In the safety of the therapeutic relationship, Rich has the opportunity to differentiate his bodily sensations and learn the vocabulary of his emotional being. Levant suggests that using a psychoeducational approach to discuss male socialization and the physiology of emotion are important elements of helping men in therapy come to accept their reactions to life events.

Men who have been have been verbally, physically, and sexually abused as children are more likely to have higher rates of all types of mental illness including affective disorders, substance abuse, and certain personality disorders. Because of traditional masculine gender role prohibitions on acknowledging victimization, many men do not willingly reveal the extent of their abuse to others.

Therapists need to approach childhood abuse issues patiently and with empathy for the shame that many men feel in revealing these episodes in their lives. It is not unusual for a man to downplay the psychological damage done by childhood abuse and to not reveal the extent of the abuse until later in treatment.

Even when abuse is disclosed, therapists must be sensitive and supportive to the sense of foreignness or strangeness that may be experienced in the revelation. Jason, an overweight year-old married man, had been referred for therapy by his family physician, who had been treating him for depression and anxiety. Jason, who had been taking buproprion for the past six months, complained to his physician that he was still having trouble sleeping and that he often had intrusive thoughts that were interfering with his relationship with this wife.

These thoughts also affected his relationships with his coworkers at the manufacturing company where he was employed as a shipping clerk. J: Sometimes I feel spacey. Sometimes I miss periods of time, like I have been somewhere else. The bad thing is that I really liked this guy. He listened to me. He seemed to genuinely take an active interest in who I was. He would be really friendly. He told me he was making sure it was clean or dried off.

J: Sure. It was weird. I felt kind of creepy and dirty when he did this. Sometimes, my penis would get hard and it felt good. I think it scared me really. T: So on one hand it felt great to get some attention from a father figure, but there was something disturbing and scary about it. J: During those times, I just blanked out. She had enough to worry about. I rationalized that he just was being helpful to me at bath time. T: Jason, do you think that your intrusive thoughts are at all related to these incidents?

J: Maybe. This whole memory thing is pretty overwhelming to me right now. J: I know it happened. But it seems unreal. I can feel myself shaking. Your reaction is normal for what happened. It can be out in the open here. In this session, the client has revealed sexual abuse for the first time.

The therapist listens and validates his dissociated feelings. Rather than being judged, Jason is allowed to talk about the disturbing images from his past. By connecting his current symptoms to the sexual abuse, the client is able to make some emotional sense of experiences he has had to repress. While it appears to be overwhelming, the therapist reassures the client that this will be a safe environment in which to explore what might be bothering him.

Although it is difficult for any client to reveal childhood abuse, it is especially difficult for men who have grown up with the code to keep painful and shameful experiences to themselves. There are some reports that suggest that a mixed therapy group of men and women who have been abused in childhood might be a facilitative modality to get at the expression of pain, loss, and anger for both sexes Knight, Trauma that occurs after childhood also has the potential to be debilitating for men.

Victims of violent crime and destructive accidents; individuals who serve to help others in traumatic situations such as police officers, fire fighters, emergency medical technicians, and emergency room personnel; and soldiers involved in combat situations are susceptible to post-traumatic stress disorder. Not only are men directly affected by the trauma, but many are also guided by their traditional male gender role socialization that tells them to keep the fear, disturbing mental imagery, and emotional pain to themselves.

Often stimuli in the environment that remind a man of the traumatic situation can trigger intense physiological reactions and send an individual into a dissociative-like state of re-experiencing the trauma American Psychiatric Association, Many men work hard to avoid talking about or participating in activities or relationships that may bring the trauma into consciousness.

Relationships toward family and friends are often marked by general irritability, outbursts of anger, and a tendency to withdraw from intimacy. Many with PTSD have difficulty falling and staying asleep at night, a hard time concentrating, and are prone to excessive vigilance of the environment for threats to their well being. The reader is referred to the DSM-5 American Psychiatric Association, for a more detailed description of the criteria for post-traumatic stress disorder.

Men who have experienced trauma not only battle the aftereffects of the traumatic situation in which they have been involved, but also the normative male socialization that has told them to keep their emotional reactions to themselves. When symptoms do emerge, not only does a man feel the impact of the trauma itself, but also the shame for not being able to contain his reaction.

Therapy with men who have been traumatized is fraught with a push-pull dynamic of self-protective defensiveness along with a desire to be free of intrusive thoughts, hyper-arousal, and pessimism Egendorf, Brooks describes a model for working with combat veterans that requires therapists to be empathic to the underlying emotional pain and the shame that covers it.

He believes that men need to reevaluate their gender role and make life changes that counter the destructive messages they have learned about masculinity. He warns therapists to be patient and reinforcing of small steps of progress while also expecting resistance to change. Successful therapy with combat veterans involves being compassionate about the sacrifices these individuals have made and the emotional wounds that may not be visible Brooks, He was addicted to speed and alcohol, and had served some time in jail for assault.

Clay was initially admitted to the substance abuse ward. Once detoxed, he went to inpatient group and individual therapy. The following is from an individual session in the working phase of his treatment. C: I used to think that being a man meant being the toughest son of a bitch I could be. A lot of good that did me. It got me some jail time and a life as a drug addict. I sure hope this therapy can help me.

C: To be honest, it is pretty painful. C: The source of my rage. I can fly off the handle so easily. I guess I used alcohol to deal with my pent up anger. Now, I have nothing to save me. I was a hothead. I actually thought that enlisting would give me a job that let me go crazy on people but I was actually more constricted.

All the damn discipline just kept it pent up. When I let go, it was worse than I could imagine. Can we back off? Go over it another day? T: No problem. You got closer to talking today than you did last week. The realization that traditional masculinity has had negative consequences is an important insight for Clay, who must change how he defines himself. He acknowledges that he is uncomfortable without his usual coping methods of using alcohol and drugs. The therapist is able to stay with Clay as he experiences the flashback without pressuring him.

In previous sessions, Clay would avoid speaking of anything having to do with his combat experience. Not only is the flashback frightening, it is also shameful to be so exposed in the presence of another man. In general, therapists working with men who have experienced severe trauma will have to deal with denial and anger in the early stages of their work. Pushing too hard for resolution at this phase will likely result in more resistance. A testing phase is also likely to occur to ensure that the therapist can handle the depth of his emotional pain. This may take the form of confrontation or cynicism about the therapeutic process.

Once a man feels trusting of the therapist, he is more likely to take the risk to reveal his inner emotional cauldron. Therapists are encouraged to stay patient, emotionally neutral, and accepting during the process. In environments where the work is with those who have been traumatized, it is important for clinicians to have their own support systems in the form of supervision, personal therapy, and outlets for emotional expression. It is common in warrior cultures for there to be a sanctioned masculine ideology that encourages toughness, independence, fearlessness, and aggressiveness toward others Lisak, a.

This cultural encouragement may have its advantages when fighting wars, but has a steep price for men who engage in this type of behavior under more civilized circumstances. While men may have a biological predisposition to act aggressively, it is our culture that encourages men to act this out more often Lisak, a.

Men are more likely than women to commit acts of violence. Higher rates of substance and alcohol abuse among men are also linked to increased rates in violent crime National Crime Victimization Survey, The impact of acting out violence against others affects not only the victims of these actions, but also places the perpetrator in danger of losing employment, family relationships, and future success in life.

Often, those who commit violence against others are incarcerated. Initial encounters with the legal system sometimes offer men the opportunity to remain out of the prison system. The ability to remain employed or maintain status in school will often be contingent upon receiving treatment for anger management, domestic violence, or violent behavior.

Many treatment programs for men utilize group interventions to address these issues. Both highly structured cognitive oriented groups e. The cycle begins when a man who has insecure attachment from childhood and adolescent experiences, encounters rejection in his main interpersonal relationship.

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This rejection leads to a sense of inner shame that he defends against through denigrating his partner and rejecting the message she is sending. Therapists should be cognizant of this cycle as they intervene with men who are act out in this way. The most popular approach for men who have anger or violence problems is cognitive-behavioral therapy.

Many men who come to counseling or therapy for anger and violence concerns may initially deny the severity of their actions. They may seem to lack intrinsic motivation to change. There is still an opportunity for clinicians to have an impact by gently reminding the client about the consequences of his actions on others and himself.

Through empathy and respect, and a focus on changing damaging thoughts and behaviors, many men will respond favorably to treatment. The essence of the cognitive-behavioral approach is that violence as a response to anger is a learned behavior that can also be unlearned Hollenhorst, The cognitive approach encourages the therapist to help the client to first become aware of the underlying thoughts and cues in the environment that lead to an escalation of anger, verbal abuse, and physical acting out.

By gently challenging distorted and misguided thoughts in a collaborative therapeutic relationship, the client is able to become aware of the consequences of his perceptions, thinking, and emotional reactions. In the process, a man learns that he is responsible for his actions even when he is in provocative situations.

Dom agreed to see the therapist alone if it would save his relationship. The following occurred in the first individual session. D: So where do we start? You must see guys in here who are a lot worse than me, who beat their wives. Tell me what circumstances bring it on. Stacy knows how to push my buttons. I try to blow it off but she keeps harping on me and then sometimes I lose it.

I feel really bad saying this out loud. We get along most of the time. T: What do you say to yourself when you feel this way? D: I feel like a bad person. Like I am no good. I wish she would stop. I feel so bad. D: Yeah. My dad used to vent at me a lot. He was an asshole. Always made me feel like I was doing something wrong. I guess I internalized that. By reminding Dom that he is not accusing him, but rather trying to help him, the therapist makes some headway in getting the client to acknowledge his actions and begin to take responsibility.

A cognitive approach encourages Dom to reflect on the steps that escalate his anger, and opens him to talking about the feelings that he is trying to avoid. Many men react with anger to cover feelings of vulnerability and hurt. It is not unusual for men to enter the therapeutic environment because of a problem with addiction. This might include difficulties with alcohol and other mood-altering substances. Addiction may have its roots in both neurochemical predisposition and traumatization. The numbing of painful experience and the conversion of a negative mood state to one that is pleasurable are often the motivators and reinforcers of addictive behavior.

Because our culture makes it difficult for men to express vulnerable emotions, outlets are often limited to legal and illegal addictive substances and activities. Brad came to counseling following a two-week crack cocaine binge. He used most of his savings to pay for the drugs. Brad had been through two day stints in a drug rehabilitation center in the past three years. He had been clean for over six months before his recent binge.

Brad is employed in a family business owned by his uncle, who has let him return to work after each of his treatments. B: I am so damn stupid. And I am so friggin' selfish. How stupid is that? T: You are really beating yourself up right now. What if we separate out the part of you that is feeling really angry with yourself from the other parts?

I was thinking you could identify the various parts of yourself that exist inside. I was thinking that you could have a dialogue with yourself. All the different parts talking to each other so we know where each is coming from. B: He never has enough. All he wants to do is escape into pleasure. He wants to be high, to have sex, to indulge himself with reckless abandon. B: Man, I would call him the hanging judge. T: Wow. Those are intensely negative self-statements. What is it like to just say them here?

B: I can feel myself getting uptight and ready to run. Like I could run out the door right now and not come back. I guess that is the addict. T: Is there a part of you that sits on the side of the conflict? Not the addict or the judge? B: Yeah, the part that is coming for help. I just want some help in this war. Maybe if I can learn some techniques for catching myself before I act out, I might have a chance.

Tweets from Pope

The therapist uses a gestalt technique to get the client to differentiate various elements of his personality.