The secret sorrows of men: impact of Dynamic Interpersonal Therapy on ‘masculine depression’

Abstract

Men are underrepresented among depression diagnoses, yet are more likely to engage in self-harm. Masculinities research has sought to better understand the mechanisms through which men may conceal or suppress depression, and has suggested that traditional diagnostic criteria may fail to recognize the many ways that gender may influence the presentation of negative affect. Ideals of hegemonic masculinity dominate military culture, making mental health treatment in a veterans’ hospital an ideal setting to work through the influence of rigid gender norms on interpersonal relationships. Relational therapy can be particularly useful to help some men reconstruct their sense of self in relation to their own rigid gender norms. Dynamic interpersonal therapy is a powerful therapeutic modality that can help men recognize and connect with parts of themselves that have been previously disowned. By giving voice to these more vulnerable affects, men may be freed up to connect to and communicate their own longing for care in relationships. We will present three case vignettes to illustrate this approach among American male veterans seeking psychotherapy at a Veterans Administration (VA) Hospital in New York City.