Male Obstacles to Healthy Responses to Stress

There are two major obstacles to males responding to stress in healthy ways, predominantly alexithymia and the fight-or-flight response versus “tend and befriend” concept.13 The term alexithymia is derived from a Greek word that means “difficulty in identifying and communicating one's feelings.” Persons with alexithymia have been described as “human robots,” or “emotional illiterates” because their interpersonal relationships are frequently hampered by poor emotional communication. They typically score very low on measures of emotional intelligence and are likely to fare rather poorly in life, regardless of their intellectual capabilities.36 Many persons with alexithymia also have chronic medical problems, particularly psychosomatic or somatoform illnesses.

Imagine for a moment that you were asked what color car is currently parked two cars to the right of yours. Aside from thinking that this is a rather foolish question, you would probably admit you did not know the answer. Yet, if each day when you came to work a colleague asked you this same question, in a matter of a week's time the hippocampus would decide that this somehow must be an important question because of the repetition, and it would begin storing this information in the brain's short-term memory. An example of the dysfunction that can occur through alexithymia would be a male growing up in a family without anyone asking him about his feelings; he would be much less likely to develop the skills required to identify his emotions. The male's body would then be reacting to emotions without any conscious awareness. If men are unaware of their fears, then they are less likely to seek healthy ways of dealing with them. Alexithymia is more common in men than in women and contributes to both physical and psychiatric difficulties.37 The inability to read one's feelings makes it impossible to recognize fear or anger and, therefore, asking for help is unlikely. This leaves the male with chronic sympathetic arousal and the eventual cascade of physical and emotional distress. This trait may have been useful in the times of hunter-gatherers because the physical aggression necessary for hunting and for combat would not encourage awareness of feelings but rather a suppression of fear and worry because actions would be preferred over intuitive thoughts.

The second challenge for men is the tendency to use the fight-or-flight response rather than the tend-and-befriend response as a healthy coping style to manage stress. Dr. Shelley Taylor believes that women are predisposed by biology and culture to respond with nurturing—which she calls the tend-and-befriend response—when they are afraid.35 She attributes this to the women's traditional role of tending to children and the family as well as inherent hormonal differences. In contrast, in most cultures men were expected to enter into a fight mode in response to threats. Taylor's study of modern families supports this tendency toward support for females and away from support for males. After a hard day at work, women tended to want to discuss their day and would nurture the children whereas men tended to withdraw and become irritable.35 Many studies have found men much less likely to seek help for a wide variety of problems ranging from depression to substance abuse. In addition, epidemiologic studies report that only one third of mental health outpatient visits are with men, just as they are much less likely to visit a physician when ill.38