Publishers Weekly - Publisher's Weekly
Hidden male depression is the focus of this clear, compelling book by a Massachusetts family psychotherapist who specializes in working with dysfunctional men. Because our culture socializes boys to mask feelings of vulnerability, he says, they bury deep within themselves damaging childhood trauma and its ensuing depressive effects when they become men. This strongly reasoned study starts out with an illustration of the "toxic legacy" that is passed, often for generations, from father to son, with each chapter adding another piece to the complex face. The lucid exposition of ideas is made more vivid through dramatizing. Real uses "composite" cases, so no actual person is depicted except the author himself. One of the most arresting aspects of the book is the autobiographical thread that he weaves throughout. Real's central concern is what he calls covert depression, a pain-filled, inchoate state that may or may not eventually erupt into overt depression. The book is wise beyond its stated scope: in setting up a model for the nature, etiology and treatment of male depression, Real ends up offering-with some gender variants-an almost universal paradigm. BOMC, QPB and One Spirit alternates. (Jan.)
Real, a psychologist with 20 years of experience treating men and their families, begins with a poignant scene of his father starting to open up and share the pain of his life. From there, Real unravels the buried feelings men have and how these feelings can lead to estrangement from self and family. The wounded boy grows to be a wounding man, inflicting on those closest to him the very distresses he refuses to acknowledge in himself. Real discusses the relation of depression to addictive behaviors, not only drug or alcohol abuse but also workaholism, gambling, and other compulsions. The cure is in confronting the addictive defenses and allowing the hidden pain to emerge. Throughout, Real gives examples of men who discover cruel, shocking traumas from childhood and their adult depression by undergoing guided imagery, talking in a group of similarly depressed men, or discussing the trauma in family counseling. Highly recommended for both public and academic libraries as well as professional counseling collections.-Susan E. Burdick, MLS, Reading, Pa.
An absorbing and informative look at the hidden long-term depression that constricts or undermines the relationships of many American men.
Real, a family therapist and teacher at the Cambridge (Mass.) Family Institute, contends that most male depression is undiagnosed because it is veiled by addictive and compulsive behavior using such varied "drugs" as alcohol, work, violence, and sex. Its key symptom is "relational immaturity," an inability or unwillingness to truly confide in and be vulnerable before a partner or child. Real traces this problem in part to the gender-polarized socialization of American children. From an early age, boys are encouraged to seek esteem through "hierarchical competition" while being discouraged from expressing feelings and bonding with others. In addition, boys sometimes "carry" the depression suffered by their fathers and expressed through emotional abuse or neglect. Much of Real's argument has been made by other clinical and popular psychologists, but he states his case particularly vividly, drawing richly on his own family history, his clinical practice, myth and legend, film and fiction. He also offers advice and case studies on how the therapist might resolve depression by helping patients overcome their fear of intimacy and redefine their notion of success. He also recounts active therapeutic interventions to stop the kind of toxic family dynamics that a husband's depression can help generate. On the downside, Real overfocuses on the father-son relationship; there is too little here on how depressed or narcissistic mothers may contribute to long-term male depression, much less on how siblings or societal factors may do so. Stylistically, it is somewhat marred by repetition, and the occasional use of a clumsy phrase ("rageaholism") or hyperbolic generalization, such as a reference to "the state of alienation we call manhood."
Fortunately, such lapses are a minor part of what otherwise is an important and rewarding work.
From the Publisher
"Offers not only crucial insights to men suffering from depression but also comfort and guidance to the women who love them." John Bradshaw
Read an Excerpt
From Chapter One: Men's Hidden Depression
When I stand beside troubled fathers and sons I am often flooded with a sense of recognition, All men are sons and, whether they know it or not, most sons are loyal. To me, my father presented a confusing jumble of brutality and pathos. As a boy, I drank into my character a dark, jagged, emptiness that haunted me for close to thirty years. As other fathers have done to their sons, my father-through the look in his eyes, the tone of his voice, the quality Of his touch-passed the depression he did not know he had on to me, just as surely as his father had passed it on to him a chain of pain, linking parent to child across generations, a toxic legacy.
In hindsight, it is clear to me that, among other reasons, I became a therapist so I could cultivate the skills I needed to heal my own father to heal him at least sufficiently to get him to talk to me. I needed to know about his life to help understand his brutality and lay my hatred of him to rest. At first I did this unconsciously, not out of any great love for him, but out of an instinct to save myself. I wanted the legacy to stop.
One might think that I would have brought to my work a particular sensitivity to issues of depression in men, but at first I did not. Despite my hard-won personal knowledge, years passed before I found the courage to invite my patients to embark upon the same journey I had taken. I was not prepared, by training or experience, to reach so deep into a man's inner pain to hold and confront him there. Faced with men's hidden fragility, I had been tacitly schooled, like most therapists-indeed, like most people in our culture to protect them. I had also been taught that depression was predominantly a woman's disease, that the rate of depression was somewhere between two to four times higher for women than it was for men. When I first began my clinical practice, I had faith in the simplicity of such figures, but twenty years of work with men and their families has lead me to believe that the real story concerning this disorder is far more complex.
There is a terrible collusion in our society, a cultural cover-up about depression in men.
One of the ironies about men's depression is that the very forces that help create it keep us from seeing it. Men are not supposed to be vulnerable. Pain is something we are to rise above. He who has been brought down by it will most likely see himself as shameful, and so, too, may his family and friends, even the mental health profession. Yet I believe it is this secret pain that lies at the heart of many of the difficulties in men's lives. Hidden depression drives several of the problems we think of as typically male: physical illness, alcohol and drug abuse, domestic violence, failures in intimacy, self-sabotage in careers.
We tend not to recognize depression in men because the disorder itself is seen as unmanly. Depression carries, to many, a double stain the stigma of mental illness and also the stigma of "feminine" emotionality. Those in a relationship with a depressed man are themselves often faced with a painful dilemma. They can either confront his condition which may further shame him or else collude with him in minimizing it, a course that offers no hope for relief. Depression in men a condition experienced as both shamefilled and shameful goes largely unacknowledged and unrecognized both by the men who suffer and by those who surround them. And yet, the Impact of this hidden condition is enormous.
Copyright © 1997 by Terry Real