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Understanding the Way Men Grieve
By J. Scott Janssen, MSW, LCSW

"Sometimes I wonder if you even care that our little boy is gone." Connie's voice is accusatory, her eyes puffy with tears as she looks at her husband, Steve. For a split-second his face flashes hurt before closing into anger.

Though I distrust generalizations, the situation seems familiar. A woman in tears, openly expressing her pain, wanting to connect with a male partner whose impermeable stoicism has left her feeling alone. A man, his heart breaking on the inside, confused amidst a world shattered by loss, locking his pain behind a wall of silence, unsure how to express vulnerability or receive support.

Is there really a difference in the way men grieve and respond to loss? When I survey memories of years as a hospice social worker I find ample evidence that there is. I've known plenty of men who fit the stereotype: emotionally controlled, disinclined to talk about matters of the heart, as apt to seek out solitude as connection, focusing on action rather than talk.

But these were the surface responses of men whose inward experiences were far more nuanced, changeable, and multidimensional than stereotypes can capture or assess. The real picture was more complex.

Still, it can be helpful to bear in mind, without being rigidly attached to, the perspectives of researchers and clinicians convinced such differences are real. This perspective suggests that, as a group, men tend to be less expressive of their feelings—with the possible exception of anger—and that this disinclination to disclose or process emotions may actually intensify during times of stress and vulnerability.

Research

There is evidence that men are more likely than women to remain silent or grieve in isolation, engage in action-oriented forms of grief expression, or lose themselves in distractions such as work or throwing themselves into a new relationship. Research suggests that men appear to be more susceptible to developing a reliance on alcohol or engaging in risk-taking behaviors following a loss and are more likely than women to commit suicide following the death of a spouse. Some studies suggest that men are more likely to use the strategies of avoidance, intellectualization, and minimization when grieving and, although research is inconsistent on the point, they may have a greater tendency to somaticize emotional and psychological pain (Black, 1991; Canetto & Cleary, 2012; Doka & Martin, 2010; Sanders, 1980, 1998; Staudacher, 1991; Stillion, 1985).

Grieving men may be at greater risk of death when compared with men of the same age who are not grieving. Some believe this may reflect the impact of internalized stress or the effects of poor self-care. Others suggest that men tend to have smaller social networks than women and more difficulty asking for and accepting support, making them less likely to receive, and more likely to reject, encouragement to prioritize one's health (Bowling, 1987; Holland et al., 2014; Jacobs & Ostfeld, 1977; Sullivan & Fenelon, 2014).

Theories about purported gender patterns among those who are grieving tend to focus on biology, socialization, or a combination of the two. Biological hypotheses range from the impact of testosterone and the nervous system to concepts drawn from evolutionary psychology (such as speculation on the biological basis of role differentiation).

Psychologist Judith Stillion, PhD, CT, articulates one of the earlier arguments on behalf of the importance of socialization. During childhood, boys and girls receive different messages that profoundly impact the ways they grieve, she says. Boys, she believes, receive four fundamental messages about what it means to be a man and what constitutes proper male behavior. She refers to the first as "the stiff upper lip syndrome," in which boys are taught that men must be strong and stoical in the face of difficulty and are discouraged from expressing vulnerability and encouraged to accept pain without complaint. The second is that a man must be in control at all times, self-reliant and able to handle any situation without asking for help. She calls this the "powerful loner stereotype." The third message is that a man must protect and keep safe those who are important to him and never trouble them with his own struggles or concerns. The last is that a man must be ever ready to overcome any challenge without fear.

Doka and Martin suggest that men and women express their grief along a continuum of styles ranging from those that they call intuitive, centering on the expression of affect, to those they call instrumental,which find expression physically and cognitively. Although they are careful to contextualize gender within a matrix of other variables—underscoring that no two people or groups will ever grieve exactly alike and that most prefer some blending of these styles—in general men seem to feel more comfortable with a style more heavily weighted toward the instrumental end.

Cultural Messages

Though we may hope boys in the rising generation of men are no longer receiving such rigid injunctions, many males continue to receive such messages as adults, even when grieving. I've worked with many men who report that when they've attempted to talk about their feelings or shed tears they have felt rebuffed or gotten the message, subtly or overtly, to "be strong," "don't cry," "suck it up," or "don't make others feel uncomfortable." Such experiences not only close down opportunities for connection and authentic support but also can undermine trust and reinforce stereotyped patterns and defenses tending toward isolation.

Cultural expectations about what constitutes healthy grieving hold that to heal, one has to speak about, process, and "work through" one's thoughts and feelings by sharing them. Ideally this allows the bereaved to adapt to the world in the absence of their loved one while maximizing social support networks and reinvesting in other relationships and meaningful activities. Those who grieve silently rather than talking about their feelings may be labeled as excessively withdrawn, clinically depressed, or incommunicative. Men who prize stoicism as an expression of independence or dignity, or as a way of not putting their burdens on others may be considered to be in in denial or out of touch. Men who engage in action-oriented expressions of grief, such as physical activity or private rituals away from the eyes of others, or who attempt to cope through distraction, positive thinking, planning for the future, or intellectualization may be accused of running away from their grief.

Though any of the above tendencies when taken to extremes or excessively relied upon can lead to complications, there is nothing inherently wrong or unhealthy about any of them. In fact, these tendencies may simply be a part of a style of grieving that social worker Tom Golden, LCSW, (2010) refers to as "the masculine side of healing."

By this he means that there may be a style of grieving and healing that men gravitate to more readily than women. In his book Swallowed by a Snake: The Gift of the Masculine Side of Healing, he puts it as follows: "The masculine side of healing is not as accepted a mode of healing as the more traditional verbal and emotional expressions. It tends to be quieter and less visible, less connected with the past and more with the future, [and] less connected with passivity and more aligned with action. As a consequence, I have noticed repeatedly that people who use a predominance of this masculine side of healing are suspected even by mental health professionals of 'not really healing.'"

By thinking in terms of a style of healing in which men may feel more at home, we can better assess and appreciate the potentially useful aspects of this style in the larger context of one's bereavement journey, rather than dismissing it as dysfunctional.

So is the inward experience of grief really different for men and women? Or is the pain simply more likely to find expression along gender lines? Maybe the difference is not so much in the experience of grief itself but in how the pain of grief is absorbed, processed, and expressed, or what we typically call mourning.

Unquestionably, many men have inherited the messages described by Stillion—the powerful loner guarding emotion behind a wall of strength, unwilling to be vulnerable, uncomfortable asking for support. But this response may be reflexive and potentially self-protective when one is feeling unsafe or overwhelmed. When the value of such responses are affirmed and the boundaries they set respected, and when the language of action, silent gestures, personal codes of honor, are decoded and affirmed, men often become more forthcoming about things which they had been struggling to carry alone.

If we mistakenly view a surface style as indicative of an unwillingness to connect or process on a deeper level, or if we discount this style as invalid, insisting that those for whom it is helpful are not doing the work of bereavement, we will miss opportunities to go beneath the surface and offer support. If we accept and respect what may be a masculine or instrumental style of healing, we can avoid the trap of stereotyped expectations and build trust by not dismissing these strategies or attempting to force ourselves beyond one's defenses.

It must be remembered, of course, that this style, although it can become an avenue into healing, may also lead to serious complications, causing men to suppress or feel shame about normal thoughts, feelings, and difficulties which often attend grief, and potentially creating distrust when it comes to asking for or accepting support. It can also lead to isolation, relational conflict, undisclosed anxiety, depression, or a reliance on dangerous forms of escapism such as drinking or extreme risk-taking, possibly leading to premature death.

It's also worth remembering that there are plenty of men who gravitate toward an intuitive style of mourning and many women who prefer one that tends toward the instrumental. And that these preferences may be more fluid than fixed, changing with the context, level of trust, and so on.

When the subject of gender differentials in grieving comes up among social workers, the conversations can get pretty lively. Some argue that, although we need to be careful not to overgeneralize, there are clear differences in style between men and women. Others may agree that it's wise to be aware of ways gender socialization can impact one's sense of self but distrust such generalizations because they can dull one's sensitivity to nuance, subjectivity, and changeability when it comes to processing and healing from any significant loss.

The good news is most hospice and bereavement social workers are flexible and inclusive when it comes to these matters, incorporating multiple dimensions of experience and expression into their work, going beyond the traditional verbal explorations that have typified grief and bereavement counseling in the past. They understand the need to take the time necessary to establish trust and safety. They respect a client's defenses and are sensitive to the ways these may be affected by gender. And most respect the potential value of solitude and of more action-oriented strategies for coping and healing, whether these strategies are preferred by a man or a woman.

— J. Scott Janssen, MSW, LCSW, is a social worker with the Hospice and Palliative Care Center of Alamance-Caswell in Burlington, NC, and an editorial advisor for Social Work Today.

References
 
Black, R. (1991). Women's voices after pregnancy loss: Couple's patterns of communication and support. Social Work and Healthcare, 16(2), 19-39.

Bowling, A. (1987). Mortality after bereavement: A review of the literature on survival periods and factors affecting survival. Social Sciences & Medicine, 24(2), 112-124.

Canetto, S., & Cleary, A. (2012). Men, masculinities and suicidal behavior. Social Sciences & Medicine, 74(4), 461-465.

Doka, K., & Martin, T. (2010). Grieving beyond gender: Understanding the ways men and women mourn. 2nd ed. New York, NY: Rutledge.

Golden, T. (2010). Swallowed by a snake: The gift of the masculine side of healing. Gaithersburg, MD: G. H. Publishing.

Holland, J. M., Rozalski, V., Thompson, K. L., Tiongson, R. J., Schatzberg, A. F., O'Hara, R., et al. (2014). Unique impact of late-life bereavement and prolonged grief on diurnal cortisol. Journals of Gerontology, Series B: Psychological Sciences and Social Sciences, 69(1), 4-11.

Jacobs, S., & Ostfeld, A. (1977). An epidemiologic review of the mortality of bereavement. Psychosomatic Medicine, 39(5), 344-357.

Sanders, C. M. (1998). Grief: The mourning after: Dealing with adult bereavement. 2nd ed. New York, NY: Wiley.

Sanders, C. M. (1980). A comparison of the adult bereavement in the death of a spouse, child, and parent. Omega. 10(4), 307-322.

Staudacher, C. (1991). Men and grief. Oakland, CA: New Harbinger Publications.

Stillion, J. M. (1985). Death and the sexes: An examination of differential longevity, attitudes, behaviors, and coping skills. New York, NY: Hemisphere Publishing Corporation.

Sullivan A. R., & Fenelon, A. (2014). Patterns of widowhood. Journals of Gerontology, Series B: Psychological Sciences and Social Sciences, 69(1), 53-62.