Show Notes

Kayla: Welcome back to the Designer Practice Podcast, and I’m your host Kayla Das.

In today’s episode, Krish Dhir, Registered Social Worker and Psychotherapist, redefines men’s mental health.

Hi, Krish. Welcome to the show. I’m so glad to have you here today.

Krish: Thanks for having me, Kayla, and allowing me to have this opportunity to talk about such an important issue.

Kayla: Before we dive into today’s episode, can you introduce yourself, where you’re from and tell us a little bit about you and your own practice journey.

Krish: Oh, absolutely Kayla. So, I’m a registered social worker and psychotherapist based out of Toronto. I’ve been practicing for over 12 years, primarily in health care and specializing in mental health.

I have pretty much worked in all areas in a hospital setting and several private practice clinics, including providing support in psychotherapy to individuals presenting with motor vehicle accidents.

Presently, I run my own private practice. It’s called Krish Dhir Social Work and Psychotherapy Services. And practice in the provinces of Ontario and Alberta, and specialize in men’s mental health.

Kayla: This is actually a concept we have not talked about on the podcast before. So, I think it’s very needed and very timely, and I’m so excited that you’re here.

So, let’s first talk about, what is the prevalence of men’s mental health? And from your experience, are there specific challenges that men face that impact their mental health that might be different from other genders?

Krish: I think that’s an amazing question. And the first thing what comes to mind with men’s mental health is the conditioning that men have from earlier years of socialization.

So, what happens as a result some of the issues I see in my practice is that men are less likely to get help. We see issues around, being hyper masculine or holding this type of mindset that being tough is the way to go. Maybe you’ve heard of the term, “man up,” “pick up that dirt” or even at certain times “suck it up.” I hear that all the time from my clients and what’s really interesting. I came across this term on the Internet called Normative Male Alexithymia. Hopefully I pronounced that correctly. Where there was a doctor psychologist specifically by the name of Dr Levant that came up with this term in 1992. That men have conditioned socially, not to express their emotions because it can be seen as a weakness.

So, I think a lot of that type of shame and guilt does arise for that. Obviously, we can’t say that all males have this type of condition. And to be clear, from my understanding, this is not a diagnosed condition, but I can say that different forms of gender norms. And as I mentioned, toxic or hyper masculinity is not the answer.

So, some of the other issues that I see is challenges for males to just identify and speak about their emotions. And as a therapist we would think that’s very simple is just to identify and label their emotions. But even understanding to navigate their physical sensations and understanding their emotions and expressing and communicating those emotions is a challenge.

Some of the things that I see or, issues rather, is I don’t have time for failure. Challenges with embracing vulnerability. All the time, I see this with my high achieving male clients is the pressure to succeed and experiencing achievement. Sometimes I hear if my family is okay, I’ll be okay. So other issues arise from just having difficulty with emotional regulations or managing difficult emotions and that leads into anger management related issues and substances as well.

And, you know, we also kind of see and hear about substance use is being quite prevalent in the male population. There has been research on that as well. However, I also want to address other issues that are prevalent, such as, we call it process addictions, or, difficult behaviors, such as gaming, gambling, shopping, as a way of coping with life transitions. That’s something I see all the time, too.

Kayla: When we think of men’s mental health, does the societal roles play a factor into some of the challenges that they face? Like, stereotypically, men tend to be the breadwinners and does that influence mental health for the men that you see?

Krish: Oh, absolutely. Kayla. I couldn’t agree even more. All the time, I hear that, in fact, this week, I can just reflect on a number of clients that I saw most of their identity comes from some form of providing for families, and also just achievement or finding some type of success at work. So, the equation is pretty simple. If I have achievement and success at work, I will be able to provide. Or the other way around, too, is in order for me to provide, I need to be successful, I need to achieve. I need to be at this certain type of position in my career. And I hear that all the time from, my male clients.

Kayla: So, when we think of men’s mental health, what are some common myths that surround men’s mental health or perhaps even myths around working with men in therapy.

Krish: Absolutely. First of all, the biggest myth is that men don’t experience mental health. Just some quick stats. In fact, suicide is a second leading cause for deaths for men under the age of 15 in Canada. And it’s a second common cause of death for men under the age of 45. In the United States of America. And globally, there’s some research that indicate that men die on approximately 75 percent by suicide from the World Health Organization. So, that’s just to start right there that men don’t have mental health issues. And it’s surprising to me sometimes that when I’m connecting with even professional colleagues, they don’t even know how much of a crisis this is. So that’s myth number 1, that men don’t have mental health.

Another, you mentioned the societal and the gender norms that men don’t cry. It’s very important to understand that men do cry and it’s okay to cry. And to actually kind of hone that emotion as well.

One of the biggest, myths I see all the time. And I can say that this is not for all men there is men that do approach me and say, I’d be comfortable if I’m speaking to a man, but there’s this underlying myth that men need to only be served by men. In fact, I’ve also experienced in my journey so far is that men might be actually triggered by another man. If they’ve had a previously challenging experience with a man or history of trauma or any type of difficult memories or unpleasant memories. I have actually seen that they prefer the opposite. They want to be connected with a woman or whoever identifies as a woman. And also, I want to be clear here when we’re speaking about men is whoever identifies as a man, that’s one thing just I want to be clear about. So I’ve seen that. I’ve seen men that have come through to connect with me and through my journey and I’ve requested to be connected with a woman.

So, another myth I see all the time is that all men are jock, like they’re all jocks and they love sport or something physically engaging. Now, in my experience, have I seen having discussions about sports or working out helpful? Absolutely. I’ve done some work with men and we’ve definitely had those discussions and we’ve made intellectual links to society based on sports and working out and martial arts. However, that’s not always true. I could see the merit and value of it being an initialized breaker. Or speaking about a certain game. But the truth is that, in my experience, I’ve seen that men do like to connect and they do not want to talk about sports, or they were never raised with sports in their family, or in their communities. Maybe it was another type of activity. Maybe it was playing games, or maybe it was dance, or maybe it was, other recreational activities. But I want to also respect that, that sports does, from a perspective of, in our profession, we call it behavioral activation, which is a very fancy word of just having a structured activity that is enjoyable. Sports does hold that type of value, but bottom line, not for all men. That’s one myth. I’ve definitely seen.

Another myth is, and it’s interesting. I still see. This is that only women, whoever identifies a woman suffer from eating disorders or body related issues. The truth is that men also have body image issues and can show up in different forms. One study indicated that 25 percent of diagnosed cases of eating disorders are men, or 1 in every 4. So that’s the huge myth.

Now this myth is pretty interesting. That all masculinity is bad. Because when we look at masculinity, we think about traditional gender norms. We think about hyper or toxic masculinity. Now, there’s a term that’s going around. It’s called positive masculinity. Where it does provide a men a sense of values and purpose and accountability because what tends to happen is men usually feel this societal pressure to conform to that toxic masculinity. And this is some men, I can’t say that all men do, but it also impacts their communication, relationships, personal, professional lives. We see burnout as a result. We’re seeing marriages and divorces happening as a result. And this comes down to that Normative Male Alexistymia. That men are kind of punished for showing their emotions or even accessing their emotions. So, that’s definitely a myth that I’d like to say that all masculinity is bad. It actually can provide some merit, if it’s in the positive form.

Kayla: Thank you so much for sharing those myths. So, how can we as therapists, keep these in the back of our mind so that we can provide the best service to our male clients?

Krish: That’s an awesome question. I think the first thing is, being aware of your own biases and continuing to have that self-awareness and understanding what the dialogue is around men’s mental health. I think it just starts with that and also spreading awareness.

I would say recognizing signs of men’s mental health or issues in men. Is a little bit different. Usually with men’s mental health and this goes specifically for therapists is just trying to read into their nonverbal cues, their facial expressions. A lot of time, there’ll be identification of, I have a headache or sleep related issues or a lot of avoidant type of behaviors.

So, advising men on creating routines that promote mental well-being. So, a lot of self-compassion could be really helpful for therapists. And I would say, and even say this that self-compassion for a lot of us. I just want to kind of add this is, it tends to be a challenge, but I would say specifically also for men. It’s an extra challenge as well. What I’ve seen is that in male clients, they do not want to even access that site. They’re afraid of it. So just being aware of that and being more sensitive around that, that even to get a guy to understand the concept of self-compassion is a whole different realm. And some of the techniques I kind of uses, is there a side of you that speaks to you with an authoritative tone? Is it dominating you? When was the last time you heard about that authoritative tone? What purpose or function did that authoritative voice serve to you? So, I get some to identify that inner critic and what function it’s supporting. And if it has no function, okay, and it’s providing you with all of these type of symptoms, all these type of problems or issues in your relationship, at your work, your own physical health. Then let’s look at the other side. And that is self-compassion.

Encouraging help seeking behaviors. Challenging gender norms. I will continue to say that. I think that’s very important. For therapists. The approach of therapy and also even coaching can be helpful too. I want to just put that out there with coaching is that keeping a very goal directed and using very simple language. In my experience, I would just say avoid the clinical jargon, when working with men. Because I’ve found men being very even logical, even when I’m doing an assessment that, okay, this is what I’m coming to you for. If it’s I want to identify and learn about my triggers, I want to work on my anger management related issues because it’s impacting my relationship. I want to prevent a divorce. I want to be a better husband, a better brother. I want to be more insightful about my emotions or even to identify triggers. So I can have some type of growth or personal development. So, using very simple language could be helpful.

One modality, that’s very helpful using with men as Acceptance and Commitment Therapy. And also, Internal Family Systems. It’s very simple. And might I also just add simple education around the nervous system as a foundational way of connecting. And I would even kind of expand this more than men to, but that’s my approach is just starting off with simple nervous system education.

Here: nervous systems divided into two. There’s a side of us that gets ready for action. Okay, so that side could be connected to that bread winning that achievement, that pressure to succeed. And there’s another side that it’s kind of like chill. It’s a chill zone. It’s more of a relaxed zone. And that’s where you can experience the moment. That’s where you can strengthen and hone those relationships. And I’m going to be very clear that none of these are actually bad. So, we know that sympathetic nervous system has a purpose as well, the fight or flight, and a freeze response when fight or flight is not accessible. But at the same time, we also know that there’s a lot of false activation of that.

So, just keeping it simple can be very helpful. Starting a conversation with intellectual links to society. Topics or discussions outside of therapy. And I can just remember this with clients is, okay, tell me about that new card game you were telling me about. Tell me about that new restaurant. And for those that do engage in some type of sports, okay, how are the Raptors doing? How is this, team doing right? Encourage that and create that safe place because right away they become in their chill zone when they can connect with that. And I think that’s really, really helpful is to keep it logical. Goal oriented. And making those intellectual links to society.

Kayla: I love that. When we think about working with men, would it be best to say, start with emotions in therapy or would it be best to start with more process to help them feel more comfortable.

Krish: I think that’s an excellent question. I would say everyone is different. I would encourage, therapists and coaches to just tune in to the client, meet them where they’re at.

In my experience, it comes down to goals. And I kind of like doing this professional personal dance. It’s between goal orientation of where we want to go with this. And it’s about creating that comfort zone. So, keeping that logical or that sense of just having a conversation, right? Because coming back to what I say that a lot of the male and especially high achieving individuals are about productivity. So, when they come into a session right away, they’re like, okay, what am I going to get from my 1st session, even to get them to do the initial assessment, they’re thinking about productivity, a discovery to happen in the assessment.

And I could definitely even say that, even for my female clients, I see that at times, but I do have to say more specifically because you’ve asked me about my experience with male clients. They want to know the outcomes way more quicker. So, it’s doing that dance. It’s like, okay, this is where we’re going. These are the goals. So sometimes we do take the emotional route, but I usually wait to maybe the 2nd session to even get to the emotions because the 1st thing is, and we know this Kayla is just to connect. Let’s just talk do the constant check ins. Especially the 1st time I’ve seen a client, it’s like, every 10 to 15 minutes, I’m doing a check in. How are you doing? How’s this going for you? And then usually a response I get is, okay, this wasn’t that bad, I’m just talking about things that I’m aware of. Okay. So even the talking is the stepping stones of creating the emotional type of understanding and understanding your emotions.

Kayla: That’s really helpful. And I just think about when I used to work with executives experiencing workplace burnout, some of my clients were men, some were women. And going back to the high achieving. Often high achieving was a huge part of that. The one thing that I heard time and time again from my male and female clients who were high achievers is they want those goals, that process, those outcomes before they talk about emotion, because that’s what helps them start feeling more comfortable in the session. That’s what builds that relationship in the session. Instead of just focusing on, I want to say the traditional feelings, emotions, even the cognitive piece connected to emotions. Usually, I work with after we created some outcomes that they can actually take away with them. And then they feel more comfortable to talk about those pieces. So process first, emotion second, versus emotions first, process or outcome second.

Krish: Absolutely. I agree with you Kayla. And I would just like to add there that it depends on the reason they’re coming to, the presentation that they’re coming with. I also work with some, I would say executives and high achieving, and I see that.

But if I have a client coming to me for a specific issue related to grief and loss, I think it would be a little bit different. It would be a little bit different where, yes, let’s start with the emotion. Let’s start with the stages of loss. And let’s kind of see what’s coming out from there. So, yeah. It is client to client, but I would agree with you with the majority. I would say it comes down to that process, that logic, and then the emotion that provides that foundation.

Kayla: And I think even in that example, it started with the education, right? It still didn’t start with the emotion, but the education behind that. And going back to when you mentioned that starting with the nervous system, that was the education piece, so it still has that process connected to it, even though it’s still about the emotions, the feelings, and the behaviors that might happen as a result of that.

Krish: Absolutely.

Kayla: So, do you have any additional advice or insights regarding men’s mental health?

Krish:  Kayla, absolutely. Just a request for therapists and coaches to continue to create awareness around the issues related to men’s mental health in an effort to reduce stigma and challenge harmful traditional gender norms.

I would request therapists and coaches to write in their communities and their blogs, their articles, if it’s their social media, to spread the awareness even more. And just to remember that not all types of masculinity is bad. As we discussed that positive masculinity provides its benefits as well.

Kayla: I love that. Krish, are you currently accepting clients into your practice?

Krish: Yes, I am.

Kayla: So, if a listener would like to refer a client to you, do you want to reiterate who you serve and also which jurisdictions you practice in?

Krish: Absolutely. So, my expertise is in men’s mental health and I would say especially around high achieving men. And I have a special interest for the racialized communities.

I practice in the provinces of Ontario and Alberta, and hopefully in the process of expanding to other provinces as well.

Kayla: Lovely. So, to connect with Krish, check out his website krishdhirtherapy.com

That’s krishdhirtherapy.com

Or you can simply scroll down to the show notes and click on the link.

Krish, thank you so much for joining us on the podcast today to redefine men’s mental health.

Krish: Thank you so much, Kayla, for giving me this opportunity.

Kayla: You’re very welcome and thank you everyone for tuning in to today’s episode and I hope you join me again soon on the Designer Practice Podcast.

Until next time, bye for now.

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