Why Can’t a Man be More Like a Woman?

The Evolutionary Psychology of Male Help-Seeking Behavior

Paul Quinnett, Ph.D.President/CEO

The QPR InstituteClinical Assistant Professor, University of Washington School of

Medicine

Backgrounder to Mantherapy

• Lanny & Mort• My response from Darwin’s Bass• Friends in low places• Birth of an idea – Sally and Jarrod• AAS workshop, paper, new book• APA Division 51 – Society for the Study of

Psychology of Masculinity - Practice Guidelines for Boys and Men expected soon…

Current Assumptions

• Remove barriers to care, suicide rates will go down

• Get men to “ask for help” and male suicide rates will plummet

• Tell men enough times to ask for help and they will do it - Poblem solved!

Reality

• “Encourage help-seeking behavior” in men is a failed strategy

• Passive systems don’t work & won’t work

• The males most at risk are the least likely to self refer, so forget the self-propelled male patient

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Ask for help or die…

Our current social marketing efforts to change male help-seeking behavior are about useful as parachutes that open on the second bounce.

Men and depression

• Men are far less likely to report depression. While there is no evidence that women experience higher rates of depression, men account for only 1 in 10 diagnosed cases of depression.1

Source: “Ranking America’s Mental Health: An Analysis of Depression Across the States.” Prepared for Mental Health America by Thomson Healthcare. November 29, 2007.

Depressed suicidal men haven’t a chance…

• 1776 PCP visits @ 2/3 female, 1/3 male• All patients screened with PHQ-9 • 128 scored positive for depression, 75 for SI• 50% of depressions “discussed”• 10% of SI “discussed”• But for SI positive men, “No male patients

initiated suicide-related discussion.” Vannoy SD, Robins LS. Suicide-related discussions with depressed primary care

patients in the USA: gender and quality gaps. A mixed methods analysis. BMJ Open 2011;1:e000198. doi:10.1136/bmjopen-2011-000198

Men not asking for help means…• More untreated psychiatric illnesses• More unintentional injuries and premature death• More HIV/AIDS• More liver disease, heart disease, heart attack• More smoking, binge drinking, HBP• More colorectal cancer• More homicides• More suicides (4 to 1)• All the Darwin Awards

Sources: multiple web sites and Addis M E, Mahalik JR. Men, masculinity, and the contexts of help seeking. Am Psychol. 2003;58:5–14.

What is it about men anyway?

Psychological explanation?(Meta-analysis of 16 studies N=5,713)

“The males’ adherence to social norms characterized by instrumentality, strength, aggressiveness and emotional inexpressiveness seem in opposition to the behavior of seeking help for psychological concerns.”

Source: Nam, et al., 2010, Gender and Help Seeking Journal of America College Health

APA report on boys and men…Division 51 – top 3 topics…

1.“Challenges in seeking help”2.“Risk taking behavior”3. “Institutional bias”

Evolution 101Evolution is not only about survival; it is about

reproduction.

Sex is the final common pathway for all evolutionary change.

No sex = no gene replication.

Marketing fitness-to-mate

Marketing reproductive fitness… “Ain’t I pretty?”

Marketing benefits!

Male Evolutionary Psychology 102

If you cannot win a girl and reproduce, you risk becoming a burden on others in your gene pool and will likely experience thwarted belongingness, e.g., “A barren branch.”

Fundamental question:

Does natural selection favor men who ask for help?

Primate survival gear

FreezeFight (kill) Flee

What do all humans fear?

Source: Buss, et al., American Psychologist, 2012

Question

“Why did Moses wander in the desert for 40 years?

Because he had to ask this guy for directions…

Strangers

Xenophobia, Tribalism, and Genocide

First 1.5 million years we protected our gene pools and engaged in collective violence, genocide if we could manage it…

We’re good at killing and are the last hominid species left standing of some known 20 competitors

Any strange male on our turf was a potential mortal threat and we could kill him at will..

What do we do now when….

We find a strange man on our property or in our house? Ask him to leave? Shoot him?

Temporarily “turned around” in unfamiliar country?

Mary: “George, just stop and ask directions.” George: “Fat chance!”

From Trevon Martin to Chicago gang shootings…

What happens to “lost” men?

• Giladites, and the lost stranger an Ephramimite. “Then said they unto him, Say now Shibboleth: and he said Sibboleth, for he could not frame to pronounce it right. Then they took him and slew him.”

• US Marines, Korean war used “Abraham Lincoln” as their password challenge, and “Lucky Strikes” as the correct counter.

Asking for help means admitting…

• You’re so stupid you got lost in MY woods.

• You didn’t bring enough other guys to take these guys out (recon in force) because, perhaps, you have no battle buddies.

• You can’t say Shibboleth or Lucky Strikes right – which means you don’t belong here and I have a right to kill you. (not hurt you, but kill you – English common law)

Ask for help from a stranger?

Best outcome: capture and life-long slavery

Worst outcome: capture, rape, torture, and a slow, painful death

Best selling T-shirt?

Who is your daddy?

Your ancient male fathers were not the fearless guys who got lost in the woods, walked up to strangers and said,

“Hi, I’m a little turned around here, can you direct me back to my village?”

No, your father was someone like Daniel Boone…

“I was never lost but I was powerfully bewildered once for

three days.” – D. Boone in Indian country

Why did Boone leave so many descendants?

Because he didn’t ask the Cherokee for directions…

A change of terms?

• Asking for help = weak and incompetent

• Accepting help = you are strong, but not quuite strong enough to lift a car out of ditch or drag whole elk back to hunting camp…

Accepting help creates “repayment reciprocity” - a good thing that stitches together the fabric of everything from military units to entire communities

Help-seeking OK

Help-seeking not OK

Help-accepting OK

NPR News Story

A suicidal, depressed, unemployed German man in his 40s was walking to a train track to step in front of a train.

On the way to the tracks he walked by an old church. “Singers needed!” said a sign on the door. He walked in.

Now a baritone in the choir, he said for the interview, “Except for seeing that sign I would have killed

myself.”

Uncle Sam Needs You!

WWII

Recruiter to man with no hands, “Yes, the Army needs you!”

“But I have no hands,” says the man. “What job can I do?”

Recruiter, “You can tell the blind guy filling water buckets when they’re full.”

“Sign me up!” cries the man.

Bottom Line?

Men don’t just need to be needed, they cannot live without

being needed…

Do not ask a man to ask for help, ask him to help you….

The Web is a DMZ for Men

Marine general officers discussing suicidal soldiers, “They won’t call us, but they might text us.”

No enemy tribe owns the internet - you can hide in the tall grass and only show yourself when you know its safe…

No banjo music; instead, meet Dr. R. Mahogany