Masculinity: a Risk for Addiction
It may come as a surprising title: masculinity itself as a risk factor for substance abuse—but yes—it is absolutely true. Let me explain a few key concepts to help elucidate this. Men are socialized differently from women; we know this on the simple basis of men preferring different colors than women (blue vs pink). This concept is deepened by research on career trajectory, where we see men preferring STEM careers while women tend to prefer artistic/social careers (yes, this has a lot to do with prototypical gender socialization). But let’s go back to the main question—just how does masculinity, as a construct, become a risk factor for substance abuse? Well, it has a lot to do with avoidance of the expression of raw emotion.
Let’s take one common thread of emotions: pain/sadness/loneliness/depression/shame. How do men communicate they are feeling this way? Rarely as the raw emotion itself. We see that men tend to gravitate toward more socially accepted emotions (for men) such as anger, frustration, humor, or any other emotion men are ‘allowed’ to express. This socialization process has roots in childhood and adolescence, where boys are taught to behave in certain ways. Research done by Pollack (1998) contends that boys and men alike are taught to feel particularly ashamed of the expression of emotions such as guilt, fear, weakness, and despair. In this sense, shame is a function of the “...toughening-up process by which it’s assumed boys need to be raised” (Pollack, 1998, p. 11). By encouraging the ‘toughening-up’ of boys, we are teaching them that emotions such as those listed above are completely inappropriate and therefore should not be communicated or expressed. If a boy were to express overt despair, depression, or fear, then the consequence of this, as Pollack (1998) identifies, is internalized shame. Shame also functions as a control for boys (and men). It controls men’s emotional expressiveness while reinforcing emotional suppression; it controls men from getting too close or connected to traditional feminine roles while reinforcing independence and discipline, and it controls men from being the “mama’s boy” and reinforces being the “real man”--all of which is what Pollack (1998) refers to as the shame-hardening process of society. It is within this shame hardening process that we see the appearance of substance abuse. Men, with nowhere to turn but those socially accepted yet inauthentic emotions, may resort to drinking behavior or user behavior in an effort to reinforce accepted emotions or to remove negative experiences with those emotions. This is strongly tied to over conformity to prototypical gender norms, which I’ll discuss later. With this in mind, it is no surprise that men attempt to mask their love and deeply embedded emotions with strength, autonomy, and pride; all of which can be precursors to addiction (men may drink alcohol to feel ‘strong’ or ‘manly’ while also reaping the benefit of negative reinforcement).
The shame-phobia that overtakes men as they become socialized bears some consideration to the contingencies that are offered to overcome the negative emotions. If a man were to feel shame, one response is to overconform to traditional masculine norms. This over conformity resembles the extinction bursting present in operant conditioning, where before the behavior is eliminated (before the shame overcomes the person), a dramatic increase or burst comes to life to prevent loss of the behavior (over conformity). Men fear the shame, and with that, they fear the loss of their masculinity (manhood has been identified as precarious), and so when shame occurs, it is no surprise a man will overconform to a traditional masculine norm to prevent the shame from overwhelming their manhood (Vondello & Bosson, 2013). Pollack (1998) would likely agree that without the over conformity, men are confronted with the prospect of ‘losing their face’--the over conformity is the response to doing whatever it takes to maintain manhood, maintain face, and avoid shame. Drinking, using, and engaging in risky behaviors is a symptom of this over conformity.
An example to illustrate the above comes from Mark, a 21-year old Caucasian male college student. One day when he was approximately fourteen years old, Mark was confronted by one of his male classmates who began to criticize him for how clean and organized his classroom desk appeared. Mark does not recall if, on that day, he made a point to organize his desk more-so than he would any other day, but regardless of whether or not his desk was actually organized, the male-to-male confrontation ensued. “Are you gay or something?” the boy remarked to Mark. Mark does not remember how he responded verbally, but he does know that after that day, he made it a point to make his desk especially messy. Mark’s response of making his desk especially messy is an example of over conformity to traditional masculine norms. Since men are socialized to appear messy and to not care about their hygiene, Mark decided the best way for his manhood to remain unquestioned was to make his desk messy/unhygienic. According to Mark, clean, organized ‘spotless’ desks were the mark of a female student, and the shame (and later the overconformity) associated with ‘being like a female’ prevented Mark from entering the ‘female realm’. It is also evident that the shame here functioned as the control mechanism mentioned above; Mark was controlled via the shame to stay away from feminine roles (cleanliness and the act of cleaning) and remain as what Pollack (1998) calls the “real boy”. Therefore, through Mark’s experience with the confrontational boy, we see how shame functions in the socialization process and how overconformity can protect against a loss of face and manhood (while avoiding shame). Drinking and using behavior is not a far stretch from this very simple example of overconformity. One could say Mark is at risk for developing an alcohol or another drug dependency due to his gravitation toward overconformity when under threat. Mark may recognize alcohol or other drugs as removing the negative experiences associated with other males—even his ‘friends’. This, too, can produce a dependency, among other factors.
So how do we prevent this? First, we acknowledge masculinity is a construct, something that changes across time. Having an open discussion—counseling—around this topic will allow someone to process and overcome the pseudo-reality that is created when one behaves simply because of his/her sexual and gender orientation. This concept also assists counselors in determining the antecedents, or the precipitating events, associated with relapse, and to determine one’s relapse potential. With this in mind, the person struggling with a dependency may be more amenable to changing their behavior thus avoiding risky scenarios and situations that could elicit a relapse. As men, it’s difficult to discuss these topics without the backlash of embarrassment; however, in a counseling or professional setting, these discussions are not only encouraged, but necessary in order to live a life free from the entrenchment of addiction.
Author: Eric Foster, MA
About the author: Eric has been a substance abuse counselor for three years, working primarily with acute patients in a detoxification and early-recovery outpatient setting. Eric subscribes to an existential/cognitive-behavioral orientation, and has written and researched extensively on the topics of power dynamics, gender prototypicality, and the counseling process. He obtained his bachelors degree in psychology while living in California, and later his masters degree in counseling psychology from Boston College. Currently, he is a doctoral candidate in clinical psychology where he is engaged in research on substance use disorders, culturally-informed perceptions of substance abuse, and gender prototypicality.