What Men Say About #MeToo in Therapy

“I have something I need to talk about and I’m afraid you’re going to judge me,” he said. He told me that he had been thinking about women he had slept with and that he felt terrible about some of the encounters.

“I didn’t rape anyone or anything like that, but I think I made them pretty uncomfortable.”

I’m a psychotherapist who works largely with men in New York City. Before last fall, I can’t remember hearing a statement like that — a voluntary admission of coercive or manipulative behavior with women. The #MeToo era has changed my work. If therapy has a reputation for navel gazing, this powerful moment has joined men in the room, forcing them to engage with topics that they would have earlier avoided.

.. But I am also heartened by the private work that men are doing in therapy and how it can help us understand the relationship between what has been called “toxic masculinity” and the reservoirs of shame that fuel these behaviors.

.. I began to feel the effect in my work not long after the stories about Harvey Weinstein broke, with a noticeable uptick after a report on the comedian Aziz Ansari. Though the accusations against famous men were in one sense far from the people I saw, they were relevant to the questions they often brought to therapy. Why did they so misunderstand the women in their lives? Why were they often being accused of hurting them?

.. He’d been experimenting with approaching women in a more “dominant” and assertive way, since he’d heard that’s what women wanted. He had made an aggressive move on a prospective date and was told that his approach was creepy.

.. he had been so focused on performing for dates that he wasn’t really connecting to them, unable to accurately read his date’s reactions.

.. appear either flat and emotionless or superficially engaged but hiding behind impenetrable niceness.

.. Most men have spent little time with their feelings and have very limited vocabulary to describe what is going on in their hearts.

.. has done such a good job of disconnecting from his feelings that he can’t ever really tell if he’s had a good time on a date.

.. Almost always, the men I work with notice a tight tension in their chests and stomachs — anxiety. They often admit that they feel this tension most of the time.

.. underneath the anxiety that is always humming along are layers of shame. Shame at having feelings at all, shame because they believe that there is something fundamentally wrong with them, shame that they are not men, they are just boys.

.. Shame is the emotional weapon that allows patriarchal behaviors to flourish. The fear of being emasculated leads men to rationalize awful behavior. This kind of toxic shame is in direct contradiction with the healthy shame that we all need to feel in order to acknowledge mistakes and take responsibility.

.. still a 15-year-old boy craving the approval of his peers: “I actually don’t even like the sex that much, but there’s something satisfying about adding a notch in the belt. I imagine other guys would be impressed if they knew.”

.. In their efforts to manage the feeling of shame, some men numb themselves. Others sink under it and slip into depression or chronic underachievement. And others take the pain that they feel and project it back out into the world with violent words and deeds.

.. They begin to heal when we can both embrace them and hold them accountable.

.. “I want you to know that I respect the courage it takes to acknowledge something like that and to share it with me, but I also don’t want you to numb yourself out, because then you’ll just forget about this and move on,” I said.

.. He began to cry and then sob. Waves of sadness emerged as he imagined the hurt that he caused these women. As the tears subsided and we began to process it, more tears came, this time tears of relief — that he’s not a monster, that he’s capable of remorse and empathy.

.. He had been desperate to boost his self-esteem through sexual conquests. He ultimately put his own pleasure before someone else’s discomfort, behavior that was forged in moments in which he had felt worthless

.. He had been thinking about one of the women he had told me about. He reached out, they met for coffee and he apologized.

Treating Patients with Respect Lowers Doctors’ Malpractics Lawsuits

I see an interesting parallel to malpractice liability for physicians. The well known and understood best way to avoid malpractice is not expertise or avoiding mistakes, it’s having good beside manners and treating patients with respect. (Expertise and attention to detail are very, very important of course but have less impact on chances to get sued than these other soft factors, according to this advice.)

I’ve seen doctors miss cancers before and escape unscathed after frank discussions with the patient, while others that do everything technically correct are sued over a hangnail. Not saying missing cancer is “ok as long as your nice”, I’m saying that people don’t really sue over money, they sue over hurt feelings and seek retribution in monetary form. (There’s a big exception to all this in the patients who are opportunistically seeking an opening to sue. They are simply dangerous to have as patients, but are usually quick to move on.)
Finally, the physician who has good bedside manners is also a better witness and more sympathetic to juries.

The Durability of Inflation Derp

OK, so some economists got it wrong. That happens to everyone, unless you’re too cowardly to make any testable predictions at all. But what you’re supposed to do when things don’t play out as you predicted is (a) acknowledge the mistake (b) try to understand what went wrong (c) revise your framework in an attempt to avoid making the same mistake again. I think I can fairly claim to have followed these rules.

What’s striking about the economists who predicted runaway inflation in 2009-2011 is that as far as I can tell none of them has even gotten to step (a), acknowledging their mistake

.. And so today we have Marvin Goodfriend, nominated to the Fed board, simply refusing to answer questions about why he thought inflation was about to explode and reducing unemployment was impossible: