The purpose of this article is to begin a more deliberate dialogue about men's issues in addiction treatment and recovery. Current models fail to address the relational needs of men; fall short of adequately addressing the impact of abuse and trauma that is so strongly linked with addiction and the life of the male addict; ignore any social context and/or the consequences of political, social, and economic power; and provide little direction in helping men to establish a healthy sense of self outside of normative masculine scripts. We suggest that a theory-based relational model could offer a road map in assisting recovering men to discover a fuller experience of themselves and to transform their experience of recovery.
Why question if men's issues are being adequately addressed in alcohol and other drug (AOD) treatment? Haven't men been the beneficiaries of treatment all of these years? The answer, quite simply, is yes and no. While countless men have successfully walked the path of recovery and have gone on to enjoy rich and full lives, too many stumble and become lost.
Until recently, professionals seldom have seemed to question the traditional approach toward treatment. Yet in the past several decades as women and other cultural and racial groups have entered the Western discourse of human experience, they have begun to question long-held views and assumptions. This has resulted in transformational models responsive to a broader range of human psychological development, and this in turn has led some to ask if the same theories, assumptions, and explanations are in fact truly representative of the male experience as well.
We acknowledge that we are not alone in being concerned with or writing about this issue.1,2 However, a simple literature search (both academic and clinical) will demonstrate the incredible dearth of information and inquiry that has been carried out thus far on this topic. This article does not pretend to offer all the answers, and its primary aim is not to question or minimize current treatment efforts. Rather, we wish to begin a more deliberate dialogue about men's issues in treatment and the recovery process.
Also, the focus of this work is primarily on the experiences of white male heterosexuals in treatment; however, it is our intention that this discussion ultimately be expanded to men of color and other socioeconomic realities and sexual orientations.
Using a relational approach
Our premise is that the relational cultural model espoused by such writers as Miller, Jordan, Kaplan, Striver, Surrey, and Covington3,45, with some adjustments, is a fitting theoretical model for men. Relational cultural theory, developed at the Stone Center at Wellesley College, originated as a response to understanding and conceptualizing women's psychological development.
The resulting theory places emphasis on connection with others or “self in relation,” stating that psychological growth is the interplay of connection and disconnection. It places emphasis on the importance of mutual, growth-fostering relationships as the source of health and happiness—and disconnection as the source of psychological problems. The theory recognizes that dominant culture through power, socialization, norms, and values plays a pivotal role in our ability to connect and stay in connection with one another.
We suggest that a theory-based relational model could offer a road map in assisting recovering men to discover a fuller experience of themselves. In the book Helping Women Recover, author Stephanie Covington, PhD, has created a relational-based curriculum designed for women entering treatment that is used by chemical dependency treatment and correctional facilities worldwide. 6 Covington's work focuses on four areas essential to recovery: self, relationships, sexuality, and spirituality. It should be noted that Covington has created a separate curriculum to address the significance of and work necessary to address the impact of trauma. 7 With Covington's permission, we offer a similar template incorporating the developmental differences inherent in men's psychological growth.
In a seminal essay, Stephen Bergman has addressed how the relational model applies to men.8 He states that traditional male psychological models fail to capture the whole of men's experience, neglecting to recognize fully the importance of mutual relationships and relational connection. Traditional theories support psychological growth as development of “self” dependent on separation and individualization—self in comparison, competition, and power over others. Drawing on relational cultural theory, Bergman suggests that men, like women, experience a primary desire for connection with others, further adding that “the seeds of misery in men's lives are planted in disconnection from others.”