I began my career working at female-only treatment center working with pregnant and parenting women who brought their children with them to treatment. Through this experience, I definitely developed what some might call an expertise in working with women’s issues in early recovery. From there I transitioned to a co-ed treatment facility where I learned how combining genders could be an incredible and redemptive tool in early recovery (I could write a whole blog on just this.) And now I find myself coming full circle in my career and am working with young adult men in early recovery. This has been a fascinating lesson for me in the dynamics of working with an all-male population and I am so grateful that I get a new perspective. Here are some of the things I am learning...

When young men fall behind their peers in education and career, it shatters their confidence. When chemical dependency disrupts a guy’s education or career, as much as they might act like they don’t care, they feel like total losers. This is not a surprise, but it is an important factor to identify with young men because so much of their manhood is attached to their ability to provide. I see a pattern with guys trying to figure out other ways to make themselves “matter” in the world – for example, they may not be in school like the rest of the guys they went to high school with, but they are the best drug dealer in town. They will find a way to matter in whatever current situation they find themselves. I love seeing the light come on in the eyes of a young man when he begins to feel like he matters at his 12 step group, with his sponsor, and with his sponsees. This, I believe, is the first step to rebuilding vision and confidence in the lives of these guys.

The bigger their ego appears to be on the outside, the more fragile they actually are on the inside. I find it very painful when I work with a young man who absolutely refuses to open up, utilize therapy, and become authentic. And unfortunately, this is more common with men. At any given time, I have a few male client’s who will not “go there” and talk about their pain, their insecurity, their wounds and their fears. These are the guys who need to talk the most. Their number one commitment in life is to never look weak. Which unfortunately, is the first indicator that there are wounds that need to be addressed. I pull out the best joining skills I have, get creative and try to dive in to their worlds. But unfortunately, there are not enough therapeutic tools and skills in the world to break through this barrier if the client is not willing. So I wait. I pray. And I talk to them about music.

Body Image is a powerful factor with men. Despite all my education and experience with eating disorders, I have been surprised at what a role body image shame plays with young men. They believe they look too young, their belly is too flabby, they can’t get big muscles no matter how hard they try, they are too chubby, too short . . . and all of this boils down to being not enough of a man, the right kind of man, or a man who can ever compete with other men. This shame is intense and must be addressed in early recovery. Self hatred is not healed over night – it is a journey that requires a lot of redemptive relationships, reliance on a higher power, and a willingness to be honest.

Traditional group therapy isn’t always the best way with young men. I am learning this through trial and error... asking a group of guys sitting in a circle to talk about feelings sometimes goes over like a fart in a space suit (Credit for this disgusting metaphor goes to my friend Curt). Group therapy is an amazing tool for peer feedback, reparative experiences, empathy and identification. However, it must used in small doses with young men and must be fairly directive. Anger, competition and humor are behaviors that have to constantly be addressed and challenged with a young male population. As I experiment with different types of therapeutic groups, I am learning that experiential groups, peer-to-peer dyad work, and guided journaling can be incredible tools to get young men to talk. By nature, young men do not want to appear weak to a group of their peers. Going around this with creative techniques can be far more beneficial than beating your head against the wall in a talk therapy group.

No matter how hard they act like they don’t care, they always want to be part of the cool kids club. Even the anti-establishment emo guys, the grateful dead guys with dread locks, the jocks, and the frat boys ALL want to be accepted and ultimately, want to be in the cool kids club. Even in their 20’s, there is so much pain that they were not “popular” in high school. Or if they were popular, they aren’t any more. Or they’re convinced they definitely can’t be popular again now that they are sober. This obsession with acceptance from peers is a dominating force in their thoughts, actions and sobriety. When we break apart the timeline with men coming back from a relapse it is always revealed that at some point they compromised their sobriety to be accepted by others. Desiring acceptance from our peers is a part of life, but in my experience, this desire becomes a block to sobriety for many young men. Drinking and drugging has been their strategic tool in their mission to be cool. And they are lost without it. This is a symptom of the internal condition of addicted individuals that are restless, irritable and discontent. These young men live in the delusion that they are in charge of their lives, but when they realize through working the 12 steps that the world and it’s people actually dominate them, it can be very powerful... and motivating!

Always. Have. Snacks. The best lesson I’ve learned working with young adult men is to always have food available. Their metabolisms are crazy fast and if we expect them to remain present in therapy, groups, and treatment, we have to feed them! I have realized that the financial investment of providing water bottles, trail mix, fig newtons, and granola bars has had a huge return of investment – I have happy, well fed clients ready to do some work!