On our podcast ‘Tales That Tethr’, tethr Founder & CEO Matt Zerker interviews entrepreneurs, experts, thought leaders, and regular people about what is means to be a man, the challenges that modern men face, and how to overcome challenges and live life in a more connected and authentic way.
Through our partnership with HeadsUpGuys, the tethr community benefits not only from their wealth of resources and research, but also from the expertise of the website’s founder, Dr. John Ogrodniczuk. Along with creating HeadsUpGuys, Dr. Ogrodniczuk is a Professor and Director of the UBC Psychotherapy Program, North America’s 2nd largest medically-based psychotherapy training program.
Back in May, Dr. Ogrodniczuk (virtually) sat down with Matt Zerker, tethr’s CEO and Founder, to share insights on the state of men’s mental health. They addressed the difficulty men have reaching out and the loneliness so many men suffer from as a result.
As the pandemic continues and for many quarantine does as well, experts predict a rising suicide rate correlating with unemployment and isolation. In light of these hard times, we’re revisiting the core of the men’s mental health crisis and reminding everyone in the tethr community that we’re in this together.
Matt Zerker: I'd love to start with your journey. Why you got into psychotherapy and why you decided to focus on men's mental health. Was there anything in your life that specifically prompted this?
Dr. John Ogrodniczuk: I've always been very curious and somebody that people seem to be comfortable talking with about stuff going on in their life. I was intrigued by the field of psychiatry, and psychotherapy in particular, because of the human aspect of talking and sharing stories and going through life narratives and really being a detective.
Early on in my career, we're talking about twenty-five years ago, I really enjoyed working with men. I think it had something to do with fewer men actually coming through my door or any mental health professionals door. So it felt kind of special when they did because I knew how much it took out of them to go and seek help. Even to this day, men don't seek help at nearly the same rate as women do. I think that's an unfortunate factor in the high suicide rates that we see amongst men. So I've made it my professional mission, both in my private practice but also my academic work and public service work, to try to provide resources to men to help better engage them in their own health, engage them with health services, and help them lead healthier, happier lives.
Zerker: From my own personal experience, I know how difficult it was to reach out and start getting the help that I needed. I'm curious, from your experience, why is it that men have a harder time reaching out for the support they need?
Ogrodniczuk: I think a big factor is how boys are socialized to be men. The academic term is ‘masculine socialization’ but it's really about how society shapes the behaviours of men and boys to act like 'men' ultimately. Some of the masculine characteristics that get communicated are a sense of stoicism, strength, sturdy oak, don't show any vulnerability - meaning don't share anything intimate that might be perceived as a vulnerability - don't ask for help because that's a behavioural manifestation of vulnerability. It's not that men consciously buy into them but when you get these messages imparted to you over and over in many different ways, and actually men are socialized by shame to buy into these, it just becomes part of their mannerisms. When it gets to a point that a guy feels like, ‘shit I'm not really doing well right now and I need help,’ they feel that they can't betray what it means to be a man and reach out for help. That's the sticker right there.
Zerker: That is a huge issue because getting to that point where they're in enough pain to actually seek help, then taking the step and knowing that the bridge of support is actually going to appear for them, that's a really hard thing for most men. What have you noticed with men that actually go and reach out for the support? What are some of the positive by-products of men actually taking that big leap and is it as scary once they take that step?
Ogrodniczuk: Well taking the first step is very scary for a lot of them. When they come through my door and sit down in the chair, a lot of them say something to the effect of, “you know Doc, I'm not your normal guy.” And I say well why is that? They say, “well because I'm here.” I say, actually, a lot of guys feel exactly like you do. If they're coming in for feeling depressed or anxious or whatever it is, a lot of men feel exactly like you do about reaching out for help.
You can physically see the relief, their shoulders will come up a bit, they'll look up from the floor and their eyes are wide. That permission to be and feel the way they are is huge. That's something that I often say is, guys need the permission from other guys to share and seek help. Once they feel that it's okay and normal for guys to do, it's a real game-changer.
Zerker: I think that word that you used, permission, is so powerful. I remember my first experience in a men's group. I was in so much pain at that point in my life. All I needed to see from the other men was that they didn't break eye contact with me. There wasn't anything that they saw in me that was wrong or broken or not manly enough. That was a massive weight taken off my chest. My experience is that men don't actually feel safe sharing with other men. There's an emotional safety issue there. Have you noticed anything like that?
Ogrodniczuk: Well that gets back to the vulnerability issue. Guys will protect themselves from being perceived as vulnerable from other guys because that somehow makes them less manly. You're absolutely right, in the early days of the men's group, it's pretty tough for guys to open up and share and be vulnerable. But once they see that the other guys aren't going to shame them, that they're attentive, that they're empathic, that they share similar thoughts and feelings, it really changes them. Because then it's like 'oh we're all in this together and we're here to help one another. I'm not just here to fix myself, but I actually have a role in helping the other people around me.' That's a big thing for guys.
Zerker: Yeah absolutely right. And it creates this feeling of brotherhood in some ways, right?
Zerker: So let’s go down that road. Tell me a little bit about your experience with men’s groups and what secret power these groups have, especially in helping men come out of the depths of despair.
Ogrodniczuk: My experience is that it often takes a lot of convincing and reassurance for guys to agree to get into a group in the first place - just any group - but especially a men's group. But once they're there and they find it's a safe place, I'm repeating myself but it just emphasizes how important these things are: a sense of universality, normalizing their own experience, hearing and seeing guys feeling the same way as them as far as feeling crappy and having serious reservations about reaching out for help and being in a group with other guys. That sense of togetherness, the cohesiveness is huge.
We know from data that we've collected from thousands of men from our stress test on HeadsUpGuys, that loneliness is the key stressor in most men's lives. It's the most frequently endorsed stressor in men's lives. So that sense of isolation, we're not talking about COVID stuff at all, this is just normal everyday lives, a lot of guys feel lonely. When you provide them with a forum where they don't feel lonely anymore, that's huge.
Zerker: What are some of the origins of why men feel so lonely today?
Ogrodniczuk: Human beings in general are social animals, we need to be around other people. There are individual characteristics that are obviously part of the puzzle but I think a big piece for a lot of guys is how we're socialized to be men. The togetherness and the sharing is not something that we're socialized to say that’s okay for guys.
Another thing is that we’re really attentive to our responsibilities. This speaks to a positive aspect of masculinity but taken to an extreme it can be hurtful. A lot of guys with their work and their families, you know it's like "I have a role to fulfill, I have to protect and provide" if you will, and they really embrace this responsibility. But done to the extent that they essentially sacrifice themselves, whether it's in their job or doing things for their family, they kind of lose themselves in those activities in order to say “I'm doing what a man should do, I'm supposed to be there for my family, I'm supposed to be a good worker.”
They forget about themselves. A lot of guys will say, “it just feels really selfish if I do something for myself while I've got my family or I've got work to do." They forget that if you don't look after yourself, you're going to comprise your ability to be a better father, or be a better husband, be a better employee, or boss.
Zerker: What are some effective things you've noticed that have really helped move the needle and create that feeling from men that they're actually taking care of themselves so that they can be better for the people their lives touch?
Ogrodniczuk: It's really giving them permission to look after themselves, saying it's okay, and it's actually needed. If you look after yourself in a regular way, keep on top of your health, keep on top of your happiness, you’re going to be much more effective in your other life roles. You can use the car maintenance analogy if you want. If you want your car running really well and serving you for a long time, keep up with the regular maintenance. You don't want to wait till something is broken and then fix it. Then the car won’t be as good for you in the future. That's often how men treat their own health. They wait for something to be broken then they try to fix it themselves, most of them find out they don't have the skills to do it, they keep fighting it and not figuring it out. They really become destitute over that because they don't know how to reach out.
Zerker: So it sounds like preventatively taking care of yourself is a huge part of this as well.
Ogrodniczuk: Absolutely. Whether it's men or women, we all have to take care of ourselves. We have to recognize what good health means in a broad, comprehensive, holistic kind of way. It's not just our diet and physical exercise, we need to look after our minds and there's a variety of ways to do it. Especially if you know something's not quite right and you’re struggling with coping, there are professionals out there. Rather than looking at it as conceding defeat or being defective in some way, it's like 'well, something is a little out of my grasp, there are people out there that are trained to provide the kind of help that I need. I'm going to reach out to them and fix whatever this is.'
Zerker: That idea of fixing is a big part of the ‘masculine mindset’ if you want to call it. We're always trying to fix problems, in our lives, and other people’s lives, and one of the things I found so helpful in my own journey was letting myself know that there isn't actually anything broken with me, it doesn't mean I'm a broken person because I need to reach out for help. It's actually a very human piece of the pie.
Ogrodniczuk: Absolutely and you know that's a big part of conceptualizing a person’s state of being. If they're depressed it doesn't mean that they are a depressed person or that's their character. That's not what defines who they are, it's currently what they're experiencing. So it may seem subtle, but it's actually really big.
The other part about ‘fixing’ is that when guys come to see me, I don't communicate ‘what can I fix for you,’ it's about, 'what can we do together'. That puts them in the role of being in control. Whenever you seek help, you're actually in control. You're the one that knows that somethings not right, you want to fix it, you're seeking the help of a professional and collaboratively you'll sort out what it is and work toward better health. It's really important for guys to understand that they're in control in this process.
Zerker: So what are some of the ways that you typically like to empower men in your sessions? Is there something that you do specifically for the men that you work with that men could actually take away for themselves and maybe even do proactively?
Ogrodniczuk: I use the word 'we' a lot. It's me and the fellow in the room working together to help get him to a better place with his health and his happiness. As far as techniques or tactics, it really is individually-oriented. I can't say that there's a general approach that works for everyone or most people. Unfortunately, there's a lot of practitioners out there that approach their work in that way. They have one model, they have one way they do things. But it's really important for the individual who comes seeking help to be approached as an individual. You're bringing some unique characteristics to this room that nobody else shares. There may be other things that are similar across people but if I presume something about you simply because you're a man then I'm missing what's really important: your own individual experience.
Sometimes you dig into really heavy, meaty stuff that's difficult to work through, and other times you look for small successes that help you feel like this is advancing. Therapy is hard work and that's what I try to communicate from the beginning. Don't expect this to work in a couple of sessions and that I'm going to do some voodoo magic stuff and everything is going to be better. We're going to be doing hard work.
Zerker: I want to switch a little bit to HeadsUpGuys. When I was starting tethr, it was one of the resources websites that I looked to and said “man if we could really do something like that, we could give men tools to seek help, to find the support that they need, that would be really cool.” So as the founder of HeadsUpGuys, tell us a little bit about the story of how it was built and the main function of HeadsUpGuys in your mind?
Ogrodniczuk: HeadsUpGuys was really started because we recognize that a lot of men, unfortunately, end up taking their life because they haven’t reached out for help or weren't getting appropriate help. Their pain becomes so bad the only escape they see is to end their life. About 75% of suicides in Canada, really globally, are men. So whatever we were doing wasn't working, so we had to try something different.
We also know that people tend to turn to the internet now as their first foray into health. If somethings hurting, somethings not quite right, you notice a symptom, you're going to Google to sort it out. Guys do this a lot. So we thought, let's try to connect with them there as a first step. We started to look at what was available for men in the area of depression and suicide and there was virtually nothing. There's a lot of great resources out there but they are all generic, none of them really spoke to me as a man. Often the presentation of the resources, despite having good information, was rather terrible. You're confronted with a wall of text and some very somber images and it's like wow, this is kind of crappy. So we thought, why don’t we create something just about men. It's for men, about men, it's engaging. If a guy comes there he knows it's for him and for other men. It's aesthetically pleasing enough that if somebody walks by their computer screen, they're not going to be embarrassed.
We were also very mindful of who we’re trying to help. If you’re depressed and you’re looking for information and you go to one of these resources that’s essentially an encyclopedia, are you going to get much out of that? The answer is no. We wanted to make sure that whatever we provided, we provided in a way that was very digestible.
Five years ago, we created this and it was our first foray into the online space. In all honesty, we didn’t really know what we were doing, but we tried. Five years later, we can probably say its worked out. We've had over 1.6 million people come to the site, we get about 60,000 visits per month. People are coming from all over the world, this isn't just Canadian.
Zerker: Let’s talk a little bit about the ambitions for HeadsUpGuys going forward. You’re having 60,000 unique visitors a month, you're reaching men all over the globe, has this success changed your ambitions or are you keeping the course and continuing to do well what you already do so well?
Ogrodniczuk: It’s a combination of both: we're sticking to doing well what we know how to do, but we're doing it on a broader scale. We no longer think of ourselves as simply a Canadian resource serving Canadians, although we're very proud of that. We know that people throughout the world are using us to help themselves. We try to speak to them by having more localized resources and stories shared with them whether it's through social media, or resources that are on the website. One initiative that we're embarking on right now is collaborating with a men's health foundation in Germany to bring HeadsUpGuys to the German speaking population in Europe. So that's just one example of how we're trying to broaden our reach. Doing what we do and know how to do, but to a wider audience.
Zerker: What are some of the most engaging points with the website and where do you find men are going most often when they come to HeadsUpGuys?
Ogrodniczuk: We have a self-check, this is a standardized screening tool, for depression and that is one of our top pages. It speaks to how people generally like taking tests but more importantly, it's a place where people can go for information. Things like, 'I'm feeling kind of crappy, I wonder if I'm depressed’ or ‘somebody suggested that maybe I might be suffering from depression, I don't know.’ The screening tool is one way to sort that out. It's not a diagnostic tool, it's a screening tool, so it gives some indication of the probability. A score is spit out after people do this and there are different prompts for what next steps are depending on the severity of their symptoms.
Another page that's a more recent development is our stress test. The stress test is a place where people can report on the frequency of the stressor, how difficult it is to manage, how long it’s been going on for them. This is all gleaned from research about the most common stressors in people’s lives. It is a very popular feature, with thousands of men filling it out. I mentioned earlier that loneliness is the top endorsed stressor. The second one is actually a lack of purpose or meaning in life. That’s very interesting.
Other popular features on the site are the blog stories and personal stories. One of the top pages we have as far as blog stories is about dealing with suicidal thoughts. From Google Analytics, we know how people get here by way of organic searches. The top terms that bring people to HeadsUpGuys all deal with suicidality. People will type into the search engine, ‘how to die,’ ‘how to kill myself,’ ‘I want to die.’ People are typing that into Google and rather than going to one of those sites that will, unfortunately, tell you how to do it, they come to ours. This clearly indicates that they don’t want to die, they simply want their pain to end. That’s why a lot of our articles around suicidality are some of the top hits.
Zerker: That really resonates with me because I spent time suicidally depressed and the big thing that I realized in myself was that it wasn't that I wanted to die, like you said, it was just that I wanted the pain to stop. I've started to glean in my discussions with a lot of men that men really just wanna be the man that they always felt like they could be. Does that resonate with you?
Ogrodniczuk: I think that actually ties in with what I said just a couple moments ago about lack of purpose or meaning in life being a really significant stressor in many men's lives. That is about being the best you can be. People often say, well what does therapy do for me? It helps you be the best version of you. That's really important, when you inspire and empower people in that way and give them hope. There's more to you and you maybe can't see it quite yet because depression really clouds your mind and it really messes with how you think about yourself, you often can't see what you have to give. But know that there's something in there and that's what therapy can help with.
Zerker: Absolutely. This has been an unbelievable chat and I really want to thank you again for doing this with me. What's kind of on deck for you right now and what are you getting really excited about from a research perspective?
Ogrodniczuk: From a research perspective, one of the things that we've been working on is trying to understand men's experiences when they identify as having a mental health problem, they haven't engaged with anybody and they don't want that help. These are the tough cookies, if you will. It's people who recognize that they're not well, something is amiss in their life, but they can't bring themselves to say I actually want help. How do we connect with them?
I don't have an answer for you yet. These are the guys that are at very high risk for taking their life later on. A very large study conducted in Australia that involved nearly fourteen thousand men looked at risk factors for suicidality. After accounting for many of the robust, well-known predictors, what turned out to be the single strongest predictor of suicidality, in men, was the sense of self-reliance. It was assessed with two simple items like, 'I don't like asking for help,’ and ‘it bothers me when I have to ask for help.' That alone was the strongest predictor of suicidality. We can bring it back to this group of guys, and they're saying, 'yeah I know I got a problem but I don't want help for it.' So these guys we should be concerned about. How do we connect with them?
Zerker: It feels like the impossible problem to solve but also like the most worthwhile problem to solve.
Ogrodniczuk: Yeah, it won’t be easy. It won’t be quick. But I think we owe it to these men and society in general. Let's be honest, if an individual takes his life, it's not just that individual’s life that's affected. It's a lot of people's lives that are affected. So, we do owe it to society to understand how to help these guys better.
(Interview has been edited for length and clarity)