30: UK Mental Health Professionals - Talking Therapies

18 avril 2023 · The Nice-ish Ramblings Podcast

00:23:30

EDITING ERROR: There is a part in the introduction where I had to put a new word in - and it sounds ridiculous… I am sorry about that. I meant to say “people have confused what I do with what a psychiatrist does” but ended up saying “what a psychotherapist does”, so needed to replace that word. Doh!

Hello and welcome to The Nice-ish Ramblings podcast with me, the Nice-ish Psychologist, where today I am discussing the second half of a two-part series focusing on the different types of mental health professionals in the United Kingdom. For context, these two episodes developed out some anecdotal experiences I’ve had where I felt that people have confused what I do with what a psychiatrist does. Additionally, even I have often wondered about the differences between what I do versus what a psychotherapist does versus what counsellors do. So, I thought I would dedicate some time to highlighting the differences between the three professions. In sharing these plans on social media, some followers got in touch requesting that their professions within the field of mental health care also be acknowledged.

And so, in the first episode (which, if you are interested is episode 28) I talked about professions that I would consider fall within psychiatric care. Namely psychiatrists, nursing staff (including registered mental health nurses and healthcare assistants), occupational therapists and social workers. In today’s episode I’m going to focus on mental health professionals that encompass what could be considered talking therapies. So today (just in case it’s not already obvious) I'm going to be talking more specifically about the professions of counsellors, psychotherapists, and psychologists.

Now I wasn’t quite sure where to start with this episode because I couldn’t quite figure out the order of things. In researching and writing this episode there seemed to be more certainty about what a psychologist does, while there seemed to be more of a fuzziness and overlap between that of counsellors and psychotherapists (if there are any counsellors and psychotherapists listening and are offended by this, I don’t mean to offend, but the fuzziness might become clear as the episode progresses). Initially I was going to start off by talking about psychologists, mainly because I am one and it’s usually easier to talk about the things you know, right? (Although I will admit that there are some new things I’ve learnt about in relation to psychologists, but I won’t give those away just yet.)

However, as it transpires, it seems to me that the best way to highlight the distinctions between all three professions is to start with counsellors, move through to psychotherapists and finally onto psychologists as there seems to be a bit of a building on from one to the next – although it’s not quit as linear as that. I mean, thinking about it now, I probably should have just invited a counsellor and a psychotherapist onto the podcast to help me out. But we learn, right! On that note, if I don’t get all of this quite right, please let me know – but also, please forgive me. My intention is to try provide clarity around the different professions, not to diminish one or to overstate the importance of another.

So, let’s start with counselling then. In looking for definitions to what a counsellor is I visited a few websites. Firstly, the National Counselling Society (NCS) notes that “counselling is a type of talking therapy that allows a person to talk about their feelings, needs and problems in a safe, structured, confidential setting. The foundation of effective counselling is providing clients with a professional therapeutic relationship based on non-judgmental respect and offering empathic understanding. Counsellors may employ a number of additional ways of working to further support their clients’ healing and development.” Similarly, the British Association of Counselling and Psychotherapy (BACP) notes that “people seek counselling to help them resolve emotional, psychological and relationship issues. Clients may be experiencing difficult and distressing events in their lives, such as bereavement, divorce, health problems or job concerns. Or they may have more general underlying feelings of anxiety or dissatisfaction with life.” It goes on further to say that “counselling involves a series of formal sessions where the therapist and the client talk about the client’s issues and feelings. Even short-term therapy typically involves six to 12 sessions. The sessions take place at a regular, agreed time and in a ‘safe’ private place where the client and therapist will not be overheard or interrupted.”

From what I can tell there are different stages of training that one can do to become a counsellor which can take three to four years. For example, the BACP notes three stages of training with the first being an introduction to counselling, which helps with gaining the basic counselling skills. The website doesn’t note what those are, though, but I’m guessing it might be skills like active listening and motivational interviewing. This first stage also provides and overview of what further training will involve if a fuller commitment is made. The second stage of training is getting a certificate in counselling skills, which provides a deeper understanding of counselling theories, ethics, and self-awareness. It notes that “this training may also be useful if your job involves advising or helping people, even if you don’t plan to become a therapist.” So, I am guessing that if you only have training up to stage two you can’t call yourself a counsellor proper. This can only happen if someone has done their core practitioner training, which is noted on the BACP as the third stage of training and provides skills, knowledge and competence to work as a counsellor or psychotherapist (see, this is where this all gets fuzzy – counselling and psychotherapy are often spoken about interchangeably).

Now, while this might not be 100% percent accurate, from a browse through the directory of institutions that provide training for counselling listed on the BACP website, it seems that the two primary therapeutic modalities that are offered for counsellors are that of integrative counselling and person-centred counselling.

Person-centred counselling (or the person-centred approach rather) was developed by Carl Rogers in the 1940s, who believed that given the right conditions a person can reach their full potential and become their true self, which he referred to as “self-actualisation” (I’m assuming this is off of Maslow’s Hierarchy of Needs). These three conditions are unconditional positive regard (which involves showing complete support and acceptance of a person no matter what that person says or does), congruence (where the therapist is real and/or genuine, open, integrated and authentic during their interactions with the client), and empathic understanding (which is the therapist's ability to understand sensitively and accurately the client’s experience and feelings in the here-and-now). The BACP notes that “with a person-centred counsellor, you’ll be encouraged to bring your own issues to the session – the counselling is led by you and not directed by the counsellor. Many clients, with no prior knowledge of counselling, believe that the counsellor will sort their problems out for them. A person-centred counsellor will help you to explore your own issues, feelings, beliefs, behaviour, and worldview, so you can become more self-aware and achieve greater independence.”

Integrative counselling, on the other hand, is a form of counselling that “draws on techniques from different types of therapy” and may include elements of the person-centred approach just mentioned. Alongside this, integrative counsellors may draw on elements of psychodynamic therapy as well as cognitive behavioural therapy (or CBT). To briefly elaborate on these, psychodynamic approaches involve bringing awareness and attention to your subconscious – the parts of your mind that are just below the surface, that are automatic, which we pay less attention to but have a really fascinating influence on the way we behave. While the CBT approaches will looks at thoughts, feelings and behaviours and helps you to change some of these where they are unhelpful using a variety of practical strategies and tools, such as journaling, thought diaries, cognitive restructuring and re-framing, etc. These are just two examples of modalities that counsellors might use, but I guess it is possible that counsellors can go onto further training and add other modalities to their therapeutic toolbelt as it were.

As for psychotherapists, the UK Council for Psychotherapy (UKCP) notes that “psychotherapists support people facing challenges in life, whether an emotional crisis such as grief or anxiety, job loss, relationship difficulties, [and] addiction. Or it may be a sense that something is not right.” Which, I’m not going to lie, on the face of it does not seem to be that much different from what was described about counselling. According to a 2017 Guardian article the main difference between a counsellor and a psychotherapist is the training in the sense that, as noted above, one can work their way up to being a counsellor from the ground up with no previous qualifications. However, psychotherapy is more of a post-graduate degree achieved after already completing an undergraduate degree in something else (which interestingly, according to this same article, does not have to be in a field related to counselling or psychotherapy). On this basis, a person will then choose a specific modality of psychotherapy to train in, be that psychodynamic, cognitive behavioural, existential, cognitive analytic, schema therapy, dialectical behavioural, hypnotherapy, just to name a few. At this point, it also worth noting that there are a few arts psychotherapies, too (I think that’s what they’re called), which are rooted (I think) in psychodynamic practice. These would encompass art psychotherapy (which uses art based materials to allow a person to express or process the things that may be going on for them), music psychotherapy, and drama psychotherapy; both of which use music and performance to do do what art psychotherapy does, but just with different expressive mediums.

It seems that there is quite a lot of overlap between counsellors and psychotherapists. However, there are a few differences noted. One article from a website called The Counsellor’s Guide highlights that one of the differences is in the length of time one might receive an intervention. That being that counselling is considered a short-term process – lasting weeks or months, while psychotherapy would be considered a longer-term process – more open ended and ranging from months to years. Another website highlights some further differences by noting that: “A counsellor is more likely to help with a specific difficulty, current problem or surface issue” (their words not mine). It goes on to say, “An example might include a bereavement or a difficulty that is not necessarily rooted in the past. A psychotherapist is more likely to help with more deep-rooted difficulties that affects a client’s life. Examples might include child abuse or trauma.” In relation to this, the same paragraph notes that “a psychotherapist or counsellor however might help with either type of issue. A psychotherapist might help a client with psychological difficulties in life caused by internal difficulties whereas a counsellor might help a client with a problem triggered by external circumstances.” So, still not 100% distinctive on the differences between the two talking therapies.

Overall, though, from what I can gather I think there are potentially three things that might distinguish a counsellor from a psychotherapist. And I guess it’s important to note that this is differentiation is on a very general and basic level. The first being the type of training they receive; the second being the length of time that a person would see either one; and thirdly, whether a difficulty is more acute and has the potential to be resolved with some guidance and support, or whether a person has a more long-standing psychological difficulties rooted in past.

Now, what about fucking psychologist, eh? Well, according to Wikipedia (you know I love a Wikipedia definition) “psychology is the scientific study of the mind and behaviour. Psychology includes the study of conscious and unconscious phenomenon, including feelings and thoughts”. It also goes on to say that “as social scientists psychologists aim to understand the behaviour of individuals and groups”. Now, I have spoken at length about the differences between the two main types of psychologists that exists in a previous podcast episode. So if you are interested in learning more about these distinctions, please go listen to episode 17 of the show. However, if you can’t be bothered, in brief there are basically academic psychologists and applied psychologists (also known as practitioner psychologists).

An academic psychologist is mostly focused on improving the research and evidence base within the field of psychology, and they do this by doing lots or research and will generally remain in the field of academia – for the most part – teaching, getting involved in further research and helping others learn about and/or do more research. It’s a very helpful and important sector of the field of psychology. On the other hand, while applied and practitioner psychologists are also interested in doing research to a degree (they have to do thesis as part of their doctoral training) they are primarily practitioners in the sense that they take what has been learned about in psychology and apply that to human beings in a vast array of settings.

According to the VeryWellMind website there are apparently 20 different types of psychologists. For example, aviation psychologists, who study the behaviour of pilots and other flight crew members. Aviation psychologists also perform research on airline safety, develop new training equipment, and help select suitable employees. Who the fuck knew that? There are also consumer psychologists (also known as marketing psychologists) who research consumer behaviour and develop marketing strategies to promote business. So, those are the bastards who likely came up with the idea that every once in a while shops just move their shelves around. And, consequently, after months of knowing exactly where to go and get your weekly food items with military efficiency, you then have to fart arse around the shops looking for the stuff you want and then buying additional crap cos you’re like, “Oh look, it’s two for one on Ginsters pies” when the last thing you need is a Ginsters-fucking-pie!

Anyway, I digress.

Now, without any disrespect to aviation and consumer psychologists - their work is no doubt invaluable (albeit in the case of consumer psychologists, somewhat annoying) - the psychologists more commonly associated with the field of mental health are likely clinical, health, education, developmental, and counselling psychologists. I would also argue forensic psychologists, but this might not be across all forensic settings. Now, as far as I know, all practitioner/applied psychologists have to do a three-year doctoral degree where they go on placements and learn about working therapeutically with the population and or within the relevant discipline of psychology. Additionally, these particular practitioners will also be trained in a number of therapeutic interventions, which range from, for example, Cognitive Behavioural Therapy (which is the alleged gold standard according to the NICE guidelines – the National Institute of Clinical Excellence), Systematic Family Therapy, and Psychodynamic Therapy. In this way, psychologists are also psychotherapists, capable of providing therapy. Because of their level of training, psychologist are also integrative in the way that they think about an individuals difficulties, and because of their expensive training and exposure to a wide variety of psychological theories, they are able apply these theories to individuals, staff, and work environments. They are also required to think about improvement to services by conducting service evaluations, and should theoretically continue to add the body of research, although this is often not possible to do given time constraints and busy case loads. It is worth noting that counsellors and psychotherapists, if working in organisations like the NHS, would likely end up doing this anyway, but these would be additional skills scaffolded onto their therapeutic skills; whereas (and as afar as I know) these are skills taught as standard on psychology doctoral training. Additionally, it is very important to stress here that in the UK psychologist are not – I repeat – they are not medically trained and can therefore cannot prescribe psychiatric medication.

Having said that, when I posted a brief outline of this episode’s content on my Instagram page, someone let me know that psychologist can in fact apply to be what is known as an approved clinician, which according to some guidance from Health Education England is formally defined as “a person approved by the appropriate national authority to act as an approved clinician for the purposes of the Mental Health Act 1983”. So, an approved clinician is someone that is approved to be an approved clinician! I think what this means is that overall responsibility of someone mental health care used to sit primary with a psychiatrist. However, more recently it has been acknowledged that other health care professionals such as psychologists, nurses, social worker and occupational therapists can apply to hold this position (which, by all accounts seems to be quite a big task to undertake). However, psychiatrists obviously have prescribing powers (as they are medical doctors, remember). But I think under this it’s possible for non-medics to apply for prescribing powers. I am aware that nurses can do this. So, theoretically if a psychologist were to apply for approved clinician status, then I think they could also apply to be a prescriber... However, I have not found anything that says this explicitly, nor can I find anywhere that anyone has done or is doing this. So, if anyone has additional insights let me know.

Sitting under the umbrella of psychologist, we also have trainee psychologists and assistant psychologists. Very briefly, then, a trainee psychologist is someone currently completing their training to become a registered psychologist. So, everything that I have just discussed about what a psychologist needs to do in order to become a registered practitioner, that is a trainee psychologist. They can effectively hold a case load of their own to manage and will slowly, over the course of three years, take on more and more clinical responsibility, while at the same time attending lectures at uni, completing various academic assignments, all while trying to plan, recruit for, analyse and write a thesis. Which is pretty much – in terms of length – a short novel.

Assistant psychologists, also known as aspiring psychologists in some respects, are pretty much that. They are assistants to registered psychologists within services, who work under the direction and supervision of those registered psychologists. The specific tasks that an assistant psychologist are asked to carry out will vary depending on the nature of the service they work in, but can range from administration and scoring of psychometric assessments, report writing, delivering low intensity group interventions, and - depending on the level of skill and experience - may also deliver low level individual interventions.

Now, in terms of psychologists, counsellors and psychotherapists, you might be wondering how to know if one of them is legit and trustworthy. For practitioner psychologists and arts therapists (the art, music, and drama therapists), they have to be registered with the Health and Care Professions Council (the HCPC). Also, the term “psychologist” is not a protected title, therefore anyone can call themselves a psychologist if they want, but can only register with the HCPC as a registered practitioner if they have completed an official doctorate in any of disciplines of psychology already mentioned. Academic psychologists, as stated in episode 17 - which I mentioned earlier - don’t register with the HCPC, but can (along with practitioner psychologists) apply for Chartership with the British Psychological Society (the BPS). In terms of counsellors and psychotherapists, they technically don’t have to register with anyone, and the term “therapist” and “counsellor” are also not protected titles. Which again means that if anyone wanted to, they could call themselves a therapist or counsellor. However, therapists and counsellors are strongly encouraged to register with some form of governing body, such as the BACP, the NCS, or the UKCP (all those governing bodies whose websites I cited earlier). Also, in order to prove they have completed some kind of training and have some kind of therapeutic skills, psychotherapists and counsellors will usually have some kind of accreditation from some kind training body. For example, in the UK, if someone trained purely as a CBT therapist, their training would need to meet the standards set out by the British Association for Behavioural and Cognitive Psychotherapies (the BABCP). So, if you are looking to work with a counsellor or therapist, make sure to check whether they are accredited and if they have joined some kind of governing body.

And that’s it - that’s it for today’s show. It’s possible that might feel like quite a lot, and I wouldn’t blame you if that feels like a bit of information overload. Hopefully I have managed to bring some clarity to the differences between the three professions. As you can see there are quite a lot of overlaps, and perhaps only a handful of distinct differences, but there are differences nonetheless. If I have failed to capture those differences accurately, I am sorry - but I tried to read up as much as I could about them all - so, if things aren’t too clear, then I blame the source material.

Additionally, whenever I refer to websites or things that I've read, you can always go and check them out within the transcripts I sometimes write for this show. For this particular podcast, I put hyperlinks in the relevant sections where I referenced sources. So if I say something that piques your interest please do go back and have a look through the transcripts, and you’ll find what I’m talking about linked there.

If you have enjoyed this episode, then please do let me know; either through rating it, sharing it, or come tell me directly. Equally, I am open to hearing your views on what has been discussed. Until next time, have a good day. Or not. No pressure.

Nice-ish.

Music

* Opening: “Chilled Ambient Minimal”

* Closing: “Seven” - Tobu

Thank you for subscribing. Share this episode.

Hosted on Acast. See acast.com/privacy for more information.

Écouter Écoute encore Continuer Écoutez...
S’abonner Se désabonner
Partager

Episodes

A Nice-ish Book Review: “Maybe I Don’t Belong Here”
9 juin· The Nice-ish Ramblings Podcast
It’s the start of Men’s Health Month and Men’s Health Week (10-16 June). In this episode, I briefly cover the origins and rationale for the week's development, and within that context, I offer a review of “Maybe I Don’t Belong Here” by David Harewood (OBE), a book about racism, mental illness, and recovery.

You can read the full transcript, which includes references, here.

Hosted on Acast. See acast.com/privacy for more information.
- Écouter Écoute encore Continuer Écoutez...
- Écoutez plus tard Écoutez plus tard
Why New Year's Resolutions Fail (And How to Overcome That... Maybe)
26 déc. 2023· The Nice-ish Ramblings Podcast
If you are like most human beings, you will likely have made a fair few New Year's resolutions in your life... and like everyone else, you may not have been able to stick to them as much as you would have liked. Personally, I am not one for resolutions or the whole "new year, new me" idea. But if you are, here are some reasons why you may not have stuck to your resolutions in the past. And (more importantly) how to make sure you can keep them... and just in time for New Year's Eve. It's like I planned this or something.

Sources
·      The top 3 reasons New Year's resolutions fail and how yours can succeed (Caprino, 2019);
·      A psychotherapist says there are 3 common reasons so many people's New Year's resolutions end in failure (Abadi, 2019);
·      10 Reasons Why New Year's Resolutions Fail (Wallen, 2020);
·      The Transtheoretical Model of Change Prochaska & DiClemente (1983)

Hosted on Acast. See acast.com/privacy for more information.
- Écouter Écoute encore Continuer Écoutez...
- Écoutez plus tard Écoutez plus tard
Episodes manquant?

Cliquez ici pour raffraichir la page manuellement.
35: The Precarious Manhood of Billionaires
14 août 2023· The Nice-ish Ramblings Podcast
Hi there. How are you? Hopefully, you’re having a nice day. Today, can we please talk about Mark Zuckerberg and Elon Musk wanting to fight each other? I have been fascinated by all of this since the initial reports of this fight being declared. However, when it all kicked off, I didn’t say much about it as I wanted to see how it all played out. But it doesn’t seem to be fizzling out at all. So here we are to think about how all of this – how this very public display of bravado – relates to a concept known as precarious manhood.
In case you are unaware, two of the most prominent tech bros, Zuckerberg and Musk, have been embroiled in a highly publicised feud. There’s obviously been some longstanding animosity between the two, given the fact that they both own two of the biggest social media companies. Still, things seemed to turn up a notch around the time that Zuckerberg was set to launch Threads. Which bears a striking resemblance to Twitter (now currently known as X, but I will continue to refer to it as Twitter because I can’t bring myself to call it X. I just think it’s a really fucking silly name. But anyway). Reports suggest that Musk was quite displeased about this development, and on June 20th, 2023, he took to Twitter to challenge Zuckerberg to a cage fight. I mean, the Tweet literally reads, “I’m up for a cage match if he is.” Which, I’m not going to lie, doesn’t feel like a very thought-through Tweet. The challenge was met with a response from Zuckerberg, who took to Instagram to inquire about the location, with Musk then suggesting the UFC Octagon in Las Vegas.
Now you would be forgiven for thinking that the situation would just have stopped there; however, it seems to have only escalated as time’s gone by.
While nothing has been set in stone – like no date or actual venue has been set – allegedly, UFC president, Dana White, wants the fight to happen and is trying to make the fight a reality. He’s been quoted as saying: “This would be the biggest fight ever in the history of the world, bigger than anything that’s ever been done. It would break all pay-per-view records.” So, we can see what his motivations might be to make this fight take place. More recently, Elon Musk has noted that the fight would be live-streamed on Twitter and that any money made would go to a charity for veterans. It seems like Musk might need to let Dana White know about what’s gonna happen with all that pay-per-view money. But, in discussing how likely the fight would be to happen, Dana White was of the opinion that Zuckerberg is taking this very seriously.
And he’s not wrong.
It’s been recently reported that Mark Zuckerberg has been training in Jujitsu for over a year and has recently been awarded his blue belt (no idea if that’s good or not, but it sounds impressive) and has also been winning competitions while he’s been at. In training for the fight, he’s reportedly been consuming 4,000 calories a day and has also reportedly (and if this is not a sign of escalation, then I don’t know what it is) had his own cage-fighting octagon installed in his garden, which his wife is apparently less than pleased about. Also, it’s been reported that Zuckerberg has been training with actual UFC stars Israel Adesanya and Alex Volkanovski (I have no idea who these people are, but if you’re into UFC you might be impressed). Volkanovski has noted that he believes Zuckerberg is serious about fighting Musk and is quoted as saying: “Man, I'm telling you he [Zuckerberg] is serious. I don't know how serious Elon is, but I'm telling you, he [Zuckerberg] is training.” So, it seems that at least one of the billionaires preparing for a fight.
Musk, on the other hand, seems to be somewhat less prepared. In all fairness, Musk has reportedly often spoken about being in “real hard-core street fights” while growing up in South Africa, with his father, Errol Musk, noting that Elon had once “aced a purple belt in Japanese karate”. Musk seems also to have once told Joe Rogan that he has trained in taekwondo, judo and Brazilian Jujitsu. Jujitsu seems to be the thing to do when you’re a billionaire. Alongside this, it has also been noted that Musk will have a significant height and weight advantage over Zuckerberg. So, looking into this, and depending on which website you look at, Musk is 52 years old, between 5’11’’ and 6’1’’, and weighs between 180 to 187 lbs. While by contrast, Zuckerberg is between 5’7’’ and 5’8’’ and weighs between 154 to 165 lbs.
However, despite this, and speaking once more about his son, Errol Musk has noted that Elon Musk “doesn't know how to go in for the kill” so to speak. So resounding support from Papa Musk there. In terms of actual training for the fight, Musk has allegedly been offered assistance by (and again, maybe this means something to you, but it doesn’t to me) UFC star Jorge Masvidal, apparently reaching out to Musk and stating that Musk needs Masvidal on his team. I have no idea if Musk has accepted this. However, Musk has apparently been (and I quote here) “lifting weights throughout the day”, adding, “I don’t have time to work out, so I just bring them [the weights] to work.” So, it looks like Musk is getting into some training, but seemingly not as much as Zuckerberg is, though.
Because of this, most people are putting their money on Zuckerberg. A boxing promoter, Eddie Hearn, has been quoted as saying, “I don't know anything about Elon Musk's training regime, but if I was Elon Musk, I’d be staying well away from it.” He followed this up by saying, “If you go in a cage with someone that knows how to do Brazilian jujitsu like it's over.” But apparently, Musk knows jujitsu too, remember? So who knows. Mr Hearn is not the only one doubting Musk’s chance in the cage. His father was also noted to have said that he's quite worried about the prospects of the fight, calling it “high school behaviour”, but also noting that Musk “loses if he wins and loses if he loses”. So, according to his father, if Musk wins, he’s a bully, and if he loses, he’s a loser. His father has gone on to say, “I think Elon has got himself into quite the difficult situation as a result of high school behaviour. They both have.” I would argue that Musk the Elder is quite astute in this observation. So, how have Mark Zuckerberg and Elon Musk gotten themselves into this situation?
Well, there are several reasons why this fight might be bulldozing its way to becoming an eventuality. Firstly, there is money to be made. Even though Musk has said that profits will go to charity, I am not so sure someone somewhere won’t be profiting off this fight in a non-charitable way. Secondly, there is the old adage that “all press is good press” (or something like that). So, there is no doubt that both Zuckerberg and Musk stand to gain with all the media attention this fight is generating, especially Zuckerberg in relation to Threads. The other one is possibly ego. But it might relate to something a bit deeper than that. It might relate to a concept called “precarious manhood.” Now, before anyone worries that I am trying to get into the minds of Zuckerberg and Musk, I’m not. I have no idea what they are actually thinking or what their motivations might be. What I am about to offer is nothing more than a social theory that could be used to inform what’s going on here. It is not a definitive answer but more of a possible hypothesis.
Precarious manhood is a theory that suggests that the societal perception of manhood is often seen as something that is not inherent or automatic but rather needs to be continually earned and proved through actions and behaviours. This theory suggests that manhood is fragile and easily lost, making it a “precarious” state. The idea of precarious manhood suggests that men are under constant pressure to demonstrate their masculinity and prove themselves as “real men.” This can manifest in various ways.
In a paper titled “Precarious Manhood and Its Links to Action and Aggression”, the authors explored the idea that because manhood is often seen as something that needs to be proven and maintained, men may feel compelled to engage in behaviours that demonstrate their toughness, dominance, and control. This can lead to actions that are more aggressive or risk-prone compared to individuals who do not feel the same pressures to prove their masculinity. The reviewed a series of experiments and studies to examine the ways in which men’s behaviours are influenced by the perception of their own manhood being precarious. They found that when men’s sense of masculinity was threatened or questioned, they were more likely to respond with behaviours that are traditionally associated with masculinity, such as aggression and risk-taking.
For example, I am going to read an excerpt from the paper: “If manhood threats activate physically aggressive cognitions among men, do they also evoke physically aggressive behaviours? To answer this question, we threatened some men’s gender status by making them perform a stereotypically feminine hair-braiding task; other men performed a gender-neutral rope-braiding task. Next, all men got to choose between hitting a punching bag or solving a puzzle. If men use aggressive displays to restore manhood, then men in the hair-braiding condition should select the punching task more frequently than men in the rope-braiding condition. Indeed, this is what happened. In a follow-up study, men first did the hair- or rope braiding task, and then all of them donned boxing gloves and hit a pad that measured the impact of their strikes. Consistent with the idea that manhood threats evoke physically aggressive displays, men who had styled hair punched the pad harder than did those who had braided rope. Finally, men in a third study did the hairstyling task and then either did or did not punch the pad. Next, they all completed a measure of anxiety. Men who
punched the pad after the hairstyling task exhibited less anxiety than men who did not punch, suggesting that aggressive displays can effectively downregulate men’s anxiety in the wake of manhood threats. Thus, these findings provide converging evidence that men use displays of physical aggression to restore threatened manhood.”
I mean, I am not sure I need to expand on this further to highlight the parallels between what Zuckerberg and Musk are doing and the above discussion of precarious manhood. But it seems possible that through various threats to their essence of being men, which may have started with Musk feeling massively threatened by Zuckerberg releasing Threads, which I guess can be hypothesised as a threat to Musk’s status, he then possibly Tweeted a flippant challenge to Zuckerberg. Who, in kind, when seeing a public physical challenge, and most likely being in a good enough state of physical prowess, took up that threat to his own masculinity and responded by taking up the challenge.
Now, when I first started writing this podcast episode, it was looking like this was all snowballing towards both men beating the shit out of each other, which would have been ludicrous. Initially, due to the possible influence of precarious manhood on this whole situation, I thought that neither of these men would want to bow out; that taking a mature position on how things are escalating would not happen. However, the social media news site, Pubity, released a Threads post by Mark Zuckerberg, who has stated he is moving on from the fight. In the post, Zuckerberg writes:
“I think we can all agree Elon isn’t serious and it’s time to move on. I offered a real date [which was apparently August 26th]. Dana White offered to make this a legit competition for charity. Elon won’t confirm a date, then says he needs surgery, and not asks to do a practice round in my backyard instead [probably because you have built an Octagon ring there, Mark]. If Elon ever gets serious about a real date and official event, he knows how to reach me. Otherwise, time to move on. I’m going to focus on competing with people who take sport seriously.”
So, while it seems that Mark Zuckerberg is allegedly moving on from the fight, he has not necessarily been mature or nice about it. In the message, it seems he has still done a few things to maintain the image of his manhood and seemingly tries to undermine Musk’s. There is the idea that Musk seems to have been offering excuse after excuse not to get involved in the fight, while Zuckerberg has openly been preparing for it, which seems to give the impression that Musk is worried and possibly scared to undertake the fight. And then there’s the jibe about competing against people who take sport seriously, which again, is a slight undercutting of Musk’s image of a man – that he does not take sport seriously because that is what men do… which, to me, is a weird angle to take, because, I don’t know about you, but I was not aware that Zuckerberg was in any way a fan of sport or sporty before this whole drama unfolded.
So, while this seems to have ended for now, the way in which Zuckerberg has ended, it leaves his image of a man capable and willing to engage in an aggressive form of sport intact while seemingly trying to undermine Musk’s image of being a “real man”. So even in this way, there are elements of precarious manhood playing out. It would perhaps have been different if Zuckerberg had put out a post that went something along the lines of, “I realise that things are getting out of hand. I reacted to Musk’s initial Tweet from an emotional place, but thinking about it now, training to beat the shit out of each other is not the mature image I want to convey to the world. So, because of this I am withdrawing from the fight.” It will be interesting to see how Musk responds to this. Who knows, if Musk feels further emasculated, this fight might still be back on. But, for both their sakes, I hope this is where it ends.
Anyway, that’s it from me. I’ll leave this with you to percolate and to think about. All resources used in this podcast are linked in the show notes at the end of the transcript. So, if you want to have a read, please do. Also, if you have any thoughts you want to share, do get in touch and let me know what they are. If you have the time, please rate the show, or leave a comment. But also, please share it with anyone else you think might enjoy it. Thanks again for listening to my bullshit. Hopefully, you’ve taken something from the show.
Hope you have a great day. Or not. No pressure.
Sources
The Sun: “Elon Musk vs Mark Zuckerberg fight updates”
Sportsmanor: “Elon Musk vs Mark Zuckerberg – Height and Weight Differences Between the Two Rivals”
Journal Article: “Precarious Manhood and Its Links to Action and Aggression”
Pubity: “Zuckerberg Withdraws from Fight with Musk”
Music
* Opening: “Chilled Ambient Minimal”
* Closing: “Seven” - Tobu

Thank you for subscribing. Share this episode.
Hosted on Acast. See acast.com/privacy for more information.
- Écouter Écoute encore Continuer Écoutez...
- Écoutez plus tard Écoutez plus tard
34: Boundaries (and More)
16 juil. 2023· The Nice-ish Ramblings Podcast
Last weekend some text messages were released by Sarah Brady, a surfer, model, and the former girlfriend of Jonah Hill. The messages were released on Brady’s Instagram stories. They quickly went viral, most notably for highlighting what Brady inferred to be controlling and demands requests made by Hill, which he described as his “boundaries” for their relationship. The release of these messages sparked some heated debate across social media with some polarizing views.
In this discussion, Dr Bekah Shallcross joins me in a rambling conversation that covers the nuances of what boundaries are, what they are not, how boundaries are upheld and agreed to between men and women In a patriarchal society, and what can be done to change this.
As always, please get in touch to let me or Dr Shallcross know your thoughts. And if you think anyone would benefit from hearing this episode, please do share it with them. Also, if you could leave a rating or a comment to let others know this show isn’t a bag of shite, that would be wonderful too.
All the best,
Nice-ish.
Music
* Opening: “Chilled Ambient Minimal”
* Closing: “Seven” - Tobu

Thank you for subscribing. Share this episode.
Hosted on Acast. See acast.com/privacy for more information.
- Écouter Écoute encore Continuer Écoutez...
- Écoutez plus tard Écoutez plus tard
33: The Benefits of Shame
30 mai 2023· The Nice-ish Ramblings Podcast
I have the utmost pleasure of being joined once more by Dr Martha - a clinical psychologist who specialises in working with young people - in a fascinating and winding discussion about shame. Shame has received a lot of attention on social media, for good reason. But, as with anything, I was keen to take a closer look at this particularly aversive and unpleasant emotion. And who better to talk to than another psychologist, and one that specialises in how shame might serve a purpose?
Dr Martha and I discuss the prevalence of shame discussion on social media, the purposes of shame, how it helps to shape social connections and behaviours, and how it can potentially be a force for good for social change.
As always, it was a thoroughly enjoyable and through-provoking discussion and hopefully, it is for you too. If you enjoyed the episode, please do share it widely on social media (tag me in it if you do), or with someone close to you who you think might enjoy it (or benefit from it).
And if you can, please leave a rating or comment. It all goes towards letting others know how good (or totally shit) this podcast is.
Thanks as always,
Nice-ish.
Resources
* Why Shame Is Good
* Why Shame and Guilt Are Functional For Mental Health
* The Positive Side of Shame
* Is Shame Necessary?: New Uses for an Old Tool
Music
* Opening: “Chilled Ambient Minimal”
* Closing: “Seven” - Tobu

Thank you for subscribing. Share this episode.
Hosted on Acast. See acast.com/privacy for more information.
- Écouter Écoute encore Continuer Écoutez...
- Écoutez plus tard Écoutez plus tard
32: Postpartum Depression and Anxiety in Fathers
17 mai 2023· The Nice-ish Ramblings Podcast
In today’s episode, I am joined by Pierre Azzam, a psychiatrist-turned-men’s coach, in which we discuss an aspect of men’s mental health that is often not thought about or considered all that much. It was an engaging and fascinating chat, which I am glad I got to have with Pierre again (we had previously recorded this episode, but the recording software malfunctioned). Hopefully, you find similar value in what Pierre shared with me.
As always, if you liked this episode and think that someone else may benefit from hearing it, please do share. And if you have the time, please leave a rating and a comment (if you can). It does go a long way to let others know if the show is helpful or a bag of shit.
All the best,
Nice-ish.
Music
* Opening: “Chilled Ambient Minimal”
* Closing: “Seven” - Tobu

Thank you for subscribing. Share this episode.
Hosted on Acast. See acast.com/privacy for more information.
- Écouter Écoute encore Continuer Écoutez...
- Écoutez plus tard Écoutez plus tard
31: How Does Prison Rehabilitation (Ideally) Work?
4 mai 2023· The Nice-ish Ramblings Podcast
Hello and welcome to The Nice-ish Ramblings Podcast with me the Nice-ish Psychologist where today I am putting a bit more of a forensic spin on the episode.
For those of you who don’t know, I am a Clinical and Forensic Psychologist, and in my actual life outside of this social media world, I sometimes get asked what kind of work I do with those in the forensic population. And how I go about trying to help these individuals turn things around for themselves. Not going to lie, it’s quite a hard question to answer. Mostly because it’s not straightforward. I mean, it’s relatively straightforward in my head, but that’s because I know what I’m doing (allegedly).
But the full answer is quite lengthy. So, I thought it could make for a good podcast episode. And so here we are, to think about how prison rehabilitation work ideally. I say ideally because human beings are complex and not straightforward. And even though we can theorise how best to help and work with individuals in the forensic population, it’s not straightforward. We’ll explore some of those reasons as we go along.
But before we get into it, as always, if at the end of this episode, you think “Bloody hell that was interesting, I bet all my friends and family would enjoy hearing this,” then please do share this episode with them. And if you could rate or leave a comment, too, that would be very much appreciated. I must admit, I found this an interesting episode to make, so hopefully you find it interesting, too. Also, I would say that if there is anything that piques your interest further and you want to know more about, do get in touch, and ask a question. I might be able to answer it then and there, or I might do a further podcast episode about it.
Now that that’s out the way and before we think about what ideal rehabilitation should look like, I thought it might be worth taking a very quick historical trip to learn about how the prison system came about. It’s a summary of three different sources, which I have included in the transcript. So, if you want to know more about something or I don’t cover something in as much detail as you’d like, do look for the relevant hyperlinks in the transcript.
So, not going to lie, the history of the prison system is a long and complex one, with roots dating back to ancient civilisations. From the dungeons of medieval Europe to the modern-day prison industrial complex, how society has dealt with crime and punishment has evolved significantly over time. In the 18th century, however, the concept of imprisonment as a form of punishment became increasingly popular. In an interview about the invention of incarceration, Ashley Rubin, a sociologist specialising in the history of prisons in America noted that there is a difference between the existence of jails and the development of prisons.
Apparently, prisons have not always been used as a punishment or deterrent for criminal behaviour, but rather as a means of keeping the perpetrator of a crime detained until the actual punishment could be carried out. Before the introduction of prisons, people were punished either through capital punishment (what we know as the death penalty and – according to good old Wikipedia – was formerly called judicial homicide”) or corporal punishment. In the 16th and 17th centuries, the sanctions for criminal behaviour were public events that were designed to shame and deter, including the ducking stool (which is a contraption that had a long arm with a seat on the end of it and was used to dunk those convicted of offences into the water and were later used to identify witches), a pillory (which is effectively a stock in which a person’s head and hands were locked in a frame at the end of a long post), whipping, branding, and stocks (which, unlike a pillory, were used to restrain a person’s feet).
Further along in the interview, in response to a question about people being locked up long before the 18th century, Rubin notes: “Yes, but those were jails, not prisons. There were, for example, workhouses in England and the Netherlands in the 16th century that held a big mix of people, including vagrants, debtors and prostitutes. Even orphans in some cases. People who had done minor things or hadn’t necessarily been convicted of a crime, or were being held awaiting trial, or until they paid a fine or for other administrative purposes. Some scholars have argued that those were the first prisons, but in my view, they were more similar to what we would call a jail today. Jail is basically a short-term holding cell, not a place of punishment, and we’ve had that throughout history.” So, initially, prisons tended to be a place where people were held before their trial or while awaiting punishment. It was very rarely used as a punishment in its own right.
In 1777, John Howard, the first penal reformer, called for reforms to the prison system, which included paid staff, proper diet, and outside inspection (which only goes to show what the conditions of this confinement would have been like before any of these things were implemented). The existing punishments of capital and corporal punishment were deemed inhumane, and they were not seen as effective in deterring crime. This led to a movement to reform the jail system, which was considered terrible, grotesque, and a hot spot for disease. The desire for a new type of punishment and the need to reform the jails paved the way for prisons as we know them.
The first prisons in the world were developed in America. The Massachusetts state prison, which opened in 1785, was the first actual prison, followed by Connecticut in 1790 and Pennsylvania in 1794. In 1791, in the UK, Jeremy Bentham designed the “panopticon” – a prison design that allowed a centrally placed observer to survey all the prisoners, as prison wings radiated out from this central position – which became the model for prison building for the next half-century. If you can’t conceptualise that, I would go have a look at the link, it is quite a fascinating design.
So, in summary, historically the prison system was designed to punish criminals and deter others from committing crimes. But over time, it has become clear that incarceration alone is not enough to prevent individuals from re-offending. This has led to a shift in focus towards rehabilitation and reintegration programs within the prison system. However, the effectiveness of the prison system has been a topic of debate for many years (over 200 years, apparently).
Then, fast forward to America in 1974, when we meet criminologist Robert Martinson who takes it upon himself to review all evaluations of offender treatment programmes available at the time. In summary, this leads him to conclude that “we haven't the faintest idea about how to rehabilitate offenders and reduce recidivism [which in case I have not mentioned it before is a fancy word for re-offending]”, which lead to the now famous question of “Does Nothing Work?” in terms of prisoner rehabilitation. Just to add, the question is famous in Forensic circles. You would be forgiven for not knowing what I am talking about. It’s no “to be or not to be”, and you’re not going to be using it in pub quizzes any time soon.
However, in response to Martinson’s review and despair, a group of Canadian psychologists proceeded to review all the literature available in the 1980s related to offending to then find out “What Works?” From this review, Donald Andrews and James Bonta developed the Psychology of Criminal Conduct (PCC), which has been around for fucking ages and is now in its 6th edition published in 2016.
The PCC highlighted that (surprise, surprise) there were in fact individual factors as to why people offended, which comprised of social, biological, and individual influences. From this, Andrews and Bonta developed the Risk-Need-Responsivity (R-N-R) model, a model of offending that stood in stark contrast to the previous attitudes of correction that relied heavily on punishment (not going to lie, I feel like the prison system is still pretty punitive these days; but anyway, it’s what the literature says...) Seemingly for the first time a model existed that forensic practitioners could use as a framework to understand the causes of criminal behaviour but also aid in reducing re-offending.
The first “R” of the R-N-R model is the risk principle, which has two key components. Firstly, it involves predicting the level of risk posed by those who have committed offences, which is not fortune-telling but is based on a combination of statistical likelihood and structured clinical judgment. To achieve this, a thorough assessment of the offender’s static risk factors (which are historical and unchangeable) and dynamic risk factors (which are potentially changeable) is required. Secondly, the risk principle involves matching the individual to an appropriate level of treatment based on their level of risk. In this way, it is proposed that present as a higher-risk should receive higher-intensity interventions, whereas those who present with a lower-risk should receive less intensive or no intervention (there have also been arguments that even those in the low-risk category should receive intervention regardless of being low-risk). But overall, this approach enables correctional institutions to direct resources to those who pose a greater risk and require a greater level of rehabilitation.
The “N” part of the R-N-R model is the need principle, which is a key factor in reducing reoffending rates through targeted interventions. To achieve this, it is suggested that interventions should focus on the dynamic risk factors, also known as “criminogenic needs.” The reason for the focus on dynamic risk factors is that, as noted above, static risk factors are historical and can’t be changed. An example of a static risk factor is something like a history of violence or previous offending. These are considered risk factors in the sense that often the predictor of future behaviour is past behaviour, and if someone has a long history of violent behaviour then there is a higher chance that person may engage in violent behaviour in the future. And a history of violence or previous offending is not something that can be changed or undone. However, static factors aren’t necessarily an absolute guarantee of future behaviour as static risk factors are influenced by dynamic risk factors (or criminogenic needs), which are changeable and can be focused on as an area of intervention. There are eight identified criminogenic needs that include a history of antisocial behaviour (it’s worth noting here that all offending can be considered antisocial behaviour, but that not all antisocial behaviour is offending – just think about people who talk loudly or on their phone when you go to the cinema; it’s certainly antisocial but no one’s going to prison for being a dick while you watch the latest Marvel instalment). Other dynamic risk factors are an antisocial personality pattern, antisocial cognitions and attitudes, antisocial associates, problematic home or work circumstances, having few positive leisure activities, and substance abuse. So, for example, through interventions that challenge attitudes and beliefs that are supportive of criminal behaviour, these attitudes and beliefs can be modified, theoretically then leading to a reduction in re-offending.
The second “R” principle is that of responsivity – or a person’s responsiveness to an intervention – which is a crucial aspect of effective rehabilitative treatments. The idea behind the responsivity principle is that it’s all well and good to identify the level of risk, and what an intervention should target, but if a person is not responsive to treatment, then things are very unlikely to change. The responsivity principle has two main components: the general and the specific components. The general component emphasizes the use of cognitive behavioural approaches to effectively reduce reoffending rates. Basically, this is linked to trying to challenge and modify beliefs and attitudes towards offending. Meanwhile, the specific component considers individual factors that may hinder successful rehabilitation, such as low motivation, personality, and, intellectual ability, and gender (having said that out loud, I am not quite sure why gender is considered an individual factor that might hinder rehabilitation. I might look into that). The theory is, that, that by addressing these individual factors, the responsivity principle increases the likelihood that rehabilitative treatments can be delivered effectively to those who have committed crimes.
That all sounds, lovely right. Think about the level of risk, figure out what dynamic risk factors need to be intervened with, and then think about how to make sure someone can engage with an intervention to address those dynamic risk factors. Pretty cut and dried. Well…
Even though the R-N-R Model is the “gold standard” by which prisoner rehabilitation is conducted (and it certainly has the breadth of empirical evidence to support this claim) the R-N-R model has come under significant criticism in the last 20 years. The primary criticism comes from Tony Ward and Claire Stewart in the early 2000s who note that in practice – so in real world, practical terms – the R-N-R model neglects the responsivity principle. And so, because of this, the R-N-R model runs the risk of reducing someone who has offended to a set of risk factors without any sense that those individuals are human beings that have basic needs that they were possibly trying to meet through their offending behaviour. From this, they developed the Good Lives Model (although, when looking at the Good Lives website, I think it was Tony Ward’s brainchild).
So, as human beings, we all have basic needs, and we all go about achieving these needs in different ways. The GLM describes eleven “goods” that we seek to achieve/obtain throughout our lives in order to live “a good life”. These are as follows: life (wanting to live a “good life” which includes healthy living and functioning); knowledge (wanting to know more about the world); excellence in work (being good at /having a job); excellence in play (having leisure time); excellence in agency (having choice about what we do, having autonomy, power, and self-directedness); inner peace (being content and free from emotional turmoil); relatedness (having good relationships, both intimate and non-intimate); community (feeling a part of/connected to something); spirituality (either through religion or spiritual connectedness and having meaning and purpose in life); pleasure (which means feeling good in the here and the now); and creativity (being able to express oneself). It has been conceptualised that “criminogenic needs” serve as indicators that an offender has had difficulty in seeking these human “goods” and has gone about trying to achieve/obtain these goods through antisocial means, either through lack of life skills (which may not have been acquired for a variety of reason) or challenging life circumstances.
An example I like to use to illustrate this is that of a parent stealing nappies for their young child because they can’t afford to buy them. You could view the parent as having antisocial tendencies and a lack of regard for the rules of society. Or, you could understand that this parent, given their financial constraints and potential limitations in being able to acquire nappies in a prosocial way, was pursuing the “good” of “life” in that they were trying to provide their child with a basic, functional need that every parent strives to fulfil for their children. While both choices are criminal, the second framing humanises the parent as someone doing the best they can within the limitations of their circumstances, and what that parent needs are opportunities to do what they need to for their children in a way that does not involve offending. Now, I can appreciate that this is perhaps an easy example to digest as the circumstances can convey a certain level of sympathy and possibly empathy. Something that might not be possible for you, good listener, to do for those who have committed crimes along the higher end of severity and harm. And that’s OK – that’s why there are folks like me doing the job we do so that you don’t have to.
The main claim behind the (GLM) is that to simply focus treatment on “criminogenic need” is to suggest that there is something wrong with a person who has committed an offence and that a more humanistic approach would be to find out what these individuals need to live a different, more prosocial life. Therefore, by finding out what “goods” a person was trying to obtain through their offending and framing. these are treatment needs, or approach goals (i.e., how best to achieve their goals), which may serve to motivate them to engage in rehabilitative strategies more effectively.
So, in summary, in forensic settings if we can a) work out the kind of “goods” a person was trying to obtain at the time of their offending, b) find out why that “good” is important to them, c) help them learn more prosocial/healthy/helpful ways of obtaining that good in the future we will then be able to reduce that person’s risk of trying to obtain those “goods” through antisocial means in the future (i.e., reduce risk of reoffending). Of course, in reality, things don't work out so neatly, and this is not to say that if a person’s goods are identified and addressed then things just fall neatly into place. There is a lot of work that goes into rehabilitation and a lot of barriers which can impede rehabilitation. But the GLM offers a framework to follow and offers a principle that positions those who have committed offences as human beings who have committed offences for specific reasons that relate to things that a non-offending population – so people like you and me – also strive for.
And there we go. That’s it for today’s episode. Hopefully, it has been informative in some way and has given you something to think about. As I have noted throughout, this is just a theoretical underpinning, but often times things are not as clear-cut as I have outlined here. But this is the framework that should underpin rehabilitation in forensic settings. Whether that is or isn’t done is beyond my capacity to know.
Like I said earlier, if you liked this episode, please rate, share, and leave a comment if you can. It all goes towards letting others know if this is a good show or a bag of shite.
As always, thanks for your time.
And I hope you have a good day. Or not. No pressure.

Thank you for subscribing. Share this episode.
Hosted on Acast. See acast.com/privacy for more information.
- Écouter Écoute encore Continuer Écoutez...
- Écoutez plus tard Écoutez plus tard
30: UK Mental Health Professionals - Talking Therapies
18 avril 2023· The Nice-ish Ramblings Podcast
EDITING ERROR: There is a part in the introduction where I had to put a new word in - and it sounds ridiculous… I am sorry about that. I meant to say “people have confused what I do with what a psychiatrist does” but ended up saying “what a psychotherapist does”, so needed to replace that word. Doh!
Hello and welcome to The Nice-ish Ramblings podcast with me, the Nice-ish Psychologist, where today I am discussing the second half of a two-part series focusing on the different types of mental health professionals in the United Kingdom. For context, these two episodes developed out some anecdotal experiences I’ve had where I felt that people have confused what I do with what a psychiatrist does. Additionally, even I have often wondered about the differences between what I do versus what a psychotherapist does versus what counsellors do. So, I thought I would dedicate some time to highlighting the differences between the three professions. In sharing these plans on social media, some followers got in touch requesting that their professions within the field of mental health care also be acknowledged.
And so, in the first episode (which, if you are interested is episode 28) I talked about professions that I would consider fall within psychiatric care. Namely psychiatrists, nursing staff (including registered mental health nurses and healthcare assistants), occupational therapists and social workers. In today’s episode I’m going to focus on mental health professionals that encompass what could be considered talking therapies. So today (just in case it’s not already obvious) I'm going to be talking more specifically about the professions of counsellors, psychotherapists, and psychologists.
Now I wasn’t quite sure where to start with this episode because I couldn’t quite figure out the order of things. In researching and writing this episode there seemed to be more certainty about what a psychologist does, while there seemed to be more of a fuzziness and overlap between that of counsellors and psychotherapists (if there are any counsellors and psychotherapists listening and are offended by this, I don’t mean to offend, but the fuzziness might become clear as the episode progresses). Initially I was going to start off by talking about psychologists, mainly because I am one and it’s usually easier to talk about the things you know, right? (Although I will admit that there are some new things I’ve learnt about in relation to psychologists, but I won’t give those away just yet.)
However, as it transpires, it seems to me that the best way to highlight the distinctions between all three professions is to start with counsellors, move through to psychotherapists and finally onto psychologists as there seems to be a bit of a building on from one to the next – although it’s not quit as linear as that. I mean, thinking about it now, I probably should have just invited a counsellor and a psychotherapist onto the podcast to help me out. But we learn, right! On that note, if I don’t get all of this quite right, please let me know – but also, please forgive me. My intention is to try provide clarity around the different professions, not to diminish one or to overstate the importance of another.
So, let’s start with counselling then. In looking for definitions to what a counsellor is I visited a few websites. Firstly, the National Counselling Society (NCS) notes that “counselling is a type of talking therapy that allows a person to talk about their feelings, needs and problems in a safe, structured, confidential setting. The foundation of effective counselling is providing clients with a professional therapeutic relationship based on non-judgmental respect and offering empathic understanding. Counsellors may employ a number of additional ways of working to further support their clients’ healing and development.” Similarly, the British Association of Counselling and Psychotherapy (BACP) notes that “people seek counselling to help them resolve emotional, psychological and relationship issues. Clients may be experiencing difficult and distressing events in their lives, such as bereavement, divorce, health problems or job concerns. Or they may have more general underlying feelings of anxiety or dissatisfaction with life.” It goes on further to say that “counselling involves a series of formal sessions where the therapist and the client talk about the client’s issues and feelings. Even short-term therapy typically involves six to 12 sessions. The sessions take place at a regular, agreed time and in a ‘safe’ private place where the client and therapist will not be overheard or interrupted.”
From what I can tell there are different stages of training that one can do to become a counsellor which can take three to four years. For example, the BACP notes three stages of training with the first being an introduction to counselling, which helps with gaining the basic counselling skills. The website doesn’t note what those are, though, but I’m guessing it might be skills like active listening and motivational interviewing. This first stage also provides and overview of what further training will involve if a fuller commitment is made. The second stage of training is getting a certificate in counselling skills, which provides a deeper understanding of counselling theories, ethics, and self-awareness. It notes that “this training may also be useful if your job involves advising or helping people, even if you don’t plan to become a therapist.” So, I am guessing that if you only have training up to stage two you can’t call yourself a counsellor proper. This can only happen if someone has done their core practitioner training, which is noted on the BACP as the third stage of training and provides skills, knowledge and competence to work as a counsellor or psychotherapist (see, this is where this all gets fuzzy – counselling and psychotherapy are often spoken about interchangeably).
Now, while this might not be 100% percent accurate, from a browse through the directory of institutions that provide training for counselling listed on the BACP website, it seems that the two primary therapeutic modalities that are offered for counsellors are that of integrative counselling and person-centred counselling.
Person-centred counselling (or the person-centred approach rather) was developed by Carl Rogers in the 1940s, who believed that given the right conditions a person can reach their full potential and become their true self, which he referred to as “self-actualisation” (I’m assuming this is off of Maslow’s Hierarchy of Needs). These three conditions are unconditional positive regard (which involves showing complete support and acceptance of a person no matter what that person says or does), congruence (where the therapist is real and/or genuine, open, integrated and authentic during their interactions with the client), and empathic understanding (which is the therapist's ability to understand sensitively and accurately the client’s experience and feelings in the here-and-now). The BACP notes that “with a person-centred counsellor, you’ll be encouraged to bring your own issues to the session – the counselling is led by you and not directed by the counsellor. Many clients, with no prior knowledge of counselling, believe that the counsellor will sort their problems out for them. A person-centred counsellor will help you to explore your own issues, feelings, beliefs, behaviour, and worldview, so you can become more self-aware and achieve greater independence.”
Integrative counselling, on the other hand, is a form of counselling that “draws on techniques from different types of therapy” and may include elements of the person-centred approach just mentioned. Alongside this, integrative counsellors may draw on elements of psychodynamic therapy as well as cognitive behavioural therapy (or CBT). To briefly elaborate on these, psychodynamic approaches involve bringing awareness and attention to your subconscious – the parts of your mind that are just below the surface, that are automatic, which we pay less attention to but have a really fascinating influence on the way we behave. While the CBT approaches will looks at thoughts, feelings and behaviours and helps you to change some of these where they are unhelpful using a variety of practical strategies and tools, such as journaling, thought diaries, cognitive restructuring and re-framing, etc. These are just two examples of modalities that counsellors might use, but I guess it is possible that counsellors can go onto further training and add other modalities to their therapeutic toolbelt as it were.
As for psychotherapists, the UK Council for Psychotherapy (UKCP) notes that “psychotherapists support people facing challenges in life, whether an emotional crisis such as grief or anxiety, job loss, relationship difficulties, [and] addiction. Or it may be a sense that something is not right.” Which, I’m not going to lie, on the face of it does not seem to be that much different from what was described about counselling. According to a 2017 Guardian article the main difference between a counsellor and a psychotherapist is the training in the sense that, as noted above, one can work their way up to being a counsellor from the ground up with no previous qualifications. However, psychotherapy is more of a post-graduate degree achieved after already completing an undergraduate degree in something else (which interestingly, according to this same article, does not have to be in a field related to counselling or psychotherapy). On this basis, a person will then choose a specific modality of psychotherapy to train in, be that psychodynamic, cognitive behavioural, existential, cognitive analytic, schema therapy, dialectical behavioural, hypnotherapy, just to name a few. At this point, it also worth noting that there are a few arts psychotherapies, too (I think that’s what they’re called), which are rooted (I think) in psychodynamic practice. These would encompass art psychotherapy (which uses art based materials to allow a person to express or process the things that may be going on for them), music psychotherapy, and drama psychotherapy; both of which use music and performance to do do what art psychotherapy does, but just with different expressive mediums.
It seems that there is quite a lot of overlap between counsellors and psychotherapists. However, there are a few differences noted. One article from a website called The Counsellor’s Guide highlights that one of the differences is in the length of time one might receive an intervention. That being that counselling is considered a short-term process – lasting weeks or months, while psychotherapy would be considered a longer-term process – more open ended and ranging from months to years. Another website highlights some further differences by noting that: “A counsellor is more likely to help with a specific difficulty, current problem or surface issue” (their words not mine). It goes on to say, “An example might include a bereavement or a difficulty that is not necessarily rooted in the past. A psychotherapist is more likely to help with more deep-rooted difficulties that affects a client’s life. Examples might include child abuse or trauma.” In relation to this, the same paragraph notes that “a psychotherapist or counsellor however might help with either type of issue. A psychotherapist might help a client with psychological difficulties in life caused by internal difficulties whereas a counsellor might help a client with a problem triggered by external circumstances.” So, still not 100% distinctive on the differences between the two talking therapies.
Overall, though, from what I can gather I think there are potentially three things that might distinguish a counsellor from a psychotherapist. And I guess it’s important to note that this is differentiation is on a very general and basic level. The first being the type of training they receive; the second being the length of time that a person would see either one; and thirdly, whether a difficulty is more acute and has the potential to be resolved with some guidance and support, or whether a person has a more long-standing psychological difficulties rooted in past.
Now, what about fucking psychologist, eh? Well, according to Wikipedia (you know I love a Wikipedia definition) “psychology is the scientific study of the mind and behaviour. Psychology includes the study of conscious and unconscious phenomenon, including feelings and thoughts”. It also goes on to say that “as social scientists psychologists aim to understand the behaviour of individuals and groups”. Now, I have spoken at length about the differences between the two main types of psychologists that exists in a previous podcast episode. So if you are interested in learning more about these distinctions, please go listen to episode 17 of the show. However, if you can’t be bothered, in brief there are basically academic psychologists and applied psychologists (also known as practitioner psychologists).
An academic psychologist is mostly focused on improving the research and evidence base within the field of psychology, and they do this by doing lots or research and will generally remain in the field of academia – for the most part – teaching, getting involved in further research and helping others learn about and/or do more research. It’s a very helpful and important sector of the field of psychology. On the other hand, while applied and practitioner psychologists are also interested in doing research to a degree (they have to do thesis as part of their doctoral training) they are primarily practitioners in the sense that they take what has been learned about in psychology and apply that to human beings in a vast array of settings.
According to the VeryWellMind website there are apparently 20 different types of psychologists. For example, aviation psychologists, who study the behaviour of pilots and other flight crew members. Aviation psychologists also perform research on airline safety, develop new training equipment, and help select suitable employees. Who the fuck knew that? There are also consumer psychologists (also known as marketing psychologists) who research consumer behaviour and develop marketing strategies to promote business. So, those are the bastards who likely came up with the idea that every once in a while shops just move their shelves around. And, consequently, after months of knowing exactly where to go and get your weekly food items with military efficiency, you then have to fart arse around the shops looking for the stuff you want and then buying additional crap cos you’re like, “Oh look, it’s two for one on Ginsters pies” when the last thing you need is a Ginsters-fucking-pie!
Anyway, I digress.
Now, without any disrespect to aviation and consumer psychologists - their work is no doubt invaluable (albeit in the case of consumer psychologists, somewhat annoying) - the psychologists more commonly associated with the field of mental health are likely clinical, health, education, developmental, and counselling psychologists. I would also argue forensic psychologists, but this might not be across all forensic settings. Now, as far as I know, all practitioner/applied psychologists have to do a three-year doctoral degree where they go on placements and learn about working therapeutically with the population and or within the relevant discipline of psychology. Additionally, these particular practitioners will also be trained in a number of therapeutic interventions, which range from, for example, Cognitive Behavioural Therapy (which is the alleged gold standard according to the NICE guidelines – the National Institute of Clinical Excellence), Systematic Family Therapy, and Psychodynamic Therapy. In this way, psychologists are also psychotherapists, capable of providing therapy. Because of their level of training, psychologist are also integrative in the way that they think about an individuals difficulties, and because of their expensive training and exposure to a wide variety of psychological theories, they are able apply these theories to individuals, staff, and work environments. They are also required to think about improvement to services by conducting service evaluations, and should theoretically continue to add the body of research, although this is often not possible to do given time constraints and busy case loads. It is worth noting that counsellors and psychotherapists, if working in organisations like the NHS, would likely end up doing this anyway, but these would be additional skills scaffolded onto their therapeutic skills; whereas (and as afar as I know) these are skills taught as standard on psychology doctoral training. Additionally, it is very important to stress here that in the UK psychologist are not – I repeat – they are not medically trained and can therefore cannot prescribe psychiatric medication.
Having said that, when I posted a brief outline of this episode’s content on my Instagram page, someone let me know that psychologist can in fact apply to be what is known as an approved clinician, which according to some guidance from Health Education England is formally defined as “a person approved by the appropriate national authority to act as an approved clinician for the purposes of the Mental Health Act 1983”. So, an approved clinician is someone that is approved to be an approved clinician! I think what this means is that overall responsibility of someone mental health care used to sit primary with a psychiatrist. However, more recently it has been acknowledged that other health care professionals such as psychologists, nurses, social worker and occupational therapists can apply to hold this position (which, by all accounts seems to be quite a big task to undertake). However, psychiatrists obviously have prescribing powers (as they are medical doctors, remember). But I think under this it’s possible for non-medics to apply for prescribing powers. I am aware that nurses can do this. So, theoretically if a psychologist were to apply for approved clinician status, then I think they could also apply to be a prescriber... However, I have not found anything that says this explicitly, nor can I find anywhere that anyone has done or is doing this. So, if anyone has additional insights let me know.
Sitting under the umbrella of psychologist, we also have trainee psychologists and assistant psychologists. Very briefly, then, a trainee psychologist is someone currently completing their training to become a registered psychologist. So, everything that I have just discussed about what a psychologist needs to do in order to become a registered practitioner, that is a trainee psychologist. They can effectively hold a case load of their own to manage and will slowly, over the course of three years, take on more and more clinical responsibility, while at the same time attending lectures at uni, completing various academic assignments, all while trying to plan, recruit for, analyse and write a thesis. Which is pretty much – in terms of length – a short novel.
Assistant psychologists, also known as aspiring psychologists in some respects, are pretty much that. They are assistants to registered psychologists within services, who work under the direction and supervision of those registered psychologists. The specific tasks that an assistant psychologist are asked to carry out will vary depending on the nature of the service they work in, but can range from administration and scoring of psychometric assessments, report writing, delivering low intensity group interventions, and - depending on the level of skill and experience - may also deliver low level individual interventions.
Now, in terms of psychologists, counsellors and psychotherapists, you might be wondering how to know if one of them is legit and trustworthy. For practitioner psychologists and arts therapists (the art, music, and drama therapists), they have to be registered with the Health and Care Professions Council (the HCPC). Also, the term “psychologist” is not a protected title, therefore anyone can call themselves a psychologist if they want, but can only register with the HCPC as a registered practitioner if they have completed an official doctorate in any of disciplines of psychology already mentioned. Academic psychologists, as stated in episode 17 - which I mentioned earlier - don’t register with the HCPC, but can (along with practitioner psychologists) apply for Chartership with the British Psychological Society (the BPS). In terms of counsellors and psychotherapists, they technically don’t have to register with anyone, and the term “therapist” and “counsellor” are also not protected titles. Which again means that if anyone wanted to, they could call themselves a therapist or counsellor. However, therapists and counsellors are strongly encouraged to register with some form of governing body, such as the BACP, the NCS, or the UKCP (all those governing bodies whose websites I cited earlier). Also, in order to prove they have completed some kind of training and have some kind of therapeutic skills, psychotherapists and counsellors will usually have some kind of accreditation from some kind training body. For example, in the UK, if someone trained purely as a CBT therapist, their training would need to meet the standards set out by the British Association for Behavioural and Cognitive Psychotherapies (the BABCP). So, if you are looking to work with a counsellor or therapist, make sure to check whether they are accredited and if they have joined some kind of governing body.
And that’s it - that’s it for today’s show. It’s possible that might feel like quite a lot, and I wouldn’t blame you if that feels like a bit of information overload. Hopefully I have managed to bring some clarity to the differences between the three professions. As you can see there are quite a lot of overlaps, and perhaps only a handful of distinct differences, but there are differences nonetheless. If I have failed to capture those differences accurately, I am sorry - but I tried to read up as much as I could about them all - so, if things aren’t too clear, then I blame the source material.
Additionally, whenever I refer to websites or things that I've read, you can always go and check them out within the transcripts I sometimes write for this show. For this particular podcast, I put hyperlinks in the relevant sections where I referenced sources. So if I say something that piques your interest please do go back and have a look through the transcripts, and you’ll find what I’m talking about linked there.
If you have enjoyed this episode, then please do let me know; either through rating it, sharing it, or come tell me directly. Equally, I am open to hearing your views on what has been discussed. Until next time, have a good day. Or not. No pressure.
Nice-ish.
Music
* Opening: “Chilled Ambient Minimal”
* Closing: “Seven” - Tobu

Thank you for subscribing. Share this episode.
Hosted on Acast. See acast.com/privacy for more information.
- Écouter Écoute encore Continuer Écoutez...
- Écoutez plus tard Écoutez plus tard
29: Men, Body Image, and Masculinity
4 avril 2023· The Nice-ish Ramblings Podcast
In this episode, returning guests Dan Osman and Calum Stronach, both involved in the world of fitness, join me for a fascinating discussion about men’s body image and masculinity. Men’s body image is something that is possibly not considered as much as it could be, and so the three of us have a go at trying to unpick what body image issues in men might look like and how this ties to contemporary ideals of masculinity.
It was an insightful and fun chat to have, and I am always grateful to have Dan and Calum share their insights with me. Hopefully this is something you learn from, too.
As always, please come share your thoughts on the episode if you have any. And, if you like it, please give me a follow or a rating on whatever platform you listen to your podcasts on. And f you think anyone else may benefit from hearing the episode, please do share it with them.
All the best and thanks for listening.
Nice-ish.
Music
* Opening: “Chilled Ambient Minimal”
* Closing: “Seven” - Tobu

Thank you for subscribing. Share this episode.
Hosted on Acast. See acast.com/privacy for more information.
- Écouter Écoute encore Continuer Écoutez...
- Écoutez plus tard Écoutez plus tard
28: UK Mental Health Professionals - Psychiatric Care
21 mars 2023· The Nice-ish Ramblings Podcast
Hello and welcome to The Nice-ish Ramblings podcast with me, the Nice-ish Psychologist, where today I am going to be discussing the first half of a two-part series focusing on the different types of mental health professionals that exist in the United Kingdom.
So, initially I wanted to focus on the differences between psychiatrists, psychologists, psychotherapists, and counsellors. For two reasons. Firstly, I am forever bemused by the number of times someone asks me – as a psychologist – if I can prescribe medication (and right at the start I want to clarify that I cannot); and I think this is because sometimes people confuse what I do with what a psychiatrist does. So, I thought it might be helpful to clarify that. And secondly, there have been times when even I am like, well, what is the difference between what I do versus what a psychotherapist does versus what a counsellor does. And I figured that if I sometimes find myself asking these questions, then it’s possible that members of the general public must be asking these questions, too.
So, that was going to be the initial podcast. However, when I shared a blurb of this episode on social media (you know, to generate that ever important hype) several followers got in touch to request that their professions be also be acknowledged within the realm of mental health professionals. Which I think is fair.
And so, along with wanting to discuss the differences between psychiatrists, psychologists, psychotherapists, and counsellors, I was also going touch on mental health nursing, occupational therapy, and social work within the realms of the mental health field; additionally, under the section on psychologists I was also going to include the other sub-roles within psychology (like trainee and assistant psychologists). Then, while researching and writing this episode, all of that started to get too big, too long, and too in-depth. And seeing as I had already missed a podcast deadline last week, I decided rather than half-arsing the whole thing, it would make sense to split the episode into two parts. With this first part focusing on the professions that I would consider focus on psychiatric care. This distinction is pretty arbitrary and stems mostly from my experiences of working in psychiatric inpatient settings. For this reason, I am going to spend some time talking you through the roles of psychiatrists, mental health nurses and support workers, occupational therapists, and social workers within the field of mental health. And in the next episode I will focus more on what could be considered the “talking therapies”; namely, psychology, psychotherapy and counselling.
It might be worth noting that while I’ve put these episodes together because I thought it might be helpful for the general public to have an overview of some of the professions involved in the field of mental health in the UK, this is exactly that: an overview. The information I have put into this episode was gathered from as many sources as I could find relating to the numerous professions discussed; but I am conscious that I might not capture all the specifics of the professions quite right. Therefore, if there are any mistakes – or for any listeners who may be part of some of the professions listed, if I do not get the nuances of your job quite right – I am sorry.
Anyway, on with the show…
First off, we’ll start with psychiatrists, mostly because this is the profession which is most unlike that of a psychologist, psychotherapist, or counsellor (as far as I can tell anyway and is one of the main reasons why I started writing this podcast episode). So, according to the NHS website, “psychiatry is a medical field concerned with the diagnosis, treatment and prevention of mental health conditions” and “a doctor who works in psychiatry is called a psychiatrist.” Psychiatrists are medical doctors who specialise in the diagnosis, treatment, and prevention of mental illness and emotional disorders.
According to the website of the Royal College of Psychiatrists (RCP, the medical body responsible for regulating and supporting psychiatrists throughout their career) a psychiatrist will have spent five to six years training to be a doctor. They will then have worked as a doctor in general medicine and surgery for at least a year, before then undertaking at least six years of further training in helping people with psychological problems. So, all in all, it takes about 12 to 13 years for a psychiatrist to get to the very end of their training.
Now, I am aware that there are different levels of doctoring. For example, before you become a consultant, there are six different levels of being a junior doctor, such as FY1 and FY2 (which are known as foundation year doctors), moving up to speciality trainee (or ST) doctors, which I think is where doctors start to specialise in different areas of medicine such as psychiatry. The specifics of progressing through the junior doctor level up to consultant are beyond the scope of my understanding, but the end result is that if someone is a consultant psychiatrist, they have pretty been doing the gig for at least a decade.
Because of this, psychiatrists have a range of specialist skills when it comes to mental health. For example, and according to the RCP website, psychiatrists can assess a person’s mental state, diagnose mental illness, and prescribe a range of medications to manage symptoms of mental illness. At this point, I am aware that some listeners might have strong views of psychiatrists and the prescribing of psychiatric medications. Or the idea of diagnosis in general. Indeed, if anyone has read up about the Power Threat Meaning Framework, it’s possible you may disagree with diagnosis and medication altogether. This is something that I would like to address and talk about in another episode in the future – but if you have any views of queries about this particular area let me know. Also, if you haven’t heard of the Power Threat Meaning Framework, have a read of it.
Right, back to psychiatrists. So, on top of these “core skills” as it were, psychiatrists will develop skills in working with specific difficulties that affect specific populations. For example, the skills and knowledge needed to work within general adult mental health will differ to those needed to work with children, and again will differ when working with a forensic population. Additionally, and whilst this is not necessarily typical (as far as I am aware, and I am always open to being wrong) some psychiatrists will train to become a psychotherapist, too; and as part of their psychiatric practice will offer therapy. This is something we I will focus on a bit more in the next episode when we look at psychotherapy.
Psychiatrists will often work in mental health settings such as community mental health centres or psychiatric hospitals, and they will often work with a breadth of other mental health disciplines such as mental health nurses and support workers (otherwise known as healthcare assistants), occupational therapists, and social workers. All of which we will now look at (and this is why I have included these professions within the distinction of those who work in psychiatric care).
Registered mental health nurses (RMNs) and support workers (also known as health care assistants or HCAs) are nursing staff who provide the day-to-day care to those experiencing mental illness either in hospital or in the community. They may work across various settings within hospitals such as psychiatric wards, outpatient clinics, psychiatric intensive care units, or specialist units such as eating disorders units or forensic psychiatric hospitals. In the community you may find nursing staff in GPs, prisons, community mental health centres, residential care, or even visiting clients in their home.
RMNs jobs and responsibilities are different from those of HCAs. RMNs will ensure that the psychiatric treatment plan outlined by the psychiatrists is carried out. They will write care plans, administer medications, monitor health conditions, take charge of shifts (especially in psychiatric wards), oversee the maintenance of notes, and make sure the legal documentation required to detain someone in hospital is above board (by this I mean paperwork required to section individuals under the Mental Health Act). HCAs duties are related to assisting the RMNs in carrying out their duties and there is some overlap. The main difference being that that nurses usually have overall responsibility and accountability for making sure that the things needed to be done in relation to patient care get done. In the UK, RMNs are regulated by the NMC, the Nursing and Midwifery Council.
So, HCAs may assist with doing the hourly observations of their service users, assist with escorting them on their leave, assisting with meals, and along with the nursing staff ensuring that the day-to-day care for those within hospital or psychiatric settings are carried out. Some further examples listed on a job application website note that HCAs are responsible for supervising service users to make sure they are safe. Now, safety could relate to safety to the service users themselves or safety from others, and health care assistants may, in collaboration with registered nursing staff, make day-to-day or moment-to-moment risk assessments to help make sure that service users do things safely or that they aren’t endangering themselves or others, which can happen.
HCAs also give practical support to service users and their families, such as with household tasks, personal care or managing their money and financial paperwork. And it is not uncommon for HCAs to provide emotional support and reassurance to service users and their families, and sometimes – again, in conjunction with registered nursing staff – educate service users and their relatives about the sorts of mental health difficulties the service users might have. So that’s nursing staff.
Another important job that is found within the realm of mental health professionals is that of the occupational therapist (OTs). The Royal College of Occupational Therapists (RCOT) notes that occupational therapy helps individuals live their best life at home at work – and everywhere else. OTs who work in mental health are concerned with helping people who are struggling with their mental health to engage in meaningful activities, which can help to improve their well-being and quality of life. Once more, according to the Royal College of Occupational Therapists, “occupational therapy in mental health is about enabling people to do the activities that matter to them, regardless of their mental health condition”. Some examples of activities that occupational therapists might help people to engage in include self-care tasks (such as washing and dressing), household tasks (such as cooking and cleaning), work-related activities, leisure activities, and social activities. The aim is to help people to develop the skills and confidence they need to manage their mental health condition and live as independently as possible. OTs use a range of different interventions to help people, which can be done on an individual or group basis.
Some examples of specific interventions that OTs might use include the use of graded exposure, which is an approach that involves gradually exposing people to situations or activities that they find anxiety-provoking, in order to help them to overcome their fears. OTs might provide practical life skills training and support to help people develop skills in areas such as time management, budgeting, and cooking. OTs can assist people who have sensory processing difficulties, which can be a symptom of certain mental health conditions or neurodevelopmental conditions (such as autism, for example). This kind of work would involve assessing what sensory difficulties service users have, and then using sensory experiences (such as touch, movement, and sound, for example) to help people to regulate their emotions and feel calmer and more relaxed. In the UK, OTs who work in mental health are regulated by the Health and Care Professions Council (HCPC).
The final role within the sort of psychiatric care side of mental health is that of mental health social workers. Now, unlike the rest of the roles discussed above, it a was a little more challenging to pin down the specifics of the social worker role in within mental health services. And so, this section is made up from some bits that I sourced from seemingly relevant webpages about social work within mental health, while some bits are from what I remember during my training.
So, according to the global definition of social work provided by the International Federation of Social Workers, social work is a practise-based profession and an academic discipline that promotes social change and development, social cohesion, and the empowerment and liberation of people. Principles of social justice, human rights, collective responsibility, and respect for diversity are central to social work.
In relation to mental health specifically, and according to a document written by the College of Social Work in 2014, social workers have a “crucial part to play in improving mental health services and mental health outcomes for citizens”. Social workers are trained to work in partnership with people using services, their families and carers, to optimise involvement and collaborative solutions (so, making sure that the voice and needs of psychiatric service users are heard and respected and advocated for). It the document also notes that “social workers...manage some of the most challenging and complex risks for individuals and society and take decisions with and on behalf of people within complicated legal frameworks, balancing and protecting the rights of different parties. The NHS website also goes on to say that as part of their job roles, social workers protect vulnerable people from harm or abuse. And I guess this in one of my main anecdotal understandings of the roles of social workers within the mental health field, is that they were really good at holding in mind the rights and privileges of those who were receiving psychiatric care. They were also a vital link, particularly in impatient settings, between service users and their families. I am pretty sure there are lots of things that mental health social workers do that I have not captured here. But, if you would like to hear more about this role (or any of the roles discussed in fact), then let me know and I can try see if anyone would like to come on and talk about their job in a bit more detail.
Now, before I end, I’m not quite able to do justice – with words – to the job that these professions do within psychiatric care. I am aware that there are criticisms that people have of psychiatric services, and it is not my place to change your views about that. But what I will say, from both my time as an HCA on psychiatric wards and through numerous inpatient placements while completing my doctoral training, the work these professionals do is tough. They are really tough and demanding job that I think often go unrecognised and underappreciated when thinking about mental health professionals. So, with that in mind, I hope this has been a helpful episode. Additionally, whenever I’ve referred to websites or documents I've read, you can always go and check them out within the transcript I’ve written to this episode (and most of my other episodes, in fact). I always put hyperlinks in the relevant sections where I talk about references. So, if I said something that piques interest please do go back and have a look through the transcripts and you will find what I'm talking about linked there.
And finally, if you have got to the end of this episode and you think, “fucking hell, that was some interesting shit” why not give it a rating, share it, or recommend it to your friends. It’s always appreciated. And as always, please do come say hi on my Instagram page. Let me know your thoughts, good or bad. I am always happy to talk further about these things. So, until next time. Hope you have a great day. Or not. No pressure!
Music
* Opening: “Chilled Ambient Minimal”
* Closing: “Seven” - Tobu

Thank you for subscribing. Share this episode.
Hosted on Acast. See acast.com/privacy for more information.
- Écouter Écoute encore Continuer Écoutez...
- Écoutez plus tard Écoutez plus tard
27: Dads Need Dad Friends
6 mars 2023· The Nice-ish Ramblings Podcast
Hello and welcome to The Nice-ish Rambling Podcast with me, The Nice-ish Psychologist, where today I'm going to be broaching the topic of dads needing dad friends. Now, while I can appreciate that most of what I am about to discuss can be viewed from a mother’s perspective, too – and indeed while researching this topic I found an Guardian article that discusses a similar topic from a mother’s perspective (or even a birthing person’s perspective to use gender neutral terms) – at the same time I am not too sure how often this kind of thing is discussed in terms of fathers. Also, this particular episode was inspired by recent events in my life, which was a kind of epiphany moment and so I thought I would talk about it and see if could be beneficial to any other dads. But like I said, there is a high likelihood that everything discussed in this episode can be experienced by all parents. And perhaps for some listening there might be some “no shit Sherlock” responses. Which would be fair. Also, as you may have noted, I referred to gender-neutral parenting earlier. While this episode is focused mostly on the experiences of fathers, where relevant and necessary I will endeavour to use gender neutral terms, too. Also, also, if you find any value in today’s episode, please do rate it, share it, or leave a comment where you can. It all goes a long way to letting others know if this is a podcast worth listening to, or if it a bag of shit.
So, I guess this particular episode begins a bit further back than the last few weeks, because while reflecting on this episode I remembered listening to an amazing audiobook version of My Child and other Mistakes, written by comedian Ellie Taylor. My partner had read the book and recommended it to me because, in her words: “She [Ellie Taylor] has the same view of parenting as you do, so you might appreciate it.” And she wasn’t wrong. My Child and other Mistakes is what I would call a very realistic parenting guide. As well as being funny, it highlights a rather brutal reality of parenting that is perhaps left out of the usual narrative of having children and becoming a parent; which in a nutshell is that parenting is usually this magical, wonderful, time where you help small human beings that you created with your partner, grow and develop, and it’s all cute and sweet and fun… which, for some it is. But for others, like Ellie Taylor and myself, it’s not necessarily our reality. I won’t spoil the book, but for anyone who, like me, has asked themselves what they fuck is going on in terms of being a parent, then My Child and other Mistakes is an utterly validating book.
Having said that, while I connected with a lot of what Ellie Taylor wrote about, there was obviously a lot I could not connect with. One of the more obviously aspects is the fact that Ellie Taylor is a biological female and much of her parenting experience involved all the ups and down that go hand-in-hand with being the person who grows and then gives birth to a child. Which I, being a biological male, can’t - and therefore did not - have that experience and therefore could not relate to. All of that was fine. The thing that did really hit me in the face, though, was when Ellie Taylor talked about the support she received as a mother. Especially when she talked about social media groups that she was a part of with other new mothers, which is something recommended by antenatal classes as a way to maintain a support network in the early years of parenting. When my partner and I joined one such antenatal group, a group was set up for the mothers by the mothers and one was set up for the father by the fathers (it was called, “DadsDadsDads”, which I must admit is a great name). The thing is, and this is what was reflected in Ellie Taylor’s book, is that my partner is still connected to some of our original antenatal group through social media , while I on occasion will wave to one of the fathers from that group if I see him locally and perhaps have a brief “How’s life?” chat in the local Tesco car park if we happen to be leaving and arriving at the same time (which has happened once or twice).
In the early months and years, my partner was connected to the other mothers, seeking and giving advice, sharing stories, getting and sharing milestone updates, being invited to birthday parties and all that jazz; while we fathers maybe met up once or twice for a curry and a beer, and pretty much kept making promises to see more of each other, all of which has fizzled out. And I couldn’t even tell you if anyone is still in that social media group because I have not received a message in it for years and I have also not bothered to check it. And I didn’t really mind this at the time, because I didn’t see them as a support network. I am not particularly proud of this, but I saw these people - these other men - as random strangers that although I had a shared experience with did not necessarily want to be friends with because I likely would not have chosen to be their friends, or made plans to go out with them socially, if we hadn’t all been having children within the same six month window. Additionally, although I have loads of male friends, I have always found making friends with other men a bit awkward. Men like to talk about sport a lot and I do not like talking about sport at all. A very grand generalisation, but something I have experienced a fair bit in my life. And it’s not just sports-talk that has generally put me off making friends with men. That’s rooted in historical experiences or going to an all-boys school and the less than pleasant way in which boys can relate to each other.
However, fast forward another year or so and I am listening to Ellie Taylor’s book, and I am connecting with her struggles and feeling fully validated by the conflicting feelings that can come with being a parent, which can flick from full-on undiluted love and adoration to near blinding rage in what seems like an instant. And I’m thinking, “Finally, someone gets it, and someone is putting how I feel into words and fuck does it feel good to be acknowledged.” And then she goes on to talk about how she managed to get through a lot of what she experienced through sharing her struggles with other mothers that were going through it too. And I felt a gut-punch. I remember sitting in that same Tesco car park where I on occasion had passing commentary exchanges with one of the dads from my antenatal class and feeling like such a twat. Because I has had a similar opportunity to have a support base, and I had essentially rejected the idea, based on a silly notion of not wanting to have to make friends with other men I did not know. And since then, had pretty much felt like I was the only person struggling in the way that I was.
OK, that sounds slightly dramatic, and is not quite true because my partner and I have had many conversations about my struggles as a parent, and we have often had conversation about how I have a view that some people are just more naturally inclined towards being parents (which is the camp I believe my partner falls into), and then there are others – like me – who I think struggle more and for whom parenting maybe doesn’t come quite as naturally. I know this is a very broad and simplistic view of things, but I have had a few conversations with other parents about this and, although not robust enough to stand up to academic scrutiny, the theory seems to be shared by them too. But despite being able to talk to my partner about my struggles with parenting, and the fact that my brother-in-law is also a father, I still felt quite isolated as a father. Now, for me, my circumstances are pretty unique in that I live quite far away from my own family and that my friendship network is scattered not only across the county, but also across the world. So, while I do have male friends and a loving and supportive family, they are not very local. But I am also not one to help myself, because, along with not wanting to make friends with antenatal dads as mentioned earlier, I believe I am of an age where I just can’t be arsed to make new friends – and, as a parent who struggles with parenting – I don’t really have a lot of energy to want to socialise with new people anyway. So, I haven’t done myself any favours.
However, despite my own circumstances, research suggests that it is not uncommon for new fathers to feel isolated. The Movember Foundation – a charity aimed at improving awareness, research, and funding for mental physical and mental health for men, commissioned a piece of research published in 2019 called “Fatherhood and Social Connections”. The research was based on a survey conducted on 4,000 men between the ages of 18 to 75 from the UK, the USA, Canada and Australia (so, 1,000 men per country), 45% of whom were fathers. The survey found the following data. 23% of men stated that they felt isolated when they first became a father, leading them to conclude that becoming a father can be an isolating experience. Interestingly, and sadly, 20% of fathers reported that the number of close friends they had decreased in the 12 months after becoming a father. Which, if you think about the first statistic, may contribute to why fatherhood could be an isolating experience. Which, again, if you think about it, makes sense. If you are someone that doesn’t have kids, and your mate now has a kid, there is a high probability that the new father might spend a lot of time talking about their kid – I know this is a generalisation, but still. And people who don’t have kids don’t really get – or necessarily care, for understandable reasons – why people talk about their kids as much as they do. And maybe it’s just me, but I tend to talk about my kids a lot – both about the good and the tough stuff. But that’s because at this point in my life they are pretty much occupying all of my time. Which is another reason why friendships might fade. It would make sense that in terms of going out and socialising that there might be less times for new fathers to go out and socialise with their friends. Especially within the first few years of a child’s life. Then if someone has more than on child that gets extended for another few years. And it’s very possible that friends might then give up asking new dads to socialise, cos what’s the point, right? So, it would make sense that some new fathers might feel their friendship group diminish over time.
Something else to think about is that the Movember research found that men and fathers don’t always recognise the importance of friendships. When asked to list three important aspects of their lives, less than a fifth of men (18% to be exact) listed having close friends as important. And coupled with this it was noted that over half of the men survey (51%) reported that even if they were satisfied with the quality of their friendships, they felt they could not talk to their friends about their problems. Then potentially linked to that, it was reported that fathers without close friends reported that their stress levels increased a lot. Which is significant, because in general 70% of men reported that their stress level increased a lot within the first 12 months of becoming a father. The report also goes on to highlight that in general, 1 in 10 new fathers experience depression after the birth of their child, and that fathers with perinatal mental health problems are 47 times more likely to be considered a risk of suicide than at any other point in their lives. All of which is important to note, because there is tonnes of literature out there to support the fact that a person’s psychological well-being is determined by the quality of their social connections and that having mutually supportive friendships can serve as a protective factor against anxiety and depression.
So, as you can see, my feelings of isolation, while specific to my own context and situation, is not something uncommon amongst new fathers. And clearly social connection is important. None of which I knew or thought about when I was rejecting the notion of getting to know the dads from my antenatal class. Something that I first came to regret when listening to Ellie Taylor talk about how helpful social connection was in her book, and the importance of which has become more abundantly clean more recently.
And yes, I was very much a psychologist at this time in my life and I still managed to have this blind spot.
The back story to this epiphany happened a few weeks ago at a soft play birthday party. Yes, a soft play birthday party. One of those surreal arenas of organised chaos where you kind of get to relax because your kids are in an enclosed area with padded climbing frames and slides, where theoretically they should be able to knacker themselves out with their friends, but there is the slim chance (as is with me) that your kids might come crying to you because they have somehow managed to injure themselves (or someone else) with over enthusiastic playing.
The birthday party was for an old nursery school friend, and I was there with my partner. A few other dads who I knew from the nursery school days had come with their wives and partners, too. And we got to chatting a bit as we sometimes do, which I always found awkward for the reasons already listed above. But these guys are always nice and I like being polite. So there we were. When all of a sudden, one of them turns to me and says “We were planning on going for a beer on Wednesday night. Do you fancy a pint?” And I was a little stumped for words. I had never been asked this in a soft play. On a Sunday. And it had been a long, looong, time since I had been asked out for a cheeky beverage on a weekday… a fucking weekday. At 8 o’clock on a weekday. Usually at 8 o’clock on a weekday I am recovering from bath and bed time on the sofa and then I myself am off to bed by about 9:30.
It took me a while to answer, because while my partner and I aren’t massively sociable at this time of our lives, there are occasions when will have some fries or family over. Or my partner might go to a yoga class. So, I mentally checked out calendar for the week, and after a bit of an awkward pause – which could have been construed as me looking for a reason to say no – I agreed.
And I’m not going to lie, because of all the reasons listed earlier in this episode, I was pretty apprehensive about it. Mostly about the 8 o’clock start time. Come the Wednesday night after my partner and I had done the bedtime routine I complained that I had to now go out and have a beer. Socially. With people I don’t know that well! Anyway, I got over that, hopped into the car and went to go meet these men. And do you know what – it was great. It really was.
Firstly, it was one of the most validating experiences I have had as a father in a long time. As you might have gathered, parenthood has been a bit of a struggle for me, and due to not really being around any other fathers I felt that I was the only one struggling in the way that I was. Now, I guess you might be wondering if there haven’t been any other parents around that I could have spoken to and who could have validated my experiences? And you would not be wrong – however, they were mostly mothers and those who had given birth to their children. I can’t say for definite, but I think it is a very different experience being the non-birthing parent – in this case a father. There is a whole host of research that focuses on the experiences that occur between a child and a mother or birthing parent, like the focus on attachment and the importance of this. While I am unaware of there being as much of a focus on non-birthing parents and what that’s like. And while the overall experience of parenting can be very similar for both the birthing and non-birthing parents, there are subtle and quite powerful differences that have, in my experience, the capacity to shape how one feels as a parent.
One of these experiences was shared with this new dad crew of mine, and that is the idea of what I call being the “bad parent”. Now there’s possibly a lot of attachment stuff that could relate to this, but from a parental perspective and trying not to think about with too much of a psychological mind, what I mean by the “bad parent” is the one who is not able to offer support or comfort to a child when they are distressed. And that child only being soothed or comforted by the other parent, who for the sake of this experience could be thought of as the “good parent”. Again, from an attachment perspective it makes sense that children are more likely to be comforted by one particular parent – in my case it is my partner, a mother. And while I don’t definitely know this for a fact, I would argue that it is the mother or the birthing parent that is more often than not in the position to comfort and sooth. Now, while I can appreciate that this might be a burden in some way, it can challenge the non-birthing parent’s perception of themselves as a “good parent”, or a competent parent. Or a parent that is loved by their child. Now, I know that cognitively I can tell myself that I am loved by my children as much as they love my partner, but it does take its toll to be screamed at and told to go away and that they only want mommy when they are upset. It can make you feel pretty crap and make you judge yourself as shit, incompetent, and useless.
But, low and behold, I was not the only father to experience this amongst my new posse of dad pals. And that felt like such a relief. I was also relieved to find out that I was not the only one that shared the view or felt like they were not a natural parent. One dad described it as having to “work hard every day to be a good parent”.
It wasn’t just the similarities that were validating, but the differences, too. There were stories, which I won’t share here as they are of a more private nature, that highlighted that while I thought my life had been massively impacted by becoming a parent, others’ lives were impacted in other ways, and in some instances in more challenging ways that I could not imagine for myself and my family. But I also learned that my child was not the only one potentially experiencing bullying, or falling out with friends, or getting into relationships. I know it sounds really stupid to say it out loud, but it was just so bizarre to find out how much I had in common with these men and that I was not, as it were, the only father going through some seriously confusing, challenging, and tiring shit with trying to raise children. I was not alone in my struggles. And that was, I am not going to lie, such a weight of my shoulder.
And so, to conclude, this one experience of going out with other dads has taught me that dads definitely need dad friends. It’s validating. It’s cathartic. It’s makes you feel less alone. And, if you are like me, you might find another dad that is even more grumpy than you are.
And just to end. While I know this episode is about dads needing dad friends, it is clear that social connections and good quality friends are super important for fathers, especially new ones. Therefore, at the same time it makes sense for fathers to have friends who aren’t parents, because actually it is probably very helpful for parents and fathers to go out and do stuff and talk about stuff that doesn’t relate to being a parent. So, I guess, again while this is about dads needing dad friends, maybe this podcast is also for men who may have friends who are fathers, or who are soon to be fathers, or who may one day be fathers – even if you don’t have kids of our own, your friendship and connection will be really valuable and helpful to you dad friend.
Anyway, that’s it from me for now. As I said at the start, if you found any value in this episode of know of anyone who may benefit from it, please share it with them. As always, the invitation is there for you to come find me on social media and say hello. You know where to find me by now, I’m sure.
As always, hope you have a great day. Or not. No pressure.
Music
* Opening: “Chilled Ambient Minimal”
* Closing: “Seven” - Tobu

Thank you for subscribing. Share this episode.
Hosted on Acast. See acast.com/privacy for more information.
- Écouter Écoute encore Continuer Écoutez...
- Écoutez plus tard Écoutez plus tard
26: The Sigma Male and “American Psycho”
22 févr. 2023· The Nice-ish Ramblings Podcast
Hello and welcome to the Nice-ish Ramblings Podcast with me the Nice-ish Psychologist where once more I am flying solo. Hope you don’t mind my singular chats, but I am still experiencing some technical difficulties with this brand-new virtual podcast studio I bought – should have just fucking forked out for Zoom. But here we are. Anyway, today I want to talk about an interesting phenomenon that I've noticed on social media. More specifically a trend on TikTok. At least it is a trend I first became aware of on TikTok and have not seen on any other social media platform – yet.
But before we get into that, a request – normally made at the end, but I thought I might try it at the start and see if it has more impact. If you appreciate the show, please show some love by sharing it or rating it on whatever platform you are listening on. As I have said before, it really helps people know if this show is a pile of shit or worth listening to. Now that that awkwardness is out the way, on with the show.
So, I say this is an interesting topic, but it might only be interesting to me. But unfortunately, because I find it interesting you have to now listen to me talk about it…unless you want to exercise your free will and stop the episode now.
According to one Yahoo! News article (yes, you heard that correctly – Yahoo! News) it’s called the “Sigma Face” trend, which seems to have become such a huge trend that there is now a filter on TikTok that helps people do the trend more accurately. Let me explain (as best I can). The trend is to pull what’s become known as the sigma face, which is a re-enactment of a scene from the film American Psycho, in which Christian Bale, who plays the main character, Patrick Bateman, pulls a series of facial expressions in response to things being said to him by a friend he is having dinner with. First, he pursues his lips and furrows his brow, before giving an affable smile and chuckle. The aim of trend is to pull of these facial expression as seamlessly and as precisely as Christian Bale does in the film. Not sure what I’m talking about? Not to worry, there’s a tutorial video on TiKTok with 1.7 million likes that I will link in the show notes in case you want to go and see for yourself.
So, how popular is the trend? Well, the same Yahoo! News article which was written earlier this month – on the off chance someone is listening to this in the future, that’s 7th of February 2023 – reports that the #patrickbatemen hashtag has received 5.5 billion views on TikTok, the #sigmaface hashtag has over 132 million views, and the #sigmalmale hashtag has nearly 4.5 billion views. It’s fair to say it’s a pretty popular trend at the moment. Not only that, but if you look it on YouTube, there are just loads of videos about the sigma male. With such titles as: “Dark Side of Sigma Males” (released 2 days ago with 11,000 views); “The Sigma Stare” (released 2 weeks ago with 107,000 views), “What is a Sigma Male?” (released 8 days ago with 22,000 views); “How Sigma Males Approach Women” (released a year ago with 214,000 views); “Why Sigma Males Have No Friends” (released two months ago with 568,000 views); and “Why Sigma Males are the Most Dangerous Breed” (released five months ago, with 677,000 views). You get the picture.
So, what’s the fuss, right? It’s just some facial expressions. No big deal.
And on the face of it, I would agree. But there are two things of note – and I will say of note as to say I am concerned about it might seem like I am making a big deal out of nothing. So, the first thing to note is that this trend seems to glorify the sigma male. According to one YouTube video, there has been a rise in poking fun at the sigma male, which might account for the popularity of the trend. But at the same time, it also makes me wonder how many people know what the sigma male is. And the second thing of note is that the poster boy sigma male is the character of Patrick Bateman… the main character in a film called (just in case you didn’t catch it the first time) American Psycho. To articulate why both components of this trend give me some pause, it might be worth looking at each component separately and then together. And again, I might be concerned, but that doesn’t mean that after listening to this you will be concerned. This is just me putting some thoughts out into the world.
So, let’s start with the sigma male. What is one of these very specific kinds of males? Well, it would make complete sense if you have never heard of a sigma male. But at the same time, if you are familiar with either the manosphere, gym bro culture, or the idea of alpha and beta males then you might have heard of the sigma male.
But, for the uninformed a sigma male is one of six male personality types that forms part of what is known as – and please, let’s keep an open mind ok; I expect nothing but complete and utter respect, and mature responses only to this – the “socio-sexual hierarchy”. That’s right, the completely real, not at all made up, completely backed up by years of scientific data and research, socio-sexual hierarchy. This wonderful fabrication of pseudo-scientific bullshit was created by Theodore Robert Beale, who at the time was known as Vox Day. The introduction to Beale’s Wikipedia page has this to say about him: “Vox Day, is an American far-right activist, writer, publisher, and video game designer. He has been described as a white supremacist, a misogynist, and part of the alt-right. The Wall Street Journal described him as ‘the most despised man in science fiction.’” Beale once had a blog, but I have no idea what the blog was about. I will be honest, there is very little about Beale on the internet, and it seems that his blog has since been deleted. However, it seems that in the 2010s one of the things Beale liked to talk about on this now deleted blog was the hierarchies of men based on the Greek alphabet. All of which, I’m going to say, is potentially based on the now debunked theory of the alpha male wolf pack leader myth (which is a story for another day).
And the hierarchy is as follows. And don’t worry – I have linked an article in at this section of the transcript which you can go and read in more depth if you’re so inclined, but I'm going to read verbatim from parts of the article anyway.
* Starting from the supposed bottom of this ridiculous hierarchy are the Omegas, who are allegedly the polar opposite of alphas. Omegas are social outcasts. Mostly nerds, they are described as needy, clingy, and avoided by everyone. Being undesirable and damaged, these “social rejects” fail to attract women.
* Then we have the Gammas. They are apparently “unattractive, bitter and introspective”. Confused with the hierarchy, they fail to follow social rules. Unsuccessful in attracting women and tend to be obsessive lovers, stalkers and narcissists.
* Following this we have Deltas who are classed as the average normal guy. They are hard workers who lack drive and ambition and struggle with attracting women. They are societies worker drones who don’t believe in self-improvement.
* Then we have my personal favourite, the Beta males, who are described as followers of the Alpha. Betas play safe and avoid risks. They lack self-esteem and confidence. Betas worship women and blindly obey orders. They are reserved and idealistic.
* Then right at the top we have the Alphas who are described as confident, dominant, charismatic, and natural leaders. Highly attractive to women, Alphas are extrovert and highly successful in their careers. They thrive on challenges. I am going to go out on a limb here and say that Beale probably considered himself an Alpha.
* And then finally we have what you have all been waiting for: the Sigma male. They are described as the introverted Alphas. Sigmas are confident lone wolves who do not seek social attention. They are immensely confident and highly attractive to women as they are mysterious and charismatic.
So then, apparently sigmas males are almost equal on terms with alphas in this horse-shit socio-sexual hierarchy, but don’t play by the rules of the hierarchy (cos, again, there is no real hierarchy to play by if you really think about it – there is only a hierarchy if you believe there is a hierarchy). Because sigmas sit outside the hierarchy and don’t play by these non-existent rules, Alphas can often find sigmas a threat (I can’t believe I am reading this shit out loud). This article goes on to further say that: “the sigma has a silent, mysterious nature and immense self-confidence. They are very thoughtful and analyse their every move. However, this doesn’t mean that they are shy. They are naturally charismatic, have a positive attitude, and have excellent management skills. The sigma doesn’t settle in life. They strive hard to reach where they aim to be and can be extremely manipulative to get what they want”. And most importantly (and by this I mean what the socio-sexual hierarchy seems to place significant importance on) “women find sigmas as attractive as alphas.” It goes on to say that “the fictional character John Wick, played by actor Keanu Reeves” is a “great” example of a sigma male. That’s right – the guy who goes around killing a billion people because they killed his dog if a prime example of a sigma male.
Now, this is where it gets interesting (and perhaps concerning, again I’ll let you decide). The John Wick character is not the only fictional character that has been used to embody the type of man a sigma male is supposed to be. In one video on TikTok I found, which is called “The Legendary Sigma Stare”, it has such characters as Norman Bates – the serial killer from the film Psycho; Jack Torrance – the father in The Shining who slowly goes insane and tries to kill his family looking after a hotel during the winter; Donnie Darko, lead protagonist in the psychological thriller film of the same name where an emotionally troubled teenager sees visions of a freaky giant rabbit that prophesises the end of the work; Aaron Stamper – a 19 year old kid, played by Edward Norton, accused of killing an Archbishop in the thriller Primal Fear (the ending is too good, so I won’t ruin it here); Walter White – mild mannered chemistry teacher who slowly turns into a cold-hearted drug dealer in Breaking Bad; Tony Montana – better known as Scarface; Hannibal Lecter – I mean, we all know who he is; Tyler Durden – the soap salesman who likes to blow up buildings in his spare time as an extremist anarchist… are we starting to notice a pattern…
Enter Patrick Bateman.
Bateman is the protagonist in the 1991 novel American Psycho, by Bret Easton Ellis. It is a satirical work that critiques the superficiality and materialism of 1980s yuppie culture. The novel has been interpreted in various ways, including as a commentary on the emptiness and moral decay of capitalism and consumer culture. The book’s Wikipedia page highlights a number of themes within the book, with one stating that “American Psycho is largely a critique of the ‘shallow and vicious aspects of capitalism’. The characters are predominantly concerned with material gain and superficial appearances, traits indicative of a postmodern world in which the ‘surface’ reigns supreme.” It has also been viewed as a critique of the patriarchal and misogynistic attitudes of the era, with some viewing it as “a cautionary tale about fragile masculinity.”
The book was also at the centre of much controversy as critics have also suggested that the novel is an exploration of the psyche of a sociopath, or a metaphor for the way in which capitalist society dehumanizes individuals. Because, in case you didn’t realise, as well as being an investment banker, Patrick Bateman is a literal serial killer. He kills a lot of people in the book. And they ways in which he does it are really fucking graphic. I have read a lot of violent books in my time, but there is one scene in the book (which I won’t describe here) that still sticks with me to this day because it was so fucking rough.
The book was then made into a film in 2000, directed by feminist film-maker Mary Harron and staring Christian Bale in the lead role. In it, Bateman is clearly wealthy, living in an immaculate looking flat, wears classy suits, eats out at fancy restaurants, works out every single day and is perfectly preened, dates pretty women, and spends a lot of time obsessing over the perfect business card. So, from a visual and materialistic perspective I can see why he might be used as the poster boy for the sigma male, or why some men might want to embody his success – I guess this is the kind of lifestyle the likes of Andrew Tate try sell the young men of today.
However, as both Mary Harron (the film’s director) and Ellis (the book’s author) have noted, the book is a critique of male values that existed in the 80s – which one might argue still exist today, which, again, is perhaps why Andrew Tate was (and shockingly still is) so popular. What follows is a quote written in an analysis of the book for its 25th anniversary in 2016: “American Psycho is a book about becoming the man you feel you have to be, the man who is cool, slick, handsome, effortlessly moving through the world, modeling suits in Esquire, having babes on his arm. It’s about lifestyle being sold as life, a lifestyle that never seemed to include passion, creativity, curiosity, romance, pain. Everything meaningful wiped away in favour of surfaces, in favour of looking good, having money, having six-pack abs, dating the hottest porn star, going to the hottest clubs… I think Fight Club is about this, too — this idea that men are sold a bill of goods about what they have to be in order to feel good about themselves, or feel important. No one can really live up to these ideals, so there’s an immense amount of dissatisfaction roiling through the collective male psyche. Patrick Bateman is the extreme embodiment of that dissatisfaction. Nothing fulfils him. The more he acquires, the emptier he feels.”
Here's the thing though. While I don’t buy the whole socio-sexual hierarchy (did I mention I think it’s a load of shit?) I get that it’s a way in which men can classify themselves and understand their position in society; and based on this they can try move up the ranks as it were (again, such a ludicrous notion). I mean, this is literally the pick-up artistry industry to a tee; and would explain why there are so many “how to be a sigma male” videos on YouTube. And I this way I can also understand the appeal of romanticising film characters that might embody a certain personality type and lifestyle. I guess it gives you something to aim for and an ideal to live up to in some way, right.
But why, why on earth would you use any of the examples that have been listed so far in this episode. All people who are dark and moody, yes, but also literally kill people or are unemphatic criminals. It speaks to this idea of what Jordan Peterson has stated that men should be capable of being dangerous. He says: “No, you should be capable of it, but that doesn’t mean you should use it. There’s nothing to you otherwise. If you’re not a formidable force, there’s no morality in your self-control. If you are incapable of violence, not being violent isn’t a virtue. People who teach martial arts, know this full well. If you learn a martial art you learn to be dangerous but simultaneously you learn to control it. Both of those come together. And the combination of that capacity for danger and the capacity for control is what brings about the virtue. Otherwise, you confuse weakness with moral virtue. “I’m harmless therefore I’m good”. It’s like no, that isn’t how it works. That isn’t how it work at all. If you’re harmless you’re just weak, and if you’re weak you’re not going to be good. You can’t be. Because it takes strength to be good. It’s very difficult to be good.”
Personally, I don’t think it’s hard to be good. And while I know Jordan Peterson isn’t talking about the sigma male here, but from what I’ve learned about this particular (completely made up) male personality type is that this is what the sigma male needs to be, which is somewhat in contrast to the earlier descriptions, in which the sigma male is posed as an outsider and mysterious, sure, but not necessarily dangerous. But then again, they are allegedly equal to the Alphas, so I guess they must be dangerous… AND moody. But anyway, I think trying to actually conceptualise the psychology behind all of this could make your head spin.
As for now, however, what am I trying to say. Well, for starters, the concept of the sigma male is not based on scientific evidence and is not widely recognised in mainstream psychology or personality theory (as far as I can tell). It is a loosely defined, with many contradictions as to what makes a sigma male. The subjectivity of which can lead to misinterpretation and oversimplification of complex psychological and social dynamics.
Secondly, Patrick Bateman is a fictional character and a serial killer, who is portrayed as a deeply disturbed individual with a lack of empathy and moral compass. Idolizing such a character is not healthy or appropriate, and just so bizarre. For me, it seems to send a harmful message about violence, domination, and the objectification of others. Also, Idolizing Patrick Bateman as a sigma male just seems to reinforce harmful gender stereotypes that promote competition, aggression, and independence at the expense of empathy, cooperation, and connection (some might call this “toxic masculinity” if they were looking for a neat term to sum it all up). This could possibly lead to harmful and isolating behaviour, as well as perpetuate damaging cultural narratives that limit individual and collective growth and development.
Finally, it is important to recognise that the novel American Psycho is a satirical work that critiques the shallowness and greed of 1980s yuppie culture. The character of Patrick Bateman is meant to serve as a warning about the emptiness and moral decay of capitalist and consumerist values, not as a role model to be imitated. In conclusion, idolizing Patrick Bateman as a sigma male is a misguided and dangerous idea that can have negative consequences for individuals and society. It is probably better to seek out healthy and positive role models that promote empathy, compassion, and respect for all people.
So, if you ever see anyone chatting about the sigma male in a way that seems to be celebrating it, you might want to have a word with them – or just avoid them altogether. Anyway, I hope this has been an interesting episode. As always, let me know your thoughts. Come find me on social media and say hello. Until next time. Bye for now.
Music
* Opening: “Chilled Ambient Minimal”
* Closing: “Seven” - Tobu

Thank you for subscribing. Share this episode.
Hosted on Acast. See acast.com/privacy for more information.
- Écouter Écoute encore Continuer Écoutez...
- Écoutez plus tard Écoutez plus tard
25: Are All Feelings Valid?
15 févr. 2023· The Nice-ish Ramblings Podcast
In today’s episode I look at the question of whether, in fact, all emotions are valid. It’s a big statement that’s often seen on social media, but I sometimes wonder if the specifics of the statement are fully understood. Therefore, in an effort to shed some light on this snapshot of emotional awareness I discuss what emotions are, why we have them, and the difference between validity and accuracy of emotions. I also discuss some tips on how to determine the validity of our emotional responses using the Dialectal Behaviour Therapy (DBT) skill of “Check the Facts” (it’s a bit messy, so see the resources below for some clearer explanations).
If you found this episode helpful, useful, or not a complete waste of time, please consider sharing it with someone else. Please also consider rating it, following the show, or where possible leaving a comment. It all helps others decide if my show is a a bag of shit or not.
Thanks as always. And hope you have a great day! (Or not, no pressure!)
Resources
DBT Skills: Checking the Facts Worksheet
Check the Facts Example (YouTube) - Lewis Psychology
Music
* Opening: “Chilled Ambient Minimal”
* Closing: “Seven” - Tobu

Thank you for subscribing. Share this episode.
Hosted on Acast. See acast.com/privacy for more information.
- Écouter Écoute encore Continuer Écoutez...
- Écoutez plus tard Écoutez plus tard
24: Calum Stronach and the #NotAllMen Podcast
8 févr. 2023· The Nice-ish Ramblings Podcast
I’m really pleased to bring you this episode with Calum Stronach, nutritionist and disordered eating specialist, and (more importantly) host of the #NotAllMen Podcast. A podcast that seeks to challenge the #notallmen hashtag and (as Calum likes to say) hold up a mirror to masculinity as it currently stands. The idea being that there are often many ways that the current framework of masculinity limits or negatively impacts men and those around them. And this podcast seeks to explore how that occurs in many different aspects of life.
I speak to Calum about some of these things, but more interestingly (at least to me) I discuss what impact hosting the podcast has had on him.
I really enjoyed having Calum on and enjoyed exploring his insight and developments with him. Hopefully you enjoy it, too.
As always, if you did like this, please share it with others, rate and subscribe to the podcast, or leave a review. Every bit of feedback helps.
Have a great day (or don’t, no pressure!)
Nice-ish.

Thank you for subscribing. Share this episode.
Hosted on Acast. See acast.com/privacy for more information.
- Écouter Écoute encore Continuer Écoutez...
- Écoutez plus tard Écoutez plus tard
23: What does it Mean to be Trauma-Informed?
1 févr. 2023· The Nice-ish Ramblings Podcast
In the realms of social media it’s not uncommon these days to see “TI” or “trauma-informed” in the bios of those who run mental health, therapy, or psychological social media accounts. But what doe that mean? Does it mean that those who state they are “trauma-informed” understand trauma? Know how to spot it in their clients? Does it mean they’ve read The Body Keeps the Score (great book, by the way) and love Gabor Mate? Or does it mean they are able to work with and help alleviate symptoms of and process trauma?
Well, in this episode I am once more joined by Health Psychologist, Jo Rodriguez (otherwise known as @straightforwardpsychology) to discuss what being trauma-informed actually means, how that might apply in social media spaces, and (most importantly) what it is not.
I always enjoy chatting to Jo and value her insights and experience (and her love of f-bombs). Hopefully you enjoy hearing us waffle on (constructively). If you have any thoughts, questions, or challenges to what we have to say, please let us know.
As always, if you liked the episode and think someone else might like it, too, please share. Also subscribe, rate, and leave a comment - it always helps to let others know how good (or bad) the podcast is.
All the best,
Nice-ish.
Resources
* (Mis)understanding trauma-informed approaches in mental health by Angela Sweeney (2018).
* Trauma-informed mental healthcare in the UK by Sweeney, Clement, Filson, & Kennedy (2016).
Music
* Opening: “Chilled Ambient Minimal”
* Closing: “Seven” - Tobu

Thank you for subscribing. Share this episode.
Hosted on Acast. See acast.com/privacy for more information.
- Écouter Écoute encore Continuer Écoutez...
- Écoutez plus tard Écoutez plus tard
22: Role Models for Men
25 janv. 2023· The Nice-ish Ramblings Podcast
Was the rise of Andrew Tate due in part to a lack of positive male role models? This is what some recent media analysis has suggested. In this episode I am once more joined by Alex Holmes, author, mental health advocate, and psychotherapist, to discuss this potentially contentious point.
Alex works with and has a passion for men’s well-being, so he was a natural choice in broaching this subject. As always, Alex’s research and insights into masculinity and manhood does not disappoint and provides a solid basis for what I feel is an in-depth and nuanced discussion around this issue. Hopefully you think so, too (and let me and Alex know what you do think - even if you think anything we say is far off the mark).
If, after listening, you think that someone else would benefit from hearing this discussion, please share it with them. Also, please do like, subscribe and leave a comment (if you listen on Apple Podcasts - I mean, you could always leave a comment there even if you don’t. Unless you have an Android phone, in which case none of this applies to you!)
Thanks for listening, your patience with putting up with my continued bullshit and letting me fill up your inbox is greatly appreciated.
All the best,
Nice-ish.
Music:
* Ending: “Unexpected” by David Bulla (NCS Release)

Thank you for subscribing. Share this episode.
Hosted on Acast. See acast.com/privacy for more information.
- Écouter Écoute encore Continuer Écoutez...
- Écoutez plus tard Écoutez plus tard
21: What is the Best Way to Prevent People from Becoming Murderers
18 janv. 2023· The Nice-ish Ramblings Podcast
In this episode I try and answer the massive question of “what is the best way to prevent people from becoming murderers?” And while it is a big question, I did have some ideas. These related to understanding how murder relates to aggression, who may benefit understanding the nature of aggression, are human beings inherently aggressive, and what role trauma might play in everything.
Hopefully it provides some food for thought. It might not be the perfect answer, but as always, the aim of what I talk about is to generate some wider perspective thinking. If you have any thoughts you would like to share or some views you would like to challenge, please feel free to get in touch.
If you think anyone else would enjoy hearing about this, please do like, share, and leave a comment. It is all greatly appreciated.
Thanks again.
Nice-ish.
Resources:
* “Aggression and Violence: Definitions and Distinctions”; https://www.researchgate.net/publication/323784533_Aggression_and_Violence_Definitions_and_Distinctions
* “Reactive and Proactive Aggression among Children and Adolescents: A Latent Profile Analysis and Latent Transition Analysis” https://www.mdpi.com/2227-9067/9/11/1733/pdf
* “Appetitive aggression”: https://www.researchgate.net/publication/327231548_Appetitive_aggression
* “Are humans evil?”
* “Is Humankind Inherently Selfish? Reconsidering the Veneer Theory in Humanities”: https://martinschmidtinasia.wordpress.com/2020/12/18/is-humankind-inherently-selfish-reconsidering-the-veneer-theory-in-humanities-i-in-action/
* “Humankind” by Rutger Bregman
* “The Myth of Normal” by Gabor Mate

Thank you for subscribing. Share this episode.
Hosted on Acast. See acast.com/privacy for more information.
- Écouter Écoute encore Continuer Écoutez...
- Écoutez plus tard Écoutez plus tard
20 - Men’s Mental Health - Who Cares? Part 2
8 janv. 2023· The Nice-ish Ramblings Podcast
Hello and welcome to the Nice-ish Ramblings podcast with me, The Nice-ish Psychologist. Today’s episode is the second half of a longer discussion about men’s mental health and whether anyone cares about it. But briefly and for context, these episodes developed after some discussion I had on my Instagram page following some statements made by UFC fighter, Paddy “The Baddy” Pimblett, a few days after a friend of his took his own life. These are the sound bites played at the start of the episode.
The statement about there being no funding for men’s mental health and that no one cares about men’s mental health struck me as odd, so I put a question about this to my followers to get a wider perspective of views. These were essentially broken down into two camps – some noted that there were internal barriers to men seeking help for their mental health while the other noted more external barriers. The internal barriers were discussed in part of one this discussion (which is episode 14 if you want to go and listen), while the external barriers will be discussed here. And hopefully there will be some conclusion as to whether there is a lack of mental health provision for men, and if in fact no-one cares about men’s mental health.
This section, this discussion around external barriers to men seeking mental health support, I found really fascinating – mostly because some of the things discussed from this side of things I had not really considered before, and some I am a bit like, “Yeah, I see where you’re coming from, but you’ve not really convinced me.”
But before I continue, it might be worth noting that this section will contain reference to the categories of primary, secondary, and tertiary healthcare. And seeing as I, someone who works in NHS healthcare, have not always understood the difference between the three I thought it might be helpful to quickly explain the differences. According to the Mind Charity website, primary healthcare is often the first point of contact when someone has any healthcare needs. This is covered by professions like GPs, dentists, and pharmacists. Secondary healthcare are services which will generally require referrals from a GP. In terms of mental health services, this would be things like psychiatric hospitals, psychological wellbeing services (such as IAPT services – which stands for Improving Access to Psychological Therapies), as well as community mental health teams (CMHTs), and Crisis Resolution and Home Treatment Teams (CRHTs). Tertiary care is healthcare that is considered specialised treatment, and in the case of mental healthcare this would be considered something like secure forensic mental health services. Huh! Turns out I work in tertiary healthcare. Who knew!
Also, this episode is not meant to diminish anyone’s mental health struggle. I am very aware the mental health services in the UK are stretched, underfunded, and generally not accessible for these reasons. There are long waiting lists, burnt out staff, and there remains a general persistence in terms of the stigma and lack of understanding about mental health that generally makes it more difficult for everyone to get the help they need. Also, as I noted in the previous podcast, I am not taking aim at Paddy Pimblett and the intention of his initial messages. In fact, there has recently been something in the news about someone saying that Paddy Pimblett’s words saved his life. Which is amazing. The aim of this podcast, rather, is to look at the accuracy of some statements made, which by and large appear to be an accepted narrative around men’s mental health. So, with that in mind I hope you can listen to to this episode with an open mind.
Anyway, external barriers.
So, one of the areas that I can understand where people are coming from, but I also don’t buy it wholly, is the idea that therapy is “feminised”. Yes, you heard me correctly: therapy is feminised.
The premises of this particular barrier appear to be two-fold. Firstly, therapy and therapists, and in fact the field of mental health and psychology in general, is a female dominated field. Secondly, alongside this is the idea that most therapies are emotions-focused and require talking about feelings. Again, these things are not wrong, which is why I can appreciate the idea that therapy is feminised: lots of women in the field and the primary modality of therapy is something that has been classed as feminine – that being talking – and that the main focus is on emotions – again, as aspect of being human that is associated with femininity.
Therefore, the issue that supposedly arises is that men might be less likely to engage with and discuss their difficulties with women. And that talking about their emotions is something men generally struggle with, so a focus on talking about emotions may dissuade them from accessing therapy because supposedly men are more solution-focused and prefer doing rather than talking.
OK, so there are a few things to point out that highlight that this is a somewhat strange, if not flawed argument.
The first thing that I find interesting or wonder about this idea of therapy being considered feminine by virtue of the fact that woman primarily work in this field: does the same concern apply to the area of general healthcare? Is general healthcare considered feminine, too? Because there is a strong gender bias of women working in the caring professions, but I wouldn’t consider general healthcare feminine. I wonder if this is because despite women making up 77% of the NHS workforce they still make up the minority of senior positions, so maybe there is less consideration of general healthcare being thought of as feminine because those in more senior, perhaps more visible positions are men. But still if the worry is that mental healthcare is female dominant, why does the same worry not exist for general healthcare. Not sure any men are refusing to go to the general hospital because there are too many female NHS staff there.
Perhaps it does have to do with the fact that most senior positions are filled by men. So, by that logic you would imagine that if more visible positions within general healthcare are filled by men, that on the whole men would be OK with visiting primary healthcare services like a GP, which up until 2017 was primarily dominated by men. (Some of you may be interested to know in that year in the UK 54% of GPs were women). However, that’s not the case – in an article by The Guardian written in 2102 (so five years before women occupied just over half of all GP positions) men were still only likely to visit the GP four times a year, while women would visit their GP on average six times a year (so, 50 percent more). Similarly, men were likely to visit a pharmacy four times a year compared to women’s average of 18 times a year. The same article highlighted that nine in ten men did not want to trouble a doctor or pharmacist unless they had a serious problem, leading the article to conclude that “men aren’t taking full advantage of the support to maintain good health which is available free of charge on their doorstep.”
Also, I don’t know about you, but I only really realised how female dominated the field of psychology and mental health was once I entered it. I might be wrong, and being an imperfect human there is usually a high chance that I am wrong about this, but I think the predominant perceived gender of therapists and psychologists is still largely masculine and male, based on those who are considered to have pioneered the development of psychology. Like Freud, Jung, Beck, Rogers, and so on and so forth. I am not sure that the average Joe would know that most therapists or psychologists are women. In fact, there was an Australian study done in 2003 (which is over 20 years ago, I admit, but the results are still intriguing to me) where adults were asked to draw images of what they thought a typical psychologist looked like. Based on 119 drawings, it was found that psychologists were largely perceived as middle-aged men.
But the shift in psychology becoming female dominated is relatively recent. In a 2011 article examining the shift in gender in psychology (which I won’t lie, if you read the article it feels a bit like a panicked “what are we going to do now that all these females are entering psychology” piece), it was noted that “the percentage of psychology PhDs awarded to men [had] fallen from nearly 70 percent in 1975 to less than 30 percent in 2008.” But whilst this shift might be noticeable to those in the field, I do wonder how much this is picked up on in the general public. But again, I am potentially wrong about that as this shift has been occurring for like the last 20 years. But if anyone wants to do a follow-up to the 2003 Australian study to see if the perception of psychologists and therapist has change, go for it.
Something else that I found interesting was the apparent inference that men would have difficulty opening up to a female therapist. One of the things about the current state of masculine culture is about not looking weak in front of or admitting ones weaknesses to other men. So, the question I ask is would a man feel OK with opening up to another man more than a woman? Because, if we are agreeing with this gendered stereotype of how therapy is viewed, surely if men are looking for someone to listen to them who stereotypically would be able to understand and empathise and would not be judgmental of their experiences would they not want that to be (again, stereotypically) a woman? I mean, this is all rhetorical because while I do believe that the gender of a therapist can influence a therapeutic relationship and has its barriers (as a male psychologist working in a women’s prison I am acutely aware of this particular therapeutic barrier), it can also serve as a facilitator. It’s possible some men might find it tough to talk to a women therapist, equally, some men might find it more reassuring and containing.
And my final thought on therapy being feminised is this: so what? If it is feminised, and it is something that is considered more feminine, why is that so bad? While delving into this topic, there has been a further inference that men are potentially a “hard to reach” target population and therefore therapy and mental health intervention should be tailored to be male-friendly. There is literature out there to suggest that in order to make therapy more accessible to men it should be masculinised. How should this be done? Well, in their textbook Perspectives in Male Psychology , John Barry and Louise Liddon suggest eleven ways in which to make therapy more male friendly; relating to the therapist, the type of therapy, and techniques.
In relation to the therapist, considerations suggested are: being empathetic, client-centred, value masculine norms, utilising a client’s characteristics (the example here is to use sport as a metaphor for recovery if a male client likes sport - which, again, sure but also metaphors are common practice to help clients understand concepts, etc. Also, women understand sport metaphors, too), considering demographics (like age, ethnicity, education level, and the sex of the therapist, which I have touched on already and might be something important to consider.
In relation to the therapy, it is suggested that male’s might prefer an indirect approach (the example given here is that men might try solve a problem rather than want to focus on their emotions), and that all male groups should be offered alongside individual therapy.
While in relation to therapeutic techniques, it is suggested that therapists consider the language they use, might think about using non-verbal communication (like avoiding direct eye contact which could make men feel uncomfortable), and last but not least, therapist should try use banter.
I suppose what’s interesting is that apart from two things mentioned (that being valuing masculine norms and the interesting suggestion to avoid eye contact, which… yeah, not sure what to make of that one), everything else is pretty much exactly the same as how I, and any other therapists I know, would work with clients… While I am not saying that all of this won’t be helpful, my query is why is it necessary, especially when there is loads of research to suggest that the current therapy modalities work for both men and women. In a 2014 editorial review of research looking into the differences in outcome of the treatment of depression between men and women, the editorial concludes that “patient-centered treatment using medication and/or psychotherapy that explores the psychosocial context of depression is likely to give the best chance of patient compliance and satisfaction, regardless of gender.” Basically, if the person seeking therapy is the focus of the intervention and their mental illness is formulated in a way that is specific to that person, and takes into account all the things about that person (one of which can be their gender) then the intervention should work. Therefore, there is no specific need to masculinise therapy because if a man seeks therapy he will already be masculinised by virtue of the fact that the therapist will focus on and deal with things specific to that man and his circumstances.
Okay, so I seem to have said a lot more about therapy being feminised that I intended, my bad. Moving on…
The second external barrier highlighted from my online discussion was that of the responses of services to men who seek mental health support. So, this was one of the more interesting points that I had not considered. In a very brief discussion with one follower – a fellow psychologist in the south of the country – they noted that their community mental health team saw an equal number of men and women referred to the service, but that men were sometimes deemed too risky to work with for reasons of verbal and physical aggression. As a consequence, these men were often signposted to local charities to receive support for their mental health. Which is an interesting response. And it has made me think two things.
The first is the fact that the men who have mental health issues are not the only ones that hold onto ideals of masculinity. It is very possible that those who work in the services that men access may also hold onto those views, as with the example of turning men away because men are automatically assumed to be more violent than women, which may be further exacerbated when coupled with the potential unpredictability of how some men present when mentally unwell (I would like to caveat this by highlighting that not everyone who is mentally ill can become violent or aggressive, but in this instance it seems to be noteworthy).
But at the same time there is also some evidence to the contrary because at the level of CMHT referral and above (so here we are talking about secondary and tertiary mental healthcare) there is a lot more provision for men than women. Let me explain…
So, in general, there are less psychiatric beds for women than there are men. In terms of psychiatric provision, everything is always measured in the number of beds - but across the UK, there are far more psychiatric beds available for men than there are women, and this only gets more concentrated when you move into forensic psychiatry too. I can’t find like an official document that evidences this, but I know from my years working on psychiatric wards this to be the case (at lease anecdotally). Again, someone let me know if I am wrong. Along side this, there is relatively recent literature to suggest that even when admitted to psychiatric services, women’s needs have not been fully met, and here I quote from an executive summary of a 2018 report commissioned by the UK Department of Health and Social Care: “[mental health services] have been designed, whether consciously or unconsciously, around the needs of men.” The executive summary also goes on to say that women’s roles as mother’s and cares were not considered in terms of the support they received, and that the relationship between gender based violence, trauma, and poor mental health was overlooked. At the same time, I would argue that the impact of trauma should be considered in relation to mental illness regardless of gender.
So, there seems to be a bit of a paradox in terms of responses to men by services. On the one hand, services may be influenced in some way by underlying assumptions and biases about men when they are mentally unwell; but at the same time there appears to be lot more resource provision when they do become acutely or chronically unwell and their needs may be more automatically catered for while in these services.
One of the final points that was made in the overall discussion about this was that there was no promotion for men or reaching out to men to access mental health support. As noted earlier, some would consider men a “hard to reach population”. Now, this is somewhat tricky because I would agree and disagree with this: I would argue that some men might be a harder to reach than others, and this would depend on which type of men we are talking about. I would argue that men that fall into any number of intersectional categories could potentially be harder to reach than others.
As part of their effort to try and reduce health inequalities, the NHS has looked into where different health inequalities exist, and they have identified that often, health inequalities - and in this instance mental health inequalities - exist in relation to sexual orientation and gender, ethnicity, which would also include race and potentially migrant status, disability, and accommodation type. So, men who fall into these categories I would argue are probably the ones who could be considered hard to reach. In an interview for the Metro for an article about male suicide in the Black community, Alex Holmes, therapist and author of the book A Time to Talk (great book by the way, you should definitely get it) – had this to says: “The specific intersection of what it means to be a Black man, a Black trans and, or, queer man, or a Black differently-abled man, at this time is definitely impacting our mental health. The systems are not in place to support us, and there are still many cultural stigmas (both intra-culturally and inter-culturally) that impact how we show up to the world.”
At the same time, I also am stumped by the assertion that there is no effort to engage men in mental health discussions or create awareness. I purposefully held back on releasing this podcast episode in November 2022 because it is also the month of Movember, and entire month dedicated to raising awareness about men’ physical and mental health. And I didn’t want this episode to be received at a time when the focus should be on further creating awareness around men’s mental health – I think the irony might have offended some. Not only that, but there is also Men’s Health Week in June, which is also used to raise awareness about men’s mental health issues.
Alongside this, there are a number of charity organisations that are explicitly aimed at fostering environments for men to open up more about their struggles. For example, “Man Down” in Cornwall, a non-profit charity that offers peer-support groups for men; then there is “Andy’s Man’s Club”, a men’s suicide charity that similarly offers peer-support groups in various locations across the UK; HUMEN, currently offers non-judgemental online support groups every Monday for men who may be struggling with their mental health and thoughts of suicide, and may be moving towards in person support groups. Then there is The Changing Room, supported by the Scottish Association for Mental Health (SAMH), an initiative providing a 12-week programme using football to bring men together to discuss mental health. And those are just some examples. These organisations are linked in the show notes, but they come from quite simple Google searches. I know this is not a competition, but just to give some context there is not necessarily the dearth of mental health support charities and groups for women.
The other interesting thing to think about is that it is commonly understood that there is a gap in male health across the world. According to the website Manual, a website that offers advice of men’s health issues - anything from hair loss, to sexual health, and also mental health - they define a health gap as “differences in the prevalence of disease, health outcomes (both physical and mental), or access to healthcare across different groups”. And the men’s health gap is defined as “a male health gap is when women are generally healthier across their lives than men.” The top ten countries that have male health gaps largely fall within the region of Eastern Europe, with Georgia ranking as the country with the worst male health gap followed by Belarus, Kazakhstan, Mongolia, Ukraine, Armenia, Moldova, the Russian Federation, Mauritania, and Slovakia. And because mental health falls under over all health provision, one would imagine that countries that had male health gaps would also then have male mental health gaps, right? So, if the UK does indeed provide poorly for men’s mental health and it is something not considered then you might expect the UK to have a male health gap, too. Right?
Interestingly though, the UK is not one of the countries without a male health gap. In fact, in the UK it is quite the opposite. According to the same website, the UK ranks 12th in the top countries that have female health gaps. So, just to be clear, overall in the UK health outcomes are worse for women than they are men; and again, this would include mental health outcomes.
So, I guess this seems like a good point to try and answer the overall question of this exploration into men’s mental health provision, that being: “In the UK does no one care about men’s mental health?” And I guess I might cop on this one a bit and let you make up your own mind. I think for me to come to an absolute conclusion would be somewhat arrogant as I am not someone who is potentially affected by difficulties with their mental health. To say one way or the other is potentially invalidating for anyone listening. But, the one thing that I have learned from doing these two episodes to thinking about barriers to men accessing men’s mental health is that there are a lot of things to consider. Some of them are internal, and there do appear to be a few external barriers. How insurmountable are they? Well, I guess it depends on the colour of your skin or who you fall in love with, and whether you think something being considered feminine is more of an issue than your mental health needs. There also appears to be quite a lot of available support and efforts to promote men’s mental health - something that does not seem to be equally championed for other genders. I hope, though, at the very least I have provided some evidence to make you think about the question and come to a conclusion for yourself.
If you are a man who is struggling with their mental health, please do consider getting in touch with your GP. Alternatively please look up any of the charities mentioned in this podcast and find a group of lads who will listen. There is also the option, if it is possible, to talk to our friends and family. I know this makes it sound a lot easier than it might actually be, but if there is anything I have learned in my time working with men, and even my own hesitancy and resistance to admitting when things are tough, it’s that we can sometimes be our own worst enemy.
Thank you very much for taking the time to listen to this ramble. As always if you think someone somewhere would find this episode interesting or may benefit from listening to it, please share it. Please also like, share, rate and leave a comment. It helps so much with letting others know about the show. Until next time - take care.

Thank you for subscribing. Share this episode.
Hosted on Acast. See acast.com/privacy for more information.
- Écouter Écoute encore Continuer Écoutez...
- Écoutez plus tard Écoutez plus tard
19: The "War on Men"
20 nov. 2022· The Nice-ish Ramblings Podcast
Hello and welcome to today’s episode of The Nice-ish Rambling Podcast, with me the Nice-ish Psychologist where today I am going to be discussing the cheery subject of the “war on men”. I say cheery with a sense of irony because in looking into some information for this episode, I have come across some quite intense information – some intense statistics that, if you are a woman, might be a bit heavy to hear. So, if you are a woman listening to this and things become a bit heavy, please do look after yourself and take a break if you need to, or just put this episode to rest. I guess this episode is more food for thought for any men that might be listening.
The reason I want to talk about this, and the reason I want men to pay attention, is because there is a growing narrative that exists online that – and as the title of this episode suggests – there is a “war on men”. It is a narrative that has long been held by what could be considered Men’s Rights Activists, a movement that essentially exists in opposition to feminism. MRAs would argue that they are egalitarians, seeking to ensure equality for all, specifically for men, and will do this by highlighting specific populations of men or areas of society in which men experience hardships. Common themes are that of unemployment, high suicide rates among men, boy’s falling behind in education, men having to go to war, supposed lack of custody rights for fathers and parental alienation, and the claim that men experience domestic abuse as frequently as women.
Now it is not the intent of this podcast episode to go through all the issues highlighted by MRAs and discuss them in detail – there is a lot of subtlety and nuance to these issues, which are very real and do exist to some extent. However, MRAs will often use these as examples to highlight how feminism, or the pursuit of equal rights for marginalised groups in general, has left men the forgotten victims of society. Laura Bates discusses Men’s Rights Activist in a lot more detail in her book Men Who Hate Women, which I would highly suggest you read if any of this is of interest to you – and so I won’t get into this right now. But what I will say is that I feel like the “war on men” narrative is fed by the MRA ideology and beliefs about society having “gone too far” with respect to feminism. But in some way, I now feel that the “war on men” narrative is weaponizing masculinity as part of its repertoire, too, suggesting that masculinity is in crisis. And the more this “war on men” narrative - which has its roots in what is known as the manosphere (Laura Bates talks about this in her book, too) - the more this narrative is starting to spread, the more it is starting to make its way into mainstream online arenas such as Instagram and Twitter.
The inspiration for this podcast episode comes from an Instagram post that was shared on the account of Lalalaletmeexplain – if you don’t know who Lalalaletmeexplain is I would highly suggest you follow her. She is a former social worker, author, and I guess she is a dating advice guru (her book is called Block, Delete, Move On), but she is also a very straight-talking feminist voice who I have learned a lot from. A lot of her content is rooted in highlighting sexist and misogynistic behaviour in the dating world, but also branches out into areas of domestic and sexual violence, and calling out general bullshit by men – as is the case with the Instagram post in question. I am not going to disclose who the post was by in this episode, but I have selected some choice passages from the caption to focus on.
The Instagram post in question has a picture of the owner of the account, a man, looking at the camera, smiling quite genially, with the title: “The War on Men” and the caption opens with these first few lines:
“There’s a war going on at the moment that a small group of people can see but the majority can’t (yet)….”“It’s a war on men designed to demonise, oppress and make men weak…”
So, I guess when I read this kind of stuff, I am always curious as to who this war is being declared by. Who is declaring this war? Usually in a war there is an aggressor and a victim I suppose; the person or people declared war upon.
Now, I don’t want to seem like I’m making things a competition, but I guess it would be helpful to point out what a war (that is, acts of aggression and violence) declared a specific gender would look like. And here I would like to declare that I have once more taken inspiration from the stories of Lalalaletmeexplain (I actually have very little of my own original ideas). But in order to do this discussion justice it might be helpful you think about three “wars” against women that are currently being perpetrated in different parts of the world. And just a warning, this is where shit gets a bit heavy.
The first example, on a war on women is that earlier this year in America, a supposed “first world” or “developed” country, the Supreme Court of the United States unleashed what was described as an “unprecedented attack on women, girls, and people of reproductive capacity”. The Supreme Court overturned Roe v Wade, a law that had provided 50 years of established constitutional protection for abortion, and has now made abortion illegal in America - which in some states also includes abortions related to miscarriages and ectopic pregnancies. And if you think about it, 50 years is not all that long for a law like this to have existed. People have grandparents older than this law. That’s absolutely bonkers if you think about it. But what’s even more bonkers is the fact that this law, a right for those who are able to give birth to choose whether they give both or not, to have autonomy over their body, has been taken away. Just like that. It actually blows my mind and I still cannot fathom how, in this day and age a person’s right to live their life how they choose have just been stripped away. It’s fucking nuts.
The second example is that in September in Iran, a 22-year-old women named Mahsa Amini died while being detained in custody. Her crime? In the capital city Tehrans, Masha Amini was not wearing a hijab in accordance with compulsory Islamic hijab laws - turns out she was wearing a hijab, but she was wearing it loosely. And so she was arrested by the morality police, taken into custody, where she later died having allegedly been beaten in a police truck on her way to being detained. I say allegedly as Iranian authorities claim no violence was used against Masha Amini, but rather that she collapsed from a heart attack.
Her death has sparked “unprecedented protests” in the country, with women defying the governments laws and cutting their hair in solidarity, and joined by men who support these women and wish to change the laws that treat the women of Iran as second class citizens, alongside other grievances of how the Iranian government treats its citizens in general. Seemingly though, these protest are nothing new - there were protests in the late 70s and 80s when the new form of government took over in 1979 and started making plans to restricted the rights and privileges of women, supposedly in line with the faith of Islam. The protests were held for the same reasons they are today, but despite the protests, new restrictions on women’s clothes, became law in 1983 - that’s just under 40 years ago. Again, that’s mad. Additionally, the death of Masha Amini is not the first time violence has been used against women by the so called morality police, not necessarily resulting in death, in the way that Masha Amini was treated (although I could be wrong about this). But it has been reported that women in Iran are continually harassed by the morality police, and if having been found to contravene the hijab laws are made to attend “educational classes” (and who knows that education looks like). This is all apparently a common occurrence.
Then, in South Africa, there is what been referred to in some news sources as a “pandemic” of femicide. The term femicide was seemingly first used in 1801, in a book called A Satirical View of London at the Commencement of the Nineteenth Century, by John Corry, where it was used to refer to the killing of a woman. However, in 1976, it was reintroduced by a feminist pioneer, Diana Russel, at the International Tribunal of Crimes Against Women in order to bring attention to violence against women, and has seen two definitions. The first from 1976 defined femicide as: “the murder of women by men motivated by hatred, contempt, pleasure, or a sense of ownership of women”. While the second definition - updated for the United Nations Symposium on Femicide in 2012, and defined once more by Diana Russel - notes that femicide is “the killing of one or more females by one or more males because they are female”.
In South Africa, the number of women killed is staggering, and the country is included in the top 25 countries in the world for the highest rates of women killed - along with other countries like El Salvador, which ranks number one. But according to the website, Africa Check, in 2020/21, a total of 2,655 women were murdered in South Africa, with an additional 898 women killed in the last quarter of 2021. To put those numbers into context, a BBC article from this year noted that, by comparison, the latest figures from the Office for National Statistics (ONS) indicate that between April 2020 and March 2021 (so the same time frame that the figures from South Africa were taken), 177 women were murdered in England and Wales, compared to 416 men. 177 women in the UK compared to 2,655 women in South Africa. However, whilst the UK numbers might not be as high as those in South Africa, the UK is still facing its own femicide issue. The same article notes that of the 177 women killed, 109 were killed by a man and 10 by a woman, and in 58 cases there was no known suspect. This means that - where the suspect was known - 92% of women were killed by men in the year ending March 2021.
There is a UK Femicide Census that analyses the murders of women in the United Kingdom. Some of the findings of the 2020 census note that 110 women were killed by men in 2020. 111 men were implicated in those murders, but at the time of publication only 79 had been found responsible for killing a woman - that means roughly a third of perpetrators had not been held accountable. Further stats highlight that 52% of women were killed by a former or current partner, 13% were killed by their son, and only 8% were killed by a stranger. 77% of killings took in the home, in 48% of cases there was a known history of violence and abuse by the perpetrator against the victim, and 53% of perpetrators were know to have previous histories of violence against women.
So, what is the point I am trying to make with all of these horrific stats? I guess it’s that when we talk about a war perpetrated against a gender, there is more evidence - more tangible evidence that can be pointed to, seen, noted down - of who the aggressors might be when it comes to violence perpetrated against women. However, there does not seem to be either a) the same level of violence perpetrated against males and men based on sex or gender or b) an obvious perpetrator. Like I said, I am not trying to say who has it worse, but I guess I am trying to highlight how this narrative of a “war on men” is vague. Although the author does go on to say this:
“Because no one is easier to control then a passive, docile, domesticated doormat that is unsure of himself and feeling a sense of shame for being a man…..”
“Despite what is unconsciously getting fed, we need STRONG men and despite the popular narrative (from the ‘woke’ numpties) there is a shit ton of people that LOVE seeing men step into their (healthy) masculine power…”
“If these c*nts in positions of power thought every single bloke was just going to roll over and become a passive passenger they were wrong.”
See, this is interesting - while the use of “cunts” might be generic, I can’t help but think that he is talking about women and feminism - I might be wrong. But even if I am wrong, there is also an allusion to them being in “positions of power”. Like, who? Who are these people, and why can’t they be named? Is that because there are no real people in positions of power trying to make men docile, passive, and domesticated. But keeping it vague helps it make it seem like it’s a bit of a conspiracy, that there are dark forces at play. Or is it the “woke numpties” who are doing this.
Also, what is it that these “cunts” and “woke numpties” are asking. Last time I checked no one was asking men to be weak or docile; I think you’ll find that men are being asked to not be stoic and emotionless, to get in touch with a wider range of emotions and increase their emotional intelligence - this does not mean weak. Also, we’re being asked to be less reliant of physical violence (or even the threat or capability of violence that Jordan Peterson likes to talk about) and deal with conflict more healthily. And as I said earlier, this does not seem to relate to any of the real world issues facing men, like unemployment, high rates of suicide, things like this. This seems to be a concern about the re-evaluation of masculinity or what it means to be a man.
Because again, the idea that there is something wrong with being weak and docile highlights that there is a particular way of being a man. Even thought the author of this Instagram post and caption talks about men stepping into healthy masculinity, there is still some delineation that one type of way of being a man is better. Like, I always struggle with the word weak when it comes to men - like, what do men like man who made this post mean when they denigrate weak men. Are they talking about physicality and physical strength? Or are they talking about like mental fortitude? Or resiliency in the face of adversity? Or how to stand you ground and be assertive? Because weak can mean so many things. But then, at the same time, there is sometimes a narrative that seems to imply that weak men are the ones who are dangerous - like, how and in what way? Are they weak because even when talking about healthy masculinity there is an element of strength needed to be a man, and with strength comes power? And so are those who denigrate weak men saying that weak men will go to dangerous lengths to obtain power? Well, probably, yeah - because if you make it that you can’t be seen as a man - even a healthy man by this particular individuals construction of masculinity - without any kind of power, then you create power as something to be coveted.
No idea if any of this makes sense - but I suppose what I am trying to highlight is that all of this - this “war on men” rhetoric - appears to be a push back against the idea that the current rule of thumb of masculinity might no longer be up to scratch. And there is something quite insidious about calling it a “war”, because if you’re calling it a war - and this might be me taking my interpretation of this a bit too melodramatically far, but still - if you’re gonna call it a war then you’re likely looking to recruit soldier in the “battle” to push back. Which might sound, as I said, a bit melodramatic, but when coupled with another segment of the caption under question doesn’t feel all that far off:
“Here’s the thing - if men wake up to what is unfolding and step into their power, they’re a lot less likely to roll over it and just take it from those in positions of power. They become a threat to the regime. So gents RISE.”
Which, I am not going to lie, sounds just a teeny bit propaganda-esuqe. It sounds a little bit like a mobilisation, a call to action, which is somewhat concerning more and more, current research is starting to highlight that younger men are buying into this narrative and this rhetoric, one might even use the term radicalised in this way, or even groomed into believing that there is a unknown force out there trying to diminish men. In a 2021 article discussing this (which also features commentary by Laura Bates), research by Dr Joshua Roose notes that one in three men under the age of 35 believe that women’s right have gone too far. And while I am not saying that the specific post in question in ad of itself is adding to this kind of belief, but I would certainly venture that it is part of the difficulty and the concern. And the fact that it is being disseminated online in a popular social media platform like Instagram, and no longer quarantined to the more clandestine, murkier, and lesser known message boards of the internet is what gives me pause.
_
Thank you for taking the time to read this (or if you have listened to it as a podcast). If you have found this interesting please do share, subscribe, or leave a rating or comment. Also, please do come share your thoughts on the topic with me on my Instagram page.
Thanks,
Nice-ish.

Thank you for subscribing. Share this episode.
Hosted on Acast. See acast.com/privacy for more information.
- Écouter Écoute encore Continuer Écoutez...
- Écoutez plus tard Écoutez plus tard
18: Men Discussing Baby Loss
8 nov. 2022· The Nice-ish Ramblings Podcast
The 9th to the 15th of October is Baby Loss Awareness Week. A week I only found out about through Dan Osman who shared a post about his daughter, Maeve, whom he and his wife lost before she was born. I realised in that moment that baby loss is not something discussed much, and especially not with men in mind (although that is probably quite understandable). And so I looked into it for the whole of Baby Loss Awareness Week. The culmination of which was plucking up the courage to invite Dan onto my show to talk about his experience.
This is that conversation. I hope the conversation is something that might help in some way.
Please look after yourself when listening to this conversation - it covers quite a sensitive subject.
If you have experienced baby loss, or know of anyone who has, please see the resources below.
Thanks,
Nice-ish
Baby Loss Resources
Sands UK
The Lily Mae Foundation
Still Parents Podcast
Baby Loss Awareness Week website

Thank you for subscribing. Share this episode.
Hosted on Acast. See acast.com/privacy for more information.
- Écouter Écoute encore Continuer Écoutez...
- Écoutez plus tard Écoutez plus tard
Montre plus

Episodes

A Nice-ish Book Review: “Maybe I Don’t Belong Here”

Why New Year's Resolutions Fail (And How to Overcome That... Maybe)

35: The Precarious Manhood of Billionaires

34: Boundaries (and More)

33: The Benefits of Shame

32: Postpartum Depression and Anxiety in Fathers

31: How Does Prison Rehabilitation (Ideally) Work?

30: UK Mental Health Professionals - Talking Therapies

29: Men, Body Image, and Masculinity

28: UK Mental Health Professionals - Psychiatric Care

27: Dads Need Dad Friends

26: The Sigma Male and “American Psycho”

25: Are All Feelings Valid?

24: Calum Stronach and the #NotAllMen Podcast

23: What does it Mean to be Trauma-Informed?

22: Role Models for Men

21: What is the Best Way to Prevent People from Becoming Murderers

20 - Men’s Mental Health - Who Cares? Part 2

19: The "War on Men"

18: Men Discussing Baby Loss