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“Chokin’ it down” : men’s experience of emotional inexpression Hoover, Stuart Michael 2011

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“CHOKIN‟ IT DOWN”: MEN‟S EXPERIENCE OF EMOTIONAL INEXPRESSION  by STUART MICHAEL HOOVER M.A., McMaster University, 1998  A THESIS SUBMITTED IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF MASTER OF ARTS in THE FACULTY OF GRADUATE STUDIES (Counselling Psychology)  THE UNIVERSITY OF BRITISH COLUMBIA (Vancouver) August 2011 © Stuart Michael Hoover, 2011  ii  Abstract Male gender socialization teaches men to resist experiencing vulnerable emotions in themselves or in others. Emotional inexpression is so foundational to the male gender role that men may be unable to express emotions, or feel compelled to “choke down” their emotions before others and within themselves. A majority of clinicians endorse greater emotional expression as desirable for men, which provides a rationale for therapeutic interventions that increase men‟s emotional expressivity. However, some authors propose that men‟s emotional inexpression can have adaptive qualities, such as enabling them to function under stressful or traumatic situations. The aim of this study was to step back and understand men‟s experiences of maintaining emotional inexpression while feeling a strong emotional reaction arising within them. A phenomenological study was conducted with six men to explore this experience. Themes arising from this study inform theory of emotional expressivity and provide possible therapeutic interventions aimed at increasing these men‟s emotional expression and lay groundwork for further studies in male emotional expression.  iii  Preface This research was approved by the University of British Columbia‟s Behavioural Research Ethics Board. The Certificate Number of the Ethics Certificate obtained was H1000980. The literature review and preliminary findings of this study were presented. Hoover, S., (2011, June). Male Emotional Inexpression and Engaging Men in Counselling and Psychotherapy. Paper presented at the annual conference of the Canadian Psychological Association, Toronto, Ontario, Canada.  iv  Table of contents Abstract .................................................................................................................................... ii Preface ..................................................................................................................................... iii Table of contents .................................................................................................................... iv List of figures .......................................................................................................................... vi Acknowledgements ............................................................................................................... vii Chapter 1: Introduction ......................................................................................................... 1 1.1 Background ........................................................................................................................... 1 1.1.1 What is emotional inexpression in men? .......................................................................... 1 1.1.2 What creates emotional inexpression in men and its consequences? ............................... 3 1.2 Definition of terms ................................................................................................................ 5 1.2.1 Emotional experiencing. ................................................................................................... 5 1.2.2 Emotional regulation. ....................................................................................................... 6 1.2.3 Emotional inhibition. ........................................................................................................ 6 1.2.4 Emotional inexpression. ................................................................................................... 6 1.3 Rationale for the study .......................................................................................................... 7 1.4 Purpose of study .................................................................................................................... 8  Chapter 2: Review of the literature ..................................................................................... 10 2.1 What is emotion .................................................................................................................. 10 2.2 What is emotional expression ............................................................................................. 12 2.3 What is emotional inexpression .......................................................................................... 13 2.4 History of emotional inexpression ...................................................................................... 15 2.5 Etiology of emotional inexpressiveness .............................................................................. 16 2.5.1 Gender role socialization: A paradigm of masculinity(ies). ........................................... 16 2.5.2 Emotional inexpression as a socialized behaviour. ........................................................ 18 2.5.3 Typologies and measures of emotional inexpression. .................................................... 20 2.5.4 Other theories of emotional inexpression in men. .......................................................... 21 2.6 Consequences of emotional inexpressiveness in men ......................................................... 21 2.7 Male emotional inexpression and therapeutic contexts....................................................... 24 2.7.1 How male emotional inexpression is addressed in therapy. ........................................... 25 2.8 Processes of emotional inexpression: How men do it ......................................................... 26 2.9 Existing research in emotional inexpression ....................................................................... 29 2.10 Gap in the literature............................................................................................................. 34  Chapter 3: Methodology....................................................................................................... 35 3.1 Research method: Phenomenology ..................................................................................... 35 3.1.1 What is phenomenology? ............................................................................................... 35 3.2 Personal assumptions and bracketing.................................................................................. 36 3.2.1 Why am I involved in this phenomenon? ....................................................................... 37 3.2.2 How might my personal inclinations and predispositions as to research value influence or even bias how and what I investigate? .................................................................................... 38 3.3 Research procedures ........................................................................................................... 39 3.3.1 Participants. .................................................................................................................... 39 3.3.2 Number of participants. .................................................................................................. 39 3.3.3 Participant demographics................................................................................................ 40 3.3.4 Recruitment. ................................................................................................................... 41  v 3.4 3.5 3.6 3.7 3.8  Data collection .................................................................................................................... 42 Data analysis ....................................................................................................................... 46 Validation ............................................................................................................................ 48 Presentation of findings ...................................................................................................... 50 Ethical issues ....................................................................................................................... 50  Chapter 4: Results................................................................................................................. 52 4.1 Participant vignettes ............................................................................................................ 53 4.1.1 Bill. ................................................................................................................................. 53 4.1.2 Frank. .............................................................................................................................. 55 4.1.3 Mike. ............................................................................................................................... 56 4.1.4 Greene............................................................................................................................. 58 4.1.5 Sasha. .............................................................................................................................. 60 4.1.6 Thomas. .......................................................................................................................... 62 4.2 Common themes ................................................................................................................. 65 4.2.1 Inexpression is disconnection from others...................................................................... 66 4.2.2 Inexpression is disconnection from self.......................................................................... 69 4.2.3 Inexpression is linked to low self-worth or worthiness. ................................................. 72 4.2.4 Inexpression is clearly defined. ...................................................................................... 73 4.2.5 Anger is an experience of inexpression. ......................................................................... 75 4.2.6 Inexpression is stillness, control. .................................................................................... 76 4.2.6.1 Subtheme: Inexpression is a physical barrier. ........................................................ 78 4.2.7 Body symptoms of inexpression. .................................................................................... 80 4.2.8 Inexpression is linked to working or providing. ............................................................. 81 4.2.9 Inexpression and the terror of expression. ...................................................................... 84 4.2.9.1 Expression is a huge fear. ...................................................................................... 85 4.2.9.2 Expression is irrevocably crossing over into the unknown. ................................... 85 4.2.9.3 Expression is a tumbling, disorienting, falling, loss of control. ............................. 86 4.2.9.4 Expression leads to harm, death. ............................................................................ 88 4.2.10 Ancillary finding: Expressing emotion progressively increases connectedness and self-worth. ................................................................................................................ 89  Chapter 5: Discussion ........................................................................................................... 91 5.1 5.2 5.3 5.4 5.5 5.6 5.7  Definitions and theories of emotional inexpression ............................................................ 92 Inexpression as choice or learned disability........................................................................ 93 Emotional inexpression and masculine socialization .......................................................... 95 Novel contributions ............................................................................................................. 96 Implications for practice ..................................................................................................... 99 Limitations and future directions ...................................................................................... 101 Conclusion ........................................................................................................................ 103  References ............................................................................................................................. 104 Appendices ........................................................................................................................... 113 Appendix A Recruitment flyer ....................................................................................................... 113 Appendix B Recruitment website .................................................................................................. 114 Appendix C Consent form ............................................................................................................. 115 Appendix D Demographics form ................................................................................................... 119 Appendix E Referral list of community resource services ............................................................. 121 Appendix F Interview orienting statements ................................................................................... 122 Appendix G Transcription procedures ........................................................................................... 124  vi  List of figures Figure 1.1 Map of emotional inexpression ............................................................................... 6 Figure 4.1: Bill's wall .............................................................................................................. 54 Figure 4.2: Thomas' activity ................................................................................................... 63 Figure 4.3: Theme map ........................................................................................................... 66  vii  Acknowledgements I hated reading the acknowledgement sections of papers! (I was obviously projecting my thesis-envy). Now that I‟ve come to the end of my thesis-writing marathon, I realize that gratitude carried me the last 10 miles, and so I am compelled to acknowledge those who helped me get here. First, thank you to my participants, you band of intrepid explorers, who risked this adventure into what my mom calls the “back 40”. Thank you to Dr. Marv Westwood for being a constant Virgil to my Dante. Thanks to Christ Church Cathedral, for generously providing space for me and my participants to work confidentially. Finally, humble thanks to my wife Michelle, who put me first and cherished me, and to my children who fuelled my engine with purpose, just by being themselves.  1 Chapter 1: Introduction 1.1  Background Emotional inexpressiveness is considered a problem by a majority of clinicians and  researchers who study men, but no study has been conducted to understand the male experience of being emotionally inexpressive. 1.1.1  What is emotional inexpression in men? Emotional inexpression can be defined as a subset of emotional inhibition, where a  person is subjectively aware of an emotion within them, and they inhibit their inward and outward expressions of that emotion (Consedine, Magai & Bonanno, 2002). How they become aware of the emotion, how they begin inhibiting it, and what form the inhibited expression does take, is a highly complex framework to completely define, resulting in overlapping constructs and theories of causation permeating the literature. For men, emotional inexpression is well documented in manuscripts that describe traditional masculinity in western society. In Corneau‟s (1991) book entitled Absent Fathers, Lost Sons, he described a “law of silence” (p. 10), referring to spiritual and emotional absence that denies many sons knowledge and access to their fathers. Hollis (1994) described how men collude in a conspiracy of silence aimed at suppressing their emotional truths. He stated that virtually all men can recall the ridicule and rejection that came from occasions when they expressed themselves. He also explained that men live lives governed by fear of their emotional sides, yet believe they ought not to be afraid of such things. As a consequence, men unconsciously collude to keep quiet about what damages them, which means not speaking their personal emotional truths, or tolerating such truths from others. This violation of their emotional truths contributes to them becoming violent themselves.  2 Emotional inexpression in men is also discussed in non-academic settings. In the satirical television program, “King of the Hill” (Lieberstein, 1997), the protagonist Hank Hill taught his niece, Luanne, how to suppress her emotions: HANK:  Luanne, sometimes life throws you a curve ball. Now there's two ways you can deal with it. You can cry -- and that's the path you've chosen -- or you can not cry.  LUANNE:  How do you not cry?  HANK:  Well, instead of letting it out, try holding it in. Every time you have a feeling, just stick it into a little pit inside your stomach and never let it out.  LUANNE  (trying it): Are you supposed to have a pain under your rib?  HANK:  Yes. That's natural. The body doesn't want to swallow its emotions. But now you go ahead and put that pain inside your stomach too.  LUANNE:  I think it's workin', Uncle Hank. I feel sick, but not sad.  What made this moment memorable to me, years after having watched it, was the comical clarity in which the writers explain what men do to manage emotional expression. Finally, my uncle told me a story that is relived each time he and my father visit one another. He explained that for the first 5 minutes of a visit, they sit adjacent to one another in the living room, make no eye contact, and talk about mutual acquaintances; after the 5  3 minutes, the conversation dies. The rest of the evening, they sit in frozen silence, unable to express themselves, and their wives do all the talking. He was aware of the emotional inexpression in himself and his brother, yet he was unable to do anything about it. Examining men‟s emotional inexpression from academic and non-academic perspectives reveals variability between individuals and within individuals in describing/conceptualizing the experience, and emphasizes experience itself as an important form of empirical evidence by which to understand it. 1.1.2  What creates emotional inexpression in men and its consequences? Emotional inexpression in men is commonly described using a paradigm called “The  new psychology of men” (Levant, 1996). This paradigm arises from the feminist theory of gender role socialization and the social construction of gender through societal values, beliefs and stereotypes (Addis & Mahalik, 2003). For men, gender role socialization represents societal beliefs about how a man should behave in most circumstances, and is learned in early childhood when developmental experiences are paired with societal responses (Good, Thomson, & Brathwaite, 2005). These authors explained that boys are shamed and ridiculed as being not masculine (i.e., feminine), if they violate these norms. The messages, delivered by family, peers and society, threaten their emerging male identities, and explain men‟s strong aversion to violating these norms. Levant (1998) described traditional masculine socialization of boys as inherently traumatic, with emotional socialization being the most visible aspect of the process. Paradoxically, masculine socialization, while arguably traumatic, is not necessarily detrimental to men or others. For example, Mahalik, Good, and Englar-Carlson (2003) developed a scale to report when conformity to male role expectations results in positive  4 outcomes for men. However, when these socialized gender roles interfere with men behaving in adaptive or functional ways, then they can be said to be experiencing gender role conflict (O‟Neil, Helms, Gable, & Wrightsman, 1986). O‟Neil et al., (1986) defined gender role conflict (GRC) as a psychological state where socialized gender roles have a negative impact on the man or others, and is conceptualized using patterns of behaviours, including restrictive emotionality. Consequences of high GRC in general include higher psychological distress, greater depression, difficulty with interpersonal intimacy, greater biomedical concerns, and poorer health behaviours (Good et al., 2005). How men restrict emotions, in themselves and others, is cardinal among the many male gender roles described in academic literature. Englar-Carlson (2006) summarized that acknowledging vulnerable emotions such as sadness, to others or even to oneself, carries for men the stigma of not living up to traditional masculinity. A “normal” state of emotional interaction among men can be described by what Levant (1998) termed “normative alexithymia” (p. 41), which is the result of boys being socialized to restrict the expression of their vulnerable and caring emotions by being emotionally stoic. Englar-Carlson (2006) stated that normative alexithymia is present in many psychologically healthy men who are unable to express their emotional states, despite the innate ability to do so. A serious consequence of emotional inexpression in men is that it proscribes men from seeking help for psychological issues (Addis & Mahalik, 2003). These authors stated that men do not consider asking for such help as “normal”, because they do not see other men exhibiting this behaviour. As an example, the authors illustrated how back pain is considered a “normal” ailment for men, while depression is not, and therefore men are more likely to seek help for the former than the latter.  5 After an extensive literature review of conceptualizations of male gender roles and norms, I could not find a single corresponding article that did not include restricted emotional expression as a cornerstone of what it means to be a man in western society. Therefore, emotional inexpressiveness can be considered of utmost importance to masculine identity formation. 1.2 1.2.1  Definition of terms Emotional experiencing. The experience of emotions can be considered in 3 dimensions: the physiological  response to the emotion, the intrapersonal affective and cognitive experiences of the emotion, and the behavioural response to the emotion (Wester, Vogel, Pressly, & Heesacker, 2002). The authors endorse these dimensions because they are inclusive of many aspects of individual experiencing, they are client-specific, and they provide a bridge between the science of emotion and counselling research and practice. Emotional experiencing can also be considered along three continua, automatic vs. controlled, voluntary vs. involuntary, and conscious vs. unconscious (Consedine et al., 2002). For example, a man blushing in embarrassment is an automatic physiological reaction that may be uncontrolled, involuntary, yet also conscious. Alternatively, his decision to change the subject of conversation could be a controlled, conscious and involuntary behavioural response to his emotional experience of embarrassment. To determine these continua in each stage requires subjective input from the man, but also observed behaviour from others to accurately corroborate (McFarland, Barlow & Turner, 2009).  6 1.2.2  Emotional regulation. Consedine et al. (2002) defined emotions as evaluation and response mechanisms that  have evolved to promote and organize adaptive behaviour. Emotions are therefore regulated in many ways to help us survive. The authors identified two common types of emotional regulation, namely experience (expression) and inhibition. I depicted their categorization of emotional regulation in figure 1.1. Emotional Regulation Emotional Inhibition  Emotional Experience  Passive  Active  Unconscious, Involuntary  Overt  (Suppression)  Subjective  (Controlled, NOT automatic)  Figure 1.1 Map of emotional inexpression  1.2.3  Emotional inhibition. Emotional inhibition refers to situations in which men restrict or inhibit their  emotional expression or experience, while emotionally aroused (Consedine et al., 2002). Coggins and Fox (2009) identified two types of emotional inhibition, passive, such as distraction, and active, such as suppression or dissociation. 1.2.4  Emotional inexpression. I considered emotional inexpression as the subset of emotional inhibition that is active,  as illustrated by the red boxes in figure 1.1. This is because passive inhibition of emotions are likely to remain involuntary or unconscious processes in men (Consedine et al., 2002), and  7 therefore not be accessible to them during interviews. Active inhibition can be further divided into behavioural inhibition, such as expressive suppression, response modulation, and display rules, and subjective inhibition, such as repression, denial and avoidance (Consedine et al., 2002). Therefore for this study, emotional inexpression will mean the subjective and behavioural experiences of men while emotionally aroused. 1.3  Rationale for the study I categorized the literature of emotional inexpression in men into three groups. The  first group comprises theoretical articles that conceptualize emotional inexpression in men within the four paradigms that masculinity can be, and has been, theorized and researched: Psychodynamic, social learning, social constructionist, and feminist (Addis & Cohane, 2005). These articles may suggest interventions or theoretical frameworks that borrow from other theories. The second group comprises articles that construct and validate measures of emotional experience, expression and inexpression. These articles often apply quasiexperimental designs to a treatment for emotional inexpression in various contexts and male populations. The final group includes studies that employ clinical case studies to describe men‟s emotional inexpressiveness, usually to exemplify a proposed method or framework for helping men gain greater expression. A possible fourth group can be the use of qualitative methods to study emotional inexpression. Qualitative methods are uncommon in the literature, perhaps as a result of the field‟s nascence, requiring that it prove its credibility in a scientific model for greater acceptance in academic and health care domains. Coggins and Fox (2009) stated there is a complete paucity of research examining the subjective experience of emotional inhibition, despite the ability for qualitative studies to examine within-person and across-situation variables that Addis and Mahalik (2003) stated are congruent with the notion  8 of many socially-constructed masculinities. In the realm of emotional inexpressiveness in men, there is no literature that examines the lived experience of men‟s emotional inexpressivity, despite the abundance of articles that suggest its importance to the mental and physical well being of men (Mahalik et al., 2003). 1.4  Purpose of study The purpose of this study was to fill a gap in the literature regarding our understanding  of emotional inexpression in men. The phenomenon I sought to understand was men‟s experience of maintaining emotional inexpression during a strongly felt emotional moment. Another way to state this is the lived experience of men choking down their emotions. To address this problem, I posed two questions: (1) What are men‟s experiences of being emotionally inexpressive?; and (2) When men become aware of strong emotions that are proscribed to them, what do they experience in maintaining a stoic, expressionless stance to themselves and the world? The research was conducted using descriptive phenomenological inquiry. I asked men to describe the experience of maintaining emotional inexpression when strong emotions were present and intense. By identifying a period of strong emotion, I believed participants would provide a rich description of emotional inexpression. Findings are expected to help develop understanding of men‟s relationships with their emotional selves and inform practitioners in clinical settings. There are several delimitations to this study. First, it contained men only. Second, participants were fluent in English, as language barriers would have intensified the challenges inherent in men trying to describe emotional inexpression, and may have confounded results. Third, participants were limited between 30 and 66 years old, capturing Erikson‟s (1963)  9 developmental stage of middle adulthood. Fourth, participants were excluded if they had a psychological illness. Fifth, participants were excluded if they were in a self-identified period of emotional stress or strain, such as a recent loss. The last two conditions protected potentially vulnerable men from the risk of being overwhelmed while describing stories of strongly-felt emotions. The goal of the study was to understand men‟s experience of emotional inexpression, as highlighted by a felt sense of something struggling to express itself from within them.  10 Chapter 2: Review of the literature I began this review by examining emotions, emotional expression and emotional inexpression. Next, I explored the history, etiology, consequences, and corrective approaches of emotional inexpression in men. I then described theoretical models of how men “do” emotionally inexpression, and review significant studies that examine this construct. Finally, I identified a gap in the literature that justifies this study. I reviewed literature of emotional inexpression in men using searches in Google Scholar, as well as ERIC and PSYCINFO databases, for keywords such as: “emotions”, “feelings”, “emotional”, “expression”, “inexpression”, “inhibition”, “suppression”, “qualitative”, “phenomenology”, “men”, and “male”. I also referred to handbooks of counselling men, including, Andronico (1996), Englar-Carlson and Stevens (2006), Good and Brooks (2005a), Pollack and Levant (1998), and Scher, Stevens, Good, and Eichenfield (1978). Finally, I examined references in books and articles that were particularly pertinent to this phenomenon, especially if they were in different disciplines, such as sociology or computer science. 2.1  What is emotion Emotion, as a philosophical study, dates at least as far back as Socrates and Aristotle,  and is conceptualized and applied in most if not all humanistic disciplines. For example, the discipline of economics models emotion to understand how individuals compete with each other, and how they evaluate the costs and benefits between alterative choices (Elster, 1998). The biological study of emotions is championed by Darwin‟s application of emotional expression to evolution and survival (Darwin, Ekman, & Prodger, 2002). Finally, researchers in the discipline of computer sciences are attempting to program computers to express and recognize affect in humans, and respond accordingly and convincingly. Picard (1997) named  11 this fascinating field “affective computing”, and recent authors are applying models of emotions to computers that are as complex as existing theoretical models of primary and secondary emotional states in humans (Becker-Asano & Wachsmuth, 2010). Within the field of psychology, many definitions of emotion have been theorized and tested as a way to improve people‟s lives. Plutchik (2000) stated there are 92 definitions and 24 theories of emotion in relevant literature. In his psychoevolutionary theory of emotion, he identified 8 primary emotional dimensions that vary in intensity like colours in a spectrum. He stated that all other emotions are combinations of these primary emotions and identifies all emotion words to be “a few hundred at most” (p. 63). He presented a three-dimensional cone, of emotion, with the primary emotions at the most intense end of a narrowing cone of lesserintensity emotions (Plutchik, 2001). Lazarus (1991) extended the theory of evolution to understand the purpose of emotions as an adaptive function. He linked an emotion to a person‟s appraisal of a safe or harmful environment. He stated that emotions evolved from reflexes and physiological drives, enabling humans to be more adaptable to specific stimuli than from basic built-in responses alone. The decoupling of behaviour from environmental input places greater dependence on intelligence and learning, rather than survival through the best fit between stimulus and response. He defined emotion as a complex psychobiological reaction that fuses intelligence with motivation, impulses, and physiology that signify, for actor and observer, that something significant for well-being is at stake. Therefore, anything that implies harm or benefit can produce emotions, including emotions themselves. Emotions act as rapid synthesizers of massive amounts of environmental stimuli that would overwhelm cognitive processes; the synthesis is a simple emotional message that can be responded to in adaptive ways.  12 The conceptualizations and categorizations of emotions reveal the complexity and depth of human emotional experiencing. Next, I reviewed how emotions are or are not expressed. 2.2  What is emotional expression Emotional expression is a complex, non-stable construct to define and measure  (Moore & Haverkamp, 1989; Wong & Rochlen, 2005). Wester et al. (2002) summarized three dimensions of emotional experiencing that included/explained existing definitions of expression: overt behaviours, subjective reports and physiological responses (see definition section 1.2.1). It is important to note that subjective reports of emotions can be further divided into cognitive experiences, such as appraisal and labelling, and affective experiences, such as arousal, pleasure and displeasure (Kleinginna & Kleinginna, 1981). Wong and Rochlen (2005) conceptualized emotional expression from a behavioural perspective. They defined emotional expression as “observable verbal and nonverbal behaviours that communicate and/or symbolize emotional experience” (p. 63). Behavioural approaches to emotional expression employ facial and vocal expression (Russell, Bachorowski, & Fernandez-Dols, 2003), written expression (Pennebaker & Seagal, 1999), body postures (Coulson, 2004), and physical reactions that reveal emotional states, such as responding to music (Sloboda, 1991). Moore and Haverkamp (1989) employed measures of participant self-report to determine changes in levels of emotional expression. They measured perception of emotions and awareness of emotional intensity, and some measures relied on a physiological response to accompany the participant‟s emotional awareness. Finally, many studies examine emotional expression using physiological responses, such as spontaneous facial responses (Ekman, Davidson, & Friesen, 1990), blush responses (De Jong, Peters, De  13 Cremer, & Vranken, 2002), heart rate and brain activity (Critchley, Rotshtein, Nagai, O'Doherty, Mathias, & Dolan, 2005). The preponderance of overt voluntary and involuntary behavioural studies of emotional expression is likely due to the congruence of involuntary physiological responses to positivist research paradigms; simply put, the body doesn‟t lie. This reveals a limitation of quantitative approaches in exploring emotional expression from the dimensions of subjective cognitive and affective experience, and provides a rationale for qualitative inquiry into this dimension. In other words, the person may have something to contribute, beyond their body reactions. In summary, emotional expression can be defined in terms of the four stage model for emotional experiencing, namely that the body responds to an emotional experience, thoughts and feelings can arise in the individual, and result in behaviours. 2.3  What is emotional inexpression Emotional inexpression can, therefore, be thought of as the absence of one or more  dimensions of emotional expression, to some overtly or subjectively measurable degree. Following Consedine et al. (2002), emotional inexpression can be considered a subset of emotional inhibition which can experienced by men as either a passive inability or an active choice. They considered inhibition from many perspectives, including how it presents as observable behaviour versus subjective experience. Regarding the former, the authors described overlapping constructs of suppression, modulation and display rules. The latter they linked to repression, denial and avoidance. The authors stated that inhibition can be considered on several continua, such as automatic versus controlled, voluntary versus involuntary, and conscious versus subconscious. Finally, they noted that positive and negative  14 emotions can be inhibited for different reasons and result in different health consequences. Along these lines of thought, Coggins and Fox (2009) identified two types of emotional inhibition, passive and active. Passive inhibition occurs when a person uses alternative representations, such as distraction, to inhibit their emotions, while active inhibition is similar to a traditional psychodynamic process of suppression and dissociation. Levant (1998) defined emotional inexpression as the inability to express one‟s inner emotional state, and applies the term “alexithymia”, from the Greek for “without words for emotions” (p. 35). He stated that this term originated from a psychiatric condition of severe emotional constriction, encountered in primarily male psychosomatic, drug-dependent and PTSD patients. He proposed that alexithymia occurs on a continuum of intensity, and that many psychologically healthy men suffer from a milder form of the condition, which he terms “normative alexithymia”, where the inability to express emotions is present, but not at a pathologically high state (Levant, 1998). Wong and Rochlen (2005) questioned the assumption that inexpression is necessarily an inability to express emotions. They cited studies supporting inexpression as a choice, rather than a learned disability. They suggested that men have emotion-related values, such as the perceived importance of expressing an emotion, and the context in which certain emotions should be expressed. Emotional inexpression, as a choice men make, can be considered a non-distinct subset of emotional expression itself. Remaining inexpressive suggests that a man is not reacting to an internal emotional reaction, which is also an expression, perhaps of indifference. Labelling men as emotionally inexpressive could be considered a biased evaluation of how we expect men should feel and behave in certain circumstances in order to  15 judge them healthy or functional. While clinicians have stated that male clients who do learn to express their emotions experience greater psychological health benefits (Brooks, 2010; Good & Brooks, 2005b; Rabinowitz & Cochran, 2002), it can be argued that there exists a relative degree of emotional inexpression in men that they find to be healthy or functional within themselves or as a result of feedback from others. This provides a justification for the present study, which treats emotional inexpression as a relative within-person construct, and not an absolute one that relies on between-person comparisons. 2.4  History of emotional inexpression Consedine et al. (2002) summarized emotional inhibition in western society over the  past 500 years. They stated that for most of this time period, western philosophy has considered emotions to be disruptive forces that are maladaptive in nature. They explained societal permission of emotional expression during historical epochs of higher or lower accepted levels of inhibition. For example, lower inhibitions existed during the medieval era, and higher forms of inhibition arose in the religious censorship of the 17th and 18th centuries, Victorian propriety, and the self-containment from the industrial revolution into the early 20th century. They concluded that in the past 40 years, the western world shifted from expectations of high inhibition and applied scientific rigor to the salutary effects of emotional expression. Plutchik (2000) identified five historical traditions of conceptualizing and theorizing emotions since the 19th century, namely evolutionary, psychophysiological, neurological, psychodynamic and cognitive. He described how leading figures in each tradition employed new hypotheses and technologies to evolve their ideas from previous traditions. One example is Walter Cannon‟s use of brain surgery on animals to critique William James‟  16 psychophysiological theory that feeling emotions is a sequential response to physiological changes in emotion. Regarding men, Levant (1998) hypothesized that their lack of emotional awareness was a learned adaptation to harsh social conditions. He identified the period of industrialization, through the Great Depression and both World Wars, as such conditions in the United States. He indicated that the struggle to maintain emotional inexpression was present intrapersonally and interpersonally with men, and that the harsh social conditions accepted such strain as a lesser evil. This argument is reflected in men‟s rationalizations that their emotional inexpressiveness was due to growing up “in a different time”. However, as the period of social hardship fades into history, this argument fails to explain why some men still adhere to this rationalization. 2.5 2.5.1  Etiology of emotional inexpressiveness Gender role socialization: A paradigm of masculinity(ies). The dominant theory in literature explaining how men came to be emotionally  inexpressive is the gender-role socialization paradigm (Wong & Rochlen, 2005). Prominent authors in this paradigm differentiate between sex roles, or essentialist perspectives, and gender roles (Addis & Mahalik, 2003; Brooks, 2010; Englar-Carlson, 2006). The essentialist perspective differentiates men from women based on theories of evolutionary biology and behaviours assumed to be generalizable between men and women. This view is considered limited, due to its inability to explain within-group differences, and its tendency to reinforce stereotypes that constrain men and women (Addis & Mahalik, 2003; Addis & Cohane, 2005). A stereotypical example of this perspective is stating that men do not express themselves  17 because of ancestral hunter/gatherer roles, as opposed to the feminine role of expressing themselves to nurture their children. Englar-Carlson (2006) stated that using the lens of gender role socialization provides a more complete understanding of men and masculinity. Using a social learning paradigm, he described gender roles as behaviours that are congruent with the socially constructed ideas of masculinity and femininity that a man learns over time from significant people in his life. Gender roles provide a more helpful understanding of within-group differences by describing masculinity on a continuum, based on the various social contexts that men grow up in. This paradigm recognizes the concept of multiple masculinities in men or within a single man. For example, two men hugging may be a socially-acceptable masculine behaviour in the context of them scoring a goal in a hockey game, but unacceptable for the same two men while watching a goal scored on a televised hockey game in a bar room. Interestingly, the acceptability of emotional expression could change if: the bar room was empty or full; they were dressed in business suits versus casual clothes; or other patrons were much older or younger than them. In each case, the same men may enact different sets of masculine norms to the same stimulus. Many models of masculinity have arisen from the gender role socialization paradigm. Englar-Carlson (2006) described two often-cited models: Brannon‟s (1976) “blueprint for manhood”, and O‟Neil‟s (1981, 1982) “masculine mystique”. The former provides prescriptive guidelines for men, including not displaying feminine behaviours (No Sissy Stuff), seeking success and competition (The Big Wheel), projecting toughness, confidence and self-reliance (The Sturdy Oak), and acting aggressively and seeking risk (Give „Em Hell).  18 Solomon (1982) later added homophobia and sexual dysfunction to this typology (as cited in Brooks, 2010). O‟Neil‟s (1981, 1982) “masculine mystique” model comprises a complex set of values and beliefs that define stereotyped masculinity, and produce dysfunction and distress for men, women, and children. He proposed that these values and beliefs are all connected to men‟s fear of femininity, which he called the unifying theme of the masculine mystique. He extended existing conceptual analyses of men‟s problems and presented six patterns of behaviour that arise from this fear, and then went on to explain how these behaviours contribute to “gender role conflict”, a term he defined as a psychological state where gender roles have negative consequences on a person or others (1981, p. 203). The ultimate outcome of gender role conflict is the restriction of a man‟s ability to fully actualize his human potential, or the potential of others around him (O‟Neil et al., 1986). Factor analysis of these constructs revealed the existence of four discrete subscales of gender role conflict: Conflicts Between Work And Family Relations; Restrictive Emotionality; Restrictive Affectionate Behaviour Between Men; and Success, Power, And Competition Issues (O‟Neil, Good & Holmes, 1995). These factors are measured in the Gender Role Conflict Scale (GRCS; O‟Neil et al., 1986), the most well known and commonly used assessment of the male psychological experience (Good, Robertson, O'Neil, Fitzgerald, Stevens, DeBord, …, & Braverman, 1995; O‟Neil, 2008). 2.5.2  Emotional inexpression as a socialized behaviour. Emotion inexpression is conceptualized and presented as a central theme in all theories  of masculine gender roles that I reviewed. Levant (1998) described the male emotional socialization process in two parts. First, he described skill deficits in boys arising because they  19 are not taught emotional skills or allowed to have experiences that would facilitate learning these skills. As examples, he cited studies demonstrating that mothers work harder to mitigate boys‟ emotional states, that fathers express fewer emotions to sons than daughters, that both parents discourage sons from expressing vulnerable emotions, and that sex-segregated peer groups bring boys together in structured, competitive groups. Boys become virtually unaware of their emotional states, and use anger as a “funnel emotion” (Englar-Carlson & Shepard, 2005, p. 389) or “the final common pathway” (Pollack 1995, p. 24) to express primary emotions such as grief, fear or shame. Second, Levant (1998) introduced trauma as inherent in the masculine socialization process of boys. He stated that some individual personalities are less congruent to the gender role, and those boys experience higher trauma in their socializations, but he also claimed that traditional masculine ideology is “inherently traumatic” (p. 38) to males. He further stated that this trauma is most clearly seen in the emotional socialization process, where boys‟ natural emotional expressivity is suppressed and channelled. Trauma is experienced by parental, peer and societal prohibition against, and punishment of, the natural emotional expression in boys. Good et al. (2005) concurred, stating that if boys become injured, experience pain, or cry, they receive punitive responses from others for their tears. Responses include being called derogatory names and shamed that they have failed to meet the cultural standard for masculinity, thereby threatening their emerging male identities. The authors stated that these responses cause boys to literally divorce themselves from expressing, and becoming unaware of their vulnerable emotions. This process is cyclical, in that a boy is emotionally injured through a process by which he learns to injure others. Hollis (1994) invoked the myth of the Roman god, Saturn, to illustrate the cycle of father destroying son, followed by son becoming  20 the destructive father himself. Therefore, if becoming emotionally inexpressive is an inherently traumatizing process that men experience and pass on to others, then emotionally inexpression in men may be an enduring, intergenerational phenomenon. 2.5.3  Typologies and measures of emotional inexpression. Emotional inexpression, as one subset of masculine gender roles, are theorized and  measured using constructs commonly arising from two models of masculine socialization. First, Brannon‟s (1976) “The Sturdy Oak” typology requires that men not show vulnerability or weakness, while “No Sissy Stuff” prohibits any acknowledgement or expression of emotions considered feminine. Together, these rules isolate men from the expression of vulnerable emotions with themselves or others. Second, O‟Neil et al. (1986) conceptualized “restrictive emotionality” to be a primary outcome of the masculine mystique, defined as “having difficulty expressing one‟s feelings or denying others their rights to emotional expressiveness” (p. 340). Emotional inexpression is also captured in the Restrictive Affectionate Behaviour Between Men subscale, defined as having limited ways of expressing one's sexuality and affection to men. Other popular scales of masculinity include the Conformity to Male Norms Inventory (CMNI; Mahalik et al., 2003), and the Male Role Norms Inventory (MRNI; Levant & Fisher, 1998). The former includes Emotional Control, and the latter measures Restrictive Emotionality as constructs that assess emotional inexpression in men. Cusack, Deane, Wilson, and Ciarrochi (2006) stated that Levant‟s (1998) normative alexithymia and O‟Neil‟s restrictive emotionality appear to be overlapping constructs that describe men‟s inexpression of emotion. In summary, emotional inexpression is theorized as part of the gender role socialization process that teaches boys how to be men in the world. This process is believed to  21 be inherently traumatic, and self-perpetuating. Finally, several scales of emotional inexpression are used to measure this construct in men. 2.5.4  Other theories of emotional inexpression in men. From a psychodynamic perspective, Scher (1979) introduced the little boy as an  archetype in many men, representing the need for affection and affirmation from both men and women. He described the great emotional neediness associated with the little boy and the problems that arise because our culture‟s sanctions against asking for, giving, or receiving emotional nourishment. He described the many aspects of the little boy, including being hurt, love-starved, angry, lonely, vulnerable and unavailable to others or to himself. This latter quality is important to men‟s inexpression of emotion, because it demonstrates how men avoid acting in the very ways that could help them gain what they are missing. The author illustrated this by example of a man who, after acknowledging his own hurt and deprivation, can finally allow others to share with him their own hurts. 2.6  Consequences of emotional inexpressiveness in men Reviewing the literature on emotional inexpression in men revealed overwhelming  support for increasing men‟s expression. Clinicians argue that the inexpression of emotional states contributes to unhealthy and dysfunctional behaviours in men. Consedine et al. (2002) summarized the costs of emotional inexpression, stating that prevailing clinical and theoretical wisdom supports emotional inexpression as typically unhealthy, particularly in cases where it occurs chronically. Brooks (2010) referred to the “dark side of masculinity”, to describe how traditional male role socialization produces a wide range of problematic interpersonal behaviours that are profoundly harmful to society and to men themselves. He outlined these behaviours in an earlier article including: violence, rape, sexual assault, sexual misconduct,  22 substance abuse, depression, suicide, risk-taking, personal neglect, fathering problems, homelessness and vagrancy (Brooks, 2001). Regarding the connection of violence to emotion, Jakupcak, Tull and Roemer (2005) examined men‟s fear of emotions as a predictor of aggression and hostility. They reported a link between men‟s fear of emotions and their expressions of anger and hostility. The authors demonstrated that teaching men to identify and practice communicating emotional states reduced their aggressive and violent behaviours. A provocative case is made that men literally die younger due to their unwillingness to ask for help (Courtney, 2000). Men‟s avoidant behaviours toward help-seeking is theorized to come from socialized beliefs that they should not express physical or emotional issues, thereby putting them at higher risk than women. This assumption is supported by correlations between men‟s help-seeking behaviours and adherence to beliefs of emotional control and inexpressivity (Addis & Mahalik, 2003, Cusack et al., 2006). Good, Dell, and Mintz (1989) stated that restrictive emotionality has clear implications for men‟s help-seeking behaviours, in that men who embrace emotional inexpression are more hesitant to seek help from others. Examining male college students, they found a significant relationship between emotionally inexpressive men and negative attitudes about help seeking. The authors concluded that reframing the stigma of seeking counselling is a necessary step, and that interventions specifically suited to emotionally inexpressive men may be necessary to avoid premature termination. Consedine et al. (2002) summarized many studies that demonstrate a connection between inexpression and physiological health factors such as decreased immune response, the onset and progression of cancer, and prolonged trauma symptoms. Regarding the latter,  23 Benotsch, Brailey, Vasterling, Uddo, Constans & Sutker (2000) stated that trauma symptoms in military veterans, such as PTSD, worsen over time. Therefore, prolonged post traumatic reactions can not only maintain their underlying physiological symptoms, but can actually worsen them. This reveals a disturbing connection to men‟s help-seeking behaviour, because if emotionally inexpressive men are more hesitant to seek help, then those populations with trauma symptoms may be at greater risk to injury, based on the degree of emotional inexpression and consequent avoidance of help-seeking. From a family perspective, O‟Brien (1988) stated that emotionally inexpressive men are unable to hear the emotional expressions of others. This results in such men being slower than women to perceive indicators of relationship difficulties, and that many fathers remain emotionally distant to the needs of family members, responding only when family distress is very high. Emotional expression, instead, is demonstrated to contribute to men‟s health and function. Pennebaker and Seagal (1999) specifically examined emotional expression through writing and gave three domains of health, namely physical indicators, behavioural indicators and self-report indicators. Physiologically, they reported that writing about one‟s feelings is associated with improved immune responses and reduced autonomic activity such as heart rate. Behaviourally, they stated that written emotional expressivity leads to higher grade point averages, faster reemployment following job loss, and lower absenteeism from work. Conversely, the assumption that male expression is always preferred to inexpression is criticized by some as categorical (Consedine et al., 2002; Wong & Rochlen, 2005). Consedine et al. (2002) challenged this assumption by stating that it draws credibility from psychodynamic theory, namely Freud‟s strangulated affect, and not from empirical evidence.  24 They also critiqued existing models that did not employ contemporary methods, such as advances in neurophysiology, to support their claims of emotional inhibition as characteristically unhealthy. They stated that emotional inexpression can offer clear adaptive advantages to the individual, such as misleading competitors, altering social relationships, avoiding punishment, and eliciting succour. They employed an evolutionary perspective that inexpression is not limited to humans but is spread among higher primates as an adaptation that promotes survival in complex societal formations. The authors acknowledged studies demonstrating the salutary effects of expression, but also cited studies demonstrating negative consequences of increased emotional expression, and called for a “middle ground perspective” (p. 209) regarding the costs of emotional inhibition. They concluded that there is evidence that some people benefit from greater emotional expression, but the benefits can vary with factors such as personal characteristics, social/cultural environment and the emotional experience. Gross and Levenson (1997) also supported an optimal middle ground of emotional inhibition, between total strangulation and completely unfettered expression. These criticisms highlight subjective experience as a method to achieve a middle ground in the study of emotional inexpression in men. 2.7  Male emotional inexpression and therapeutic contexts In a recent book on masculinity, Brooks (2010) stated that nothing hinders men from  considering therapy more than the belief that they will have to get in touch with their feelings. Due to restrictive emotionality being a major value of traditional masculinity, men who openly express their emotions risk censure from self or others. However, the author explained that the therapeutic culture itself shares responsibility for men‟s aversion to therapy. In a chapter entitled: “How Psychotherapy has failed boys and men” (p. 33), he introduced  25 masculinity from a cultural perspective, explaining that psychotherapy has been slow to adapt to many cultural groups, and therefore does not treat men as well as it should. Betz and Fitzgerald (1993) described an antithesis between the male role and what would be considered a “good” client in therapy, exemplified by psychological mindedness, willingness to selfdisclose, and capacity for emotional intimacy. If emotional inexpression causes men to underreport psychological health issues, and that therapeutic settings require men to first be emotionally expressive, then there is indeed a problem, because the very men who would benefit most from therapy are the most unwilling to participate in it. 2.7.1  How male emotional inexpression is addressed in therapy. When men enter therapy for specific diagnoses, such as depression, substance abuse,  or domestic violence, they receive empirically support interventions, such as cognitive behavioural therapy, interpersonal therapies and psychopharmacological interventions (Good et al., 2005). However, these authors stated that these problems are associated with men tending to externalize anxieties and distress, rather than internalizing it. In other words, providing therapy for behaviours that surface due to bottled-up emotional truths treats the symptoms rather than the underlying causes. The authors concluded that a greater understanding of masculinity-related issues can improve the effectiveness of prevention and treatment efforts. Betz and Fitzgerald (1993) considered programs intended to change men into better clients, but also explored a “bring-the-mountain-to-Mohammed” (p. 359) strategy of changing therapy to better suit the needs of men.  26 2.8  Processes of emotional inexpression: How men do it How men are emotionally inexpressive is colloquially described by the fictional Hank  Hill in the introduction. My literature review on emotional inexpression revealed four theories explaining how it works in men. First, Wong and Rochlen (2005) provided a heuristic to theorize how covert emotional experience is translated into overt behaviours (emotional inexpression, by their definition) through a 5-step process. Beginning with prereflective reaction, a stimulus activates a physiological arousal in a person, usually preconscious and automatic. Second, the stimulus triggers a basic affective state that the person becomes aware of. Third, the person attempts to label and interpret the emotion. Fourth, they evaluate the response as acceptable or not to their beliefs and values. Finally, they evaluate the social context for possible expression of the emotion. The authors applied their process model to emotional inexpression by exploring disruptions to each stage of the model. The first stage is generally not controllable, however they stated that individuals have differing thresholds for emotional activation, and may not react at a physiological level to a stimulus. Disruptions of the second stage are considered repression emotions, which for men are often vulnerable emotions such as grief or fear. Men convince themselves that they are not experiencing these feelings, and do not proceed to express them further. The authors considered disruptions to the third stage to be where Levant‟s (1998) “normative male alexithymia” occurs. This is a deficit in applying cognitive mechanisms to interpret an emotion. Men who cannot identify what they experience are unable to express the emotions. Disruptions to the fourth stage involve men‟s values and beliefs about the emotion they have identified. If they find it unacceptable to express, then  27 they will not express it. Finally, the fifth stage disruptions involve men‟s perceived inappropriateness to express the emotion in a certain time, place and social context. The second theory is provided by Lazarus (1991) who employed a theory of cognitive appraisal of the process of emotion. He stated that how a person reacts emotionally to an encounter depends on an evaluation of what the encounter implies for their well-being. This means that if a person‟s evaluation of the relationship to the environment is known, then their emotion reaction can be predicted. His theory of emotional appraisal includes what he termed an “action tendency” (p. 628), or an urge to respond to the encounter in a particular way, such as crying in sadness. However, he stated that in all but the most extreme states of arousal, people can suppress their action tendency and choose from a wide array of coping options. Under stressful circumstances, people most often engage in a combination of cognitive and emotional coping strategies to do this, such as not crying in sadness but instead thinking about something emotionally neutral and feeling angry in reaction to the sadness. The choice to suppress an action tendency and employ certain coping activities are thought to be influenced by a person‟s beliefs about the coping options available, their probable effectiveness, and the social appropriateness of actions associated with the coping strategy. This reasoning is congruent with how men are thought to be socialized to restrict emotional expression, in that learned gender roles, or beliefs, dictate certain behaviours (coping strategies) that may be incongruent with the emotion they feel and may need to express (action tendency). Coggins and Fox (2009) identified one such coping strategy in men, termed “emotional coupling”, or replacing one emotion with another, such as anger for sadness. The third theory of how men are emotionally inexpressive is provided by Mayer, Salovey, and Caruso (2008), who employed the term “Emotional Intelligence” for a series of  28 skills and abilities in the experience of emotions. They categorized four stages that range from lower levels that carry our fundamental, discrete psychological functions, to more developmentally complex levels that serve personal self-management goals. Each stage is described as a continuum of capacity that differs between and within individuals, depending on context. The first stage is to perceive, appraise, and express emotion is considered most basic, dealing with nonverbal reception and expression of emotion, such as through facial and vocal expression. An example is the capacity to recognize fear in the face and voice of another person. The second stage involves accessing emotions to facilitate thought describes the capacity of emotions to enter into and guide cognitions, such as the link between mood and creative thought. Stage three involves understanding emotions and the patterns of possible messages and actions associated with them. For example, in certain social contexts, anger could mean a reaction to unfair treatment and invoke a need to protect. Finally, the fourth stage is to manage or regulate emotions, meaning the extent that a person can remain open to and self-regulate emotional signals, so long as they are not too painful or overwhelming. This capacity enables people to promote their own and each other‟s personal and social goals, such as expressing empathy to support a person in psychological pain. Emotional inexpression in men can be understood as a lack of capacity or skill set in one or more of these stages. However, the final stage seems most congruent to the phenomenon this study seeks to explore, namely the management of emotions that are painful or overwhelming. As a fourth theory, Levant (1998) stated that when men cannot identify their emotions directly, they rely on cognitions to deduce what they should feel under given circumstances. He employed the term “action empathy” (p. 41) to describe how men empathize in terms of seeing things from another‟s point of view and predicting what they will or should do, as  29 opposed to feel. This theory serves as a reminder that the process of emotional inexpression can be as simple as it is complex. In summary, these models describe a process approach to emotional inexpression that begins as a (possibly unconscious) physiological reaction in the body, and then moves to awareness by the person, where it may or may not be identified or evaluated. If identified, it is not expressed as emotion, but as action. This process informs us of the possible voluntary or involuntary stages of awareness, identification and evaluation that men employ to maintain emotional inexpression. 2.9  Existing research in emotional inexpression Gross and Levenson (1997) tested 180 American female undergraduate psychology  students for inhibition while emotionally aroused, and measured behavioural responses, physiological activation and subjective experiences that accompanied the inhibited group versus controls. All participants watched four films designed to elicit neutral, amused, or sad feelings; the treatment group was told before each film to suppress their emotional reactions. Participants were pre and post tested for 18 emotional states, using a 9-point Likert scale developed purposefully for the study. They also video recorded the participants‟ faces as they watched each film and had 4 independent judges code their facial responses using a behavioural coding system created in a previous study. Finally, they measured 9 physiological readings of each participant using a Grass Model 7 polygraph. These included heart rate, skin conductance temperature, respiration and somatic activity. The authors discovered that in the treatment group, behavioural responses were drastically but not completely suppressed across positive and negative emotions. Physiologically, they discovered that suppression of positive and negative emotions reduced somatic activity but increased cardiovascular activity. Finally,  30 suppressing positive and negative emotions lowered participants self-report of amusement. The authors postulated that emotional inhibition carries a physiological cost, may diminish cognitive performance, and can lead to decrease interpersonal functioning, due to incongruent communication of emotional states to others. The last two findings, however, were hypothesized from the existence of the results, rather than from the magnitude of such results. In other words, increased sympathetic response may lead to impaired cognitive performance in the extreme, but did the inhibition of emotions create an extreme sympathetic response? The self-report measure demonstrates the limits of a quantitative method of inquiry into emotional inhibition, given the number of competing variables that could explain the effects. Also, by limiting the study to women, perhaps due to convenience sampling, the authors missed the chance to study emotional inhibition on male participants, which may have produced a more significant effect, given the socialized prohibition of emotional expression in men. Schwartz and Waldo (2003) approached emotional inexpression within the rubric of gender role conflict in men. The authors hypothesized that high gender role conflict in men leads to high rates of partner abuse, and tested a group intervention to reduce gender role conflict. The authors tested 21 men from the south-western U.S. who were attending partner abuse prevention groups, and were mostly mandated by a court to attend. Fourteen men attended the treatment group, which employed psychoeducation of gender role conflict in men and confronted the four factors in gender role conflict, while teaching skills such as emotional expression and empathic listening. The remaining 7 men participated in a comparison group called The Duluth Model, which employed a feminist approach of reframing partner abuse as tactics of maintaining power and control over women. The authors pre and post tested the  31 participants with the Gender Role Conflict Scale to measure changes in gender role conflict, and with the Critical Incident Questionnaire to assess therapeutic factors that arose during stages of group development. They discovered that the treatment group showed a significant drop in gender role conflict, and specifically on subscales of Restrictive Emotionality and Restrictive Affectionate Behaviour Between Men. The authors reported that this result is encouraging because restrictive emotionality is believed to contribute to abusive behaviour in men. They also discovered that the therapeutic factors experienced by participants fit the topics that the group addressed. The authors acknowledged limitations, including small sample size, non-random assignment of participants to groups, and no follow-up assessments to determine effect duration. Moore and Haverkamp (1989) conducted a quasi-experimental study to determine if a structured group intervention could decrease men‟s emotional inexpression. They recruited 28 psychologically healthy men, aged 30-62, from a mid-western U.S. city, and randomly assigned them to treatment and control groups. All men were pre and post tested for emotional expression using 4 established tests of emotional expression, namely the Emotions Scale, the Expression of Emotions Scale, the Written Performance test, and the Behavioural Test of Expressiveness. The treatment group participated in a 10-week program designed to teach emotional expressiveness. Their primary conclusion was that the treatment group did raise men‟s ability to express their emotions, although there were questions about the ability for the measures to accurately capture self-reports of emotional expressiveness. The authors also found that increases to expression were not dependent on knowledge of subjective states of emotion, meaning that expression performance was not a guaranteed result of increased awareness of emotions.  32 In a recent qualitative study, Coggins and Fox (2009) employed grounded theory to explore emotional inhibition with 10 male and female British psychology undergraduate students who rated highly on a measure of inhibition. They defined emotional inhibition as a process of distancing oneself from an emotional experience. The authors screened participants for high emotional inhibition using two measures, the Acceptance and Action Questionnaire measuring experiential avoidance, and the Brief Symptom Inventory measuring psychopathy. They used a grounded theory approach, employing a developmental perspective of emotional inhibition, and explored links between parenting styles and emotional inhibition. The authors asked participants how they accounted for their emotions, their strategies for maintaining inhibition, and the developmental pathway they identified as guiding their emotional processes. They found four major themes of emotional inhibition, namely emotions in childhood, current coping strategies, perceptions of emotions, and impacts of inhibition. From these themes, they proposed a process theory of emotional inhibition that employed the four themes. They found evidence supporting the hypothesis that some basic emotions may develop more slowly in people and become “stuck” compared to others (p. 72). Over time, these stuck emotions threaten the person‟s sense of self and they are inhibited. The authors state that emotional inhibition is predominantly based on beliefs regarding emotions, and that inhibition techniques are modelled in childhood. A limitation of the study was the impact of screening of participants for emotional inhibition on the generalization of findings. Since the authors identified with emotional inhibition strongly enough to engage in the study, it makes sense that the general population would also be able to describe the phenomenon accurately enough for a more generalizable theory to emerge. Secondly, a potential confound in this analysis was the use of female and  33 male participants‟ self-descriptions of early childhood experiences. Gender role socialization is experienced differently in boys and girls, meaning different pathways to emotional inhibition would be given from each gender. The authors recognized this after interviewing several female participants and identifying a theme describing a lack of experiencing anger. This theme is central to the socialization of girls in western society, and therefore is an expected theme, but may not be generalizable to boys (Lerner, 1980). The authors used a negative case analysis, by interviewing males to explore differences based on gender, but the resulting grounded theory was still generalized to men and women. This seems like a watering down of their model of emotional inhibition, given the vastly different ways men and women are socialized to express emotions. Applying gender role socialization to describe emotional inhibition as a learned behaviour in each gender separately would reduce this confound. Finally, McFarlane et al., (2009) employed interpretive phenomenological analysis (IPA) to explore the use of metaphor to facilitate emotional expression for people with chronic disease. They explained how emotion can be more accurately confirmed between the subjective experience of the individual and his/her behaviours, as observed by others. They interviewed 10 tutors who taught a self-management course to people with chronic disease. They employed a triple hermeneutic, namely the researcher‟s interpretation of the tutors‟ perceptions of the emotional expression of the chronic-disease sufferers. This was a novel application of the IPA process that addressed the concern that people can be mistaken by their own emotions and report inaccurately. They discovered that language can be used to modify a person‟s experience and reporting of emotion, which can off-load the hitherto unexpressed emotion and afford relief to them.  34 These authors acknowledged the difficulty that people have expressing emotion, and employed the triple hermeneutic to improve accuracy of the meanings attributed to emotional inhibition. They identified that metaphor can enable emotional expression with salutary effects on people suffering from a chronic disease; however the study reveals little about the experience of emotion, as it treats emotion in terms of how it manages goals. Therefore results were less about the phenomenon of emotional expression and more about innovative ways to cultivate emotional expression, which in turn facilitates goal achievement. 2.10 Gap in the literature In summary, quantitative research attempts to measure emotional expression or inexpression in subjects quasi-experimentally. Given the difficulty in defining this construct, such quantitative studies are like shots in the dark, in that the broader discussion is restricted when measures disagree with one another or are not significant; findings become sparse and overwhelmed by postulation. Alternatively, existing qualitative studies provide rich detail of the construct of emotional inexpression. However, they either treat emotional expression as a means to an end, or they examine the phenomenon in men and women together, which does not answer how gender roles relate to the process of emotional inexpression. Given the importance of emotional inexpression to male identity, the current study will address this gap in the literature through a phenomenological inquiry of emotional inexpression in men.  35 Chapter 3: Methodology 3.1  Research method: Phenomenology Colaizzi (1978) stated that the first step in psychological research is the identification  of the phenomenon to be studied. My study sought to understand men‟s experience of emotional inexpression. I asked men to report their “lived experience” of being inexpressive with their emotions. A phenomenological orientation was the best fit to describe this experience, because it required that I achieve a perspectival understanding of the phenomenon and identify its structure (Osborne, 1990). The former requirement is an understanding of the phenomenon from the perspectives of individuals, as opposed to interpretations by assessments or third party observations. The latter means the research built structure around the experience of emotional inexpression through a thorough analysis of the deep experiences of participants. 3.1.1  What is phenomenology? Phenomenology itself was founded in the philosophy of Edmund Husserl, who  reasoned that understanding human knowledge was based upon the understanding of consciousness (Osborne, 1990). Husserl introduced the notion of intentionality, meaning that consciousness always has an object. This is congruent with the existential view that we are “of the world”, and that reality is construed by the subject. To understand phenomenology in the context of research methods, Colaizzi (1978) provided a historical account of the separation of experience from theory in natural science research. He explained that this rift began slowly, influenced by the increased critical thinking and new philosophical ideas of the Renaissance period. He gave two examples. First, Galileo‟s demonstration that all physical objects could be designated quantitatively by  36 mathematical formulae led to more precise descriptions and understandings than could be accomplished experientially. Second, Wilhelm Wundt‟s method of experimental psychology heralded the modern scientific age, where legitimacy for scientific psychology required the elimination of human experience from research methods through forceful use of “operational definitions” and “objectivity” (p. 51). The former term ensures the replicability of research to validate its findings, and the latter ensures that human experience does not confound or bias the findings. However, Colaizzi (1978) presented a paradox in scientific psychology: to study a phenomenon, we must first have experienced it to know its existence; yet to ensure objectivity in its study, we eliminate experience of the phenomenon. To solve this paradox, he stated that objectivity must be redefined from a phenomenological perspective, namely that participants are objective when their statements faithfully express what stands before them. This objectivity is fidelity to phenomena; “a refusal to tell the phenomenon what it is, but a respectful listening to what the phenomenon speaks of itself” (p. 52). In other words, objectivity requires the researcher to recognize and affirm both his/her experience and the experience of others, because experience cannot be objectively eliminated. Extant quantitative studies of emotional inexpression in men are similarly paradoxical, in that they adhere to a scientific definition of objectivity, yet acknowledge, a priori, that emotional inexpression is difficult to measure due to variable individual experiences. 3.2  Personal assumptions and bracketing To describe phenomena, Colaizzi (1978) explained that the philosophy of  phenomenology exists almost in antithesis to traditional psychology, in that there is a dimension to the person-world that is irreducible to the natural scientist, and must be  37 examined another way. He concluded that phenomenology must be measured against the fruitfulness of its own aims. To explain the aims of phenomenology, the author described content-method-approach unity, where a researcher interrogates the reasons for studying a phenomenon before launching into methods and designs. Therefore, as the researcher, I engaged in a process of self-interrogation regarding this phenomenon. One method for this process is bracketing. Personal bracketing is endorsed as recognition of the unavoidable presence of the researcher in the formulation of the study, the data, and its interpretation (Osborne, 1990). I chose two questions from a list that Colaizzi (1978) posed to bracket the phenomenological researcher. 3.2.1  Why am I involved in this phenomenon? To answer this question, I acknowledge that I have a great interest in emotional  inexpression, in myself and in others. My journey as a counsellor-in-training has shown me that emotional inexpression exists as a phenomenon, and that I continue to struggle expressing certain emotions that were historically proscribed to me as a male. As a counsellor, I witnessed other men choking down their emotions, and worked with them to find the permission to express that which was forcing itself out of them. This had a great effect on them, and they described feeling lighter, in control and grateful for having released their emotions. However, I have not always known the right things to say, nor have I noticed when a man was struggling to remain inexpressive unless he mentioned it to me. The research question came to me as I asked myself what I most wanted to know about the men I planned to help, and I realized that I didn‟t know enough about how they are in the world. The results from this study directly relate to my therapeutic work, and hopefully other counsellors find them equally helpful when dealing with men and emotions.  38 3.2.2  How might my personal inclinations and predispositions as to research value  influence or even bias how and what I investigate? I am inclined to believe that greater emotional expression is healthy in men. This comes from my personal experiences of significant men in my life who do not express themselves and the consequences of this behaviour to me and others. Therefore, I could have biased my interview data and analysis by inadvertently focusing on how maintaining emotional inexpression costs the participant, instead of just focusing on the concrete descriptions they provide. To inoculate my study against this bias, I kept the research question present during interviews and analysis, as a reminder to me and my participant, that experience of the phenomenon is of utmost significance, and not the meanings or interpretations that may arise. I also kept an in-depth research journal that marked my thoughts and reactions to the participants, their interviews and my analyses of the data. This journal provided the basis of the participant vignettes presented in the results section. Second, I chose “emotional inexpression” to represent the experience I sought to measure. By defining the experience, and advertising it so, I acknowledge that I have foreclosed on other possible experiences of the phenomenon. I chose this term because it seemed to me to convey the least sense of judgement to the phenomenon. For example, inhibition conveys to me a feeling of lacking something. In describing the phenomenon to others, I found myself speaking not in definitional terms but in story, trying to convey what it “is like”, as opposed to what it is. Therefore, while I ask participants for the essence of the phenomenon according to them, I also imprint my version of it on them by the verbal and nonverbal communications I employ. I relied upon active listening skills to minimize this possible biasing of their experience.  39 3.3 3.3.1  Research procedures Participants. The study examined the lived experiences of 6 men from Vancouver, British  Columbia, who experienced a deeply felt sense of emotional inexpression. Participants had to meet four exclusion criteria to be eligible for the study. First, they had to be between 30-65 years of age; this is discussed in more detail in Participant demographics (section 3.3.3). Second they had to be proficient in speaking English, because I believed language barriers would have intensified the risks and challenges inherent in the study, and I did not have the means to translate the interviews and create accurate transcriptions. Third, they could not have a psychological illness, and fourth, they could not have recently undergone an impactful emotional ordeal, such as a major loss. The last two conditions protected potentially vulnerable men from the risk of being overwhelmed while describing stories of strongly-felt emotions. These criteria were clearly posted on advertisements (see appendices A and B). 3.3.2  Number of participants. Wertz (2005) stated that the right number of participants for a phenomenological study  is answered by considering the nature of the problem and the potential yield of its findings. In a related study, Coggins and Fox (2009) interviewed 10 participants to qualitatively explore emotional inhibition. Due to the depth of interview protocol, and that I was the sole researcher in the study, I wanted 5 to 8 participants. Saturation was met after the 3rd interview, as I found no new themes emerge beyond the 4th interview, and concluded the study after the 6th participant.  40 3.3.3  Participant demographics. Participants were very diverse for such a small sample. Demographic information  included age, primary ethnic/racial/cultural background, marital status, sexual orientation, and highest level of education. Age: Participants‟ ages spanned 4 decades, at 32, 40, 44, 58, 61, and 66 years, providing a full range of life experience. Moore and Haverkamp‟s (1989) study of emotional inexpressive men employed Erikson‟s (1963) developmental stage model to restrict their study to men aged 35 to 55 years old, calling this range middle adulthood. Middle adulthood provided this study a helpful age range for participants, because I sought men who exhibited the challenges and tasks congruent with this stage. The challenge is the struggle between generativity and stagnation, while tasks central to this stage include expressing love through more than physical contacts, contributing to society, and avoiding feelings of stagnation that arise from excessive self-centredness and being unwilling to help society. I widened the age range to be age 30-65 to provide flexibility in the interpretation of middle adulthood for men, and in fact widened it further to accommodate a 66 year old man, because he identified himself in that developmental stage. Primary ethnic/racial/cultural background: Participants indicated their primary ethnic/racial/cultural background as Caucasian (of which one was from the eastern U.S.), South Asian/Middle Eastern, East Asian, and Latin American. Marital status and sexual orientation: Three participants identified themselves as homosexual, while three were heterosexual. Two were single, three were married/commonlaw, and one was separated/divorced.  41 These two demographic variables highlight that participants brought a diversity of self-identified cultural variables, beyond the heterosexual, Western European experience that predominates many studies of men and masculinity (O’Neil, 2008). This was a welcome result, given that the recruitment did not target men with specific cultural variables, but did target public recreation centres, doctor’s offices, men’s groups, and churches, where a diverse sample of men would be exposed to the poster. Highest level of education: All participants identified themselves as having postsecondary education; three had Graduate/Professional Studies, while the other three were College/University graduates. In summary, Osborne (1990) advised that participants be people who have experienced and can illuminate the phenomenon. This posed an interesting dilemma for this study, as the phenomenon of emotional inexpression required participants who were relatively unable to express their emotions, and presumably unable to express their inability to express their emotions. Therefore, I sought men who did not express themselves, yet I proposed that they were the most fitting group to describe this inexpression. This dilemma posed a risk to the findings of this study, but also justified studying it, due to the reclusive, secretive, yet relatively unstudied nature of emotional inexpression in men. To find these men, I relied upon a poster and website that described what I was looking to investigate; I believe that this narrowed the field of participants to those men who identified with the phenomenon. 3.3.4  Recruitment. A poster and website described a study of men holding in or holding down their  emotions (see appendices A and B). The poster was posted, with permission, in community  42 centres, doctor‟s offices, and a church in Vancouver, BC. The website was sent to various leaders of men‟s groups and religious organizations to disseminate to their memberships. 3.4  Data collection I employed semi-structured phenomenological interviews for data collection. Osborne  (1990) stated that the interview is the most common procedure for phenomenological data collection, and suggested three phases for interviewing participants. The first phase establishes rapport and trust between interviewer and participant. He stated that good rapport is crucial to bringing out the most authentic descriptions from participants. The second phase is usually in the form of open-ended dialogue or interview. The interview is to be minimally structured so as to not lead the participant, and to capture as much of the phenomenon as the participant experienced and describes it. He suggested active listening as a valuable skill for this phase. The third phase involves follow up with the participant for successive datagathering and validation of analysis based on the previous interview. Appendix F contains the interview orienting steps that helped me to follow these phases. Participants were asked for at least two interviews. Before the first interview, I prepared participants by explaining the phenomenon to be studied and provided the consent form. I invited them to write notes for themselves ahead of time that they could refer to or share with me during the interview. At the first meeting, participants completed the consent form and demographics form (appendices C and D). The consent form outlined the purpose of the study and disclosed potential risks and benefits of involvement. It also highlighted limits to confidentiality, anonymity, and the participants‟ right to withdraw at any time without penalty or harm if they chose to. The demographics form contained information on age, profession, education, ethnicity, sexual orientation, marital status, and the Gender Role  43 Conflict Scale; this scale assessed the participant‟s thoughts and feelings about their genderrole behaviours (GRCS; O‟Neil et al., 1986). A copy of the consent form was provided to each participant for their records. The demographics form was not. The first interview lasted 2 hours. It began with 15 minutes of introductions, rapport building, explanation of the study, use of audio recordings, and reviewing and signing the consent and demographic forms. The next 90 minutes was a recorded, open-ended dialogue about emotional inexpression, and is described in detail in the next section. The final 15 minutes was spent bringing the participant back to a state of emotional neutrality, if needed, and reminding them to write down any further descriptions or recollections that arose before we met again. Between interviews, I sent participants a copy of the transcription, a vignette I created to describe their individual orientation to the phenomenon, and thematic analysis to provide them time to review the findings before we met the second time. I explained to all participants the basic process of how I turned their transcribed interview into the data from which I would create their vignettes and the common themes. This provided them with an understanding of the transcript and validation process, and included them as collaborators in the final product. The second interview took place within a month of the first interview, and lasted 30 minutes to 1 hour. I verbally reviewed consent, and then I validated the transcript, the vignette and the thematic analysis with them. I asked the participant: “Please read the vignette and themes provided. Do they represent your experiences?”, or “Can you see yourself or others in these themes?” Participants were told they could freely disagree with my results, change or remove some findings from the study, or edit the transcript if it did not capture their experiences. Participant also had opportunities to provide further descriptions that they were  44 aware of since the first interview, or in response to my analysis. Participants were invited to provide written feedback to analysis via e-mail. This is discussed in the validation section to follow. Interviews: Fischer‟s (1978) phenomenological inquiry into an emotional state provided a helpful guide to the open-ended interview. He suggested that phenomenological inquiry ask two interrelated questions: “What is the phenomenon that is experienced and lived?” and “How does it show itself?” (p. 175). He asked participants to characterize a situation where they experienced being anxious, to describe the experiences and activities during which they realized they were anxious, and to concretely portray the experiences and actions they lived through during the phenomenon. Wertz (2005) stated that the most outstanding quality of data sought is concreteness. He described how the researcher must direct the participant away from hypotheses, opinions, explanations, interpretations, or generalizations about the phenomenon. He suggested asking for concrete examples of how the participant approached the phenomenon, asking for detail in what happened before it was experienced, as well as the experience itself and what happened consequently. For this study, I first asked participants: “Think of a time when you were aware of strong emotions in you”. I followed this sensitizing question with: “Now think of a time when you were aware of strong emotions in you and you were aware of holding them in or keeping them down to remain emotionally inexpressive. Describe this to me”. These questions provided contrast that helped them identify the struggle to maintain emotional inexpression, which I believed was more describable than the latent state of being emotionally frozen or static. I believed it was important to focus as much on what participants  45 do, as on what they don‟t do, to remain inexpressive, and helped them explore both perspectives. Finally, Colaizzi (1978) described four sources of descriptive data and methods for observing and recording such data. For this study, I used dialogal interviews, combined with the method of imaginative listening, which was analogous to the counsellor skill of active listening. However, because the phenomenon I sought to understand was beyond experiential awareness of some participants, or incommunicable as a concrete phenomenon, I also employed Colaizzi‟s third data source, namely the “observation of lived-events” (p. 65). This addressed moments when emotional inexpression was not describable for the participant, but was observed by them in others, and that these observations were describable. To do this, I asked participants to describe what they saw and not what they think they saw, thereby returning to the “primacy of perception” (p. 67). To record this data, Colaizzi recommended the method of perceptual description, which is a process of not observing and summing discrete perceptual facts, but to take in the entire perceived event without analysis. To do this, I asked: “Think of a time you witnessed a man choking down his emotions. Describe what you saw in detail.” In each interview, I experienced a narrowing-in on what the phenomenon meant to the participant. They all began with less concrete details, and the conversation took on a wandering quality that explored emotional inexpression from what felt to me like a mile-high view that included circling the general experience and talking in terms of others‟ experiences. As the interviews progressed and participants became more comfortable with myself and the topic, they became much more concrete, speaking specifically and in terms of themselves. In this way, all interviews became richer in detail as time progressed.  46 3.5  Data analysis Fischer (1978) applied Colaizzi‟s (1978) procedure for data analysis to understand an  emotional experience, namely being anxious; this informed my approach to the interview data on emotional inexpression. Fischer stated that the researcher must begin with description, and then to reduce or condense the descriptions to essential psychological meanings. This second step must be done while ensuring fidelity to original descriptions, or protocols, and to characterize the essence of what each reveals about the individual‟s styles. To understand the general psychological meaning of a human way of being-in-a-situation, the researcher must solicit several such descriptions from different individuals who have experienced the phenomenon. To analyze the interviews, I first transcribed them, and then I employed Colaizzi‟s three-stage process of coding the interview data. To transcribe, I read all the interviews, which he termed “protocols”, to make sense of them in their entirety. Lapadat (2000) explained that transcription fits within a constructionist paradigm by the very nature of how conversation is contextually constructed; as context cannot be stripped from talk, it should not be stripped from transcriptions. She provided several examples of transcription protocols, but cautioned to resist creating transcripts that try to fit all needs. To this end, she stated that the researcher have a predetermined convention, but also must be flexible to inventing a transcription convention that fits best with the kind of data he/she is receiving. For this study, I used precise verbal transcription, augmented with significant nonverbal reactions in parenthesis, such as pauses, vocal emphasis, or eye contact. See appendix G for the guide I followed for all transcriptions. I kept a notepad during interviews, and wrote analytic notes that aided transcription. Also, I commenced the transcription process immediately after the  47 interviews, to preserve my reactions and memories of significant moments, and used analytic memos during this process to record what was impactful for me. I applied Colaizzi‟s three-stage process of coding transcriptions by first rereading each protocol and extracting “significant statements” from them, which are phrases or sentences that directly pertain to the experience of emotional inexpression. Next, I formulated meanings from what the participant said, without losing connection to what the participant actually said. Another way to say this was that I categorized the significant statements. To do this, Colaizzi (1978, p. 59) suggested a “precarious leap” of creative insight on the part of the researcher. In other words, to move beyond what the participant said, without losing connection to the actual uttered words and meanings. Analytic memos were instrumental for me to recall these moments and provided an audit trail of how I came up with the meaning units. Third, I organized all categories into clusters of themes. This also required creative leaps on my part, to ensure the themes were representative of the statements that comprised them. Finally, I combined all the themes into an “exhaustive description” of the phenomenon of emotional inexpression. During all stages of analysis, Neuman (2003) encouraged taking analytic memos. These memos contained my thoughts and ideas about the coding process as it unfolded. Memos also accompanied each coded theme, and contained the rationale for its formation and more in-depth description of what I thought the theme meant. Fischer (1978) stated that creating themes from the data goes beyond cataloguing according to types of situations or common phrases, and to remember that each person, in order to describe their lived experience, had to have an understanding of the meaning of the phenomenon. In other words, he took each description as a variant exemplification of the meaning of the phenomenon, and thematized the interrelated patterns of “situation”,  48 “experiential”, “bodily” and “actional” themes constituted in each (p. 176). Therefore, I tried to understand each participant‟s description of emotional inexpression as a perspective of the phenomenon, especially if it disagreed with my perspective. This coalesced into vignettes, which contained my description of the participants‟ events and descriptions. 3.6  Validation Obsorne (1990) differentiated the validation process in phenomenology from natural  science research, by highlighting how the former is a descriptive science with what he called “empathic generalizability” (p. 86). Regarding reliability, he stated that measurements are never free of context, meaning that situations are not replicable, yet multiple perspectives can lead to a unified description of a phenomenon. To maintain reliability in this study, I followed the author‟s advice and argued my interpretation as persuasively as possible and supported my arguments with references to the data. Regarding validity in phenomenology, I identified several assessments for this study (Osborne, 1990). First, the bracketing of my orientation to the phenomenon enables the reader to understand how I arrived at my interpretations. I identified and explored bracketing questions herein to situate myself as the researcher towards the research and towards readers of my findings. Second, during the theme construction phase of data analysis, Colaizzi (1978) recommended that the researcher check original protocols within each theme to identify any part of a protocol that did not fit within the theme. If found, the theme itself must be reexamined. He noted that themes may seem unrelated or contradicting of each other, however this may not be proof of invalid analysis, but of a real existential component of the phenomenon. I kept detailed records of the collection and analysis process, and maintained an audit trail of theme construction. I also re-read all protocols in each theme, ensuring they fit  49 within the theme description. This process resulted in a focusing of the theme descriptions, and helped provide order to the theme presentation. Third, I checked interpretations with coresearchers and participants. Osborne (1990) noted that this is a suggestive validation, as participants may reject a valid interpretation due to personal feelings about the interpretation, rather than its validity. I presented each participant with his transcribed interview, a vignette describing him and his experiences, and the themes I categorized his statements into and asked for any corrections he had. Participants were given time to review, discuss, accept, or reject the themes I discovered. All participants suggested minor changes to their transcripts. Some participants suggested different words in their vignettes, or particular constructs in the theme descriptions. For example, the term “anger” was a much stronger word for some participants, leading to theme descriptions that respecting a broad range of feelings between participants that may not include that term. In all cases, the participants‟ suggestions were incorporated into the transcripts, the vignettes and the common theme descriptions. Fourth was the process of presenting coherent and convincing arguments. Osborne stated this is a crucial validity check made by members of the research community. My research committee, namely Dr. Marv Westwood, Dr. Marla Buchanan, Dr. Bruno Zumbo, and Dr. Donal O‟Donoghue, reviewed my arguments, to determine if they were convincing. Finally, the structure of the phenomenon presented should resonate with people who are not involved in the study but have experienced the phenomenon. To do this, I asked 4 male graduate students who had experienced emotional inexpression to read the findings and state whether the description of the phenomenon resonated with their experiences of it. They all reported that the themes did resonate with their experience of emotional inexpression.  50 3.7  Presentation of findings Wertz (2005) stated that the presentation of phenomenological research is usually  more volumous than quantitative methods. He explained that reports go beyond framing the problem in existing knowledge to include depth methods used, selection of participants, situations chosen, data collection procedures, and methods of organizing and analyzing data. He illustrated how researchers can report in many formats to help readers gain a greater understanding of the concrete lived experience of the phenomenon, such as raw data, the researcher‟s organization of data, and sample analyses of procedures employed. These extras in the report give the reader more opportunity to follow and judge the soundness of the researcher‟s conclusions. Findings need not be restricted to written discourse, but can include diagrams, tables, illustrations and photographs. He highlighted descriptive quotations from the participant as a hallmark of phenomenological research because such findings ground the claims made by the researcher. This study employed verbal interviews that were audio recorded, transcribed, analyzed into themes and presented. I presented vignettes of each participant that included diagrams of their descriptions. I also presented themes that arose from the interview data. Themes were also presented graphically in figure 4.3. Finally, I presented quotations from participants that were representative of each theme. These quotes enable the reader to gain a concrete understanding of the theme and how it fit in the larger description of the phenomenon. 3.8  Ethical issues Neuman (2003) provided several ethical issues that can arise in qualitative inquiry; I  identified and addressed three for this study. First, the privacy of participants‟ data may change over time, after findings have been published. To minimize this risk, participants were  51 fully informed of this fact before they agreed to participate, and were asked to choose a pseudonym. I also asked participant‟s to pay attention if they felt their vignette revealed too many disclosing demographic details about them and to tell me, as specific demographic details could be generalized to guarantee their anonymity; this happened on occasion and was rectified during the validation interview. Second, the interview process explored a sensitive subject for participants, which could have resulted in their discomfort or possible suffering. To minimize this risk, participants were fully informed of risks due to disclosure, and the consent was revisited at least twice verbally to ensure it remained informed to them. During interviews, I periodically asked participants if they were feeling too high a level of emotional discomfort, and prepared to discuss stopping the interview with them if they did feel discomfort. Participants did not indicate a wish to stop at any time I checked in with them, and appreciated knowing the rationale for my check in. Finally, each interview ended with a period of readjustment where we discussed neutral topics, such as next steps, and I checked on the participant‟s emotional state before they left the interview. Third, participants may have wanted to engage in further analysis and discussion of emotional subjects, perhaps in a therapeutic setting, and may not have voiced this desire. At the beginning of the first interview, I provided each participant with a list of resources that included no-cost and low-cost counselling services that I ensured were able to take on new clients. This provided a range of supports for them, after the study ended. Finally, I offered participants a token amount as a thank you for their efforts. This was a guaranteed, constant, and minimal amount, so that they did not feel pressured to continue the study in order to receive remuneration.  52 Chapter 4: Results The results of this study came from an interview and follow-up session with each participant. The interviews themselves averaged 90 minutes each, and when transcribed into 12-point font, double-spaced pages, ranged in length from 31 to 52 pages. This chapter is divided into two main parts. First, I provide a short vignette of each participant, and then I present the main themes that emerged for all participants during their interviews. In section 4.1, each vignette contains demographic information about the participant, the results of their Gender Role Conflict Scale (GRCS), and then an overview of how emotional inexpression was described by them. The GRCS provided a measure of each participant‟s gender-role conflict, and specifically to note the degree to which each participant ranked the subscale of Restrictive Emotionality. This subscale is defined as “as having restrictions and fears about expressing one‟s feelings as well as restrictions in finding words to express basic emotions.” (O‟Neil, 2008, p. 367). The participants used visual metaphors to describe inexpression, and I presented some of these metaphors visually in the vignettes. Each participant read his own vignette and validated its contents. This was done to ensure that the participant‟s confidentiality was not compromised by the demographic description, and to validate the accuracy of their descriptions of emotional inexpression. I wrote each vignette within two days of interviewing each participant, during the transcription stage of data analysis. I ordered the presentation of vignettes alphabetically, according to pseudonym. In section 4.2, the thematic analysis is divided into 9 main themes and one ancillary finding. I present the description of each theme that participants validated, and then provide evidence and support for the themes using direct participant quotations as much as possible.  53 4.1  Participant vignettes  4.1.1  Bill. Bill identified as a 44-year old single, homosexual, South Asian/Middle Eastern man,  who has college/university education and works as a technical writer. His gender role conflict scale averaged 3.38 (on a scale of 1 to 6, where higher numbers reflect more gender role conflict). His Restrictive Emotionality subscale scored slightly higher at 3.90, indicating no high or low restriction expressing emotion or finding words for basic emotions. He was articulate and thoughtful, and engaged collaboratively with the interviewer in describing what emotional inexpression was to him. He learned about the study from a poster at a community centre. Bill described emotional inexpression as a way to protect his significant relationships. He gave several examples to illustrate how emotions being held in can burst out and hurt others. He said that he learned this from observing his father, who was considered a pillar of his community, yet who secretly abused his mother for years. He described the contradiction between his loving father and his abusive father as how emotional inexpression presents itself paradoxically in men. He said that he holds down his emotions, because expressing himself would damage his significant relationships, leaving him isolated. Bill employed visual metaphors to describe emotional inexpression. To him, strong or “deep” emotions are accompanied by fear. He describes the fear of expressing as a “black abyss”. Going into this abyss would feel like falling off a cliff into a vast, unknown and unsafe “human wilderness”, without any reference points. He felt he would tumble through this abyss without return. He also described going into the abyss as if he were a tiny candle in  54 a vast darkness, and that the candle is sustained by his personal power or will power.  “Black Abyss” Fear/Unknown/Confusion “Not me”, Loss of self, death No return Wilderness Unsafe place Being shunned “The Wall”: External measure to protect me Arises when “things start to get deep” Transparent Powerful: “like drug addiction” “the wall is superficiality.” “boredom, inactivity, status quo” Antisocial, frustrated, alone Figure 4.1: Bill's wall  To protect himself from the abyss, Bill described “the wall”, which is a protective measure that is external to him. See figure 4.1.The wall arises to protect him from the abyss. It manifests as him saying to himself “that’s not worth it”, “change the subject”, or by getting angry. Although he can see through the wall, it is extremely powerful. He described the power of the wall as being as strong as a drug addiction, in that he would do or say anything to not “get to the bottom” of his deeper feelings. The wall, however, also has superficiality, boredom, inactivity and status quo attached to it, which limits his growth and keeps him alone, frustrated and antisocial with others.  55 4.1.2  Frank. Frank reported to be a 66-year old single homosexual Caucasian Canadian man, who  has graduate/professional education and works as a health and life coach. He grew up in the eastern United States. His gender role conflict scale was moderate at 3.03 (on a scale of 1 to 6, where higher numbers reflect more gender role conflict), with a moderate score in the Restrictive Emotionality subscale, at 3.20. This subscale did not reveal high or low restriction expressing emotion or finding words for basic emotions. He was gentle, thoughtful, and patient with his feelings as he recalled them. He learned about the study from an online advertisement sent by a local men’s organization. Frank described holding in emotions as being tied to hiding his sexual orientation from society. He said it was like a game he agreed to play, with his parents and the larger culture. Through his early years, he described how being a gay man in the U.S. was isolating and filled with shame, secrecy and profound loneliness. He never came out to his parents, and said that during strongly felt emotional times, he had absolutely no one to turn to, making even his personal journal entries cryptic. For many years, he was required to compartmentalize himself and suffer alone, to protect his life from “major disasters”. These included dishonourable discharge from his military career, being publically known as a homosexual, which he described as “verboten”, being shunned and shamed by people he knew, and having his parents find out. He described himself feeling responsible for his parents, wanting to “be the kind of little boy they really wanted”. Therefore, Frank endured tremendous losses of connection with significant partners and at the same time had to put on a happy face, so as not to raise suspicion by his friends or coworkers. His description of disconnection and fear of discovery of himself as a true gay  56 man stands as a vivid example of how his emotional truths were forced down by lack of understanding and fear of reprisal from others. Listening to his story, I wondered how anyone could recognize their true selves, while surrounded by such pervasive fear and inauthenticity, and reflected that this exemplifies how lost many men are to their emotional sides, having been divorced from them since childhood. Frank described emotional inexpression as a mask that he can feel covering his face. The mask serves to protect him from revealing emotions that may burden others, or may expose him. He described the mask as a happy smile on the outside and pure pain on the inside. He stated that he is much more aware of his emotions, but that he sometimes still struggles not to put the mask on to cover them. He called this a conditioned response, which he pays attention to as a signal that he’s not being authentic to himself. Finally, Frank described the experience of holding his emotions in as being a suffocation in his body. He said that when strong feelings arose, he used to go very still, stop breathing and smother his feelings, and felt smothered by the experience. He said that he could not breathe his true self in these moments. He said that over time, he has come to feel much more able to fully feel his emotions, and express them authentically and congruently. 4.1.3  Mike. Mike described himself as a 32-year old married heterosexual Caucasian man,  originally from eastern Canada, who has college/university education and works as an electrician. His gender role conflict scale was moderate, at 3.51 on a scale of 1 to 6, where higher numbers reflect more gender role conflict. He reported a higher score in the Restrictive Emotionality subscale, at 4.50; this score tends toward more restrictions or fears about expressing his feelings, or trouble finding words to express basic emotions. He was  57 respectful, friendly and courageously truthful when describing emotionally-charged moments. He learned about the study from a poster in a physician’s office. Mike related a story of holding back his sadness. During his grandfather’s funeral, he described witnessing his uncle “choking up a bit” while delivering a heartfelt eulogy. Seeing his uncle, who “never shows a chink in his armor”, express like this caused Mike to feel his own sadness “well up” inside him. He described having to balance his expression between two extremes, stating “I still wanted to express something; I don't want to be a total statue, sitting there. But not enough that it's too powerful and affecting everyone else really strongly”. When asked what this would look like, he responded “I would have a few tears on my face, and I would be probably slouched over a bit. And I'd be stuffed up too. And that would be the extent of it.” To achieve this balance, he controlled his rising emotions by telling himself “remember that you've got a job to do”, regarding his roles as eldest male grandchild and pall-bearer. He busied himself in the moment by checking on his younger cousins and handing out tissues to them. He also recalled looking to his grandmother as a model of strength during this time, and hoped to display this strength to others in his family, saying to himself: “I really have to set an example”. He described this balance of holding in his sadness using a water metaphor. He said that emotions welling up inside of him would be like a pail, about to overflow with water. He described that the pail has a valve on the bottom that allows some pressure to release as controlled expressions of sadness or anger, but that he must keep a lid on the rising water to prevent himself from going into a raw emotional place. Mike talked about holding in his anger. He described losing control over his anger when he and his siblings were exposed to an intense domestic argument between his father  58 and step mother. He said that his emotions took over, and he joined in the yelling. When his emotions took over, he said that he lost control of himself. He reported the experience as “putting all my emotions into that, and it was very physical reaction”. His experience of a scary, physical reaction of being out of control, followed by exhaustion afterwards, was compared to a near-death experience he had in a serious car crash. He said that going into his raw emotions like this was as if he were going into great harm. He explained that his greatest fear would be hurting anyone while in this emotional place. 4.1.4  Greene. Greene identified as a 40 year old, married/common law, homosexual, East Asian  male who is a college/university graduate and works as a software analyst. His gender role conflict scale reported moderate levels of gender role conflict, with an average score of 3.84 (on a scale of 1 to 6, where higher numbers reflect more gender role conflict). His scores for the Restrictive Emotionality subscale were higher at 4.00, tending to more restriction expressing his emotions or finding words to describe basic emotions. He learned about the study from a poster at a community centre. He was soft spoken, articulate and responded slowly and thoughtfully to questions. Greene provided two stories to describe emotional inexpression. In the first story, he described emotions as getting in the way of him being productive at his work. He said that he values finishing a job productively and efficiently, calling this the “big picture”. However, if he is engaged in emotional interactions, he feels distracted from being able to finish his work. In order to return to a state of productivity, he has to distance his emotions from himself. He said that one way to do this was with background music, in that the music acts as a shield to hold his emotions away from him. The shield provides him the space he needs to get back into  59 his head and get the job done. He said that the shield does not act to crush his emotions, only to keep them at a distance, which reduces their distracting effects and enables him to regain momentum on his work. In response to holding emotions during a strongly felt moment, Greene recounted a time of intense grief. He had lost a beloved pet and had returned to his job, only to be confronted by the pictures of his pet he kept in his workspace. He states that he experienced an intense “wave” of emotion welling up in him, and threatening to burst forth. He described this wave as being made up of memories, loss, sadness, and crying. It was imperative to Greene that he maintain inexpression in his workplace, because he felt expressing would collapse his work identity, in that others would perceive him as weak, and not able to work under pressure. He said that he did not want to expose that part of himself and be connected to his co-workers in that way, because he felt they would associate his emotional outburst with females and would lay down preconceived notions of appropriate behaviour on him. He wanted to choose the people he would express himself to, and described struggling to remain inexpressive as a “dam holding back the water”. His said that losing this struggle was an intense helpless feeling of being forced into an “open place”. Exposure is connotated with weakness to him, and once exposed, he said that “people remember”, meaning that he could not return to his preferred state of connectedness with them. He said that his wish in such a situation would be to “hide in a room somewhere”. He very carefully articulated specific behaviours during the first moments of holding in this wave of emotion. He recalled going absolutely still, staring intently at the picture, and stopping breathing. His first thought was “I cannot cry here”, which he described as the first effort he made to hold back his emotions. He described his stillness and self-talk as his shield  60 against the wave. However, he felt the shield buckling as his emotions began to overwhelm him in the form of memories and images, and he then started distracting himself by focusing on his work and organizing his email; he called this “getting into the routine”. He said that this effort reinforced the shield and enabled him to continue to hold his emotions down and function appropriately. Finally, Greene described emotional inexpression as trying to stay out of a whirlpool or vortex of water. He said that going into his “raw, pure emotion” would be as if the water were pulling him under; a dim, frightening, intense place, where he would be drowning and overwhelmed, spinning without any control. He did not imagine that he would be able to escape this place if he went into it, and that it would not be a safe place at all. He said the fear of this place was at least 9/10. 4.1.5  Sasha. Sasha identified as a 61 year old, married, Latin American/Canadian Caucasian male,  who is a college/university graduate and works as in the helping professions. His gender role conflict scale tended to low levels of gender role conflict, with a score of 1.92 (on a scale of 1 to 6, where higher numbers reflect more gender role conflict). His scores on the Restrictive Emotionality subscale averaged 2.00, also tending to less restriction in expressing his emotions or trouble finding words for basic emotions. He learned about the study from an online advertisement sent by a local men’s organization. I found him to be articulate, honest, and very curious to explore his experiences and feelings. Sasha described emotional inexpression as self-preservation. He attributes his inexpression to early messages he received from family, church and community. He was taught that expressing feelings such as sadness, anger or playfulness would threaten his  61 connection to significant others. If he expressed such emotions, he felt others would disown, exile, and abandon him; this felt akin to death. He recalled that emotions were always kept under strict control. This control took the form of parameters of acceptable interaction, but also roles in his society. Early in his life, Sasha felt cast in a role of being “the other”. He worked to change this role, but found that the very parameters that ensured his membership to his community also enforced this role. He related times when others expected him to show vulnerable emotions, and that his expression of such emotions would be an admission of his other-ness, leading to his condemnation. He was caught in a state of inexpression in order to prove himself worthy of acceptance by his community. Therefore, he avoids expressing certain emotions to protect him from a place where parameters of interaction and connection are unknown. He described this state of being without parameters as a terrifying experience, where he would question his own sanity. To manage his emotions, Sasha learned to “fly under that radar”, and avoid notice. However, when events conspired to put him in a place where strong emotions rose up in him, he described holding his feeling in using “armour”. This armour manifested by him becoming inwardly “like a statue”. In that moment, he described feeling absolute terror that, if he should express what is inside him, others will see him as a “traitor”, “spy” or “imposter”, and stated that they would then bring him “down to a nobody”. He called expressing in that moment the “ultimate risk”, because being exposed for what he felt would result in him being thought of as less than human. To mitigate this risk, Sasha would only show parts of himself to people, stating that this keeps him safe, because then nobody could know him completely, and they could not expose him completely. However, this strategy also worked to keep him disconnected from others.  62 4.1.6  Thomas. Thomas described himself as a 58 year old divorced, heterosexual, Caucasian male,  who works as an engineer. His gender role conflict scale reflected neutral levels of conflict, averaging 3.08 (on a scale of 1 to 6, where higher numbers reflect more gender role conflict). His Restrictive Emotionality subscale was lower, at 2.60. This indicates that he tends to lower restrictions or fears about expressing his feelings and finding words to express basic emotions. He learned about the study from an online advertisement sent by a local men‟s organization. He was interested in the research topic and was eager, respectful, and expressive. Thomas revealed several structures of emotional inexpression. He described the experience of holding in emotion as a state of disconnection, from himself and others. He also explained how he learned to be inexpressive, and described the intense fear that arose when he held his emotions in. Thomas described being inexpressive as feeling low self-worth and disconnection from himself. While being in a state of emotional inexpression for many years, he reported being highly active and productive, because he felt self-worth through his accomplishments. He described being frenetically busy, “the energizer bunny” in this pursuit of self-worth. Thomas also described emotional inexpression as a feeling of being lower than worthless, which he called “accident prone”. He said that he often hurt himself while working hard, sometimes quite severely, and would revile himself for the injury. He then would redouble his work efforts to prove himself fearless at injury. See figure 4.2.  63  Frenetic activity  Accident proneness  • Improved self-worth  • Body as tool  Feeling worthless Redoubling efforts • Prove fearlessness  Self-reviling for injury  Figure 4.2: Thomas' activity  For example, he described accidentally cutting his abdomen open while working with a chainsaw, and having to be hospitalized for the injury. Once released, he said that the first thing he did was to fire up the chainsaw again to prove that he was not afraid of it, and that the injury really did not matter to him. To Thomas, emotional inexpression caused a pervasive state of worthlessness that he was trying to overcome with frenetic activity. His body was merely a tool to help him be productive and feel some self worth from his accomplishments. Any injury to him caused unwanted feelings of fear to arise that he repressed with revulsion towards himself, and coming “back over the top” to reengage in work activity. Thomas described holding in his emotions as times that he felt disconnected from others. He described his relationships as horrid, because he could not connect with significant others at a “heart level”, despite wanting to. He said that this contributed to feeling isolated  64 and disconnected from his world. This was particularly apparent during crises in his life, because his response to emotions rising up in him, such as grief, fear, or even pride, was to tell others that there was nothing to talk about, to focus on tasks, and to just “move on”. In contrast, he described that having risked expressing his emotions, he felt as if he had suddenly dropped a physical weight that he had been carrying, and felt lighter on his feet. He reported gaining a great sense of connection and self-worth that comes from relationships with others, and describes this connection as his “greatest joy”. Thomas described the manner in which he learned to be emotionally inexpressive. At age 14, he challenged his father by relating to him using vulnerable emotions. In response, his father engaged him at an entirely different level; they were no longer father and son, but man to man. He said that his father made it very clear that this was no way for men to speak to one another, and that he was playing foul, and “trumping” him, by being a “whiny brat”. He remembered his father “standing straight” before him, with intense eye contact and speaking to him in a serious way that conveyed a strong intention to connect. However, this form of connection was not father to son; he used the term “man to man”, implying that his father had removed paternal connection from him and spoke as a stranger. He remembered having no ability to respond to this, and feeling completely shut down by the experience. However, in describing another time when he had to stand up to his father, he recalled “standing straight”, just as his father had, and remaining still in the face of the emotional chaos he was feeling inside. Finally, Thomas described that the feeling of letting emotions out while trying to hold them in as a feeling of “absolute terror”, which he as a “black hole” or “bottomless pit”. He stated that if he actually let his emotions out during those highly emotional moments, he  65 feared he would fall into that pit and “lose his mind forever”. In response to how he managed to not express, he said that he would tell himself to shut down those feelings, and distract himself in any way possible. This usually involved an outward expression of anger or indifference to others. He said that the terror was such that there was no length he would not go to in avoiding expressing. 4.2  Common themes The protocols resulted in 786 significant statements, organized into 50 coded  meanings. These meaning coalesced into 9 major themes, one subtheme, and one ancillary finding. Figure 4.3 is a conceptual map of how I envisioned the themes linking. Each theme is them described, starting by the boxed theme description that I validated with each participant.  66  Inexpression is disconnection from others  Inexpression is disconnection from self  Inexpression is linked to working or providing  Inexpression is linked to low self-worth or worthiness  Inexpression is clearly defined  Inexpression is stillness, control  Anger is an experience of inexpression  Body symptoms of inexpression  Inexpression is a physical barrier  Inexpression and the terror of expression  Ancillary: Expressing emotion progressively increases connectedness and self-worth Figure 4.3: Theme map  4.2.1  Inexpression is disconnection from others.  Theme description: Disconnection from others was a two-case, reciprocating theme. Participants explained how society taught or expected them to disconnect to hold down their feelings feeds into how they use inexpression to disconnect others from the rising emotions in themselves. The former arose when participants found others around them unsafe to express to. The latter is described as the experience of men hiding parts of themselves from others. All six participants spoke of emotional inexpression as a state of being disconnected from others. They described this state in two cases. First, participants considered emotional inexpression as expectations of others, such as family, friends or workmates; the men were  67 taught not to relate or connect using certain emotions. Second, participants reported hiding parts of themselves from others as a way to maintain emotional inexpression. For most participants, the first acted as a reinforcer of the second, in that the expectation of others to not express carried clear consequences that caused men to hide themselves from others whenever such emotions were present. In both cases, participants noted that emotional inexpression involves their isolation from others. In the first case, holding down emotions was an early expectation from parents, for others, it came from their wider social communities. Thomas explains how his father instilled inexpression to him: “one of the very few times, at the heart level, he said to me „don't speak to me that way‟. It just got me; that I wasn't allowed to challenge him in that way. There was something about being emotionally expressive that was just shut down.” Sasha said that if he expressed emotions, “I won't be believed. And if I'm not believed, then I‟m not part of the community. So credibility was important. Stiff upper lip. No external expression of emotion.” Bill, Frank, and Mike spoke of holding emotions back to protect significant relationships. Bill said he kept emotions from his father because “I figured I guess it would ruin our relationship. It would forever change things”. Frank said he kept his feelings from his parents, because “I felt like I wanted to make their parenting job as easy as possible. Be the kind of little boy they really wanted.” Mike stated that when emotions arose in the presence of extended family: “I was part of the immediate family, so I felt it was part of my duty to be a strong person there. And try to not make the situation any worse than it already is.” Finally, Greene conveyed the ongoing expectations of emotional inexpression from his workmates, stating “people would think lesser of me, they'll think of me as being weak. Maybe not able to handle challenges.”  68 The impact of emotional inexpression on men‟s livelihoods is a related theme that is continued in section 4.2.8. Regarding the second case, participants stated that they hide away parts of themselves from others as a way of maintaining emotional inexpression. They described using distracting or deflecting statements, inauthentic expressions of happiness, or what they described as playing a game with others. Thomas explained how he used words, such as “don‟t worry about it”, or “just move on”. Greene added “just leave me be until I'm done”. Bill explained how when he felt emotions coming up, he would “deflect it”, by getting others to “just stop, I guess. Cause then that stops the stress-producing situation. Change the subject.” Bill provided deflecting phrases such as “stop talking about this”, “I‟m getting tired of hearing that”, and “you don‟t need to talk about that”. Greene, Mike, and Sasha explained that they allow people to only see certain parts of their emotional selves. Greene said that when he felt emotions rising up in his workplace, “I don't have that connection with those people, not at that level. So, I didn't want them to see that.” Mike said “I cried a little bit, but not as much as I was feeling I wanted to”, while Sasha explained: So this is part of me I'm not going to show you. I'm going to show you parts of myself. I'm not going to show you the whole of myself, because then you can't expose me, because you don't know all of me. You can expose the parts that you know of me. Finally, Frank said “I would retreat to my room, in my own space, and be with my emotions, myself.” However, without the opportunity to retreat, he described a game he played with others to show them only parts of his emotional side. He described this game as “an act”. He said that “I think my coping strategy would be to sort of laugh things off and be  69 evasive. Sort of dismissing things with a laugh.” To do this, he said “I was putting on a facial expression that was pretend.” All participants identified that disconnecting from others isolates them. Bill said that “The whole world closes in, <whooshing sound, bringing hands into chest> yeah there is that feeling. I'm on stage, alone, all of a sudden.” Sasha stated, “I felt totally, totally alone”. Frank echoed this, stating that being disconnected from others in this way was “lonely, profoundly lonely.” Thomas explained that he was “just really disconnected, just wandering”. Greene employed the term “focus” to describe how he must isolate himself from others to keep his emotions in check: “I need to focus on this, otherwise it's [emotions] going to distract me from getting it [work] done”. An ancillary finding was that most participants said expressing emotion left them more connected to others. This is discussed in section 4.2.10. 4.2.2  Inexpression is disconnection from self.  Theme description: Being emotionally inexpressive was described as being disconnected from the self. Participants distracted or diverted themselves, or pushed their emotions down or away. They also described losing awareness of themselves, their thoughts, feelings, actions, and/or memories. This theme manifested during the interview itself, when participants sometimes struggled to stay present. The second theme involving inexpression-as-disconnection arose in a felt sense of participants being disconnected from themselves. Disconnection from self was described as an active effort that participants put forth to control their emotions, but also as a loss of selfawareness in their thoughts, feelings, actions or memories of past events. I also experienced participants struggle to stay present in the interview as they worked to describe this felt sense. A subtheme that arose was that men described emotional inexpression in terms of self-worth  70 or worthiness. This led to an ancillary finding that expression improves self worth, described in section 4.2.10. In a similar fashion to how men hide parts of themselves from others, participants reported hiding or putting away parts of themselves during strongly felt emotional moments. This manifested as either a pushing down of the unwanted but rising emotion, or distracting themselves from what was really going on, around or inside them. Thomas gave himself a series of directive and aggressive phrases while holding in emotions: “Don't go there, keep it secret, don't talk about it, all that. Don't express it”, and “push that down, minimize it”. Stronger internal messages included: “Just swearing at myself, reviling myself, you know „you're a stupid son of a bitch‟, swearing at me!” Sasha also used self-talk to stay inexpressive, but his phrases focused on distracting himself: “there was denial, there was shut down, this isn't happening." Bill referred to an internal self-questioning, or “quick processing that occurs”. He states that “the processing part is: do I have to be right in this situation?”, and provided several phrases that pop into his head when “things start to get deep”, such as: “No. That's not worth it. Change the subject. Decide to just not talk. Get mad at each other, or split". Frank described messages of endurance: “So I was probably saying to myself that this is just something I have to get through.” Greene and Mike reported internal messages of delaying feelings. Greene said: “I tried to think about „I can't cry now‟”, and “I had to say to myself, basically „not now‟”. Mike added “Give it some time, and it will pass. For me, if I can just hang on for a period of time, I know that it will pass, eventually. I just need to focus on it, and think about it. And just go ok, just keep a handle on it, and don't let go, just hang on, and you'll get over it in a little bit.” All participants described actions and behaviours they  71 engaged in that disconnected them from their feelings. These behaviours centred on work or busyness, and are covered in section 4.2.8. Disconnecting from themselves had another effect on participants. They reported not being aware of themselves while holding back their emotions. Thomas illustrated this, stating: “by withholding, I avoided the pain of being aware of my emotions.” However, this avoidance meant that he and others remained unaware of their thoughts, feelings, behaviours, and struggled to recall details of the strongly-felt moments. Bill described being in a state of emotional inexpression as “vacuous”: I know when I concentrate on that feeling, it's almost like I've got it a bit of amnesia around it. I can understand what you want to get a description of, but I have a blank space around it. I guess because it's an emotional dam, and so by definition, you can't conceptualize the emotion. Thomas stated: "I would get myself into a state. And it wasn't until after some days or weeks later, I would say „what the hell was that about?‟" Sasha said that when struggling with rising feelings, “I don't feel. The words, the looks, can't contact me”. He explained the state of disconnection as: “I didn't have the words. I mean, it just sort of didn't compute.” Mike reported trouble with held-in emotions arising in other contexts: Well, maybe you're watching a movie, or having a discussion or argument with somebody. And then you find you have this emotion for some reason, and you're really not sure where it came from. Cause you're thinking: “well what I'm doing right now really wouldn't bring this on, cause I've done this or seen this before, and I really haven't had this reaction. But now I do, so where is it coming from?”  72 Frank said that holding down his emotions was “like an automatic response. Or nonresponse you might say. The first impulse is not to let it out.” Similarly, Greene reported he was unaware of holding his breath in such moments, stating “cause I mentioned that I do have a habit of doing that [holding breath]. But I never think about why. It just happens.” Finally, the disconnection from self manifested at times during each interview. This happened frequently enough to be considered a finding that supports the disconnecting impact of holding in one‟s emotions. I noted that participants sometimes struggled to answer my questions, despite a strong desire to do so, and drifted from the story or changed the subject from time to time. They identified with the phenomenon, and had thought about the research question prior to the interview. However, interviews took on a wandering quality, particularly at the outset. This felt to me like an archaeological excavation, where parts of the artifact were identifiable only after much sweeping and sometimes a break to look away from what was uncovered. One participant admitted “<Long pause, looking down, self-reflective> I did kind of change the topic or change the subject for a moment.” Another said “I just can't think of anything. Whenever I try to think about it, it just floats away”, while a third admitted “I'm not really answering the question.” Common to all interviews was that participants became more focused and certain of their descriptions of emotional inexpression in the second half of the interview. Bill commented “I feel good, because in the last half-hour feels like we were talking about what you are trying to study.” 4.2.3  Inexpression is linked to low self-worth or worthiness.  Theme description: Participants described emotional inexpression in terms of self-worth or worthiness. Inexpression can be a consequence of low self-worth, or expressing emotions will result in lower self-worth.  73 Emotional inexpression was described by all participants in terms of their sense of self-worth or worthiness. They reported this in a number of ways. The desire to disappear from the strongly-felt moment arose for two participants. Sasha said “if a big black hole had appeared and swallowed me, I probably would've gone”, while Greene wished “that I could hide in a room, somewhere.” Mike stated: “It feels terrible. It's not good. You feel you're in a funk, and you gotta try to figure out a way out”. Participants also described how being inexpressive links to self-worth. Bill said: “Where we're meaningless in the scheme of things. And then I'm left with a, you know, when you stare off into the distance and you feel drained or „let‟”. Greene added: “Less. Not worthless, but less”, and “What is left? I would feel „not very much‟”. Sasha said: “I felt like a piece of shit. I felt like this big <tiny space between fingers>. Unworthy. Sub-human almost”, while Thomas said: “It's even lower than worthless. It's like, almost not fit to live”. Frank named the feeling that was arising in him in the moment, stating: “What's coming up now is sadness. Like there was something wrong with me”. These moments struck me as some of the most intimate and serious of the interview. Participants made these statements with quieter, reflective voices. An ancillary finding was that most participants reported improved self-worth as they learned to express emotions. This is discussed in section 4.2.10. 4.2.4  Inexpression is clearly defined.  Theme description: Participants clearly knew emotions that are not to be expressed, sometimes calling them negative emotions. These included sadness, fear, and anger. They also identified acceptable emotional expressions, including happy, sunny, beaming, pleasant, and smiling.  74 Participants were very clear and certain about emotions that are allowed to be expressed and those that are not. Four participants referred to emotions in a dualistic way of being positive or negative. Greene stated “you never really see, well, you don't see people expressing negative emotions really”, echoed by Thomas: “We were never allowed to express negative emotions”, and Sasha said “anything to do with negativity was not”. All participants talked about “sadness” and “crying” as the primary forbidden emotion to express. Bill, Frank, Mike, Sasha, and Thomas discussed how anger was also not to be expressed. Fear was specified by Mike and Thomas. Bill, Sasha and Thomas also identified joy, praise and pride respectively as emotions that they would not express. Regarding sadness, when asked to recall a time when they held in a strong emotion, every participant chose a story that involved a major loss and how they held back sadness. Recalling my most poignant experiences with each man, I am drawn to their stories of significant loss. In addition to what emotions are not allowed, participants were equally clear about what was permitted to express. Thomas stated: “There were lots of times when we laughed and had fun, and were happy. That was quite okay”, and Mike concurred: “Joy, happiness, satisfaction, relief, laughter”. Greene said “The only emotional outbreaks I see people express are positive things. So, if somebody is getting married. Or if somebody's having a baby. [...] And everyone's happy and beaming and cheery and stuff like that”. Sasha added: “You don't express emotion. You just, you know, have that smile on your face.”, while Frank said “my emotions were not welcome, except for sunny, pleasant ones”. Bill described how expression has to stay on the surface: “I don't want to have deep talks with you; we‟re supposed to play  75 the tennis, throw a ball, go for a beer, watch strippers. I don't want to have deep talks with you, that‟s not what guys are supposed to do”. 4.2.5  Anger is an experience of inexpression.  Theme description: When asked about how they felt while holding in emotions, participants said that a range of angry feelings would arise, from a bad or frustrated feeling to outright rage. All participants talked about how holding in their emotions caused anger to arise in them. During the validation process, I learned that the term “anger” ranged in meaning from an irritated feeling that participants were cursorily aware of, to full blown rage that they could not control. Therefore, it is important to highlight that this feeling arose along a continuum for participants. Sasha said his feeling of anger was directed to others “I was actually more angry at the people”. During the validation interview, he said that anger for him was a bigger term than he would normally ascribe, but acknowledged a lesser feeling arising while holding in his feelings. Greene similarly acknowledged that he would not get outright angry while holding back feelings, instead stating “I feel bad”. He said that holding in his emotions “becomes a distraction in my mind”. Frank spoke to the anger that arose in him, but stated that he had to hold that feeling in too, calling it “anger that I couldn't express”. Thomas described the feeling of holding down emotion as “angry, vindictive, accusing, manipulative, blaming other people”. Thomas, Mike, and Bill all talked about how pushing down emotions caused anger to “burst out”. Bill said “I guess I'm holding it down and it comes out, I bark out”, while Mike stated: “For myself, you could have a short temper”. Thomas described how his anger would “burst out in a different way”:  76 It's kind of like you push it down here and it pops out over there, and you push it down and it pops out over there [making a pushing motion downward with one hand and pointing his other hand in another direction]. Sometimes I think what happened was my emotions would kind of burst forth in other ways. That I was looking, I image the energy was looking for an outlet, and I didn't find it, and so it would burst forth and I would be impulsive in meetings, or I would say something that was kind of off-the-wall. This result indicates that men holding down emotions feel some degree of anger within them, and based on the previous theme, may struggle to hold their anger in as well as the primary emotion. At a point of every interview, usually after some archaeological surveying of the phenomenon, every participant talked about a specific, strongly-felt moment. I found these moments the most emotionally intense. All six participants described three awarenesses while maintaining inexpression. The first was a stillness in their minds and bodies; the second was employing work and busyness to continue to stay inexpressive, and the third was an intense fear of expressing emotion. 4.2.6  Inexpression is stillness, control.  Theme description: The act of being inexpressive was described as a struggle for internal control. Participants described this struggle as beginning with a stillness in body, breath and focus as they contended with the rising emotions within them. They described the struggle using metaphors of physical barriers, such as a force of will, a shield, a wall, a mask, a prison, and armour. The stillness contributed to the sense of disconnection and felt, for some, to be external to themselves.  77 When in a state of holding down rising emotions, all participants described a stillness that they experienced in their body, breath or mind. Greene said “when I paused, I became still”. Similarly, Bill said “I pause. I do that whole pause thing”. Frank said he becomes “totally cool”, and said “it's almost like everything stops”. Thomas described his internal state: “I just felt really solid and grounded”; and how he presented himself: “I was standing tall, clear, and straight on”. Sasha described his internal state: “I get very, very calm”, and poignantly said “I just inwardly become like a statue”. Mike described stillness in recognizing his uncle struggling to hold in emotions: Mike:  From his facial expression, and the way he was speaking, you could sense he was trying to hold it together. So, as he was talking, there was pauses. And his speech was, he was choking up a bit, so that's what kind of led up to it.  Interviewer:  You said pauses, tell me more about that.  Mike:  As he was speaking, he had to stop, and try to gather his thoughts, I guess. Or try to keep his emotions in check, for him to carry on.  Three men discussed how they stopped breathing during these moments. Greene said “I don't think I breathed at that moment”, while Mike explained: “My breathing changed a little bit; you're breathing a lot more shallow”. Frank stated “As I try to remember the body feeling, I think I held my breath. Gut sucked it in and just blocked it off. In my belly, in my stomach”. He said that stopping his breath is “a freezing of affect”. Constrained. Suffocating is a good word. I remember sort of feeling smothered, emotionally. Psychologically, emotionally smothered. I couldn't breathe my  78 true self. I'm not sure if I'm expressing it right. I wasn't allowed to fully breathe my real self. Finally, four participants discussed eye contact in that moment. They explained how their visual focus became as still as their bodies. Bill said “All of a sudden, we are looking straight into each other's eyes. Like definitely, it's become some moment of truth. Cause we're trying to have a deeper conversation”. Mike added that he watched his uncle during a shared moment of inexpression: “I was keeping an eye on him the whole time. I was watching him the whole time, because I really wanted to hear what he had to say, and I really wanted to focus all my attention to him”. Thomas similarly described his father: “Looking me clearly in the eye, and with a real strong intention to connect”. Greene and I had the following exchange as he described holding back intense feelings: Interviewer:  Did you look around?  Greene:  No.  Interviewer:  Your eyes were?  Greene:  Pretty much fixated, looking...  Participants described an initial stillness in body and focus when struggling to maintain emotional inexpression. This led to a subtheme of what this stillness looked like to them. 4.2.6.1  Subtheme: Inexpression is a physical barrier. Five participants used metaphors to describe what emotional inexpression looked like.  These metaphors all involved a physical barrier between them and exposure to the rising emotions. Sasha said “there is that armour that I have, and it builds up, and it keeps building up. And it works, until it doesn't work”. If it fails to work, he said of himself: “the imposter  79 usually gets exposed [...] and then he's brought down to being a nobody”. For Bill, when strong emotions arise, “this sort of wall just comes up”, and described it as external to him: “It seems to be independent of me. I didn't create it, it arises out of a situation. It's like an outside energy reaction to my feelings”. Frank said that “editing” his emotions was to “put on a mask, my inauthentic face”. Finally, Mike and Greene spoke of water metaphors for their inexpression. Mike explained: “It's kind of like you're filling up a bucket of water, and it's starting to spill over, and then you open a tap up, to let it off, to keep the water from spilling over”. To contain the water in the pail, he described inexpression as “it's kind of like a lid”. Greene had several: “The dam holding back the water”, “I am using it [distraction] as a shield of sorts to keep it [emotions] at a distance”, and “I'm trying to put something between me and those emotions. So in a way, it [distraction] does become a shield”. For three participants, this physical barrier of inexpression also felt like a trapped place for them. Frank said “what came to me was being in a cage, confined. A prison, really tightly bound”, while Bill characterized it as “like being held prisoner”. Greene described being in a place of trying to control his emotions: Greene:  That I can't hold it, but I also can't let it go either.  Interviewer:  What's that feeling like?  Greene:  Difficult. Frustrating. Frustrated.  This trapped feeling may explain the source of anger arising in men who are holding down strong emotions.  80 4.2.7  Body symptoms of inexpression.  Theme description: Participants described awareness of body reactions to emotional inexpression. Symptoms include chronic mind and body reactions, tightness in the body, and acute body pain. All participants identified somatic reactions to being emotionally inexpressive. As they recounted past stories of holding in strong emotions, they could clearly locate and describe them. Frank felt pain in his face: Frank:  It was painful, it was hurtful to hold it in.  Interviewer:  Okay so there's pain, but then holding in the pain is painful?  Frank:  Yes.  Interviewer:  Are you aware of what that pain feels like, or looks like, or where you feel that kind of pain?  Frank:  All over my face. As we‟re talking, I‟m really aware of my face.  Mike also felt pressure in his head, stating: “It's like my sinuses are plugging up.” Bill explained how his feelings are felt in his midsection: That whole thing involves a weird tightness here. <Indicating chest> Sometimes at night I wake up with a really strong emotion. This thing comes up like that. It's very bizarre. <Indicating upward movement from stomach into the chest with hands> Yeah that's like the rising is a feeling, even though it's a constriction moving, it's like that longing, loss feeling. Greene and Mike also described a “heavy” feeling, or “heaviness” they each felt “in my chest”. Sasha similarly felt his inexpression in his chest:  81 Interviewer:  Are you aware of where you might've felt it in your body at the time?  Sasha:  Yeah, a lot in my chest.  Interviewer:  Yeah. What's the feelings? Is it a tension?  Sasha:  A tightness, a tightness, it was sort of like a big block of cement on my... <indicating chest>  Interviewer:  On your chest. And you're trying to keep that in?  Sasha:  I was again trying to betray no emotion.  Thomas said he felt it as “just a tiny bit of ache and tense, and it's in my stomach”, but also attributed holding in emotion to chronic allergy conditions: “Almost like I had this urge to cry and didn't. And what was coming out was an awful lot of eye irritation, really bad eye irritation most times.” He also said that holding in his feelings led to recurring nightmares: I mean traumatic nightmares where I was really afraid of my everyday world, because I was holding in that anger”. These body and mind reactions to holding down emotion were clear to participants, as several of them reflexively brought their hands to parts of their bodies as they spoke. 4.2.8  Inexpression is linked to working or providing.  Theme description: Work and busyness are employed by men as a tactic to maintain control and inexpression when emotions are strongly felt. Holding in emotions is described by men as a condition of preserving their livelihoods. The consequence of failing to remain inexpressive has a direct impact on the male provider role. All six participants discussed emotional inexpression in the context of their work. This arose as engaging in work as a tactic to stay emotionally inexpressive, or believing that  82 emotional inexpression preserves their livelihood. The latter point is a continuation of the theme of disconnection from others, where the expectations of society play a strong role in keeping men from expressing their emotions. In this case, participants reported that being inexpressive preserved their livelihoods, and their identities as men. As described in his vignette, Thomas applied himself to his work to keep himself from expressing strong emotions: “be busy, get distracted, do something else, yeah. [...] Do something to take this away from expressing, yeah. Hide it, bury it, get caught up in sex, or making money, or doing work or do something to distract”. Similarly, Mike stated: “Remember that you've got a job to do, and stay focused”. Sasha used the term “tow the line” to describe how he was: “Steady Eddie, not brilliantly exciting, but nose to the grindstone”. Frank said he would focus on his piloting duties: “I was definitely aware that I have a lot of emotion going on, and that I was functioning in spite of it all. I remember shortly after takeoff, feeling tears wanting to well up, then feeling <laughter> (That emotion coming up?) Yeah. Doing my job”. Greene provided a detailed description of how his work helped reinforce the “shield” he was putting up to keep his emotions from coming out: I try to think about what I have to do, work wise. And then go through my inbox in Outlook. Just to check what e-mails are there, stuff like that, what I have to do. Making a little task list for the day. Checking with my boss to make sure that this is the correct priority of what I need to work on. And then trying to focus. During the interviews, I reminded participants that I was looking for what they thought or felt would happen if they expressed, regardless of the likelihood of these events actually happening. They all discussed how being emotionally inexpressive preserves their place at  83 work. This was an important finding because it related to the male provider role, which is a central theme in the socialization of men in our society. Thomas explained a process of evaluating the risks of expressing himself to a co-worker: “I thought that if it backfired, that, if in fact he tried to kind of judge me, or hold it against me. I took the risk that that would be less, the risk of that happening”. Sasha described that expression would impact his career: “Watch out fella, if you screw this up, you're gonna screw up your life”. Mike described inexpression as a duty to be strong for others: “So I tried to keep that [sadness] under control, because I am one of the pallbearers too. So there's stuff I gotta do after this too, right. So I have that in the back of my mind too. I have to get up in front of everybody, with my cousins, and carry him [his grandfather] out”. Bill likened emotional inexpression to conformity at work, stating: “Job is the prime example of conforming”, and said he does not express himself because “I'm in a career. It's superficial, but I want my peers to accept me”. Greene also kept emotions held down to manage co-worker perceptions: “Cause I'd always be wondering „how do they perceive me now?‟ And every decision they make where I'm involved, was that a factor?” He went further to say: “Because most people associate emotional outbursts with females, not with men. So all these preconceived notions about how people should behave would be laying down upon me.” This statement illustrates socialized messages that men are supposed to be business-like in their emotional containment. Frank provided a powerful illustration of how expressing himself would have been received in 1950s US: Frank:  Well, if I talk to somebody about this, they'll know I'm gay. And I'll be court-martialed, thrown out of the military, my parents will find out. And I made a conscious choice not to do all that, so it would be a major disaster in my life, on many levels.  84 Interviewer:  So what would you lose?  Frank:  I would lose my social standing, as an "officer and a gentleman". I'd be dishonourably discharged, I'd be shamed. I'd be a publicly known homosexual at a time when that was totally verboten. I would have put my parents through all kinds of anguish.  This theme reveals that a state of emotional inexpression involves the male provider role. Participants either used work or busyness to keep their emotions held down, or actively considered their work identities as also threatened by the emotions rising up in them. 4.2.9  Inexpression and the terror of expression.  Theme description: While in a state of emotional inexpression, participants described that which they were avoiding, namely the expression of emotions that were rising up in them. The rising emotions were described as a building and unstoppable force that they must stop. They described expression using metaphors of a bottomless pit, an abyss, a nothingness, and a whirlpool. Going into expression was considered crossing over into the unknown, and felt like tumbling, disorientated, into a loss of control from which they would not be able to return. Emotional expression was described as a tremendous fear or terror. Participants felt such a place would lead to harm, death or threaten their minds. The barrier that participants described (in section 4.2.6.1) arising between them and their emotions led to descriptions of what crossing that barrier would look like. All participants talked about what the other side of inexpression looks like for them. These experiences organized into four sections.  85 4.2.9.1  Expression is a huge fear. Participants unanimously described fear when they considered allowing held in  emotions to surface. Thomas and Sasha independently used the word “terror” to describe what they were holding back from. Thomas said “with my emotions, it's like „wooooo, can't go there!‟ It's like terror, just absolute terror”, while Sasha said “I was in pure, absolute terror”. When asked if Bill‟s “abyss” was a safe place to go, he emphatically said “No!” Greene ranked the fear as a 9 out of 10, while Sasha ranked fear at 8/10, saying “it was huge. It was absolutely huge”. Mike ranked it a 7/10, assuming: “I have methods and mechanisms to handle it”; without these, he said “I think it would probably be higher”. Frank called it “kind of a „yikes‟ feeling. Like my mask has been ripped off”, and said “it was probably the biggest fear I was wrestling with at that point”. In an attempt to not focus participants on describing the phenomenon of fear, I asked them to describe more detail of what expressing emotions would be like, while trying to hold them in. This led to two descriptions of that place. 4.2.9.2  Expression is irrevocably crossing over into the unknown. First, all participants described showing emotion in the moment of inexpression as an  unknown place. Further, they described an experience of crossing over irreversibly, if they were to go into their emotions. Thomas called it “a black hole, a bottomless pit”. He situated himself in reference to it: “by withholding, I avoided the fear of whether that pit is bottomless. If I go into that hole, will I ever come back?” Sasha described the loss of boundaries as being “totally exposed”, stating: “I [felt that I] could've died at that time, because I didn't have any parameters in terms of what's expected here”. Mike said: “It feels like you step over a line”, and described the other side as “a dark place” where he would not be able to think, he would  86 be out of control and “just reacting”. The fear of this place included “you don't know how it's going to end”. Frank referred to the “unknown, which is scary”, and when asked if there was a bottom, said “There is a bottom there somewhere!” He elaborated more, saying: “I think that's why I felt like I had to keep such a tight lid on it. What did the cartographers used to say, „beyond here are the dragons‟. So it's like that. It's Terra incognito. And I don't want to go there.” Finally, he spoke to the irreversibility of expressing, stating “it seemed irreversible, if I drop my mask, I could never put it back on again.” Greene referred to is as “not a safe place, it's more of an open place”. Regarding crossing over, he said: Interviewer:  Can you come back from that place once you go in there?  Greene:  Not really, because people remember.  Interviewer:  So once you've lost containment...  Greene:  You're out there.  Bill described crossing over as going over a wall that protects him, and said “we clicked over”. In describing what the place looked like, he called it “Black. The abyss. A hole, a black vacuousness, nothingness”. He also described it as a “new territory”, stating: “it's very abstract, it's like I'm aware that I am this <indicating that tiny space between his fingers>, and there's this <indicating a wide space between his hands>”. He also agreed there was a chance he would not return from what he termed a “human wilderness”. 4.2.9.3  Expression is a tumbling, disorienting, falling, loss of control. Participants then all described a loss of control if they were to cross over from  emotional inexpression. Bill said it would be “going somewhere out of my control, loss of control”. Once there, he said “I won't have any grounding” and compared the experience to falling off a cliff. He said it would be “utter confusion, brain overload, panic attack.”  87 Regarding his dark place, Mike said: “It felt like I was no longer in control, it was my emotions that were in control.” He described entering this place: “It's more like falling into it. Like you've tried to hold back as much as you can, and ultimately you've just fallen over.” Frank also described a falling sensation: Frank:  It would be some kind of out of control, disorientation. Because I was still really confused about who I was. <Cycling hands>  Interviewer:  You're doing a tumbling motion?  Frank:  Yeah, kind of tumbling. An out of control, disorientating, sort of falling off a cliff, falling out of an airplane.  Interviewer:  Describe it to me, as best as you can. You're falling into something. Pretend I'm looking through your eyes, what am I seeing?  Frank:  The image of falling out of an airplane is good, because there's a lot of space I‟m falling into. Tumbling and falling. Terrified. Feeling a loss of control.  Greene described a vortex of water that represented the emotions he was holding back overcoming him: Greene:  The image that comes to mind, which is slightly different now, it's kind of like a whirlpool. You know where the water is kind of whirling. And I'm going to be sucked into it.  Interviewer:  You're going to be sucked into the middle? (Yes.) What's down there?  Greene:  Just raw, pure emotion.  88 Sasha discussed showing emotions as a loss of control with unknown consequences: “And being angry is out of control. Because I think for a lot of us, men, women, anyone is fearful of anger, because it‟s sort of like you don't know where it will take you.” Thomas described losing his mind in that place: “That was the fear for me, I recall. That I had a fear of losing my mind, and what that meant I don't know, but those are words that come up”. He also said “I think the fear was, if I lose that, [his mind] it was gone permanently”. 4.2.9.4  Expression leads to harm, death. Finally, participants were asked what would happen to them while they were in the  place of emotional expression. They all mentioned some form of harm or even death that they felt would befall them. Bill said: “I would think of myself as a small candle, but if that candle went out, I would cease to exist”, and “that could trigger psychosis or breakdown.” Greene said “it would be like I would be drowning.” Sasha said that being in the place felt like he would not endure: “I don‟t think I could‟ve survived. I don‟t think I would have had the inner strength”. Mike and Thomas said that expressing emotions could lead to death. Thomas explained: “During the Second World War if you cried while you‟re buddies were shot, you‟re likely to get shot too”, and if he expressed: “That I was going to be suicidal, that I was kind of going to follow that path”. Mike also described going into emotions as “feeling like this is going to be the end”, by relating a near-death experience he had: I was in a vehicle accident, where the car flipped over, and it was right over the edge of a cliff. And while that was actually happening, when it was flipping over, that fear of getting hurt badly or worse, the body was doing similar things than when you're getting really emotional and really upset about something.  89 The terror of expression was vividly described by all participants. Once they situated themselves in relation to the boundary between inexpression and the other side, their descriptions came quickly and clearly. I noticed our dialogue became more intertwined, and I felt a greater knowing of the places they described. In response to this, Thomas said to me “Yeah, I take it you know a little bit about that <smiling, laughing>”. These moments reflected a shared understanding of the terror of expression and why we, as men, hold our emotions in; it is not a random choice, we have a very good reason for doing so. 4.2.10 Ancillary finding: Expressing emotion progressively increases connectedness and self-worth. Theme description: The journey from inexpression to expression is a process that increases self-worth and reconnection. An ancillary finding to the study came from 4 participants discussing how their own journeys from being highly inexpressive to more expressive improved their lives. These findings centred on how expression, while terrifying, does lead to being more deeply connected to others and improves self-worth, and that going from inexpression to expression is, itself, a process. Bill stated “the more we interact with each other, the more we need each other”. Sasha commented: “I think that because I had the terror, and then I had the breakthrough, that it was one of the best highs that I ever had in my life. I felt human, I felt connected to other people.” Thomas said: “And going forward I see myself as worth more, after that. (Having let it out?) Yeah.”, and “in terms of the difference for me, disconnection is probably the biggest single difference from being emotionally inexpressive to being emotionally expressive. And the greatest joy now I have is being connected with people.”  90 Regarding the process of being more expressive, Frank stated: “I think I'm still learning to not put on a mask, it's still an ongoing process”, and “it was a gradual process, I think I'm still in that process. But I think I've come a long way.” Mike summarized: “It feels great, like it's good for our relationship, but also for ourselves as individuals. Cause you're better able to handle these really emotional or stressful moments in life, cause you got somebody you can relate it to. I'm still not that great at it, talking about feelings and stuff. But we try to make an effort to do it”. These descriptions were given as a contrast to what participants felt like during inexpressive moments, a proof by contradiction to explain what inexpression is not.  91 Chapter 5: Discussion The purpose of this study was to fill a gap in the literature regarding our understanding of emotional inexpression in men. To do this, I posed the questions: What are men‟s experiences of being emotionally inexpressive? and: When men become aware of strong emotions that are proscribed to them, what do they experience in maintaining a stoic, expressionless stance to themselves and the world? To answer these questions, I conducted a phenomenological inquiry into the experiences of emotional inexpression in men, resulting in 9 major themes and 1 ancillary finding: 1) Inexpression is disconnection from others, 2) Inexpression is disconnection from self, 3) Inexpression is linked to low self-worth or worthiness, 4) Inexpression is clearly defined, 5) Anger is an experience of inexpression, 6) Inexpression is stillness, control, 7) Body symptoms of inexpression, 8) Inexpression is linked to working or providing, 9) Inexpression and the terror of expression, and Ancillary Finding: Expressing emotion progressively increases connectedness and self-worth. In answering the research questions, I sought to understand my participants‟ experiences as accurately as possible, understanding that this phenomenon may not be one that they had thought about or discussed before. Reflecting on my own experiences of emotional inexpression revealed that it arose in brief and intense moments, during which I wished to be somewhere else. Therefore, I believed that I was asking men to describe something filled with rich detail, but surrounded by a cloud of denial, distraction, deflection or dissociation. Our findings (my participants and I, collaboratively) were therefore as concrete as we could make them, to ensure we described emotional inexpression, and I believe did answer the research question.  92 5.1  Definitions and theories of emotional inexpression The themes support Consedine et al.‟s (2002) definition of emotional inexpression.  They authors divided inexpression into subjective (internal) and behavioural (external) experiences, which map to the themes of Inexpression is disconnection from self and Inexpression is disconnection from others, respectively. In the former, the authors used words such as repression, denial and avoidance, which are reflected in participants‟ descriptions of pushing down feelings, or distracting themselves during strongly felt moments. The authors employed terms expressive suppression and display rules to describe external behaviours of inexpression. These behaviours are supported in the Inexpression is disconnection from others theme, where participants reported hiding themselves from others to hold in their emotions. Lazarus‟ theory of emotion as a person‟s appraisal of a safe or harmful environment arose many times with participants. First, the Inexpression is clearly defined theme contains a clearly understood demarcation between which emotions may be expressed and which may not. Next, the Inexpression and the terror of expression theme described the lack of safety that participants experienced, when struggling not to express proscribed emotions. The participants described harmful environments they would be in, should they express. These environments were not cognitively thought of at the time, as evidenced by the Inexpression is disconnection from self theme. Yet participants knew not to go into expression, describing that doing so would lead to harm or death. Finally, Lazarus describes how men use coping strategies to suppress an “action tendency”, such as expressing a proscribed emotion. The Inexpression is stillness, control and Inexpression is linked to working or providing themes contain many such strategies, such as the body stillness that participants experience, and the busyness they engage in to hold down emotions. Interestingly, Lazarus suggested feeling  93 angry in reaction to sadness as an example of a suppressed action tendency. This is what Coggins and Fox (2009) termed “emotional coupling”, and is directly supported by the Anger is an experience of inexpression theme. This theme also supports Schwartz and Waldo‟s (2003) hypothesis that restrictive emotionality contributes to abusive behaviour in men. 5.2  Inexpression as choice or learned disability Emotional inexpression was considered by Wong and Rochlen (2005) to involve  stages of choice, including, but not limited to Levant‟s (1998) “normative alexithymia” as a learned disability to identify and express emotions. The results of this study supported both perspectives, and suggested that they are not incompatible. As a choice, the inexpression-asdisconnection themes contain many statements supporting choices that each participant made regarding his emotions, such as what they told themselves, what they told others, and how they behaved in order to be emotionally inexpressive. Wong and Rochlen (2005) further provided a 5-stage model of choice for emotional expression, and explored inexpression as a function of disruptions at various stages. The findings of this study support each stage. First, regarding the physiological threshold of conscious awareness, the Body symptoms of inexpression theme revealed that participants do have somatic reactions that are remembered long after the event and can act as early appraisers of inexpression. The second and third stages involve men convincing themselves they are not experiencing their feelings, and labelling and interpreting their responses; the authors stated that this stage is associated with alexithymic deficits in processing and regulating emotional states. These stages are supported by the internal messages participants made in the Inexpression is disconnection from self theme. The fourth stage involves men‟s values and beliefs about expressing the emotion, which is supported by the Inexpression is  94 low self-worth and the Inexpression and the terror of expression themes. In particular, participants‟ beliefs that they are not worthy to express, and that expressing is a huge fear with dire consequences. Finally, men‟s perceived appropriateness for expressing in the social context is directly supported by participant descriptions of how societal and work expectations dictate the appropriateness of inexpression. These were covered in the Inexpression is disconnection from others and the Inexpression is linked to working or providing themes. Regarding Levant‟s “normative alexithymia” theory of inexpression as a learned disability, in the Inexpression is disconnection from self theme, participants described losing awareness of their thoughts, feelings, actions and even their presence during the interview itself. This finding may suggest a disability, because participants were motivated but unable to provide detailed descriptions, and were sometimes frustrated by the inability. Regarding the learned component of Levant‟s theory, participants described societal messages in the Inexpression is disconnection from others theme, as lessons that were taught and reinforced to them. Related to the topic of the disabling effects of inexpression, Gross and Levenson (1997) hypothesized that emotional inhibition may diminish cognitive performance and interpersonal functioning. This study confirmed these postulates. First, the Inexpression is disconnection from self theme demonstrated how when participants pushed their feelings down, they lost awareness of themselves, their thoughts, feelings, actions, and memories. This may indicate decreased cognitive performance, given that other memories of the event were clear to them. Second, the Inexpression is disconnection from others theme demonstrates how interpersonal functioning is directly affects and is affected by emotional inexpression.  95 To summarize the choice versus disability debate, it seems that participants may choose to hold down their emotions, but that there may also be a cost to this choice in the form of “normative alexithymic” symptoms of disconnection that appear to disable men from functioning intrapersonally, by not recalling specifics or emotions around the strongly-felt events, or interpersonally, by contributing to their disconnection from others. The inability to express emotions may be an ongoing function of choices to not express emotions. This is continued in the limitations and future directions subsection below. 5.3  Emotional inexpression and masculine socialization Several topics in the literature on masculine socialization were supported by this study.  First, O‟Neil‟s (1982) “normative masculinity” referred to men providing for their families and succeeding in the workplace. This is similar to Brannon‟s (1976) “The Big Wheel” typology of men succeeding and competing. Brooks (2010) summarized that a central component of men‟s identity is “work”. These authors explained how men see themselves through providing and succeeding in the workplace. This was strongly demonstrated by all participants in the Inexpression is linked to working or providing theme, where they described emotional inexpression as a preservation of their livelihoods. They reported that inexpression protected far more than their jobs; inexpression protected the very ability to provide and therefore preserved their masculine identities. The theme of Inexpression as disconnection from self provides evidence in support of what Good et al. (2005) called “boys undertaking a process of divorcing themselves from awareness and expression of the vulnerable emotions required to nurture others in gentle ways” (p. 700). Good and Brooks (2005b) extrapolated on this idea, employing Bowen family systems theory to describe how masculine socialization requires men to limit, give up, or deny  96 aspect of themselves. Participants clearly stated that they took actions to divorce themselves from their emotions, and lost awareness of their thoughts, feelings, and presence around these events. These authors further stated that this self-denying process creates overwhelming anxiety in men, which Pleck (1995) referred to as “discrepancy strain”, or the psychological consequences of violating actual or imagined gender roles. The link between disconnection and anxiety is supported in the Inexpression and the terror of expressing theme. Participants described moments when they struggled to hold in strongly-felt emotions that they did not want to express. They all described dire consequences that they thought would happen if they expressed in those moments. 5.4  Novel contributions There are several new contributions from this study. First, the disconnection that men  feel from others and within themselves has been raised by clinicians (Good and Brooks, 2005b; Good et al., 2005). However, this study extends how men experience disconnection, in themselves and with others, and supports emotional inexpression both as an active choice and a learned disability. Second, the terror of expressing emotions is a new finding of this study. Prominent authors in the psychology of men use words such as “distress” (Englar Carlson, 2006, p. 33), “highly aversive” (Good et al., 2005, p. 700), “afraid” (Pollack, 1995, p. 25), “fear of femininity” (O‟Neil, 2008, p. 367) “powerful internal prohibitions” (Rabinowitz & Cochran, 2002, p. 19) or “anxiety” (Good and Brooks, 2005b, p. 5) to describe what men face if they were to express their emotions. Wong, Pituch, and Rochlen (2006) attempted to quantitatively account for the relationship between restrictive emotionality and trait anxiety, citing studies  97 that established a correlation between gender role conflict and anxiety in men. This study adds a new perspective to this body of research, by assigning degrees and descriptions to the fear that arises in men who are struggling to hold down emotions, including the fear of experiencing fear itself. These findings, enrich the terms clinicians use and measure to describe what men experience when they hold in strong emotions. This study also contributes to the hypothesis that men are relationally traumatized for expressing proscribed emotions. Pollack (1995) referred to this as a “trauma of abandonment”, describing the traumatic disruption of early holding environment due to premature separation from maternal and paternal caregivers (p. 14). Parents or significant others may unwittingly threaten men during formative years with explicit or implicit messages of abandonment. Thomas described this dynamic when his father “shut down” his emotions: “I was clearly not just a little boy anymore, I was questioning his authority. And he saw me questioning his authority. He didn't punish me, but he let me know that, in a very clear way, that if you're going to be a man, don't play that kind of a game”. The threat of abandonment is paired with emotional inexpression, and recalled years later as “disconnection”, and avoided with terror. A possible antidote to this disconnection may lay in the reconnection that men experience in groups that practice emotional expression (Rabinowitz, 2005; Westwood, McLean, Cave, Borgen, & Slakov, 2010). Another new finding is the stillness that men experience in the first moments of holding down their emotions. Participants described the stillness in body, breath, and eye contact that arose during strongly-felt emotional moments. Based on participant descriptions and my own experiences, I propose two hypotheses to explain the stillness of emotional inexpression. First, participants described being engaged in an internal fight for control, as  98 rising emotions were threatening to emerge against their will. The fight for control may be so intense that it demands complete focus and attention to hold the emotions back; this may manifest as an equally complete stillness in body. Second, men may be in what Gray (1987) termed a “freeze” response to a fearful situation. He explains that freezing is not a reaction to pain, but a reaction to the warning of impending danger, or to fear itself (p. 18-19). He described the freeze response as remaining still, a “stop, look, and listen” action tendency that is thought to be adaptive, in that frozen prey are harder to see, compared to fleeing prey. Participants reported going still in the first moments of holding down a rising emotion, which bears resemblance to the freeze response. Participants described engaging in work or busyness to augment their initial efforts to hold in emotions. Gray (1987) stated that the freeze response is followed by the fight/flight response, which could explain men‟s desire to get busy in order to cope with their fear of the rising emotions. Busyness can be thought of as fighting through the moment, as described by Thomas in the “energizer bunny” metaphor, or a flight from the moment, as Greene explained how he used work tasks to avoid the powerful emotions he was feeling. A third new finding came from the diversity of participants that responded to the advertisement. Good et al. (2005) said that many of the models of masculinity are based on white American males. The participants of this study, while not a statistically significant sample, did represent a multicultural mix of ethnicity, age, and sexual orientation. This suggests that the component of these theoretical models that deals with emotional inexpression in men may extend to populations beyond white American males.  99 5.5  Implications for practice This study provided several important implications for counselling men. First,  participants identified emotional inexpression as disconnection. This is an invaluable construct to describe the experience of holding in feelings. Men in counselling who present with Levant‟s “normative alexithymia” would, by definition, struggle to describe what is going in inside them. An exploration of what disconnection looks like for them may be a relieving term, in that male clients may feel understood in a way they haven‟t been before. Having a term other than the vacuum of emotional inexpression can be a rallying point for men to explore these emotional experiences. Exploring disconnection can also externalize what may be a confusing internal experience, and may lead to helpful metaphors for emotions, such as was provided by participants in this study. In my own clinical practice, I have employed the word disconnection and have experienced positive “a-ha!” moments with male clients. It stands as a starting point for the emotional archaeology to follow in counselling. The disconnection from others that men experience can be mitigated by all-male therapy groups. Rabinowitz (2005) discussed several factors underlying the success of men‟s group work, including male support, trust, action orientation, dealing with discomfort and emotional safety. He stated that the group can act as a container for the strong emotions that men fear to express, including the anger that often arises in place of these emotions, and helps men trust one another with their feelings. This trust is a form of reconnection that can be an antidote to the disconnection of emotional inexpression. Westwood et al. (2010) provided group therapy for traumatized and emotionally-isolated military veterans. The therapy included developing trust and emotional disclosure in group members, and their research  100 found that the groups fostered greater connection and camaraderie between members, and that men reported increased intimacy with significant others following the group work. Second, the participants provided a very clear idea of the tremendous fear that they experience when faced with expressing emotions they considered “negative”. This is invaluable feedback that helps counsellors understand what they ask of their male clients when pressing for emotional expression. To highlight this point, Sweet (2006) stated that the biggest error made by female therapists is underestimating the degree of sadness and frustration many men experience. Ipsaro (1986) and Scher (2001) provided similar arguments for male counsellors, stating that lacking appreciation for the power of male gender role socialization can result in male counsellor discomfort with their client‟s expressions and a less effective therapeutic relationship. However, these authors are illuminating what isn‟t effective, and not providing a clear path forward for counsellors. Using the results of this study, counsellors can understand and embrace the terror that their male clients may experience when confronted with “negative” emotions; a corollary to this is that participants also provided a list of emotions considered “negative”. This enables counsellors to empathize more accurately with their clients, and to titrate the degree of experiencing of these emotions, particularly if they believe their clients have not faced these emotions for a long time; doing so progressively exposes men carefully to their feared emotions, thereby lessening the fear and enabling a greater range of expression. Third, participants provide counsellors with an understanding of where the “funnel emotion” of anger comes from (Englar-Carlson & Shepard, 2005). They said that anger arises as the expression of the various emotions they are not expressing, enabling counsellors to explore not only what is not being expressed, but what factors contribute to that inexpression.  101 Fourth, participants give counsellors the concepts of stillness and busyness during strongly felt moments. Counsellors who notice their male clients going very still may think them to be calm or dissociative. These results provide another option; their male clients may be struggling to hold down a strong feeling. Secondly, male clients who deflect and begin to act “busy” or work-like can be using these actions as a tactic to return themselves to familiar, if barren, emotional ground. In both cases, counsellors have an observable piece of evidence informing them about what their clients may be experiencing, especially if their clients cannot articulate their experiences. Finally, the participants provided many metaphors to describe the experience of holding in emotions. Counsellors can employ these metaphors with male clients who seem to be stuck for words to describe their feelings. Their clients can either embrace these metaphors as their own, or replace them with others more suitable to them. In both cases, these metaphors act as ports of entry into the emotional experience of male client. 5.6  Limitations and future directions A limitation of this study was that the term “emotional inexpression” was not well  understood by participants. This may explain their interchanging of held-down emotional states with family secrets and untold stories, although I do not rule out story-making as a means for conveying an emotional state. I was challenged to understand the degree to which the term emotional inexpression may have foreclosed on the phenomenon I sought to study, by predefining the experience. Future qualitative studies exploring related constructs, such as inhibition or suppression could provide valuable comparison or contrast that helps further define these terms, based on how men experience them.  102 Related to this, another limitation was that only dialogal interviews were used. Participants may have found other forms of expression to have more accurately described this experience. For example, employing visual aides, such as pictures of men holding back emotions, or men in movies holding their emotions down, may have helped participants to grasp the phenomenon more clearly. Alternatively, using a narrative approach, with written vignettes of emotional inexpression, may better sensitize participants to the experience sought. Regarding future directions, this study revealed a structure to emotional inexpression that could be studied and tested. For example, the barrier that participants describe between them and their emotions could be explored using qualitative inquiry, or it could be measured as a construct of inhibition. The terror of expression is another structure that could be explored. This invites experiential therapies into research, as studies could examine how exposure to the fear of expressing may cause extinction of this fear in men. Stemming from the link between choice and disability raised in earlier in the discussion, I wonder if the theory of brain plasticity could explain whether emotional inexpression leads to a loss of emotional functioning over time. Future studies could explore brain functioning, perhaps with emerging technological brain imaging, to determine what is happening when men are struggling to identify strongly-felt and proscribed emotions. These images could reveal brain functioning that is similar to other disabilities, and provide concrete evidence to what seems, from the outside, to be a cause-and-effect impact of emotional inexpression; namely men don‟t use it and so they lose it. The Inexpression and the terror of expression theme reveals an interesting perspective on substance abuse in men. Curtin, Patrick, Lang, Cacioppo, and Birbaumer (2001) demonstrated that alcohol dampens anticipatory fear through cognition impairment;  103 combining this result with the findings of this study suggests that men only show emotions when they are drinking because their fear of expressing is cognitively inhibited by alcohol. Future studies could examine the link between alcohol consumption, the expression of emotions, cognitive processes during strongly-felt moments, and the degree to which fear of emotional expression is mitigated by drinking. Finally, Levant (1998) described the emotional socialization of boys being the most visible aspect of an inherently traumatic process. Future studies could explore not only how emotional inexpression is taught as relational trauma, but whether qualitative interviewing of participants has a salutary effect on trauma symptoms of emotional socialization. Participants in this study anecdotally said that this was the case for them, that the very act of interviewing them led to awareness, change and even improvements in their lives. All participants stated that the transcribed interview was a valuable, historical document for them, which indicates an unintended windfall from their participation and this methodology. 5.7  Conclusion The 6 men who participated in this study did what I consider to be intrepid work, by  revisiting the lived experience of what I believe was a powerful relational trauma. I found support in my belief that emotional inexpression is not something that men do because “we are just men”. I agree with one participant, who said that emotional inexpression an act of self-preservation. Strong emotions arising in men may not actually kill us, but it feels deadly serious. I believe that anyone who truly wants to understand men and their emotions must first come to this serious place.  104 References Addis, M. 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Psychology of Men & Masculinity, 7(2), 113-126.  113 Appendices Appendix A Recruitment flyer  114  Appendix B Recruitment website  115 Appendix C Consent form Department of Educational and Counselling Psychology, and Special Education  Chokin’ it down: Men’s Experience of Emotional Inexpression Consent Form Principal Investigator: Dr. Marv Westwood, Department of Educational and Counselling Psychology, the University of British Columbia. Co-Investigator: Stu Hoover, Masters student in the Department of Educational and Counselling Psychology, the University of British Columbia. Problem: Emotional inexpressiveness is considered a problem by a majority of clinicians and researchers who study men, but no study has been conducted to understand men‟s experience of being emotionally inexpressive. Purpose: The purpose of this study is to fill a gap in the literature regarding our understanding of emotional inexpression in men. The phenomenon I am seeking to understand is men’s experience of maintaining emotional inexpression during a strongly felt emotional moment. Another way to state this is the lived experience of men choking down their emotions. To address this problem, I pose the questions: What are men’s experiences of being emotionally inexpressive? When men become aware of strong emotions that are proscribed to them, what do they experience in maintaining a stoic, expressionless stance to themselves and the world? This study will contribute towards a master’s thesis, which will be a public document. Study procedures: If you agree to participate in this project, you will be invited to take part in 2 interviews at a location that ensures your confidentiality. The total time commitment to participate in this study is a maximum of 4 hours over a 1-2 week period. If you are interested in participating, I will send you this consent form and provide you 24 hours to read it and formulate questions before asking for your participation. We will arrange a time and confidential location to meet for a maximum of 2 hours. In this first meeting, I will read and explain this consent form to you and answer all questions you have about it. We will then spend up to 90 minutes completing the interview. This interview will be audio recorded, and I will ask specific questions about your experiences of maintaining emotional inexpression during a strongly felt emotional moment. I will be seeking your concrete descriptions of your experiences and will remain non-judgmental of your values, beliefs or meanings of the events. My goal is to accurately understand your  116 experiences of this phenomenon. Finally, we will take 5 minutes to arrange our follow up interview, and for me to explain how you can take written notes of thoughts or descriptions that arise between our meetings if you choose, and bring them to discuss. I will also ask if you agree to receive the full transcription of our first interview plus my thematic analysis of your experiences, either electronically or by mail. I will also ensure that you can receive these documents confidentially. Between our meetings, and at least 24 hours before our second meeting, I will send you the full transcription of our first interview plus my thematic analysis of your experiences. You may review the transcript and analysis and prepare any questions or comments that arise for us to discuss at the second meeting. Our second meeting will begin with a renewal of this consent form and answering any questions you have. We will then spend up to 45 minutes reviewing and validating my thematic analysis of the first interview. I seek your agreement, or corrections, to my interpretations and themes. You are free to question or disagree with what I have provided. This will be audio recorded in case our discussion leads to new descriptions of your experiences. Following this validation of my analysis, we will spend up to 45 minutes discussing anything you wrote down or recalled between our meetings that you feel helps further describe your experiences. After this, the study will end, and I will provide you with an honorarium as thanks for your participation. This is a gift card for $25 to either Tim Hortons, Starbucks coffee, or Chapters/Indigo books. Potential Risks: There is the possibility of: a) Some level of anxiety at describing your personal stories and emotions. b) Some negative emotions while revisiting potentially painful experiences or memories c) Unexpected negative emotions from sharing something you have rarely or never discussed. d) Discomfort due to new insights or understandings about past events while engaged in discussion. e) Seeing significant events or people in your life in a negative way after reexperiencing the event and related emotions. f) Anxiety during the research interview due to sharing your experience. To minimize these risks, I will ensure that you have complete control and discretion over what material you share. Your comfort and safety as a participant is my primary concern. If at any point you start to feel uncomfortable, you may tell me so, or just say “pass”, and I will  117 understand that you want to pause or stop the interview. I will also pay attention to levels of intimacy, and any discomfort I notice in you and will check on your willingness to proceed at such times. Should any intense emotions arise during the interview, I commit to debrief these with you, or should you want to continue to explore issues that arose from your participation, I will provide you with a handout at the beginning of the study that includes information about counselling services in your community. Your confidentiality will be protected with the utmost care. Only the principal investigator and co-investigator will have access to audio-recorded interviews and transcripts and this data will be password protected and kept in a locked filing cabinet in the principal investigator’s office in the Neville Scarfe Education building on the UBC campus. You will choose a pseudonym to be used to identify the transcripts and to be used in the written report of findings and no identifying information will included in the written report. Potential Benefits: Potential benefits include: a) A greater understanding of how you express your emotions. b) Gaining a sense of acceptance and understanding of your past; c) A new perspective of significant events that you discuss. d) Increased comfort expressing previously proscribed or forbidden emotional states. e) Therapeutic benefit from having been listened and attended to without judgment. f) Gaining a sense of knowing yourself better Confidentiality: Your participation in the research interview will be recorded and retained by me, and participants will not be identified by name in any reports of the completed study. The results of this study will become a public document in the form of a master’s thesis. You are welcome to view your own digital audio-file or interview transcript and may request this of the co-investigator who will give you access to only your own data.  118 Consent: Your participation in this project is entirely voluntary and you may refuse to participate or withdraw from the study at any time until the study is completed. If you have any concerns about your treatment or rights as a research participant, you may contact the Research Subject Information Line in the UBC Office of Research Services (604.822.8598) or if long distance (RSIL@ors.ubc.ca). Your signature indicates that you consent to participate in this project. Your signature below also indicates that you have received a copy of this consent form for your own records  _______________________________________________________________________ Participant Signature  Date  _______________________________________________________________________ Printed Name of the Participant  (_____)___________________________________________________ Telephone  _______________________________________________________________________ E-Mail &/or Mailing Address  □ Check if you would like a copy of a report on the findings, ensure you have provided me an e-mail or mailing address.  119 Appendix D Demographics form  THE UNIVERSITY OF BRITISH COLUMBIA Department of Educational and Counselling Psychology, and Special Education 2125 Main Mall Vancouver, BC, Canada, V6T 1Z4 Tel: (604) 822-9223 Fax: (604) 822-3302 “Chokin’ it down”: Men’s experience of emotional inexpression Participant Demographics Information Sheet  Pseudonym: Age:  Birth Month:  Birth Year:  What is your primary occupation? ______________________________________________  What is your primary ethnic/racial/cultural background? (please check one box only):  (note: Please do not record nationality, such as “Canadian”, for this question.)  120 Marital Status (place a check in the appropriate box): -law – never married  Sexual Orientation: _____________________________________ What is the highest level of education you have obtained? Less than high school High school graduate Some college/university, but no degree College/university graduate (received degree) Graduate/professional studies Trades program Other: (please specify: ______________________________________________) Study Title: “Chokin’ it down”: Men’s experience of emotional inexpression Principal Investigator: Dr. Marvin Westwood, Professor in the Dept. of Educational and Counselling Psychology, and Special Education, UBC. Co-investigator: Stu Hoover, Dept. of Educational and Counselling Psychology, and Special Education, UBC.  121 Appendix E Referral list of community resource services Study: Chokin’ it down: Men’s Experience of Emotional Inexpression If you find you are experiencing strong emotions or negative moods, sadness, or depression and you would like to know more about these issues or if you would like to speak with someone to discuss emotional issues, the following is a list of resources that are available in the greater Vancouver area as well as on-line: 1) Mental Health Services (Free Services) -- Vancouver --------------604-675-3898 -- Fraser Health -------604-514-7940 -- New Westminster ------604-777-6800 -- TriCities ------------604-777-8400 -- Maple Ridge-------------604-467-6034 -- SFU Surrey ---------604-587-7320 -- UBC New West Clinic-604-525-6651 -- UBC Vancouver ---604-822-3811 2) Sliding fee scale Counselling -- Family Services of Greater Vancouver 604-731-4951 1616 West 7th, Vancouver -- Jewish Family Service Agency 604-257-5151 950 West 41st, Vancouver 3) Vancouver Health Initiative for Gay Men (604) 488-1001 http://checkhimout.ca/about 4) Referrals/Information -- B.C. Association of Clinical Counsellors 1-800-909-6303 www.bc-counsellors.org -- British Columbia Psychological Association 604-730-0522 http://www.psychologists.bc.ca/drupal/find_psychologist_full For immediate assistance: 1) Crisis Centre 604-872-3311 or 1-800-784-2433 24 hour distress line www.crisiscentre.bc.ca 2) Mental Health Emergency (BC Healthlink) 604-874-7307 24 hour Services http://www.healthlinkbc.ca Online Resources: Canadian Mental Health Association (BC) http://www.cmha.bc.ca “Here to help”: Mental health information (BC) http://www.heretohelp.bc.ca Internet search terms you can try: “men” + “emotion”, “suppression”, “inhibition”, “expression” Books: Hollis, J. (1994). Under Saturn's shadow: The wounding and healing of men. Inner City Books. Corneau, Guy. (1991). Absent Fathers, Lost Sons. Trans. Larry Shouldice. Shambhala.  122 Appendix F Interview orienting statements Interview #1 Preliminary        Describe study including interview procedures Ask participant to hear the four criteria without answering o You are an adult man, aged 30-65 years o You can speak English proficiently o You do not have a psychological illness o You are not currently undergoing any big emotional ordeals at this time (e.g. very recent loss, divorce, etc.) Ask them if they can say yes to all four or no to one or more of the four Explain consent & get signature from participant Administer demographic questionnaire  Warm up “As I mentioned in the consent form, I will be audio-recording our conversation to make sure I have accurate records of what is going on. I‟ll just turn on the equipment now” Rapport-building: Ease into the process with questions / comments related to weather, how they came to find out about the study, finding the interview space, etc. Principle Research Questions – Keep these in mind during interview What are men‟s experiences of being emotionally inexpressive? When men become aware of strong emotions that are proscribed to them, what do they experience in maintaining a stoic, expressionless stance to themselves and the world? Renew Consent before starting the interview So before we begin, I want to revisit the consent and make sure you are comfortable with proceeding with the interview and that you know you can stop the interview at any time without having to explain anything to me. Principle Interview Orienting Statements a) “Think of a time when you were aware of a strong emotional reaction in you.” b) “Think of a time when you were aware of a strong emotional reaction in you and you were also aware of yourself holding it in or holding it down inside you to remain neutral or inexpressive.” If participants cannot think of a specific concrete example to describe the phenomenon c) “Think of a time you witnessed a man choking down his emotions. Describe what you saw in detail.”  123 Clarifying questions   Describe the details of the setting/people/season or anything/anyone you remember vividly.  What are all the details you remember? Any impactful details?  Who was there, what did you notice about them that you find significant?  Describe what you recall thinking/feeling/doing as you were holding it down?  What places in your body were you aware of during this moment?  What was the dominant reaction in you as you held down this emotion (e.g. fear, anger, sadness, numbness)  What was your goal (trying to do) during those moments?  What do you think others were trying to do in those moments? *Make sure you get EMOTIONAL, BEHAVIOURAL AND SOMATIC reactions, not just cognitions* Closing out Thank you for your time. I need about a week to transcribe and analyze the interview. For our second interview, I would like to check my results with you to ensure I got your experience right. Can I send you a copy of the transcript and my results ahead of our next interview? This gives you time to review them before we meet. [Ensure it’s a confidential email or address] Interview #2 Preliminary   Renew consent & answer questions from participant.  Validation of Analysis I want you to go through the statements I pulled from our interview and check whether the themes I gathered them into makes sense of your experience. If something jumps out at you as wrong, please say something. Review of written material (if applicable) Termination of Study Thank you for your participation. I have a gift card for you. Would you like to receive the final report when it‟s finished?  124 Appendix G Transcription procedures Summary: I want to capture the pace of speech, as it goes faster or slower. I believe this is an indicator of the participant being in an anxious state versus a more reflective and relaxed state. I wonder if the former arises as the participant struggles to name or disclose a difficult truth, and the latter arises after he has done so, and sees himself/is seen, and feels more relaxed within himself for deeper reflection. “” – I use quotation marks when the participant talks in the third person, capturing what someone else said, or things he said to himself. The quotes capture the participant giving evidence of what was actually said. This arose often for some participants, as they used direct quotes to get their points across, or provide examples to their stories. <> – I used inequality brackets to indicate non-verbal signs, such as pauses, tone, pace, shifting, pointing, laughing. I CAPITALIZED text that was suddenly louder. I italicized text that was said with more meaning, such as more slowly, or with eye contact. If the participant was indicating that word or words was particularly important. [] – I used square brackets around my analytic notes that came up during the listening and transcribing. () – I used round brackets to incorporate anything the other person said in the midst of either myself or the participant speaking. Examples include prompts or indications of understanding by me, or short agreements by the participant to my paraphrasing. Larger or more meaningful interruptions or clarifying breaks had a hard return. XXX – I used XXX for unintelligible syllables. I eliminated text that was repeated, unless the repetition was used by the speaker to make a point. I eliminated sentence stems that the speaker gave up on, because they were thinking about how to start the sentence. For example, if the speaker begins talking about general people‟s reactions, such as “You know, people…”, but then switches to “For me …”, then I eliminated the first part, as it only confuses the transcription, and reveals nothing more than the speaker talking through their thoughts. If they said more than a few words and switched, I would keep everything, in case the first part had some evidence in it. I eliminated “you know”, and “like”, unless they seemed necessary to the point the speaker was making. For example, if the speaker says: I‟m like, “hell, yeah!”, then I would keep the „like‟, because it reveals that the speaker is saying something to himself, and explains the use of quotations.  

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