The Male Menopause

A recent episode of ‘Women’s Hour’ on BBC Radio 4 provided a rare opportunity to hear men discussing their emotional lives, and a chance to recapitulate some of the thorny old issues of the relation between ‘mind’ and ‘body’.

It was a programme about the ‘male menopause’, a medical condition all the more intriguing because nobody was entirely sure whether it exists. In its non-medical incarnation it is the well known ‘mid-life crisis’.

It seems that many middle-aged men complain of various distressing symptoms – cold sweats, hot flushes, sleep disturbance, tiredness, impotence and loss of sexual desire, a general lowering of the zest for life – which seem to parallel symptoms of the menopause in women. In some cases this can be controlled by hormone replacement therapy using testosterone. A number of men phoned the programme to explain what they had suffered and the struggle they went through to find a doctor to take it seriously. Was it a physical condition (hence the hormone therapy), or was it only ‘in the mind’?

Recent findings have shown the complex interaction of mind and body. A shout of ‘Fire’ in a theatre will produce hormonal and behavioural changes in members of the audience. They will experience a rush of adrenalin as they scramble from their seats. Testosterone levels in spectators at a football match are known to be depleted or increased depending on whether the supported team has won or lost. Cortisol levels are increased in a toddler whose mother has unexpectedly left the room. Adolescents watch horror films for their physical effects rather than intellectual content. And involuntary ideas can pop into our minds to cause similar bodily experiences.

In the programme itself, I heard no mention that ‘the mind’ can have a profound effect on hormone levels in the body, or indeed that the psychological can be ‘real’. Testament was frequently followed by testimonial as stories which began with a litany of symptoms were brought to conclusion by a miracle cure. At one point a man phoned in to advocate the healing properties of the written word. He had all the symptoms and felt seriously ill. In desperation he paid for a private consultation and was issued with a full written report which gave him a clean bill of health . From that moment he was cured.

Freud would not have decried the efficacy of this cure (he wrote about such things in his 1905 paper ‘Mental Treatment’), but he might have asked himself how it came about. Perhaps I should add that I, too, am of an age when I look at the adverts for private health checks and my hand automatically reaches for a pen to write down the contact number.

One striking thing about the programme was the tone of the discourse. It was presented as ‘men talking about their feelings’, and the sympathetic voices of the presenter and studio experts reinforced the specialness of the occasion. Each person mentioned some life event that was associated with the onset of symptoms: retirement, threat of redundancy, marital breakdown and so on. Along with the description of symptoms, this gave the programme its semblance of candour, since each man was presented as a wounded soul, subject to the slings and arrows of outrageous fortune, rather than being the master of events. Interestingly enough there was no mention of the death of a parent as one of the precipitating causes, although fear of death was hinted at, if not openly acknowledged, in the constant worries about general health.

What the discussion avoided, in all its supposed candour, was any idea that ‘the psychological’ is WHAT’S INSIDE YOUR HEAD – the thoughts, fears and phantasies that you might have cascading through your brain when you wake up in the middle of the night in a sweat – rather than the stresses and life events that these men were quite willing to ‘own up to’.

With all the aura of the confessional mode, as if we were privy to an intimate exposure, what was being revealed were the most mundane commonplaces of life. The fact that it was indeed unusual to find men publicly admitting that they are not always completely in control of themselves shows just how much further we have to go to achieve some acceptance of the proper realm of psychology in our daily lives.

Freud realised how difficult it was for people to reveal what is inside their minds. That is why he invented the ‘fundamental rule’ of analysis: say anything that comes into your mind. Tracing phantasy life back to the phenomenon of children’s play, he says the following:

“People’s phantasies are less easy to observe than the play of children. The child, it is true, plays by himself or forms a closed psychical system with other children for the purposes of a game; but even though he may not play his game in front of the grown-ups, he does not, on the other hand, conceal it from them. The adult, on the contrary, is ashamed of his phantasies, and hides them from other people. He cherishes his phantasies as his most intimate possessions, and as a rule he would rather confess his misdeeds than tell anyone his phantasies….

“A child’s play is determined by wishes: in point of fact by a single wish – one that helps in his upbringing – the wish to be big and grown up. He is always playing at being ‘grown up’, and in his games he imitates what he knows about the lives of his elders. He has no reason to conceal this wish. With the adult, the case is different. On the one hand, he knows that he is expected not to go on playing or phantasying any longer, but to act in the real world; on the other hand, some of the wishes which give rise to his phantasies are of a kind that it is essential to conceal. Thus he is ashamed of his phantasies as being childish and as being unpermissable.”

‘Creative writers and Daydreaming’ (1908)

Schools discussion topics

What kind of thoughts might a middle-aged man wake up with in the middle of the night?

How might these thoughts be connected to the symptoms of the ‘male menopause’?

What childhood situations and ideas might these adult thoughts be related to?

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