A study of help-seeking behaviours, masculinity, and the autonomous application of emerging health strategies.
Why are men choosing psychedelics to help improve their mental health and wellbeing, over methods like talk therapy? How can existing services adjust? This research project accompanies my study on the MSc Psychedelics: Mind, Medicine and Culture postgrad degree course at The University of Exeter, UK.
According to academic studies women use, and benefit from, talk therapy services far more than men (with notable exceptions). For example: 44.8% of Australian men quit therapy within 1–4 sessions and never return (Spendelow, 2015; Hill, 2015). More men engage with talk therapy than ever before, but they remain cautious and unmotivated (Good & Robertson, 2010; Sierra Hernandez, 2014).
APA professional psychotherapeutic guidelines for men and boys (2018) fail both science and help-seekers, according to Ferguson (2018) who claims the male APA framework focuses on masculinity as a social construct alienating men with diverse identities in particular (Smith et al, 2022; Springer, 2023).
Men claim to be equally aware of mindfulness programs – known to enhance a sense of spirituality – as women are (Simonsson et al 2020). But more men leave mindfulness programs before completion (Landau & Jones 2021), plus men benefit less overall (Ford et al, 2020).
Conversely, media reports claim men are seeking to address spiritual needs (Men's Health, 2020; The Guardian, 2022; NHS, 2022; THEOS, 2022). In contrast to both talk therapy and mindfulness services, surveys show men are intrigued by psychedelic approaches to mental health and spirituality (EG Palmer and Maynard, 2022). How do psychedelic approaches differ to existing services, and why does that appeal to men?
‘Meaning-making’ is considered key to men's mental health (Brown et al, 2023): it's one of many benefits associated with psychedelic experiences that are also generated by spiritual and religious practices (Hartogsohn, 2018; Park, 2013). Diverse approaches to understanding influential ‘mystical’ psychedelic experiences (Griffiths, 2006; Palitsky et al, 2023) offers potential for outreach to both men, and minority groups who are currently under-represented in both psychedelic trials and mental health services (Kamboj et al, 2015; Sjöstedt-Hughes, 2023).
Female ex-military and emergency service-people quit existing trauma therapies at the same levels as men (Blain et al., 2010) implying core limitations besides any gender bias (Lentz et al, 2021). Feminist psychologists criticise therapeutic narratives, EG demonisation of negative emotions (Yakushko, 2018, 2019a & 2019b), similarly to some male patients (EG Danforth & Wester, 2014; Seidler et al., 2024).
Moral injury involves rupturing of what an individual considers certain, or true (Molendik et al, 2022). Studies show moral injuries arising from, for example, difficult choices misunderstood outside of context, and/or a sustained, perceived, direct or indirect, lack of support, are a key component in cases of post traumatic stress disorder (PTSD). This affects military, emergency services, and other professionals including teachers and leadership (Van Middendorp et al, 2018; Lentz et al, 2021).
Psychedelics show promise for treating PTSD (Mithoefer et al, 2010; Burback et al, 2023). Ontological shock, collapse of psychic reality in psychedelic harm reduction terms (Argyri et al, 2024 & 2025) has similarities to moral injury. Psychedelic communities, however temporary, provide shared spaces to meaningfully explore moral injury, leading to reconstruction of self and meaning in a transformative learning process (Buechner et al, 2020). Traditional indigenous wisdom provides frameworks for new conversations around complex issues contributing to PTSD, such as family and belief system wounds (Healy et al, 2021; Healy, 2021; Vogt, 2013), including ongoing moral injuries.
“Of nine core psychology texts only three mention power – and none money”
Dr. David Smail, Why Therapy Doesn't Work
Men's therapy initiatives lead to stereotyping of men and men's issues (Harding & Fox, 2014). Psychedelics aid confusion around identity and social roles during these ‘liminal times’ (Bhatt & Wiseman, 2024; Roseman et al, 2021). During psychedelic experiences, men can examine ‘rigid, outdated male stereotypes.’ Autonomous identities develop that men find preferable to contemporary, feminised, strategies (Petersen et al, 2022; Springer, 2023).
Emerging spiritualities, including nature-based religions, encourage exploration of diverse masculinities, for better or worse (Feraro, 2022, 2023a & 2023b; Whitehead & Letcher, 2023). Decolonisation initiatives among South African hospital workers led to higher self-reported rates of personal growth and self-knowledge (Matahela & van Rensburg 2023), both associated with improvement in men's wellbeing. Psychedelic decolonisation of the self is a lifelong learning process, where one works toward a personal vision aligning values and relationships (Jooste & Frantz 2017; Shields, 2008).
“For us, there is no spring: just the wind that smells fresh before a storm”
Conan the Barbarian
Men claim clinician-patient power dynamics feel inappropriate (Benakovic et al, 2024). Psychedelics might help by increasingly enhancing therapeutic alliance (Levin et al, 2024; Murphy et al, 2022). ‘Meeting them where they're at’ is an important characteristic of men's group facilitators. Most men lack the emotional literacy required for meaningful talk therapy exchanges, and would benefit from developing communication skills (Stewart et al, 2022). For facilitators, relaying standards and managing interactions provides opportunities to model positive behaviour and encourage vulnerability (Stewart et al, 2022).
Recent group LSD therapy research shows psychological interventions are often required before transpersonal elements can be examined, supporting Grof (2022) and verifying a continuing role for contemporary biomedical services (Oehen & Glasser, 2022).
“Looks like Karen'll be alright. But I'm thinking about the mandem”
Darren 'Le Baron' Springer, Breaking Convention 2023
Openly and successfully advocating for beneficial psychedelic use violates social norms intended to protect the vulnerable and/or less competent (Petersen et al, 2022). Social pressure, not men themselves, continues to insist on capitalist vocations for men and women: men pursuing decolonised lifestyles encounter social othering, even if also satisfying traditional markers of masculinity and success (Petersen et al, 2022).
Emphasis on men's services can be impeded by gender conflict: tailored programs show promise (Cox et al., 2014, Kivari et al, 2016) but wider replication appears elusive (Seidler et al, 2026).
“Chaos gives birth to a new order of greater complexity than before”
Maria Papaspyrou, Femtheogenic Consciousness, 2015
From: Integrating Integration, University of Exeter, 2024
‘What can services learn from men seeking psychedelic treatment?’
More Research
How Psychedelics Help Men Engage with Spirituality →Argyri, E. K., Evans, J., Luke, D., Michael, P., Michelle, K., Rohani-Shukla, C., Suseelan, S., Prideaux, E., McAlpine, R., Murphy-Beiner, A., and Robinson, O., (2024). Navigating Groundlessness: An interview study on dealing with ontological shock and existential distress following psychedelic experiences. SSRN. https://doi.org/10.2139/ssrn.4817368
Addis, M. E., & Mahalik, J. R. (2003). Men, masculinity, and the contexts of help seeking. The American psychologist, 58(1), 5–14.
Benakovic, R., Wilson, M. J., Kealy, D., Rice, S. M., Oliffe, J. L., Sharp, P., & Seidler, Z. E. (2023). Drivers of dropout and enhancers of engagement for male military veterans in therapy: practitioner perspectives. Counselling Psychology Quarterly, 1–20. https://doi.org/10.1080/09515070.2023.2276219
Bevens, C. L., & Loughnan, S. (2019). Insights into men's sexual aggression toward women: Dehumanization and objectification. Sex Roles: A Journal of Research, 81(11-12), 713–730. https://doi.org/10.1007/s11199-019-01024-0
Bhatt, K.V., Weissman, C.R. The effect of psilocybin on empathy and prosocial behavior: a proposed mechanism for enduring antidepressant effects. npj Mental Health Res 3, 7 (2024). https://doi.org/10.1038/s44184-023-00053-8
Brown, T. L., Oliffe, J. L., Kealy, D., Rice, S. M., Seidler, Z. E., & Ogrodniczuk, J. S. (2023). The influence of meaning in life on psychological distress among men. Current Research in Behavioral Sciences, 4, 100114. https://doi.org/10.1016/j.crbeha.2023.100114
Cheadle, T. (2022). A Critical Framework for Masculinities, Sexualities and Esotericism. Correspondences, 10(1).
Cox, D. W. (2014). Gender differences in professional consultation for a mental health concern: A Canadian population study. Canadian Psychology/Psychologie canadienne, 55(2), 68.
Feraro, S., & Feraro, S. (2020). Women and gender issues in British Paganism, 1945–1990. Springer.
Feraro, S., & Doyle White, E. (2019). Magic and Witchery in the Modern West. Springer International Publishing. https://doi.org/10.1007/978-3-030-15549-0
Feraro, S. (2021). A Song of Wood and Water: the ecofeminist turn in 1970s–1980s British Paganism. In Radical Transformations in Minority Religions (pp. 102-117). Routledge.
Feraro, S. (2022). “Penis, Power and Patriarchy”: Troubled Masculinities in British Paganism Set Against the Feminist Challenge of the 1970s and 1980s. Journal for the Study of Esotericism, 11(1).
Ford, C. G., Vowles, K. E., Smith, B. W., & Kinney, A. Y. (2020). Mindfulness and meditative movement interventions for men living with cancer: a meta-analysis. Annals of Behavioral Medicine, 54(5), 360-373.
Ferguson, C. J. (2023). The American psychological Association's practice guidelines for men and boys: Are they hurting rather than helping male mental wellness? New Ideas in Psychology, 68, 100984. https://doi.org/10.1016/j.newideapsych.2022.100984
George, J. R., Michaels, T. I., Sevelius, J., & Williams, M. T. (2020). The psychedelic renaissance and the limitations of a White-dominant medical framework. Journal of Psychedelic Studies, 4(1), 4-15. https://doi.org/10.1556/2054.2019.015
Good, G., & Robertson, J. (2010). To accept a pilot? Addressing men's ambivalence and altering their expectancies about therapy. Psychotherapy, 47, 306-315. https://doi.org/10.1037/a0021162
Green, R.K. (2019). Psychedelic Citizenship and Re-Enchantment: Affective Aesthetics as Political Instantiation. In: A Transatlantic Political Theology of Psychedelic Aesthetics. Palgrave Macmillan. https://doi.org/10.1007/978-3-030-15318-2_6
Griffiths, R. R., Richards, W. A., McCann, U., & Jesse, R. (2006). Psilocybin can occasion mystical-type experiences having substantial and sustained personal meaning and spiritual significance. Psychopharmacology (Berl), 187(3), 268-283. https://doi.org/10.1007/s00213-006-0457-5
Grof, S. (2016). Realms of the human unconscious: Observations from LSD research. Souvenir Press.
Harding, C., & Fox, C. (2015). It's not about “Freudian couches and personality changing drugs.” American Journal of Men's Health, 9(6), 451-463.
Hayes, S. C., Ciarrochi, J., Hofmann, S. G., Chin, F., & Sahdra, B. (2022). Evolving an idionomic approach to processes of change. Behaviour Research and Therapy, 156, 104155. https://doi.org/10.1016/j.brat.2022.104155
Healy, C. J., Lee, K. A., & D'Andrea, W. (2021). Using Psychedelics With Therapeutic Intent Is Associated With Lower Shame and Complex Trauma Symptoms. Chronic Stress, 5. https://doi.org/10.1177/24705470211029881
Healy, C. J. (2021). The acute effects of classic psychedelics on memory in humans. Psychopharmacology, 238(3), 639-653. https://doi.org/10.1007/s00213-020-05756-w
Jones, G.M., Nock, M.K. Race and ethnicity moderate the associations between lifetime psychedelic use and psychological distress. Sci Rep 12, 16976 (2022). https://doi.org/10.1038/s41598-022-18645-3
Jooste, K., & Frantz, J. (2017). Self-leadership traits of academics to conform to a changing higher education environment. African Journal of Health Professions Education, 9(4), 199-202.
Kamboj, S. K., Kilford, E. J., Minchin, S., Moss, A., Lawn, W., Das, R. K., … & Freeman, T. P. (2015). Recreational MDMA and self-focused compassion. Journal of Psychopharmacology, 29(9), 961-970.
Kivari, C. A., Oliffe, J. L., Borgen, W. A., & Westwood, M. J. (2018). No man left behind: Effectively engaging male military veterans in counseling. American Journal of Men's Health, 12(2), 241-251.
Landau, S. D., & Jones, F. W. (2021). Finding the spiritual in the secular: A meta-analysis of changes in spirituality following secular mindfulness-based programs. Mindfulness, 12, 1567-1581.
Lentz, L., Smith-MacDonald, L., Malloy, D., Carleton, R. N., & Bremault-Phillips, S. (2021). Compromised Conscience: A Scoping Review of Moral Injury Among Firefighters, Paramedics, and Police Officers. Frontiers in Psychology, 12, 639781. https://doi.org/10.3389/fpsyg.2021.639781
Levin, A. W., Lancelotta, R., Sepeda, N. D., et al. (2024). The therapeutic alliance between study participants and intervention facilitators is associated with acute effects and clinical outcomes in a psilocybin-assisted therapy trial. PLoS One, 19(3), e0300501. https://doi.org/10.1371/journal.pone.0300501
Mahalik, J. R., Good, G. E., Tager, D., Levant, R. F., & Mackowiak, C. (2012). Developing a taxonomy of helpful and harmful practices for clinical work with boys and men. Journal of Counseling Psychology, 59(4), 591.
Matahela, V. E., & van Rensburg, G. H. (2023). Towards Decolonizing the Self: Nurse Educators' Engagement in Personal Mastery. Creative Nursing, 29(2), 197-203. https://doi.org/10.1177/10784535231195442
Molendijk, T., Verkoren, W., Drogendijk, A., et al. (2022). Contextual dimensions of moral injury: An interdisciplinary review. Military Psychology, 34(6), 742-753. https://doi.org/10.1080/08995605.2022.2035643
Murphy, R., Kettner, H., Zeifman, R., et al. (2022). Therapeutic Alliance and Rapport Modulate Responses to Psilocybin Assisted Therapy for Depression. Frontiers in pharmacology, 12, 788155. https://doi.org/10.3389/fphar.2021.788155
Naghavi M. Global, regional, and national burden of suicide mortality 1990 to 2016: systematic analysis for the Global Burden of Disease Study 2016. BMJ. 2019;364:l94.
NHS (2022). Mental Health and Spirituality: Clinic Building Workforce Competence and Capability Together. Lessons Learnt Report. June 2022.
Nielson, E. M., & Guss, J. (2018). The influence of therapists' first-hand experience with psychedelics on psychedelic-assisted psychotherapy research. Journal of Psychedelic Studies, 2(2), 64-73. https://doi.org/10.1556/2054.2018.009
Oehen P, Gasser P. (2022). Using a MDMA- and LSD-Group Therapy Model in Clinical Practice in Switzerland. Front Psychiatry, 13. https://doi.org/10.3389/fpsyt.2022.863552
Palitsky, R., Kaplan, D. M., Peacock, C., et al. (2023). Importance of Integrating Spiritual, Existential, Religious, and Theological Components in Psychedelic-Assisted Therapies. JAMA Psychiatry, 80(7), 743-749. https://doi.org/10.1001/jamapsychiatry.2023.1554
Palmer, M., & Maynard, O. M. (2022). Are you tripping comfortably? Investigating the relationship between harm reduction and the psychedelic experience. Harm Reduction Journal, 19(1), 81.
Park, N., Park, M., & Peterson, C. (2010). When is the search for meaning related to life satisfaction? Applied Psychology: Health and Well-Being, 2(1), 1-13.
Petersen, M. A., Feldes, S., & Cova, V. S. (2022). Ayahuasca Calling: Sacredness and the Emergence of Shamanic Vocations in Denmark and Peru. Anthropology of Consciousness, 33(2), 255-278. https://doi.org/10.1111/anoc.12165
Rabinowitz, F. (2017). Men's group therapy. In The SAGE Encyclopedia of Psychology and Gender (Vol. 4, pp. 1156-1156). https://doi.org/10.4135/9781483384269
Richards, M. (2011). Gaining perspective: incidents that damage the therapeutic alliance as described by male mental health clients. WWU Graduate School Collection, 186. https://cedar.wwu.edu/wwuet/186
Seidler, Z. E., Rice, S. M., River, J., Oliffe, J. L., & Dhillon, H. M. (2018). Men's Mental Health Services: The Case for a Masculinities Model. The Journal of Men's Studies, 26(1), 92-104. https://doi.org/10.1177/1060826517729406
Self, W. (2020). Why Men Are Seeking Consciousness and Spirituality in 2020. Men's Health UK. https://www.menshealth.com/uk/health/a30712679/spirituality-in-2020/
Shepherd, G., Astbury, E., Cooper, A., et al. (2023). The challenges preventing men from seeking counselling or psychotherapy. Mental Health & Prevention, 31, 200287. https://doi.org/10.1016/j.mhp.2023.200287
Sherwood, H. (2022). Non-religious are hardline, easygoing or spiritual, says UK thinktank. The Guardian, Fri 23 Sep. https://www.theguardian.com/world/2022/sep/23/non-religious-are-either-hardline-easygoing-or-spiritual-says-uk-thinktank
Shields, D. (2008). Leaders' emotional intelligence and discipline of personal mastery. Cardinal Stritch University.
Simonsson, O., Fisher, S., & Martin, M. (2021). Awareness and experience of mindfulness in Britain. Sociological Research Online, 26(4), 833-852.
Sjöstedt-Hughes, P. (2023). On the need for metaphysics in psychedelic therapy and research. Frontiers in Psychology, 14. https://doi.org/10.3389/fpsyg.2023.1128589
Smith, D. T., Faber, S. C., Buchanan, N. T., Foster, D., & Green, L. (2022). The Need for Psychedelic-Assisted Therapy in the Black Community. Frontiers in psychiatry, 12, 774736. https://doi.org/10.3389/fpsyt.2021.774736
Smith, S., & Inhorn, M. C. (2016). Emergent masculinities, men's health and the Movember movement. In Handbook on Gender and Health. Edward Elgar. https://doi.org/10.4337/9781784710866.00040
Spendelow, J. S. (2015). Cognitive–behavioral treatment of depression in men: Tailoring treatment and directions for future research. American Journal of Men's Health, 9(2), 94-102.
Van Middendorp, S., Spann, R., & Buechner, B. (2018). Moral injury on the front lines of truth: Encounters with liminal experience and the transformation of meaning. ResearchGate.
Vogt, D., Smith, B. N., King, L. A., et al. (2013). Deployment risk and resilience inventory-2 (DRRI-2): An updated tool for assessing psychosocial risk and resilience factors among service members and veterans. Journal of Traumatic Stress, 26(6), 710-717.
Waling, A. (2019). Problematising ‘Toxic’ and ‘Healthy’ Masculinity for Addressing Gender Inequalities. Australian Feminist Studies, 34(101), 362–375. https://doi.org/10.1080/08164649.2019.1679021
Whitehead, A., & Letcher, A. (2023). ‘We'll All Dance each Springtime with Jack-in-the-Green’: The ‘Green Man Complex’ in Contemporary British Culture. Journal for the Study of Religion, Nature & Culture, 17(2).