Defining Health

1. Men’s Health and Sexuality An “Adaptation” ApproachDr. Brian ScottScott Psychological ServicesNgee Ann Citywww.scottpsychologicalservices.com

2. Defining Health • Health - absence of illness, disease, disability. • Health - state of intense well-being (energy, enthusiasm, self-actualized). • Health - not just physical but also mental, social, and spiritual components

3. Definition of “to adapt” • Latin ad – “to”, and aptus - “fit” (apt=suitable). To become adjusted to new conditions. • “It is not the strongest of the species that survives, nor the most intelligent, but rather the one most responsive to change.” (Unable to verify but often attributed to Darwin.) • E.g. Stephen Hawking, black holes, origins of the universe, has amyotrophic lateral sclerosis. Recently, first person with disability to float in zero gravity.

4. Examples of life stressors that require us to adapt in order to maintain our health • medical problems which can arise at any age e.g. Arthritis, erectile dysfunction. • losses, failures, weakness/deficits, E.g. Not being promoted, death of a loved one. • aging and the associated changes (any mental decline, possible sagging body, decreased libido) and • our mortality.

5. How man can adapt to health/aging problems • Physically • Eat healthy meals regularly • Balance of rest and exercise • Recent research shows that exercise doesn’t have to be vigorous; moderate exercise is very beneficial • Mentally or Psychologically • Develop adaptive beliefs, empowering, positive attitudes and beliefs • Get mental stimulation • Socially • Have a positive support group • Spiritually • Develop a spiritual program: meditation, Yoga, Religion

6. Psychological difficulties can prevent adaptive responding • Many times our automatic psychological responses are inappropriate e.g.emotions such as denial, anger, depression. We tend to try to change the outside world than our own cognitions/behaviours e.g. blaming others. • Overly simplistic assumption of causation. Usually a medical or psychological problem is caused by an interaction of several factors. • Maladaptive beliefs which interfere with adapting e.g. Beliefs about what it means to be a man.

7. Complex causation: e.g. erectile dysfunction caused by one factor, several factors , or interaction of factors. • Biologicaal • Age-related changes such as decreased blood flow or nerve damage • Medical problems e.g. diabetes, alcoholism • Psychological • Performance anxiety • Behavioural • obesity increases risk by 90% • Smoking increases risk by 50%

8. Stereotypical beliefs about masculinity which interfere with adaptation. • Strong and independent. • Competitive, attain, and maintain top rank, power, a position of respect • Avoid seeking help from others e.g. Do not seek help for psychological, medical problems • Avoid showing emotions outwardly • Ideal attractive male is “young, handsome, muscular”

9. Good and Brooks (2005) in New Handbook of Psychotherapy and Counseling with Men” Eds. Glen E Good& Gary R. Brooks.p. 3 state: • “The paradox of modern masculinity is that regardless of a man’s accomplishments or successes, he is, in some maddening ways, continually driven to new accomplishments-it is never enough. He may be fixated on overtaking the men above him on the various hierarchical ladders of achievement and also horrified at the prospect of being overtaken by other men hell-bent on moving up the same ladder.”

10. Competition among men • George Bernard Shaw, on opening night of his play Pygmalion, sent telegram to Winston Churchill: "Am reserving two tickets for you for my premiere. Come and bring a friend -- if you have one." • Churchill, wired back: “Impossible to be present for the first performance. Will attend the second -- if there is one."

11. How male stereotype beliefs may interfere with adaptation to medical problems or aging.

12. There are powerful and yet subtle factors which create and maintain these stereotypical male characteristics. • Genetic/Evolutionary: Being competitive, independent, not showing emotion were adaptive in our ancestral hunter gatherer groups but many times not in modern society. • Developmental: From birth on we are socialized into male stereotype. • Marketing and culture: Superheroes in comic books over last five decades has gone from the Greek ideal to steroid enhanced muscles.

13. Marketing of a new male stereotype

14. Marketing of a new male stereotype

15. Are the obvious signs of aging related to longevity? • Danish study published in 1998 in The Journals of Gerontology showed that balding, wrinkles, and gray hair are not linked to longevity.

16. How man can adapt to health/aging problems • Physically • Eat healthy meals regularly • Balance of rest and exercise • Mentally • Develop adaptive, empowering, positive attitudes and beliefs • Get mental stimulation • Socially • Have a positive support group • Spiritually • Develop a spiritual program: meditation, Yoga, Religion

17. Adapt physically: developing a physical fitness program right for you • There are over 22 research studies disproving the widely held belief that ONLY VERY VIGOROUS exercise can provide health benefits. • “Moderate exercise: No pain, big gains” Harvard Men's Health Watch, May 2007

18. Recent studies showing highly significant benefits of moderate exercise/daily activities: Simon, HB, The No Sweat Exercise Plan: Lose Weight, Get Healthy, and Live Longer (New York: McGraw-Hill, 2006).

19. Recent studies showing highly significant benefits of moderate exercise/daily activities: Simon, HB, The No Sweat Exercise Plan: Lose Weight, Get Healthy, and Live Longer (New York: McGraw-Hill, 2006).

20. Cardiometabolic exercise points for selected activities; for general health aim for 150 points a day or about 1,000 points a week.(Simon 2006)

21. Cardiometabolic exercise points for selected activities. For general health aim for 150 points a day or about 1,000 points a week.

22. Exercise has sexual benefits • A 2006 study from Sweden reported that regular exercise e.g. running is associated with a reduced risk of moderate and severe symptoms of benign prostatic hyperplasia (BPH). • A Harvard study, linked 30 min of walking per day to a 41% reduction in the risk of erectile dysfunction. • A randomized clinical trial (2004) reported that moderate exercise (averaging less than 28 minutes a day) can help restore sexual performance in obese, middle-aged men with erectile dysfunction.

23. Evidence that frequent sex has health benefits • A Harvard study showed that compared to men who reported 4–7 ejaculations per month across their lifetimes, men who ejaculated 21 or more times a month enjoyed a 31% lower risk of prostate cancer. • This result was supported by similar results in an Australian study • (Harvard Men's Health Watch, December 2005)

24. How man can adapt to health/aging problems • Physically • Eat healthy meals regularly • Balance of rest and exercise • Recent research shows that exercise doesn’t have to be vigorous; moderate exercise is very beneficial • Mentally • Get mental stimulation • Develop adaptive, empowering, positive attitudes and beliefs • Socially • Have a positive support group • Spiritually • Develop a spiritual program: meditation, Yoga, Religion

25. Adapt mentally: Exercise your mind • More than 2,000 years ago, the Roman orator Cicero observed, “Old men retain their mental facilities, provided their interest and application continue.” • Get mental stimulation through • Computer games • Sports • Crossword puzzles

26. Think postive: Your beliefs and attitudes can profoundly affect your longevity • Study conducted in 2002, on 338 men and 322 women aged 50 and older found evidence of the importance of positive attitudes towards aging. • Journal of Personality and Social Psychology, 83 (2): pp 261-270. A premier journal.

27. Positive self-perceptions of aging included statements such as: • “I have as much pep as I did last year,” • “I am as happy now as I was when I was younger,” • “As I get older, things are better than I thought they would be.” • My life is full. I feel hopeful. Life is worthwhile. • Lived average of 7.5 years longer.

29. How man can adapt to health/aging problems • Physically • Eat healthy meals regularly • Balance of rest and exercise • Recent research shows that exercise doesn’t have to be vigorous; moderate exercise is very beneficial • Mentally • Develop empowering attitude, positive attitudes, beliefs • Get mental stimulation • Socially • Have a positive support group • Spiritually • Religion, Yoga, meditation,

30. A strong positive social support group correlates with: • lower blood pressure • longer life expectancy • decreased risk of heart attacks. • reduction (42% in one study) in the risk of dementia.

31. Join a group: Don’t isolate Many men seem to be very insular, perhaps because of the masculine stereotype. • Join an activity group/club e.g. exercise group for older men at YMCA • Join a support group or a self help group e.g. for men who have survived prostate cancer, eg for bereaved older men. • Group helping others e.g. Good Samaritans

32. How man can adapt to health/aging problems • Physically • Eat healthy meals regularly • Balance of rest and exercise • Recent research shows that exercise doesn’t have to be vigorous; moderate exercise is very beneficial • Mentally • Develop adaptive, empowering, positive attitudes and beliefs • Get mental stimulation • Socially • Have a positive support group • Spiritually • Develop a spiritual program: meditation, Yoga, Religion

33. Adapt spiritually • Meditation (abundant research from Herbert Benson and others of benefits of daily meditation) • Yoga • Religious

34. Health, sex, and a balanced life • Hippocrates 2,400 years ago said “If we could give every individual the right amount of nourishment and exercise, not too little and not too much, we would have found the safest way to health.” • Modern research shows the health benefits of a balance of moderate exercise, relaxation, sleep, food intake, sexual activity, group membership, and spirituality.