Male Discourses of Anxiety and Help-Seeking in an Online Discussion Forum

Abstract

This dissertation presents a qualitative analysis of men’s accounts of their experiences of living with anxiety and seeking help for that anxiety within posts to an online discussion forum. It is widely acknowledged that, while men are less likely to seek help for mental health conditions such as anxiety, they are also 3-4 times more likely to die by suicide. Statistics such as these have led many to describe the state of men’s mental health as a silent crisis. The difficulties associated with diagnosing and treating men with mental health disorders might well be exacerbated in the case of anxiety disorders. Such disorders are more likely to be viewed as a personal weakness rather than a legitimate illness when compared to other mental health conditions. Further, masculine social norms confer an expectation that men exhibit good health. It has also been argued that hegemonic masculine norms are not conducive to seeking help for mental health conditions. The culmination of these factors means men may face particular challenges in talking about and seeking help for their anxiety. Indeed, even though anxiety disorders are the most common mental health disorders amongst Australian men, men’s anxiety has been argued to be under-researched and poorly understood. The data analysed within the present dissertation consist of posts collected from a publicly accessible Australian anxiety online discussion forum. Online discussion forums have been argued to have particular value for men, who are typically less likely than women to seek help in traditional face-to-face mental health settings, particularly for sensitive health-related issues. Online discussion forums also offer researchers an opportunity to investigate how mental health-related supportive interactions between peers unfold. Such forums allow researchers to gather data from sources that exist independent of researcher involvement to investigate how people understand their mental health issues. The studies presented in the four analytical chapters of this dissertation explore how men construct their experiences of anxiety and account for their support seeking practices in the context of that anxiety. The analyses in this dissertation employ a range of qualitative methodologies, informed by a social constructionist epistemology. Study one employs thematic analysis, informed by principles of discursive psychology, to examine how men’s accounts of their anxiety attend to issues of authenticity, and the types of support that men appear to be seeking online. Posters work hard to construct themselves as authentically anxious, and by doing so, claim some entitlement to request support from a community of individuals who have also experienced anxiety. Study two utilises a discursive psychological approach, informed by principles of membership categorisation analysis, to examine how men describe the source of their anxiety. The analysis describes how men’s descriptions of the source of their anxiety should be understood as culturally bound and related to expectations and obligations associated with their social context and category memberships. Study three takes a thematic analysis approach, informed by principles of discursive psychology, to examine how men describe the lived experience of anxiety. The analysis shows how anxiety was constructed as a series of out-of-control emotional and physical states, over which the men hoped to regain control. Findings additionally show how the self-punitive constructions that men use to describe their distress are associated with these experiences of a loss of control. The findings of this study have implications for understanding suicide in the context of anxiety, as well as the value of various interventions for treating anxiety in men. Study four uses discursive psychology to examine men how accounted for engaging in troubles-telling about their anxiety, a stereotypically ‘feminine’ activity. Such an approach enables the analysis to capture the complex, inconsistent, and contradictory accounts of anxiety and masculinity. In particular, discursive psychology enables me to demonstrate how issues of masculinity and anxiety are organised around ideological dilemmas. Findings demonstrate how men reproduced hegemonic masculine ideals of strength, self-reliance and emotional stoicism in the face of adversity, while simultaneously making aspects of their emotional lives visible to the online community. In the concluding chapter, the implications of the results are discussed. Specifically, I consider how the findings from the four studies (two published and two under review at the time of final submission) are relevant to understanding the particular challenges of being a man with anxiety. I also discuss implications for understanding masculinity and help-seeking in the context of anxiety. By enhancing our understandings of how men describe their experiences of living with, and seeking help for anxiety, this research offers valuable insight into improving understandings of men’s experiences of anxiety as well as how researchers and clinicians alike might work to facilitate more effective support services for men. The findings also offer valuable contributions to qualitative research more broadly, particularly concerning the value of collecting and analysing naturalistic data.