Article published in The Phoenix:

A Journal of Recovery; April, 2001

Twenty-five years ago, I was a senior at Eastern Illinois University and looking forward to going home for Thanksgiving. Although I had distanced myself emotionally from my family, I kept making the effort to connect. The holiday was another chance to do that. Having arrived Tuesday night, I was relaxing on Wednesday. My mom was at work, my sisters at school, it was just me and my dad at home. He was home because the week before he had been hospitalized with a heart attack(his third) and he was still recovering. It was mid afternoon, Dad had told me he was going to take a hot shower. I was looking for a tool to fix a couple things around the house. This was the normal way things went when I came to visit. Broken things would be left for me to fix, giving my folks time to do other things and giving me a chance to prove my worth in a small way. I couldn't find the tool and went looking for my dad to ask him where it was. I found him, beyond answering my question, dead on the bathroom floor. The cause of death was heart disease, I'll spare you the specifics.

In the years since I have struggled with many questions. One is why did my dad die so young? He was only 56! Another is why did he tell me so little about his pain and struggle? A third question is what can I do to prevent heart disease in myself, given that my dad and both of his brothers had it and I am at considerable genetic risk? These are questions I intend to address for the rest of this article.

Addressing the first question: With the information I have been able to gather, it's a testament to his constitution and his one-time levelof physical fitness that my dad lived as long as he did. He went from being a champion athlete in high school and two-letter performer (football and track) in college to the Marine Corps in 1942. Like so many young men, he wanted to do his part in the war. He came back with a classic case of post-traumatic stress disorder (my opinion based on his lifelong behavior) and malaria. A man who weighed 235 lbs in boot camp dropped down to 155 lbs by the time of his discharge. He told of constantly feeling like a tire with most of its air let out. Malaria does these things to a man. He weighed 265 lbs (most of it fat) when he died. He did that to himself. In addition to eating excessively, dad smoked two packs of cigarettes a day, never exercised, drank at least a six-pack every night after supper, and lacked close friends. He isolated and self-medicated himself to death.

That aforementioned isolation is a primary symptom of post-traumatic stress disorder and a common characteristic of being male in this country. He told me so little about his pain because we were both male and he was undoubtedly afraid to let me see his weakness. He may have believed I could not understand or he may have thought he was protecting me from something that was too big for me to handle. I prefer that he would have told me why he was withholding his truth and then let me choose whether I wanted to hear it. As it was, I could sense the distance between us and lacked the skills to bridge it.

As I have recently learned, many of the things my dad did in his later years were signs of male menopause. Yes, you read right, male menopause, also called mid-life crisis, andropause (andro being Greek for man), or male mid-life passage (the term I prefer and will use from here on out). The intense self-questioning that accompanies this mid-life passage leads to withdrawal from others, attempts to live out unrealized dreams (think affairs with younger women and red sports cars), depression, self-medication, and erectile dysfunction (think limp). Some men experience hot flashes, night sweats, or difficulty sleeping. I have described some of the aspects of this "crisis" from the perspective of a man experiencing it. What do people in that man's life see? They find him to be short-tempered and defensive. He may pull away from his regular means of support, quit his job, decline a promotion, divorce a woman he has been married to for many years, develop a drinking problem or engage in some other chemical abuse, engage in an affair with a woman or man (many married gay men finally act upon long suppressed desires during this time), suddenly put on weight by overeating, unexpectedly devote obsessive attention to his physical appearance through exercise or dieting, or behave recklessly while driving. The key words here are suddenly and unexpectedly.

The foregoing lists some of the the destructive behaviors of a man in midlife. There are constructive behaviors, too. He may sober up, begin an exercise program, get out of an unhealthy marriage, come out of the closet, leave an oppressive job, start his own business, require more authenticity from those around him than he had before, move on from people in his life who held him back (a recent bumper-sticker sighting: THOSE WHO HAVE ABANDONED THEIR DREAMS WILL DISCOURAGE YOURS), or take on a volunteer project. Daniel J. Levinson in his book The Seasons of a Man's Life describes this experience from a slightly different angle, "The initial focus in the Mid-Life Transition is on the past. A man's review of the past goes on in the shadow of the future. His need to reconsider the past arises in part from a heightened awareness of his mortality and a desire to use the remaining time more wisely. Now the life structure itself comes into question and cannot be taken for granted... As he attempts to reappraise his life, a man discovers how much it has been based on illusions and he is faced with the task of de-illusionment...The process of losing or reducing illusions involves diverse feelings-disappointment, joy, relief, bitterness, grief, wonder, freedom-and has diverse outcomes. A man may feel bereft and have the experience of suffering an irreparable loss. He may also feel liberated, free to accept more flexible values and to admire others in a more genuine, less idealizing way."

All these characteristics (I'm purposely using words other than "symptom" because that word implies a disease and I am describing a natural condition that every man confronts as he ages) are the result of several factors, the dominant one being a change in the balance of male/female hormones. We all have both testosterone and estrogen in our systems, when the ratio between these two and other hormones shifts, each of us will experience physical effects. Some of these effects are dramatic, others are subtle.

As challenging as the change of life is for the man experiencing it, those around him also find it challenging. Some may accuse him of being irresponsible. Or as Phil Donahue said near the end of a program he hosted in the late 1970s on male mid-life crisis, "We can only assume that you are simply using this as an excuse to justify being selfish and you should just get over it and act like a man." (My paraphrase based on a segment I saw on TV 9/17/00) Perhaps Mr. Donahue changed his tune once his own hormonal shift developed some momentum. Our culture demands that men "suck it up" and "get on with it". There is little room for men to acknowledge pain, whether physical or emotional, without being regarded as whiners. If you disagree with me, that is that YOU have no such expectations of men, take a few moments and ask those men in your life who you trust how they experience your expectations of them. While you are at it, you might ask those same men their impressions of the cultural expectations of being male and how they address those expectations. At the very least, you will have a chance to connect with each of these men in a new way. You might also learn something about the life of men in this country and about yourself. This is an exercise that offers equal value for men and women. We all have our quiet, hidden judgments of how men are expected to behave. As men, we have those hidden judgments of ourselves.

Here is another assignment: each man reading this could learn something by asking an older woman what she experienced and learned as she went through menopause. Even if you are too young to have yet experienced the male midlife passage, you might learn something. At the very least you will most likely become closer. If you become uncomfortable as she speaks, you can ask her to pause while you process that discomfort. As a man you are expected to just keep going and deal with discomfort later. You can change the way you deal with that expectation.

The greatest handicap any of us has in dealing with male midlife passage is the denial of struggle or weakness that we grew up with. That is certainly obvious as I look back at my dad. At the time, of course, I saw nothing unusual since I was practicing that same denial. That denial once served me, as a boy and young man, by allowing me to survive in a culture that would not accept anything else. Now the denial obstructs my ability to care for myself and engage those I love in intimate ways. This doesn't mean I totally neglect self-care and intimacy, I simply struggle with them.

So, it would appear that the roots of "male midlife crisis" lie in our formative years as boys. The words "male midlife" are descriptive of a simple biological fact. The term "crisis" is a different matter. What do you think of when you read that word? Probably a lot the same things I think of. What to do then?

A primary characteristic of a crisis is that it is, with foresight and action, often easily preventable. The only prevention for male midlife is early death.

Now, what can I do differently, to address my mid-life passage, successfully avoiding a crisis, and prevent heart disease from taking me as it did my dad? I have been looking for answers to this question for many years. I'll share some of them with you.

1. I have belonged to a regular group in my men's community for many years. The many (100s) members of this local community have all completed a male initiation called the New Warrior Training Adventure Weekend (Warrior Weekend, for short). Those of us in the small group I call home call ourselves the Black Clan. We grew out of a renewal weekend (which had a green clan, red clan, and blue clan also) many years back and have continued twice monthly meetings of challenge and support since. Although I have the same fears of having my weakness witnessed as my dad did, I choose to face that fear and acknowledge it to myself and others. The men close to me tell me that they can see something going on, so I might as well get it out there. A number of studies in recent years have pointed to the heart protective function of self-disclosure and intimate relationships that grow from that. It seems that shameful secrets and the attendant isolation contribute to heart disease and a host of other

I didn't join a men's group to prevent heart disease, I did it because I was lonely for male companionship and want to learn more about myself than I already know. I have often felt a mixture of fear and joy when approaching a men's weekend or a group meeting. Even after all these years, those old patterns of fear persist within me. I must report, however, that the joy continues to grow and the fear is dissolving.

2. Drawing from the destructive example of my father, and from some sense of superiority (I hate to admit), I never have smoked a cigarette. The smell of cigarette smoke nauseates me, so I avoid secondhand smoke, too.

3. Another behavior I adopted in reaction to my dad was to avoid alcohol, especially beer. I was 25 when I first drank a glass of wine with a trusted friend. Ten more years passed before I felt solid enough inside to drink a beer. I was scared, on a level I took years to articulate, that I would turn into my dad. Now, I may have wine or beer once in a while with a meal. Interestingly enough, current research is telling us that the dark beers and wines that I enjoy, when consumed in moderation, appear to help the heart and prevent cancer.

4. Something that Dad and I share is a love of food. This is an area of significant struggle for me. I enjoy those rich foods so much! I have made an agreement with myself. I can indulge in ice cream (his favorite), chocolate, baked goods, or red meat occasionally. No need to become a food fundamentalist, food is fun as well as nutrition.

That said, the bulk of my diet is organic vegetables, fruit in season, beans, whole grains, fish, poultry, and eggs. You may exclaim, "Eggs!? We've been told all these years that eggs have cholesterol and will clog those arteries right up." Eggs and red meat probably have the the worst reputation in relation to heart health of any food. So far, it appears that red meat's reputation is well-deserved. Eggs, however, are a different matter. An article in the Journal of the American Medical Association a few years back told us that the conclusions that medical science had made about eggs were false. The article went on to say that before 1960, the egg was considered nature's perfect food. The article's authors suggested that this is closer to the truth than seeing the egg as villain. They simply suggest that we eat eggs in moderation, which is an excellent idea for any food

5. Fortunately, I enjoy vigorous exercise so I do it consistently. Some days I take it easy and just go for a walk, swim, or light bicycle ride. Others, I go for a hard run or other challenging workout. The important thing is that I stay active rather than sedentary. Certainly, there are days when I resist what serves my best interest. I procrastinate and have to push myself to workout, or I just skip it. This gives me opportunity to exercise self-forgiveness (something my dad lacked) and to renew my commitment to conscious self-care.

6. Some of the above strategies ease the passage through mid-life. Another one has two faces. As we age and face big changes within, we need a place we can stand. Malidoma Some', in his writing and speaking says the young men need the older men and the older men need the young men. So, I have a mentor who is an elder and I mentor other men. I resist asking for support and giving it. I do both anyway because there is something inside that calls me to and it enriches my life. This, of course, leads to the spiritual dimension of life. By spiritual I mean acknowledgement and acceptance of a mystery bigger than myself. Many researchers have discovered that men who have a spiritual practice, of any sort, are healthier than men who lack a conscious spirituality. So I pray, in simple and personal ways, as I open myself to the mystery within and outside myself.

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