Men and Psychotherapy

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I’ve been a clinical psychologist for over 30 years. I’m unusual as a psychotherapist in that I am a man, and also because I work with a lot of men. Over the past few decades, the vast majority of psychotherapists, as well as the majority of people seeking psychotherapy, are female. Psychotherapy has become primarily women talking to women.

Stereotypically, men are thought to be less interested in psychotherapy because of longstanding cultural prohibitions against needing, much less asking for, help of any kind. Men are said to be reluctant to even ask for directions when they’re lost. With the advent of the women’s movement, and the feminization of psychotherapy, I believe that men are increasingly reluctant to seek psychotherapeutic help. I think that men understand, correctly, that most therapeutic approaches are increasingly designed for, and intended to be attractive to their primary customers—women.

The values espoused by many therapeutic approaches, such as emotional openness and vulnerability, are often at odds with some of the values many men hold dear. In addition, men understand that their wives are either sending them to individual therapy, or bringing them to couple’s therapy, anticipating that the therapist’s values will be aligned with their own. Men often feel emotionally inadequate in a therapist’s office, pathologized for being guarded or defensive, emotionally withdrawn, or not sufficiently vulnerable and emotionally open. In couples’ therapy, men often worry they will end up as the identified patient, the one who needs fixing.

About seven years ago, I decided to start a psychotherapy group for men. I’ve been leading therapy groups for over 45 years, but I was uncharacteristically anxious before the first meeting of this group. I thought I had made a huge mistake putting together a group of all men. Women disclose more in therapy than men do. It is most often the women in a therapy group who take the lead in being more emotionally open. The men often learn from the women and open up more over time. I anticipated that it would be very difficult getting the men in the room to talk to each other and that I would have to do a lot of what therapists call “pulling teeth,” meaning doing a lot of work to get the men to open up and talk about their internal lives.

I couldn’t have been more wrong. I have never seen a group open up and share as quickly as that group did. The men were openly expressing feelings within the first hour, some of them crying openly, and the entire group decided to hug each other at the end of the group, something they still do every week. What I learned is that the stereotype about men being reluctant to open up in therapy is mistaken. Men are actually dying to talk to about their internal experience. Apparently, it’s opening up to women that’s more challenging.

I think it is truly unfortunate that we have created a situation in which men are reluctant to seek help from psychotherapy because there is a lot for men to gain, some of which is very different from what they might believe. Here is an abbreviated list of some of what men stand to gain in therapy. If some of these things are already true for you, congratulations. You’ve probably already done some good work in your life, whether in therapy or not, and deserve all that you have earned. I’ll start with the ones that are more obvious, the ones you may already associate with therapy, and move to some that may be more surprising to you.

1. You are likely to feel significantly less anxious and/or depressed. This is not surprising, but most people expect this from a course of psychotherapy. The research is quite clear that psychotherapy is a very effective treatment for both anxiety and depression, and that it is dose-dependent, meaning that the longer you stay the more you are likely to get (Seligman, 1995).
2. You will probably feel less alone. Tom Joiner struck a nerve with his book Lonely at the Top (Joiner, 2011), suggesting that men’s power and privilege comes at the high cost of neglecting relationships and closeness, leaving many men profoundly and isolated. You may not have thought about this for yourself, but imagine your wife leaving town for the weekend and see what comes up for you. Do you feel uncomfortable, worried about how you will fill the time, or do you look forward to it as an opportunity to catch up with people you feel close to?
3. Closely related to this is the fact that you are likely either to make real friends for the first time, or to get a lot closer to the friends you have. Men often tell me they have friends, and then I ask them if these friends are people they would talk to about some of the things they are talking to me about. The answer is most often no, that there is no one in their lives that they talk to about more personal matters.
4. Also related to this, you are likely to feel closer and more connected to your children, more comfortable and even enthusiastic about being an active father. Again, imagine your wife tells you that she is going out of town for the weekend. Do you feel anxious, and start thinking about who you can get to help you with the kids, or do look forward to this as a chance to spend more time with them?
5. One that may surprise you is that even if you seek out individual therapy for yourself, you are still very likely to get much closer to your wife. It is likely that she will be less disappointed and angry with you, more interested in listening to you talk about your life, and more emotionally supportive, more affectionate with you, and more interested in sex, which will happen more often and be a lot more satisfying for both of you.
6. Last, and perhaps least expected, people in therapy generally are more successful in their work, however they define that. This one is hard to explain, but it probably has to do with being able to be more fully yourself in the world.

I hope this list has been helpful to you, and maybe even started you thinking about where you might like some help in your life. In a future column, I’ll help you understand where you might look for that help.