\n<\/p>\n
W<\/span>hen Jake, a businessman in his 50s, first arrives at\u00a0my therapy practice, it\u2019s obvious that he has some misgivings. Jake\u2019s marriage to Louise is in trouble, and she has insisted he come and see me. \u201cIf not for Louise, you wouldn\u2019t be here, would you?\u201d I enquire tentatively. He looks sheepish at first; then emboldened, he gives an emphatic \u201cNo.\u201d As is almost always the case, Jake\u2019s wife has registered a\u00a0problem that has passed him by, and prompted his visit. Over the next few weeks, we sift through a maze of obstacles, and in the end, Jake is full of emotion: \u201cI\u2019m alone in the world, everyone leans on me, there\u2019s no one for me,\u201d he says. \u201cThere\u2019s no one to turn to.\u201d<\/p>\n It\u2019s a common pattern, one I\u2019ve seen throughout my 35 years as a psychologist specialising in male mental health. Men make up only 33% of referrals to NHS talking therapies. They don\u2019t come easily, and when they do seek help in a crisis, they can disappear as suddenly as they arrive. Yet male vulnerability is clear \u2013 men report lower levels of life satisfaction than women and make up three-quarters of suicides and problems with addiction. But despite the increase in awareness around male mental health, men still tend to think there\u2019s a stigma to speaking with a\u00a0professional, even though most of those who have tried therapy have a positive experience.<\/p>\n So why are men still so reluctant to talk? Here are the issues I see again and again.<\/p>\n Historically, men\u2019s roles centred on work and provision; women\u2019s on caregiving, looking after the home and raising children. Today, men still tend to be more action-oriented and task-focused. This is partially hardwired \u2013 boys tend to lag behind girls in verbal and emotional attunement; women speak more words in an average day.<\/p>\n Action comes before the development of language; it is our mother tongue, and men tend to stick with this early way of communicating, which is shaped both by biology and the social context. When it comes to expressing distress, men find it more difficult to do so verbally. They are far less likely to say they are depressed or anxious; instead, they are prone to acting out when troubled. Without even realising why, they may find themselves driving too fast, getting into altercations, drinking or using pornography when they experience emotional difficulty.<\/p>\n Women have been more likely to seek professional help in the form of talking therapies, and as a result therapy has developed through the female lens. Services are often \u201cfeminised\u201d in design, with an emphasis on talking directly about feelings, which can be uncomfortable for men, who tend to respond better to \u201cshoulder-to-shoulder\u201d conversations than\u00a0face-to-face discussions.<\/p>\n They often prefer group therapy for its sense of camaraderie and shared experience, allowing connection without being in the spotlight. Coaching and mentoring show promise <\/strong>as male-friendly approaches. I often find this with my patients: you begin by talking about their work setting \u2013 an area they feel comfortable discussing \u2013 and end up talking about more intimate personal struggles, because going straight into the personal is too threatening. Services working with male veterans combine activity such as walking and talking with traditional talk therapy. The Men\u2019s Sheds Association, which encourages people to come together to make, repair and repurpose, supporting projects in their communities, say that 89% of participants feel less\u00a0depressed after engaging with it.<\/p>\n I\u2019m struck by how many men come to see me as a milestone birthday approaches \u2013 when they\u2019re 39 or 49, say. Reflecting on a reunion with old friends, one middle-aged patient told me: \u201cWhat a relief \u2013 there was none of the competitiveness that made it so difficult to connect when we were younger. We can all relax now; we\u2019ve got to where we\u2019ve got to in life.\u201d He said he could never have allowed himself to seek therapy earlier: \u201cIt would have been like exposing my belly to my adversary without my armour on.\u201d<\/p>\n The drive to strive is deeply encoded in men, and can stop us getting help when we\u2019re down. Showing weakness feels hazardous when your position in the\u00a0pecking order matters, and yet concealing it ultimately leads to greater fragility. Men are acutely shame-prone when it comes to showing vulnerability, fearing it will lower their status in the eyes of others.<\/p>\n Science helps us make sense of this. Male infants are more emotionally reactive than girls, less able to\u00a0self-soothe, and more dependent on external regulation from caregivers. Yet we continue to expect boys to be more resilient, to show less emotion. The very infants we encourage to be robust are those most negatively affected when deprived of comfort.<\/p>\n Therapy, which encourages emotional expression, can feel threatening when you\u2019ve been raised to believe that showing your feelings is shameful. I have met many men who struggle with sexual dysfunction but feel unable to talk about it \u2013 sometimes avoiding relationships entirely rather than seeking help.<\/p>\n And yet I cannot recall a single younger man who has regretted starting therapy. A safe therapeutic environment allows men to look at the behavioural patterns that limit them \u2013 and to begin to let them go.<\/p>\n <\/span> Illustration: Nathalie Lees\/The Guardian<\/p>\n From the 19th-century novel centred on the buccaneer living a solitary existence to the modern cult of the \u201csigma male\u201d (the online celebration of men who need no one), the legacy of \u201cmen going it alone\u201d casts a long shadow. Therapy, by definition, begins with the client admitting they can\u2019t do it all alone.<\/p>\n The single most important thing that makes for a\u00a0good life is strong, meaningful relationships; they are as important in predicting longevity as being a non-smoker. Yet men find it hard to step away from the powerful and harmful notion that there is safety in being solitary and self-sufficient.<\/p>\n What happens in the therapy room? Gradually, men begin to test out the possibility that connection isn\u2019t weakness but nourishment. The development of an authentic, connected relationship with their therapist proves it.<\/p>\n \u201cI don\u2019t think I can keep it up,\u201d says Marcus, referring to his fiancee\u2019s wish to talk about their relationship. \u201cI\u00a0can do it for a bit, but then we keep going and going and I feel completely overwhelmed.\u201d Later he admits that it makes him feel inadequate.<\/p>\n With men, the expression of strong emotion can often only be tolerated in bitesize chunks. They are often raised to approach difficulties mechanically: identify, act, solve. This is helpful when the problem is practical, but when it is emotional they can become unstuck. Therapy, which requires patience and uncertainty, doesn\u2019t fit this template. It may be necessary to provide men with a practical framework, such as specific techniques to manage symptoms of depression, panic attacks or other problems with anxiety (Why Has Nobody Told Me This Before? by Julie Smith is really useful for this).<\/p>\n Michael had been in a same-sex marriage for almost 30 years when he came to see me. Their sexual relationship was good to begin with, but there hadn\u2019t been much intimacy for the past two decades. It hadn\u2019t occurred to them to seek help, and Michael retreated deeper and deeper into using pornography and talking to strangers online. He felt alone and\u00a0guilty, acutely depressed and desperate to be\u00a0released from the prison he had created for himself. Michael\u2019s husband discovered that he was\u00a0researching methods to take his life and this brought him to my consulting room.<\/p>\n On the whole, men tend to have less patience and want a quick fix. As a result, the threshold for action tends to be higher, and thus men will often allow things to fester and become worse before they seek help. A problem that might have been addressed earlier becomes overwhelming, and can lead to needless despair and suffering.<\/p>\n There are exceptions \u2013 such as Stormzy, Prince Harry and the footballer Tyrone Mings \u2013 but media accounts of men in therapy often emerge when they are in crisis, such as when they go to rehab.<\/p>\n Therapy is framed as a redemptive arc \u2013 a tidy solution to adversity. Men often come to therapy expecting immediate results, and need to be helped to let go of the fantasy of a swift remedy, learning instead to turn up, sit with vulnerability and allow progress to unfold in small, unheroic steps.<\/p>\n We rarely see men discussing therapy as routine maintenance, the way we might talk about going to the gym or managing diet. Men are also considerably underrepresented in the psychological professions, including counselling and psychotherapy, which furthers the impression that these services are not suited to the needs of men and boys.<\/p>\n Therapy is about confronting the things we would prefer to avoid. It might uncover long-buried pain, guilt or grief. The fear that the whole structure might collapse if you start pulling on the threads is something everyone must overcome when they seek help, but it is particularly acute in men. They tend to feel deeply ashamed of their suffering, concealing it not just from others but from themselves.<\/p>\n The paradox is that therapy doesn\u2019t strip away strength \u2013 it redefines it. It offers a space where control can loosen without consequence, where emotions can be named rather than managed. The real challenge is cultural: masculinity links worth with resilience, while therapy still signals fragility.<\/p>\n If you\u2019re trying to help a man you care about take\u00a0the first step, offer unpressured side-by-side connection and understanding, not instruction, advice or critique. And if you\u2019re the man hesitating on the threshold, you don\u2019t have to be at crisis point to seek support. It\u2019s not self-indulgent to talk about yourself. Instead it helps you be less self-focused, and to concentrate on the things that really matter, to make good connections with those closest to you.<\/p>\n Dr Stephen Blumenthal is a consultant clinical psychologist and psychoanalyst in the NHS and in private practice<\/em><\/p>\n","protected":false},"excerpt":{"rendered":" When Jake, a businessman in his 50s, first arrives at\u00a0my therapy practice, it\u2019s obvious that he has some misgivings. Jake\u2019s marriage to Louise is in trouble, and she has insisted he come and see me. \u201cIf not for Louise, you wouldn\u2019t be here, would you?\u201d I enquire tentatively. He looks sheepish at first; then emboldened,<\/p>\n","protected":false},"author":1,"featured_media":43318,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[51],"tags":[1326,14999,337,1329,6591,16264,7333,891,3305,628,809],"class_list":{"0":"post-43317","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-health","8":"tag-dont","9":"tag-feelings","10":"tag-life","11":"tag-men","12":"tag-reasons","13":"tag-shameful","14":"tag-showing","15":"tag-style","16":"tag-taught","17":"tag-therapy","18":"tag-theyre"},"_links":{"self":[{"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=\/wp\/v2\/posts\/43317","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=43317"}],"version-history":[{"count":0,"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=\/wp\/v2\/posts\/43317\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=\/wp\/v2\/media\/43318"}],"wp:attachment":[{"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=43317"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=43317"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=43317"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}Men are primed for action rather than words<\/strong><\/h2>\n
Therapy is \u2018feminised\u2019<\/strong><\/h2>\n
Showing vulnerability is risky in a hierarchy<\/strong><\/h2>\n
The age-old go-it-alone mentality<\/strong><\/h2>\n
Emotional claustrophobia<\/strong><\/h2>\n
They wait until crisis point<\/strong><\/h2>\n
A shortage of role models<\/strong><\/h2>\n
Fear of what they may find<\/strong><\/h2>\n