Why Men Still Shy Away from Therapy: A Psychologist's Insight
When Jake, a businessman in his 50s, first stepped into my therapy practice, his reluctance was palpable. His marriage to Louise was faltering, and she had insisted he attend the session. "If not for Louise, you wouldn't be here, would you?" I asked gently. After a sheepish pause, he responded with a firm "No." This scenario is all too familiar in my 35 years as a psychologist specialising in male mental health. Jake's wife had identified a problem he had overlooked, prompting his visit. Over subsequent weeks, we navigated a complex web of obstacles, culminating in Jake's emotional revelation: "I'm alone in the world, everyone leans on me, there's no one for me," he confessed. "There's no one to turn to."
The Stark Reality of Male Mental Health
This pattern repeats itself consistently. Men account for only 33% of referrals to NHS talking therapies, often arriving only in crises and sometimes disappearing just as abruptly. Despite growing awareness, male vulnerability remains evident: men report lower life satisfaction than women, constitute three-quarters of suicides, and face higher rates of addiction. Many still perceive a stigma in speaking with a professional, even though most who try therapy have positive experiences. So, what holds men back? Here are eight recurring issues I encounter.
1. Action Over Words: A Historical Legacy
Historically, men's roles centred on work and provision, while women focused on caregiving and home life. Today, men remain more action-oriented and task-focused, partly due to biological and social factors. Boys often lag behind girls in verbal and emotional development, and women typically use more words daily. Action precedes language as a form of communication, and men tend to stick with this early method. When distressed, they struggle to verbalise feelings like depression or anxiety, instead acting out through behaviours such as reckless driving, altercations, drinking, or pornography use during emotional turmoil.
2. The 'Feminised' Nature of Therapy
Therapy has evolved through a female lens, as women have been more likely to seek talking therapies. Services often emphasise direct emotional discussion, which can discomfort men who prefer "shoulder-to-shoulder" conversations over face-to-face dialogues. Group therapy appeals for its camaraderie, while coaching and mentoring offer male-friendly alternatives. In my practice, starting with work-related topics often leads to personal struggles, as diving straight into intimacy feels too threatening. Initiatives like the Men's Sheds Association, which combines activities with community projects, report that 89% of participants feel less depressed after involvement.
3. Vulnerability Risks in Hierarchical Settings
Many men seek therapy around milestone birthdays, such as 39 or 49, when competitiveness wanes. One middle-aged patient noted the relief of reconnecting with old friends without rivalry, admitting he couldn't have sought therapy earlier: "It would have been like exposing my belly to my adversary without my armour on." The drive to succeed is deeply ingrained, making weakness seem hazardous in status-conscious environments. Men often fear shame and lowered status from showing vulnerability, despite concealment leading to greater fragility. Science supports this: male infants are more emotionally reactive and less able to self-soothe, yet we expect boys to be more resilient, depriving them of comfort when needed most.
4. The Go-It-Alone Mentality
From 19th-century buccaneers to modern "sigma males" celebrated online, the ideal of solitary self-sufficiency persists. Therapy inherently requires admitting one can't do it alone. Strong relationships are crucial for longevity, comparable to not smoking, yet men cling to the harmful notion that solitude equals safety. In therapy, they gradually learn that connection is nourishing, not weak, through authentic relationships with their therapist.
5. Emotional Claustrophobia
Marcus expressed overwhelm at his fiancee's desire for relationship talks, feeling inadequate. Men often tolerate strong emotions only in small doses, raised to approach problems mechanically: identify, act, solve. This works for practical issues but falters with emotional ones, as therapy demands patience and uncertainty. Providing practical frameworks, like techniques for managing depression or anxiety from resources such as Julie Smith's book, can help bridge this gap.
6. Waiting Until Crisis Point
Michael, in a same-sex marriage for nearly 30 years, sought help only after his husband discovered he was researching suicide methods. Intimacy had faded decades prior, leading Michael into pornography and online interactions, feeling guilty and depressed. Men typically have less patience, wanting quick fixes, so they often let problems fester until overwhelming, causing needless despair.
7. A Shortage of Role Models
While figures like Stormzy, Prince Harry, and Tyrone Mings have spoken about therapy, media often frames it as a crisis response, such as rehab. Therapy is portrayed as a redemptive arc, leading men to expect immediate results. They need help abandoning the fantasy of swift remedies, embracing vulnerability and incremental progress. Rarely do men discuss therapy as routine maintenance, like gym visits, and their underrepresentation in psychological professions reinforces the idea that these services aren't for them.
8. Fear of Uncovering Hidden Pain
Therapy involves confronting avoided issues, like buried pain or guilt. The fear that pulling on threads might collapse one's entire structure is universal but acute in men, who often feel ashamed of suffering and hide it even from themselves. Paradoxically, therapy redefines strength, offering a space to loosen control and name emotions without consequence. Culturally, masculinity equates worth with resilience, while therapy signals fragility, creating a significant barrier.
Taking the First Step
If you're supporting a man, offer side-by-side connection without pressure, advice, or critique. For men hesitating, you don't need to reach crisis point to seek help. Talking about yourself isn't self-indulgent; it reduces self-focus, fosters meaningful connections, and prioritises what truly matters. In a safe therapeutic environment, men can examine limiting patterns and begin to release them, paving the way for healthier lives.
