Why are most men averse to seeking therapy and what can we do about it?

According to SAMSA (Substance Abuse Mental Health Services Administration) about 14% of American men report facing a mental health challenge.  The 2014 Men’s Health Forum reveals that 4 out of 5 suicides are men, and suicide is the most common cause of death for men under the age of 35 in the United States.

Interestingly, research shows that men do in fact benefit from therapy, often within the first few sessions.  Their therapeutic prognosis for improvement is slightly greater than that of women, statistically.  Yet, getting in the door is a struggle and men are more resistant.

Men are more likely to seek pharmacological treatment than talk therapy and they are statistically more likely to “act out” their mental health symptoms behaviorally.

If you are a man seeking counseling, or you want to support a man seeking counseling, consider these reasons why it might be a good idea:


  1. Men come to therapy for the same reasons women do.

Men often come to therapy because they feel “stuck”.    The stuck-ness could be related to grief, stress, anger management, relationship concerns, fatherhood, health problems, impotence or sexual issues, body image issues, loneliness, career or personal crossroads – you name it.

I don’t totally get the terms “women’s issues” or “men’s issues” because what they encompass are simply “human issues”.  We are different, but we are the same.  We all have emotions. We all have thoughts. We all have vulnerabilities.  And for all of us, it takes a village.

  1. You can help change the cultural standards of masculinity. Fight the stigma.  Let men cry.

While the social roles and gender norms are expanding, stereotypes still run very deep in our culture.   You’ve heard, “Real men solve their own problems.”  Asking for help is a no-no for lots of men.  Talking about, or even having complex emotion and vulnerabilities, is not “manly.”

Men are often expected to participate in a delicate balancing act. They’re asked to be strong, masculine, providers, and doers.  Simultaneously, they are required to be emotionally available in relationships, vulnerable about what they think or feel, and resilient to work and life’s stressors.  They are criticized for failure to deliver in either territory.  It’s a tight line to toe.

Thankfully, there is movement towards awareness and increased consciousness of the need to allow men to speak up about their emotional needs AND their mental health troubles.   In 2003, the National Institute of Mental Health fought the stigma by launching their “Real Men. Real Depression.” campaign to raise awareness: More than 6 million men suffer from depression annually.

By being one of the guys who can talk about their feelings, you’re a pioneer and leader in your culture.  You break down barriers and dividers that are not helpful.   You model that it is acceptable, and you free up other men to follow suit.  I’ve seen this unfold in front of my eyes while running psychotherapy process groups with men.  It’s one of the bravest things I’ve witnessed.

I attended the Women’s March in Washington, DC in January 2017.   I felt tremendous gratitude for the women suffragettes who fought 100 years prior for my right to vote.  If my predecessors hadn’t stepped up to the plate, women wouldn’t be where we are today – what if they allowed limiting societal beliefs to dictate their choices 100 years ago?

Everybody’s fighting for their voice.  For men, there is this stigma around emotional vulnerability.   To change this, we need to give men the space and respect to show their vulnerability and reveal their deeper, multidimensional layers.  And men need to take the risk.  As the statistics show, it is as serious as life and death.

  1. Prevention is a whole lot easier than intervention and crisis stabilization. By talking about your problems, you won’t suffer as many consequences related to acting them out.

Avoiding emotions does not actually make them disappear.  Just how putting a lid on top of a boiling pot of water leads to the bubbles seeping out the sides, unexpressed emotions spill out, one way or another.  Emotions need a place to be.   It’s like they need to be cared for.

Men are more likely to feel angry, frustrated and irritable when depressed.  Because anger is a more active, energizing emotional state, we tend to become more impulsive when we linger there.  The tendency to externalize problems leads to behavioral aggression, substance use, or habits.

In my work in the mental health crisis ER, I witnessed how commonly men avoided seeking help until the point of emergency due to their fears of the judgments of others. They often hid the weight of their struggles.  They did not want to be perceived as weak and this was reinforced since they were on the elementary school playground.   The men I spoke with in the ER often expressed a lot of shame for “letting it get this bad”.  They dealt with added stressors like losing jobs, housing, or relationships as a result of declining mental health that did not get addressed.   Many of them made contracts to get help sooner, should the problems arise again in the future.

Heed their advice.

  1. Tangible results and changes are possible and can be expected.

Men get huge benefits from counseling.  Just receiving the empathic witnessing provided as you share about your experiences is a healing factor.  Almost like having a coach, a therapist can be both the cheerleader and accountability partner who helps you reach your goals and stay on track, whatever those goals may be. (You set them.)

Men are more likely to benefit from therapy with assigned, realistic, achievable tasks like homework and behavioral goals, according to some research.  Typically, I have found that men tend towards “fix it” mode.  Finding an expressive outlet can be helpful, and in therapy I’ve witnessed men returning to their earlier outlets for emotional expression, such as music.  Some of the greatest pieces of art and music were created out of emotional turmoil and release.

Men I see in counseling have considered antidepressants, but that is reserved as a last-resort-scenario.  I’m really glad that therapy can be seen as a less-intensive alternative because in the Journal of Clinical Psychiatry it was reported that up to 70 percent of patients prescribed antidepressants did not actually meet criteria for a clinical diagnosis of depression.  I am not discounting the fact that medications can be needed in some cases, but I believe that men often need a neutral outlet in which to be heard. Therapy can provide that.

So when you schedule your first appointment with a counselor, tell him or her that you want to make some S.M.A.R.T. goals (simple, measureable, achievable, realistic, and timely).  See if you can’t feel empowered by expressing yourself, taking risks, and setting an example!

Something I hope you take away from reading this is that asking for help is a sign of strength, not weakness.  I like this African Proverb: If you want to go fast, go alone. If you want to go far, go together.  Too often we humans, especially men, “tough it out”.  There is no shame in reaching out when you need it the most. 

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