Why Don’t Men Seek Therapy? Masculinity.

By Dr. Christopher Kilmartin

Scene one: an 8 year old child comes home from school and says, “The other kids are picking on me.” The parent responds with, “I’m so sorry, honey. Does it make you feel sad?”

Scene two: another 8 year old child comes home from school and says, “The other kids are picking on me.” The parent responds with, “Well, what are you going to do about it?”

You might have guessed that the child in the first scene is a girl; the second a boy. Parents and other adults tend to socialize girls to take the inward journey – to spend time thinking about how they feel. Boys are socialized toward the world of action—to solve the problem.

In the extreme, both can be problematic. The tendency for women to “ruminate”—to dwell on feelings passively, is thought to be responsible for doubling their risk of depression compared with men. Men, however, have at least double the risk for substance abuse and four times the risk for suicide.

So mental health demands both healthy expression of feelings and an action-oriented understanding of the problem. Complicating things for men are the continual messages we get from the culture that doing anything–running, dancing, acting, talking, or looking–“like a girl” is to be avoided at all costs. Children are remarkably sophisticated pattern-seeking organisms, and so boys learn that talking about feelings is not for them.

And then there is the problem that nobody really helped boys understand masculinity; it was merely enacted for us and we rarely saw anyone being critical of the demands to never display vulnerable emotions. We felt the pressure but could not name it. And when one cannot name a pressure, it is very difficult to resist it.

If as a boy, if your father and/or other important men in your life seemed larger than life—always in control, never sad, worried, or unconfident—then you probably thought had the sense that “I will never be that.” It can be very healing for men to understand that these men had learned and internalized the performance of masculinity, and thus that they were no different from you—sometimes feeling low, unsure, afraid. You compared your inner experience with others’ appearances and inevitably came up short.

So if you struggle with depression, anxiety, or some other mental health problem, you have to fight your masculine socialization to deal with it. First, you have to understand a little bit about masculinity. Once you can name it, you are in a better position to resist it at the times when failing to do so conflicts with an important life goal or value and/or hurts another person. Most of us value having good feelings and being fully present for our loved ones, and so we have to do some things that we were taught are “feminine” but are really human as well as essential for managing our inner struggles.

Next, ask for help. The old joke was that we can’t even ask for directions when we are lost (Thank God for GPS!) but we can ask, and we have to. You can’t wait for a time when picking up the phone and calling a therapist will be comfortable; that is very unlikely. You have do it despite being uncomfortable. Then, when you get into treatment, you will have to talk about your feelings and your inner life. It will feel awkward, but do it because it’s important.

Self-disclosure, feeling awareness, and introspection are skills, and skills improve with practice. Remember the first time you tried to swing a golf club, play a chord on the guitar or piano, build something out of wood, change a tire, or dribble a basketball? You felt awkward then, too, but if you stuck with it, over time it became second nature. These psychological skills are no different; young girls learned them as a matter of course, but the culture conspired against our learning the same things. And when do we invest time and effort in learning a skill? When we value the outcome.

Take solace in the fact that if you struggle with mental health or problems in living, you are not alone. Many men do, even those who have cultivated the appearance that they are always sure of themselves. Forgive yourself for not being what other men appear to be, but are actually not, and understand that acting like an unfeeling machine is highly overrated.

Dr. Christopher Kilmartin is a professor of Psychology at Mary Washington University and the author or co-author of several books, including “The Masculine Self” (5th ed., with Andrew P. Smiler) and “Overcoming Masculine Depression: The Pain Behind the Mask” (with John R. Lynch).