Why Therapy Sucks For Men
Therapy Sucks For Men: We’re going to talk about why therapy sucks for men. And that may sound kind of confusing because here I am, a man. Here I am, a psychiatrist doing psychotherapy with men. So what on earth am I talking about? Why do I think therapy sucks for men? In my experience, as a psychiatrist, I do actually believe that there are systemic biases that make it hard for men to engage in therapy. And today, we’re going to talk a little bit about it.
- What those systemic factors are
- How we can understand them,
- How to overcome some of those factors and move towards more emotional health.
So we have to start by understanding where this idea that talk therapy is the gold standard for treating mental illness comes from. So what we really need to understand is that the majority of patients in the history of psychotherapy have been women; about 60 to 70% of patients today who engage in psychotherapy are women. The other thing is that about 60–70% of therapists today are actually women. So I think what happened early on in psychiatry or psychotherapy was that the majority of people we were helping were women. And so, as a doctor, when I look at 10 of my patients, I see, Okay, so it looks like talking to people about their feelings, on average, is the most successful thing that I can do. But even though that’s factually correct, I may not be taking into account that seven out of those 10 people are women. And maybe the people who are getting the most help with talk therapy or talking about their emotions are actually women. And it’s not just me that says this, if you actually look at the American Psychological Association, guidance for working with boys and men, they sort of point out a systemic bias in the way that we diagnose men and women. And that’s a lot of the diagnoses that women get, like depression and anxiety, for which, by the way, women are about two to three times as likely to be diagnosed. A lot of those diagnoses have to do with feelings, and being able to articulate stuff.
So, for example, major depressive disorder involves feeling sad when you’re depressed, which makes sense. And that a lot of men are actually diagnosed with what we call externalizing disorders, things like addictions, sociopathy, or antisocial personality disorder. So these are disorders that involve behaviors. So I think they’re sort of cluing us in on a really important idea, which is that when men feel something, they act on it, as opposed to articulate it or talk about it. And if we tunnel down a little bit about how men deal with their emotions, we’ll kind of see that this is true in general as well. Because if you’re a man, an emotion is a problem to be solved, not something to be talked about. Right? So think about it, if you get bullied on the playground, and you feel ashamed of yourself and will call you a fat kid and beat you up. That isn’t something you talk about. In fact, if you go and cry to mommy or cry to the teacher, you’re actually treated worse, you’re taught that articulating problems and talking to people is cause for punishment. Instead, what you’re supposed to do, if you’re a man, is fix the problem, right? So if kids make fun of me for being fat, I’m supposed to lose weight, get ripped, and learn martial arts, and the next time they talk, I am going to teach them who’s boss. So if you sort of think about it, the solution to an internal feeling of being ashamed is to take action and change the circumstances that make me feel that way. If I’m feeling ashamed, because I don’t have a job, and I don’t have any money. What should I do about that? Should I go cry to Mommy about how I don’t have a job or money? Should I cry to my girlfriend about how I’m broke all the time? No, if you’re a man, you need a man to fuck up, go out there, get a job, and start making money. If you’re feeling bad in here, as a man, what we’re taught is that you’re supposed to go fix the problem out there. And this also manifests in men’s reluctance to engage in couples counseling.
