‘Real Men’ Get Therapy

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In response to a recent article in the Pacific Standard, Ozy Frantz offers suggestions on how to get more men the help they need from therapy.

The recent “Aversion to Therapy: Why Won’t Men Get Help” article by Betsy Bates Freed and David Freed in the Pacific Standard outlines fairly well the core problem of men and mental health: How do we get men to go to the therapist? Very few men—even those with genuine problems—seek mental health help. Of those who do, many simply take pills instead of the recommended combination of pills and therapy. Others have no recourse but emotional repression, substance abuse, or even suicide.

The situation is particularly bad, of course, because of the Great Recession. The risk of men committing suicide goes up as unemployment goes up, while the female suicide risk remains stagnant, possibly because men are more likely to define their self-worth through their jobs. A host of indicators—from alcohol sales to suicide rates—shows that men are in distress. Even worse, the men who are at highest risk because of the recession are masculine men…the exact ones who don’t want to get therapy in the first place.

Many of the proposed interventions are, frankly, as embarrassing to men as the “Science: It’s a Girl Thing” ads are to women. An ad campaign with firefighters and the tag line “It takes courage to ask for help”? Please. That’s not helpful; it’s patronizing. It’s two steps away from “you would take your car to a mechanic, so why not take your brain to one?”

The first step to getting men to get help, I think, is to treat mental illness and emotional distress as an ordinary part of life. It’s not shameful or a sign of weakness or failure to have depression or suicidal urges. It’s just a thing that happens sometimes, to all kinds of men—the most masculine as well as the least. Once it’s been reframed as a routine misfortune, there might be less stigma around seeking help for it. 

We need greater openness about mental health issues from all kinds of men. Many prominent celebrities—including such masculine figures as Buzz Aldrin, Terry Bradshaw, and Harrison Ford—have struggled with depression. Perhaps a campaign where both celebrities and ordinary men talk freely, authentically, and without stigma about their experiences with suicidal urges and mental illness would be effective.

But PSAs can only be so effective. Tom Matlack, the founder of the Good Men Project and an alcoholic in recovery himself, says, “An obvious place to look [for strategies to get men into treatment] is the treatment of PTSD among returning veterans. What has worked there is to take the stigma out of admitting you had a problem by using peer outreach.”

I think that peer-to-peer outreach is extremely important. A message that might seem condescending or simply irrelevant from a media source might be intensely personal if it comes from a friend. While it can be difficult for men who are seeking or have sought therapy to be open about it, it can also make their friends think “hey, he got therapy, and he’s a cool dude, not weak or anything…maybe I should too.”

Similarly, if you know a man (or, really, someone of any gender) who shows signs of undergoing psychological stress, such as extreme mood swings, social withdrawal, or an inability to cope with daily activities, ask them whether they’ve considered therapy. A lot of times, people say “get therapy” in a harsh, stigmatizing, “you’re crazy” way which can make it more difficult for people to realize it’s an option for them. Instead, I think an affirming attitude that reassures people that they can get therapy and still be masculine would be very helpful.

Beyond making men more willing to go to therapy, however, is the idea of changing therapy itself to fit men better. One of the suggestions I found most interesting in the Pacific Standard article was reframing therapy itself as “skills training” or “solution workshops.” Many more masculine men who wouldn’t be caught dead in therapy might actually find “skills training” helpful—especially if it’s presented as a way to become more successful in business or personal life. Cognitive behavioral therapy, especially, is very well-suited to being repackaged in this way.  

Similar suggestions include getting more men into psychology, so that men can choose a male psychologist they might be more comfortable with. Some therapists may choose to develop a less emotive style and instead present themselves as a partner who can help men solve problems. These suggestions don’t just make it easier for masculine men to get therapy—they can help women too. Some women may be more comfortable with a male therapist than a female, after all. There are lots of women who are more comfortable with a problem-solving approach than an emotion-based one. It’s about catering to different personality types, even if one type tends to be more common among men.

Ultimately, however, most of these are just temporary patches. The ultimate solution to men’s mental health problems is getting rid of the idea that men are somehow “less men” just because they seek medical care, whether it’s mental or physical. If all men are taught that their worth comes from more than just their occupation, their suicide risk won’t go up with a recession. And with a healthier definition of masculinity and the knowledge that everyone who identifies as a man is a real man, we can free men to be able to receive mental health care if they want or need it.

Ozy Frantz is a student at a well-respected Hippie College in the United States. Zie bases most of zir life decisions on Good Omens by Terry Pratchett and Neil Gaiman; identifies more closely with Pinkie Pie than is probably necessary; and blogs at No, Seriously, What About Teh Menz?

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