Myths That Prevent Men From Getting Help.

Often when men make their way into my office it is during a time of crisis. Not a Hollywood style psychiatric crisis that ends with a straitjacket and a robotic psychologist reciting a list of highly intellectual sounding diagnoses that don’t actually fit together in the real world. These crises aren’t as flashy, but the pain and implications are visceral and real.

Sometimes it is a marriage that has hit a breaking point. Or a second marriage that is hurtling towards divorce like the first. Other times it’s a level of work stress that has become unsustainable, and bleeds too much into home life. A temper that has damaged too many relationships. Loneliness that has reached critical mass.

The examples could go on and on, but there’s a common thread. The crisis that brings them in is a long standing pattern that has finally done too much damage.

It is no secret that men aren’t always the best at asking for help. Not only is this not a secret, there is research to prove it. As I touched on in a recent article the reasons for men seeking help less often are complex, and it is a goal of mine to make accessing therapy as easy as possible.

In that spirit I want to dispel a few of the most common barriers for men. Beliefs that prevent men from getting help and making changes before the point of crisis.

1. I am going to have to talk about my emotions.

Sure, at some point in therapy there’s going to have to be some delving into emotional content, some talking about feelings. But that doesn’t need to be where therapy goes right out of the gate. There is no expectation that on session number one you will have to offer lengthy, sophisticated, eloquent descriptions of your emotional response to various people, situations, memories, etc.

Frankly, men tend to have a baseline, subclinical, level of alexithymia. For those unfamiliar with the term it is a fancy way of saying they have difficulty identifying and expressing emotions. So, it would be unfair and helpful to demand a lot of emotional talk up front.

The goal of therapy isn’t to perfect the art of talking about emotions. While emotions are unavoidable, you set your own goals. We only need to work with emotions enough to get you to those goals.

2. You are going to try to convince me to take medications.

Nope, I most definitely am not. Psychotherapists and psychologists don’t prescribe medications, and personally, I rarely suggest medication to any of my clients. Even the colleagues I know that more commonly suggest medication don’t try to convince anyone to take them against their will. I’ve been doing this for a while now, and the situations I have come across in my career where I felt someone really needed medications have been very few and very far between.

Those tend to be pretty dire situations. Job loss or divorce are imminent and we don’t have the time to make changes in therapy without a pharmaceutical boost. True psychosis where the options are basically medication or hospital. Outside of those extremes my inclination to move you towards medications is essentially zero.

Now, if you are on the fence about whether or not medications are the right option for you I am happy to do some work around that to help you make the right decision for you. If you come into therapy with no interest in medications, well, that’s pretty much the beginning and end of it right there. The topic probably doesn’t even come up.

3. All we are going to do is talk about the past.

This particular objection usually comes with a tone of impatience, of urgency. When I hear this on a consultation call it is usually followed up with some version of “I’m tired of talking about the past and I want to make changes”. The old Freudian trope of reclining on a coach to endlessly talk of one’s past to a near silent therapist is, fortunately, nothing more than that: a trope.

I do have a couch in my office, but no one lies down on it (one time someone did, but that was it). Truth is there is some necessity to discussing the past in therapy. I am starting at zero, and to understand how to get you out of where you are now, I have to understand a bit about what got you here.

We only need to talk about the past enough to learn how it influences the present. We only need to know enough to facilitate the changes you want to make. Any therapist (any good one, anyway) is going to be much more interested in change as well, not endlessly discussing the past.

4. My problems aren’t that bad, other people have it worse.

As with the previous items, there is some truth here. In just about any situation you find yourself in “it could always be worse”. Hell, even if we are talking life and death there is probably always a more traumatic death to be had. I can also say that I have never seen this sentiment bring much comfort, and I have certainly never seen it bring about any meaningful change.

The insidious side of this well intentioned thought is the invalidating quality it has. It often carries the implication that things could be worse, I don’t have a good enough reason for feeling the way that I do (anyone who works with me knows that emotions don’t need a reason, but that’s a different conversation). However much worse a situation could be has little bearing on the distress it causes. Sure, could be worse, but could also be better too.

“That probably sounds so trivial compared to what you must hear”. As often as I hear that I have honestly never thought “yup, too trivial for my time”. Frankly, if someone goes through the effort of setting up appointments and is willing to pay what they pay me I imagine the problems they want to work through are tied to some pretty painful things. Anything tied to the painful things in your life is more certainly worthy of therapy, and worthy of my time.

What I would love, is for men to make their way into my office well before the point of crisis. Rarely do I get a call that starts with “I noticed I’ve been struggling a bit and I want to get ahead of things”. Usually what I will hear early on is “I’ve been putting this off for a while, probably too long”.

This is the main reason I practice therapy through a masculine lens. That doesn’t mean that we “bro down”, or I run therapy sessions like one of those militant retreats where guys pay a bunch of money to have some form of “coach” shout personal growth and development into them. It means that ways in which men both suffer and engage in therapy are unique.

Those subtle differences have often been overlooked and neglected, leaving therapy less acceptable for men. If I am being honest I was certainly guilty of neglecting them as well earlier in my career. In starting to explore some of my own narratives around masculinity I realized how some of them contributed to me not being able to get out of my own way. My hope is dispelling these myths can help other men get out of their own way and get the help they need and deserve.