Image of a man standing in a front yard representing therapy for men at Texas Insight Center with Danny Clark, LCSW

Therapy for Men

Danny Clark, LCSW

“Try not to become a man of success, but rather try to become a man of value.”

— Albert Einstein
Image of a father holding his daughters on the page for men's mental health and therapy for men at Texas Insight Center in Houston Texas

Breaking the Silence: Men’s Mental Health and Therapy

Less than 16% of therapists in Texas are male, which may be why so many men go without therapy. Not only do graduate schools that train psychotherapists employ fewer male therapists, but they also dedicate minimal attention to male-specific issues. In fact, when I was getting my masters in clinical social work, we only discussed men’s issues related to domestic violence and suicide. I find the lack of support and understanding of men’s mental health to be one of the biggest tragedies in the U.S., Not just for men but for children, women, families, and policymakers.

What is Really Going On?

Let’s break this down a bit more. Research has shown that only 8% of men nationwide went to therapy in 2021. compared to 12% of women. In addition, men are more likely to die by suicide (39,255 deaths in 2022). twice as likely to die from alcohol-related deaths (20 deaths per 100,000 – See fig 8), and even higher for drug-related deaths (40 deaths per 100,000).

When we look at issues related to homicides in the US. – Texas being the highest – Men are 10 times more likely to commit a homicide. Also, the prevalence of mental health issues of incarcerated individuals can range from 30% upwards of 60%. Most of the problems are related to substance and alcohol addiction, depression, and anxiety.

So, if men are struggling with mental health issues, why aren’t they going to therapy? Much of the research points the finger at men themselves!

Why don’t men go to therapy?

Ironically, a lot of men’s mental health research focuses on barriers to treatment. The body of scholarly literature does a fantastic job of pointing out why men don’t go to therapy. However, research struggles to identify ways to work with men around those barriers. One of the most notable barriers for men to go to therapy is the fear of what others think. We call this stigma.

There are a number of other reasons why men don’t go to therapy. A study evaluating men who recognize the need to go to therapy but don’t go identified many points. Men reported found that cost, the belief they could handle the problem on their own, fear of others’ opinions, and the belief that it wouldn’t help were the top reasons.

In another systematic review, the authors point out the reason for a lack of help-seeking on “conformity to traditional gender norm.” They indicated that men will seek help if therapy is accessible, appropriate to their present needs and engaging. I personally agree with these three factors the most.

A man sitting in a chair reading in the section about why men don't go to therapy for the Texas Insight Center in Texas and Houston near the Rice Village

Two adult males visiting in casual clothes on the men's therapy page for the Texas Insight Center in West University

Why I think men don’t go to therapy

The lack of men in therapy might stem from the fact that we often don’t equip therapists with the necessary skills to address their unique needs during their training. Criticizing men for not being sensitive enough while simultaneously neglecting their mental health needs contributes to stigmatization. Do I think men need to go to therapy? Yeah! Do I think it is easy? No! As a male therapist, I know a few things about the experience of being a man and being a trained therapist. Let me explain why men don’t go to therapy and how I approach things.

We don’t want to talk about our feelings.

It’s uncomfortable, it’s embarrassing and yes, it feels threatening to our masculinity. So, those who believe men should readily ‘bare their souls to a professional’ are sadly holding a mistaken belief. Men don’t do this! They talk about their feelings through humor, venting, self-reflection, contemplation and problem-solving. It’s a language that isn’t taught and has no lexicon. I can appreciate this language with my male clients. I am trained well enough to know that something is sinking in or helping my client without spreading a bunch of adjectives on the table like dominoes. Not until my client fully trusts me will they talk about their thoughts out loud.

We have trust issues.

Male trust issues have been around since the dawn of time. Trust was once built on experiences of war, loyalty, duty and the need to protect. Today, we call this the foundation of male-gendered norms of masculinity and there is nothing wrong with that. Maybe we don’t ride off into the night to fight for our King, but we sure as heck respect integrity, loyalty and truth when it comes to sharing any resemblance of a struggle to a therapist.

One of the most common concerns I hear from men in my office is that they don’t want a therapist who is going to make them talk about anything they don’t want to talk about. While no therapist will make you talk, trusting that the therapist won’t use some form of crafty therapeutic manipulation to corner a client into sharing something they aren’t ready to share is a huge concern of my male clients.

We don’t want to be blamed for everything.

My male clients have told me they didn’t like their previous therapist because they felt they were being blamed for everything happening (with some exaggeration). This is a real problem in therapy for many people, but I think it hits the core of masculinity if handled incorrectly.

When men realize they are at fault for something, it strikes the core of their inner strength and no amount of “validation” or “acceptance” will be louder than the inner voice of weakness. For example, when I sit with my male clients, I respect this struggle. I may not agree with it and I might feel like it’s helpful to have vulnerability, but epiphanies of wrongdoing are to be dealt with strategically.

Men don’t want to make amends as much as they want to make it right (see honor above). In reality, men want to fix the problems, so I help make the building plans and figure out what is needed to “get this project off the ground.”

We get confused with the language of therapy.

This is a big one for me. Transparency with my clients about my approach to therapy and why I do what I do is important in my practice. I think men typically like to know how things work, and if I can’t explain why I am doing something, I am introducing distrust with my client (See point #2 above).

I hear men say things like, “I have no idea how going to therapy would help,” or “What does therapy even do for someone?” or the infamous “I can handle this on my own.” These are invitations to talk shop. I like to get in there and talk about the nuts and bolts of why we approach therapy in various ways. How therapy works can be weird, but once we begin to understand its functionality, we learn to use it as a tool for a more fulfilling life.

Men have options

We may never know why someone doesn’t go to therapy. What is important is that the right therapist is available for them. Being the right therapist means working with a population that you understand. Being a trained therapist with no knowledge of men’s issues is like asking a screwdriver to do the work of a wrench.

I specialize in working with men and fathers through life transitions, challenges, and losses. I appreciate the need for men to go to therapy, and I understand its complexities. If you want to find out more about my approach, give me a call or complete the contact form below.

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