Do Men Really “Need” To Be In Therapy?

Social media is littered with the notion that more men should be in therapy, or even that all men need to be in therapy. As a therapist I find this second statement to be absurd and counter-productive in engaging men who could actually benefit from my help.

Therapy is underutilized by men in general, that’s not the debate here. The complication happens when we move from the general to the specific. By this I mean you have to ask yourself should you—if you’re a man—or should the man you care about be in therapy? That’s tougher to answer, but worth exploring through the following key questions:

1. What would be the desired outcome of therapy and can that outcome be achieved through other means?

It’s all well and good for a partner to say “I’m leaving you if you don’t see a therapist,” and this has been the impetus for many men to engage in sessions, at least in terms of showing up. But it’s worth asking the question, what is it that I want the therapy to accomplish? Is it a change in attitude, more helping out around the home, more active job-searching, less anger? 

We need to remember that the therapy business is a part of a larger group, namely, the change business. And change may come about from something other than therapy. If a man is more likely to reach those desired positive outcomes from getting back into something he used to do, or having a heart-to-heart with real consequences laid out if there is no change, or finding a new activity that gives him a sense of pleasure or purpose, then I’m not so sure that therapy is the answer.

2. What is this particular man’s idea of therapy?

Through pop culture and our own experiences and attitudes, we’re all going to have a somewhat distorted view of what therapy is. By having the conversation about what therapy can be, and what type of therapy is preferred, a man who is ambivalent about therapy would be more willing to give it a try.

Therapy can be focused on supportive listening about long-standing issues, with gentle encouragement to explore alternative interpretations. Therapy can be future-focused, with a solution-oriented approach that doesn’t explore the past in any way other than what the client feels is necessary to explain. Therapy can be very interactive or one-way, it can involve teaching skills and helping clients understand the influences and counters to various symptoms. It can be an experience “in the room,” or the sessions can be a footnote in the treatment in that the real changes happen between sessions by making changes and taking interpersonal risks in the real world. It’s worth considering a little bit what might be engaging for a specific man with a specific concern.  

3. If he were to go, how would a man know that therapy turned out to be worth his time?

This is similar to question 1, however we are assuming that therapy is the change process that we really want to consider over others. We are valuing the potential benefit of working closely with a professional to understand symptoms of the problem, develop goals, and work through the process of instituting positive changes in one’s life. This is a good thing! However it’s important to consider, just like in question 1, what difference we’re hoping to get out of the process.

If a man is able to identify at least one thing that would be a potential positive benefit from therapy, even if that thing is “well I’ll get X off my back at least,” then we have a good starting point in terms of willingness to engage in the process. Ideally he can identify the presence of something positive in his life as opposed to simply the removal of something negative, e.g. “I would be able to speak up for myself at work,” versus “I would not feel so bad all the time.”

4. What if nothing else is working?

In this case, what does he have to lose? I would recommend one of two things. Either he should commit to two sessions, since the majority of providers will use the first session as an intake and then the second session will be more of what the real therapy will be like. Or go with a brief therapist, who will not have as extensive an intake process, since they prioritize starting actual treatment during the first session.   

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The above questions are worth considering, if you’re a man who is unsure about the usefulness of therapy, or if you want a man you care about to give therapy a try. Above all, recognizing that therapy is not the only answer is a good start, as there are many paths to positive change. Being open to that possibility will only help build more commitment if therapy ends up being the change process of choice.

Steve Rudolfmen, therapy