Would more men be open to going to therapy if they had resources tailored specifically for them, and if the office had Emotional Support Animals for appointment use?
I am an actual licensed therapist and while there are a number of real actual creating barriers specific to men pursuing mental health treatment there are a few factors I’ve consistently seen that are ubiquitous across gender, race, sexuality, class, etc
Money, time, availability
Therapy is inaccessible. I am a therapist who mostly works with insurance companies. They pay me about 100-115/hr. My clients will often have a high deductible health plan which means they need to pay this $100-115 per session until they hit their deductible, which can be 5,000+ dollars. It’s a lot to ask someone to pay $100+ weekly. On top of that they still usually have a responsibility afterwards of (typically) 10-30% so $10-34.5 per meeting which is still a notable weekly cost for many people on the high end especially after shelling out $400+ a month for months on end.
Other clients have PPO insurance which is a fixed cost per meeting but this can vary wildly. More affluent clients have excellent PPOs where they might pay $10-20 per meeting which is not terrible. But that’s rare. We are often covered under the “specialist” copay and many PPO plans have tiered provider coverage now. So a copay for me might be $50 or more per meeting (the worst I saw was $125 which was absurd because it was actually $27 more than I’d get from the insurer in question).
So you have this on top of these plans taking hundreds of dollars out of each pay check. “Well budget for it”. Hard to do because the need for therapy can be inconsistent and many of these people are coming in fo(and specifically symptoms like poor money management). Then on top of that even if you do budget for it you have the inherent issue that the need for outpatient therapy is often not dire/acute so if something more pressing comes up (eg a serious dental/medical issue, car breaks down, short on rent) therapy might be the corner to cut if it’s already established because in the overwhelming majority of cases you won’t die without it; it will just lower your quality of life (sometimes significantly so)
Then comes the time portion. Even if you can get past the cost barrier you have the availability of the therapist and yourself. I’m a night owl and I work late but many of my colleagues don’t. I’m pretty nontraditional though, no kids and my partner is very career oriented themselves whereas many of my peers tend to value the traditional 9-5 much more so they can be home for their children and such.
So when you go to schedule with someone it’s often that you can only get seen during business hours. It’s one thing when it’s a doctors appointment that you have once every few months that you need to duck out of work for but a weekly hour long engagement is much harder to explain. This brings back in the masculinity issues - many men find this basically impossible to disclose to the workplace and basically wouldn’t even try to get an exception for weekly therapy. Even without explicitly saying so asking for 1 hour open a week consistently for a doctors appointment is going to be perceived as therapy by many. But stigma aside many of us simply can’t do that. I’m on the practitioner side and I know I’ve ignored my own physical health at times because it was inconvenient to schedule doctor appointments during my workday.
Our systems of employment (at least in the USA) simply do not provide or protect for medical leave, even when it’s very brief and especially when you are a low level employee (executives and admins tend to have less of an issue ducking out for doctors appointments in my experience at least). There is no legal right to paid or unpaid time off for medical appointments in the USA and that is completely disgusting in 2023.
The final piece is practitioner availability. I have a waitlist through October at the moment and am not accepting new clients. All of my colleagues are in the same boat. The old practices I used to work at constantly call me to see if I’ll take any referrals because their waitlists are so overloaded. The hospitals and clinics I have referral relationships with email me every week for updates. It’s extremely stressful. Every new client, especially adolescent, complains that they are happy to finally have someone after waiting 3-6 months. Even if someone wants a therapist they have to wait ages. It is not uncommon that I get someone and when I call them to start they say they don’t even remember why they called in the first place.
We need more people doing the work. Or ideally we need to make societal reforms so that there are less people experiencing mental health issues. I’ve been doing this almost 15 years now. I, and anyone who doesn’t exclusively work with the rich, can tell you that a significant degree of what we work with is people who lack resources and not proper mental illness. I mean, it is depression and anxiety, but it’s because they have been paycheck to paycheck for years or theyre under a mountain of student loans or credit card debt and the stress is just too much to bear. And their jobs won’t give them raises and there aren’t any other jobs out there that pay more. Not everyone is a software developer or investment banker that can jump ship to another 6 figure job with cushy benefits. Most people work jobs that pay 40-60k with shit benefits and little upward mobility.
To answer your question more directly:
In my opinion it’s a systemic issue based around that super fun phrase everyone loves, “toxic masculinity”. I personally do not subscribe to gender labels but I am amab/male presenting and get a lot of male clients as a result. Many of them tell me they hide the fact that they are in therapy from everyone but their partner. This is indicative of the problem; that being in therapy is weak. That being in therapy makes them a bitch, a wuss, all kinds of pejorative terms. It’s bad, is my point.
So part of the answer imo is not in having doggies and cool dude stuff in the office. Its far more complex and involves redefining masculinity to still including things like being a lumberjack or carpentry or whatever. From there though you need to shed the part where it means you have to be emotionally numb to everything, constantly display strength, embrace the fucked up misrepresentation of stoicism that has you shove all your feelings into your stomach, and glorify anger, rage, and violence as the only appropriate means of emotional expression.
this could also be extended to the stigma surrounding therapy itself and the tendency to associate therapy need with weakness. This is an issue that goes beyond therapy though; there are people who won’t see medical doctors for the same reason even though they’re in physical pain. Our pride is our downfall.
Tldr make therapy cheap and accessible, make protections for workers to seek medical care, increase the amount of practitioners (or decrease the need for them), and systemic reform to the societal concept of masculinity and pride. So probably gonna take awhile
This is a fantastic response, and it’s good to see someone taking a practical view of time/money/availability concerns.
One aspect I haven’t seen raised much is a slightly subtler parsing of the whole masculinity thing. Perhaps it’s generational (I’m genx), perhaps it’s cultural (I’m not from the US), but I think perceived weakness is a misreading of the motivation, or perhaps even a more-acceptable out, for many guys.
Perhaps this might give someone out there an angle they find useful, who knows?
A chunk of it from my perspective, and as best I can gather for a lot of guys I know, isn’t about being seen as a pussy, it’s just… my problem to deal with, not something anyone else has control over or responsibility for, any more than they can go pee for me when I need to. The anxiety here isn’t jocks kicking sand in your face, it’s the sitcom dad asking what the hell you expect him to do about it, idiot.
It’s associated with and caused by cultural gender norms and the way we’re raised, but I think it’s a misleading oversimplification to suggest that it’s just about not appearing masculine enough. It’s not about being ‘man enough’ to tough it out, it’s that as men, they’re taught that the only resource they have is themselves.
And a second major facet is that for a lot of guys, losing control of their emotions in and of itself represents painful catastrophic failure. While guys definitely get punished and shamed for displaying vulnerability, the flipside of that is that they tend to rely on the resulting rigidity for refuge and protection. But especially since they get no opportunity to practice controlled, minor release of negative emotions, that protection is all or nothing; one good crack and the entire structure collapses. And that’s not the cathartic but ultimately healing purge people think of it as, but rather a terrifying, traumatic and destructive breakdown of everything that’s holding them together. And most guys I know would no more put themselves in that harm’s way than they’d shove their arm down a garbage disposal.
Again: caused by shitty gender norms, but the connection isn’t the one people usually paint. We’re no longer told during our upbringing that boys don’t cry; that’s a horrible relic of the bad old days. Instead boys are told that only babies cry. Crying isn’t feminised, it’s infantilised. The shame associated is not due to being inadequately male, but inadequately adult (but only if you’re male). This of course does women no favours; when men see crying in women as accepted and encouraged, what they hear is that women must be fundamentally infantile on some level themselves.
If we want to see better emotional resilience in men specifically, and better use of mental health resources by men, I think the most effective change would be a cultural shift creating a safer environment in which they can be vulnerable. There’s no use telling men that they should be vulnerable, in a society that will just hurt them for it; the ground needs to be prepared first. That means a hard, critical look at gendered expectations around emotional expression in children, and a significant change to how they’re raised. It means treating phrases like ‘man-baby’, ‘man-flu’ and ‘male tears’ as toxic and offensive on par with racial slurs, and a bunch of surrounding attitudes treated like the ingrained racism of boomer grandparents.
It’d be really nice if we could stop telling people how to do their gender altogether, and stop using gender-compliance as a proxy for admirable character traits. Every time well-meaning people promote the notion that Real Men Are (generous / honest / hardworking / etc.), they’re pushing the converse, that insufficiently-masculine people are (mean / shifty / lazy / etc.), and that makes the whole problem worse, not better.
This is pretty much what I meant by that fucked up misinterpretation of stoicism
Like you have the actual Aurelius stoicism which has some very good value; everyone should read meditations once or twice. But then it’s been cliff notes’d and perverted by a bunch of people into to lose the message entirely from “be in control of your emotions” to what you’ve described: horrific rigidity to keep it all in at all times until of course it doesn’t work anymore and you break down spectacularly. Like somehow the message has gone from “control” to “emotional numbness”
A similar dynamic has happened with nihilism where some the writings on it are not so bleak and terrible; that it is an expression of freedom. But over the years it’s been perverted into nothing matters, why bother
This was quite simply the greatest ‘not rant’ I’ve read in a long time. Really well reasoned and I completely agree (although, in New Zealand we don’t suffer from nearly as much pressure).
One of the things that really keeps me repelled by conventional therapy in business hours is not just the time out from work, but it’s the emotional hangover that lasts hours or days in some cases. Fuck trying to pokerface my way through that one - one drop of verbal praise and it’ll be the ugly waterworks all over again…
Wow, I’m seeing a lot of strong anti-therapy vibes here, so I’ll pitch in my two cents.
Therapy is a great tool, if you go into it with clear expectations and you can stomach the cost- both in time and money. Some insurance providers cover it, some don’t, but either way if you don’t have a therapist that you vibe with, you need to be willing to swap around until you find someone that fits you. Note, however, that there’s a big difference between a therapist that is right for you, and one that just doesn’t challenge you.
My experience with Cognitive Behavioral Therapy has been really positive; my first therapist that I really got along with professionally was a great teacher, I really learned how to unpack things that I was feeling in the moment. He helped teach me tools to alleviate the intensity of moments that seemed dire, and to then reflect on why they felt that way, afterwards.
There’s a lot of people who think that it’s supposed to magically fix you, and no, it’s not. It’s work. Genuinely some of the hardest work I’ve done has been applications of the stuff I’ve learned in therapy. But, while I recognize that with stuff like chronic depression, true cures are rare-to-impossible, I’ve got a much better handle on my negative thoughts and self-esteem than I had pre-therapy. It’s been a tremendous help.
I think more tools for people in general would be incredible - the work of normalizing therapy has come a long way, but still it has even further to go. I think the biggest barrier is always cost, and in a perfect world we’d treat both sickness of the mind and body free for everyone.
Therapy is never a cure. If you have a problem then therapy can help you confront it and deal with it, but if we have a massive society-wide mental health crisis it will not be solved by each man individually seeking therapy.
We need meaning in our lives, something worth dedicating ourselves to, and the means to pursue it. Mercenary capitalism won’t provide that.
In short, I don’t see an answer. I think it will get worse.
Addendum:
Most importantly, this new wave of mental health problems is not caused by a new wave of “not being vulnerable.” It’s a societal issue and must be confronted there, not shunted onto each individual man.
One reason I dont want to do therapy is simple paranoia. Anything you tell your therapist can be subpoenad by a court. That alone is enough to keep me from trusting a therapist with anything of substance.
That said, anything in my life that might motivate me to do something that would land me in court is probably something I should see a therapist about.
Truth is, I’m unlikely to do anything that would land me in court, so I should probably see a therapist about this paranoia.
In this economy?
In the US I feel like it’s just as much of an issue of access as it is, perhaps, a stigma that you “aren’t a man” if you go to therapy.
Therapy is expensive, and health care doesn’t always cover it.
The US government can find little space guys, but they can’t find me a good affordable healthcare plan.
Disclaimer at the beginning, my reply is purely anecdotal and based on my own life and experiences. I can’t speak for everyone else.
I really don’t think that talk therapy is best suited for most men. Men don’t process emotions, conflict, or fears in the same way that women do. We have been shaped differently by societal norms, and don’t have the same foundation to process our issues simply by talking about them. We have been taught to shut up and deal with situations on our own. Talking about our struggles and asking for help is a sign of weakness, and even if we manage to ask for help, the chances that we will truly open up are slim.
Again, I can only really speak for myself, but for talk therapy to truly be effective it has to be more than just talk. We need a foundation; maybe starting with something like cognitive behavioral therapy to give us the tools to understand how to process our emotions would be a good start. Men are taught to understand and explore only a small handfull of emotions. Anger, jealousy, fear, happiness, and if we’re lucky, love.
I personally have had to do a lot of work on my own self, and my own understanding of my emotional landscape, just to begin to be able to open up. I can honestly say that even if I had spoken with a therapist - and I have had the opportunity to do so - that it probably wouldn’t have been useful to me, at least not in the past. Maybe now it would be useful to talk to a therapist, but in working on myself I feel that I have also learned to move past many of my own issues, or at the very least am on the right path to be able to handle them on my own.
Anyway, that’s my two cents.
I don’t know what it’s like in the rest of the world, but I always hear how many people seek a therapist, but can’t find one. I don’t even know if there’s something wrong with me, but I’m interested in finding out. But I don’t think it’s bad enough to warrant to “steal” a spot for somebody who actually needs it, just for interest sake. (Could be the “man” in me talking though, saying “I’m fine”)
I will say it every time it’s even slightly relevant until I die, The Will to Change by Bell Hooks should be mandatory reading for men. Men suffer unique mental health crises at the hands of patriarchy and need specialized care just as much as anyone else.
To address your specific question though, I think possibly, but not much, because the men who need help and care most are the ones most resistant to reaching out and the ones most insistent on rugged independence and getting up, dusting themselves off, and jumping back in the fight without treating their wounds.
Sure… But if there is a massive incidence of these “wounds” then therapy and self help is too little too late.
Why is nobody ITT talking about the causes of this wave of misery? We are putting all the responsibility on individual men to show their vulnerability with no interest in solving the initial problems!
That was my intention with plugging The Will to Change, it’s definitely not a “here’s why men suck” piece, it’s a feminist analysis on all of the unique harms that men are subjected to under patriarchy, how those manifest, and how to heal from them. Any analysis of the suffering of men under patriarchy that lands on individual responsibility as a cause for psychological suffering is a bad one.
Sure, but that patriarchy has been around for a long time and this wave of despair is new. You could probably solve some problems that way, but it’s not the solution to the big problem we’re facing here.
Rising inequality and alienation are the problems.
Animals might be a nice feature, but if that is the selling point of the session ibdoubt much will come of it.
Therapy that tries to have me accept the fucked up state of the world is a non starter.
I would rather die than participate, enable, or support a corrupt and mal-guided society.
Honestly i do not think there is any hope for me. I can not trust anyone, so therapy isnt going to work. The only way for me to escape is death.
I mean, you don’t have to accept the current state of the world as good or natural because of therapy
Honestly, the world seems like it’s always been a brutal place. Nature is fucked and most things die being eaten alive.
But you’d probably have to accept the state of the world is currently happening and that should be accepted becw, well, it is, regardless of good or bad.
Give it a try homie, talking things out with a professional can give you perspective of your own opinions and how they are formed, and how to process them in a way that is helpful.
It sounds like you don’t want to accept anything that might suggest your opinions or beliefs may not be 100% correct, or that someone else might be “more right” than you - which doesn’t sound healthy.
Therapy isn’t some trick, it should help you understand and accept your own limits as a human, healthy boundaries with others, how to begin trusting people or how to identify those who are more likely to be trustworthy, and give you better understanding of your own agency and how to let go of things that are beyond your control, or individual abilities to influence/change.
No amount of therapy with teams of the world’s greatest therapists will matter if you don’t want to understand and grow into a better version of yourself though!
My life is evidence hunanity is evil by nature, deed, and desire.
I have been exploited and betrayed by family, friend, coworker, teammate, manger, etc.
There is no one i trust in this world because everyone i did trust, broke that trust to steal from me.
I have no desire to help or enable such a species.
Humanity has shown me its true nature, and my concious soul is revolted.
Death is the only way to move beyond the pain, suffering, and evil of this existence.
Even if you have been greatly wronged by everyone you trust, that doesn’t necessarily mean you were ever even around trustworthy people. So personal experience may feel like the only reality or truth but once you realize that it’s only true specifically for you and only up to this point, you might be able to understand its not a universal rule or experience.
There’s so much to experience beyond pain, loneliness, distrust and suffering (outside of incurable medical pain)
It does exist and it is available to you, but when anyone has their trust destroyed beyond repair multiple times it will take work to let the pain go and look inward and forward to get what you want out of life.
For all I know, you’re the asshole in everyone else’s life and you blame them for breaking your trust - or you are a complete victim who has been taken advantage of every step of the way and it’s impossible to conceive of a person existing who isn’t working every angle to take advantage of you.
You do have agency and you can control how you think and feel about most things. It sounds like you are convinced that life only exists in a single, permanent, unchangeable state - and if you don’t attempt any change in this perspective it will become a self fulfilling prophecy.
But once you realize the control you can exert over these thoughts and perspectives you’ll hopefully realize that despite other people, when you’re an adult life is what you make of it, not what it makes of you.
It does take monumental, constant effort. Especially compared to how easy it is to give up/admit defeat/believe things are permanent and unchangeable. Doubly so if that’s the mental state you’re already in.
Therapy can give you the tools to climb the mountain, but it’s not gonna move your arms and legs up the mountain for you.
I look around and its not worth it.
Humanity is a crude and barbaric species. It was a mistake for my soul to inhabit this vile creature.
And if IATA, even more reason for me to off myself.
Ive been patient, waiting for justice, waiting for people to realize exactly what kind of society their behaviors are manifesting. No such luck.
If anything people are naturally drawn into a rhetoric (sic.) based tribal facism.
And humanity will inevitably disrupt a peaceful equilibrium for their own gain.
I’d rather not be part of that.
I wouldn’t object to having a dog to pet in an appointment but don’t think it’s entirely necessary. Like anything, though, it’s best when tailored for the needs of the patient so no harm in offering it. The important part is developing rapport between the therapist and patient so they both feel comfortable discussing uncomfortable topics. If that isn’t working out, maybe it’s time to get a referral to a colleague.
This ends up kinda like one of those “pull yourself up by your bootstraps” situations though, it’s not always easy to advocate for yourself and you may not even know what you need yet when you’re unfamiliar with the process. I think it’s less a matter of needing to change what sort of therapy is available and more about changing our attitudes toward therapy so the contents of one’s underwear isn’t seen as relevant (aside from the cases where it very specifically is).
isn’t men’s mental health an oxymoron?
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Men, in general, are perfectly mentally healthy. There are men who suffer from such things as schizophrenia, bipolar disorder, post-traumatic stress disorder–these men require medical treatment for these disorders as much as I require glasses for my myopia. These are medical problems that require medical solutions.
I am not one of those men. I’m one of the many men who operates under a constant layer of depression, anxiety and anger. For men like me, “Therapy” is pretty much a scam. What’s the difference between going to see a “therapist” and going to a fortune teller to read some tarot cards? It costs a lot, insurance won’t pay for it, it takes up a lot of time, and nothing about your situation is ever improved. I’m depressed and anxious and angry because society by and large doesn’t work. The rich are ruining the world for the rest of us out of sheer greed. I’m a widely skilled man, I’m an auto mechanic, a carpenter, a pilot, a programmer…I’ve never had a job that paid all of my bills. And there is nothing.
Nothing.
NOTHING.
NOTHING!!!
that a master’s degree in a tweed jacket can write on a legal pad that will fix that.
“Resources tailored specifically for them” What “resources?” They ain’t got no “resources.” They’ve got a box of tissues and a stack of board games for the neglected/abused children they have to handle. They don’t have a July that isn’t the hottest on record, health insurance that pays for eye glasses, or stable food prices in there.
Talking about “emotional support animals” makes me think that this is a question of marketing. Therapy for MenTM where the therapist wears flannel and a bushy beard with a waxed mustache, the whole place is wood paneled, there’s pictures of axes on the walls, all the furniture is brown leather. Focus groups have shown this is effective for marketing hygiene products, kitchen implements, clothes and alcohol to men, maybe it’ll work for mental health counseling.
The world we live in, at least in regards to this, is a woman’s world and it’s not fit for men. It’s forcing men to do what’s best for women, then if they have any issues things that worked on women are used on men. If men act like women at the end then great, if they still act like men then they are broken.
Now I probably lost a load of people already but bare with me.
Women/ girls have issues then men/boys have to do something about it. Boys constantly get told how to behave how awful their sex is how they need to do this and that and they are wrong, they are responsibly etc. But it doesn’t matter if they are perfectly good citizen and boy it’s still their fault for all the wrong in the world. Nothing ever goes back the other way. Some rich guy has a load of money, that means all guys are responsibly for having a load of money and all guys need to make less money. It’s stupid.
But more to the point how do you make guys happy? Guys do not want one on one sessions when they can talk about all their issues and cry then feel better. That’s a woman’s solution to a problem. Men are built different and need solutions.
The best thing I found is being part of a men only group where we physically hurt each other and used our aggression to have fun with each other. (Rugby). Especially when I was younger men need that testosterone release. Then we all went to the pub got fucked up, was dicks to each other. But we had each others backs. This is what women do not get. They see us fighting each other, calling each other cunts and what not. But if you did something bad the group will let someone call you a cunt and get put in your place, if you are doing something bad the group will step in. If you did nothing wrong then it keeps going on. But we still talk and look out for each other. Here is the point. Who do you think I would rather talk to? Some person in a open collar shirt and fancy office trying to look approachable? Or some guy in a shirt and tie covered in beer, in a dark room, with a black eye and arms the size of my head, that earlier in the day called me a fucking pussy and told me to man the fuck up and get in the game because I just got pushed off a tackle. I bet 9/10 women would get that wrong. Also I’m the person that would respond well to that sort of encouragement, I don’t need to feel sorry for myself that doesn’t help. I need motivation. Women don’t get that either.
Men need men only spaces where they can de-stress and shoot the shit. This is why pubs have been so popular with men. But we need a revival of social clubs. Just a place where you can go to hang out and not need to drink, somehow children need to be involved too by maybe not every day.
Yikes, if this is really your worldview, it seems pretty small and is dismissive of a lot of realities that both men and women live in. To be clear, I’ve tried to parse what you’re saying, and generally it seems you’re calling out symptoms of an issue where the conclusion is men are “built different”. It would be nice if life were so black and white.
