treat men’s issues
Men’s issues can refer to a number of concerns that may affect mental or physical health and well-being and lead men to seek therapy. Statistically, men do not typically seek therapy in high numbers, but when they do, they generally report the same types of concerns that might lead anyone to seek therapy, such as depression, stress, anxiety, and relationship concerns.
Historical, Social, and Cultural Factors
Men’s Issues and Problems
Male psychology and psychotherapy methods designed specifically for men are both relatively new phenomena. Throughout human history, men have frequently been defined by distinct roles as hunters, warriors, and providers for their families, tribes, and communities, and many male-dominated cultures have traditionally given men a higher status than women. Male rulers and military leaders as well as largely male-led businesses, churches, and societies have played a significant part in contributing to cultural and social expectations of men. The roles of men were seldom questioned or debated and generally were not psychoanalyzed: Leading pioneers in the fields of psychology and psychiatry, such as Sigmund Freud, the founder of psychoanalysis and modern psychology, had little to say about a distinct male psychology.
Today, however, a growing list of psychologists, research scientists, and other experts are contributing to the psychological and interpersonal understanding of men. Fields such as anthropology and modern brain science come together to help men define themselves in ways separate from previously conceived ideas of manliness and male behavior, such as the “macho male” stereotype, a cultural standard up through the 20th century that, in some instances, still has an impact on male behavior today. A greater understanding of early human behavior and recent findings from modern brain science have helped created a deeper understanding of some emotions, behaviors, and attributes that may be particular to some men. This knowledge may help facilitate an understanding of certain actions, thoughts, and feelings that men may be more likely to experience, especially those that relate to traditional cultural ideas of masculinity.
Stereotypes of women as a “weaker gender” and of men as “protectors,” which can be seen frequently in literature, movies, television, and so on, have also contributed to the development of certain ideas that may be harmful. In recent years, these ideas have increasingly been recognized as potentially problematic, and a number of social norms and cultural expectations are changing. When faced with the reality that certain ideas and behaviors considered to be traditionally masculine may be problematic, some men may find it helpful to deepen their understanding of potentially harmful beliefs and assumptions about gender and masculinity.
What Brings Men to Therapy?
As the role of men in the workplace, in relationships, and in society has changed to more strongly reflect equality, some men who have long existed in a male-dominated environment may find it difficult to adjust to societal changes and may experience stress and frustration when certain attitudes or behaviors are challenged. Stress at one’s job, in familial relationships, or as a result of one’s pursuit of romantic relationships and intimacy may also lead an individual to seek therapy.
One challenge men may face is the way that symptoms of mental health conditions are experienced. For example, a man who is experiencing depression may be angry and irritable, and men in general have been shown to often be less likely to cry, discuss their feelings, or express internal thoughts of suicide. Posttraumatic stress may also lead to anger, as well as aggression, and men with PTSD may be somewhat more likely to cope with symptoms by using drugs or alcohol. Men may avoid seeking help until a point of crisis is reached, fearing that others will see them as weak, but treatment may become more complicated as a result.
While there are no male-specific diagnoses in the current edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), common issues reported by men seeking therapy include:
Stress, which may present with somatic pains, complaints, or feelings of irritation or frustration
Work adjustment issues such as procrastination, avoidance, anger, or success sabotage
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Substance dependency or addiction
Other dependency or addiction—Internet, gaming, gambling, sex
Body image issues
Depression, which might be experienced as boredom, lack of motivation, or feeling that one is blank or “stuck”
Some men may experience fear and shame related to preconceived notions of their roles and responsibilities. For example, a man whose employment income is not sufficient to provide for the needs of his family may experience feelings of frustration or emasculation stemming from the belief that he should be able to provide for his family. This may especially be the case when a spouse or partner brings in more income or has a higher-paying job.
Because men are often conditioned by social norms to refrain from showing certain emotions, such as emotional vulnerability, fear, sensitivity, or dependence, they may fear that expressing these emotions will lead them to be perceived as less masculine. However, keeping back these emotions may cause other emotional difficulties, and those who attempt to hold back their feelings may find that health and well-being are negatively affected by the practice.
According to a recent study conducted by the American Psychological Association, men are often more likely to be diagnosed with substance dependency or mental health conditions related to antisocial personality or behavior. The study suggests that men seem to more frequently externalize their emotions, and this externalization may lead to harmful or negative expression.
Challenges Related to Fatherhood
Fatherhood, while often a great source of joy, may cause stress and anxiety to develop in both parents. Possible sources of stress might include:
New responsibilities, such as diaper changing, feeding, and providing constant care, which may take time to adjust to.
Limited paternity leave. Some fathers may wish to spend more time with the newborn and experience frustration because they cannot be as supportive to their partner as they wish.
Sleep deprivation, which is likely to affect both parents.
Financial difficulties due to increased food and medical costs, plus other expenses, which are likely to place stress on both partners.
Prioritization of the needs of the newborn, which generally leaves less time for partners to focus on their relationship.
Depression or low spirits.
Cultural Norms and Development
Growing up, boys may experience societal or familial pressure to be tough or “manly” or otherwise conform to cultural standards of masculinity. They may be expected and encouraged to prefer certain toys or colors and pursue particular activities. Boys who express different preferences or who attempt to pursue activities that are considered to be feminine may be gently discouraged, redirected, or in some cases, mocked. This behavior may be connected to homophobia and transphobia, whether these prejudices are outright or deeply rooted, or fears that a boy will not “become a man.”
However, a boy’s preference for the color purple over the color green or his inclination to take ballet classes rather than play football does not necessarily indicate sexual orientation or gender identity. As an increasing number of parents and educators understand and accept this fact, children are likely to become better able to express themselves fully without being discouraged. In addition, as sexual orientation and gender identity are increasingly recognized as an unalterable part of nature, parents are likely to be more willing to encourage and support their child in all ways.
Encouraging all individuals, regardless of gender, to express feelings honestly, develop healthy relationships with peers of all genders, and be considerate and respectful of others may be more helpful to development than encouraging children to conform to gender-based stereotypical ideals.
Statistics of Men in Therapy
According to a recent Substance Abuse and Mental Health Services Administration (SAMHSA) survey, over 14% of American men experience some type of mental health challenge, and more than 3% of men face serious mental health challenges. The survey also shows that the number of men who seek treatment for mental health concerns is significantly lower than the number of women with mental health concerns who utilize available mental health resources. Some mental health professionals believe that this is because some men, due to social and cultural norms, may find it difficult to place trust in a therapist, and this trust is generally necessary in order to discuss issues of a personal nature.
The SAMHSA survey suggests that while over 72% of women with diagnosable depression obtain professional care, only 60% of men with depression seek treatment. In 2012, for example, American men were less likely than American women to utilize outpatient mental health services (5% vs. 9%) and less likely to use prescription medication (9% vs. 16%) for mental health issues experienced in the past 12 months. Age also seems to be a significant factor in treatment-seeking behavior, as men over 50 years old were shown to be much more likely to seek help for mental health issues than men between the ages of 18 and 25.
Therapy for Men
Only about one third of all people in therapy are men. Research shows that men are less likely to seek help for mental health issues than women are, and studies also show that men may often delay getting help until there is a crisis. Research shows that men are less likely to seek help for mental health issues than women are, and men may delay seeking help until they are in crisis.Further, because men may also tend to be more concerned about privacy, they may require greater reassurance that therapy will not adversely affect their image, position, or standing. Some researchers have suggested reworking the description of therapy in order to make it more appealing to men. It is also believed that when men understand that many men experience depression and other mental health concerns, they may be more encouraged to seek help when needed.
Men have been shown to be less likely than women to follow through with treatment recommendations. This behavior does not always characterize a resistance to treatment, however. “Real men solve their own problems” is a common stereotypical belief that may lead many men to consider the act of asking for help to be shameful. Therapy generally requires open and honest communication about feelings, relationships, and other personal issues, and men may tend to be more guarded and defensive when discussing these topics.
When therapists and other mental health professionals normalize the reluctance to share personal feelings and any defensive tendencies and address misconceptions regarding “typical male behavior,” men in therapy may be more willing to address their concerns and thus may be more likely to see results in therapy. Therapists are often able to help men explore aspects of “normal male behavior” that society has overlooked or encouraged and help them become better able to address feelings, get needs met, and achieve goals in an effective and healthy manner.
Men who are experiencing barriers to communication or other challenges in an intimate relationship may find couples counseling to be helpful. In couples counseling, both partners can express feelings and emotions, explore reasons behind behavior that may be affecting the relationship, and discuss goals, whether the goals relate to the relationship or are of a personal nature. Many couples in therapy report concerns over differing communication styles, general communication issues, relationship goals, and concerns relating to intimacy both emotional and physical.
Research shows that men may be more likely to succeed in therapy when assigned realistic and achievable tasks, such as homework assignments and specific behavioral goals. Therapy groups may also be helpful, and some men may find that joining a therapy group is an easier first step than seeking either individual or couples counseling. In a therapy group, men may receive support and encouragement from other men who identify with them and are experiencing similar issues. Issues that are often experienced by men may be normalized in a group therapy session, and men may find themselves more readily able to take advice from men with whom they can identify.
Anger as a symptom of depression: Marco, 42, enters therapy in conjunction with anger management classes as a condition of continued employment after his outbursts at work become problematic. He tells the therapist that he feels like nothing is going right for him lately: He has been passed up for a promotion by a newer employee, his wife frequently expresses dissatisfaction with their relationship, and his finances are not quite what he had hoped they would be in his current stage of life. The therapist helps Marco explore each of these issues, and in the process, Marco’s loneliness also surfaces. He reveals that his best friend since high school committed suicide four years earlier and since then, he has found that areas of concern in his life have become harder to handle. Communicating with his wife is difficult, as he does not want to admit to her the extent of his sadness and low spirits, and his reluctance to express emotion has created distance between them. He also tells the therapist that he drinks more than he would like to, and gaining several pounds has further lowered his spirits. The therapist helps Marco realize that the anger he is experiencing is likely a symptom of depression. At first Marco brushes off this suggestion, but as the therapist further describes the condition of depression, he begins to accept the diagnosis. Once he does, the therapist helps him address his feelings and gives him small daily tasks to improve self-care, improve his communication with his wife, and express his dissatisfaction in the workplace in a more constructive manner. Marco begins to see small improvements early on, and over time, he finds his mood much improved. Reaching out at work both enables him to build new friendly relationships and to succeed in achieving the next promotion he tries for. Discussing his low spirits with his wife also greatly strengthens their relationship, and they are able to renew their intimacy with a little work.
American Psychological Association. (2011). Definition of terms: Sex, gender, gender identity, sexual orientation. Retrieved from http://www.apa.org/pi/lgbt/resources/sexuality-definitions.pdf
Eaton, N. (2011, August 18). Study Finds Sex Differences in Mental Illness. Retrieved from http://www.apa.org/news/press/releases/2011/08/mental-illness.aspx
Mayo Clinic. (2015). New dad:Tips to manage stress. Retrieved from http://www.mayoclinic.org/healthy-lifestyle/infant-and-toddler-health/in-depth/new-dad/art-20045880
National Institute of Mental Health. (n.d.). Use of mental health services and treatment among adults. Retrieved from http://www.nimh.nih.gov/health/statistics/prevalence/use-of-mental-health-services-and-treatment-among-adults.shtml
Nelson, G. (Ed.). (n.d.). Men and Mental Illness. Retrieved October 19, 2015, from https://www.urmc.rochester.edu/encyclopedia/content.aspx?ContentTypeID=1&ContentID=4565
Substance Abuse and Mental Health Services Association. (2012). Results from the 2012 national survey on drug use and health: Mental health findings. Retrieved from http://www.samhsa.gov/data/sites/default/files/2k12MH_Findings/2k12MH_Findings/NSDUHmhfr2012.htm
Winerman, L. (2005). Helping men to help themselves. Retrieved from http://www.apa.org/monitor/jun05/helping.aspx