Understanding Men’s Mental Health in Therapy 

“Men’s Issues” can be a term fraught with controversy. While there are many issues that are legitimate concerns for men and boys in therapy (and in broader society) that don’t apply to women and girls, there is a pattern of bad-faith actors using “men’s rights” or “men’s issues” as a distraction from discussions about gender inequality and feminism. My intent here is to highlight and discuss a series of topics that men face and frequently bring into therapy.

Barriers to Men Getting in the Door

Men present less often than women to therapy. Although there has been a growing acceptance of seeking mental health treatment over the past 20 years, about 17% of men reported seeking mental health treatment in 2024 vs. over 24% of women. Here are a few contributing factors to why men do not seek out and attend therapy as often as women.

Societal Messages about Men’s Emotions

Many men are conditioned to ignore or downplay their emotions, so therapy that addresses emotional content vs. “solving the problem” may seem less helpful and effective. Often, men experience the emotional symptoms of depression as numbness or anger, while common portrayals of depression show it as a person feeling sadness and melancholy. This mismatch leads many men to not identify themselves as experiencing a depressive episode, when that is exactly what they are going through. A failure to recognize our own emotions can stop many men from even considering therapy, even if we can be helped a great deal by it.

Delaying Going to Therapy

Men tend to seek out therapy when they are already in crisis, following a loss (like a death or a breakup), or when encouraged by friends and family members. This means that men may be less likely to attend therapy as a preventative step in their struggles or to gain insight. As a result, therapy can feel like it NEEDS to provide an immediate solution to an external problem or a strong negative feeling. This puts a lot of pressure on the therapist and the client to have the correct answers right away. To use a metaphor, therapy works best when men treat it like going to the gym rather than a trip to the emergency room.

Increased Social Stigma

Men can experience additional social stigma compared to women about going to therapy, asking for help, or showing vulnerability (even to family and close friends). Even when we get help, both men and women as groups are less empathetic toward men! As men, we are expected to be stoic, “suck it up”, and just solve problems without complaining. There is still a widespread belief that going to therapy means that there is “something wrong with you” or that “you are weak.” In fact, the opposite is more often true. Therapy is a great place to discover and re-invest time in our strengths, build resilience, and get a wider perspective on change and problem-solving.

Feeling Uncomfortable in Couple’s Counseling

In couples counseling, straight men can feel “outgunned” in terms of being able to communicate their feelings and concerns in a relationship. This can show itself by men feeling like their wife or girlfriend is communicating directly with the therapist, but they are speaking another language. Men may hear about their friend’s bad experiences with couples counseling and be wary of going, even if they want to go to a counselor in their own relationship.

Traditional Talk Therapy Doesn’t Look Like Typical “Male Bonding” Activities

Men are more prone to socialize while doing an activity, playing a sport or game, or cooperating on a shared physical task than women. Traditional talk therapy that happens sitting in a room together or on a call typically eliminates “outside distractions” like these activities to put the emotional and mental content of the session front and center. Many men say they get more out of therapy when doing something like taking a walk or playing a game while talking to their therapist.

There Aren’t Enough Male Therapists

The data shows a lack of male providers and role models in therapy practices. In many places, male therapists can be rare, overbooked, or not available at all. Nationwide, it is estimated that men make up just 24-25% of therapists.

Lack of Messaging

There is a lack of campaigns addressing the importance of therapy for men. Some research shows that direct campaigns to raise awareness and speak to men specifically about mental healthcare are effective, but more research needs to be done to determine the best messaging. When we think about our father and grandfather’s generations, it might be unthinkable to imagine them going to therapy. Widespread messaging about what therapy is and how men can benefit from it may be the catalyst for some societal change.

What are Men’s Issues in Therapy?

In general, people enter into therapy when they feel something is not right in their lives. They may be looking for a specific solution, a set of tools to help address the problem, or simply to be heard by a trained and empathetic professional. There is certainly a lot of overlap between why men and women might seek out therapy: feeling depressed, anxious, or manic; dealing with obsessions or compulsions; experiencing psychosis; experiencing a death or breakup; and many others. Here are a few issues men tend to address in therapy more often or in different ways than women.

Identity and Self-worth

For decades, masculinity was defined by protection, stoicism, and providing. When men don’t easily fit into this mold, it can bring on questions about what our value and identity should be. Working with a therapist can provide a space free of judgment to help define our self-worth and identity as men.

Career Stress, Financial Stress, and Burnout

If you are feeling lost at work, checked out, or so stressed out that you aren’t performing like you used to, you may be experiencing burnout. Men focused on being aware of and avoiding burnout is an excellent goal for therapy.

Fatherhood and Parenting

Millennial and Gen-Z dads are more connected and involved in their children’s lives than previous generations. Many dads feel enormous pressure to parent perfectly and can experience imposter syndrome when not living up to our full potential. Likewise, becoming a father can open up wounds from our own childhoods, and healing those wounds can be a great goal for therapy.

Anger Management

For many men, anger is the go-to negative emotion. Expressing anger is cathartic; it gets an immediate response, and men have no shortage of angry role models to choose from. Of course, anger can be off-putting to others and put us at risk for a laundry list of poor social and health outcomes. Anger management is a common theme when men come to therapy, even if it is not the primary issue they come in for. We see many clients who learn that “anger is a secondary emotion” and how to identify the primary emotion paired with the anger.

Behavioral Addictions – Pornography, Video Games, and Gambling

Men are disproportionately affected by addictions of all kinds when compared to women. Three major behavioral addictions that are on the rise and significantly affect men are pornography, video gaming, and gambling.

Men are nearly 4x more likely than women to be addicted to pornography; 11% of men and 3% of women identify as being addicted to pornography.

A study from Norway involving individuals who are addicted to video games showed stark differences between the genders. In the survey of participants addicted to video games, 62.7% were male, and 37,3% were female. Other figures place the percentage of all male addicted gamers as high as 90%.

If any of the above issues are a concern for you and you are interested in beginning therapy, Serengeti Wellness is accepting new clients in person at 155 N Michigan Ave., Chicago, IL, and online.

What Helps Men in Therapy?

Strengths-based and Problem-Solving Focused Approaches

Many men prefer therapy with specific objectives and structure. Therapists who focus on clients’ strengths and solving concrete external problems can often see more progress in their male clients compared to an approach that focuses on thoughts and feelings. Common examples that I employ include Acceptance and Commitment Therapy, Client-Centered Therapy, and Problem Solving Therapy.

Having a Male Therapist

When facing problems, most of us want to talk to people who are more like us and have had shared experiences. Many men can feel reluctant to talk to women in therapy, especially when it comes to sex and relationship issues. Working with a male therapist can ease some male clients feel more comfortable.

Removing Social Stigma

Outside of therapy, men can help to remove the social stigma of being vulnerable and asking for help by talking candidly about their emotions and sharing when they have had positive experiences with mental health treatment. Some men will never consider therapy as something that might help them as long as there is social stigma that says that therapy is only for people who are weak or sick. All men owe it to each other to help break down this pattern of stigma because we will all be healthier when the stigma is gone.