Therapists and Depressed Men

Therapists and Depressed Men

Except for my first experience in therapy, I spent years working with psychiatrists (back in the days when they did more than write prescriptions), depressed the whole time, perhaps getting a temporary lift, but quickly losing whatever short-term benefit the sessions may have provided. According to many therapists, as I explain below, this is a common experience for men. Usually the problem is traced back to the difficulty many men have in expressing feeling. They’re not comfortable with emotions (so goes the common idea about men, or at least, the social role men are raised to fill), resist therapy and won’t let it work, even if they give it a try.

For the most part, I’ve accepted that explanation. Even though I had many doubts about the different types of therapy I had tried, I well knew that I had never really let the therapists see everything going on in my emotional life. I had rarely found therapists (luckily there were a couple of wonderful exceptions) who were willing to discuss, let alone rethink, their own approaches in any depth. The guiding assumption: We know this form of therapy works. It’s all up to you.

It was startling, then, to read an entire issue of a professional magazine devoted to the question: Why aren’t therapists more effective with men? The editors start with a couple of facts. Only a third of all psychotherapy clients are men, and that can’t mean they have fewer emotional problems than women do. They also regress after treatment much more often than women. So, these articles ask, what’s wrong with what we in the psychotherapy community are doing?

I’d never heard therapists evaluating their own methods and suggesting that the reactions of men, though obviously not good for them, weren’t all that surprising. Yet that’s what these articles are all about. They find that many in the profession don’t really know how to respond and adapt to the needs and styles of men.

Writing in the latest issue of Psychotherapy Networker, four therapists describe the psychological dynamics that guide many men and offer examples of the techniques they’ve used to create more responsive and effective therapeutic experiences. The articles don’t talk specifically about depression, but many of the ideas are particularly relevant to depressed men. While all these articles are full of interesting insights, I found one especially helpful.

David Wexler, in Shame-O-Phobia: Why Men Fear Therapy, focuses on two critical dimensions in the lives of many men. Read the rest»