Men are less likely to come to counselling than women: only 36% of referrals to NHS talking therapies are for men. Why is this? Why do so few men seek help?
I believe that many men are reluctant to seek help because they view counselling as something for women, they believe that talking about emotions make them less of a man. As a counsellor I believe I can help by encouraging men to recognise and understand that emotions are not only for women, they are an important part of everyone, denial of emotions can be extremely damaging not only for mental health but physical and financial wellbeing too.
According to Mental Health Foundation around 1 in 8 men have admitted to having common mental health issues such as depression, anxiety, OCD, and panic disorder. The figures for women suggest 1 in 5. Men notoriously under report, deny or hide issues so how accurate is this picture?
The statistics give a different, worrying picture:
- 3x as many men as women die by suicide
- Nearly three quarters of adults that go missing are men
- 87% of rough sleepers are men
- Men are 3 x as likely to become dependent on alcohol or drugs
- They are more likely to be compulsorily detained (or sectioned) than women
- Men are 1.5 times more likely to be victims of violent crime but also more likely to perpetrate crime
- They make up 95% of the prison population
Many men may be reluctant to ask for help because they believe unhelpful stereotypes such as: ‘Boys don’t cry’, ‘Man Up!’ and ‘Be a real man!’ Men have traditionally been expected to be the family breadwinner, be strong and in control. This may serve a purpose and many families still adhere to this, but it can become toxic. When it does it is equally damaging for men and women. Many men believe that they need to be extremely self-reliant which makes it less likely that they would reach out for help emotionally or financially and may only value emotions such as pride and anger as acceptable masculine emotions. Some men have extreme aspirations for physical, intellectual and sexual dominance, devalue women’s bodies, opinions and sense of self and condemn anything in a man that could be viewed as feminine or equate any form of affection for another man with homosexuality. When a man is upset and he is told “Don’t be a girl” this is equating strength, resilience and emotional numbness with masculinity, which is destructive for both genders, and dismissive of everyone's emotions.
Another possibility is men may be unable or unwilling to open up or they may not be very good at recognising their own emotions. If they are not used to talking about emotions, they might not recognise them in others or themselves. It is thought that men may show different symptoms of depression than women. Men are more likely to ‘act’ rather than ‘feel’. Depression can cause them to be irritable, angry, or engage in risky behaviour. They are more likely to use harmful coping methods such as drugs or alcohol or use escapist behaviour such as throwing themselves into work. They may not realise why they are behaving this way. Men tend to have different relationships with their friends than women do too. They tend to relate to their friends with banter rather than talking about their feelings and emotions. They may feel that to do this would ‘feminise’ them. So instead, they laugh when they want to cry, invalidate their own emotional responses and use violence instead of speaking about what has made them upset, fearful or angry.
Stigma around asking for help is very real. I have always tried to bring my son up to be open minded and as a single mother I thought I was doing a brilliant job at this. My 18-year-old son tells me however that he would be put off going to counselling if he thought anyone would find out. He told me he thought it was ‘shameful’ and ‘something that girls do’. Clearly, I have got this wrong somewhere along the line. Toxic masculinity is very invasive; counselling does not fit with his image of what a ‘real man’ is.
Men are also prone to using defence mechanisms such as compartmentalisation. This is when they figuratively lock away in a box thoughts and feelings that do not fit their world view. This can have its uses in a stressful modern life; for example, it may not be helpful to be thinking about a relationship breakdown whilst trying to operate a crane but the danger comes when the emotions are locked away and never examined. This is more likely to happen if they do not fit with the man’s self-image. The emotions may bring feelings of shame and they may believe that by admitting to these emotions means that they are not a ‘real man’.
Emotions however serve a very important function, they are part of our evolutionary fight, flight or freeze response. They drive us to take actions we need for our survival so if we feel injustice, anger drives us to fight against it. If we are in danger our fear would make us take flight i.e., run away or hide. Or if we work with a difficult boss, anxiety may cause us to freeze before we say or do something that would make us lose our job. By showing our emotions we can show to others that we need help or support. By acknowledging and recognising our own emotions we can see when something important is happening and when and if we need to make changes in our behaviour.
As a counsellor I believe I can help by encouraging men to recognise and understand that emotions are not only for women and help them to unlock the parts of themselves they have locked away. Emotions are something that happen to us all, they are not all bad and not a sign of weakness. Going to counselling is not about making men more emotional or more ‘feminine’ but a way to learn how to recognise emotions and accept them. They can begin to make friends with the different aspects of themselves. It is important to show compassion for all the parts, especially the parts locked away through shame. It takes a lot of courage to ask for help. In my experience men tend to react well to psychoeducation, if they can understand why they feel a certain way they are more likely to be accepting of it. They can then begin to take control of all other areas or their lives including overall health, relationships, career and finances. They can choose to accept themselves as they are and then learn to change to be the person they strive to be. Real men have emotions too, all men are real already.