"Men Want Someone to Be Real With Them"

I remember saying to a friend of mine, “I’ve got problems at home”. He said, “Do you really want to talk about this, or shall we just talk about records?” So we stuck to talking about music.

Women talk about emotions. Little girls talk about emotions. Gay men talk about emotions. But heterosexual men do not. And the more working class and blue collar you get, the higher the suicide rates among men are. The less talking, the more jumping – that’s your rule.

We look at mental health through the lens of the Diagnostic and Statistical Manual, and it’s guidance for depression is guidance for women. It doesn’t include guidance for men, because men act out: whether it’s through drinking a lot, getting into fights, or having lots of unprotected sex, men do. That also means men are less likely to come forward for therapy, though you’ll see plenty of men in AA meetings. Men want a solution: ‘Look, I want to fix this’. It can be difficult to say, ‘It’s a process. Let’s you and me sit down and talk about stuff, and see what we can create between us’.

A few years ago, in Aspen, Colorado, there was a series of funded adverts for Man Therapy featuring a fictional therapist called Dr Rich Mahogany. The suicide rate at this time was off the clock among normal working guys – foresters, bar workers, ski instructors. The therapist in the adverts is just a total bloke, and the tagline is, ‘Because you can’t just rub some dirt on your emotions’. It had a huge impact, thousands of men called. In the UK, we’re probably a bit po-faced for that approach. But it proved that men want someone to be real with them, and to normalise. What men absolutely don’t want to see is a picture of a man crying, with a middle-aged woman with grey hair with her hand on his shoulder.

How do you engage more men in therapy? Above all, I start with the thinking and then move to the emotions. I listen to them, and find out what they’re proud of. I praise all the interesting things that they’ve done. They need to know that they are respected. Men need appreciation before you do anything else, because they’re much more fragile than women, and more sensitive to shame. They seldom bend, rather, they’re like ice, they crack. They say, ‘I’m not doing this s***, I’m out of here’.

One of the other things I do with clients is tell them to be their own doctor, get proactive. I tell them to start studying the issue they’ve got, and become an expert in it. If loneliness is your big thing, who else is lonely, what’s it all about? I also spend a lot of time with men and women saying, ‘Ok, let’s start rebuilding your database and putting an army around you. Phone this person, tell them what’s happening for you’. Men tend to be more power driven than relationship driven, to have allies rather than friends. So when they face major life changes, like divorce, they are particularly vulnerable.

I think there is much to be said for men that is currently not being said. In this particular, febrile #metoo culture, men don’t really get a look in. They’re just the enemy. People talk about ‘toxic masculinity’, and there is a message that something about being a man is wrong. These days, I think it’s actually become harder for men to be completely honest. But within a consulting room, you can talk about anything they want. It’s probably the last place in the UK that men can do that.

As told to: Isobel Todd