The statistics are familiar by now. Men are significantly less likely than women to seek help for mental health difficulties, less likely to talk to a GP, less likely to book a therapy session, and far more likely to reach a point of crisis before anything happens. Suicide remains the leading cause of death in men under 50 in the UK.
People tend to respond to those numbers in one of two ways. Either they treat them as evidence that men need to be told, more loudly and more often, that it’s OK to talk, or they treat them as evidence that something more structural is going on. I think it’s the second one, and I think that distinction matters if we want to actually help.
It isn’t stubbornness
The usual explanation, the one you hear in awareness campaigns and in a lot of well-meaning commentary, is that men have been socialised to suppress emotion and equate vulnerability with weakness. That’s true, as far as it goes. But it stops short of something important.
What I see in the room with men is rarely simple stubbornness or a failure to understand that feelings are allowed. It’s something more functional than that: a set of adaptations that made genuine sense at the time they were formed, and that have been reinforced, often successfully, for decades.
Many men grew up in environments, whether at home, school, or in peer groups, where emotional expression brought consequences. Ridicule, rejection, the withdrawal of approval, the subtle or not-so-subtle message that needing something makes you a liability. The response to that environment, which was to develop self-sufficiency and not signal distress, wasn’t weakness. It was intelligence. The problem is that an adaptation that protects a child doesn’t always serve the adult.
The problem isn’t information
There’s a common assumption that men avoid help because they don’t know it’s available, or haven’t been told clearly enough that it’s acceptable to struggle. If that were true, two decades of mental health awareness campaigns would have shifted the numbers significantly. They haven’t, at least not enough to matter.
What I see in the room with men is less a lack of information and more a deeply established internal logic: a set of conclusions formed early, reinforced consistently, and rarely examined, about what it means to need something, what happens when you show that you do, and whether the risk of finding out is one worth taking. That logic didn’t arrive from nowhere. It came from experience, often repeated experience, of what was and wasn’t safe to express.
Telling someone “it’s OK to talk” doesn’t touch that. It addresses the surface without reaching what’s underneath.
“I should be able to sort this out myself”
One of the most common things I hear from men in a first session is some version of: “I probably shouldn’t need to be here.” Sometimes it’s said with a kind of self-deprecating humour. Sometimes it’s said with real shame.
The belief underneath it, that needing support is a sign of inadequacy rather than a sign of being human, tends to have deep roots. And it creates a particular bind: the worse things get, the more compelling the internal argument that you should be handling it becomes, because the alternative, admitting you can’t, feels like confirmation of something you’ve been trying to disprove for years.
This is one reason why men often come to therapy later than they might have, and in a more distressed state than women who present with similar difficulties. The threshold for it becoming acceptable to seek help is set too high, and in the meantime, a lot of damage accumulates.
What therapy for men actually looks like
I want to be direct about this, because I think some men avoid therapy in part because they have a picture of it that doesn’t match what it actually is. They expect to be required to perform emotional disclosure on demand, to weep about their childhood in front of a stranger, to feel worse before they feel better and have no particular say in what happens.
Relational therapy doesn’t work like that. It works through relationship: through two people paying careful attention to what’s happening between them, noticing patterns as they emerge, making sense of things gradually. There’s no performance required. You’re not expected to arrive with emotional fluency you don’t yet have. You’re not going to be pushed faster than is useful, and you have more agency in the room than most people expect.
A lot of men, once they’re actually in a session, find it less threatening than they anticipated, not because the work is shallow, but because the model isn’t what they feared.
The thing that tends to shift something
In my experience, what often moves men from “I should probably do something about this” to actually doing something is a specific event rather than a gradual erosion: a relationship that reaches a breaking point, a conversation with a partner who says clearly that something needs to change, a moment where the usual strategies stop working and there’s nothing left to try.
That’s not the ideal entry point, but it’s a common one, and it’s worth naming honestly. If you’re reading this and recognising that you’re in that position, the fact that it took a crisis to get you here doesn’t mean you’ve left it too late. It means you’ve reached a point where the cost of not addressing something has become clearer than the cost of addressing it. That’s a reasonable place to start.
If you’re considering therapy
You don’t need to have a clear sense of what’s wrong or what you want from therapy. You don’t need to be in a state of emergency. You don’t need to have tried everything else first.
What you do need is a therapist you can trust, a sense that the space is safe enough to be honest in, and enough willingness to stay with the discomfort of something new. The rest tends to follow from that. If you’d like to have a conversation about whether therapy might be useful for you, you can get in touch here. I work with men both in person in Bude, Cornwall, and online across the UK.
Leave a Reply