Therapy can provide a space to finally say what’s really going on.
“How are you?”
“I’m fine.”
Sometimes it’s true.
Sometimes it’s simply the easiest answer.
In my work as a psychotherapist, I meet many men who have spent months, sometimes years, dealing with anxiety, stress, trauma, relationship difficulties or low mood without really talking to anyone about how they feel.
It isn’t necessarily because they don’t want to talk.
Sometimes they don’t know where to start. Sometimes they don’t want to worry the people around them. And sometimes previous attempts to talk about their feelings haven’t gone particularly well.
For some men, “I’m fine” becomes a habit.
Why some men find it difficult to talk about their feelings?
We have made progress in the way we talk about men’s mental health, but many men have grown up with very different messages.
“Man up.”
“Grow a pair.”
“Get on with it.”
“Don’t let it get to you.”
“Be strong.”
“Deal with it.”
These messages can be surprisingly powerful.
If you’ve spent much of your life believing that being strong means being self-reliant, admitting that you’re struggling can feel uncomfortable.
There can also be a fear of being judged, appearing weak or burdening other people.
And, importantly, some men have tried to talk.
They may have been dismissed, told that other people have it worse or found that the person they spoke to simply didn’t know how to respond.
If talking about your feelings once left you feeling exposed or unheard, it’s understandable that you might be reluctant to do it again.
Men’s mental health doesn’t always look like sadness
When we imagine somebody struggling with their mental health, we may picture someone visibly distressed.
But that’s not always what I see in therapy.
A man can be going to work, looking after his family, socialising and appearing to function perfectly well while struggling internally.
Sometimes difficulties show themselves in other ways.
You might notice that you’re:
- More irritable or angry than usual
- Withdrawing from your partner, friends or family
- Constantly keeping yourself busy
- Drinking more
- Struggling to sleep
- Losing interest in things you normally enjoy
- Feeling emotionally numb or disconnected
- Worrying or overthinking
- Finding relationships more difficult
- Experiencing sexual or intimacy difficulties
- Feeling exhausted despite continuing to push yourself
None of these automatically means that somebody has a mental health problem. But changes in how you feel, behave or relate to other people can be worth paying attention to.
“I’m just tired”
One thing I’ve noticed throughout my work with men is that emotional distress isn’t always described using emotional language.
Instead of saying:
“I feel anxious.”
“I feel overwhelmed.”
“I feel low.”
You may find yourself saying:
“I’m exhausted.”
“Work’s just stressful.”
“I’ve got a lot on.”
“I’m just tired.”
“I’m fine.”
Sometimes those descriptions are exactly right. But sometimes they’re easier words for something that’s much harder to explain.
You don’t need to reach crisis point before seeking help
There can be an assumption that therapy is something you turn to when everything has fallen apart.
It doesn’t have to be.
People come to therapy for many different reasons.
You might know exactly what you’re struggling with. Or you might simply recognise that you don’t feel like yourself anymore.
You don’t need a diagnosis.
You don’t need to know what you want to say.
And you certainly don’t need to arrive with a perfectly articulated explanation of how you feel.
“I’m struggling, but I don’t really know why” is enough of a place to start.
What actually happens when someone comes to therapy?
For someone who isn’t used to talking about themselves, the idea of sitting opposite a therapist and discussing feelings can sound daunting.
That is something I understand.
A good therapist isn’t expecting you to walk into the room and immediately disclose everything you’ve never told anyone.
Therapy develops at a pace that allows trust to build.
Initially, we might talk about what’s brought you to therapy, what’s happening in your life now, what you’ve noticed changing and what you’d like to be different.
Sometimes the conversation starts with something very specific – anxiety, a relationship problem, a traumatic experience, difficulties with sex or simply feeling unable to cope.
As therapy progresses, we can begin to understand what’s contributing to those difficulties and what might help.
For many men, there’s also something powerful about being able to speak honestly without worrying about upsetting somebody they love or being expected to look after the other person’s feelings.
Therapy gives you permission to make the conversation about you.
I’ve seen men’s vulnerability throughout my career
My understanding of men’s vulnerability began long before I became a psychotherapist.
I previously worked as a midwife.
On labour wards, I saw men at moments when they could do very little to control what was happening around them.
They might be watching someone they loved in pain. If a birth became complicated, they could feel frightened and helpless while simultaneously believing that their role was to remain strong and supportive.
Later, as a psychosexual therapist, I encountered vulnerability in a different way.
Men began sitting opposite me talking about things they had sometimes never discussed with anybody before – erectile difficulties, performance anxiety, sexual confidence, relationships, shame, trauma and fears about not being “good enough”.
Some arrive incredibly nervous.
Then, gradually, they start talking.
Seeing somebody realise that they can discuss something they have carried alone without being judged is one of the most rewarding parts of my work.
Different circumstances. Different stages of life.
But I’ve repeatedly seen how much men can carry without other people necessarily knowing.
Therapy isn’t the only place men can talk
It’s also important to acknowledge that private therapy isn’t accessible to everyone.
Support can take many forms.
For some men, it might be their GP or NHS mental health services. For others, it may be a men’s group, workplace support, a charity or community organisation.
And sometimes the first conversation is simply with a friend, partner, relative or colleague.
We need to encourage men to talk.
But we also need to become better at listening when they do.
You don’t always need to have the right words or solve the problem.
Sometimes being willing to hear:
“Actually, I’m not doing very well” without immediately trying to fix, minimise or dismiss it is enormously important.
Perhaps we need to ask the question twice
“How are you?”
“Fine.”
It’s such an automatic exchange that neither person may give the answer much thought.
Perhaps occasionally we need another question.
How are you really doing?
And perhaps we need to make it safe enough for the answer not to be:
“I’m fine.”
Therapy for men’s mental health in Wirral and online across the UK
I am a psychotherapist and psychosexual therapist working with men experiencing a range of difficulties, including anxiety, trauma and PTSD, stress, relationship problems, sexual difficulties and sexually compulsive behaviours (sex addiction).
I offer confidential psychotherapy from my practice in Wirral, as well as online therapy across the UK.
If you’re considering therapy, you don’t need to know exactly what’s wrong or what you’re going to say before you make contact.
Sometimes knowing that things don’t feel right is enough.
How are you really doing?
#HowAreYouReallyDoing
