Many men picture therapy as a couch and a lot of talking about feelings. Here is what it actually looks like, with some help from the family therapist Terry Real.
There is a book by the family therapist Terry Real whose title says almost everything about men and therapy: I Don’t Want to Talk About It. He wrote it about the depression so many men carry without ever calling it that.
That title is the most honest description I know of how a lot of men feel about therapy. Not opposed to it, exactly. Just quietly certain it is not for them.
So let me tell you what it actually looks like, and borrow some of Terry’s wisdom along the way.
It rarely starts with feelings
Most men do not walk in wanting to explore their feelings. They walk in because something stopped working. Sleep went first, or patience did. A relationship keeps running into the same wall. A temper shows up at home and nowhere else. A job that looks great on paper starts to feel like nothing at all.
Terry has a line for this that I love. As he told the Seattle Times, “Depressed women tend to have pain; depressed men tend to have trouble.” Men often do not arrive saying they hurt. They arrive saying something keeps going wrong.
That is a perfectly good reason to start. You do not need a better one, and you do not need the right words.
The trouble is often covering something quieter
Real describes something he calls covert depression: depression that hides inside behavior we tend to file under normal for men. Working all the time. Drinking more than you would say out loud. Anger that seems to come from nowhere. Pulling away from the people closest to you.
He sees those patterns as ways of escaping a pain that never got a name. They work for a while. They also cost a lot, and usually the people you love most pay part of the bill.
In his book he puts it plainly: “The only real cure for covert depression is overt depression.” What he means is that the feeling underneath has to be allowed to surface before it can heal. That can sound frightening. In practice, it is usually a relief.
The first session is mostly a conversation
Your therapist will ask what brought you in, what an ordinary week looks like, and what you would like to be different. You decide how much to share and how fast. Nobody is going to pry the door open.
It is also not a one way interview. You can ask how they work, what you will actually do in sessions, and how you will both know if it is helping. A good therapist will be glad you asked.
You do not have to be good at talking about feelings
Real writes about how early boys learn that being stoic is the price of being a man. Anger is allowed. Focus is allowed. Sadness, fear, loneliness and need are a lot less welcome.
That is not a character flaw. It is training, and training can be updated.
Part of therapy is building that vocabulary slowly, and it often starts somewhere concrete. What happens in your chest when your boss emails at nine at night. Where the tension sits before an argument. What you reach for when a day goes badly. Noticing that counts. That is the work.
Good therapy for men is relational
Terry’s whole approach is built on relationship, and I share that belief. Much of what weighs on men happened in relationship, often through what was missing as much as through what happened. So the repair tends to happen in relationship too, including the one with your therapist.
That does not mean every session is deep. Therapy can be very practical. CBT gives you tools for the thoughts that run the show at two in the morning. ACT helps you stop wrestling with what you feel so you can keep moving toward what matters. Some sessions will feel like working a problem with a sharp, honest colleague who is entirely on your side. Others will go further. Both are real therapy.
The question that changes things
One of my favorite things Terry has said came in a conversation on Tim Ferriss’s podcast, where he described growing from boyhood into manhood as a change in the question you ask the world: “A man’s question of the world is ‘What’s needed here?'”
I think therapy is often where men learn to ask that question of themselves. What is needed here, in my body, in my relationship, in the way I talk to my kids, in the way I talk to myself. Not as a performance. As care.
Does it matter if my therapist is a man?
For some men it does, at least at first. It can feel easier to say certain things to someone who has lived some version of them. For others it makes no difference, and some men open up more easily with a woman.
Fit matters more than anything, and you are allowed to ask for whatever will make it easier to show up. When you reach out to us, our intake team asks what you are looking for and matches you on that. If the first match is not right, tell us and we will help you find a better one.
Not sure where to start?
If you are curious but not ready to talk to anyone yet, start with one of our free quizzes. The anxiety quiz and the depression quiz each take a few minutes, and they can help you put words to what you have been noticing.
They are not a diagnosis. They are a starting point, and sometimes seeing it on a screen is what makes it real enough to do something about.
If you are thinking about it
At Marra, the first step is a free 15 minute consultation with our intake team. You tell them what is going on, and they help figure out which of our therapists fits. Some of our therapists focus on therapy for men specifically. We see clients in person in River West and online anywhere in Illinois, and sessions are 55 minutes.
If you are not ready yet, that is okay too. Keep this somewhere you can find it. Nothing about this door closes.
If you are having thoughts of harming yourself, please contact the 988 Suicide and Crisis Lifeline by calling or texting 988. It is free, confidential, and available 24 hours a day.
