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Writer's pictureScott Carter

Why do Men do so Poorly in Therapy?

How the Mental Health Industry is Failing Men and Boys


I recently listened to the super viral song by a young man who calls himself Oliver Anthony which has become the ballad of the struggling American and the working man. The song is called "Rich men north of Richmond" and if you haven't heard it, I highly recommend doing so. It's easy to see why the song has gone so viral, the song and the way he sings it hit me to the core. It's just so relatable to so many of us. In the time since, I've listened to this dude talk and I've grown extremely appreciative of his genuineness and his authenticity. The lyrics of his popular song are quite impactful and one line in particular has stood out to me. "Young men are putting themselves 6 feet in the ground 'cause all this damn country does is keep kicking them down." As best as I can tell, this is the only time a musician, artist or 'celebrity' has even mentioned the suicide epidemic that we see with men, especially young ones.


An epidemic that is quite profound and traumatically impactful in the fabric of our culture and society but it's not a problem that is even talked about in the mental health community. Therapists are dead silent about it. They don't have conversations about it, they don't express concern about it and one might be forced to think that therapists, for the most part, are apathetic about this issue. As a therapist, I am highly critical of the mental health industry. It's become extremely difficult for me to defend this profession while keeping my personal and professional integrity. I believe in therapy and I believe in therapists when they're doing things the way they should be done and that includes leaving out their personal biases against men but sadly, that's become too much to ask.


"Most women don't know the emotions and the psychology of men"

How men are regarded in the therapy industry


I spend some time here and there scrolling through Reddit and the main subreddit or forum that is dedicated to therapy and therapists has turned into an interesting way for me to gauge the direction of therapy and mental health in general. Lately, I've noticed a bit more buzz around treating men and boys and I've noticed that, not surprisingly, it's met with a fair amount of controversy. While therapists are taught and encouraged to be without judgment and without bias, they are miles away from this expectation and standard. The majority of mental health professionals are women, it's a female-dominated field and many of them, unfortunately, hold men in low regard.


I recently saw a video done by a male therapist who told a story of a time when he was training a group of therapists as part of their continuing education. When the training started, he wrote "Men are..." on a whiteboard and asked the therapists, mostly female, to fill in the blank. The responses were things like, "men are pigs," "men are filth," or "men are dogs," etc. When I heard this story from him, it reminded me of the exact same thing that had happened when I was in graduate school. The women in my cohort, the ones studying to become mental health counselors, were presented with the same prompt during one of our classes. The instructor wrote, "men are..." on the whiteboard. The women openly expressed their disgust toward men and when the men in the group protested, they turned on us and became angry with us as though we were the ones sitting there doling out insults toward women when nothing could have been further from the truth.


Not all of them did this, of course, but enough of them did that one couldn't help but be a bit troubled and alarmed at the lack of willingness there was amongst these women to look at their own biases and how their apparent beliefs and attitudes toward men could be harmful or destructive in any way. Sadly, I have come to find this to be true about a lot of women. You can't give them feedback or ask them to look at their own behavior. Sadly, we live in a culture that goes miles and miles out of it's way to make excuses for harmful and destructive women and those women can easily be therapists or psychologists. Believe me, nobody will try and deter them even if they openly express hatred and disdain for men. Again, not all of them, not even close but believe me, there are enough wolves in sheeps clothing in this industry that any and every male should be cautious about who they hire to be their therapist.


We have situations like these and hear stories like these and then we wonder why so few men attend therapy and remain in therapy. Sadly, these types of attitudes and treatment toward men are acceptable in the industry. I've known many female therapists that I've loved and thought weren't just good therapists but just good people. And as much as I've loved them, there are many female therapists who are equally awful and when I was young and inexperienced I remember feeling shocked about how heartless, cold and mean many of them could be. There are nasty people who decided to become therapists and they're around almost every corner.


When I was in graduate school, I didn't have a choice but to sit through a brief lecture about feminist therapy. I honestly couldn't give you much information or details about this so called therapy model other than how it has been applied in mental health and it has essentially been to always treat women like they are the heroes and the victims and to always treat men like the villains and the oppressors. This is especially true, apparently, in couples therapy, feminist therapy approaches couples with the attitude that the man is 100% of the problem and the woman is 0% of the problem and the men that have been audience to this can vouch for me.


And then they wonder why men don't attend therapy or do well in therapy. Mind you, there is no "masculinist therapy," that would be considered sexist and evil. And frankly, I agree. That would be a destructive and unethical way to provide therapy. I would never be able to sleep at night if I was forcing myself to do the mental gymnastics required to convince myself that men never do anything wrong and that they're never part of the problem but again the opposite is perfectly acceptable in the mental health industry.


I believe that I've done my due diligence to tell the truth about how therapists often treat men but for those who care about them or for those of you out there who are men and who have been soured by therapy, perhaps I can convince you to re-engage provided that you find a good therapist that doesn't unapologetically hate men.


Men are misunderstood


I spent several years being involved with a local men's support group which I also helped run once I had been a member for awhile. The group focus was on the individual and how he could be the best man that he could be and yet throughout all of my time there, I was forced to admit that when it came to men, their issues and why they did so poorly in therapy, were things I was struggling to really understand which was difficult for me to do because I'm both a man and a therapist. After all, if I was struggling to understand them and what was happening with them, then certainly even the most well intended female therapist was certainly going to struggle as well.


Dr. Robert Glover authored a book called "No More Mister Nice Guy" about so called "nice guys" and what he called "nice guy syndrome." It's a good book for men as a way for a man to get their feet wet in regards to learning about people pleasing and feeling shame but Dr. Glover has often said that therapists are only about to retain about 5% of their male clients with most of them lasting only three sessions or less. Up until the last couple of years, I agreed that this was true because it was consistent with my own experience. But again, I admit, that for many years, I wasn't understanding men and their issues and I really had to walk my own path in order to get around some of those barriers.


"Being misunderstood is part of being a man"

The psychology of men is largely misunderstood and is totally lost on mental health professionals. This kind of knowledge isn't promoted or supported. Most therapists don't understand men and don't really care to. A therapist must actively seek to understand the psychology of men if they want to know more about it. If I, as a man, have struggled to understand the psychology of men, then certainly women are missing the mark even more. I don't believe that most women know the males in their lives or are even close to understanding them. Women don't know the psychology or the emotions of the men in their lives. These men go unseen and misunderstood. To be fair, those men generally don't even know themselves but that's a separate issue that I'll address later.


Men are going to do poorly in therapy as long as they remain misunderstood but the current state of affairs goes beyond that. They aren't just misunderstood. Many times, the therapist they're sitting in front of isn't really even trying to understand them. Assumptions are made, they are ignored and often disregarded. Men know they are misunderstood, they can feel it. It's become a part of their life. They live in a silent state of loneliness and suffering which they've just learned to live with, what other choices do they really have? Being misunderstood has always been one of my troubles as a man. It's a lonely experience which just makes things that much more difficult.


By being misunderstood, it's creating complications with our ability to feel a sense of belonging and acceptance which really is one of those basic human needs. Men need a sense of community and a sense of belonging. Granted, this is true for everyone but men have traditionally had a tribe of other men who were a part of their immediate circle and support. I even make the argument that men do better with groups of men than women do with groups of women. I think women are better with one on one interactions whereas men are better in groups. Neither is good or bad and neither are superior to the other, they just are. Modern men lack that sense of tribal connection with other men and it's not something that can easily be solved in one on one talk therapy.


Men are holding everything in


I've noticed over the years that a lot of men come to therapy and they don't appear to be troubled or in distress a lot of the time. Sometimes, the opposite seems entirely true. They talk as though they're doing just fine. Occasionally, they report to me that they have come to therapy to placate an angry wife or girlfriend who has insisted that they have problems and they need professional help. From time to time I will be contacted by a wife or girlfriend who wants to set up therapy for the man in their life. I'm usually reluctant to accept those clients because a person shouldn't go to therapy because someone else has given them some kind of ultimatum and is forcing them to be there. A therapist can't do much for someone that doesn't want to be there and a therapist can't do much for someone that doesn't want to change.


"We live in the 'great repression' of emotions

When they arrive for that first session, it often seems as though their goal is to convince me that they're doing just fine and what I've learned over the years is that they're usually having issues because they're struggling to hold everything in. Convincing me that they're fine is a bad habit that is a defense mechanism and helps them to avoid feeling ashamed. Their efforts to convince me that they're fine are probably more an effort to convince themselves. When they can't hold everything in any longer, they usually have some kind of episode and breakdown. Their significant others are often getting angry and upset with them when it happens and so they start thinking that the solution to their problems is to get better at holding things in when that's not the answer at all. In this way, they are in a state of self-betrayal but they also need help with being able to express themselves better and in more healthy ways. They need healthy outlets. They need catharsis.


Catharsis refers to actions and methods that provide a person with an emotional release or an emotional purge. We live in a mentally sick culture that stays stationary and stuck where they are when they need a means of emotional release. They don't get it by scrolling through social media or watching TV for hours on end. Exercise, for example, isn't just good for you physically. It's good for you emotionally. It's cathartic. Studies have shown that exercise helps reduce depression and anxiety and it's not just because the exercise itself produces healthy endorphins and neurotransmitters that help and change your mood, it also helps provide you with an emotional release. The stuff that you hold in can't help but come out of you when you exercise.


Men need cathartic means of letting their emotions out and while talking about things can help, it often just reinforces their feelings of frustration. And while I support them in finding the right person or therapist in which to address their thoughts and their emotions, they also need some means to deal with it and a way for them to purge those emotions. I've often been frustrated for teenage boys when they've had parents, especially moms who have seemed hell bent on restricting some of the means that their boys can deal with and process their emotions. They can't play sports because sports are dangerous, they're discouraged from hanging out with friends, expressing themselves, listening to certain types of music or just being able to leave home to explore and be free to make their own choices are often discouraged by controlling parents. And moms, I'm sorry, but it's usually you doing it. I even argue that violent video games can be a means of catharsis for boys but I say even with some hesitation because I've grown leery of how addictive video games have become. I'm more concerned about the addictiveness of video games and the effects they have on the pleasure centers of the brain than the violence that is portrayed.


Recently, a video was making the rounds online that showed a group of men, 20 or 30 strong, standing together in a wading pool at the base of a waterfall. Together they were yelling or "roaring" at the top of their lungs. It's just a lot of raw masculine expression but it, of course, attracted a fair amount of anger and criticism. It's to be expected, men can't do anything without being criticized and torn down for it. It's the world we live in. People hate us no matter what we do but the critics were saying things like "anything but therapy" when they don't realize, or care to realize, that this is their therapy. This is their catharsis and an effective one, at that. It gave them a connection to nature, physical movement, a sense of belonging and a means to release their emotions by screaming at the top of their lungs. Those men, I guarantee, felt a whole hell of a lot better and were far less likely to lash out violently at anyone, especially women. We are living in what I have come to call "the great repression" in which people, especially males, are repressing their emotions to an extreme and unhealthy level. Those emotions don't just go away. They build up inside until he can't contain them anymore and when he has his breakdown, it can get ugly. All of that tension has to be released somehow and the more that he holds it in, the bigger and uglier his episode can be. This is probably one of the most important realizations that I've had about men in recent years. They're repressing their emotions. They get all kinds of messages about how their masculinity is evil, violent and toxic and they are often raised by women and around women who push these destructive notions and ideas onto them. They grow up believing that the emotions and the psychology they were born with are inherently abusive and destructive and so they push their emotions down while becoming resentful in the process. In time, they are their own worst enemy and a hurricane of confusion and inner conflict.


Society knocks them down


There's a lot and I do mean a lot of rhetoric floating around out there and our men and boys are absorbing it on a near daily basis. Personally, I take the opportunity at times to live under a rock. I think it's just healthy to take a break from it all and I sympathize with how challenging it can be to just put the phone down for awhile. We, as men, are often hearing that we're useless, unwanted and unneeded and that yes, it's ALL MEN. Apparently, the new trend on social media is to find men doing day to day things like spending time with their kids, riding a bike or going swimming and calling it "new ick unlocked." We can't do anything without absorbing the constant hatred and criticism of destructive women.


We're also told that we don't have any real problems because, apparently, being universally hated and blamed isn't a 'real' problem while also being gaslit by feminists who continue to deny that they hate men and that they are good for men. As a man who has come to a healthy place with his masculinity and who has walked his own path of healing, I can say with full confidence it's in spite of feminism, not because of it.


Statistically, men are failing. They represent the majority of the incarcerated, the addicted and the homeless. They dominate suicide deaths and school drop out statistics. They overwhelmingly represent those who work in the dirtiest jobs that humans have managed to conjure up. They are the roofers, the factory workers and the garbage truck drivers. If your toilet is spewing raw sewage at 3 A.M. the plumber that shows up is going to be a man. Guaranteed.


And yet, repeatedly, we are told that we are worthless, useless, unwanted and unneeded. As I've already mentioned, they aren't coping well and many of them are being carried away into addiction. The life that is laid out for most of us is one of misery and despair. There aren't enough of us that have any scrap of real purpose or meaning in our lives and so it's common for men to ask themselves every single day why they're even getting out of bed in the morning.





The struggle is so hard and yet so misunderstood. The mental health industry largely ignores the challenges that men have and those challenges are ignored and disregarded. Men continue to be misunderstood in therapy. It would be nice if they could get some validation with those lonely struggles but it generally doesn't happen. A large number of female clinicians are out of touch with these issues. They haven't experienced them like we have. He needs a hand up but he doesn't get it. If he doesn't find his own way back to his feet, he's going to stay down. Therapy is supposed to offer a hand up to them and sadly, it often doesn't. At least not for men.

Men feel ashamed to have wants or needs


Most people seem to accept and acknowledge this factor to some degree and yet men are overwhelmed with extremely negative reactions when they express anything having to do with what they want or what they need. As Dr. Glover has pointed out, many of our modern men and so called "nice guys" have laregetly been raised by women who offer validation and approval only when he's doing things that are pleasing to them instead of supporting and validating what is good for him personally. When he seeks to address his own wants and his own needs, he is often met with disapproval, especially by the women in his life and they develop shame over it starting at young ages.

I'm sorry, not sorry, but we live in an era where a lot of women really make everything about them and I couldn't help but notice these days that online forums of therapists are littered with female therapists that talk about their clients offending them or gripe about men who open up to them and say things they don't like. I don't read much of this stuff but when I do I read it between the fingers of my 'facepalm.' "Bitch, they aren't there for you!" I want to jump through my computer and choke them.


If men can't talk about their needs and their wants that go constantly unmet in therapy then, by God, where can they?! Half of the time they're sitting in front of a therapist who is making everything about them and then we wonder why they don't go to therapy. It's hard enough for them to get up, swallow their pride, admit they need help, show vulnerability, show weakness and make an appearance week in and week out without feeling ashamed of not being able to handle things on their own.


It takes a lot for a man to ask for help. Men are strong. They really are but they need to know that they need help just like everyone else and there's nothing wrong with that. Men didn't face or deal with this as much in the past because they usually had groups of men around them to support them.


Boys are lacking healthy male figures and healthy male interaction


Years ago when I was employed by someone other than myself I was approached with a request to work with a particularly angsty 13-year-old boy who had been in foster care and had seen multiple female therapists with almost no effectiveness. He was still angry, acting out and having a multitude of behavior problems. This type of kid happens to be my specialty; I love tough kids. I was approached by his current therapist who, like the others, was essentially giving up on him and wanted to transfer him to me. She told me that she felt like he needed a strong male figure to talk to him. I truly and deeply appreciated that she was able to acknowledge this was an important factor for reaching this troubled kid. I honestly thought it was big of her to admit that in some cases, what a boy needed was a grown man that he could look up to instead of just another disapproving adult female.


I agreed to work with this kid, I can't say no to things like this but we weren't able to make the proper accommodations to make it happen and I would imagine that this was just another teen boy who was going to fall through the cracks. Fortunately, I have been able to work with and connect with the struggle of many other boys and men who had never found their way through the lonely, turbulent and messy process of sorting out their masculinity. Some of my all time favorite work as a therapist has been when I've been able to work in a trio with a father and a son. Fathers often struggle to connect with their sons and identify with their issues because most of these fathers haven't sorted out their own struggles.


More recently I've really enjoyed being able to talk to one young teenager about relationships, happiness, emotions, respect and kindness as well as pornography and sex all with his father present. You can tell this kid is just soaking up the positive attention and positive connection with two grown men who are invested in his growth and his maturation into manhood without any judgment or shame placed on him. When, frankly, this is often what they get from their mothers. It's also been extremely positive for him to build such a positive relationship with his own dad when so many of us have lacked any real positive male models or father figures. One of my first, and only, positive male models was my 4th grade teacher who was always kind, always calm but always firm. He was fun and caring and it's because of him that I truly learned to love books and reading. His impact on me has lasted to this day.


Most males have not had good positive male role models or positive father figures in our lives. I was raised by a generation of traumatized men whose psyche had been ripped apart by the trauma of war. Even if a man is 40 years old he can greatly benefit from the influence of a positive male role model and a man who understands his struggle and that is just something that is hard for him to get from therapy because, again, most therapists who are women who don't know or understand the psychology of men. They've walked a different path and while I believe that they could, with some effort and dedication, build their understanding, most of them don't care to. Men, in fact, feel extremely validated and helped when a woman validates them on a deep level. It's very therapeutic. There just aren't enough of these women out there.


I know I've said a lot of seemingly negative and disparaging things about women here and I regret none of it. I realize that many people out there will likely see me as some kind of woman hater. I want to respond this way. The greatest hero in my life is my mother, who, to this day, supports and loves me. She is and always has been my biggest cheerleader. Frankly, she agrees with every last bit of what I've said here. She loves men, she tells me so and she's sad that they have become the dog that society kicks. I don't hate women, in fact, I love them very much which is why I'm speaking the truths that I believe they need to hear. I only know how to be honest and true to myself, it's part of what makes me a man.


I'm convinced that more men would attend therapy if their needs were being met there. In recent years I've noticed that the therapy industry is climbing on the train with a certain subculture that doesn't hold back on its heavy criticism toward men. That's a nice way to say that they're constantly and relentlessly letting us know how much they hate us. No, men don't attend therapy as often and why on earth should they when therapy is just one more adversary they have to contend with and when it's just one more thing that doesn't hesitate to minimize them and knock them down?


I know not all therapists knock them down, there really are some really good ones out there but there are enough bad ones that it's unfortunately leaving black marks on what should otherwise be a noble line of work. If you're a man who needs a therapist who understands and supports you, I hope you'll reach out to me.


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