Men and therapy – Why do fewer men seek help?

Maria Sandgren

2 days ago

22 min read

Fewer men than women seek psychotherapy. This does not necessarily mean that men are doing better or have less need for support. Many seek help only when their difficulties have become difficult to ignore: when a relationship is at risk of ending, sleep is persistently disrupted, panic attacks have become overwhelming, anger is affecting other people, or work has become difficult to manage.

Men’s reluctance to seek help is sometimes explained by saying that they do not want to talk about their feelings. There may be some truth in this, but it is an incomplete description. Many men spend a great deal of time thinking about their problems. They try to understand what went wrong, what they need to do, and how the situation might be resolved. This thinking, however, often takes place in solitude and is directed toward finding an explanation and a solution before sharing the problem with someone else.

Expectations that men should be capable, independent, and able to sort out difficulties on their own can influence both how they understand their distress and when they seek help.

Talking about worry, grief, fear, or uncertainty may feel unfamiliar, particularly for someone who has learned that feelings should be dealt with by doing something about the situation. When solutions do not work, a man may instead become more withdrawn, think even harder, and find himself increasingly alone with what he is trying to manage.

Understanding patterns without generalising

In this article, I explore why fewer men seek therapy, why many men find it difficult to talk about what they feel and need, the problems that bring men to therapy, and how therapy can become a place where they no longer have to understand and resolve everything on their own.

The patterns described here do not apply to all men, nor are they unique to men. Women may also try to resolve problems by themselves, find it difficult to talk about feelings, or withdraw when something becomes overwhelming.

The purpose is not to describe men and women as two uniform groups, but to explore how certain expectations of masculinity may affect men’s relationship with their emotions, their need for other people, and their willingness to seek help.

Why do fewer men seek therapy?

Seeking therapy can mean pausing to recognize that something is not working and inviting another person into what one has not yet been able to understand or change. For someone who is accustomed to seeing independence and problem-solving as important aspects of being capable, this can be a significant step.

In many contexts, men are still expected to demonstrate their competence by solving problems, making decisions, and keeping things running. This applies not only to practical matters and working life. The same approach can extend into close relationships and the way men respond to their own mental health. When something becomes difficult, the natural response may be to identify the cause, devise a solution, and put it into action.

This is not a problem in itself. The ability to engage with difficulties and look for solutions is valuable. Problems arise when it becomes the only available way of responding to what is happening.

When problem-solving is no longer enough

Not every human problem can be resolved through greater effort or a better plan. Grief cannot be organized away. Fear does not always disappear through self-reasoning. Stress responses may be experienced as disruptions when they may also be signals of overload. Conflicts in a relationship are difficult to resolve unless both people have an opportunity to understand what the other person feels, needs, and is trying to protect.

When needing help becomes difficult

If a man nevertheless believes that it is his responsibility to resolve the situation on his own—as a form of self-sufficiency—the need for help may feel like a personal failure. He may think that he should be able to pull himself together, gain better control, or work out what needs to be done.

Contacting a psychologist then becomes more than a practical decision. It may also mean entering an unfamiliar position in which he does not have the answers and can no longer rely solely on his own ability to put things right.

Men may also be uncertain about what will be expected of them in therapy. Do you have to be able to talk about your feelings in detail? Will the psychologist understand the way you think? Will there be something concrete to work with? If therapy is presented primarily as a conversation in which you are expected to describe how you feel and remain with uncertainty, the threshold may be high for someone who is not yet accustomed to doing so.

A reflection

One sign that it may be time to seek help is the growing recognition that he cannot move forward with a problem or a relationship on his own. A man may need help without thinking of help as what he needs. Instead, he may believe that he needs to try harder, think more clearly, or find the solution he has so far overlooked.

What appears from the outside as resistance or unwillingness may be an attempt to engage with the problem, take responsibility, and do something about it. But when engagement means thinking, planning, and arriving at a solution by himself, the man risks becoming increasingly alone with precisely what needs to be understood together with someone else. Those around him may experience him as withdrawing. Within him, there may be many thoughts and a strong desire to do something about the difficulties.

Sharing what one thinks, feels, and needs can be a significant step. But it can also ease the burden and make change possible without the man having to understand and carry it through entirely on his own.

– Maria Sandgren

Men think a great deal – but often on their own

Many of the men I meet in the therapy room have spent a long time thinking intensely about their problems. They go over conversations, try to understand their partner, examine their own actions, and consider different ways of changing the situation.

Their thinking often takes the form of problem-solving. What went wrong? What happened? What do I need to do? How can I make the situation work? This may continue for a long time without the man telling his partner or anyone else very much about it.

When thinking happens on your own

One reason may be that he first wants to finish thinking it through on his own. Sharing his thoughts while they are still incomplete means revealing his uncertainty. He then has to let someone else see that he does not yet know what he thinks, feels, or wants to do. If his idea of being capable is associated with understanding and solving problems by himself, this may feel more exposing than presenting a finished answer.

When the solution he has envisioned does not work, the man may become even more withdrawn. He tries to understand the problem better, considers more possibilities, and may become increasingly absorbed in his thoughts. To him, this may indicate that he is taking the problem very seriously. His partner, however, mainly sees his silence and distance.

In a close relationship, a painful discrepancy may therefore arise between what the man believes he is doing and what his partner can see. He is trying to solve the problem, while his partner feels left alone with it. The more the partner asks questions, seeks answers, or tries to make contact, the more pressure the man may feel to arrive at a response. He withdraws further in order to think, and the distance between them increases.

The man’s withdrawal may therefore be an attempt to understand and resolve the problem. At the same time, it affects those around him, who are left without contact and do not know what is happening.

When attention remains focused on the problem

This way of thinking may also keep his attention focused on what should be done, while less attention is directed toward what is actually happening within him. It may be easier to focus on the circumstances and the problem than on his own experience. Perhaps he is afraid of losing the relationship, feels sorrow at being unable to reach his partner, or feels ashamed that he has not been able to resolve what has become difficult. What he himself needs in the relationship, at work, and in other areas of life may be considerably harder to put into words.

A reflection

Thinking together is different from presenting a solution. It means allowing another person to take part in what is still unfinished, contradictory, or difficult to understand. The uncertainty is shared without either person knowing from the outset where the conversation will lead or what they will come to understand together.

When thinking remains private

When a man becomes withdrawn and silent, it does not necessarily mean that he has stopped caring. He may be fully occupied with trying to understand what went wrong and what he should do. But when this thinking takes place on his own, his partner has no access to his worry, care, or uncertainty. What was intended as an effort to engage with and resolve the problem may instead contribute to a growing distance.

Beginning to talk does not require the man to already know what he feels or to have finished thinking everything through. The conversation can become the place where what has so far remained his private thoughts gradually becomes possible to understand—both for him and for the person he is trying to reach.

– Maria Sandgren

Why do many men talk less about their feelings?

Men do not feel less than women, but many may have had fewer opportunities to develop a language for emotions. From an early age, they may have learned to deal with what they feel on their own, preferably by doing something about the situation. When something troubles them, their attention may therefore turn quickly toward what has happened, what needs to be done, and how the problem can be resolved.

This can make it more difficult to remain with their own experience long enough to distinguish what they are actually feeling. A man may know that something is wrong without knowing whether what he feels is primarily fear, grief, shame, anger, or helplessness. Instead, he may notice that he is having difficulty concentrating or sleeping, feels restless and tired, or experiences pressure in his chest and other physical symptoms. For some, it is not until a panic attack occurs that the intensity of the body’s response becomes apparent.

When emotions show up in other ways

Emotions may also become visible through the way a man acts or relates to other people. Fear may be followed by an increased need for control or by avoidance of what feels uncertain. Grief may show itself through silence, fatigue, or a loss of interest in what was previously meaningful. Shame may evoke self-criticism and a wish to conceal what he experiences as a failure. When a man feels helpless, he may become angry or withdraw completely.

At the same time, anger needs to be understood as an emotion in its own right and not always as a defense against something else. It may be an understandable response to feeling dismissed, mistreated, obstructed, or treated unfairly. But anger may also become the most readily available expression when grief, fear, or vulnerability is more difficult to recognize and reveal. In therapy, it is therefore important to understand both what the anger is about and how it is expressed. Understanding the emotion does not mean excusing actions that harm or frighten other people.

When the words are not there yet

A man may not always be able to answer when his partner asks what he feels. The question may be experienced as a demand to articulate something that has not yet become clear to him. If he feels ashamed that he cannot answer, he may become silent, irritated, or dismissive. His partner may then become more upset or try even harder to reach him.

The path toward a conversation about feelings may therefore need to begin with something concrete. What happened just before he withdrew? What did he notice in his body? What did he want to say but hold back? What did he think would happen if he spoke about it? By staying with a particular situation, what initially felt only uncomfortable, overwhelming, or difficult to understand may gradually become clearer.

A reflection

A man does not need to recognize himself as afraid for fear to influence the way he acts. He does not need to be able to describe his grief in order to be carrying a loss. Sometimes emotions first emerge indirectly—in the body, in irritation, in problems with sleep, in work, or in the distance from other people.

Not having words for what one feels is not the same as having no feelings. Words can develop when another person remains present, listens, and helps direct attention toward what is happening. Understanding what one feels then becomes not something that must first be accomplished alone, but something that can grow in the encounter with another person.

Hearing oneself speak and taking in what another person says can offer new perspectives on both one’s own experience and what is happening in the relationship.

The patterns described here do not apply to all men, nor are they unique to men. Women may also try to resolve problems on their own, find it difficult to talk about emotions, or withdraw when something becomes overwhelming. The purpose is not to describe men and women as two uniform groups, but to explore how certain expectations of masculinity may affect men’s relationship with their emotions, their need for other people, and their willingness to seek help.

– Maria Sandgren

What brings men to therapy?

Men rarely seek therapy with the general wish to become better at talking about their feelings. More often, there is a specific problem that has become difficult to live with. It may involve stress, anxiety, sleep problems, depression, loneliness, or a relationship that is no longer working.

When a specific problem becomes difficult to live with

Relationship difficulties are a common reason for seeking help. A man may have been told that his partner is considering leaving, or he may have begun to question whether they can continue together. He may feel that their conversations always end in the same conflict, that he does not understand what his partner expects of him, or that he is not enough. Sometimes he seeks therapy after a separation, when what was previously held together by daily life and shared responsibilities can no longer be maintained.

Men may also seek help for problems with anger. They may notice that their irritability is affecting their partner, children, or work, that the same conflicts keep recurring, or that their reactions are stronger than they would like. In therapy, it is important to understand both what the anger is about and how it is expressed. Trying to understand an emotion is not the same as excusing actions that harm, threaten, or frighten other people. Conversation can provide additional perspectives on what is happening and create more space between the feeling, the impulse to act, and the consequences of the resulting actions.

For others, the way into therapy is through prolonged stress, overwork, or sleep difficulties. Their thoughts may revolve constantly around doing their work well, making the right decisions, and avoiding mistakes. Their distress begins to affect their ability to be present and to work in the way they would like. A man may have continued to function for a long time but now feels increasingly tired, tense, or emotionally disconnected. When he no longer recovers as he once did, it becomes clear that something needs to change.

Anxiety and panic can also make the need for help impossible to ignore. When the body responds with a racing heart, dizziness, pressure in the chest, or an intense sense of danger, the problem becomes tangible. It may then feel easier to seek help for the physical symptoms than for the fear or stress associated with life or work.

Other men seek help after a loss. Someone close to them may have died, a relationship may have ended, a job may have been lost, or their body and abilities may have changed. The loss may also be less tangible—a loss of direction, vitality, or meaning. Life may continue to function outwardly while no longer feeling alive.

When the problem opens up a broader understanding

The stated reason for seeking therapy often becomes a path toward a broader understanding. Irritability may also contain a sense of helplessness. Constant work may be connected to worry or a fear of no longer being needed. Silence may hold grief, shame, or a strong wish not to make the situation worse. As the man begins to explore the specific problem that brought him to therapy, more aspects of his experience may gradually become possible to understand.

A reflection

A person does not need to understand the whole problem before seeking therapy. It may be enough to recognize that something no longer works as it once did and to look for a way toward change.

What is initially described as stress, sleep problems, anger, or conflict in a relationship may gradually prove connected to experiences and emotions that have long been carried alone. The immediate reason for seeking help is no less important because there may also be something more to understand. It is often where the conversation needs to begin.

– Maria Sandgren

From solving alone to understanding together

Therapy does not begin with the person seeking help having to provide a detailed account of his emotional life. The conversation can begin with what he already recognizes: the situations that are not working, the thoughts that keep returning, his bodily responses, and what he has tried to do so far.

Together with the therapist, he can explore what happens in the moments when he becomes irritated, withdraws, or feels pressured to find a solution. What is stirred in him when his partner is disappointed? What happens inside him when he cannot put the situation right? What makes him become silent just as the conversation approaches something important?

When thinking connects with emotions

Thinking does not need to be abandoned. But it can be brought into contact with bodily responses, emotions, needs, and relationships. This creates a different kind of understanding from one based solely on analyzing the problem from the outside. The man may gradually begin to notice what is happening within him while the situation is unfolding, rather than only much later, when he is alone with his thoughts.

Emotions help us notice what matters, what we long for, and what we are trying to protect. They can also make us more aware of our needs, boundaries, and the difficulties we face. Being familiar with one’s emotional life is therefore an asset. This does not mean that emotions always tell us what to do, but they are an important part of the understanding we need as we find our way through life and our relationships.

Talking about feelings does not mean having to describe them in a particular way. It can begin with noticing that something hurts, that one is afraid of losing someone, or that one longs for closeness while also wanting to withdraw. It may also involve becoming clearer about what one thinks, needs, and is no longer willing to accept. But it can equally mean experiencing closeness and warmth and becoming more aware of what evokes interest and motivation.

When understanding creates more possibilities for action

When a man becomes better able to notice and express what he feels, more ways of responding become available to him. He no longer has to choose between solving the problem and remaining silent. He can speak about his uncertainty before he has a finished answer, ask for help, set a boundary, express care, or share responsibility with someone else.

This can also change his relationships. A partner who is given access to his worry and grief, but also to his care, warmth, longing, and hopes, no longer encounters only silence. This can create greater calm and closeness even before the problem has been resolved. It becomes possible to think together and to approach the difficulty as something in which both people are involved, even when they experience it differently.

The aim of therapy is not for a man to talk more about feelings for the sake of talking or to become a different kind of man. It is about gaining greater access to his emotional life and, through it, to what matters. When thoughts, emotions, and actions can be understood as parts of a larger whole, the man can become more involved in his own life. Sometimes this understanding reveals something that needs to be explored further; at other times, it becomes a starting point for change.

A reflection

Thinking together does not mean giving up one’s independence or capabilities. Speaking about uncertainty can be a way of becoming more involved in one’s own life, one’s relationships, and the problem that could not be resolved alone.

Strength does not have to consist solely of enduring and continuing to function. It can also be expressed in the ability to remain present in a difficult conversation, allow another person to understand what is happening, and receive help when it is needed.

– Maria Sandgren

Blog

Men and therapy – Why do fewer men seek help?

Understanding patterns without generalising

Why do fewer men seek therapy?

When problem-solving is no longer enough

When needing help becomes difficult

A reflection

Further reading

Books (in Swedish)

What research shows

Men think a great deal – but often on their own

When thinking happens on your own

When attention remains focused on the problem

A reflection

When thinking remains private

Further reading

Books (in Swedish)

What research shows

Why do many men talk less about their feelings?

When emotions show up in other ways

When the words are not there yet

A reflection

Further reading

Books (in Swedish)

What research shows

What brings men to therapy?

When a specific problem becomes difficult to live with

When the problem opens up a broader understanding

A reflection

Further reading

Books (in Swedish)

What. research shows

From solving alone to understanding together

When thinking connects with emotions

When understanding creates more possibilities for action

A reflection

Further reading

Books (in Swedish)

What research shows

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