I’m A Therapist Who Treats Hyper-Masculine Men. Here’s What No One Is Telling Them.

"Wanting to understand this population more, I began to dig into books, resources, and training on masculinity and the socialization of men in traditionally 'masculine' fields."
The author.
The author.
Photo Courtesy of Kristal DeSantis

John came into my office ― like many of the men I work with ― at his wits’ end. His wife had given him the ultimatum: “Therapy or I’m out.” John had never been to therapy before and as he sat there on my couch, hands clasped, eyes on the floor, his discomfort was plain to see.

As a therapist who specializes in couples therapy and works with a lot of male clients, I am no stranger to this scenario, so I keep a tennis ball in my office for just this reason.

“Hey John, you wanna toss the ball with me?” I asked.

He looked up in surprise. “Sure,” he said. After a few bounces back and forth, he caught the ball in his hand. “I had no idea this is what therapy is like.” He smiled for a moment, then got serious.

“I’m not sure what I’m doing here,” he said. “I think I’m a pretty good husband. I know I’m busy with work a lot, and maybe I drink a little too much, but I’m not a bad guy, you know?”

His story isn’t unique. It is common for me to receive an email or phone call from a man coming into therapy with the threat of divorce hanging over his head.

There has long been a stigma against men admitting that they need outside support, particularly in the realm of relational or mental health. Over the past few decades, therapy has become more normalized for women with nearly 1 in 4 American women seeing a therapist in 2021. But in the same year, only 12% of American men went to therapy. Vulnerability among men is still often correlated with the idea of “weakness.”

Traditional socialization of men encourages them to not talk about their feelings, to deny that they need help, and to project a veneer of confidence and competence no matter how they truly feel. Unfortunately, this approach has led to many men suffering in silence. Suicide among men is nearly 4x more likely than among women and over 70% of those who die by suicide are male.

However, there is starting to be an awareness among men that addressing their mental health is crucial to overall happiness. And as more and more women access therapy and begin self-improvement work, they are more likely to want their partners to also be doing their own mental health work. The modern healthy relationship is based on a foundation of equally healthy partners.

From the beginning of my career, I knew I wanted to specialize in sex, trauma and couples therapy. As I began my practice, I found that the couples I really enjoyed working with tended to be what we refer to as “high-conflict couples.” Not every clinician who specializes in couples enjoys the high-conflict work, so I became a local resource for those types of clients.

With those couples often came “therapy-resistant men” whose partners had made therapy a part of an ultimatum. In many of my couples, I recognized that the male clients often had unaddressed trauma in their past that was making them reactive in their relationships. Many of the men I was working with as part of a couple were veterans, police officers or first responders, and they were carrying around a significant amount of unaddressed trauma.

Wanting to understand this population more, I began to dig into books, resources, and training on masculinity and the socialization of men in traditionally “masculine” fields. I became trained in trauma therapy and in counseling first responders and veterans. As I continued my work with men, trauma, and couples, one of the biggest things I found through my research was that there is an enormous disconnect between what men are being encouraged to provide and what their partners actually want from them.

I have heard this same refrain from many men in my office over the years, men who feel like they have done everything by the book. Married and partnered men come into therapy asking, “What do women want these days?” What I often see is not that men lack the willingness to meet their partners’ needs, but that they have no clue what they are. This is not because men are less emotional, or lack empathy, or are not “wired that way,” but rather because they don’t have the tools to do what their partners are asking them to do.

John had come from a home in which he was not provided with the support he needed to develop basic relational skills. His parents avoided emotional conversations and used alcohol to self-regulate, which is what John noticed he was doing in his own marriage as well.

What I’ve seen is that so much conflict in relationships happens when there is a struggle between men trying to “be men” in the ways they have been taught are valuable and women who are actively resisting the traditional confines of femininity.

John was from an old school traditional upbringing that told him that as the “man of the house,” his role was to provide for his family first and foremost. This had led him to pursue his career at the expense of being present with his family. This was a point of conflict between him and his wife as she also was a working parent who wanted more emotional connection and presence from him.

The world today is full of unhealthy messages when it comes to relationships. Social media has given rise to new male “mentors” with the message that men are only useful for their production value, and women are only useful as trophies. These men say a man “proves his worth” via a big paycheck, expensive cars and a fit body. This objectification of, and dismissal of the humanity of both men and women has led to a deep divide between the genders and a lack of safety and trust in relationships.

The modern man cannot exist according to the old rules, and a modern healthy relationship cannot be designed to the same metrics we have used in the past. The traditional ways we have encouraged men to show up in relationships have led to depression, anger, and loss of a sense of healthy identity.

This is why I am so passionate about the work I do. In my work with men, I want to dispel the myth that therapy is something weak. Instead, it is like going to the gym, it’s something you do to get strong. I also encourage men in embracing healthy masculinity by learning the four skills of self-awareness, stability, self-regulation and self-expression. These are basic conflict and communication and life skills that make an enormous amount of difference in any relationship.

John’s wife wanted to hear about his feelings, his hopes and dreams. She wanted his participation in nurturing their kids, and John wanted to be a different father than his father was to him. By developing some skills for nurturing the connection between himself and his children, he was able to provide his sons with a healthy role model of fatherhood.

At the end of the day, the work I do with men and couples is to provide a new way forward. Providing men with a new model of healthy relationship allows them to embrace their masculinity and their full humanity ― ultimately working toward a place of expansion, healing and understanding.

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