Why Men Don't Go to Therapy (And Why That's Changing)

I've been a therapist for nearly 30 years. The majority of my individual clients are men. And one of the most common things I hear from a new client — usually in the first session — is some version of "I probably should have come in a lot sooner."

That's not surprising. Men are wired — or raised, or both — to handle things themselves. Asking for help goes against the grain for most of us. So guys white-knuckle it, drink through it, work through it, or just wait and hope it passes. Sometimes it does. Often it doesn't.

But something is shifting. Men are coming into therapy younger, earlier in a crisis, and more willing to name what's actually going on. Here's what I've observed over nearly three decades — about why men resist therapy and why that's starting to change.

Why Men Avoid Therapy

The most common reason is simple: it feels like admitting defeat. Most men I know — myself included — were raised with the message that you handle your own problems. You don't complain. You figure it out. Even if we weren’t given these messages directly from our parents, this is the training we got from society. Calling a therapist means something has gone wrong enough that you can't fix it yourself, and that's uncomfortable.

There's also a persistent image problem. A lot of guys picture therapy as lying on a couch while an old guy with a beard asks how you feel about your mother. That's not really an accurate picture of therapy. Sometimes it makes sense to talk about your mother or your childhood, but often this isn’t relevant to what you’re struggling with in the here and now.

And, sadly, there is still a stigma around men going to therapy. Men are still more likely to be judged for going to therapy than women are. That's changing, but it hasn't gone away.

And for many men, no one in their family ever modeled this. If your father never talked about his emotional life — and most of our fathers didn't — you're reaching for a tool that was never in the toolbox.

What I'm Seeing Change

In the last decade or so, I've noticed real shifts in the men coming to see me. More of them are coming in earlier — not after the divorce is final or the DUI, but before things have completely fallen apart. That's new, and it matters, because the sooner someone gets help, the better.

Men also seem to be more willing to name what's going on. Anxiety. Burnout. A drinking pattern that's gotten out of hand. A sex addiction they've been managing alone for years. Relationship patterns they can't seem to break no matter how many times they try. That kind of self-awareness used to be rare in guys. It's becoming more common.

Some of that is generational. Younger men grew up in a culture where mental health is at least part of the conversation. Some of it is practical — telehealth removed a lot of the difficulty and discomfort in getting help. You don't have to drive to an office or sit in a waiting room worrying about someone seeing you. Most of my clients now do sessions from their desk, their car, wherever works for them.

What to Expect When You Reach Out

You don't have to have it figured out before you reach out. You don't need to know what to say. Most men who contact me say something like, "I think I need to talk to someone." That's enough to get started. I’ll ask you questions to help us both get a very clear sense of what’s going on and whether or not I’m the one to help. If not, I’ll be transparent about this.

If we do end up working together, therapy with me is a conversation. It's direct. I'm not going to make you do exercises that feel pointless or spend six months talking about your childhood if that's not relevant to what you're dealing with. If something isn't working, we'll say so and adjust.

The men I work with come in for all kinds of reasons — addiction, relationship problems, affairs, job stress, anxiety, a general sense that something needs to change. What they have in common is that they decided to stop waiting.

For more information, visit my Men's Counseling page.

Feel free to contact me with any questions.