Why We Need to Talk About Men's Emotional Health

Part 1 of the series on men's emotional health

In my therapy practice, I see something that breaks my heart and fuels my curiosity: men are struggling in ways we are not adequately addressing. They sit across from me, often out of desperation, their own or their partner's, and they are suffering. But their suffering rarely looks like what we have been trained to recognize as distress. Often, they don't even know they are suffering. They have been so used to dismissing or minimizing their emotional experience that they seem genuinely unsure what they are feeling. What they need. Who they are. They also don't quite trust that we actually want them to be vulnerable. They don't know what they don't know, or what they might be missing.

The women, meanwhile, are often exhausted from carrying the emotional and mental load of the relationship. Tired of trying to get their partners to wake up to their own emotional worlds. Lonely from feeling unseen, unable to make contact with the inner core of the person they love.

When I ask a new male client how he is doing, I almost never hear "I'm depressed" or "I'm anxious." I hear "I'm fine." Or "Work has been stressful." Or "I don't know. I'm okay. I just get frustrated sometimes." What I see, though, tells a different story. Exhaustion behind the eyes. Shoulders permanently tensed. A flatness in affect that suggests someone who has been holding their breath for months, maybe years. A man who has learned to perform fine so convincingly that even he believes it.

And a man who doesn't trust that emotional work is worth the effort. A sense that he can never get it right, so why bother. Or too exhausted to even approach the work, because there is such a backlog that even minor emotional topics feel like opening floodgates he doesn't have the strength to weather.

These men are not refusing help. They are bewildered by their own inner experience, unable to name what is happening inside them because they were never given the language for it. They are working with a vocabulary of maybe five emotions when the situation calls for fifty. They have been taught that emotional awareness is weakness, that vulnerability is failure, and that asking for help is admitting defeat.

There is something else I hear from men, something that is often hard for women to hear. That they don't feel safe to be vulnerable. That there isn't space for their experience. That they need to be approached with more softness and patience in order to feel safe trying.

A note on gendered language: I use "men" and "women" throughout this series for clarity, but these patterns are really about survival strategies and attachment styles, avoidant or anxious, pursuer or withdrawer. They can show up in any gender configuration.

What the data actually shows

The data on men's mental health is alarming, and it rarely gets discussed with the urgency it deserves.

In 2024, men in the United States died by suicide at roughly four times the rate of women: 22.3 per 100,000 versus 5.6. Men account for nearly 80% of all suicide deaths despite women attempting suicide more often. This disparity tells us something crucial. When men reach crisis, they do not reach out. They reach for lethality.

Men comprise the vast majority of those incarcerated, with the trauma and disconnection that entails. They experience higher rates of substance use disorders, often using alcohol and drugs not recreationally but as self-medication for pain they cannot name. They die younger from what researchers call deaths of despair: suicide, overdose, and alcohol-related liver disease. The increase has been dramatic over the past three decades.

Then there is the friendship collapse. The Survey Center on American Life has documented what is now called the male friendship recession. The share of American men reporting six or more close friends has fallen from 55% in 1990 to around 27%. One in five single men reports having no close friends at all. Loneliness is as harmful to physical health as smoking fifteen cigarettes a day. Men are increasingly dying alone even when they appear surrounded by people.

And yet men are diagnosed with depression and anxiety at significantly lower rates than women. Does this mean men are doing better emotionally? No. It means our diagnostic criteria are gendered, built largely on presentations more common in women, and we are missing male suffering because it does not fit our templates.

What I see that does not get counted

The man who works seventy hours a week, not for the money but because work is the one place he still feels competent. The man who snaps at his children over nothing, then is crushed by shame and has no idea how to repair. The man who has lost interest in sex, hobbies, and friends but insists he is just tired. The man who drinks every night to quiet the noise in his head. The man who cannot remember the last time he felt joy.

These men often do not meet criteria for major depressive disorder. They are still functioning. Still going to work. Still maintaining basic responsibilities. But they are not okay. They are numb, disconnected, running on fumes. Terry Real calls this covert depression. Ronald Levant describes it through the lens of normative male alexithymia, the culturally trained inability to identify and express emotions.

Their partners see it. Their partners are often frantic with worry, trying everything to reach them. But the men themselves frequently cannot see it, or will not name it. They have been socialized so thoroughly to equate emotional awareness with weakness that they have severed the connection between what they feel and what they can acknowledge feeling.

This is not about centering men's pain

A clarifying point before going further. This series is not arguing that men have it harder than women or other marginalized groups. It is not asking women to take on more emotional labor. It is not excusing harmful male behavior or sidestepping the realities of male violence.

It is asking a different question: if we want men to show up differently in relationships, families, and communities, we have to understand what is actually happening inside them. Patriarchal conditioning damages everyone, including those it supposedly privileges. Men's emotional restriction and disconnection serves no one.

bell hooks named it precisely: "The first act of violence that patriarchy demands of males is not violence toward women. It is the violence of self-mutilation, the violence that severs a boy from his emotional life." That severing creates men who are disconnected from themselves, and people disconnected from themselves inevitably create disconnection and harm in their relationships. When men heal, their partners benefit, their children benefit, their communities benefit. Men's liberation from patriarchal constraints is bound up with everyone else's.

What this looks like in the therapy room

As a therapist who specializes in couples and relationships, I cannot do my work without understanding masculine psychology. When I sit with a couple in crisis, I have to understand that the man who is stonewalling is not necessarily being cruel. He is often physiologically flooded, emotionally overwhelmed, and defaulting to a coping strategy that was adaptive in childhood: shut down, go away, wait for it to pass.

When he says "I don't know" in response to questions about his feelings, he is often telling the truth. He genuinely does not know. The neural pathways between sensation and language were never fully developed. He learned early that noticing brought punishment, so he stopped noticing. Asking him now to identify his emotions is like asking someone who never learned to read to analyze poetry.

His withdrawal is rarely about not caring. More often, it is about caring so much that the intensity of emotion feels dangerous, unmanageable, like something that might destroy him if he lets it in. So he does what he was taught. He puts his head down, soldiers on, and tries to fix things through action rather than feeling.

Understanding these patterns lets me build interventions that actually work. Instead of asking how do you feel, which activates shame, I might ask where do you notice that in your body. Instead of face-to-face emotional processing, I might suggest walking sessions where we talk shoulder-to-shoulder. Instead of expecting verbal fluency, I might use metaphor, movement, or goal-oriented exercises that create side doors into emotional experience.

What this means if you love a man who shuts down

If you love a man who struggles to be emotionally available, understanding masculine socialization can transform your relationship. It helps you see that his emotional limitation is not about you. It is not a rejection of you. It is not evidence that he does not love you. It is a wound he carries from a lifetime of conditioning.

This does not mean accepting emotional unavailability or stopping asking for what you need. It means understanding what you are working with. You can see his shutdown as a nervous system response rather than intentional dismissal. You can recognize his anger as possibly the only emotional channel he has access to, rather than proof he does not care. You can understand that building emotional intimacy with him may require different approaches than what worked in other relationships.

Many of the women I work with experience profound relief when they understand these patterns. Years of confusion suddenly make sense. The mystery of why he can be so competent at work but so lost in emotional conversations becomes clear. The reason he seems to care deeply but cannot show it the way she needs becomes understandable.

Understanding does not require accepting harmful behavior. You can hold compassion for his wounds while maintaining boundaries about what is acceptable. You can see the scared boy underneath the defended man while still requiring the adult to show up and do his work. Both things can be true.

What this series will cover

The series will trace the developmental journey of boys learning to disconnect from their emotional selves, drawing on Niobe Way's research on the collapse of male friendship in adolescence and on what Michael Reichert and Andrew Reiner have written about how we raise boys. It will examine the evolutionary and historical context: what men were built for over millennia and the mismatch between that and what modern life asks of them.

It will turn to depth psychology and Marie-Louise von Franz's work on the puer aeternus, the eternal-boy archetype that captures so many of the men I see in midlife who cannot land in their lives.

It will name the therapy problem directly. Most modern psychotherapy was developed by women, based on research with women, using methods that assume emotional fluency. For many men, walking into a therapy office feels like being asked to speak a language they were never taught. I will look at what works instead: somatic and body-based approaches, men's groups and circles, and the kind of structured shadow work that Connor Beaton has built into his MensWork curriculum.

The series will hold the both/and on patriarchy: that men have structural power and are also wounded by the very system that privileges them. And it will close with what healing actually looks like, what works clinically, and where there is genuine hope.

Who this series is for

Therapists and helping professionals who want to understand masculine psychology more deeply, especially those whose training covered women and trauma extensively but barely touched men's developmental patterns.

Partners of men who struggle emotionally, who are exhausted from pursuing connection with someone who keeps withdrawing, who wonder if their partner even has feelings, who oscillate between compassion and resentment.

Men themselves, who have always felt something was wrong with them because emotional life feels foreign and confusing. Men who have been told they are too closed off, too angry, too shut down, but have no idea how to be different. Men who want to heal and do not know where to start.

And anyone who cares about relational health, family wellbeing, and creating a world where all people can access their full humanity.

A note on my perspective

I come to this work as a couples and relationships therapist trained in Emotionally Focused Therapy and the Gottman Method, with depth-psychological influences from Jung, Marie-Louise von Franz, and contemporary object relations. My practice is informed by feminist theory, attachment research, and trauma-informed care. I work with clients across the gender spectrum and across many relationship structures.

My interest in men's healing is not a departure from feminist principles. It is an extension of them. As Terry Real has written, the cure for the disease of patriarchy is the same for men and women: it is reconnection. Patriarchy cannot be dismantled without addressing how it damages men's capacity for connection, vulnerability, and emotional wholeness.

My hope is that this series creates more understanding, more compassion, and more effective pathways to healing. Men deserve therapeutic approaches that actually meet them. Their partners deserve partners who can show up emotionally. All of us deserve a world where men are free to be fully human.

Next in the series: "The Man in My Office: What Male Suffering Actually Looks Like"