Beginning without an emotional vocabulary
Some men seek therapy after a partner describes them as distant or angry, while others notice tension, poor sleep, overwork or drinking before recognising sadness, shame or grief. A question about feelings may seem vague or exposing when the person knows something is wrong but has little language for it.
Family learning, culture, occupation, trauma, neurodivergence and depression can each contribute, so gender provides only part of the context. Many men speak comfortably about emotion, and many people of other genders find it difficult, which makes the individual's history more informative than a stereotype.
Self-reliance and the meaning of receiving help
A large meta-analysis associated stronger conformity to some traditional masculine norms with poorer mental health and less favourable help-seeking attitudes. More recent reviews also link heightened conformity with lower help-seeking and engagement, although associations differ across norms and circumstances.
Responsibility, loyalty and practical problem solving may help someone engage in therapy, while a rigid expectation of self-reliance can make receiving help feel like failure. The work can examine when a familiar strategy is useful and where it prevents the person from responding to what is happening.
Using specific situations
An early session can focus on what happened before an argument, the first bodily change and what the person did next. Tension in the jaw, an urge to leave or an increasingly critical response can make a sequence easier to discuss than an immediate request for a deeper feeling.
Rating scales, emotion lists or written reflection may help distinguish feeling threatened from feeling ashamed, disappointed or exhausted. These methods should have an understandable purpose, connected with noticing the response early enough to make another action possible.
Evidence and gaps in male-focused treatment
A review of 110 randomised studies of depression interventions found that men made up about a quarter of participants. Reviews of approaches to engaging men recommend transparent, collaborative and goal-focused work, while the number of rigorous trials of specifically male-tailored programs remains small.
A 2024 systematic review of treatments for alexithymia, or difficulty identifying and describing emotions, reported promising findings across several methods alongside wide variation in study quality and approach. That evidence supports considering treatment while limiting claims that one particular therapy is the established answer.
Reviewing change in daily life
Change may become visible in staying in a conversation, speaking more directly or recovering after conflict, as well as in the ability to identify feelings. Asking for help or allowing grief to be present without immediately acting on it can also be relevant goals when they fit the person's concerns.
A therapist can begin where the person has access and explain why more difficult material may become useful to approach. Reviewing a recent interaction gives both people a way to see whether emotional awareness is making a difference outside the session.
Research drawn on
- Wong YJ, Ho MHR, Wang SY, Miller ISK. Journal of Counseling Psychology. 2017;64(1):80–93. Meta-analyses of conformity to masculine norms and mental health-related outcomes. View source
- Mansfield AK, et al. 2025. The role of gender norm conformity in men’s psychological help-seeking and treatment engagement: a scoping review. View source
- Seidler ZE, et al. American Journal of Men’s Health. 2018. Engaging men in psychological treatment: a scoping review. View source
- Knox J, Morgan P, Kay-Lambkin F, et al. Current Psychology. 2023;42:30322–30337. Male involvement in randomised trials testing psychotherapy or behavioural interventions for depression: a scoping review. View source
- Tsubaki K, Shimizu E. Behavioral Sciences. 2024;14:1173. A systematic review of psychological treatments for alexithymia. View source
AI disclosure
Brent Munro researched, wrote and reviewed this insight, with ChatGPT assisting in literature searches, limited research comparisons, editing and image generation. He retains full responsibility for the published content.