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  • I am an actual licensed therapist and while there are a number of real actual creating barriers specific to men pursuing mental health treatment there are a few factors I’ve consistently seen that are ubiquitous across gender, race, sexuality, class, etc

    Money, time, availability

    Therapy is inaccessible. I am a therapist who mostly works with insurance companies. They pay me about 100-115/hr. My clients will often have a high deductible health plan which means they need to pay this $100-115 per session until they hit their deductible, which can be 5,000+ dollars. It’s a lot to ask someone to pay $100+ weekly. On top of that they still usually have a responsibility afterwards of (typically) 10-30% so $10-34.5 per meeting which is still a notable weekly cost for many people on the high end especially after shelling out $400+ a month for months on end.

    Other clients have PPO insurance which is a fixed cost per meeting but this can vary wildly. More affluent clients have excellent PPOs where they might pay $10-20 per meeting which is not terrible. But that’s rare. We are often covered under the “specialist” copay and many PPO plans have tiered provider coverage now. So a copay for me might be $50 or more per meeting (the worst I saw was $125 which was absurd because it was actually $27 more than I’d get from the insurer in question).

    So you have this on top of these plans taking hundreds of dollars out of each pay check. “Well budget for it”. Hard to do because the need for therapy can be inconsistent and many of these people are coming in fo(and specifically symptoms like poor money management). Then on top of that even if you do budget for it you have the inherent issue that the need for outpatient therapy is often not dire/acute so if something more pressing comes up (eg a serious dental/medical issue, car breaks down, short on rent) therapy might be the corner to cut if it’s already established because in the overwhelming majority of cases you won’t die without it; it will just lower your quality of life (sometimes significantly so)

    Then comes the time portion. Even if you can get past the cost barrier you have the availability of the therapist and yourself. I’m a night owl and I work late but many of my colleagues don’t. I’m pretty nontraditional though, no kids and my partner is very career oriented themselves whereas many of my peers tend to value the traditional 9-5 much more so they can be home for their children and such.

    So when you go to schedule with someone it’s often that you can only get seen during business hours. It’s one thing when it’s a doctors appointment that you have once every few months that you need to duck out of work for but a weekly hour long engagement is much harder to explain. This brings back in the masculinity issues - many men find this basically impossible to disclose to the workplace and basically wouldn’t even try to get an exception for weekly therapy. Even without explicitly saying so asking for 1 hour open a week consistently for a doctors appointment is going to be perceived as therapy by many. But stigma aside many of us simply can’t do that. I’m on the practitioner side and I know I’ve ignored my own physical health at times because it was inconvenient to schedule doctor appointments during my workday.

    Our systems of employment (at least in the USA) simply do not provide or protect for medical leave, even when it’s very brief and especially when you are a low level employee (executives and admins tend to have less of an issue ducking out for doctors appointments in my experience at least). There is no legal right to paid or unpaid time off for medical appointments in the USA and that is completely disgusting in 2023.

    The final piece is practitioner availability. I have a waitlist through October at the moment and am not accepting new clients. All of my colleagues are in the same boat. The old practices I used to work at constantly call me to see if I’ll take any referrals because their waitlists are so overloaded. The hospitals and clinics I have referral relationships with email me every week for updates. It’s extremely stressful. Every new client, especially adolescent, complains that they are happy to finally have someone after waiting 3-6 months. Even if someone wants a therapist they have to wait ages. It is not uncommon that I get someone and when I call them to start they say they don’t even remember why they called in the first place.

    We need more people doing the work. Or ideally we need to make societal reforms so that there are less people experiencing mental health issues. I’ve been doing this almost 15 years now. I, and anyone who doesn’t exclusively work with the rich, can tell you that a significant degree of what we work with is people who lack resources and not proper mental illness. I mean, it is depression and anxiety, but it’s because they have been paycheck to paycheck for years or theyre under a mountain of student loans or credit card debt and the stress is just too much to bear. And their jobs won’t give them raises and there aren’t any other jobs out there that pay more. Not everyone is a software developer or investment banker that can jump ship to another 6 figure job with cushy benefits. Most people work jobs that pay 40-60k with shit benefits and little upward mobility.

    To answer your question more directly:

    In my opinion it’s a systemic issue based around that super fun phrase everyone loves, “toxic masculinity”. I personally do not subscribe to gender labels but I am amab/male presenting and get a lot of male clients as a result. Many of them tell me they hide the fact that they are in therapy from everyone but their partner. This is indicative of the problem; that being in therapy is weak. That being in therapy makes them a bitch, a wuss, all kinds of pejorative terms. It’s bad, is my point.

    So part of the answer imo is not in having doggies and cool dude stuff in the office. Its far more complex and involves redefining masculinity to still including things like being a lumberjack or carpentry or whatever. From there though you need to shed the part where it means you have to be emotionally numb to everything, constantly display strength, embrace the fucked up misrepresentation of stoicism that has you shove all your feelings into your stomach, and glorify anger, rage, and violence as the only appropriate means of emotional expression.

    this could also be extended to the stigma surrounding therapy itself and the tendency to associate therapy need with weakness. This is an issue that goes beyond therapy though; there are people who won’t see medical doctors for the same reason even though they’re in physical pain. Our pride is our downfall.

    Tldr make therapy cheap and accessible, make protections for workers to seek medical care, increase the amount of practitioners (or decrease the need for them), and systemic reform to the societal concept of masculinity and pride. So probably gonna take awhile

  • This is purely anecdotal of course, but most of my (male) friends and family members who resist going to therapy aren't really turned off because of access to a specific service tailored for them or not; they're "turned off" from it largely because of the social perception of men going to therapy in general.

    What I mean to say is, no, I don't think we need more therapy "tailored" towards men, all (decent) therapists already specifically try to bend their particular therapy-ing style to match their client, regardless of gender. We need to change the perception of what it means to get therapy (at least in my opinion).

    1. I can't afford hundreds of dollars an hour, and if I could I'd be in a vastly better place anyway.
    2. I see thinking as something I do, not something that happens to me. As such, my inner Red Forman takes a deep fucking breath at the idea of paying someone else to tell me well don't do that then.
    3. My goals would involve the damage not being done in the first place. My coping skills in the face of what did happen, I'm honestly pretty impressed with. Unless you've got a time machine and a shotgun, there's not a lot you can offer me.
    4. Some support would be nice, but the suggestion that being angry about the harm done to me is a flaw on my part that needs fixing... rankles, you know? (and at the same time, validation-as-a-service would be as empty and downright masturbatory as extracting an apology from an AI)
    5. Dog-as-a-service, heck yeah. I don't really want to pay psych prices or go get my soul flayed as a condition of entry, though.
    • This is actually very interesting and gets at the heart of the problem in many different ways. Very true that there's a money barrier that excludes some that might be most in need of services. There needs to be a more focused effort on providing assistance to those who need it at reduced rates or with additional insurance help.

      But the bigger problem still remains with helping men (and women frankly, but moreso men) to understand what therapy/counseling is and is not. For years psychologists have been naming symptoms and diagnosing individuals with such and such disease or shortcoming on the part of the individual. Just like everything in the corporate world, they rely on statistics and numbers to come up with definitions for problems and for solutions.

      I'm currently enrolled in a master's program to obtain my licensing for professional counseling, and I can tell you that the attitude on that is finally starting to bend. I hear what you're saying about not wanting therapy to simply be a self-affirmation circle-jerk because it doesn't feel helpful to be told how wonderful you are by a person just to be knocked right back down again in a real-world experience.

      But beneath even your resistance there's still an admission that support can be helpful. In my personal opinion, I think counseling/therapy is a purposeful space to open up about experiences and feelings that you wouldn't otherwise have an opportunity to express. Talking to yourself or talking to animals is helpful, but simply being able to unburden your thoughts to another human being that doesn't know you and won't judge you (or at least... they're paid not to judge you) for your opinions or past mistakes can be a hugely beneficial step towards true healing.

      Ultimately no counseling or therapy techniques can be effective until you decide they can be. It's about helping to reframe your thoughts in ways you might not have considered, and it's also meant to give you useful tools for coping with feelings both now and in the future. Successful counseling is one in which the client feels comfortable and confident about how to deal with the hardest parts of human existence.

      More needs to be done to educate people about what they can expect from counseling so they can make their own decisions about whether or not it would be useful to them. Being able to word vomit my insecurities with a stranger for an hour is surprisingly uplifting and helps me clear my head towards whatever's coming next.

    • the suggestion that being angry about the harm done to me is a flaw on my part that needs fixing…

      If the day ever comes when you would prefer not being angry about the past, when you would prefer to embrace joy on a daily basis, then and only then would therapy be worthwhile. As long as you're not lashing out at others with your anger, then only you, alone, are being hurt by your anger.

  • Wow, I'm seeing a lot of strong anti-therapy vibes here, so I'll pitch in my two cents.

    Therapy is a great tool, if you go into it with clear expectations and you can stomach the cost- both in time and money. Some insurance providers cover it, some don't, but either way if you don't have a therapist that you vibe with, you need to be willing to swap around until you find someone that fits you. Note, however, that there's a big difference between a therapist that is right for you, and one that just doesn't challenge you.

    My experience with Cognitive Behavioral Therapy has been really positive; my first therapist that I really got along with professionally was a great teacher, I really learned how to unpack things that I was feeling in the moment. He helped teach me tools to alleviate the intensity of moments that seemed dire, and to then reflect on why they felt that way, afterwards.

    There's a lot of people who think that it's supposed to magically fix you, and no, it's not. It's work. Genuinely some of the hardest work I've done has been applications of the stuff I've learned in therapy. But, while I recognize that with stuff like chronic depression, true cures are rare-to-impossible, I've got a much better handle on my negative thoughts and self-esteem than I had pre-therapy. It's been a tremendous help.

    I think more tools for people in general would be incredible - the work of normalizing therapy has come a long way, but still it has even further to go. I think the biggest barrier is always cost, and in a perfect world we'd treat both sickness of the mind and body free for everyone.

  • I am a man who has been to therapy a few times during my life. I'll not try to sell it as a be all, end all solution but it can be helpful.

    At least as helpful was a men's support group that I went to while divorcing.

    I think the bottom line is that men need to connect with men and talk things out sometimes. However you do that, with friends, at a support group or with a therapist does not really matter. Male isolation is real and that is what we as a society should be very concerned about.

  • I'm a woman but due to my interests in traditionally masculine activities and general disinterest in conventional gendered behaviours, I hang around a lot of men. Most of my close friends have been men. From my experience, if men want to improve their mental health then they need to develop a better relationship with vulnerability and the shame they've been conditioned to feel around that.

    Mental health stigma exists for everyone and as a society we need to fuck this right off. Mental health challenges are part of the human experience in the same way physical illnesses are and we need to support people accordingly. I've noticed that a lot of men tend to have issues with expressing their feelings out of fear of being vulnerable. The outdated myth that men are less emotional really doesn't help this situation either. This can also create barriers for men in seeking mental health support, both formal and informal.

    It needs to more okay for men to be vulnerable. All people are vulnerable and it doesn't make you weak. All people need support at some point in their lives. Emotions are really hard and it's better to recognise and acknowledge them than it is to push them down. Expressing vulnerability and overcoming difficult feelings shows bravery and strength.

  • Disclaimer at the beginning, my reply is purely anecdotal and based on my own life and experiences. I can't speak for everyone else.

    I really don't think that talk therapy is best suited for most men. Men don't process emotions, conflict, or fears in the same way that women do. We have been shaped differently by societal norms, and don't have the same foundation to process our issues simply by talking about them. We have been taught to shut up and deal with situations on our own. Talking about our struggles and asking for help is a sign of weakness, and even if we manage to ask for help, the chances that we will truly open up are slim.

    Again, I can only really speak for myself, but for talk therapy to truly be effective it has to be more than just talk. We need a foundation; maybe starting with something like cognitive behavioral therapy to give us the tools to understand how to process our emotions would be a good start. Men are taught to understand and explore only a small handfull of emotions. Anger, jealousy, fear, happiness, and if we're lucky, love.

    I personally have had to do a lot of work on my own self, and my own understanding of my emotional landscape, just to begin to be able to open up. I can honestly say that even if I had spoken with a therapist - and I have had the opportunity to do so - that it probably wouldn't have been useful to me, at least not in the past. Maybe now it would be useful to talk to a therapist, but in working on myself I feel that I have also learned to move past many of my own issues, or at the very least am on the right path to be able to handle them on my own.

    Anyway, that's my two cents.

  • I don't know what it's like in the rest of the world, but I always hear how many people seek a therapist, but can't find one. I don't even know if there's something wrong with me, but I'm interested in finding out. But I don't think it's bad enough to warrant to "steal" a spot for somebody who actually needs it, just for interest sake. (Could be the "man" in me talking though, saying "I'm fine")

  • I'd be interested in petting doggos and hanging out if that's what you mean by tailored, but not any traditional therapy. Going affects my employment opportunities, which I care about far more than my mental health. If I wanted to not suffer everyday of my life I'd shift my priorities, expectations, push my boundaries or off myself. Since I haven't done those things yet, things must be fine enough.

    I would have a very bad opinion of any version of myself that was happy or content while being aware of all the terrible things we human beings get up to.

    The only way I could be convinced to genuinely engage with therapy is if I thought it'd achieve some material goal of mine like making more money. Proving some positive correlation in earnings or attainment of things that men normally want with therapy would probably help. I'd reluctantly go and commit completely if I thought it'd significantly improve the likelihood of achieving my current or future goals. No dogs necessary at that point, just data.

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