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Hey y 'all, today we're going to talk about why therapy sucks for men.
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And that may sound kind of confusing because here I am a man, here I am a psychiatrist doing psychotherapy with men.
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So what on earth am I talking about?
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Why do I think therapy sucks for men?
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In my experience as a psychiatrist, I do actually believe that there are systemic biases that make it hard for men to engage in therapy.
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And today we're going to talk a little bit about what those systemic factors are, how we can understand them,
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and even how to overcome some of those factors and move towards more emotional health.
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If you're ready to take the next step on your mental health journey, check out Dr. K's guide.
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It's an immersive resource that distills over 20 years of my experience laid out in a way
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that is tailored to your needs.
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So if you're ready to better understand your mind and take control of it, check out the link in the description below.
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So we have to start by understanding where this idea
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that talk therapy is the gold standard for treating mental illness comes from.
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So what we really need to understand is that the majority of patients in the history of psychotherapy have been women.
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About 60 to 70 % of patients today who engage in psychotherapy are women.
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The other thing is that about 60 to 70 % of therapists today are actually women.
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So I think what happened early on in psychiatry or psychotherapy is that the majority of people we were helping were women.
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And so when me as a doctor, when I look at 10 of my patients and I see,
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okay, so it looks like talking to people about their feelings on average is the most successful thing that I can do.
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But even though that's factually correct, I may not be taking into account that seven out of those 10 people are women.
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And maybe the people who are getting help to the most with talk therapy or talking about their emotions are actually women.
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And it's not just me that says this.
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If you actually look at the American Psychological Association's guidance for working with boys and men,
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they sort of point out a systemic bias in the way that we diagnose men and women.
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And that's a lot of the diagnoses that women get, like depression and anxiety, which by the way,
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women are about two to three times as likely to be diagnosed with that stuff.
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A lot of those diagnoses have to do with feelings and being able to articulate stuff.
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So for example, major depressive disorder involves feeling sad when you're depressed, right?
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Makes sense.
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And that a lot of men are actually diagnosed with what we call externalizing disorders,
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things like addictions or sociopathy or antisocial personality disorder.
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So these are disorders that involve behaviors.
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So I think they're sort of cluing us in on a really important idea, which is that when men feel something,
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they act on it as opposed to articulate it or talk about it.
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And if we tunnel down into a little bit about how men deal with their emotions,
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we'll kind of see that this is true in general as well.
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Because if you're a man, an emotion is a problem to be solved, not something to be talked about, right?
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So think about like if you get bullied on the playground
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and you feel ashamed of yourself and people call you a fat kid and beat you up, that isn't something you talk about.
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In fact, if you go and cry to mommy or cry to the teacher, you're actually treated worse.
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You're taught that articulating problems and talking to people is cause for punishment.
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Instead, what you're supposed to do if you're a man is fix the problem, right?
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So if kids make fun of me for being fat, I'm supposed to lose weight, get ripped, learn martial arts, and the next time they talk,
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I'm going to teach them who's boss.
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And so if you sort of think about it, the solution to an internal feeling,
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feeling ashamed, is to take an action and change the circumstances that make me feel that way.
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If I'm feeling ashamed because I don't have a job and I don't have any money, what should I do about that?
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Should I go cry to mommy about how I don't have a job or don't have money?
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Should I cry to my girlfriend about how I'm broke all the time?
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No. If you're a man, you need to man the fuck up.
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Go out there, get a job, and start making money.
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If you're feeling bad in here, as a man, what we're taught is you're supposed to go fix the problem out there.
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And this also manifests in men's reluctance to engage in couples counseling.
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So oftentimes, if you're in a relationship, and I'm assuming a heteronormative relationship for a second, and your wife or your girlfriend says,
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hey, I think we need to go see a counselor, oftentimes men will be reluctant to engage in that.
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And if you actually look at the research for why men are reluctant, what you discover is it's not
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that they're trying to put their head in the sand or they're avoiding a problem or anything like that.
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They actually feel outgunned in therapy.
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They feel like when they go to a couple's counselor, my partner is so much better at understanding and articulating their feelings
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that they can sort of make their case better than I can.
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And when the therapist tries talking to me, like, I just say, I don't know a lot, or I'm not sure.
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Like, I don't know how to, someone's asking me to play basketball, but I don't know how to dribble.
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And so what men actually feel like in couples counseling is that they don't know how to effectively communicate.
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So imagine a situation where you're like going into a court of law
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and there's a judge there and your wife makes her case, right?
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She says, hey, Alok is neglectful.
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He doesn't appreciate me.
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I do so much for him.
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And I know he works hard, but he's really short with me sometimes and it really hurts and I feel really underappreciated.
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And then as a man, how do I respond to this?
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I don't speak the language of emotions and
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so as a dude
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you're like you don't know how to communicate in the way
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that therapists like so men literally feel outgunned to engage in things like couples therapy
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and that's because we as men communicate our emotions in a different way
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so my favorite example of how men communicate differently is the negative expression of a positive affection.
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So when we like someone and we're proud of one of our homies or our bros, we don't say that to them, right?
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In fact, what we do is we kind of dog them about it.
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If my friend has been single for a while after a bad breakup and starts dating someone else,
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and I feel really proud and good about that, I don't say, hey friend, I'm really proud of you.
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And I'm proud that you've been able to find someone who sees the lovable qualities within you that I see.
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I'm proud that you found someone who treats you the way that I think you deserve to be treated,
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who loves you for who you are in the way that I love you for who you are.
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In the history of humanity, I do not think that sequence of words has ever been spoken by a single man.
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That's not what we say.
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What do we say?
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We say, bruh, GG, noob, you're whipped.
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I guess we'll never see you again.
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And we're smiling the whole time.
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We're not like, why don't you text me anymore?
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I know you haven't been texting me.
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I feel hurt.
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Instead of what we do is we actually dog on this guy, right?
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We're like, we call him whipped and we call him a wuss.
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And we call him like, we say all these negative things, right?
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Like, oh, where's the apron strings?
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We'll say all this like misogynistic crap.
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But the whole time we're like expressing appreciation and smiling at him.
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So men have this negative expression of a positive affection.
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When we feel good about something, we can't just say that, right?
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Because that's not what we we're taught.
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Instead of what we have to do is we have to insult the person that we're proud of.
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That's not how psychotherapy works, right?
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So if this is my mode of communication, I go see my therapist and my therapist is proud of me.
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They don't say, hey, fucker, you got a job.
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You suck.
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I guess you're not going to be coming to therapy anymore
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because you ain't got this time because you got all this work to do.
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You know, screw you.
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That's not what your therapist says.
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In fact, we're trained to say the opposite.
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So the way that we're trained to speak in therapy is, first of all, don't speak very much, right?
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Don't solve problems.
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Just sit there and listen and ask this person lots of questions that they're going to say I don't know to.
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How do you feel about that?
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How does that make you feel?
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I don't know.
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Well, how does that make you feel?
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I don't know.
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And so then if you're a dude and you go to therapy, you feel like an idiot, right?
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Because they're asking you all these questions.
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You're supposed to know what you feel, but you don't know.
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And that's because of the way that we've been taught about our emotions.
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The last thing to consider is that when it comes to emotional health, men are very physical with it.
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So even if I ask a dude, hey, like, you know, it sounds like you got dumped.
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Tell me a little bit about how you feel.
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The dude may not be able to say, I feel unlovable.
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I'm full of fear that perhaps I won't be able to find a partner.
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I'm afraid that I'm fundamentally broken in some way that precludes me
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and maybe destines me to be alone for the rest of my life.
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That's not what dudes say.
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What dudes say is it felt like she ripped my heart out.
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It felt like she stomped on my balls.
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And if you say that as a dude, the other dudes will know exactly what you mean, right?
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Like we all know like, oh man, like, oh, it's not just ripped your heart out.
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It's also a stomp on the balls.
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I felt that, man.
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The last time I got dumped, I found out my partner was cheating on me.
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Felt like she kicked me in the nuts, dude.
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I know exactly how you feel.
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That's how we talk.
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We're very physical in nature.
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The other thing is if you talk to men about who support each other, right, and they say, if you get dumped,
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what's the first thing you should do?
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Hit the gym, baby.
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And that's where we may assume that this relates to confidence, that if you start working out,
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you get buffed, and you look at yourself in the mirror, and you're like, I'm so sexy.
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But we don't even acknowledge for a moment that there may be a physiological aspect to improve your mood.
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And one of the biggest mistakes
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that I think we've made in the field of psychotherapy is that we've separated out the mind from the body.
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Whereas if you look at modern science, we know that anxiety is not just an emotion.
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It's not just in your mind, that emotions have physical ramifications, that anxiety can induce diarrhea and change the rate of your peristalsis.
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Anxiety activates your sympathetic nervous system and reduces blood flow to places like your stomach
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and increases blood flow to other parts of your body.
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So we know that emotions are actually very physiological in nature.
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So why is it as a society
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that we've kind of gotten on this track of simply talking about them instead of acting physically?
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And a lot of the men that I've worked with, I've sort of noticed that this physical component is way more important than the talking component,
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at least compared to the women that I've worked with.
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Just to give you all a simple example, I find that the men in my office need hugs way more than the women.
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Now, there are a lot of complications to
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that there's a gender dynamic right between me and the woman where maybe the woman doesn't feel as comfortable to hug me.
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Maybe I don't feel as comfortable to hug the woman.
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So I'm not saying that that's like a statement of fact.
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But what I've noticed is that like hugging men, the patients in my office who are dudes,
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leads to like a lot more emotional healing and sometimes tears
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and all this kind of stuff and like more dick jokes after we're done.
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Right.
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So there's something very physical about the way that men deal with their emotions.
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And so if we assume all of this is true.
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What does this mean for you as a dude?
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So I know this sounds kind of weird,
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but the first thing that I'd recommend is that you actually seek psychotherapy if you're struggling in some way.
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And that may sound weird because you said, Dr. K, there's a systemic bias.
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Yeah, but it's still the best evidence -based treatment that we have for dealing with mental illness.
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Medication is just as good, by the way.
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And another thing we need to keep in mind is that there are randomized controlled trials on many types of psychotherapy,
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which show that they are equally effective for men and women.
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So it's not like psychotherapy works.
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It's just that if you're engaging in psychotherapy as a man,
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there may be a couple of things that we can arm you with to really make that psychotherapy really worthwhile.
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So the first recommendation that I have is that you see at least three psychotherapists,
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or at least you see at least three before you give up on therapy.
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If you love the first one, then stick with them.
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And so a lot of psychotherapy is about fit,
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and it may just be hard to find someone who's able to communicate with you in a way that is helpful.
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So a couple of things that I would recommend, some language that you can use if you go to psychotherapy.
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So the first is just simply let your therapist know, hey, I'm not really aware of what I feel all the time,
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and I'm not very good at articulating my feelings.
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Because oftentimes therapists will say, how do you feel?
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And as dudes, we don't know how to answer that.
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So just be transparent with them at the beginning.
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Another thing that I'd recommend is that y 'all check out this idea of normative male alexithymia,
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which is this idea that men are, by default, it's normative.
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So it's like most men are colorblind to their internal emotional state.
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So check out our video on alexithymia if y 'all want to.
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And then you can even tell your therapist that, hey, I'm concerned that I'm a little bit alexithymic.
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So you're signaling to them that you may not be able to participate in therapy in a default way.
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The next thing that you can do is ask your therapist to change their style a little bit
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if it isn't working for you.
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So you can tell them, hey, I've noticed that you're really quiet.
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And then you kind of ask these questions like, how do you feel over and over and over again?
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And then I keep answering, I don't know.
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Can you try to be a little bit more active
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or offer a little bit more guidance instead of being quieter and asking only open -ended questions?
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Can you help me understand stuff or guide me in some way?
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And some therapists may feel really uncomfortable with that.
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They may turn that around into a question, why do you feel like you need more guidance?
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I don't know, because this doesn't seem to be helping very much.
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So you can just ask them to change their style a little bit.
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And the third thing that you can do if number one and number two don't work is after two or three sessions,
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I would just go to them and say, hey, I don't feel like I'm actually getting a whole lot out of this therapy.
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So you seem to be asking certain questions that I have difficulty answering.
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And I'm hoping that you can recommend a different therapist who's a little bit more active,
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can offer a little bit more guidance or asks questions in a way that can help me understand my emotions better.
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And I know that this sounds mortifying.
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Oh my God, as a dude, why would I ever do that?
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As anyone, as any patient, why would I ask to see a different therapist?
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It means that I don't think they're good.
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And it doesn't mean that they're not good.
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It just means that they're not really helping you very much.
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Or at the minimum, you can have a conversation about what's working and what isn't.
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And then hopefully y 'all can work through that stuff.
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So I, as a therapist, actually don't feel, I mean, I feel bad in some ways,
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but I'm really grateful for all of my patients who have come to me and said, hey, Dr. K, this is not working.
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Because then one of two things happen.
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One is either we work on it, and then we actually make a breakthrough of some kind, and now we're really jiving together,
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or I recommend that the person go see someone else.
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And what's my duty as a doctor or someone's duty as a therapist?
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It's to help the person, not help the person myself.
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It means giving that person whatever kind of help they need.
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So oddly enough, I'm still recommending that y 'all try psychotherapy because it is still an evidence -based, very effective approach.
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The other thing to consider, though, is that a lot of emotions live in our body.
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And as men, sometimes we need to do more bodily stuff.
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So there are studies that show that...
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Tai Chi and yoga, for example, are effective treatments for a lot of things like mood disorders or anxiety or things like that.
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So adding a physical component to your emotional health is very, very helpful.
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The other thing to consider is that there's a range of new and kind of in vogue things called somatic therapies.
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So these are therapies that incorporate the body in some way.
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So good examples of this are EMDR or EFT, which is the emotional freeing technique or tapping.
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So when I first encountered these studies about 10 or 15 years ago, and I used to sort of,
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my area of interest was evidence -based complementing alternative medicine, I thought all this stuff was like kind of BS, right?
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So it's like the idea behind tapping is
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that your emotions are stored in your body and that you can tap on certain parts to free emotions.
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And I was like, this doesn't make any sense.
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This is all BS.
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And it turns out that over the last decade or so, there have been some studies that actually show that this is a pretty effective technique.
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We're not really 100 % sure you know, the studies aren't super high quality,
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but there's more and more evidence that stuff that is not classically effective may be effective.
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And specifically that a lot of somatic therapies seem to be gaining a lot of weight and gaining a lot of interest.
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So I encourage y 'all to seek out more bodily oriented kind of evidence -based techniques.
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And the last thing that I just want to share with y 'all is that I've seen that across the globe,
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there's a lot more men's work kind of going on.
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And this isn't psychotherapy, but it's just sort of groups of men will get together
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and will participate in all kinds of either communication or even like some sorts of like physical rituals or like taking hikes.
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There's sort of this very like physical component to their emotional health, which they all sort of get together and do.
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So I can't speak to specific things like that.
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I'm just sort of pointing that out as a trend.
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So at the end of the day, I know it sounds kind of weird,
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but I do think that therapy sucks for men for a lot of reasons.
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Some of that has to do with the way that we're raised.
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Some of that has to do with the way that psychotherapy was developed.
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And so as men, we sort of really need to think a little bit about how can I become emotionally healthy?
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So I definitely give therapy a shot, but go in with some of these disclaimers in mind.
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Go in understanding that you may not be perfectly suited to this, that you're stepping onto the basketball court,
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but you don't necessarily know how to dribble.
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And so just recognize that and ask your therapist for help.
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And the second thing to consider is that especially as men, a lot of our emotions live in our bodies.
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We may need to leverage our bodies or do some kind of bodily work to really help us achieve emotional health.
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Vocabolario e note di pronuncia per questa lezione
Questa lezione di conversazione si basa sul video “Why Therapy Sucks For Men”. Le parole che ritornano più spesso: psychotherapy, therapist, emotion, therapy. Questo video contiene 269 frasi e 3650 parole da ripetere con lo shadowing. Il parlato dura 17:29. Chi parla va veloce, circa 209 parole al minuto: aspettati suoni legati e ridotti. Il 85% delle parole rientra nelle 3.000 più comuni dell’inglese; conviene studiare le altre prima di iniziare.
Vocaboli chiave di questo video
15 parole del video che vale la pena imparare, con pronuncia e significato:
| Parola | Pronuncia | Significato |
|---|---|---|
| therapist sostantivo | /ˈθɛɹəpɪst/ | terapeuta, terapista |
| emotion sostantivo | /ɪˈməʊ.ʃən/ | emozione |
| engage verbo | /ɪnˈɡeɪd͡ʒ/ | attirare, convergere |
| anxiety sostantivo | /æŋˈzaɪ.əti/ | ansia, ansietà |
| disorder sostantivo | /dɪsˈɔɹdɚ/ | disordine |
| communicate verbo | /kəˈmjuːnɪkeɪt/ | comunicare, informare |
| suck verbo | /sʌk/ | succhiare, suggere |
| guidance sostantivo | /ˈɡaɪdəns/ | guida, direzione |
| component sostantivo | /kəmˈpoʊ.nənt/ | componente |
| systemic aggettivo | /sɪˈstɛm.ɪk/ | sistemico |
| rip verbo | /ɹɪp/ | strappare |
| bias sostantivo | /ˈbaɪ.əs/ | pregiudizio, predisposizione |
| dump verbo | /dʌmp/ | scaricare, buttare |
| bodily aggettivo | /ˈbɑdɪli/ | corporale, corporeo |
| technique sostantivo | /tɛkˈniːk/ | tecnica |
I phrasal verb che sentirai
| Parola | Significato |
|---|---|
| check out verbo | investigare |
| find out verbo | scoprire |
| go out verbo | uscire, andare fuori |
| point out verbo | additare |
| turn out verbo | risultare |
Frasi da ripetere
Frasi brevi e complete del video che puoi riutilizzare nella conversazione di tutti i giorni:
- Why do I think therapy sucks for men?
- We're not like, why don't you text me anymore?
- How do you feel about that?
- How does that make you feel?
- What does this mean for you as a dude?
La grammatica di questo video
Le strutture che chi parla usa di più, con le parole esatte del video:
| Struttura | Nel video |
|---|---|
| Present perfect have/has + participio passato — un’azione passata che conta ancora adesso | have been · has been · you've been |
| Forma passiva be + participio passato — conta ciò che accade, non chi lo fa | is tailored · be diagnosed · are actually diagnosed |
| Frasi relative who / which + frase — un’informazione in più su una persona o una cosa | people who are · idea, which is · someone who sees |
Pronuncia a cui fare attenzione
Chi parla usa 133 contrazioni e forme ridotte, come don't, you're, I'm. Pronunciale nella forma breve, così come le senti.
- I suoni “th”: therapist /ˈθɛɹəpɪst/, breakthrough /ˈbɹeɪk.θɹuː/, sympathetic /ˌsɪm.pəˈθɛt.ɪk/, worthwhile /ˌwɜː(ɹ)θˈwaɪl/, psychotherapy /ˌsaɪkoʊˈθɛɹəpi/
- I suoni “sh” e “zh”: emotion /ɪˈməʊ.ʃən/, ashamed /əˈʃeɪmd/, affection /əˈfɛk.ʃən/, punishment /ˈpʌnɪʃmənt/, medication /mɛdɪˈkeɪʃən/
- Parole lunghe — attenzione all’accento: anxiety /æŋˈzaɪ.əti/, communicate /kəˈmjuːnɪkeɪt/, articulate /ɑːɹˈtɪk.jə.leɪt/, participate /pɑːˈtɪs.ɪ.peɪt/, psychiatrist /ˌsaɪˈkaɪ.ə.tɹɪst/
I suoni difficili per chi parla italiano:
- /h/ — va soffiata, non è muta: helpful /ˈhɛlp.fl̩/, hug /hʌɡ/, whereas /(h)wɛɹˈæz/, humanity /hjuˈmænɪti/, heal /ˈhiːl/
- Consonante finale — senza aggiungere una vocale dopo: therapist /ˈθɛɹəpɪst/, engage /ɪnˈɡeɪd͡ʒ/, communicate /kəˈmjuːnɪkeɪt/, articulate /ɑːɹˈtɪk.jə.leɪt/, suck /sʌk/
- /æ/ — più aperta della “e”: anxiety /æŋˈzaɪ.əti/, sand /sænd/, aspect /ˈæspɛkt/, whereas /(h)wɛɹˈæz/, humanity /hjuˈmænɪti/
Come esercitarsi con questo video
- Ascolta tutto il video una volta senza parlare e annota le parole che non conosci.
- Inizia a velocità 0,75×, fai shadowing frase per frase e torna alla velocità normale quando diventa facile.
- Registrati e confronta con l’originale, facendo attenzione a parole come therapist, emotion, engage.
Cos'è la tecnica dello Shadowing?
Shadowing è una tecnica di apprendimento delle lingue supportata da studi scientifici, originariamente sviluppata per la formazione dei traduttori professionisti e resa popolare dal poliglotta Dr. Alexander Arguelles. Il metodo è semplice ma potente: ascolti un audio in inglese di madrelingua e lo ripeti immediatamente ad alta voce — come un'ombra che segue il parlante con un ritardo di solo 1–2 secondi. A differenza dell'ascolto passivo o degli esercizi di grammatica, lo shadowing costringe il tuo cervello e i muscoli della bocca a elaborare e riprodurre simultaneamente i modelli di discorso reale. La ricerca dimostra che migliora significativamente la precisione della pronuncia, l'intonazione, il ritmo, il discorso connesso, la comprensione dell'ascolto e la fluidità del parlato — rendendolo uno dei metodi più efficaci per la preparazione alla prova di speaking dell'IELTS e per la comunicazione reale in inglese.