The Questions Men Search For But Don't Say Out Loud: Answered by Male Clinical Psychologists
Seeking support is not always straightforward, and for many men it can feel like a significant step just to consider it. In this post, five male clinical psychologists who work with men have answered the questions that come up most often, including the ones that tend to go unasked.
Why don't more men seek help?
Dr Ross G. White, Clinical Psychologist at Strive2Thrive (www.strive2thrive.co.uk) and author of The Tree That Bends: How a Flexible Mind can help you thrive
Despite growing awareness around mental health, many men still struggle to seek support. There remains a noticeable gap when it comes to men receiving help that can make a big difference to how they feel. Understanding why this happens is an important step towards changing it.
A key barrier relates to rigid notions of masculinity that obsess over the importance of self-reliance. From a young age, many boys are taught to be strong, independent, and emotionally restrained. A by-product of this is that being vulnerable is regarded as unmanly, it feels like a weakness rather than an inherent part of being human. As a result, conceding that you are struggling can feel shameful. Many men feel they should be able to handle their problems on their own, without outside support. While independence can be a strength, it can also become a barrier when it stops someone from reaching out when they truly need it.
Closely tied to this is the stigma surrounding mental health. While stigma affects everyone, masculine preoccupations with status can mean that men are particularly fearful of being judged as incapable or less competent. This fear can prevent them from being open, even with people they trust. Some men may also worry that if they start talking, they won't be able to manage what comes out. It's important for mental health professionals to allay these concerns and emphasise that support helps people feel better in the long run.
Another challenge is emotional awareness. The parenting of boys tends to place less emphasis on them developing a nuanced understanding of their emotions and the language they can use to describe them. Instead of recognising fear, sadness, or loneliness, these emotions may show up as stress, anger, or frustration. When you can't clearly name what's wrong, it becomes much harder to get the help you need.
Practical issues play a role too. Mental health services aren't always designed with men in mind, and some may struggle to find spaces where they feel comfortable. Talking face-to-face with a mental health professional may feel intrusive and awkward; men sometimes feel more comfortable talking shoulder-to-shoulder. The language of 'therapy' may also be off-putting for some, counselling, coaching, personal development, talking with someone, or emotional skills training might be more acceptable. On top of that, busy schedules, financial pressures, and other responsibilities often push mental health a lot further down the priority list.
It's also worth noting that men often cope differently. Rather than talking about their struggles, they may turn to distraction, throwing themselves into work, exercise, or other activities. While these can provide temporary relief, they don't get to the root of the problem. Reframing these forms of coping as temporary fixes, or indeed part of the problem rather than solution, might help.
Finally, a lack of visible role models can reinforce the silence. When men don't see others speaking openly about mental health, whether in their personal lives or in the public eye, it can feel like staying quiet is simply what's expected. Thankfully, this is starting to change, with high profile men such as Ireland rugby players Andrew Porter and Caelan Dorris speaking candidly about their struggles and the support they have received.
Supporting more men to seek help starts with developing conversations about it further. Exploring concerns about being open, normalising vulnerability, and creating spaces where men feel safe to talk are all important steps. Seeking help is not a sign of weakness, it's a smart move that signals awareness, courage, and strength.
Why fewer men seek help in therapy
Dr Jeri Tikare, Specialist Clinical Psychologist
There are several factors to consider regarding the challenges that men often encounter when seeking therapy. One possible influence stems from societal norms surrounding masculinity. In some cultures, there exists a prevalent belief about the qualities that define someone who identifies as a male, which often discourages expressions of vulnerability, which is a key part of the therapeutic process. This cultural narrative suggests that men should be self-reliant and resilient, handling life's difficulties without seeking help.
Consequently, the idea of engaging in therapy can evoke difficult emotions for men. For some, participating in this process may be seen as a sign of vulnerability or an acknowledgement of personal struggles, which can lead to internal conflicts. Many men may worry about feeling inadequate or view themselves as "weak" or "failures" if they consider reaching out for help. These feelings can significantly impact their self-identity and adherence to societal expectations, often resulting in the suppression of emotions and a reluctance to seek support.
Another important aspect to consider is the representation of gender within the therapy community. The predominance of female therapists may present a barrier for some men when seeking help. Many individuals might feel more at ease discussing personal matters with someone they feel they can relate to on a gender level. This potential disconnect can foster apprehension or reluctance in men's willingness to engage in the therapeutic process, even as they navigate the intricacies of their emotions and the societal pressures that shape their decisions.
In summary, the combination of societal expectations and concerns about representation in the therapeutic community creates an environment that makes it more challenging for many men to prioritise their mental health and seek the support they truly need.
What happens in a therapy session?
Dr Jeri Tikare, Specialist Clinical Psychologist
What occurs in a therapy session is influenced by various factors, including whether it is an initial assessment or a follow-up session and the therapeutic modality employed by the practitioner. During the assessment session, the practitioner typically works alongside the client to establish a sense of safety and set boundaries, which are essential for effective therapeutic engagement. This may involve discussing confidentiality, note-taking, session timeframes, and contract terms, among other topics. The practitioner will also clarify the client's therapy goals and conduct a comprehensive risk assessment, laying a foundation for the therapeutic process.
In subsequent sessions, the structure may vary based on the therapeutic modality. For instance, in cognitive behavioural therapy, the practitioner might outline a specific plan or focus for the session, whereas other modalities may adopt a more fluid approach to engagement.
Throughout therapy, practitioners support clients by discussing their experiences, past, recent, or ongoing, across various life areas, such as relationships and work. They may also address current feelings of distress, including issues like low mood, stress, and anxiety.
Practitioners engage in various strategies to facilitate the therapeutic process, which include actively listening to the client's concerns and utilising both verbal and non-verbal communication to validate and contain the client's difficulties. Different therapeutic techniques may be employed to help clients feel understood and to identify patterns contributing to their challenges. The aim is to support clients in processing difficult feelings they may be avoiding and recognising behavioural patterns that were previously adaptive but are now unhelpful.
Once links and patterns are identified, the practitioner assists the client in exploring more constructive ways to manage difficulties, which may include skill building, psychoeducation, and learning new strategies for effective distress management. The overarching responsibility of the practitioner in therapy is to foster a sense of safety, acceptance, and support, helping the client to navigate their inner world and encouraging a compassionate therapeutic environment where the client feels comfortable expressing themselves openly.
What actually happens in a session? (Continued)
Dr Steve Jones, Principal Clinical Psychologist, author of ACT Made Yorkshire
This can depend on the reasons for being in the session, the model the therapist practices and the goals you are working towards. However, as a general rule, therapy is a conversation to support meaningful change. A collaborative space where you can work on being you and transferring that out of the clinic room and into the "real world".
What does confidentiality in therapy mean?
Dr Jeri Tikare, Specialist Clinical Psychologist
Confidentiality is a crucial element in establishing a sense of safeness within the therapeutic process, which serves as a foundation for meaningful change. Essentially, it means we ensure clients understand that everything they share in therapy remains private, confined to their relationship with the practitioner and, if applicable, others involved in their care. We explain what happens to their routine notes, the outcome measures administered, and any other personal information they divulge during sessions.
A key part of confidentiality is informing clients about its limitations. For instance, if a client reveals information that raises concerns about their safety or the safety of others, such as children or vulnerable individuals, we have a responsibility to discuss that information with appropriate parties who can provide help. In such cases, we emphasise that we will be there to support them throughout the process, making it as collaborative as possible. This approach underscores the caring nature of breaching confidentiality, maintaining trust, and reinforcing the therapeutic relationship.
Does talking really help?
Dr Steve Jones, Principal Clinical Psychologist, author of ACT Made Yorkshire
Short answer, yes. Holding thoughts in your head is an echo chamber and rattles around the inside of your head. Talking about it not only helps to understand that it might not be as true as your mind tells you it is but helps to share the weight.
How many times have you started to say something and then stopped half way through while saying "oh never mind, doesn't matter". This is because it moves from one part of your brain to another and is processed differently. Just the process of speaking aloud does this with uncomfortable thoughts too. That's in addition to the techniques and skills a therapist can bring to help create a narrative and make sense of the threads that make a tapestry of your life.
Can men get postnatal depression?
Dr Steve Jones, Principal Clinical Psychologist, author of ACT Made Yorkshire
All points of transition can lead to unwanted thoughts and feelings. Sometimes these can rise up unexpectedly and can feel intolerable. A change in identity and role can do this to anyone. Having a child is a huge shift, not just in identity but also in your relationship with your partner. If we fall into a self critical pattern relating to these thoughts which we don't like it can spiral. Turning towards these thoughts with kindness, compassion and openness is an important step. Just as we would offer this kindness to a new Mum, we can offer this kindness to a new Dad.
Do I need therapy?
Dr Joe Oliver, Founder of Contextual Consulting, Associate Professor and Consultant Clinical Psychologist
A lot of men come to therapy asking this question, and often what they're really asking is, "Is what I'm dealing with serious enough?"
Therapy isn't just for crisis. It can be useful any time you notice you're getting stuck, doing more of what doesn't work, or moving away from the kind of person you want to be.
In my work, we often focus less on "what's wrong with you" and more on how you relate to your thoughts and feelings, and whether your actions are taking you towards or away from what matters.
You don't need to be falling apart to benefit from that. Sometimes it's just about getting unstuck and moving forward a bit more deliberately.
How long does therapy take?
Dr Brett Hayes, Clinical Psychologist, Specialising in Men’s mental health, burnout, stress, anxiety and trauma
This question comes up often, and it makes sense that it does. When someone is considering therapy, they are usually already at a point where things are not working the way they want them to, and what they have already tried has not shifted it. At that stage, it is natural not to know whether things can be different, or how long it might be before change happens. That uncertainty is part of what makes this feel like an important question to answer before starting.
There are also real-world constraints to consider. Time, energy, money, and insurance sessions are not unlimited, and for many people there is a genuine pressure to get the most out of therapy as quickly as possible. It is also not uncommon to carry some concern about whether therapy will work at all, whether because of previous experiences of help-seeking that did not go well, or a sense that the problem is too complex or too longstanding to shift. And for those without that history, it is entirely reasonable to simply want a realistic sense of what to expect and when.
Whilst each person is different, both clinical experience and research can offer some useful anchors. It is worth noting that individual differences can influence the process considerably, and progress is not always linear. For some, brief therapy is all that is needed, and 1 to 4 sessions is not uncommon for more focused difficulties, or for working on one specific part of a larger problem. For most presentations, 8 to 12 weekly sessions is the range the research tends to support, though it can be difficult to give a definitive number at the outset. If a pattern has been present for a long time, or more than one area of life is affected, longer-term work of six months to a year or more is not unusual either. Duration is not always determined by severity alone. What someone wants from therapy, and how they want to work, also plays a part.
An initial consultation with a therapist can give a clearer sense of likely timescales from their perspective. From there, setting clear goals and regularly asking "how would we know when we are done" can help keep the work focused and give a shared sense of direction. Therapy tends to feel most purposeful when both the client and the therapist have a clear picture of what completing it would look like. It is also not uncommon to start feeling some sense of being understood from the first consultation or assessment session. For many people, some early shift begins to emerge within 2 to 4 sessions. That shift can feel significant, or it can be more subtle, both are signs that the work is headed in the right direction.
If at any point therapy does not feel like it is helping, it is worth raising that in the room. How easy that feels will often depend on the relationship with the therapist, and that relationship matters more than is sometimes acknowledged. If there is no sense of being understood, listened to, or trusted, that is worth naming directly. If it does not feel possible to raise it, it may be worth considering whether the fit is right, because the quality of the therapeutic relationship is consistently one of the strongest factors in whether therapy produces meaningful change.
It is also worth thinking about what kind of therapy might suit. There is some evidence that many men prefer a more action-oriented approach, focused on practical skills and specific goals. If that is the case, a more open-ended or exploratory therapy may not feel like the right fit. Equally, if someone is looking for something less structured and more reflective, more behavioural approaches such as ACT, CBT, or EMDR may not be what they are looking for either. Neither preference is wrong, and getting a sense of this before starting therapy can help in finding the right approach and the right person.
The following section offers some practical guidance on where to look.
How do I find a therapist in the UK?
Dr Brett Hayes
As with many things, knowing where to look makes this more straightforward than it might initially seem. Below is a practical guide to the main routes available in the UK.
Through a GP
A GP is often the first port of call, as they are able to provide an initial assessment and, where appropriate, refer on to further support. This includes referral to NHS Talking Therapies, which offers free, evidence-based psychological treatment for anxiety and depression. Waiting times can vary by area and the work tends to be shorter-term. For difficulties that are more complex or longstanding, a GP can also refer to secondary mental health services or, in some cases, specialist services.
NHS Talking Therapies
It is also possible to refer directly, without going through a GP first, at www.nhs.uk/mental-health/talking-therapies-medicine-treatments/talking-therapies-and-counselling/nhs-talking-therapies. Previously known as IAPT, this service covers therapy for anxiety, depression, stress, and related difficulties, and is available online, by phone, or in person depending on location.
Finding a private psychologist or therapist
For those considering private therapy, the most important thing to establish is whether the person is properly qualified and registered. In the UK, the title Clinical Psychologist is protected by law, meaning anyone using it must be registered with the Health and Care Professions Council (HCPC). Registration can be verified at www.hcpc-uk.org. For therapists and counsellors more broadly, registration is not yet a legal requirement in the UK, so it is always worth checking qualifications and registration status independently before committing to work with someone. Prfo
The following directories are a reasonable starting point for finding a therapist or psychologist. For transparency, the author (Dr Brett Hayes) is listed on both Psychology Today and My Triage Network and has no commercial relationship with either:
My Triage Network (https://mytriagenetwork.com): A service where you can get screened and connected with the right mental health professional, at no cost.
Psychology Today (www.psychologytoday.com/gb): therapists are searchable by area, presenting difficulty, and therapy type, returning individual therapist profiles.
Counselling Directory (www.counsellingdirectory.org.uk): therapists are searchable by area, presenting difficulty, and therapy type, returning individual therapist profiles.
Find a Psychologist (www.findapsychologist.co.uk): psychologists are searchable by area, presenting difficulty, and therapy type, returning individual therapist profiles.
The British Association for Counselling and Psychotherapy (BACP) (www.bacp.co.uk): lists accredited therapists and counsellors, searchable by location and specialism.
The British Psychological Society (BPS) (www.bps.org.uk): lists chartered psychologists, searchable by location and specialism.
EMDR Association UK (www.map.emdrassociation.org.uk): shows accredited EMDR therapists by location. Particularly useful for those looking for trauma-focused therapy.
What to look for
It is worth looking for someone whose specialism matches what is being brought to therapy. A psychologist or therapist who works regularly with stress, burnout, anxiety, or men's mental health more broadly is likely to understand the context without it needing to be explained from scratch.
Most private psychologists offer an initial consultation before any commitment to ongoing work which is worth doing. It gives a sense of whether the therapist understands the difficulty, and whether the working relationship feels like it could be productive. The fit matters, and it is reasonable to speak to more than one person before deciding. There is no obligation to proceed, and no pressure to commit on the basis of a single conversation.
For those with private health insurance, it is worth checking the policy before approaching a private practitioner directly. Many insurers, including Aviva, AXA Health, Bupa, Cigna, and WPA, cover psychological therapy and hold lists of registered providers on their panels.
If you are experiencing a mental health crisis or are in urgent need of support, please contact your GP or call NHS 111. The Samaritans are available 24 hours a day on 116 123.