Counselling Men

Man staring out at sea

There has been an increasing focus on men’s mental health. Rio Ferdinand, Professor Green, Prince William, Alistair Campbell, David Harewood have all featured in recent documentaries, talking about the mental health struggles they’ve gone through. A sense of urgency has come from the alarming rates of male suicide in particular. The repeated message is if you’re struggling, talk to someone.

This is a simple message, but it’s one many men find challenging. How often do we hear men saying things like “I didn’t talk to anyone because I didn’t want to appear weak” or “I just need to Man Up”.

Why focus on men’s mental health?

Data sets collected through the NHS IAPT (Improving Access to Psychological Therapies) programme shows nearly two women access mental health support for every man who does. Further studies show:

  • Men account for over 75% of all suicides, which is the leading cause of death for men under 35.
  • Men score significantly lower than women on the UK’s national well-being survey.
  • Nearly three times more men have substance misuse issues than women.

So there’s evidence there is a need for more support, and the IAPT data sets also show therapy is just as effective for men as for women. But too many men aren’t accessing the help that could make a real, potentially life-saving difference.

Why is it different for men and women?

It might seem there’s an obvious reason why men are less likely to seek help. As mentioned above, men often say it’s because they need to be strong, and not show weakness.

There’s a problem, though. For that to be the reason, then it would mean women don’t feel the same need to be strong, and are okay with being seen as weak.

That doesn’t fit with my own experience of women, whether in the therapy room or not. I believe there must be something else going on.

What does it mean to be strong?

Instead, I think it’s about how men and women, in general, view strength and weakness.

I say in general, because of course there are many, many exceptions to every rule. But clearly there is something to do with gender going on.

Being strong can suggest physical strength. But there’s a different definition used in Transactional Analysis which might be useful here. Psychotherapists Iain Stewart and Vann Joines, in their book TA Today, define a need to be strong as “you’re only OK if you hide your feelings and wants from people. Don’t let them see you’re weak.” I would suggest the gender difference might be based on which feelings it’s important to keep hidden.

Boy’s don’t cry

How often have we all heard “boys don’t cry”? We may have been told that by our parents. Or heard it from childhood friends or through books, films, TV etc. When I was little, being accused of “crying like a girl” was a source of shame. This could often mean that when experiencing a loss, or disappointment, it wasn’t okay to feel sad. As boys, some men may have learned to replace that feeling with one that was more acceptable, perhaps anger, which could be experienced as guilt if directed inwards.

Girls don’t get angry

Women, on the other hand, will often have heard the message when young that they mustn’t get angry. Expressing their anger could lead to similar shaming from friends or family. Crying, however, often didn’t have the same taboo. As girls, some women may then have learned to replace the anger they felt with the more acceptable feeling of sadness.  

But why does this mean fewer men consider counselling?

The possible relevance of which emotions need to remain hidden can be seen if we try a quick experiment. I’d like you to picture a man sitting with a counsellor in a therapy room. He starts to feel emotional. Now look at his eyes. Are there tears in them?

I suspect the answer is yes. “Feeling emotional” is often used as another term for feeling sad. And whenever counselling is shown in films, TV, books, comics etc, it almost always involves people crying. Indeed, no therapy room is complete without a box of tissues.

So if you’re a man who feels a need to be strong, and sees crying as a sign of weakness, it’s easy to see why you might decide counselling isn’t for you.

How can we change this way of thinking?

The temptation is simply to say no, men don’t need to be strong. It may be a clear message, and I have seen campaigns aimed at challenging that belief. But we’re talking about many men’s deeply ingrained sense of identity. It’s a huge task, probably needing society as a whole to change.

Instead, I would challenge the beliefs that counselling is about crying, and crying is a sign of weakness. Both those views are based on misunderstandings about what counselling is about and what emotions are for.

You don’t have to cry during counselling

As a counsellor myself, I don’t see my job as making anybody do anything they don’t want to. Some people do cry, and yes, I do keep a box of tissues handy. But they certainly don’t have to. The effectiveness of counselling isn’t measured by the quantity of tears.

All emotions are equal

Emotions are generally grouped into four main categories: happiness, anger, sadness and fear. As humans, we evolved to experience all of these, in all their variations of intensity. They are equally important, and all provide crucial information about our needs and wants:

  • Happiness: Feeling happy tells us our needs and wants are being met, so we can take steps to make sure this continues.
  • Anger: Feeling angry tells us our needs and wants are not being met, so we can take steps to get those needs and wants met.
  • Sadness: Feeling sad tells us our needs and wants in the past weren’t met, or something we need or want has been lost. We can then take steps to come to terms with the past and perhaps try to get those needs and wants met in the present.
  • Fear: Feeling afraid tells us our needs and wants are under threat of being lost, so we can take steps to keep them safe.

There are many ways this information system can go wrong, including the ways described above. This is an important area counselling can help. Connecting with our authentic emotions can help us to make healthier choices in our lives.

Emotions are not a sign of weakness

Hopefully, by understanding why we experience emotions, it will show why it doesn’t make sense to see sadness, or any other emotion, as a sign of weakness. It’s simply our bodies giving us information. It would be like saying feeling hungry, or thirsty, is a sign of weakness.

What we choose to do with that information is up to us. There can be both helpful and damaging ways of expressing our emotions depending on the situation. Old patterns might need to be looked at and new decisions made. There may well be no perfect choices, it might take real strength and courage to deal with some situations. But being open to all the information we have available, gives us the best possible chance of success.


The message that if you’re struggling, talk to someone, is a simple one. And the reasons why so many men still don’t do that are complex. But I hope that challenging some of the myths around what counselling involves, and what emotions are for, might make a difference. Counselling isn’t just about crying. All emotions are equal, have a purpose, and none are a sign of weakness. Life can be challenging for everyone, and nobody should feel they need to suffer in silence.