Why boys and men don't come to therapy - Fear of Change and Recovery

Many men and boys worry about how therapy might affect their relationships, especially with friends, colleagues, their community, and their spouse. There’s a fear that by seeking help, they might be seen as weak, different, or even rejected if they start to change. The fear of being perceived differently is often tied to guilt—guilt for having negative thoughts or feelings about their loved ones, particularly if those feelings challenge the expectations set by family or close relationships. For example, some men may feel guilty about the idea of confronting their parents or loved ones about things they’ve said or done that have caused harm.

In therapy, some boys and men may need to talk about some deeply painful experiences, things they've been carrying for years. This could include harsh words from their parents that have stuck with them and shaped their self-esteem. Phrases like “You’re ungrateful,” “You’ll never be good enough,” or “I sacrificed everything for you” can weigh heavily on a person, especially if those words came from someone they love and trust. Other common phrases could include “I provided for you,” or “I’m the reason you have a roof over your head,” which often come with the implication that the person should feel eternally indebted.

Such statements are often used to control or guilt-trip, making the child or adult feel as if they owe their parents everything, regardless of how they feel or what they need. There’s also the line of thinking that "You are a little child, you don't understand anything," which can leave someone feeling like their emotions and perspectives are invalid, contributing to feelings of inadequacy. Being told things like "You were born yesterday, and now you expect to know everything," can make a person feel as though they have no right to express their needs, especially if those needs challenge the authority or sacrifices of their parents.

These words and actions can leave lasting scars, and therapy often requires unpacking these difficult emotions. However, the fear of how opening up in therapy might affect their relationships or how their loved ones will react can prevent many men from seeking the help they need. There’s a real concern that confronting these painful truths will change the way their family or spouse sees them, or that they’ll be accused of not appreciating everything that was done for them. This emotional burden makes it even harder for men to take that first step towards healing.

The anticipation of potential conflict or resentment in the relationship adds to the anxiety. An example of this might be a man who discovers that he is pansexual or bisexual after being married, loving his wife, and starting a family. Coming to terms with his sexuality could be a huge internal struggle, and he may fear the impact this revelation would have on his marriage and family life. It could cause a major shift in his personal identity and his relationships, leading him to question how others will view him and how his family might react.

Similarly, someone who decides to change their lifestyle—perhaps by giving up alcohol, cutting out sugar, or eating healthier—may face resistance, not only from their own internal struggles but also from the people around them. This could alter their relationship with their spouse or friends, especially if these habits were previously part of their shared lifestyle. It might be even more dramatic if someone decides to downsize their home or change their living situation, moving from a big house in the suburbs to a smaller apartment in the city in order to reduce stress and simplify their life. This decision, too, could cause friction within the family.

For others, a shift in religious beliefs—like converting to Buddhism, Islam, or Christianity—can deeply affect family dynamics. A person might face rejection or confusion from their family if they embrace a religion that’s different from what they were raised with. Similarly, a man who has been working in a high-paying job, providing for his family, and living a comfortable middle-class lifestyle might suddenly decide that he wants more meaning in his life. After a life-changing event, like a car accident, he might decide to give up his lucrative career to become a teacher or youth worker. While this may bring him personal fulfilment, it can create significant stress and anxiety about how his decision will affect his family, especially if it means giving up the luxury vacations, the shopping sprees, and the lifestyle they’ve grown accustomed to.

"Everybody has a plan until they get punched in the face. Then, like a rat, they stop in fear and freeze."

This famous quote from Mike Tyson resonates deeply because it reveals a universal truth about how people react when confronted with adversity. Beyond the initial impact of a physical blow, Tyson astutely observes the psychological response that follows—a moment of fear-induced paralysis.

This response extends beyond physical altercations to encompass life's broader challenges, particularly those related to mental health and personal growth. There's often a profound fear associated with change and recovery, rooted in the belief that our struggles define us. Many individuals perceive their identity and positive qualities as intricately intertwined with their hardships. Therefore, the idea of resolving these issues can evoke a sense of loss or uncertainty about who they will become without them.

This fear of change and recovery manifests as self-doubt and apprehension. It's not just about overcoming the immediate challenge but also about navigating the unfamiliar territory of a life less defined by adversity. The prospect of letting go of familiar struggles can be daunting, akin to losing a part of oneself that has become strangely comforting in its familiarity.

For many, this fear becomes a significant barrier to seeking help, especially in therapeutic settings where the goal is often to heal and grow beyond past traumas or ongoing struggles.

One of our roles as psychotherapists is to sustain hope for our clients, especially in times when they cannot sustain it themselves. Sometimes, we must lead and let our clients follow. However, if we get too far ahead, we can become out of sight, which can be counterproductive.

An interesting analogy comes from observing young children. If you have children or have spent time around them, you'll notice a period when they have a habit of running away from their parents, expecting to be chased. Occasionally, when a parent doesn't follow, you can see the fear on the child's face as they realize they are alone.

I recently watched a clip online where a little girl told her dad she was leaving home. The dad played along, packed her a small backpack, opened the front door, and waved goodbye. The girl walked to the end of the garden, looked left, then right, froze for about 20 seconds, and then ran back into the house crying. The point is that as professionals, it's easy for us to tell our clients how they can recover, change, transform their lives, correct errors in judgment, heal, and reframe their experiences. However, we must ensure we don't leave them feeling abandoned or overwhelmed in the process. We may find meaning, which is wonderful, but the reality is that this process can be extremely painful. For many men and boys, it makes them feel out of control. They've been playing a game where they know the rules and what is expected of them. While there may be uncertainty, there is a lack of volatility.

When we push men further out of their comfort zones in therapy to confront emotions they've been avoiding, it can have profound and sometimes difficult impacts on their lives. This is especially true for issues tied to family expectations, cultural pressures, and identity, which can be deeply challenging to navigate.

A common example in the Black community involves the pressure many Black men feel to send money back home to their families in Africa. It’s a widespread practice across many African households, where men and women regularly send financial support to relatives back home—whether it’s £100 or even up to £1,200 a month. However, a growing number of younger Black men who’ve been raised in the UK are starting to question this expectation. They find themselves in a difficult position because the people they’re supporting live in a country far from where they live, and many of them don’t feel the same connection to that place. They’ve grown up in the UK, where their immediate family and social circle are, and the financial pressures of daily life in the UK make it hard to justify sending large sums of money back home.

These men often feel a sense of guilt and obligation to send money, but at the same time, they’re faced with the reality that their finances are stretched, and they can’t afford to continue this practice without putting their own well-being at risk. When they try to set boundaries or explain their situation to their parents or extended family, they find it extremely difficult. Many of them feel that negotiating with their family members is nearly impossible. Their parents, often from older generations, may view it as their duty to provide for family back home, and this can create a tense, unspoken conflict between the younger men who are trying to live in the present and their elders who expect them to maintain tradition.

For some of these Black men, this issue presents a complex emotional dilemma. They may want to do the work in therapy, confront their feelings of resentment, guilt, or frustration, and establish healthier boundaries with their families. But when they try to do so, they often face a harsh price for it—whether it’s a sense of alienation, guilt from breaking family expectations, or fear of damaging relationships with loved ones. This situation can make therapy feel like an even more daunting task, as the emotional and cultural weight of these issues can be immense.

They will need to talk to people in their lives, such as parents or cousins, about past events. While therapy and healing are beneficial, and setting boundaries is important, they must then go and live these changes in their everyday lives. As a male progresses in emotional awareness and mastery, they often unearth more issues for those around them. Setting boundaries and addressing behaviours can be helpful and healing, but it can also cause discomfort and challenges for others who must confront these issues.

When I share my own story openly, it surprises many people. I've reached a point where I've examined and come to terms with my experiences, allowing me to talk about them honestly. However, this openness can trigger strong reactions in those around me. Many people aren't accustomed to such honesty and vulnerability. Many men and boys hold secrets they'll never share, even with themselves. It's crucial for therapists to recognize this. Emotional mastery can have ripple effects and lingering emotional residues that affect relationships and personal growth.