What Brings Men to Therapy

For a long time, men were expected to tough it out. That was the code — stay strong, stay silent, deal with it. But things are changing. Slowly, more men are questioning the rules they were handed. They’re asking different questions, and looking for different answers.

That shift shows up in the numbers. Counselling for men has grown rapidly over the last decade. The British Association for Counselling and Psychotherapy notes a steady rise in men seeking support — not just in crisis, but in response to a deeper realisation: what’s worked until now, doesn’t work anymore.

When Roles Shift, Questions Follow

Much of what defined masculinity a generation ago is no longer fixed. In many households, men are no longer the sole breadwinners. Gender roles have opened up — but they haven’t always been replaced with clarity. What does it mean to be a father, a partner, a lover, when the old expectations don’t fit, and new ones haven’t quite landed?

These shifts can be liberating — but also disorienting. Especially when deeper questions surface:
What do I want to pass on? What’s still mine, and what was inherited? What’s underneath the stress, the withdrawal, or the tension in my relationships?

Counselling for men is – I have learned – different from counselling women. Even despite the many changes our contemporary societies have gone through, it is not part of our process of education and socialisation that men are taught to productively engage with the whole rainbow of feelings, emotions, thoughts and behaviours.

What Brings Men to Counselling

Men come to counselling for all kinds of reasons. Some want to face past trauma. Others are trying to work through grief, addiction, or the long tail of a medical diagnosis. Some are in the middle of a career collapse or a relationship breakdown. Others are dealing with restlessness — what we sometimes call a midlife crisis — or simply a persistent sense of “this isn’t it.”

I’ve worked with men who feel stuck, lost, ashamed, isolated, exhausted, afraid of their own reactions, or unsure of their own desires. Sometimes, all at once.If you want a deeper reflection on how shame, silence, and emotional reactivity shape the inner life of men, I wrote more about that here.

There’s no checklist for when to seek help. But the truth is: for many men, waiting doesn’t make it easier. It just makes the habits harder to shift.

The Cost of ‘Being a Rock’

I was once told that to “be a man” meant to “be a rock”: tough, unmovable, impermeable to outside influences. One can build a house on a rock. However, “being a rock” also means “never changing”, never feeling anything, taking on the temperature of the outside, hurting life if ever it were to be thrown.

That interpretation of masculinity comes with costs.
Distance from the people you love, even when you’re in the same room.
A loneliness that doesn’t have a name — just a presence.
Rage that erupts, or simmers beneath the surface, or turns inward until it becomes silence.
A life that feels like performance, not presence. Getting through the days, not living them.

For many men, being masculine means “toughening it out”, or to suppress what feels uncomfortable. Whether it is soldiers coming back from the battlefield, high-flying executives of multinational corporations, or the vocational craftsmen who bring their skills to our homes: maintaining respect in our own eyes, and in the eyes of the ones we ourselves respect is crucial.

Nobody wants to be seen as a failure, or as weak. Unfortunately, this desire to be seen to be strong leads to a whole set of avoidable difficulties and problems. Instead of seeking counsel, instead of finding a space where one can spar and share, instead of seeking constructive solutions there are numerous men who self-medicate through sex or porn, through violence and isolation, through alcohol or drugs.

Michael Kimmel once described the inner conflict many men live with: the pull between being a “good man” — kind, fair, present — and being a “real man” — tough, dominant, respected. Those roles don’t often align. And the pressure to choose, or perform both, leads to burnout, illness, broken connection, and years of emotional avoidance.

It’s one reason why men live shorter lives — not just because of biology, but because of what’s left unspoken, unchecked, untreated.

Choosing a Different Way

You don’t have to unravel everything overnight. You don’t need a grand vision or a 10-step plan. What’s needed is presence, willingness, and enough courage to stop pushing it down.

That’s what counselling can offer — not a fix, but a place to bring what’s real. A space to question, reflect, adjust, repair. On your terms, in your time.

To be willing and able to do that, to step onto that path, is incredibly liberating and empowering. It is a quest to find the answers within oneself, and no longer blindly follow the definitions and requirements handed down. It is a journey to the deepest depth of one’s own being, as a man – but above all as a human being.

If something here feels familiar — if you’ve been wondering whether it’s time to talk to someone — you can read more about my approach to counselling for men. I work with men across Switzerland and online.