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Home News Health

Therapy is failing men – but it doesn’t have to

Male mental health is misunderstood, and as a result men are feeling let down by therapy, yet positive alternatives exist

Andrew Pain by Andrew Pain
16-06-2026 12:00
in Health
Reading Time: 6 mins read
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A man sits on the sofa in a therapy room with one leg crossed over the other, he has his head in his hand

image by Nik Shuliahin. Free to use under Unsplash License

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“I tried counselling, but just didn’t feel a connection.” 

This is a statement I’ve heard many times over. It breaks my heart when men question themselves because counselling or therapy didn’t work, convinced it must be down to their own failings. It obviously works for everyone else, right? 

If you identify as a male and struggled to make a connection when you sought counselling, you’re not alone and you’re not stupid or a luddite either. You’re actually pretty normal. 

Why I thought therapy isn’t for men

During my former marriage, which was violent and abusive, I was in counselling for several years, because I wanted to know how to be a better man. I hoped counselling would help me mature into the wise and lovable husband I wanted to be. At that point in my life, I’d become conditioned to believe that the responsibility for the abuse lay entirely with me, that I kept provoking my wife because I was such an idiot, so her reaction was justified. 

Having never had counselling or therapy, I had no reservations about the process. I embraced it fully, hoping it would give me answers, stop the abuse and save my marriage, but it was ineffective on several fronts. After two years of regular sessions, I didn’t find the secret to a happy marriage, nor did I experience any profound insights. I didn’t grow as an individual, nor did the counselling process open up any conversation about the fact that I might be in a controlling or abusive relationship. The lack of progress was just more evidence that I was indeed the village idiot. My wife was right. There really was no hope. 

But why was counselling so ineffective for me? And seemingly for so many other men too? 

Social habits are causing a communication breakdown 

In Deborah Tannen’s book from the 1990s, You Just Don’t Understand, she proposes that women and men communicate differently, with women, on average, more likely to use communication for connection, expressing emotions and building relationships, whereas men are more likely to use communication for an exchange of information or problem solving. 

She describes it in her book as ‘rapport talk’ (women) vs ‘report talk’ (men). Academics caution about treating her work as hard science (and of course, her work is increasingly dated) but if we can agree that, as a trend, there may be small differences between how men and women may communicate, then Tannen’s work might help to explain why the activity element within so many men’s communities today, such as UK Men’s Sheds and Well Run Brum, are so important in helping men to bond and talk more easily as they feel increasingly ‘safe’ to do so. The activity is the hook, behind which the conversation can naturally unfold over time, and move beyond ‘report’ talk to ‘rapport’ talk. It’s not that men can’t talk openly and will only ever revert to ‘report’, it’s just that it may take time for men to feel comfortable to move from ‘report’ to ‘rapport’, and share their mental health.  

Traditional therapy is being undermined by testosterone

The Swiss neuroscientist and psychologist Chris Eisenegger has spent much of his career studying how hormones affect social behaviour, motivation and decision making. In 2011, he co-authored an influential review, ‘The role of testosterone in social interaction’, where he reframed testosterone as less of a ‘violence hormone’ and more of a ‘status regulation hormone’. His main points have stood the test of time. With significantly more testosterone in our systems than equivalent-age women, men are likely to have a heightened sensitivity to social threats, particularly threats that signal a potential loss of standing or respect. 

So, if we want men to avoid bottling things up, to go against years of parental and societal conditioning in many cases, and talk comfortably about our struggles, then we must also recognise that on a biological level, it may feel harder and more unnatural for us to do that than for women – not because we’re emotionally illiterate cavemen, but because of biology and, more specifically, testosterone.

Community groups are a powerful alternative

It may be something to bear in mind if you’re thinking about starting your own men’s community. It’s also something to bear in mind if, as a bloke, you’ve previously tried counselling and got nothing from it. 

My Friday football network has a primary purpose (football), but then in the pub after the game, talking about feelings happens – not always, but sometimes. The deeper stuff, if and when it happens, is a natural outworking of being part of a group who are open for friendship that extends beyond the game and beer. The more we trust each other, and people start opening up, the more we can be increasingly open about our mental health without fearing a loss of social status. 

I don’t say to my wife on a Friday evening, “I’m off to therapy”, but on reflection, maybe the football community is a form of therapy for me, but without the label. 

We’re missing male counsellors – but progress is being made

It might help if we had more male counsellors. Currently, only 20-25% of counsellors and therapists in the UK identify as male. My counsellor was female with sessions undertaken in her counselling room. Would it have helped had I engaged with a man? We’ll never know, but increasing the number of male counsellors, and accessibility to male-friendly therapy, is a big step forward.

There’s a lot to feel encouraged by as we move forward. There is an emerging network of male counsellors in the UK, offering everything from walk and talk therapy, paddleboarding therapy, and weekend retreats which include counselling, group work, dips in the nearby waterfall. 

There are men’s community groups springing up everywhere in the UK. from Men’s Pie Club to Man V Fat (the football league for overweight men). The list is endless: valuable progress towards addressing male mental health.

So if counselling didn’t work for you, it’s not your fault, nor is it the end of the road. It may be that what you need is male-friendly therapy, something which meets beyond the confines of a counselling room, and something which enables you to open up over time, and as part of an activity.

A therapist sits in a chair and a crying patient site in a chair next to them
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Andrew Pain

Andrew Pain

Andrew is a TEDx and CPD accredited speaker, a podcaster, award-winning campaigner and author of 'Honestly, Man: why masculinity feels confusing, shame doesn't help and what to do about it' (all profits made on the sales of the book, will be invested in charities supporting men and boys work in the UK) Andrew is on a mission to create resilient and decisive communities, where people can think clearly under pressure, adapt with less stress and work cohesively as each other's allies, regardless of culture/gender. Andrew serves diverse organisations, including; National Highways, HSBC, University of Liverpool, Amazon, NFU Mutual and National House Building Council. Outside of his work, Andrew is also a father of 5, with 3 boys under 12, which means he's a warzone reporter, neurotic health and safety officer, peace negotiator, triage nurse, masterful blackmailer and bribery guru, tutor, maid, cook and cleaner, and failing caretaker.

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