Therapy for Men

Most of the men I work with are disciplined, and they've had to be. They've built serious careers. Many have been sober for years. What they often haven't been able to build is trust in themselves.

They're skeptical of their own feelings, and of their instincts and judgment too. Some of that skepticism was earned the hard way: there was a time when wanting something led somewhere bad. So they learned to lean on structure instead. Rules, routines, a strict moral code, a schedule that leaves no gaps. It works. It holds things together. But it can start to feel like the structure is running the life, and the person inside it is mostly keeping up.

What often brings men here

Most of the men I work with are good company. They're funny, easy to talk to, quick to put other people at ease. Often the first thing they tell me is something like, 'I think I just care too much about what people think.' They usually say it with a laugh.

It's true, and it's rarely the whole story. Underneath the ease there's often a kind of private aloneness: a sense that there are things nobody else could really help with, so there's no point bringing them up. The jokes keep things light. They also keep people at a certain distance, even people who are close.

In relationships, they're usually the reliable one. They handle things, they show up, they don't make their problems anyone else's. Partners often say they feel close to them, and also that they don't really know what's going on inside. Leaning on someone just isn't something that comes naturally, or even seems especially useful. The result can be a life that's full of people and still quite lonely.

It can look like:

• Not quite trusting a feeling until you've checked it against a rule.
• Routines that keep you steady, and a low dread when something disrupts them.
• Being asked what you want and reaching for what you should want instead.
• Feeling like a fraud in a life that, by every outside measure, is going well.
• Guilt you can't trace to anything you've done.
• Dating that turns into an exam: rereading texts, rehearsing what to say, unsure whether you even like the person or just want to get it right.
• Wanting very much to be a good man, and measuring that by rules rather than by how you feel.

What the work looks like

Most men haven't had many conversations like this, where nobody needs anything back and nobody's waiting to tell you what to do. Some find it strange at first. Most come to rely on it.

I tend to follow more than lead. Often the most useful thing is the question that lets you get there yourself. We start with whatever brings you in, including 'I care too much about what people think.' It's a good place to begin.

This isn't a replacement for a program that is working for you. Many men I see stay connected to their recovery communities. This is a different kind of work, aimed at the parts of a life that a program isn't designed to reach. I've trained specifically in the psychoanalytic understanding of compulsion, including how it shows up with food, sex, work, and substances, so the focus stays on what the pattern does for you rather than on the label.

What tends to change

Over time, men often find they can trust a feeling without needing it approved first. The structure stays, but it becomes something they use rather than something that holds them up. Decisions in relationships start to come from what they actually want, and success starts to register as something they can feel. These changes come slowly, and they tend to last.

“Visiting April is always a highlight of my week. She is disarming and thoughtful in her approach to conversation.”

— Verified patient, Zocdoc

Who this isn't right for

If you're in the middle of active use and need help getting it under control, a structured program is the right first step, and I'm glad to help you find one. This work is often most useful once that ground is steady.

I see individual adults 21 and older. I don't offer couples therapy or court-mandated treatment.

Should a man see a male therapist?

Some men prefer to, and that preference deserves respect. Many of the men I work with find it useful to examine their patterns with a woman, because so much of how they learned to keep distance happened in relationships with women. We can talk about what it brings up on the first call.

Further reading: What Sobriety Doesn't Touch →