The Roots of Men’s Mental Health: How Men’s Group Therapy Can Help

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The Roots of Men’s Mental Health: How Men’s Group Therapy Can Help

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Working with adolescent and adult men for the past decade, I’ve discussed almost every topic you might imagine – relationships, addiction, anxiety, sex, racism, body dysmorphia, anger, meaning and everything in-between.  But I’ve noticed that one issue pops up more than any other:


Throughout elementary and middle school, research shows that American boys of all backgrounds form deep personal connections with other boys their age. We share secrets, become vulnerable, and express how much we care for each other.  But then, usually around high school, something changes.  These now young men form fewer friendships, and sometimes lose all of their vulnerable and trusting close connections.  And unfortunately, this problem is getting worse.

The Root of the Issue

Typical male loneliness takes two forms – external and internal loneliness.

Externally – Men have few close friends with whom they can have fun with, find support, and generally feel accepted.  A 2021 poll from Survey Center on American Life found that men with “no close friends” quintupledfrom 3% in 1990 to 15% today. Similarly, while 15% of men report having 10+ close friends, this is down from 40% in 1990.  While some of this is certainly due to the recent pandemic, a stream of articles have been penned over the past decade about this steady trend.

Internally – Even if a guy has a few friends to hang out with, those relationships are likely to still be emotionally isolating.  Compared to women, men are half as likely to have recently “received emotional support” or to “tell a friend you loved them”.   Similarly, women are 50% more likely to have recently had “a private conversation in which you shared personal feelings or problems”.

Psychologists call this lack or even inability to open up with others alexithymia, literally meaning “no words for emotions”.  And all too often, this is exactly what I see with clients.  Frequently when I start working with a new client, I’ll ask him something like, “And what came up for you? What emotions?” after he describes a stressful, or even traumatic event. And then he’ll reply, “nothing much” or even “I don’t know.”  For many of us, simply accessing our emotions or finding words for them can be a challenging task.

On top of this, even if we can find the words, too often society punishes men for emotional vulnerability.  Most guys nod when I say that happiness and anger are the only emotions we’re “allowed” to share.  And not only is fear and sadness criticized or dismissed, but both men and women often value a man insofar as he is strong, confident, reliable, assertive, independent, successful, and so on.  In a recent SheKnows survey, 76% of men and 84% of women admit to using phrases like “man up” and “be a man” towards boys.

For most men, being emotionally vulnerable means practicing a skill we were never taught, while risking, at worst: being ‘punished’, and at best: seen as less valuable as men.

The Fall Out

 While mental health is complex and has many contributing factors, this loneliness and emotional inhibition feeds into the other issues that my clients grapple with

·Relationships – It’s almost a truism that communication is necessary for any healthy couple.  But for men who are taught to be competitive and how to win, instead of how to compromise and speak vulnerably, creating deeper connection after conflicts can feel impossible.  For men struggling with their emotions, too often the outcome is either avoiding any real discussions or shifting into the only emotion they know: anger.  Both options always lead to increasing disconnection and conflict.

Anger – This important emotion, when coming up and expressed in a healthy way, is key to motivating us to challenge injustices in our lives. However, too often anger comes up as a secondary emotion, meaning that even though it’s what’s being expressed, it’s really covering up a more basic emotion at the root of the issue, usually sadness or fear.  Without the ability to get in touch with these deeper emotions, or possibly fear of expressing them directly, men never address the real issue and instead turn to anger.

Depression – With few people to turn to, and often no one to even see the sadness and fear that stews deep down, many men’s loneliness turns to hopelessness.  And since depression often to leads to self-isolation or presents itself as irritability, especially in men, this can often create a deadly feedback loop.  Sadness leading to isolations and/or anger that pushes people away, feeding the root causes of the lonely depression itself.  Given that men are also much less likely to see a therapist, it’s sad but understandable why men are more than 3x as likely, compared to women, to die by suicide, nearly 80% of all deaths.

Anxiety –Whether it’s competition with other men or the pressure from all sexes to appear confident and successful, many men live with constant fear that they won’t be good enough.  And given the lonely nature of male friendships and focus on independence, making a mistake is only on you.  Even if a client is engaged and confident, the constant lonely competition they’re being judged on often adds a layer of anxiety to virtually every life goal and relationship.

Substance Abuse – Alone and trying to deal with anger, sadness, anxiety, and shallow relationships, it’s no wonder men try to numb the pain of these emotions through drug use.  In the US, men are much more likely to use almost all illicit drugs, and this use is more likely to result in overdose deaths or emergency room visits.  Healthy coping mechanisms, like sharing the emotional pain they’re carrying or relying on close friends for support, are too often unavailable or feel, given how we’re raised, to be impossible.

Old Attempts

A wide variety of men’s groups have popped up over the past few decades.  But their inability to address the common issue of loneliness has led each, in their own way, to fall apart.  For example…

The Mythopoetic Men’s Movement – Inspired from Carl Jung and Arthurian myths, these back-to-our-primal-nature men’s groups sought to connect men with deeper peer relationships and spiritual purpose.  And there is a lot to be said for this!  Having worked as a wilderness guide myself, there is a lot of good to be gained in the masculine pursuit of survival and the awe inspiring beauty of nature.  But the movement saw itself as in conflict with feminism and modernity, even technological progress.  Its antidote was to return to something old instead of create something new – something where men didn’t have to be just strong solo providers but could also learn to engage the real vulnerabilities they shared.

The Men’s Rights Movement – Men’s rights activists, similarly saw themselves as fighting against feminism, but are largely the polar opposites of mythopoetic groups.  This loose ‘movement’ was able to present men’s anger in a more vulnerable way, arguing that there are ways society disadvantages men.  But this vulnerability and victimhood largely stopped at anger, and too often sexism, and did little in terms of healing and connection, which the mythopoetic groups hoped for.  In the end, they too looked back to an idealized past instead of creating something new.

New Solutions: Men’s Peer Support Group

Men’s Peer Support Groups – Time and again, I’ve seen men create real supportive relationships, one’s where they’re able to finally express what they’re actually feeling instead of bottling it up.  And in doing so, they’re able to tackle the other issues destroying their life.

How does the group work?

·       When participants feel comfortable enough, they can unburden the sadness, anxiety, grief, guilt, and other emotional weights they’ve been holding in.  And not just to the open air, but to a group of similarly struggling guys who can really hear you.  There’s also a lot less loneliness in hearing that others are experiencing similar things.

·       They can also voice the extreme, and sometimes distorted thoughts that are coming up – “I’m a horrible person,”  “Everyone hates me,”  “I’m just going to fail” – and get the reality check that we need.

·       We’re able to constructively process disagreement, social anxiety, and other issues that comes up in real time.  Being vulnerable feels dangerous, but it will also create a lot more safety and trust to challenge ourselves.  In this kind of space, we can do the hard work of learning to engage each other in new ways.


Interested in joining the Men’s Peer Support Group? Schedule an appointment now with Paul Chiariello, LMSW, directly on the online scheduler below. The group starts on Tuesday March 15th.


“Paul Chiariello, LMSW, is a Senior Clinician at Loving at Your Best, located at Union Square in Manhattan. Paul has advanced training in Schema Therapy, Emotionally Focused Therapy and Cognitive Behavioral Therapy”

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